The prevalence of substance use is high among adolescents in several region around the world, specifically in Chile, and its prevention is an important public health challenge. We describe the adaptation and the feasibility to implement the Icelandic model of substance use prevention in adolescents “Planet Youth” in Chile as first experience in Latin America. This community prevention model focuses on the environment, culture and the promotion of health in adolescents, informed by local risk and protective factors. Implementation requires collaboration between academia and municipal authorities. Six municipalities of the Metropolitan Region, the University of Chile and the Icelandic Centre for Social Research and Analysis collaborated in the implementation of the Planet Youth model since 2018 in Chile. A substance use survey was translated, adapted, and applied to 7354 tenth grade students. The results were informed to schools and municipalities in order to work on modifications of the main risk and protective factors in their own community. In 2020, the prevention process has required some adaptation due to COVID-19 pandemic. We discuss sociocultural factors in the adaptation of this international prevention model transferred to Latin America. The implementation of the Planet Youth model is feasible in Chile and offers an opportunity to effectively prevent the substance use behaviors of adolescents in Latin America.

Resumen El consumo de sustancias en adolescentes es altamente prevalente en varias regiones del mundo, y especialmente en Chile, siendo su prevención un importante desafío para la salud pública. Este artículo describe el modelo islandés de prevención del consumo de sustancias en adolescentes “Planet Youth”, su adaptación y factibilidad de implementación en Chile, como primera experiencia en Latinoamérica. Este modelo comunitario está enfocado en la prevención ambiental y en la promoción de la salud de niños, niñas y adolescentes, basado en un diagnóstico local y oportuno de factores protectores y de riesgo, con colaboración de la autoridad local y la academia. Seis comunas de la región metropolitana en colaboración con la Universidad de Chile y el Icelandic Centre for Social Research and Analysis inician su implementación en 2018. Se tradujo y adaptó la encuesta islandesa que fue aplicada a 7354 estudiantes de 2° medio, cuyos resultados se retroalimentaron a colegios y municipalidades para trabajar en la modificación de los principales factores de riesgo y protección. En 2020, el proceso ha requerido algunas adaptaciones debido a la pandemia por COVID-19. Se discute acerca de factores socioculturales relevantes en la adaptación de estrategias basadas en evidencia internacional que se transfieren a un país diferente. La implementación del modelo Planet Youth es factible en Chile y ofrece una importante oportunidad para prevenir el consumo de sustancias en jóvenes de manera efectiva en Latinoamérica.

ABSTRACT INTRODUCTION : The nutritional status, physical activity (PA) and psychosocial variables pose new challenges for the elderly. The objective was to describe and explore psychosocial and nutritional aspects along with physical fitness and activity level in elderly attending retirement centers in the city of Buenos Aires. METHODS : An exploratory, observational, cross-sectional and quantitative study was carried out. It included a non-probabilistic sample of male and female self-sufficient elderly in six Buenos Aires communes during 2017-2018. The study assessed age, sex, socio-economic level index, socio-family appraisal, cognitive reserve questionnaire and Pemberton happiness index, nutritional status by Mini Nutritional Assessment, anthropometry by body mass index, physical fitness by muscle strength and functionality, energy expenditure and PA level by accelerometry. RESULTS : In a sample of 150 elderly people aged 74±7 years, 90% (n=135) were women. There were 48% belonging to a low socio-economic level, with social risk indicators in 50%, well-being in 97.6%, and satisfactory cognitive reserve in 53.6%; 53.7% had overweight/obesity, predominantly in the quartile 1, and 10.2% had risk/malnutrition. Muscle weakness prevailed in quartiles 3 and 4. A majority of the 57 elderly who used the accelerometer had sedentary PA and low energy expenditure. DISCUSSION : The studied sample showed social risk/problem, excess weight and sedentary activity.

