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Background: Psychiatrists are at high risk of developing burnout and mental health problems mainly due to their emotionally demanding jobs, difficult working conditions, long working hours, and poor work-life balance. As leisure activities are associated with better physical and mental health, engaging in these activities has been recommended as a measure to improve the wellbeing of healthcare workers. However, it is unclear the extent of which psychiatrists and trainees are involved in leisure activities, what type of activities they prefer, or how these impact their self-perceived health, stress, confidence in stress management, and satisfaction with their social support. Objective: The aim of this study was to identify differences in self-perceived health, perceived stress, confidence in stress management, and satisfaction with social support, between psychiatrists and trainees who engage in different leisure activities, compared with those who do not. Methods: This was a cross-sectional study, including Mexican psychiatrists (n = 355) and trainees (n = 330) who agreed to participate through an online survey. Results: 73.1% of participants engaged in some leisure activity, being solitary-passive activities the most reported. Those who have a leisure activity reported lower stress, greater confidence in stress management, and more satisfaction with their social support. Passive-solitary activities were associated with less perceived stress and better confidence in stress management, while active-solitary and social activities were associated with better satisfaction with social support. Conclusion: Psychiatrists' and trainees' wellbeing benefits from engagement in leisure activities, which should be part of their daily schedules to reduce stress, and potentially improve their mental health.

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BACKGROUND: There is research evidence regarding the presence of stigmatising attitudes in psychiatrists towards people with mental illness, but a lack of studies and interventions focused on this issue in low and middle-income countries. AIMS: To assess the feasibility of implementing an anti-stigma intervention for Mexican psychiatric trainees, and its potential effects. METHODS: This study comprised a pre-post design with outcome measures compared between baseline and 3-month follow-up. Quantitative outcome measures were used to evaluate the potential effects of the intervention, whilst the process evaluation required the collection and analysis of both quantitative and qualitative data. RESULTS: Twenty-nine trainees (25% of those invited) participated in the intervention, of whom 18 also participated in the follow-up assessment. Outcome measures showed the intervention had moderately large effects on reducing stereotypes and the influence of other co-workers on trainees' own attitudes. The main mechanisms of impact identified were recognition of negative attitudes in oneself and colleagues, self-reflection about the impact of stigma, one's own negative attitudes and recognition of one's ability to make change. Participants accepted and were satisfied with the intervention, which many considered should be part of their routine training. However, trainees' work overload and lack of support from the host organisation were identified as barriers to implement the intervention. CONCLUSIONS: A brief anti-stigma intervention for Mexican psychiatric trainees is feasible, potentially effective, well accepted and was considered necessary by participants. This study also suggests mechanisms of impact and mediators should be considered for developing further interventions, contributing to reducing the damaging effects that mental health-related stigma has on people's lives.

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Despite their training, psychiatrists have been found to have negative attitudes towards people with mental illness, including the patients they treat. Similarly, studies focused on service users have identified psychiatrists as a source of stigma. Even though negative attitudes in psychiatrists have been identified in different countries and settings, in Mexico the attitudes of these professionals have never been assessed. Because of this, we invited psychiatric trainees from a hospital in Mexico to participate in individual interviews to describe their opinions regarding mental health-related stigma, to evaluate their attitudes towards people with mental illness and to identify factors that could be influencing their attitudes. Interviews were audio recorded, transcribed and analysed using thematic analysis. A total of 29 trainees participated in the study. The results suggested that trainees recognised psychiatrists can have negative attitudes towards people with mental illness, such as poor empathy, judgement and labelling, and mainly towards patients considered difficult and with borderline personality disorder. Participants recognised these attitudes can influence their relationship with patients, and considered it is necessary to develop interventions to improve their own attitudes and reduce mental health stigma. From this study we concluded Mexican psychiatrists are not free from stigma towards people with mental illness. However, Mexican psychiatric trainees are interested in improving their attitudes and reactions towards their patients.

