Dra. Salvo-Garrido, Lilian

El suicidio es una importante causa de muerte en personas de 60 y más años. Los intentos de suicidio (IS) son un poderoso factor de riesgo. Objetivo: Describir y evaluar la relación de características sociodemográficas y clínicas con IS en personas mayores hospitalizadas en Unidad de Psiquiatría del Hospital Herminda Martin de Chillán, Chile, y efectuar un seguimiento de dicha conducta durante 13 años. Métodos: Estudio correlacional con datos de base estadística y seguimiento de serie de casos durante 13 años. Participaron 49 personas mayores con IS y 194 sin IS que estuvieron en hospitalización psiquiátrica entre el 01/01/2011 y 31/12/2023. Se efectuó seguimiento hasta octubre de 2024. Se estudiaron variables sociodemográficas y clínicas. Se realizó análisis descriptivo y bivariado. Resultados: El IS se relacionó significativamente con grupo etario de mayor edad (mayores de 70 años), sexo masculino y presencia de factores estresantes en el grupo primario de apoyo y problemas de vivienda. Los métodos suicidas más empleados fueron la ingesta de medicamentos y la asfixia por ahorcamiento. La conducta suicida se relacionó significativamente con diagnóstico psiquiátrico especialmente con trastorno depresivo, pero no con enfermedad médica comórbida. Un porcentaje considerable tenía IS previos y reiteró la conducta post alta. Los factores precipitantes y razones para morir más aludidos fueron los conflictos familiares y sentimientos adversos. En el seguimiento se constató 1 suicidio, 2 muertes por complicaciones de un nuevo IS y 1 muerte por condiciones médicas durante su hospitalización por IS. Conclusiones: Las características de los IS de personas mayores se asemejan a las del suicidio. En este grupo etario se requiere focalizar la prevención no sólo en la pesquisa y tratamiento de la depresión, sino que también en conducta suicida previa, factores psicosociales adversos y en la continuidad de los cuidados con intervenciones de seguimiento.

Background: Clinical simulation is a strategy with broad support especially when face-to-face medical attention is difficult. In Psychiatry, the use and availability of simulation is lower than in other medical specialties, even for remote teaching. Aim: To report a pedagogical experience whose objective was to develop and implement the simulated patient technique as a teaching strategy for psychopathology and face-to-face Psychiatry for Psychiatry residents and remote for undergraduate medical students. Material and Methods: Six residents and 115 medical students participated in the activity. A descriptive qualitative-quantitative study was designed. Surveys were used to measure the quality and satisfaction of clinical simulation and simulation in psychopatho- logy and psychiatry. In addition, an opinion was requested about the activity. All residents and 104 students participated in the assessment. Results: The simulations were satisfactorily evaluated. The participants perceived that the pedagogical activity favored the development of generic competencies and specific skills for general Psychiatry. Conclusions: Simulation in Psychiatry does not replace face-to-face practical teaching, but it is a transitional and complementary method for clinical activities.

Suicide and suicidal behaviors are a significant public health problem, for which several prevention modalities have been implemented. The identification and treatment of suicidal risk is a critical step in prevention, especially in primary health care, a level where most of the population consults. This article focuses fundamentally on the research on suicide risk in primary care by proposing an action guide for the assessment and management initial of suicide ideas and attempts.

Background: Short-stay psychiatric hospitalization is a necessary resource to treat mental disorders with severe decompensation that cannot be resolved outpatiently. Knowledge of your results helps in clinical and administrative management. This study aims to evaluate the evolution of hospital indicators, sociodemographic and clinics characteristics of inpatients in a short-stay unit of psychiatry. Material and Methods: Longitudinal, retrospective, trend study was conducted in a universe of 4,563 egress of short-stay psychiatric unit of Chile, for 14 years, from 01/07/2005 to 30/06/2019. Hospital indicators, sociodemographic and clinical variables were evaluated. Results: during the period under study: The egress decreased, the average days were prolonged, the occupational index increased and the turnover rate decreased. A low number of patients, predominantly socioeconomic and psychosocial adversities, were frequently re-hospitalized. The greater the number of hospitalizations longest stay. Administrative and judicial hospitalizations were increased; the latter with the highest average stay. Hospitalization of males, adolescents, young people and older adults increased. Communes and primary care center with a greater population, proximity and access predominated. It remained frequency of schizophrenia and other psychotic disorders and personality disorders, doubled affective disorders, tripled substance disorders, doubled dual pathology, and personality disorder was common in comorbidity with substance disorder and affective disorders Conclusions: strategies would be required with the Judicial System and Health Service, implement adolescent unity and addiction unit, and strengthen multidisciplinary care for older adults.