RESUMEN INTRODUCCIÓN : El estado nutricional, la actividad física (AF) y las variables psicosociales plantean nuevos desafíos en los adultos mayores (AM). El objetivo fue explorar y describir aspectos psicosociales, nutricionales, aptitud y AF en AM que asisten a centros de jubilados de la Ciudad Autónoma de Buenos Aires (CABA). MÉTODOS : Se realizó un estudio exploratorio, observacional, transversal y cuantitativo con una muestra no probabilística de AM de ambos sexos, auto-válidos, en seis comunas de CABA durante 2017-2018. Se evaluó edad, sexo, índice de nivel socioeconómico (NSE), valoración sociofamiliar, cuestionario de reserva cognitiva e índice de bienestar de Pemberton, estado nutricional por Mini NutritionalAssessment, antropometría por índice de masa corporal, aptitud física por fuerza muscular y funcionalidad, gasto energético y nivel de AF por acelerometría. RESULTADOS : En una muestra de 150 AM de 74±7 años, el 90% (n=135) eran mujeres. El 48% pertenecía a un NSE bajo. Hubo presencia de riesgo social en el 50%, bienestar en el 97,6% y reserva cognitiva satisfactoria en el 53,6%. El 53,7% presentó sobrepeso/ obesidad con predominio en cuartil 1, y hubo 10,2% con riesgo o malnutrición. La debilidad muscular prevaleció en el tercer y cuarto cuartil. De los 57 AM que usaron acelerómetro, la mayoría tenía AF sedentaria y bajo gasto energético. DISCUSIÓN : La muestra explorada mostró riesgo/ problema social, exceso de peso y sedentarismo.

Background: Patient Health Questionnaire (PHQ-9) has nine questions and is used in diabetic or hypertensive patients to detect depressive symptoms. The PHQ-2 uses the first two questions of the PHQ-9 to rapidly detect those patients that should answer the whole questionnaire. Aim: To validate the PHQ-2 to detect depressive symptoms in diabetic or hypertensive patients consulting at Primary Health Care (PHC). Material and Methods: Secondary analysis of data obtained during the baseline assessment of a clinical trial. Diabetic and hypertensive patients aged 18 years or more, attending a public health care clinic of Metropolitan Santiago, were invited to participate. Those accepting, answered the Patient Health Questionnaire (PHQ-9), consisting in nine questions about depressive symptoms. Demographics and health data were also collected. The PHQ-2 capacity to discriminate PHQ-9 scores equal or higher than 10 and 15 and the correlation between both versions, were assessed. Results: Ninety-four participants aged 64 ± years (73% women) answered the questionnaire. A cut-off score of 3 or more points in the PHQ-2 achieved the best tradeoff between sensitivity and specificity for discriminating PHQ-9 scores equal or higher than 10 (area under the receiver operating characteristic curve (ROC) = 0.92, 95% confidence interval [95% CI] = 0.87 to 0.97) and 15 points (area under the ROC curve = 0.95, 95% CI = 0.92 to 0.99). Both versions had a high positive correlation (r = 0.87). Conclusions: The PHQ-2 allows a stepped, simple and accurate screening for depressive symptoms. Diabetic or hypertensive patients with 3 or more points should be immediately assessed with the remaining questions of the PHQ-9.

Abstract Introduction: socio-economic differences lead to food and nutritional inequalities. Diet is a modifiable risk factor by public health activities, on the way to the prevention of chronic non-communicable diseases. Objective: to estimate food inequalities in Argentina based on the socioeconomic level of the population, analyzing the consumption of different food groups. Methods: Argentine data from the Latin American Study of Nutrition and Health. Sample: 1,266 individuals stratified by gender, socioeconomic level and geographic region. Intake: 2 24-hour reminders with the multi-step technique. Analysis: with the NDS Software average consumption values of 11 food groups were analyzed by socioeconomic level and country region. Results: the population with lower socioeconomic status consumes significantly less fruits, vegetables and dairy products than the population with medium to high socioeconomic level. Fruits: 59 vs. 79.1 and 106.3 g/d, respectively; p = 0.000. Vegetables: 82.3 g/d vs. 112 and 118 g/d; p = 0.000. Dairy products: 114 g/d vs. 165 and 137 g/d; p = 0.000). On the contrary, it consumes a greater volume of soft drinks and industrial juices (680 mL/d vs. 527 and 590 mL/d, respectively; p = 0.000), infusions with added sugar (568 mL/d vs. 385 and 309 mL/d; p = 0.000), bread (85 g/d vs. 75.5 and 66.7 g/d; p = 0.012) and pastries (159 g/d vs. 147 and 122 g/d; p = 0.008). Conclusions: Social vulnerability is an important determinant for diet quality. Interventions designed to reduce social inequalities as linked to nutrition and health are essential.