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OBJECTIVE: The objective was to determine and compare demographic features, professional activities and adversities, physical health conditions, and self-care behaviors related to the most frequently self-reported mental health problems among psychiatrists and psychiatry trainees. METHODS: A cross-sectional, retrospective, comparative study was conducted on a total of 330 (48.2%) psychiatry trainees and 355 (51.8%) psychiatrists from Mexico through an online survey. Demographic features, professional activities and adversities, physical and mental health problems, self-care behaviors, and social support were examined. Comparative analyses and multiple logistic regression models were performed. RESULTS: Major depression, anxiety, and burnout were the most common mental health problems reported with a higher frequency of anxiety disorders in psychiatry trainees. Being a woman, having a physical health problem, and lack of restful sleep were the main risk factors in both groups. Consultation in the government sector and having patients with severe suicidal ideation affected more psychiatry trainees. Perceived discrimination and inadequate eating schedules were risk factors for mental health problems for psychiatrists. CONCLUSION: Psychiatry trainees constitute a vulnerable group for anxiety disorders. Particular attention should be paid to how students cope with the training experience to determine whether additional support is required. These professionals face major stressors leading to a high prevalence of depression, burnout, and anxiety. Encouraging psychiatrists to have better health habits is a step in the right direction, which must be accompanied by tangible organizational avenues to do so and creating a culture that truly promotes self-care.

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The COVID-19 (coronavirus disease 2019) pandemic has had a significant global impact. Physical, emotional, and psychological health, particularly its specific mental health area, has been affected. Patients with rheumatic diseases are more likely to be concerned about COVID-19 than the public in general. Depression and anxiety are the symptoms most commonly reported by these patients. Therefore, now more than ever before, rheumatologists and psychiatrists should work together to improve the care of rheumatic disease patients, identifying the symptoms that uniquely reflect mental health problems, so the patients' quality of life can be substantially improved.

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Negative attitudes towards people with mental health disorders have been widely studied and identified in the general population, and even within health care professionals. Moreover, studies focused on service users have also identified mental health professionals, including psychiatrists, as a source of stigma. However, in Mexico and Latin America few studies have been conducted addressing this issue. To explore mental health service users' perceptions of stigma by members of the general population and by psychiatrists in Mexico, service users at a psychiatric hospital in Mexico were invited to participate in either focus groups or individual interviews, which were audio recorded, transcribed and analysed using thematic analysis. A total of 47 service users participated in this study. The results suggested that participants were not only aware of the possible consequences of mental health related stigma, but they have also experienced stigmatisation for having a mental illness. Participants also considered psychiatrists can hold negative attitudes towards people with mental illness, something that can represent a barrier for them to have optimal quality of care. Therefore, participants agreed that these attitudes should be addressed to improve the care they received from these professionals. This study suggests that, like members of the general population, psychiatrists are also considered as a source of stigma by people with mental illness in Mexico. These findings not only add to previous work conducted in Mexico and other countries, they also confirm the importance of addressing negative attitudes in this group of health professionals.

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Preceded by an introduction that highlights the importance of acknowledging those who spoke out and led the Argentinian psychiatric field for more than a century, thirty Argentinian psychiatrists are presented and their ideas are summarized in this manuscript. These psychiatrists include: Arturo Ameghino, René Arditi Rocha, Gregorio Bermann, José T. Borda, Gonzalo Bosch, Exequías Bringas Nuñez, Domingo Cabred, Raúl Camino, Lanfranco Ciampi, Juan Dalma, Francisco De Veyga, Noel Feldman, R. Horacio Etchegoyen, Jorge García Badaracco, Mauricio Goldenberg, José Ingenieros, Cristofredo Jakob, Alejandro Korn, Enrique Eduardo Krapf, Osvaldo Loudet, Lucio Meléndez, Braulio Moyano, Juan M. Obarrio, Elpidio R. Olivera, Carlos Rodolfo Pereyra, Enrique Pichón Rivière, José María Ramos Mejía, Telma Reca, Carolina Tobar García, Guillermo Vidal.

