There is increasing research exploring depression in carers of people with dementia. This study explored the relation of entrapment, shame and guilt to depression in a group of 70 carers of those with dementia. As in other studies the experience of entrapment in the role was highly related to depression. Moreover, experiences of shame relating to self-criticism, other people's expectations and the fear of their criticism were significantly related to depression, entrapment and guilt. Guilt however, as focused on the fears of harming others, letting others down and sense of responsibility, was not associated with depression or entrapment. Depression in carers may relate in part to feeling trapped in a role but also being vulnerable to criticism and feelings of inadequacy in that role. In this study, degree of behavioural disturbance/dependence was not found to be significantly associated with any of the research variables.

El presente estudio tuvo por objetivo describir la prevalencia de sintomatología de salud mental y hábitos de salud, y analizar diferencias según sexo, procedencia y nivel socioeconómico en una muestra por conveniencia de 601 estudiantes de 3 universidades chilenas de Arica, Concepción y Temuco. Los participantes respondieron la 1a Encuesta de Salud Mental Universitaria, la cual estuvo compuesta por 6 instrumentos de salud mental que miden variables sociodemográficas y cuadros de salud mental más frecuentes en esta población. A través de análisis de frecuencias y diferencias de grupos (t de Student y ANOVA), los resultados revelan que más de un 45% de los participantes presenta sintomatología de riesgo asociada a depresión, ansiedad, o estrés, existiendo comorbilidad; las mujeres presentan mayor ansiedad y estrés, mientras que los jóvenes de procedencia urbana mayor ansiedad. Un 5% presenta ideación suicida y un 14% revela conductas alimentarias de riesgo, siendo éstas más prevalentes en mujeres. Además, un 50% reporta síntomas de insomnio y un 42%, hipersomnia diurna, siendo esta última más frecuente en jóvenes urbanos. Existe un variado y preocupante consumo de sustancias, siendo los varones los que presentan mayor consumo en tabaco, alcohol, marihuana y alucinógenos, mientras que las mujeres consumen más tranquilizantes, constatando también diferencias en tabaco y alcohol según procedencia y nivel socioeconómico. Estas cifras corroboran la alta prevalencia de diferentes problemas de salud mental entre los universitarios de esta muestra, señalando la necesidad de profundizar su estudio e implementar programas de promoción, prevención y tratamiento oportuno en este grupo.

Background and Aims:A relatively small proportion of patients account for a disproportionate share of healthcare utilization and cost with, on average, 1% of patients responsible for 20-25% of cost, 5% of patients for 40% and 10% for two thirds. These “high-utilizers” frequently suffer from co-morbid medical and psychiatric illnesses, but they are not well characterized in terms of diagnoses, current treatment patterns, or long-term outcomes. We sought to characterize further such patients at a large inner city acute care hospital.Methods:We applied a validated tool, Patients At Risk for Re-hospitalization, to the entire hospital population and then performed a mixed methods (quantitative/qualitative) study of 100 patients judged to be at high risk (>67%) of re-hospitalization during the ensuing year.Results:Of over 130,000 patients, 6,000 were identified. These individuals were overwhelmingly non-elderly adults (96% ages 18-64). Most common medical diagnoses were hypertension (49%), asthma (41%), diabetes (33%), and HIV/AIDS (32%). Schizophrenia, bipolar illness, or other psychosis was found in 48%. Over two-thirds had substance abuse diagnoses. Although 56% had made at least one emergency department visit in the past two years, only 37% had seen a primary care provider. Patient interviews revealed high rates of unstable housing, social isolation, and failure to appreciate the severity of health problems.Conclusion:High utilizers of general health care have very high rates of serious mental illness and substance abuse. Interviews suggest need for improved medical/psychiatric coordination with community outreach. Although such interventions are resource intense, the economic and health benefits may be large.