Resumen Introducción: las diferencias socioeconómicas acarrean desigualdades alimentarias y nutricionales. La dieta es un factor de riesgo modificable con acciones de salud pública, camino a la prevención de enfermedades crónicas no transmisibles. Objetivo: estimar las desigualdades alimentarias en Argentina en función del nivel socioeconómico de la población, analizando el consumo de distintos grupos de alimentos. Métodos: datos argentinos del Estudio Latinoamericano de Nutrición y Salud. Muestra: 1266 individuos estratificados por género, nivel socioeconómico y región geográfica. Ingesta: 2 recordatorios de 24 horas con técnica de pasos múltiples. Análisis: con el NDS Software se analizaron los valores medios de consumo de 11 grupos de alimentos por nivel socioeconómico y región del país. Resultados: la población con menor nivel socioeconómico consume significativamente menos frutas, verduras y lácteos que la población de nivel medio y alto. Frutas: 59 vs. 79,1 y 106,3 g/d, respectivamente; p = 0,000. Verduras: 82,3 vs. 112 y 118 g/d; p = 0,000. Lácteos: 114 vs. 165 y 137 g/d; p = 0,000). Por el contrario, consume un mayor volumen de refrescos y jugos industriales (680 ml/d vs. 527 y 590 ml/d, respectivamente; p = 0,000), infusiones con azúcar agregada (568 ml/d vs. 385 y 309 ml/d; p = 0,000), pan (85 g/d vs. 75,5 y 66,7 g/d; p = 0,012) y bollería (159 g/d vs. 147 y 122 g/d; p = 0,008). Conclusiones: la vulnerabilidad social es un determinante importante de la calidad de la dieta. Intervenciones diseñadas para reducir las desigualdades sociales vinculadas a la nutrición y la salud resultan imprescindibles.

The high consumption of added sugars in the diet of the Argentine population and its consequent effect on health are current concerns both at the clinical and public health levels. The objective of this study was to determine the main sources of added sugars in the Argentine diet and the proportional energy contribution of each of them. The sample consisted of 1266 individuals, representative of the country’s urban population from 15 to 65 years old, stratified by region, age, gender and socio-economic level. Two 24-hour dietary recalls and one socio-economic questionnaire were carried out. Among the total food and beverages consumed by Argentines, 26.9% of added sugars were provided by soft drinks and 23.8% by infusions. The third place, with 15.4%, came from baked goods (bread, cookies, etc.) and the fourth, with 12%, from ready-to-prepare juices, ahead of sweets and candies and dairy products. Men, compared to women, consumed significantly more added sugars in soft drinks (32.6 vs. 22.1%), while women consumed more added sugars in infusions (25.5 vs. 21.8%), baked goods, sugar and honey. The lower income population consumed significantly more sugar in infusions at the expense of “mate” (21.4 vs. 7 g/day), while no differences were observed in the consumption of soft drinks by socio-economic level (32.9 vs. 34.4 g/day). Urgent measures based on education could improve the consumption habits of added sugars and the health of the population.

El alto consumo de azúcares añadidos en la dieta de la población argentina y su consecuente efecto sobre la salud son preocupaciones actuales tanto a nivel clínico como de salud pública. El objetivo del presente estudio consistió en determinar las principales fuentes de azúcares añadidos de la dieta argentina y determinar el aporte proporcional de energía de cada una de ellas. La muestra consistió en 1266 individuos, representativa de la población urbana del país de 15 a 65 años y estratificada por región, edad, género y nivel socioeconómico. Se efectuaron dos recordatorios de ingesta de 24 horas y un cuestionario de nivel socioeconómico. Entre el total de alimentos y bebidas consumidos por los argentinos el 26.9% del azúcar lo aportaron las gaseosas y el 23.8% las infusiones. El tercer lugar, con 15.4%, provino de los panificados (pan, galletitas, facturas) y el cuarto, con 12%, de jugos listos para preparar, por delante de los dulces y golosinas y lácteos. Los hombres, en comparación con las mujeres consumieron significativamente más azúcares añadidos en gaseosas (32.6 vs. 22.1%) y las mujeres más en infusiones (25.5 vs. 21.8%), panificados, azúcar y miel. La población de menores recursos consumió significativamente más azúcar en infusiones a expensas del mate (21.4 vs. 7 g/día) y no se observaron diferencias en el consumo de gaseosas por nivel socioeconómico (32.9 vs. 34.4 g/día). Urgentes medidas basadas en la educación podrían mejorar los hábitos de consumo de azúcares y la salud de la población.