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Psychiatry's practice in Latin America is unique as it comes from the junction of the indigenous cultures and their conceptualization of mental disorders, the European colonizers who brought with them the early modern psychiatric conceptualizations and, later, the Africans who were forced to migrate to the continent as slaves and introduced elements of the African culture. With this background in mind it is easier to understand why Latin America is a multiethnic and multicultural continent. In order to be able to practice in this particular context, Psychiatry should take into account all the aforementioned elements in the design of its educational programmes. Nevertheless, Latin American countries have a tremendous deficit in mental health providers and, as such, are in dire need to strengthen their residency programmes and their recruitment processes in order to be able to meet the needs of the population. This paper sets out to review the current state of psychiatric education in Latin America and describe in more detail the current training programmes available in the region. It also discusses the perceptions of Latin American psychiatric residents regarding their training programmes and presents possible alternatives for the future of training.

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Abstract Introduction In 2016, there were 4,393 psychiatrists in Mexico, with an estimated rate of 3.68 per 100,000 inhabitants. It is essential to keep this information updated in order to achieve the overall objectives of mental health care. Objective Estimate the total number of psychiatrists and paidopsychiatrists in Mexico in 2018; identify their geographical distribution, and compare the results with those obtained in 2011 and 2016. Method Comparative, longitudinal study. Various sources were consulted to update the number of psychiatrists and paidopsychiatrists in 2018 and to determine their sociodemographic characteristics. These characteristics were compared with those found in 2011 and 2016. Results A total of 4,999 specialists in psychiatry practiced their specialty in Mexico in 2018, 365 of whom are child and adolescent psychiatrists. A rate of 3.71 psychiatrists per 100,000 inhabitants was obtained for a population of 124,737,789. Regarding pedopsychiatric specialists, if we consider a population of 37,714,991 inhabitants under 16, the corresponding rate is .96 child and adolescent psychiatrists per 100,000 minors. These specialists are unevenly distributed throughout the country. Approximately 60% of all psychiatrists and child and adolescent psychiatrists practice in the three largest cities in Mexico. Discussion and conclusion Although the national rate of psychiatrists was increased in comparison with 2016, it is still lower than that recommended by the World Health Organization (WHO). The geographical distribution of psychiatrists is uneven due to centralization and economic factors as happens in many countries in the world.

Resumen Introducción En 2016 se contabilizaron en México 4,393 psiquiatras, con una tasa estimada de 3.68 por cada 100,000 habitantes. Es necesario mantener actualizada esta información para alcanzar los objetivos globales de atención a la salud mental. Objetivo Estimar el número total de psiquiatras y paidopsiquiatras en México en 2018; determinar su distribución geográfica y comparar los resultados con los obtenidos en 2011 y 2016. Método Estudio comparativo y longitudinal. Se consultaron diversas fuentes para actualizar el número de psiquiatras y paidopsiquiatras en 2018 y conocer sus características sociodemográficas. Se compararon estas características con las encontradas en 2011 y 2016. Resultados Un total de 4,999 especialistas en psiquiatría ejercen su especialidad en México en 2018 y de estos 365 son paidopsiquiatras. En una población de 124,737,789 habitantes, se obtuvo una tasa de 3.71 psiquiatras por cada 100,000 habitantes. Respecto a los especialistas en paidopsiquiatría, si consideramos una población de 37,714,991 habitantes menores de 16 años, la tasa correspondiente es de .96 paidopsiquiatras por cada 100,000 menores. Existe una distribución desigual de estos especialistas en el país. Alrededor del 60% de todos los psiquiatras y paidopsiquiatras ejercen en las tres mayores ciudades de México. Discusión y conclusión Aunque la tasa nacional de psiquiatras se incrementó en comparación con la obtenida en 2016, sigue siendo todavía menor a la recomendada por la Organización Mundial de la Salud. La distribución geográfica de los psiquiatras es inequitativa debido a la centralización y a factores económicos como sucede en muchos países del mundo.

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El presente artículo se centra en el aporte docente de cuatro psiquiatras peruanos durante el periodo de creación de la Escuela de Psicología de la Universidad Nacional de San Agustín en Arequipa. Estos profesionales (Carlos Neuenschwander Landa, Noel Altamirano Velasco, Marco Carpio Bernedo y Claudio Mendívil Echevarría) transmitieron sus enseñanzas y experiencias a las primeras generaciones de psicólogos arequipeños. Se analiza su formación y su contribución a la psicología a través de su valiosa labor docente.

