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This study investigated the psychometric properties of the Autism Mental Status Examination (AMSE) in a Brazilian sample of children and adolescents with autism spectrum disorder (ASD). A sample of 260 children and adolescents, comprising 56 (21.5%) females and 204 (78.5%) males, was assessed. The participants were submitted to both the childhood autism rating scale (CARS-BR) and the AMSE. The CARS-BR was used to estimate ASD severity and the cutoff point on the AMSE. Spearman's correlation test was employed to determine the correlation between the AMSE and CARS-BR scales. The cutoff values were calculated using the ROC (receiver operating characteristic) curve, identifying the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). The homogeneity of the items of the AMSE was determined using Cronbach´s alpha. The AMSE exhibited good internal consistency (0.74), sensitivity (0.91) and specificity (0.98); and high correlation with the CARS-BR (ρ = 0.91, p < 0.01). Preliminary results showed that the AMSE is a tool with good psychometric properties for ASD screening.
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Transtorno do Espectro Autista/diagnóstico , Testes de Estado Mental e Demência/normas , Psicometria/normas , Adolescente , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Sensibilidade e EspecificidadeRESUMO
INTRODUCTION: Simulation has been used as a learning tool in different disciplines and professions, including medicine and its specialties. Its usefulness is directly related to the integration of objectives, contents, methodologies and specific resources in each area of knowledge. OBJECTIVE: To describe the development of an educational experience implemented in the Pontificia Universidad Javeriana Cali (Cali, Colombia) with medical students of Human Behavior II program, between 2012 and 2013. This experience was performed with simulated patients played by actors of the Altergesto theater group, that were interviewed by students under the supervision of psychiatrists and teachers of the subject, using the Simulated Hospital of the University. METHODS: A historical development recall of the teaching sequence was made from the first half of 2012 to the second half of 2013, a statement of pedagogical objectives, and a description of the teaching-learning strategies. RESULTS: 158 interviews were conducted over a period of two years during which it was necessary to raise methodological solutions to adapt this teaching sequence to the content and objectives of the subject. CONCLUSIONS: The high-fidelity simulation, integrating actors who represent psychiatric patients mixed with the technology of a Simulated Hospital was useful to achieve compliance with the objectives proposed in the course of Human Behavior II, as a part of the program of Medicine at the Pontificia Universidad Javeriana Cali. In parallel, the construction of experience as an interdisciplinary project and the practical approach of this strategy may impact on cognitive, emotional, behavioral dimensions of the participants, encouraging meaningful learning. An easy access database for the collected material and the study of the effects of this strategy in the formation of long-term students is needed.
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Educação de Graduação em Medicina/métodos , Entrevista Psicológica , Simulação de Paciente , Psiquiatria/educação , Colômbia , HumanosRESUMO
Introducción: La simulación se ha empleado como herramienta de aprendizaje en diferentes disciplinas y profesiones, como la medicina y sus especialidades. Su utilidad está directamente relacionada con la integración a los objetivos, contenidos, metodologías y recursos específicos en cada área del conocimiento. Objetivo: Describir el desarrollo de una experiencia pedagógica implementada en la Pontificia Universidad Javeriana Cali con los estudiantes de Conducta Humana II del programa de Medicina entre 2012 y 2013. Dicha experiencia se apoyó en la participación de pacientes simulados por actores del grupo representativo Altergesto, que fueron entrevistados por los estudiantes con la supervisión de los psiquiatras docentes de la materia, utilizando el Hospital Simulado de la Universidad. Métodos: Recuento histórico del desarrollo de la secuencia didáctica desde el primer semestre de 2012 hasta el segundo semestre de 2013, planteamiento de los objetivos pedagógicos y descripción de la estrategia de enseñanza-aprendizaje. Resultados: Se realizaron 158 entrevistas en un periodo de 2 años, en el transcurso de los cuales fue necesario plantear soluciones metodológicas para adaptar la secuencia pedagógica a los contenidos y los objetivos de la materia. Conclusiones: La simulación de alta fidelidad, integrando a actores que representan a los pacientes psiquiátricos y la tecnología del Hospital Simulado, resultó útil para lograr el cumplimiento de los objetivos propuestos en el curso de Conducta Humana II del programa de Medicina de la Pontificia Universidad Javeriana Cali. Paralelamente, la construcción de la experiencia como un proyecto interdisciplinario y el enfoque práctico de esta estrategia pueden impactar en las dimensiones cognitivas, emocionales y conductuales de los significativo. Es necesario construir una base de datos de fácil acceso con el material recopilado y estudiar los efectos de esta estrategia en la formación de los estudiantes a largo plazo.
Introduction: Simulation has been used as a learning tool in different disciplines and pro-Simulation scenario fessions, including medicine and its specialties. Its usefulness is directly related to the Psychiatric interview integration of objectives, contents, methodologies and specific resources in each area of Simulated patient actor knowledge. Objective: To describe the development of an educational experience implemented in the Pontificia Universidad Javeriana Cali (Cali, Colombia) with medical students of Human Behavior II program, between 2012 and 2013. This experience was performed with simulated patients played by actors of the Altergesto theater group, that were interviewed by students under the supervision of psychiatrists and teachers of the subject, using the Simulated Hospital of the University. Methods: A historical development recall of the teaching sequence was made from the first half of 2012 to the second half of 2013, a statement of pedagogical objectives, and a description of the teaching-learning strategies. Results: 158 interviews were conducted over a period of two years during which it was necessary to raise methodological solutions to adapt this teaching sequence to the content and objectives of the subject. Conclusions: The high-fidelity simulation, integrating actors who represent psychiatric patients mixed with the technology of a Simulated Hospital was useful to achieve compliance with the objectives proposed in the course of Human Behavior II, as a part of the program of Medicine at the Pontificia Universidad Javeriana Cali. In parallel, the construction of experience as an interdisciplinary project and the practical approach of this strategy may impact on cognitive, emotional, behavioral dimensions of the participants, encouraging meaningful learning. An easy access database for the collected material and the study of the effects of this strategy in the formation of long-term students is needed.
