Open Access
Behavioral and sociodemographic predictors of anxiety and depression in patients under epidemiological surveillance for COVID-19 in Ecuador
(Public Library of Science, 2020) Paz, Clara; Mascialino, Guido; Adana Díaz, Lila; Rodríguez Lorenzana, Alberto; Simbaña-Rivera, Katherine; Gómez-Barreno, Lenin; Troya, Maritza; Páez, María Ignacia; Cárdenas, Javier; Gerstner, Rebekka M.; Ortiz-Prado, Esteban; Ciencias de la Salud; Osasun Zientziak
Ecuador has been one of the most affected countries by the Corona Virus Disease 19 (COVID-19) pandemic, by April 2020 this country presented the highest rates of mortality in Latin America. The purpose of the present study was to identify behaviors during confinement and sociodemographic variables associated with the mental health status of confirmed or suspected COVID-19 patients who were part of the epidemiological surveillance program in Ecuador that included mandatory confinement and self-isolation. A cross-sectional study was performed from March 22th to April 18th, 2020 using an online survey. The survey collected socio-demographic information and severity of depressive symptoms using the Patient Health Questionnaire-9 and anxiety symptoms through the Generalized Anxiety Disorder-7. A total of 759 patients completed the questionnaire, 20.3% presented moderate to severe symptoms of depression and 22.5% moderate to severe symptoms of anxiety. Being a woman and from the Coastal region were risk factors. Exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to an hour was associated with better mental health. Regression analysis indicated that the mentioned behaviors explained approximately 17% of the variance for depression sum scores and 11.8% of the variance for anxiety sum scores while controlling for gender and region. Understanding the association between sociodemographic variables and psychological states in patients with COVID-19 is relevant to tackle future public mental health problems and to implement health policies that are intended to palliate further psychiatric complications. Promotion of modifiable behaviors such as exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to less than an hour is recommended.
Open Access
Normative data for test of learning and memory in an Ecuadorian adult population
(Routledge, 2020) Rodríguez Lorenzana, Alberto; Nuñez Fernández, Silvia; Adana Díaz, Lila; Mascialino, Guido; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
Objective: The objective of this study was to develop norms for two neuropsychological tests of learning and memory in an Ecuadorian adult population. Method: 322 healthy individuals, ages between 18 and 84, were enrolled in the Metropolitan District of Quito. Participants were administered a comprehensive neuropsychological evaluation that included tests of learning and memory (Rey-Osterrieth Complex Figure Test [ROCF] and Hopkins Verbal Learning Test-Revised [HVLT-R]). Backward stepwise multiple linear regression analyses were used to examine the influence of demographic variables age, education, and gender on test performance. Normative data were developed adjusting for demographic variables found to be significant in the final regression models. Results: The final multiple linear models revealed performance on tests of learning and memory worsened with age and improved as a function of education. A user-friendly Excel-based calculator is presented to calculate the z score and percentile automatically based on raw score and sociodemographic information. Conclusion: This is the first study that presents normative data for tests of learning and memory for an adult population in Ecuador. It is expected that these norms will help to improve the clinical practice of neuropsychology in Ecuador by limiting erroneous raw score interpretation and incrementing diagnostic accuracy.
