Universidad del Desarrollo

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Síndrome de Ovario Poliquístico y Salud Mental en Adolescentes
(2024)
María Rosario Matte
;
Juan Pablo Del Rio
;
Olga Fernández
;
Nicolás Crisosto King
<jats:p>El Síndrome de Ovario Poliquístico (SOP) es el desorden endocrino-metabólico más frecuente en las adolescentes. Se asocia a complicaciones metabólicas, cardiovasculares y reproductivas. Hallazgos recientes sugieren también una asociación con patología psiquiátrica, tanto en las pacientes afectadas como en su descendencia. En la presente actualización, se realizó una síntesis de la literatura reciente relativa a la salud mental en mujeres y adolescentes con SOP. Se realizó una búsqueda sistematizada en PubMed, Epistemonikos y Scielo de los artículos publicados en los últimos 5 años. Se confirmó que existe un aumento significativo del riesgo de presentar trastornos por ansiedad, depresión, trastornos alimenticios, trastorno obsesivo compulsivo, trastorno afectivo bipolar y psicosis en mujeres con SOP. Además, presentan riesgo de trastornos del neurodesarrollo, tales como trastorno del espectro autista y trastorno por déficit atencional e hiperactividad, tanto en ellas como en su descendencia. La hiperinsulinemia y el hiperandrogenismo podrían explicar parte de estas asociaciones, afectando la maduración del sistema nervioso central, especialmente durante la vida intrauterina y la adolescencia. El distrés derivado de las características fenotípicas físicas de la enfermedad también podría impactar la salud mental de las pacientes. Aún no se cuenta con suficientes estudios que expliquen el origen de esta correlación, ni tampoco con ensayos clínicos que aborden la salud mental de forma específica en estas pacientes. La evidencia actual sugiere la necesidad de evaluar activamente la salud mental de estas pacientes y coordinar a los distintos equipos de salud que intervengan en el manejo de la patología.</jats:p>
1
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Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial
(2022)
PÉREZ EWERT, JANET CAROLA
;
ALDONEY RAMIREZ, DANIELA
;
Marcia Olhaberry
;
Olga Fernández
;
María I García
<jats:p> Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families. </jats:p>
16 1Scopus© Citations 4
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An Adjunctive Internet-Based Intervention to Enhance Treatment for Depression in Adults: Randomized Controlled Trial
(2021)
PÉREZ EWERT, JANET CAROLA
;
Olga Fernández
;
Cristián Cáceres
;
Álvaro E Carrasco
;
Markus Moessner
<jats:sec> <jats:title>Background</jats:title> <jats:p>Internet-based interventions promise to enhance the accessibility of mental health care for a greater number of people and in more remote places. Their effectiveness has been shown for the prevention and treatment of various mental disorders. However, their potential when delivered as add-on to conventional treatment (ie, blended care) is less clear.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective</jats:title> <jats:p>The aim of this study is to study the effectiveness of an internet intervention (ASCENSO) implemented in addition to face-to-face treatment as usual (TAU) for depression.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A 2-arm, parallel-group, randomized controlled trial was conducted in an outpatient private mental health care center in Chile. In all, 167 adults, diagnosed with major depressive disorder, without severe comorbidities, and with internet access, were included. Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider–assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center’s internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients’ limited use of the online platform.</jats:p> </jats:sec> <jats:sec> <jats:title>Trial Registration</jats:title> <jats:p>ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467</jats:p> </jats:sec>
12 1Scopus© Citations 11

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