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DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMíA Y BENEFICENCIA QUE AFECTAN LA TERAPéUTICA DEL INTENTO SUICIDA
Mondragón,Liliana; Monroy,Zuraya; Ito,Ma. Emily; Medina-Mora,Ma. Elena;
Acta bioethica , 2010, DOI: 10.4067/S1726-569X2010000100011
Abstract: the aim of this study is to know the conflicts between beneficence and autonomy principles present in physician-patient relationship during therapy of suicidal attempt. research was carried out in two psychiatry hospitals of the city of mexico. the sample included three subjects with suicidal attempt, older than 18 years, attended as outpatients for an injure self inflicted last year, and three psychiatrists treating these patients. information was obtained by individual interviews with previous informed consent. an argumentative discourse analysis was carried out to find meaning given by participants to bioethics principles and possible conflicts between them. conflicts between beneficence and autonomy were related to the benefit of treatment, respect to patients values and beliefs, among others. this study present relevant ethical considerations in the clinical scenery, by offering to the psychiatrist a bioethical analysis which allows him/her to act according with beneficence while respecting the autonomy of the patient in cases of suicidal attempt and, in this way, to give them better attention.
Los malestares masculinos: Narraciones de un grupo de varones adultos de la Ciudad de México
Fleiz Bautista, Clara;Ito Sugiyama, Ma. Emily;Medina-Mora Icaza, Ma. Elena;Ramos Lira, Luciana;
Salud mental , 2008,
Abstract: introduction distresses related to depressive conditions in men have not been sufficiently acknowledged, and yet less studied. the difference between distress and its attention is originated in factors such as a rigid and dual classification of the problem, a false conception that it is a <>, and the social stigma that leads men to accept and face negative emotional states that affect their life quality. this article shows the results of a qualitative study which sought to uncover the social construction of distress from a gender approach and to deepen the understanding about the way men live it and exteriorize it. the concept of loss was taken as a methodological strategy throughout the study to access the male distress experiences, considering that, before an emotionally meaningful loss or an unfavorable event, individuals may react using those experiences. method four adult men participated in the study; they were selected using an intensive intentional sampling strategy. we carefully selected only a few cases, seeking to characterize the object of study and to obtain profound information based on reality; they were males who had suffered an important loss. they received a detailed explanation of the study and its objectives, voluntarily accepted to participate and allowed the recording of the interviews. confidentiality and anonymity were guaranteed. the information was gathered by means of in depth interviews and a thematic guide. we developed categories of analysis from the guide and the study objectives to classify data. categories were grouped according to their meanings and they generated subcategories that allowed a deeper and more precise analysis. results the analysis focused on the experiences of four men: manuel (30 years old), oscar (36), josé (40), and rodrigo (40). they lived in mexico city. manuel and rodrigo completed high school education, while oscar and josé obtained a college degree. they had different marital status: oscar is
DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMíA Y BENEFICENCIA QUE AFECTAN LA TERAPéUTICA DEL INTENTO SUICIDA DISJUN ES NAS CONCEP ES SOBRE AUTONOMIA E BENEFICêNCIA QUE AFETAM A TERAPêUTICA DO INTENTO SUICIDA CONFLICTS BETWEEN AUTONOMY AND BENEFICENCE CONCEPTIONS WHICH AFFECT THE THERAPEUTICS OF SUICIDAL ATTEMPT
Liliana Mondragón,Zuraya Monroy,Ma. Emily Ito,Ma. Elena Medina-Mora
Acta Bioethica , 2010,
Abstract: El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía que se presentan en la relación médico-paciente durante la terapéutica del intento de suicidio. La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 a os -quienes eran atendidos en consulta externa a causa de una lesión autoinfligida en el último a o- y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos. Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma, procurar una mejor atención para ellos. O objetivo do trabalho é conhecer as disjun es entre os principios de beneficência e autonomia que se apresentam na rela o médico-paciente, durante a terapêutica do intento de suicidio. A pesquisa foi realizada em dois hospitais psiquiátricos da Cidade do México. A amostra incluiu três sujeitos com intento suicida, maiores de 18 anos, que eram atendidos em consulta externa por causa de uma les o autoinfligida no último ano, e a três psiquiatras que tratavam destes pacientes. A informa o foi obtida com prévio consentimento informado em entrevistas individuais. Se levou a cabo uma análise de discurso argumentado para encontrar os significados que os participantes outorgaram aos principios bioéticos e as possíveis disjun es entre estes. As discordancias entre a beneficência e a autonomia estiveram relacionadas com o benefício do tratamento e o respeito pelos valores e as cren as dos pacientes, entre outros. Este trabalho apresenta considera es éticas relevantes para o cenário clínico ao oferecer ao psiquiatra uma análise bioética que lhe permita atuar de acordo com a beneficência e respeitar a autonomia do paciente frente aos casos de inten o de suicidio e, desta forma, procurar uma melhor aten o para eles. The aim of this study is to know the conflicts between beneficence and autonomy principle
Characteristics of Mexican women admitted to emergency care units: alcohol consumption and related problems
Romero,Martha; Mondragón,Liliana; Cherpitel,Cheryl; Medina-Mora,Ma. Elena; Borges,Guilherme;
Salud Pública de México , 2001, DOI: 10.1590/S0036-36342001000600004
Abstract: objective. this article describes the demographic characteristics and psychological differences in a sample of female heavy and non-heavy drinkers who attended three emergency services of the mexican city of pachuca, hidalgo. material and methods. a sample of patients seen at emergency services (es) patients over the age of 18 was selected using es admission forms. twenty-five-minute, face-to-face interviews were conducted by a group of trained interviewers. patients answered various questionnaires and scales to measure alcohol consumption and to provide information on variables that have proved to be related to female drinking. results. thirty-six women (5.2%) out of 717 of the total number of women were found to be heavy drinkers according to the tweak scale. this group of women had 2.3 times the risk of becoming depressed, 2.87 times the risk of taking other drugs, 1.95 times the likelihood of having been sexually abused and 1.57 times the risk of displaying suicidal ideation. conclusions. data from this small analysis confirm international findings that problem drinking among females throughout the life cycle is linked to depression. as regards the screening instruments employed, it is necessary to conduct more in-depth research to enrich their contents and increase their reliability and validity when used among female populations. in this study, the tweak proved to be extremely useful for studies in emergency services. the english version of this paper is available too at: http://www.insp.mx/salud/index.html
Characteristics of Mexican women admitted to emergency care units: alcohol consumption and related problems
Romero Martha,Mondragón Liliana,Cherpitel Cheryl,Medina-Mora Ma. Elena
Salud Pública de México , 2001,
Abstract: Objective. This article describes the demographic characteristics and psychological differences in a sample of female heavy and non-heavy drinkers who attended three emergency services of the Mexican city of Pachuca, Hidalgo. Material and Methods. A sample of patients seen at emergency services (ES) patients over the age of 18 was selected using ES admission forms. Twenty-five-minute, face-to-face interviews were conducted by a group of trained interviewers. Patients answered various questionnaires and scales to measure alcohol consumption and to provide information on variables that have proved to be related to female drinking. Results. Thirty-six women (5.2%) out of 717 of the total number of women were found to be heavy drinkers according to the TWEAK scale. This group of women had 2.3 times the risk of becoming depressed, 2.87 times the risk of taking other drugs, 1.95 times the likelihood of having been sexually abused and 1.57 times the risk of displaying suicidal ideation. Conclusions. Data from this small analysis confirm international findings that problem drinking among females throughout the life cycle is linked to depression. As regards the screening instruments employed, it is necessary to conduct more in-depth research to enrich their contents and increase their reliability and validity when used among female populations. In this study, the TWEAK proved to be extremely useful for studies in emergency services. The English version of this paper is available too at: http://www.insp.mx/salud/index.html
El consumo de drogas en México: Resultados de la Encuesta Nacional de Adicciones, 2011
Jorge Villatoro,Ma. Elena Medina-Mora,Clara Fleiz Bautista,Midiam Moreno López
Salud mental , 2012,