Open Access
Anxiety and depression in patients with confirmed and suspected COVID-19 in Ecuador
(Wiley, 2020) Paz, Clara; Mascialino, Guido; Adana Díaz, Lila; Rodríguez Lorenzana, Alberto; Simbaña-Rivera, Katherine; Gómez-Barreno, Lenin; Troya, Maritza; Páez, María Ignacia; Cárdenas, Javier; Gerstner, Rebekka M.; Ortiz-Prado, Esteban; Ciencias de la Salud; Osasun Zientziak
The rapid spread of the novel coronavirus, SARS-CoV-2 throughout the world has forced local and national administrations to take unprecedented measures to reduce the impact of the coronavirus diseases (COVID-19) pandemic. In South America, the arrival of the virus took longer than in other regions of the world, nevertheless, the impact has already been unprecedent. For instance, Ecuador was one of the most affected countries by the pandemic, reported hundreds of deaths each day during the last weeks of March and the first weeks of April 2020. The mortality rates were high during these months due to late implementation of restrictive measures of social distancing and limited capacity of health services (testing capacities and contact tracing). In this scenario, the Ecuadorian Ministry of Public Health (MoPH) established an epidemiological surveillance program for COVID-19 confirmed and suspected patients. The Department of Mental Health at the MoPH in Ecuador lead an active surveillance of the emotional impact of the disease by deploying an online self-reporting tool among patients to identify needs and provide standard of care treatment. The authors of this study were asked to participate in the development of this survey. The tool recorded sociodemographic variables and responses from two questionnaires: the Patient Health Questionnaire (PHQ-9) to measure the presence and severity of depressive symptoms, and the Generalized Anxiety Disorder (GAD-7) to assess the presence and severity of anxiety symptoms.
Open Access
Multivariate base rates of low scores on tests of learning and memory among Spanish speaking children
(Taylor & Francis, 2020) Benito Sánchez, Itziar; Ertl, Melissa M.; Ferrer Cascales, Rosario; Oltra Cucarella, Javier; Ibáñez Alfonso, Joaquín A.; Saracostti Schwartzman, Mahia; Soto Añari, Marcio; Cadavid Ruiz, Natalia; Rodríguez Lorenzana, Alberto; Rivera, Diego; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
To determine the prevalence of low scores on two neuropsychological tests commonly used to evaluate learning and memory in children. 6,030 healthy children from 10 countries in Latin America and Spain were administered Rey–Osterrieth Complex Figure (ROCF) and the Test de Aprendizaje y Memoria Verbal–Infantil (TAMV-I). Results showed that low scores are common when multiple neuropsychological outcomes (tests and/or scores) are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores in a given individual when evaluating learning and memory using various sets of scores to reduce false-positive diagnoses of cognitive deficits in pediatric populations.
Open Access
Marital stability during the year after traumatic brain injury in an ecuadorian sample: a repeated-measures study
(MDPI, 2024-11-26) Mascialino, Guido; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Watson, Jack D. ; Rodríguez Lorenzana, Alberto; Paz, Clara; Ciencias de la Salud; Osasun Zientziak
Background: Traumatic brain injury (TBI) is a major cause of death and disability worldwide and often leads to long-lasting emotional, physical, and cognitive changes and results in reduced functioning across multiple domains. These changes often lead to strain in marital relationships as the uninjured spouse grapples with adapting to the changes in their partner. Aims: The purpose of this study was to examine the probability of marital stability after TBI at 6 and 12 months following injury (i.e., probability trajectory across those two time points), as well as predictors of that probability trajectory. Methods: The study design was repeated-measures and observational. Patient recruitment and follow-up took place from January 2018 to March 2020 in Quito, Ecuador. Ninety-seven TBI survivors were recruited while hospitalized in the neurosurgery unit of Hospital Eugenio Espejo, a tertiary care center. Patients were assessed at 6 and 12 months after their injury. Hierarchical linear modeling (HLM) was used to examine baseline predictors of linear marital probability trajectories across 6 and 12 months after injury. A final set of HLMs included each of the previously significant predictors from the first model, time, and the interaction terms between time and the previously significant predictor. Results: The first HLM found that marital probability remained stable between 6 and 12 months after TBI. Individuals who were employed at baseline had higher marital probability trajectories than those who had been unemployed. Older individuals had higher marital probability trajectories than younger individuals, and women had higher marital probability trajectories than men. Conclusions: This is the first study to examine marital probability trajectories for an Ecuadorian adult population with TBI, and the data are of great value to understanding post-TBI outcomes in the region. These results can inform interventions and support systems to bolster marital resilience in the aftermath of TBI. Further research is warranted to explore the nuances of these relationships and to validate these findings in diverse populations.