This article focuses on the educational contribution of four Peruvian psychiatrists during the process of creation of the School of Psychology at the National University of San Agustin in Arequipa. These professionals (Carlos Neuenschwander Landa, Noel Altamirano Velasco, Marco Carpio Bernedo y Claudio Mendivil Echevarría) transmitted their knowledge and experiences to the first generations of psychologists trained in the city. Their formation and contribution to psychology are analyzed through an examination of their valuable educational labor.

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La investigación sobre Tratamientos Combinados (TC) se ha centrado en estudiar los criterios que utilizan los profesionales a la hora de implementar este tipo de abordaje, pero son escasas las investigaciones que permitan conocer la perspectiva del paciente respecto a este tipo de tratamiento. Este es un estudio exploratorio, cualitativo conformada por 49 sujetos, residentes en CABA y GBA, que han recibido TC en los últimos dos años o lo están recibiendo en la actualidad, con el fin de evaluar los siguientes aspectos: 1) orientación teórica de profesionales; 2) comunicación entre profesionales; 3) efectos adversos de los tratamientos; y 4) experiencias de los pacientes respecto al TC. Los resultados preliminares sugieren que los pacientes en su mayoría conocen el tipo de tratamiento que realizan los psicólogos, siendo mucho menor el porcentaje de pacientes que conoce el tratamiento aplicado por su psiquiatra. En lo que respecta a informar los efectos adversos de los tratamientos son los psiquiatras quienes lo hacen en la mayoría de los casos pero es alta la cifra de pacientes que no han recibido esta información de ningún profesional tratante. Los pacientes presentan mayormente experiencias positivas respecto al TC basadas principalmente en la potenciación de los tratamientos y la contención de ambos profesionales. En lo que concierne a las experiencias negativas, la mala comunicación entre profesionales es la característica destacada. Este estudio se encuentra en proceso y sus conclusiones son provisionales.

Research on Combined Treatment (CT) is based largely on studies that seek to explore the criteria used by professionals involved in the combined therapies, though, there is little research exploring the perspective of CT users. We perform an exploratory qualitative study. A questionnaire was administered to 49 patients from CABA and GBA that are having CT or had been received it during the last two years to assess the following aspects: 1) professional´s theoretical orientation; 2) communication among professionals; 3) Side effects of treatments; and 4) patient experience regarding CT. Preliminary results suggest that most patients know the type of treatment carried out by psychologists, being lower the percentage of patients who know the psychiatric treatment. Regarding providing information about treatments side effects, psychiatrists reported in most cases, but there is a high number of patients who have not received this information from any treating professional. Concerning patient´s perspective on CT, the majority have positive experiences, being highlighted the empowerment of both treatments and professional care. On the other hand, bad communication between treating professionals were emphasized among negative experiences. This study is ongoing so its conclusions are tentative.

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The authors of the present selection of Latin American Psychiatry texts were characterized by a common deep humanistic attitude. These prolific writers were able to establish or extend the scope of the discipline in which they chose to act, questioning the establishment of rigid boundaries within the framework of a rigorous epistemological reflection. Thus the systematizing spirit of Jose Ingenieros' in the context of positivist evolutionism, resulted in the act of founding a discipline that integrated the biological and the social. In the case of Guillermo Vidal his conception of mental health went beyond the biomedical to consider psychotherapies as an emotional commitment, continence and empathic understanding; with regard to César Cabral his formation and extensive clinical practice resulted in a work defined by the inquiring into the theoretical concepts underlying Psychiatry and Clinical Psychology. This brief selection does not exhaust the issues or the level of ideas and discussions of Psychiatry in Argentina, but constitutes a textual corpus representative of a disciplinary conception understood as scientific and humanistic endeavor.