Abstract: Introducción. En el contexto internacional, México es uno de los países con bajo nivel de consumo de drogas, pero que, a su vez, reporta un incremento si se consideran las tendencias epidemiológicas más recientes. Con la finalidad de mantener un diagnóstico actualizado del consumo de drogas en la población general y de identificar los grupos en mayor riesgo, se llevó a cabo la Encuesta Nacional de Adicciones 2011 (ENA). Objetivo Conocer la prevalencia alguna vez en la vida de uso de cualquier droga y de cualquier droga ilegal a nivel nacional y regional en población de 12 a 65 a os. Así como conocer las tendencias que ha seguido el consumo a partir de 2002. Material y métodos La ENA 2011 es un estudio aleatorio, probabilístico y polietápico con representatividad nacional y para ocho regiones del país. Incluye poblaciones rurales y urbanas. La muestra fue de 3 849 adolescentes y 12 400 adultos quienes contestaron un cuestionario estandarizado en versión computarizada que contiene las secciones de tabaco, alcohol, drogas médicas (opiáceos, tranquilizantes, sedantes, anfetaminas) e ilegales (mariguana, cocaína, crack, alucinógenos, inhalables, heroína y metanfetaminas). Todos los participantes leyeron y firmaron una carta de consentimiento informado. Se hizo énfasis en el carácter voluntario y confidencial de la información. Resultados La prevalencia de consumo de cualquier droga alguna vez en la vida a nivel nacional creció significativamente entre 2002 y 2011 al pasar de 5.0% a 7.8%, mientras que el consumo de cualquier droga ilegal incrementó de 4.1% a 7.2%. Por sexo, en los hombres el consumo de cualquier droga pasó de 8.6% a 13% y de drogas ilegales de 8.0% a 12.5%. En las mujeres, la primera aumentó de 2.1% a 3.0% y la segunda de 1.0% a 2.3%. Las drogas de preferencia continúan siendo la mariguana (6.5%) y la cocaína (3.6%). A nivel regional el consumo de cualquier droga creció significativamente en la Occidental (5.5% a 10.3%), Nororiental (5.5% a 10.3%), Norcentral (7.5% a 9.2%) y Centro Sur (4.2% a 7.5%). En cuanto a las drogas ilegales, también se encuentra un incremento estadísticamente significativo en estas regiones, sin embargo el crecimiento fue proporcionalmente mayor en la región Centro Sur, al pasar de 3.5% a 6.8%. Conclusiones Los resultados de la ENA se alan un crecimiento en el consumo de drogas ilegales de 2002 a 2011, especialmente de la mariguana. Asimismo, se observa que los hombres de 18 a 34 a os son la población más afectada por dicho consumo, mientras que en los adolescentes el aumento ha sido mínimo. Por otra parte, el estudio
Consumo de drogas entre adolescentes: resultados de la Encuesta Nacional de Adicciones, 1998
Medina-Mora Ma Elena,Cravioto Patricia,Villatoro Jorge,Fleiz Clara
Salud Pública de México , 2003,
Abstract: OBJETIVO: Describir el consumo de drogas y los factores de riesgo en adolescentes de 12 a 17 a os. MATERIAL Y MéTODOS: Los datos provienen de la Encuesta Nacional de Adicciones 1998, realizada en hogares ubicados en zonas urbanas de la República Mexicana. El dise o de la muestra fue probabilístico, estratificado y por conglomerados en varias etapas de muestreo, donde la última unidad de selección fue un individuo en la vivienda. Los resultados se analizaron obteniendo los intervalos de confianza de las prevalencias del consumo de drogas, y se realizó un análisis de regresión logística para evaluar los factores asociados con el consumo de drogas. RESULTADOS: El 3.57% de los varones y 0.6% de las mujeres habían usado una o más drogas excluyendo al tabaco y al alcohol; 2.14 de hombres y 0.45% de mujeres lo habían hecho en los doce meses previos al estudio, y 1.4 de los hombres y 0.3% de las mujeres en los 30 días anteriores a la encuesta. La mariguana es la droga más usada (2.4 y 0.45%), seguida por los inhalables (1.08 y 0.20%) y la cocaína (0.99 y 0.22%) por hombres y mujeres, respectivamente. El riesgo de usar drogas se asoció con ser hombre, no estudiar, considerar fácil conseguir drogas, no ver mal el uso de drogas por parte de los amigos, que éstos las usaran, usarlas por parte de la familia y estar deprimido. CONCLUSIONES: El entorno que rodea a nuestros jóvenes de 12 a 17 a os indica que el consumo de drogas está cada vez más presente. Los índices de consumo se han incrementado, especialmente en la región norte del país y en las grandes metrópolis (Tijuana, Ciudad de México y Guadalajara, principalmente). Estos datos refuerzan la necesidad de desarrollar campa as que permitan detectar a los menores que tienen problemas emocionales y darles la atención apropiada para evitar que consuman drogas como un mecanismo para enfrentar problemas de esta naturaleza. Asimismo, es necesario identificar a los menores con mayor probabilidad de desarrollar dependencia, quienes requieren de intervenciones preventivas más intensas.
