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
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; Núñez 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
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
Normative data for test of verbal fluency and naming on ecuadorian adult population
(Frontiers Media, 2020) Rodríguez Lorenzana, Alberto; Benito Sánchez, Itziar; Adana Díaz, Lila; Paz, Clara; Yacelga Ponce, Tarquino; Rivera, Diego; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Objective: To generate normative data for verbal fluency and naming test in an Ecuadorian adult population. Methods: The sample consisted of 322 healthy adults (18–84 years old) recruited from Quito, Ecuador. The verbal fluency and Boston Naming Test (BNT) were administered as part of a larger comprehensive neuropsychological battery. Multiple linear regression analyses were used to generate the normative data taking into account age, education, and sex. Results: For phonological verbal fluency, results indicated that only education was significantly related to the performance of the letters “A,” “S,” and “M.” However, the performance on the letter “F” was significantly associated with age and education. For semantic fluency, the performance on “animals” was significantly influenced by age, quadratic age, and education, whereas that for “fruits” was explained by quadratic age, education, and sex. The performance on the BNT was significantly influenced by age and education. A Microsoft Excel-based calculator was created to help clinicians to obtain the normative data on this test. Conclusion: This normative data will help neuropsychologist in Ecuador to use these tests both in research and in their clinical practice to improve the diagnosis of cognitive deficits in the population.
Open Access
A nationwide study of incidence and mortality due to traumatic brain injury in Ecuador
(Karger, 2020) Ortiz-Prado, Esteban; Mascialino, Guido; Paz, Clara; Rodríguez Lorenzana, Alberto; Gómez-Barreno, Lenin; Simbaña-Rivera, Katherine; Díaz, Ana María; Coral-Almeida, Marco; Espinosa, Patricio S.; Ciencias de la Salud; Osasun Zientziak
Objective: Traumatic brain injury (TBI) is a public health problem worldwide. Information regarding TBI from low- and middle-income countries is scarce. The objectives of this study are to determine the incidence, mortality and geodemographic distribution of TBI in Ecuador. Methods: A population-based analytical study from 2004 to 2016 was conducted in Ecuador. Men and women with a diagnosis of TBI from all ages (0–110 years) were included. Data was obtained from official hospital-discharges records and retrieved from the National Institute of Statistics and Census (INEC) Database. We analyzed data by region, province and canton with a monthly resolution. The incidence, mortality, case fatality rates and the risk of developing TBI within the population were calculated based on the last 13 years of available data. Results: A total of 124,576 hospital admissions and 5,264 deaths due to TBI were registered in Ecuador from 2004 to 2016. The overall TBI-related hospital admission rate was 70.68 per 100,000. The sex- and age-specific rate was 90.1 per 100,000 for men and 64.1 per 100,000 for women. Mestizos’ population has the highest adjusted incidence rate of 195.6 per 100,000, followed by the indigenous with 61.4 per 100,000 and Afro-Americans with 14.2 per 100,000. The overall annual mortality rate during the study ranged from 2.11 to 3.35 per 100,000. Case fatality rates were significantly higher in older populations, becoming fatal in up to 27% of men >90 years/old and in 15% of women older than 90 years/old. Conclusion: This is the first recorded epidemiological study of the socio-demographic distribution of TBI in Ecuador to date. The study found that young men were almost 4 times more likely to be hospitalized due to TBI than women of this age. Fatalities due to TBI were less likely to occur among younger age groups, increasing significantly among the elderly population. The national incidence rate of TBI has been decreasing since 2011, which coincides with the introduction of stricter alcohol regulation, suggesting that this measure might have played a role in this reduction.