The high consumption of added sugars in the diet of the Argentine population and its consequent effect on health are current concerns both at the clinical and public health levels. The objective of this study was to determine the main sources of added sugars in the Argentine diet and to determine the proportional energy contribution of each of them. The sample consisted of 1266 individuals, representative of the country’s urban population from 15 to 65 years old, stratified by region, age, gender and socio-economic level. Two 24-hour intake records and one socio-economic questionnaire were carried out. Among the total food and beverages consumed, 26.9% of added sugars was contributed by soft drinks and 23.8% by infusions. The third place, with 15.4%, was obtained by baked goods (bread, cookies, etc.) and the fourth, with 12%, from ready-to-prepare juices, ahead of sweets, candies and dairy products. Men, compared to women, consumed significantly more added sugars in soft drinks (32.6 vs. 22.1%) and women more in infusions (25.5% vs. 21.8%), baked goods, sugar and honey. The lower income population consumed significantly more sugar in infusions at the expense of “mate” (21.4 vs. 7 g/day) and no differences were observed in the consumption of soft drinks by socio-economic level (32.9 vs. 34.4 g/day). Urgent measures based on education could improve the consumption habits of added sugars and the health of the population.

El alto consumo de azúcares añadidos en la dieta de la población argentina y su consecuente efecto sobre la salud son preocupaciones actuales tanto a nivel clínico como de salud pública. El objetivo del presente estudio consistió en determinar las principales fuentes de azúcares añadidos de la dieta argentina y determinar el aporte proporcional de energía de cada una de ellas. La muestra consistió en 1266 individuos, representativa de la población urbana del país de 15 a 65 años y estratificada por región, edad, género y nivel socioeconómico. Se efectuaron dos recordatorios de ingesta de 24 horas y un cuestionario de nivel socioeconómico. Entre el total de alimentos y bebidas consumidos, el 26.9% del azúcar lo aportaron las gaseosas y el 23.8% las infusiones. El tercer lugar, con 15.4%, provino de los panificados (pan, galletitas, facturas) y el cuarto, con 12%, de jugos listos para preparar, por delante de los dulces, golosinas y lácteos. Los hombres, en comparación con las mujeres consumieron significativamente más azúcares añadidos en gaseosas (32.6 vs. 22.1%) y las mujeres más en infusiones (25.5% vs. 21.8), panificados, azúcar y miel. La población de menores recursos consumió significativamente más azúcar en infusiones a expensas del mate (21.4 vs. 7 g/día) y no se observaron diferencias en el consumo de gaseosas por nivel socioeconómico (32.9 vs. 34.4 g/día). Urgentes medidas basadas en la educación podrían mejorar los hábitos de consumo de azúcares y la salud de la población.

Background: Postpartum depression (PPD) is a public health issue, and appropriate screening may lead to clinical gains. Aim: To describe the screening for PPD, its relationship with the use of health care services, and treatment access barriers in Chilean public primary health care (PHC) centers. Material and Methods: Puerperal women attending PHC centers for a well-child check-up were assessed for the presence of PPD using the Edinburgh Postnatal Depression Scale and a structured psychiatric interview. PPD cases were assessed by telephone three months later. Also, women with PPD and PHC workers were interviewed to explore treatment barriers. Results: Of the 305 women assessed, 21% met diagnostic criteria for PPD. Sixty five percent of assessed women were previously screened for PPD while attending well-child check-ups. The results of the screening were communicated to 60% of them and 28% received some management indication. After three months of follow up, 70% of PPD cases continued to be depressed, and two thirds of them did not consult a health care provider and most of them rejected psychotherapy or medical treatment. Conclusions: Management of postpartum depression should be substantially improved in public PHC from screening to treatment.

