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Biomedical subjects

B R Lima

Publications and source records attributed to B R Lima.

14 recordsLinked to original sources
PubMed1993

Emotional distress in disaster victims. A follow-up study.

One hundred thirteen adult victims of a major Latin American disaster were screened for emotional distress 1 and 5 years after the catastrophe. We used the Self-Reporting Questionnaire to identify emotionally distressed victims. Results indicate that the prevalence of emotional distress decreased from 65% in 1986 to 31% in 1990. However, a comparison of the symptomatology on these two assessments indicates a similarity in the frequency and profiles of symptoms among the distressed. Also, the most frequent symptoms and the strongest predictors of emotional distress were essentially the same. These findings provide empirical support to the clinically observed course of emotional symptomatology of disaster victims and to the focused training of health workers on selected emotional problems that are consistently present over time.

Adult↗
PubMed1992

Psychiatric disorders among emotionally distressed disaster victims attending primary mental health clinics in Ecuador.

Previous studies in developing countries have demonstrated post-disaster stress disorders in a substantial share of the people living through a natural calamity, but questions have remained as to the severity of these mental health problems. This article reports information derived from a 1987 study of Ecuadorian earthquake victims that shows many of the victims had diagnosable psychiatric disorders and provides insight into the nature of those disorders.

Adult↗
PubMed1992

[Psychiatric disorders among victims of disasters in Ecuador].

Previous studies in developing countries have demonstrated post-disaster stress disorders in a substantial share of the people living through a natural calamity, but questions have remained as to the severity of these mental health problems. This article reports information derived from a 1987 study of Ecuadorian earthquake victims that shows many of the victims had diagnosable psychiatric disorders and provides insight into the nature of those disorders.

Adolescent↗
PubMed1991

Psychiatric disorders among poor victims following a major disaster: Armero, Colombia.

We evaluated 102 adult victims of low socioeconomic status living in tent camps 8 months following the Armero disaster in Colombia to ascertain the level of psychiatric morbidity. Ninety-one percent of the subjects identified by the screening instrument as being emotionally distressed met DSM-III criteria for a psychiatric disorder. The most frequent diagnoses were posttraumatic stress disorder and major depression. These findings indicate that a simple screening instrument can be reliably used for the detection of significant emotional problems among disaster victims. They also show that these victims are not merely distressed; rather, they present clear and treatable psychiatric disorders that center on anxiety and depression. Interventions for their adequate management need to be designed, implemented, and evaluated. In a developing country, however, the high prevalence of mental disorders among disaster victims far exceeds the specialized mental health resources. The general health sector, particularly the primary level of care, must participate actively in the delivery of mental health services to meet this need, particularly for a socioeconomically disadvantaged population. The narrow range of psychiatric disorders detected among the disaster victims makes it possible to circumscribe the training of the primary care worker in disaster mental health to these priority conditions.

Adult↗
PubMed1989

Disaster severity and emotional disturbance: implications for primary mental health care in developing countries.

Two months following the 1987 earthquakes in Ecuador, 150 patients in the primary health care clinics of the area were screened for emotional problems; 40% of them were emotionally distressed. Risk factors included not being married, reporting poor physical or emotional health, and having ill-defined physical complaints. The findings from this research are discussed in relation to a disaster of much greater intensity, whose victims were studied by the authors, utilizing the same instrument and research design. The comparison between these 2 groups of disaster victims revealed that: 1) the prevalence of emotional distress was smaller among the Ecuador victims, but the frequency of symptoms among the distressed was similar for both groups; 2) the symptom profiles were remarkably similar; and 3) the most frequent symptoms and the strongest predictors of emotional distress were very similar. These findings support a focused training of health care workers on selected emotional problems that are regularly present among victims of different disasters.

Adolescent↗
PubMed1989

[Mental health for all in Latin America and the Caribbean. Epidemiologic bases for action].