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RESUMEN: Introducción: En el año de 2011 había en México 3 823 psiquiatras, con una tasa estimada de 3.4 por cada 100 mil habitantes. Es necesario mantener actualizada esta información para alcanzar los objetivos globales de atención a la salud mental. Objetivo: Estimar el número total de psiquiatras en México en 2016; determinar su distribución geográfica y comparar los resultados con los obtenidos en el año 2011. Método: Estudio comparativo y longitudinal. Se consultaron diversas fuentes para actualizar el número de psiquiatras en 2016 y conocer sus características sociodemográficas. Se compararon estas características con las encontradas en 2011. Resultados: Un total de 4 393 psiquiatras ejercen su especialidad en México en 2016. Sobre una población de 119 530 753 habitantes, se obtuvo una tasa de 3.68 psiquiatras por cada 100 000 habitantes. Existe una pobre distribución de estos especialistas en el país. Alrededor del 60% de todos los psiquiatras ejercen en las tres mayores ciudades de México. Discusión y conclusión: La tasa nacional de psiquiatras se incrementó en comparación con la obtenida en 2011, sigue siendo inferior a la recomendada por la Organización Mundial de la Salud (OMS). La distribución geográfica de los psiquiatras es inequitativa debido a la centralización y a factores económicos.

ABSTRACT: Introduction: In 2011 we had 3823 psychiatrists in Mexico, with an estimated rate of 3.4 per 100 000 inhabitants. In order to achieve the global targets of mental health attention, it is important to update this information. Objetive: To estimate the total number of psychiatrists in Mexico in 2016; detemine their geographic distribution and compare the results with the ones obtained in 2011. Method: Longitudinal and comparative study. Diverse sources of information were consulted in order to update the number of psychiatrists in 2016 and to know their sociodemographic characteristics, that were compared with the ones obtained in 2011. Results: 4 393 psychiatrists practiced their specialty in Mexico in 2016. With a population of 119 530 753 inhabitants, we obtained a rate of 3.68 psychiatrists per 100 000 inhabitants. There's a poor distribution of theese specialists in the country. Around 60% of all psychiatrists practice in the tree major cities of Mexico. Discussion and conclusion: The national rate of psychiatrists increase in comparisson with the one we found in 2011, it remains lower that the one recommended by the World Health Organization (WHO). Geographic distribution of the psychiatrists is inequitative because of centralization and economic factors.

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Psychiatrists’ views on the mind-brain relationship (MBR) have marked clinical and research implications, but there is a lack of studies on this topic. Objectives: To evaluate psychiatrists’ opinions on the MBR, and whether they are amenable to change or not. Methods: We conducted a survey of psychiatrists’ views on the MBR just before and after a debate on the MBR at the Brazilian Congress of Psychiatry in 2014. Results: Initially, from more than 600 participants, 53% endorsed the view that “the mind (your “I”) is a product of brain activity”, while 47% disagreed. Moreover, 72% contested the view that “the universe is composed only of matter”. After the debate, 30% changed from a materialist to a non-materialist view of mind, while 17% changed in the opposite way. Discussion: Psychiatrists are interested in debates on the MBR, do not hold a monolithic view on the subject and their positions are open to reflection and change, suggesting the need for more in-depth studies and rigorous but open-minded debates on the subject...

Psychiatrists’ views on the mind-brain relationship (MBR) have marked clinical and research implications, but there is a lack of studies on this topic. Objectives: To evaluate psychiatrists’ opinions on the MBR, and whether they are amenable to change or not. Methods: We conducted a survey of psychiatrists’ views on the MBR just before and after a debate on the MBR at the Brazilian Congress of Psychiatry in 2014. Results: Initially, from more than 600 participants, 53% endorsed the view that “the mind (your “I”) is a product of brain activity”, while 47% disagreed. Moreover, 72% contested the view that “the universe is composed only of matter”. After the debate, 30% changed from a materialist to a non-materialist view of mind, while 17% changed in the opposite way. Discussion: Psychiatrists are interested in debates on the MBR, do not hold a monolithic view on the subject and their positions are open to reflection and change, suggesting the need for more in-depth studies and rigorous but open-minded debates on the subject...