Open Access
Psychometric properties of the 28-item General Health Scale (GHQ-28): analysis from the classical test and item response theories in Ecuadorian university students
(Sapienza Università Editrice, 2024-12-16) Moreta-Herrera, Rodrigo; Rodríguez Lorenzana, Alberto; Mascialino, Guido; Castro-Ochoa, Fabián; Narváez-Pillco, Viviana; Caycho-Rodríguez, Tomás; Mayorga-Lascano, Marlon; Ciencias de la Salud; Osasun Zientziak
Background: Monitoring mental health in the university population is essential to be able to meet the demands and needs of this segment. For this, it is essential to have properly calibrated instruments to adequately describe reality and enerate adequate decision making. Aim: Confirm bi-factor model and measurement invariance by gender of the 28-item General Health Questionnaire (GHQ- 28) in universitystudents in Ecuador according to Classical Test Theory (CTT). In addition, analyze the discrimination parameters, item difficulty and global reliability according to the Item Response Theory (IRT). Participants and procedure: A descriptive and instrumental design of the GHQ-28 from a bi-factor model was used with 476 participants, of whom 61.5% were women and 38.5% men, aged 17 to 47 years (M = 21.2; SD = 3.7), from 34 higher education centers in Ecuador. Results: The factorial validity of the GHQ-28 was confirmed based on a bi-factor model. In addition, it showed measurement invariance across gender of the participants according to the CTT. The items of the scale present adequate discrimination and difficulty, and the global reliability of the measure is correct based on IRT. Conclusions: The GHQ-28 is a valid test that can be applied to a university population in Ecuador. The scale is essentially unidimensional in its assessment of psychological distress and the contribution of the IRT broadens and complements the information on the known items of the scale previously collected by the CTT.
Open Access
Normative data of neuropsychological tests of attention and executive functions in Ecuadorian adult population
(Routledge, 2021) Rodríguez Lorenzana, Alberto; Ramos Usuga, Daniela; Adana Díaz, Lila; Mascialino, Guido; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
Objective: The purpose of this study was to generate normative data for five tests of attention and executive functions (M-WCST, Stroop test, TMT, BTA, and SDMT), in a group of 322 Ecuadorian adults from Quito between the ages of 18 and 85. Method: Multiple regression analyzes taking into account age, education, and gender were used to generate the normative data. Results: Age and education were significantly related to test performance such that scores decreased with age and improved as a function of education. An online calculator is provided to generate normative test scores. Conclusions: This is the first study that presents normative data for tests of executive functions and attention in an Ecuadorian adult population. This data will improve the clinical practice of neuropsychology and help to develop the field in the country.
Open Access
Nivel educativo y la autonomía funcional en adultos que residen en Quito (Ecuador)
(Fundación Universitaria Konrad Lorenz, 2019) Adana Díaz, Lila; Cuadros-López, Alejandra; Andrango-Guerrón, Dilan; Rodríguez Lorenzana, Alberto; Yacelga Ponce, Tarquino; Loureiro, Clara; Ciencias de la Salud; Osasun Zientziak
La incapacidad funcional del adulto asociada al envejecimiento poblacional genera un problema de salud pública. El objetivo de este artículo es estudiar la asociación existente entre el nivel educativo y la autonomía funcional de los adultos del Distrito Metropolitano de Quito (DMQ) en Ecuador. Para ello se realizó un análisis secundario con la información de la base de datos del estudio “Montreal Cognitive Assessment (MoCA): datos normativos para la población ecuatoriana”, que tiene un diseño transversal con adultos de 45 a 85 años. Se utilizó un modelo multivariado de regresión logística. El tamaño muestral fue de 328 participantes, de los cuales 301 fueron incluidos. Los resultados muestran diferencias significativas en cuanto al nivel educativo y la autonomía funcional: primero, permiten observar que un nivel educativo igual o mayor a los 12 años de instrucción es un factor de prevención de la pérdida de la autonomía funcional; segundo, muestran que hay una mayor posibilidad de pérdida de autonomía en función de la edad. Esta asociación existente entre el nivel educativo y la preservación de la autonomía funcional en el adulto en el DMQ muestra la importancia de promover el acceso a prácticas educativas permanentes en la población como parte de un programa de prevención de la pérdida de la autonomía mencionada.