The aim of this study was to estimate the needs for mental health services in Latin America and the Caribbean by the year 2000. Two types of data were used: statistics on mortality due to psychosocial and psychopathological causes, and data on psychiatric morbidity which were extrapolated from a study on the prevalence of psychiatric disorders in Puerto Rico. As a result of a rise in the prevalence of certain psychiatric disorders that lead to death, particularly those that involve violence, it is predicted that gross mortality from these causes will increase by 11.2% between 1985 and the year 2000. Parallel to this trend will be an increase in the number of years of potential life lost. In addition, it is estimated that 88.3 million people in Latin America and the Caribbean will suffer specific psychiatric disorders. This figure represents an increase of 48.1% over 1985. There will also be a rise in the gross prevalence figures for this group of disorders. There is no question that the predicted population growth differential will have a serious impact on the demand for mental health services. The worsening of socioeconomic conditions in Latin America and the Caribbean, coupled with other social factors, may cause the increases to be even greater. Health authorities, administrators, planners, and professionals will need to allow for this increased demand for services if the goal of mental health for all is to be attained by the year 2000.

Age Factors↗
PubMed1988

[Primary mental health care for the victims of the disaster in Armero, Colombia].

Seven to eight months after the disastrous volcanic mudslide that destroyed the town of Armero, Colombia, 200 victims were screened up by means of the Self-Reporting Questionnaire (SRQ) for emotional disorders identification. In order to assess disorders' specific nature, a 104-victim subsample was interviewed by psychiatrists. The most frequent diagnosis ranged among (a) Post-traumatic stress syndrome, (b) Depressión, and (c) Generalized anxiety disorder. Our findings help us to point out that (1) In a developing country a higher prevalence of well-defined emotional disorders among victims of any first-magnitude disaster is to be detected at such a level it can safely be said a real epidemic is to be tackled with, (2) Basically, the identified symptomatology confines itself to anxiety-depression disorders, (3) SRQ is indeed an apt instrument for disasters victims screening, and (4) Mental health specialized resources proved to be insufficient for an adequate coverage of the needs of the affected communities to be performed. As far as mental health is concerned, if the necessary services are to be offered so that all aspects involved are taken care of, it is imperative that victims be attended to by primary care workers. So far, mental health primary care area is still lacking a systematical research within a disaster situation framework. We understand that our paper may serve as an initial orientation for this care strategy being duly implemented and furthered up.

Adolescent↗
PubMed1987

Concurrent medical and psychiatric disorders among schizophrenic and neurotic outpatients.

The records of two groups of patients (358 schizophrenics and 69 neurotics), attending the community mental health center of the Johns Hopkins Hospital, were reviewed to assess the extent and severity of reported medical problems. Results indicate that 38% of the schizophrenics and 53% of the neurotics report medical problems, but schizophrenics present with serious medical problems more often than do the neurotics. The authors draw attention to the need for properly assessing the severity of these medical problems and for adequately coordinating psychiatric and medical care. Strategies to overcome these difficulties are suggested.

Adult↗
PubMed1987

Screening for the psychological consequences of a major disaster in a developing country: Armero, Colombia.

Seven months following the volcanic eruption that destroyed the small town of Armero, 200 victims were screened for emotional problems with the Self-Reporting Questionnaire, a simple and reliable instrument. Fifty-five percent of the victims were found to be emotionally distressed. Variables associated with the presence of emotional distress included living alone, having lost previous job, feeling not being helped, not knowing date for leaving temporary shelter, being dissatisfied with living arrangements, complaining of non-specific physical symptoms or epigastric pain, and presenting several physical problems. The high prevalence of emotional distress supports the need to deliver mental care to disaster victims in developing countries through the primary level of care. Our findings provide guidelines for early detection of individuals at risk for developing emotional problems.

Adolescent↗
PubMed1987

[Psychiatric epidemiology].

This paper presents a critical synthesis of models and methods in psychiatric epidemiology, with special reference to the developing world. Basic epidemiological concepts and their application to psychiatric epidemiology are reviewed. Lastly, the relevance of these developments for the Third World is described, underlining their role in General Health and Mental Health planning and policy.

Adolescent↗
PubMed1985

Coordination of services for outpatients under concurrent medical and psychiatric care.

The proportion of outpatients with concurrent medical and psychiatric problems is high and is expected to increase, but coordination of services has not been satisfactory. The medical and psychiatric records of 28 patients under regular psychiatric and medical care were abstracted, for a total of 323 visits, to ascertain issues related to assessment and coordination of care. Results indicate that psychiatric therapists and primary-care providers do not perform satisfactorily in assessing medical and psychiatric problems, respectively, and in initiating coordination of their patients' health care. The implications of these findings for the training, education, and supervision of staff are discussed.

Community Mental Health Services↗