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OBJECTIVE: To explore the rationales of mental health professionals (mainly psychiatrists and psychologists) from 8 countries for removing specific diagnostic categories from mental disorders classification systems. METHOD: As part of a larger study, 505 participants indicated which of 60 major disorders should be omitted from mental disorders classification systems and provided rationales. Rationale statements were analyzed using inductive content analysis. RESULTS: The majority of clinicians (60.4%) indicated that 1 or more disorders should be removed. The most common rationales were (a) problematic boundaries between normal and psychopathological conditions (45.9% of total removal recommendations), (b) problematic boundaries among mental disorders (25.4%), and (c) problematic boundaries between mental and physical disorders (24.0%). The categories most frequently recommended for deletion were gender identity disorder, sexual dysfunction, and paraphilias, usually because clinicians viewed these categories as being based on stigmatization of a way of being and behaving. A range of neurocognitive disorders were described as better conceptualized as nonpsychiatric medical conditions. Results were analyzed by country and country income level. Although gender identity disorder was the category most frequently recommended for removal overall, clinicians from Spain, India, and Mexico were most likely to do so and clinicians from Nigeria and Japan least likely, probably because of social and systemic factors that vary by country. Systematic differences in removal rationales by country income level may be related to the development, structure, and functioning of health systems. CONCLUSION: Implications for development and dissemination of the classification of mental and behavioral disorders in WHO's ICD-11 are discussed.

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There are few available and reliable data regarding the number and geographic location of psychiatrists in Mexico. It is important to have these data in order to know if the mental health needs of the country are being met. This study is an attempt to update both the current data on this subject by locating the most psychiatrists possible, and also to learn more about how they manage their medical practice. Methods Descriptive and cross-sectional study. Several sources available in Mexico were consulted such as Mexican Psychiatry Associations, health care institutions, universities, telephone directories among several others, to locate psychiatrists and to identify where and what kind of practice they have. Results According to our several data bases, 3823 psychiatrists were counted in Mexico, 225 of these being child and adolescent psychiatrists. The rate of psychiatrists obtained was 3.47 psychiatrists per 100 000 inhabitants and 0.69 child and adolescent psychiatrists per 100 000 inhabitants under 15 years. 56% of psychiatrists practiced in the Federal District. There are 1.8 male psychiatrists for every female psychiatrist. Discussion The number of psychiatrists in Mexico is still below the rate that the World Health Organization recomends. The distribution by gender is shifting towards more equality. Psychiatrists were found to be grouped in urban areas of the country. The number of psychiatrists and child and adolescent psychiatrists seems to be insufficient to cover the needs of the country.

Existe poca información disponible y actualizada acerca del número de psiquiatras en México y sobre su localización geográfica. Es importante conocer estos datos para saber si se cubren las necesidades de salud mental del país. Este estudio busca actualizar tanto los datos disponibles sobre este tema al localizar el mayor número de psiquiatras posibles, como el tipo de práctica en su especialidad y si cuentan con la certificación correspondiente. Metodología Se trata de un estudio descriptivo y transversal. Se consultaron múltiples fuentes disponibles en México, como las asociaciones psiquiátricas mexicanas, las instituciones hospitalarias, las universidades, los directorios telefónicos y otros, para localizar a los psiquiatras, identificar dónde ejercen y conocer el tipo de su práctica profesional. Resultados Considerando nuestras diversas fuentes de búsqueda, se contabilizó un total de 3 823 psiquiatras para una población total de 112 000 000 de habitantes. Del número total de psiquiatras, 225 tienen la subespecialidad de paidopsiquiatría. Se obtuvo una tasa de 3.47 psiquiatras por cada 100 000 habitantes y de 0.69 paidopsiquiatras sobre una población de 100 000 habitantes menores de 15 años. El 56% se encuentra en el Distrito Federal. Hay 1.8 psiquiatras varones por cada mujer en esa especialidad. Discusión El número de psiquiatras en México aún está por debajo de la tasa recomendada por la Organización Mundial de la Salud. La distribución por género está cambiando hacia una más equitativa. Se encontró que los psiquiatras están agrupados en las zonas urbanas del país. El número de psiquiatras y paidopsiquiatras es insuficiente para cubrir las necesidades de salud mental del país.