Open Access
Validation of the Purpose in Life Scale-Short Form in an ecuadorian sample: factor analysis, reliability and graded response model
(UCOPress, 2023) Moreta-Herrera, Rodrigo; Rodríguez Lorenzana, Alberto; Mascialino, Guido; Caycho-Rodríguez, Tomás; López-Calle, Claudio; Gallegos, Miguel; Cervigni, Mauricio; Martino, Pablo; Vilca, Lindsey W.; Ciencias de la Salud; Osasun Zientziak
Introducción: El propósito de vida se analiza dentro del bienestar psicológico, se trata del sentido de vida que tienen las personas, lo que tiene implicaciones en áreas como la salud mental. Actualmente se requiere instrumentación precisa para su valoración de la población ecuatoriana, la cual por el momento es limitada. Objetivo: corroborar la estructura unidimensional de la Escala de Propósito en la Vida-Versión Corta (PIL-SF), la equivalencia de medida según género, la confiabilidad y los parámetros de discriminación y dificultad en una muestra de adultos ecuatorianos. Métodos: Estudio instrumental del PIL-SF bajo los preceptos de la Teoría Clásica de Test y la Teoría de Respuesta al Ítem. Participantes: 743 adultos ecuatorianos (64.2% mujeres y 45.8% hombres) de 18 a 73 años (M = 24.7, DT = 7.9). Resultados: Se confirmó la estructura unifactorial del PIL-SF con ajuste adecuado. Además, el PIL-SF es invariante a nivel fuerte en función del género y no se presentan diferencias a nivel de medias latentes. La confiabilidad de la consistencia interna es aceptable por grupo y los parámetros de discriminación y dificultad de los ítems son adecuados. Conclusión: El PIL-SF es una herramienta válida, confiable y precisa para medir el constructo Propósito en la Vida en adultos ecuatorianos.
Open Access
Assessing the suitability and psychometric properties of the Spanish version of the YP-CORE for adolescents in Latin America: a study in Ecuador
(BMC, 2024-11-18) Valdiviezo-Oña, Jorge; Ortiz-Mancheno, Nicole ; Valdivieso-Arias, Gabriela; Erazo-Pérez, Diego; Rodríguez Lorenzana, Alberto; Evans, Chris; Paz, Clara; Ciencias de la Salud; Osasun Zientziak
Background: This study had two main objectives: firstly, to assess the suitability of the Spanish translation of the Young Person¿s Clinical Outcome in Routine Evaluation (YP-CORE) for use in Latin America, and secondly, to investigate its psychometric properties specifically with Ecuadorian adolescents. Methods: The research consisted of two phases. In Phase 1, insights were gathered from 19 adolescents and 12 experts regarding their comprehension of the YP-CORE. Based on the feedback received during this phase, a revised version of the YP-CORE was developed. In Phase 2, a psychometric assessment of this modified version was conducted with 298 adolescents in Ecuador, aged 11 to 17 years. Results: The psychometric analysis revealed that this adapted version of the YP-CORE demonstrated satisfactory levels of acceptability, internal consistency, and test-retest reliability. The factor analysis favored a two-factor model over a single factor, yet the minimal substantive distinctions between these two factors do not justify the use of subscale scoring. Furthermore, the scores indicated age-related differences, with older adolescents (aged 14 to 17 years) obtaining higher scores, and gender-related variations, with females scoring higher. Conclusions: This study addresses the need for, and provides, a Spanish-adapted YP-CORE tailored for use in Latin America. This freely available version has the potential to offer valuable insights into interventions for adolescents in the region and to enhance our understanding of their psychological distress.