RESUMO Neste relato se examinam os desafios de realizar um estudo transversal multicêntrico em países com culturas diversas e os ensinamentos tirados. O Estudo Latino-americano de Nutrição e Saúde (ELANS) serviu de estudo de viabilidade, englobando as cidades mais populosas de oito países da América Latina (Argentina, Brasil, Chile, Colômbia, Costa Rica, Equador, Peru e Venezuela) em 2014–2015, representando cerca de 40% da população das Américas. A amostra pretendida compreendeu 9.000 indivíduos com 15 a 65 anos de idade e foi estratificada por localização geográfica (exclusivamente áreas urbanas), sexo, idade e nível socioeconômico. Os seis principais desafios identificados foram: estruturar as equipes e selecionar as sedes, elaborar um único protocolo, obter as aprovações dos comitês de ética, realizar trabalho de campo simultâneo, assegurar a qualidade dos dados e extrair os dados e manter a consistência em todas as bases de dados. Os ensinamentos tirados demonstram serem imprescindíveis harmonização, estudo-piloto, uniformidade dos procedimentos, ótimo controle da qualidade dos dados e comunicação e colaboração entre as sedes. Entre as barreiras estão a complexidade organizacional, recrutamento de colaboradores e pessoal de pesquisa, cooperação institucional, desenvolvimento de infraestrutura e identificação dos recursos. Antes do início do trabalho de campo, deve-se chegar a um consenso sobre medidas e resultados uniformes e metodologia de coleta de dados assim como um plano para o gerenciamento e análise dos dados, comunicação, publicação e disseminação dos resultados dos estudos. Apesar da sua complexidade, tais estudos têm um grande potencial de fundar uma base científica para estudos de nutrição, atividade física e outros tópicos relacionados à saúde, ao mesmo tempo que facilitam comparações entre os países da América Latina.

ABSTRACT This report examines the challenges of conducting a multicenter, cross-sectional study of countries with diverse cultures, and shares the lessons learned. The Latin American Study of Nutrition and Health (ELANS) was used as a feasibility study involving the most populous cities of eight countries in Latin America (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014–2015, about 40% of the population of the Americas. The target sample included 9 000 individuals, 15–65 years of age, and was stratified by geographic location (only urban areas), gender, age, and socioeconomic status. Six principal challenges were identified: team structuring and site selections; developing a single protocol; obtaining ethic approvals; completing simultaneous fieldwork; ensuring data quality; and extracting data and maintaining consistency across databases. Lessons learned show that harmonization, pilot study, uniformity of procedures, high data quality control, and communication and collaboration across sites are imperative. Barriers included organizational complexity, recruitment of collaborators and research staff, institutional cooperation, development of infrastructure, and identification of resources. Consensus on uniform measures and outcomes and data collection methodology, as well as a plan for data management and analysis, communication, publication, and dissemination of study results should be in place prior to beginning fieldwork. While challenging, such studies offer great potential for building a scientific base for studies on nutrition, physical activity, and other health topics, while facilitating comparisons among countries.

RESUMEN En este informe se examinan los retos de llevar a cabo un estudio transversal multicéntrico en países con culturas diversas y se transmiten las enseñanzas extraídas. Se usó el Estudio Latinoamericano de Nutrición y Salud (ELANS) como un estudio de factibilidad realizado en el período 2014–2015, que incluyó las ciudades más populosas de ocho países de América Latina (Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela) y abarcó a cerca de 40% de la población de la Región de las Américas. La muestra establecida incluyó a 9 000 personas de 15 a 65 años de edad, y fue estratificada según la ubicación geográfica (solo zonas urbanas) y por sexo, edad y situación socioeconómica. Se encontraron seis retos principales: estructurar los equipos y seleccionar los sitios; preparar un protocolo único; obtener las aprobaciones éticas; terminar simultáneamente el trabajo sobre el terreno; velar por la calidad de los datos y extraer datos y mantener la uniformidad en todas las bases de datos. Las enseñanzas extraídas muestran que la armonización, los estudios piloto, la uniformidad de los procedimientos, el riguroso control de la calidad de los datos y la comunicación y colaboración entre todos los sitios son imperativos. Los obstáculos incluyeron la complejidad de la organización, el reclutamiento de colaboradores y personal de investigación, la cooperación institucional, el desarrollo de infraestructura y la definición de los recursos. Antes de comenzar el trabajo sobre el terreno, se debe llegar a un consenso acerca de mediciones y resultados uniformes y la metodología de recopilación de datos, así como un plan para la gestión y el análisis de los datos y la comunicación, publicación y difusión de los resultados del estudio. A pesar de que estos estudios constituyen un desafío, hacen posible establecer una base científica para los estudios sobre la nutrición, la actividad física y otros temas de salud, al facilitar las comparaciones entre los países de América Latina.