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El presente estudio se basa en la Encuesta de Calidad de Vida de la Organización Mundial de la Salud (WHOQOL-BREF), que se utilizó para analizar la calidad de vida y los factores que contribuyen a su calidad de vida en Psiquiatras Infanto-Juveniles y Neuropediatras, además de residentes de ambas especialidades en Chile. Se realizaron entrevistas electrónicas a 79 profesionales, asociados a la Sociedad de Psiquiatría y Neurología de la Infancia y de la Adolescencia. Los resultados mostraron que las puntuaciones medias en cada dominio del WHOQOL-BREF de los profesionales son las siguientes: la capacidad física (CF) es de 15,11 +/- 2.55, el bienestar psicológico (BP) fue de 15,22 +/- 2.08, relaciones sociales (RS) fue 14,63 +/- 2.75 y el medio ambiente (MA) 15,04 +/- 2.39. Estas puntuaciones medias fueron inferiores a las de la población general. Por último, se realizaron regresiones múltiples por pasos para examinar las características del Psiquiatra Infanto-Juvenil, Neurólogo Infantil y residentes de la especialidad. El estudio encontró que los siguientes tres factores: la percepción subjetiva del estado de salud, los hogares, los ingresos y el estrés de apoyo familiar insuficiente, fueron significativamente correlacionados con los cuatro dominios de regresión múltiple análisis. Los resultados destacan que los cuidadores de los niños y adolescentes con discapacidad intelectual parecen mostrar una menor WHOQOL-BREF puntuación media que la población general, probablemente por una combinación de estrés, la salud y los factores de ingreso de los hogares. Estas conclusiones deben tenerse en cuenta en la formulación de políticas para proporcionar medidas de mayor apoyo e intervenciones más específicas para los psiquiatras infanto-juveniles y Neuropediatras.

The present study is based on World Health Organization´s quality of life (WHOQOL-BREF) scale to examine quality of life of child and adolescent psychiatrists and child neurologists in Chile, and the factors contributing to their quality of life. Structured interviews were conducted with 79 practitioners. Self-evaluation of their quality of life revealed that 72 percent considered it good or very good, while 58 percent were pleased of very pleased with regards to health satisfaction. The mean scores obtained in each domain of WHOQOL-BREF were: physical capacity (PC) 15.11 +- 2.55, psychological well-being (PW) 15.22 +-2.08, social relationship (SR) 14.63 +- 2.75 and environment (EN) 15.04 +- 2.39. Finally, multiple stepwise regressions were conducted to examine the characteristics of the practitioners which more likely explained the WHOQOL-BREF mean scores. The study found that marital status was significantly correlated to psychological well-being and environment; religion was significantly correlated to the environment; and the number of work places with physical capacity and quality of life score. The results highlights that child and adolescent psychiatrists and child neurologists display a higher WHOQOL-BREF mean score than the general population however, in certain domains the scores are lower, probably due to a combination of stress and health factors. These finding must be taken into account in policy making to provide better and more specific supports and interventions for the child and adolescent psychiatrists and child neurologists.

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Este trabalho objetivou investigar as concepções implícitas acerca da loucura e de sua cura nas perguntas realizadas por psiquiatras, nas consultas de evolução. O trabalho de campo realizou-se no setor de internação de um hospital psiquiátrico público. Ao todo, foram observadas 88 consultas, realizadas por 4 psiquiatras do hospital, 2 homens e 2 mulheres. Os dados apontam para a presença de uma noção reificada da loucura como doença mental, cujos traços concretos seriam os sintomas mentais listados nos principais compêndios psiquiátricos, DSM e CID, bem como para uma crença na cura como a supressão de tais sintomas. O medicamento apareceu como a principal solução e sua prescrição como a forma privilegiada de tratamento.(AU)

The present study aimed to investigate the implicit conceptions related to insanity and its treatment in the questions conducted by psychiatrists in the progress visits. The fieldwork was performed in the hospitalization sector of a public psychiatric hospital. A total of 88 visits conducted by 4 psychiatrists of the hospital - 2 men and 2 women - were observed. The data indicate the presence of a reified notion of insanity as a mental illness, whose actual traces would be the mental symptoms listed in the major psychiatric books, DSM and ICD, as well as a belief in the healing as a suppression of such symptoms. The drug appeared as the main solution, and its prescription as the preferential treatment method.(AU)

RESUMO

The recently modified General Law on Health (Ley General de Salud) establishes in article 74b, section VII, that any individual with mental or behavioral disorders will have <

