Presentación en Congreso Mundial de Psiquiatría Infantil

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Los docentes de la Unidad, Muriel Halpern, Marcela Larraguibel, María Elena Montt y Matías Irarrázaval participaron como presentadores en el 22º Congreso de la Asociación Internacional de Psiquiatría Infantil y Especialidades Asociadas (International Association for Child and Adolescent Psychiatry and Allied Professions World Congress, IACAPAP), en Calgary, Canada.

El Dr. Irarrázaval presentó los resultados preliminares de su proyecto FONDECYT 11130615 y dirigió el Simposio denominado “Promoting Resilience in Latin America: Mental Health Research Initiatives in Chile” (Promoviendo la Resiliencia en Latinoamérica: Iniciativas de Investigación en Salud Mental en Chile”. Este Simposio es el primer Simposio aceptado por un grupo chileno en un congreso de la IACAPAP y fue el único organizado exclusivamente por investigadores de Latinoamérica, mostrando los resultados de tres iniciativas que se están desarrollando en nuestro país:

  1. A Pilot Randomized Controlled Trial of a Preventive Intervention Program for Depression in Chilean families
 (Prieto Fernanda, Irarrázaval Matías et al.)
    Objective: To evaluate the acceptability and feasibility of an adaptation of the Beardslee Preventive Intervention Program for Depression in Chilean families.
    Methods: 
    Study Design: Pilot two-group, single-blind, randomized controlled trial. Families (n=64) with at least one child between  6–12 years of age, and one parent with actual episode or history of depression will be recruited. Families will receive seven sessions delivered at their homes. This will include psychoeducational and interpersonal techniques focusing on increased understanding within the family, education about mood disorders, and promotion of resilience-related behaviors and attitudes.
    Primary Outcome: Acceptability and feasibility of the intervention. Qualitative and quantitative information about parents and the caregivers experience after each session, and after the intervention for further optimization. Secondary outcomes: The effects of the family intervention on parental depression, children’s depressive and internalizing symptoms and global family functioning (1 year follow–up).
    Results:
    This is an ongoing project, which is expected to provide a useful tool in the prevention of depression and comorbid disorders in children with depressed parents. Results will be available between June and July 2016.
    Discussion:
    Recent efforts to develop preventive interventions for children with depressed parents have been successful and suggest that the preventive approach for depression is not only desirable, but also feasible. The Beardslee Preventive Intervention is a strategy for families with parental depression that promotes significant and sustained positive effects on mental health and functioning of children and parents; and it is expected to have similar results in our country.
  2. Encouraging Early Prevention of Mental Disorders in Primary Healthcare: The Child Psychiatry Support Program (API) (Ortega Beatriz et al.)
    Introduction: The Child Psychiatry Support Program (API) is a collaborative mental health initiative, between Primary Healthcare Centers (PHC) and tertiary level mental health services in Valparaíso, Chile. The program includes a daily telephone consultation, multidisciplinary assessment and training of primary care practitioners (PAP) on mental health evaluation and treatment tools, in order to promote early prevention, early diagnosis and treatment of mental disorders, and reduce chronicity and referrals to tertiary health care level.
    Objectives: To describe the effectiveness of the API program in terms of frequency of referrals, and satisfaction of the primary care practitioners.
    Methods: A longitudinal, prospective, quasi-experimental study of time series of two groups over a period of 12 months. The frequency of referrals before and after the program were quantified and compared. The satisfaction of the primary care practitioners with the program was assessed through API/MCPAP surveys applied before and after the intervention.
    Results: Over a period of 12 months, 105 phone calls were received. 64 consultancies were completed, 19 were for training in the assessment and treatment in child mental health and 45 for multidisciplinary assessment. Between 2012 and 2013, there was a 13% decrease in the number of mental health referrals, and an 8% decrease in the referrals rates during the same period. There was a statistically significant improvement in the satisfaction of the PAP teams in terms of access to psychiatry consultation, sense of capacity to meet their needs and timely answers to their questions by a mental health specialist. 73% of the PAP felt comfortable diagnosing and treating child and adolescent psychiatric patients in primary health care, attributed to this collaborative program.
    Conclusions: The API program has proven to be an innovative and useful resource for primary health care teams. It significantly improved their satisfaction on access and timely response to psychiatry consultation, and response capacity in child and adolescent mental health. The API Program appears to be a useful tool for early prevention of mental health problems, by achieving greater resoluteness at the primary health care level, and reducing the referral to the mental health specialist unit.
  3. VOLANTIN (Kite) Program: A Resilience Promotion Program for Chilean School Aged Children. (Halpern Muriel, Larraguibel Marcela, Montt María Elena)
    Introduction: 

    Adapting interventions for a population different to the one for which it was originally designed is a key factor in the effectiveness of preventive programs. Considering this, a promotion program to increase resilience was adapted for Chilean children.
    Objectives:
    Present the developing and preliminary results of acceptability and efficacy of the program “VOLANTIN” in Chilean school-aged children.
    Methods:
    Phase I: elaboration of Volantin, a resilience promotion program adapted for school-aged Chilean population. 40 children (ages 7 – 11) from two public schools in Santiago completed a Visual Images Preference survey. The visual design for the program was selected considering these results. It’s acceptability and applicability were tested in a sample of school-aged patients from a community mental health center (N=10).
    Phase II: program adaptation and other changes made according to phase I results. Afterwards, 31 students, aged 8-9 years (41% female) were intervened. Pre and post intervention assessment was done.
    Results:
    Phase I: The VOLANTIN resilience promotion program for school-aged children was based in a comprehensive family and integrative personal developmental model. Key components of the program include: accepting diversity, adopting healthy habits, adaptive social skills, emotion regulation and problem solving skills, impulse control, assertiveness and cognitive restructuring. Originally, it consisted of nine sessions for children and one session for their parents. The program was easily applied and well received by the patients sample.
    In Phase II : Modifications were done and the current version of the program consists in ten sessions for children and one session for parents.
    Children who followed the program showed significant reduction in anxiety symptoms (F= 14.204; p<0.001). Decrease in depressive symptoms and increased self-esteem were observed, however these results did not achieve statistical significance.  There were no difference in the average score of The School Aged Resilience Scale and the Volantin Questionnaire pre and post intervention and there were no sex differences in the results.
    Conclusions:
    VOLANTIN program appears to be a promising intervention for school-aged students showing a significant reduction in anxiety symptoms. A larger sample is required to test the efficacy of the program and to better assess other variables that showed no significant reduction.

 

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