Background: In the treatment of depression, primary care teams play an important role, whose effectiveness improves when inserted into a collaborative model of disease management. Aim: To report the results of a clinical trial carried out to test the effectiveness of a collaborative program between primary health teams and specialists supported by an electronic platform. Material and Methods: Physicians from four community hospitals belonging to the Reloncavi Health Service network, recruited 81 patients with depression aged 37 to 43 years, 84% of whom were female. Participants were divided in an active group, which participated in the collaborative program and a control group, which received the usual care, according to the Ministry of Health’s Guidelines for Depression. The main outcome was the Beck Depression Inventory (BDI-I) score at three months of intervention. Results: Participants had an average of 29.6 points (95% CI: 27.6-31.6) in the BDI-I and 38% of them had a high suicide risk. There were no statistically significant baseline differences between active and control group. In the intervention group, the BDI-I score changed from 30.0 (95% CI 27.0 to 32.8) to 15.3 (95% CI 11.8 to 18.8). In the control group the score changed from 29.2 (95% CI: 26.4-31.9) points to 20.8 (95% CI 16.8 to 24.7). The decrease was significantly higher in the intervention groups. Conclusions: A program of this kind may be useful to assist primary care teams in remote areas of the country to improve treatment outcomes for depression.

Background: Suicidal behaviors and depression are prevalent phenomena among adolescents, and are considered a public health problem. Aim: To determine the prevalence of depressive symptoms and suicidal behaviors and the relationship between both phenomena, in a representative sample of students from ninth grade in Santiago, Chile. Material and Methods: We recruited a probability sample of 2,597 adolescents who answered a questionnaire with questions about suicidal behavior and the Beck Depression Inventory (BDI-II). Results: The lifetime prevalence of suicidal ideation and planning was 21 and 14%, respectively. The prevalence for the past two weeks was 6.7 and 4.4% for suicidal ideation and planning, respectively. Autolytic behaviors, once in lifetime and in the past week were referred by 26 and 4% of respondents, respectively. In one third of these, self-harm coincided with recent suicide ideation or planning. All levels of suicidal behavior were more frequently reported by women. Clinically significant depressive symptoms were present in 23.5% of adolescents. Females doubled male rates. Severe depressive symptoms were present in 9.4% of the sample. A higher level of suicidal behavior correlated with more severe forms of depression. Sixty percent of adolescents who reported recent self-harm, had clinically relevant depressive symptoms. Two thirds of them had severe symptoms. Conclusions: Suicidal behavior in Chilean adolescents is prevalent, and there is an association between this behavior and the level of depression. The school is a good place to identify and develop preventive measures for teenagers.

Background: The presence of emotional problems may trigger drug abuse. Aim: To determine the association between illicit drug use and severity of depression symptoms among students of public secondary schools in Santiago, Chile. Material and Methods: A probabilistic sample of2,597 adolescents aged between 12 and 18 years (45% women), attending first year in public high-schools in Santiago, answered self-report questionnaires about consumption, during the last 30 days ,of alcohol, tobacco and marihuana, and the Beck Depression Inventory - II. Logistic regression models were used to study the association between drug use and severity of depression symptoms, adjusting by sex. Results: Tobacco and marihuana use was reported by 38 and 13% of students, respectively. Frequency of consumption was significantly higher among women. Mild, moderate or severe depressive symptoms were found among 16%, 14% and 9% of students, respectively. Depressive symptoms were more common among women. There was a significant association between drug use and severity of depression among participants of both genders. Conclusions: The association between depressive symptoms and drug use should be considered on the design of treatment guidelines for these health problems in Chile.

