The objective of this work was to determine the frequency and clinical associations of anti-ribosomal P protein antibodies (Anti-P) in a cohort of Chilean patients with systemic lupus erythematosus (SLE). Between 1996 and 1998, 141 consecutive patients with SLE were examined prospectively according with a standard protocol. Disease activity was measured by MEX-SLEDAI in 138 patients. Anti-P positivity was determined by double immune diffusion or Western blot and ELISA. Anti-P was found in 21 (15%) patients. In the Anti-P positive patients recent onset SLE (disease duration of 1 year or less) was more frequent (P = 0.018). Anti-P was found in 23% of 83 patients with active SLE vs 4% of the 55 patients with inactive SLE (Yates corrected P = 0.00479). An association with anti-dsDNA antibodies by Farr assay was observed. Anti-P positive patients had a median Farr of 65 IU/ml (1.4-1240) and Anti-P negative of 12 IU/ml (1.4-992; P-value = 0.0084). During the study only two patients had lupus psychosis and they were Anti-P positive. No association was found with liver disease (six patients, two with Anti-P antibodies) or active glomerulonephritis (22 patients four with Anti-P). Our data shows that the presence of Anti-P antibodies supports the clinical diagnosis of lupus psychosis.
Objective: To analyze suicidal behavior and build a predictive model for suicide risk using data mining (DM) analysis. Methods: A study of 707 Chilean mental health patients (with and without suicide risk) was carried out across three healthcare centers in the Metropolitan Region of Santiago, Chile. Three hundred fortythree variables were studied using five questionnaires. DM and machine-learning tools were used via the support vector machine technique. Results: The model selected 22 variables that, depending on the circumstances in which they all occur, define whether a person belongs in a suicide risk zone (accuracy = 0.78, sensitivity = 0.77, and specificity = 0.79). Being in a suicide risk zone means patients are more vulnerable to suicide attempts or are thinking about suicide. The interrelationship between these variables is highly nonlinear, and it is interesting to note the particular ways in which they are configured for each case. The model shows that the variables of a suicide risk zone are related to individual unrest, personal satisfaction, and reasons for living, particularly those related to beliefs in one's own capacities and coping abilities. Conclusion: These variables can be used to create an assessment tool and enables us to identify individual risk and protective factors. This may also contribute to therapeutic intervention by strengthening feelings of personal well-being and reasons for staying alive. Our results prompted the design of a new clinical tool, which is fast and easy to use and aids in evaluating the trajectory of suicide risk at a given moment.
aim: In efforts to develop reliable methods to detect the likelihood of impending suicidal behaviors, we have proposed the following.Objective: To gain a deeper understanding of the state of suicide risk by determining the combination of variables that distinguishes between groups with and without suicide risk.Method: A study involving 707 patients consulting for mental health issues in three health centers in Greater Santiago, Chile. Using 345 variables, an analysis was carried out with artificial intelligence tools, Cross Industry Standard Process for Data Mining processes, and decision tree techniques. The basic algorithm was top-down, and the most suitable division produced by the tree was selected by using the lowest Gini index as a criterion and by looping it until the condition of belonging to the group with suicidal behavior was fulfilled.results: Four trees distinguishing the groups were obtained, of which the elements of one were analyzed in greater detail, since this tree included both clinical and personality variables. This specific tree consists of six nodes without suicide risk and eight nodes with suicide risk (tree decision 01, accuracy 0.674, precision 0.652, recall 0.678, specificity 0.670, F measure 0.665, receiver operating characteristic (ROC) area under the curve (AUC) 73.35%; tree decision 02, accuracy 0.669, precision 0.642, recall 0.694, specificity 0.647, F measure 0.667, ROC AUC 68.91%; tree decision 03, accuracy 0.681, precision 0.675, recall 0.638, specificity 0.721, F measure, 0.656, ROC AUC 65.86%; tree decision 04, accuracy 0.714, precision 0.734, recall 0.628, specificity 0.792, F measure 0.677, ROC AUC 58.85%).
Se estudió la relación entre estilo de vivencia depresiva, satisfacción familiar, malestar en las relaciones interpersonales y conducta suicida en 405 consultantes a salud mental en la Región Metropolitana, Chile, a través de una muestra intencionada. Se clasificaron en: intento de suicidio de alta gravedad, intento de suicidio de baja gravedad, ideación suicida y sin conducta suicida. Se utilizaron los instrumentos DEQ, OQ-45.2, APGAR, RFL, Escala de Riesgo-Rescate y Escala de Intención Suicida. Se realizaron ANOVA, 2 y modelos de mediación y moderación de procesos condicionales. El grupo con intento suicida de alta gravedad mostró una predominancia del estilo dependiente. Hubo una alta presencia del estilo autocrítico en la muestra total, especialmente en el grupo con ideación suicida. Los grupos con riesgo suicida presentaron mayores índices disfuncionales de malestar interpersonal y una mayor percepción de disfuncionalidad familiar grave que el grupo sin conducta suicida. La satisfacción con el funcionamiento familiar mostró un efecto en la intencionalidad de morir al momento del intento de suicidio. Estos resultados subrayan la importancia del funcionamiento familiar y las relaciones interpersonales en el riesgo suicida.Palabras clave: suicidio, relaciones familiares, relaciones interpersonales, trastorno depresivo, riesgo suicidaThe relationship between depressive experience style, family satisfaction, discomfort in interpersonal relationships, and suicidal behavior was studied in a purposive sample of 405 mental health patients in the Metropolitan Region of Chile. They were classified into high severity suicide attempt, low severity suicide attempt, suicidal ideation, and no suicidal behavior. The instruments used were: DEQ, OQ-45.2, APGAR, RFL, Risk-Rescue Rating Scale, and Suicidal Intent Scale. ANOVA, 2 , and models of mediation and moderation of conditional processes were conducted. The high severity suicide attempt group showed a significant predominance of the dependent style compared with the group without suicidal behavior. There was a high presence of the self-critical style throughout the sample, especially in the suicidal ideation group. The groups with suicide risk had higher dysfunctional rates of interpersonal discomfort and a greater perception of severe family dysfunction than the group without suicidal behavior. Satisfaction with family functioning was observed to influence the intention to die at the time of the suicide attempt. These results underscore the importance of family functioning and interpersonal relationships in suicide risk.
The study shows a discrepancy between the importance given to social responsibility and academic primary care training in Latin America and the practices implemented by medical schools. It highlights the need to refocus medical education policies in the region.
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