Una de las limitantes más importantes que explican la diferencia entre las personas que necesitan servicios de salud mental y las que acceden a éstos, es el insuficiente número de psiquiatras. La media mundial de psiquiatras por cada 100 000 habitantes es de 3.96 (DE 5.94), la distribución de psiquiatras varía de una región a otra; existe un promedio de 0.06 en los países de bajos ingresos y de 9.0 en los de altos ingresos. La psiquiatría, como especialidad médica, es relativamente reciente. Es hasta el siglo XIX cuando el tratamiento de los trastornos mentales empieza a ser objeto de una especialidad médica. En México, la enseñanza de la psiquiatría como especialidad independiente se inicia en 1950. En 2010 se abrieron 137 plazas para la realización de la residencia en psiquiatría en diferentes partes de la República Mexicana. A pesar de esto, el número de psiquiatras es insuficiente además de que el ámbito de su actividad no corresponde a las recomendaciones de la Organización Mundial de la Salud. El objetivo del presente trabajo fue determinar el número y la distribución de los psiquiatras en la República Mexicana y proponer nuevos campos de acción del psiquiatra. Metodología Se realizó un estudio descriptivo, transversal, heterodémico. Se revisaron las siguientes fuentes de información: el Directorio de la Asociación Psiquiátrica Mexicana (APM) de 2008, el Directorio del Consejo Mexicano de Psiquiatría (CMP) de 2008, el Censo de 1990 y el II Conteo de Población y Vivienda 2005. Resultados En el Directorio de la Asociación Psiquiátrica Mexicana se encontraron 1 397 socios activos. En el Directorio del Consejo Mexicano de Psiquiatría están anotados 1430 psiquiatras certificados. En los últimos 20 años hubo un incremento de psiquiatras del 29%, pues pasaron de 1 108 a 1 430. Para el 2005 la población aumentó de 81.2 a 103.3 millones de personas, es decir hubo un incremento del 27%. Esto indica que la cantidad de psiquiatras se ha mantenido constante respecto al número de habitantes. Observamos que, en total, hay más psiquiatras certificados que miembros de la APM. En cuanto al segundo objetivo, a excepción del Distrito Federal, en el resto del país el número de psiquiatras por número de habitantes es notablemente inferior a la media mundial de 3.96/100 000 habitantes. En promedio, hay 1.3 psiquiatras/100 000 habitantes. En 22 Estados hay menos de un psiquiatra/100 000 habitantes. No se identificó ningún psiquiatra adscrito al primer nivel de atención y casi la mitad estaba adscrita a hospitales psiquiátricos. Conclusiones En México el número de psiquiatras es insuficiente para atender las necesidades de la población por lo que la opción es, como ha propuesto la OMS, reestructurar la atención a los trastornos mentales. En el modelo propuesto se establece un continuo desde la atención que se proporciona directamente en la comunidad, hasta la que se proporciona en los llamados centros de <

RESUMO

Este trabalho objetivou investigar as concepções implícitas acerca da loucura e de sua cura nas perguntas realizadas por psiquiatras, nas consultas de evolução. O trabalho de campo realizou-se no setor de internação de um hospital psiquiátrico público. Ao todo, foram observadas 88 consultas, realizadas por 4 psiquiatras do hospital, 2 homens e 2 mulheres. Os dados apontam para a presença de uma noção reificada da loucura como doença mental, cujos traços concretos seriam os sintomas mentais listados nos principais compêndios psiquiátricos, DSM e CID, bem como para uma crença na cura como a supressão de tais sintomas. O medicamento apareceu como a principal solução e sua prescrição como a forma privilegiada de tratamento.

The present study aimed to investigate the implicit conceptions related to insanity and its treatment in the questions conducted by psychiatrists in the progress visits. The fieldwork was performed in the hospitalization sector of a public psychiatric hospital. A total of 88 visits conducted by 4 psychiatrists of the hospital - 2 men and 2 women - were observed. The data indicate the presence of a reified notion of insanity as a mental illness, whose actual traces would be the mental symptoms listed in the major psychiatric books, DSM and ICD, as well as a belief in the healing as a suppression of such symptoms. The drug appeared as the main solution, and its prescription as the preferential treatment method.