Background: Chile is receiving immigrant populations coming from other Latin-American countries. Aim: To determine the prevalence of Common Mental Disorders (CMD) among immigrants who live in Independencia, a quarter in Santiago, Chile. Material and Methods: A cross sectional study was carried out in the primary health care clinic and in the state-funded school of Independencia. A representative sample of 282 adults and 341 children were interviewed. Mental disorders were diagnosed using CIS-R and MINI structured interviews. Results: The interviewed immigrants came mostly from Peru. The prevalence of mental disorders in the adult population was 17.8% and among children, it was 29.3%. Conclusions: The adult immigrants have a lower prevalence of mental disorders than the Chilean population but it increases among children. Barriers of access to health services, that should be solved, were detected.

Background: Postpartum depression (PPD) is a mood disorder that occurs during a specific period of women’s lifetime: puerperium. The prevalence of PPD ranges from 8% to 30%, and a three-fold increase is seen in emerging as compared to developed countries. Aim: To characterize women consulting in primary care facilities for PPD. Material and Methods: Social and demographic features, obstetrical history, clinical symptoms and puerperal care of 440 postpartum women that sought help in primary care and were diagnosed as depressed, are described. Results: These women had no paid employment (82.7%), had unplanned pregnancies (62.5%) and lacked adequate social support (59.4%). From the clinical viewpoint, most of these puerperal women had a family history of depression (64.2%) and 31% had suffered from previous depressive episodes. The clinical symptoms of these patients consisted of depressed mood (93.2%), anhedonia (87.9%) and fatigue (87%). Conclusions: Women depressed postpartum form a group that requires more clinical attention due to its great biological vulnerability, active depressive symptoms, and enormous psychosocial risk. The mother and child program, which benefits them, needs to be combined with a mental health component that can offer them a treatment adapted to their psychosocial context.

Background: Depression is common among women, specially during breeding. Aim: To characterize post-partum depression in a group of women attending a primary health care clinic and its relationship to quality of life. Material and methods: The sample included women meeting criteria for Major Depression, with a child of up to 11 months old. Exclusion criteria included the presence of psychosis, history of mania, alcohol abuse, illegal drug use, high suicide risk, and receiving mental health care in the last three months. Structured interviews used were the Edinburgh postpartum depression scale (EPDS), Mini International Neuropsychiatric Interview (MINI), Medical Outcomes Study Questionnaire (SF-36) and questions about incapacity and health care use. Results: The sample included 159 women with a median age of 27 years (range: 16-43 years). Thirty three percent were married, 30.8% lived in common law marriage, 9.4% were divorced, and 26.4% were single. Most (89.3%) were housewives, 31% were students, and 6.9% were employed. The average score on the EPDS was 17 points (S.D. 4.2). The average SF-36 somatic score was 42.7 points (S.D. 8.2), and the emotional score was 30.3 (D.S. 0.3). The relation between the average score on the EPDS and the somatic and emotional scores was statistically significant (p=0.000-0.006). Conclusions: Most women were mildly to moderately depressed. Their depression was associated with a marked impairment of activities of daily living. These findings add to the evidence suggesting that depression is associated with marked disability cultures, even when the depression is mild to moderate

Cytochrome P450 (CYP) enzymes participate in the metabolism of a variety of naturally occurring and foreign compounds by reactions requiring NADPH and O2. The diversity of reactions catalyzed and its extensive substrate specificity render CYP enzymes as one of the most versatile known catalysts. Individual members of the CYP superfamily are expressed in almost every cell type in the body. As compared to hepatic enzymes, the regulation of human extrahepatic CYPs has not been so well studied. In general, the levels of some hepatic CYP enzymes are depressed by diseases, causing potential and documented impairment of drug clearence and clinical drug toxicity. However, modulation of CYPs is enzyme selective and this selectivity differs in different diseases. This article reviews some basic concepts about CYP and its regulation in some disease states such as hypertension, diabetes, obesity and hepatic, infectious and inflammatory diseases (Rev Méd Chile 2004; 132: 85-94).