Del tabaco al uso de otras drogas: el uso temprano de tabaco aumenta la probabilidad de usar otras drogas?
Medina-Mora Ma. Elena,Pe？a-Corona Marco Polo,Cravioto Patricia,Villatoro Jorge
Salud Pública de México , 2002,
Abstract: Objetivo. Analizar la probabilidad de abuso de sustancias en relación con la edad de inicio del consumo de tabaco. Material y métodos. Los datos provienen de la Encuesta Nacional de Adicciones (1998) realizada en población urbana. Resultados. La edad de mayor riesgo para experimentar con sustancias es entre los 15 y los 19 a os. Solamente en 5.6% de los usuarios de drogas y 13% de los que han consumido alcohol, el uso del tabaco no ocurrió primero. La probabilidad de beber en forma consuetudinaria y de presentar dependencia es mayor cuando la edad de inicio es temprana y disminuye en la medida en que se retrasa la edad de inicio. La experimentación con drogas, el continuar usándolas y el poliuso son más frecuentes entre quienes se iniciaron antes de los 15 a os. Conclusiones. El inicio temprano en el consumo de tabaco incrementa la probabilidad de uso y abuso de sustancias.
Consumo de drogas entre adolescentes: resultados de la Encuesta Nacional de Adicciones, 1998
Medina-Mora,Ma Elena; Cravioto,Patricia; Villatoro,Jorge; Fleiz,Clara; Galván-Castillo,Fernando; Tapia-Conyer,Roberto;
Salud Pública de México , 2003, DOI: 10.1590/S0036-36342003000700005
Abstract: objective: the aim of this paper is to describe drug and associated factors use among adolescents (12 to 17 years of age). material and methods: data come from the recent encuesta nacional de adicciones, 1998 (national survey on addictions) undertaken in urban areas of mexico. a probabilistic, multi-stage, stratified cluster sampling design was used to select the study population. the sampling unit was the individual in each household. statistical analysis consisted of the estimation of prevalences of drug use, with 95% confidence intervals. associations were analyzed using logistic regressions models. results: excluding tobacco and alcohol, 3.57% of males and 0.6% of females have used one or more drugs; 2.14% and 0.45% used them in the 12 months previous to the survey, and 1.4% and 0.3% in the previous 30 days, respectively. marihuana was the drug more often used by males (2.4%) and females (0.45%), followed by inhaled solvents (1.08% and 0.20%), and cocaine (0.99% and 0.22%), respectively. the risk of using illicit drugs was associated to being male, having dropped out from school, perceiving availability, drug use by family and friends, social tolerance among friends, and symptoms of depression. conclusions: adolescents between 12 to 17 years of age are exposed to increasing drug use. the rates of drug use have risen, especially in the northern region of mexico and in the big urban areas (tijuana, mexico city and guadalajara). these findings emphasize the need to develop campaigns to detect emotional problems. preventive measures should provide appropriate care to prevent drug use as a mechanism to cope with such emotional conflicts. also, more intense preventive interventions should be targeted to adolescents with a high probability of developing drug abuse.
La depresión con inicio temprano: prevalencia, curso natural y latencia para buscar tratamiento
Benjet,Corina; Borges,Guilherme; Medina-Mora,Ma Elena; Fleiz-Bautista,Clara; Zambrano-Ruiz,Joaquín;
Salud Pública de México , 2004, DOI: 10.1590/S0036-36342004000500007
Abstract: objective: to estimate the prevalence of early onset depression in the mexican population and compare its natural history, comorbidity and treatment latency between early onset and adult onset depression. material and methods: the national survey of psychiatric epidemiology (enep) is representative of the mexican urban population aged 18 to 65. the diagnostic instrument is the composite international diagnostic interview (cidi). statistical analysis was performed with descriptive and logistic regression analyses, considering the multistage, stratified and weighted sample design of the survey. results: two percent of the mexican population has suffered from depression as children or adolescents, with an average 7 episodes during their lifetime (compared with 3 episodes for adult onset); the first episode lasted a mean of 31 months (compared with 16 for adult onset) and generally did not receive any treatment. conclusions: the longer duration of the first episode and the greater number of lifetime episodes for subjects with early onset is attributed to the lack of early detection and of timely treatment of depression in mexican youth.
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