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Humanos , Masculino , Feminino , Adulto , Estudantes de Medicina , Exercício de Simulação , Aprendizagem , Categorias de Trabalhadores , Organização e Administração , Pacientes , Psiquiatria , Ensino , Tecnologia , Estratégias de Saúde , Conhecimento , MétodosRESUMO
This study examines modality in doctor-patient interactions during psychiatric interviews. Twenty three interviews were conducted in Spanish and were video-recorded. The patients are members of a small community in rural California. Using the interpersonal metafunction (Eggins 2004; Halliday 1994) and approaches in pragmatics literature this work reveals the lexicogrammatical choices the patients and the doctor make using both qualitative analysis and quantitative analysis. Spanish modalization can be realized through modal operators (e.g. might), mood adjuncts (e.g. possibly), and the conditional and future tenses. In addition to these, oral contexts have alternative forms of expressing modalization such as using the preposition como 'like' and tag questions (e.g. right?) as the pragmatics literature has described. This work makes a methodological contribution by highlighting the analytical tools that alternative approaches to discourse analysis (pragmatics in this case) make available and how they complement the interpersonal metafunction. The results of this study reveal that patients use modalization at particular moments in the interview, for instance when discussing their symptoms and conditions to deliver their information carefully and to recognize the social status of the doctor. The doctor also strategically uses modalization when he asks sensitive questions in order to displace responsibility from the patients and avoid a face-threatening situation.
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El incesto es un tema lleno de mitos y es importante conocer la transcendencia en el ámbito emocional de los menores, niños y niñas, que son víctimas de abuso sexual por parte de un pariente cercano y los motivos que llevan al resto de la familia a callar estos sucesos. Conocer características de las posibles víctimas y de los posibles agresores nos permitirán evaluar las circunstancias en que se da el abuso sexual y sus secuelas a corto y largo plazo...
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Humanos , Masculino , Feminino , Abuso Sexual na Infância , Psiquiatria Infantil , Psiquiatria Comunitária , Violência Doméstica , Família , Medicina Legal , Psiquiatria Legal , Incesto , Entrevista Psicológica , PsiquiatriaRESUMO
The objective of the present study was to establish the frequency of psychiatric comorbidity in a sample of diabetic patients with symmetric distal polyneuropathy (SDPN). Sixty-five patients with type 2 diabetes mellitus were selected consecutively to participate in the study at Instituto Estadual de Diabetes e Endocrinologia. All patients were submitted to a complete clinical and psychiatric evaluation, including the Portuguese version of the structured clinical interview for DSM-IV, the Beck Depression Inventory, the Neuropathy Symptom Score, and Neuropathy Disability Score. SDPN was identified in 22 subjects (33.8 percent). Patients with and without SDPN did not differ significantly regarding sociodemographic characteristics. However, a trend toward a worse glycemic control was found in patients with SDPN in comparison to patients without SDPN (HbA1c = 8.43 ± 1.97 vs 7.48 ± 1.95; P = 0.08). Patients with SDPN exhibited axis I psychiatric disorders significantly more often than those without SDPN (especially anxiety disorders, in general (81.8 vs 60.0 percent; P = 0.01), and major depression - current episode, in particular (18.2 vs 7.7 percent; P = 0.04)). The severity of the depressive symptoms correlated positively with the severity of SDPN symptoms (r = 0.38; P = 0.006), but not with the severity of SDPN signs (r = 0.07; P = 0.56). In conclusion, the presence of SDPN seems to be associated with a trend toward glycemic control. The diagnosis of SDPN in diabetic subjects seems also to be associated with relevant psychiatric comorbidity, including anxiety and current mood disorders.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , /psicologia , Neuropatias Diabéticas/psicologia , Transtornos Mentais/epidemiologia , Polineuropatias/psicologia , Assistência Ambulatorial/estatística & dados numéricos , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos Mentais/diagnóstico , Transtornos Mentais/etiologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Índice de Gravidade de Doença , Fatores SocioeconômicosRESUMO
Con la finalidad de estimar la prevalencia de transtornos mentales en estudios epidemiológicos en la comunidad, hemos desarrollado la Entrevista Psiquiátrica Modificada (EPM), un instrumento semiestructura derivado de la Standardized Psichiatric Interview de Goldberg y colaboradores, para ser aplicada por entrevistadores con experiencia clínica en el área de la salud mental. Este artículo tiene como finalidad evaluar el grado de acuerdo entre entrevistadores clínicos (utilizando un diseño entrevistador-observador), empleando la EPM en pacientes que asistieron a la consulta externa de un hospital general de la Secretaría de Salud, como parte de una investigación sobre prevalencia de transtornos mentales en un segundo nivel de atención médica. Se analizó el grado de acuerdo entre los entrevistadores en las diferentes secciones que comprenden el instrumento en base a tres estadísticos: correlación producto-momento de Pearson, estadístico de Kappa y el Coeficiente "Y" de Yule. Los resultados obtenidos indicaron un alto nivel de confiabilidad en cada una se las secciones de la EPM