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Biomedical subjects

G Canino

Publications and source records attributed to G Canino.

At least 55 records · Page 3Linked to original sources

Children of alcoholic parents in the community.

The relationship between parental alcoholism and risk for maladjustment in the offspring was investigated in a community sample. Children of parents who met criteria for DIS/DSM-III alcohol abuse or dependence and children of parents who met criteria for ten other diagnoses were compared to children of "normal" parents. The data were obtained from the merging of the data banks of two major psychiatric epidemiology studies of the adult (17-64) and child (4-16) population of Puerto Rico. Results indicated that parental alcoholism in addition to creating an adverse family environment had an effect on the relative risk for maladjustment in the offspring (as measured by scores on the Child Behavior Checklist). Although previous studies have reported higher levels of externalizing behaviors in children of alcoholics, an increased risk for internalizing symptoms was observed in the children studied. Similar findings were obtained for the children of parents with other psychiatric disorders suggesting that the effects of parental alcoholism in children ages 4 to 16 may not be different from the consequences of parental mental illness per se.

Adolescent↗

[Importance of the family as a resource in social support in Puerto Rico].

In this article we examine the role of the family in the provision of social support by studying the identity of persons which the participants consider available for providing support. We define social support as that human relationship in which socio-emotional (closeness, intimacy counseling), instrumental (goods and services) and recreational (companionship for recreation) resources are interchanged. Based on a probabilistic sample of the adult (17-68 yrs.) population, 912 persons were successfully interviewed (response rate = 90.4%) using a structured interview schedule. Results indicate that close relatives (parents, brothers/sisters, sons/daughters) are the main resource of all types of support, not only of the general population but also of specific demographic groups defined by their gender, age (17-39, 40-68) and schooling (0-11, 12 + yrs). The marital partner was also identified as an important support resource, especially emotional and recreational; more distant relatives were also important for providing instrumental support. Although the compared groups showed many similarities, they also differed in various aspects both when individually and jointly analyzed. It is concluded that the family is very important in the provision of social support in Puerto Rico (PR).

Adolescent↗

[Use of health services in Puerto Rico by persons with mental disorders].

As part of a major study on the prevalence of mental disorders in Puerto Rico, this paper describes the mental health care utilization patterns of persons with a DIS/DSM-III disorder within the last year. The main findings of this analysis show that (a) There is a high rate of health service utilization, (b) The public sector is the main provider of services, (c) People with a DIS disorder tend to resort to the non-psychiatric physician, (d) People with alcohol abuse and/or dependence tend to use the services of general practitioners while schizophrenics, somatizers, and people with cognitive impairment tend to apply for the services of mental health specialists. Seeking help from other sources such as clergymen or spiritualists does not substitute the use of health services.

Adolescent↗

[The Composite International Diagnostic Interview (CIDI): an epidemiologic instrument suitable for using in conjunction with different diagnostic systems in different cultures].

The Composite International Diagnostic Interview (CIDI), written at the request of the World Health Organization/US Alcohol, Drug Abuse, and Mental Health Administration Task Force on Psychiatric Assessment Instruments, combines questions from the Diagnostic Interview Schedule with questions designed to elicit Present State Examination items. It is fully structured to allow administration by lay interviewers and scoring of diagnoses by computer. A special Substance Abuse Module covers tobacco, alcohol, and other drug abuse in considerable detail, allowing the assessment of the quality and severity of dependence and its course. This article describes the design and development of the CIDI and the current field testing of a slightly reduced "core" version in Puerto Rico. The field test was being conducted in 19 centers around the world to assess the interviews' reliability and its acceptability to clinicians and general people in different cultures and providing data on which to base revisions that may be found necessary. In addition, questions to assess International Classification of Diseases, ninth revision, and the revised DSM-III diagnoses are being written. If all goes well, the CIDI will reliably allow investigators to assess mental disorders according to the most widely accepted nomenclatures in many different populations and cultures.

Cross-Cultural Comparison↗

[Utilization of health services in Puerto Rico of persons with mental disorders].

As part of a major study on the prevalence of mental disorders in Puerto Rico, this paper describes the mental health care utilization patterns of persons with a Diagnostic Interview Schedule (DIS) disorder within the last year. The main findings of this analysis show that a) there is a high rate of health service utilization, b) the public sector is the main provider of services c) persons with a DIS disorder use more the non psychiatric physician d) those with alcohol abuse and/or dependence tend to use more the services of general practitioners while schizophrenics, somatizers and those with cognitive impairment use more the services of mental health specialists. The use of other resources such as clergy or spiritualists do not substitute the use of health services.

Adolescent↗

The internal consistency and concurrent validity of a Spanish translation of the Child Behavior Checklist.

The Child Behavior Checklist's applicability to a Hispanic sample was assessed by an examination of the instrument's internal consistency and concurrent validity. The CBCL and TRF were administered to a community sample representative of children of Puerto Rico aged 4 to 16. Cronbach's alpha was used to assess the internal consistency of empirically derived scales. The relation of CBCL and TRF scores to clinical diagnosis, adaptive functioning, and need for services served as indicators of the concurrent validity of the instrument's Spanish version. The results indicate that the total behavior problem scores on the instruments are good continuous measures of maladjustment for children in Puerto Rico. A child with high values on the scales has a high probability of being classified as a case by a psychiatrist. High levels of internal consistency were found in most subscales. Only scales comprising low prevalence problems showed poor internal consistency.

Adolescent↗

Epidemiological comparisons of Puerto Rican and U.S. mainland children: parent, teacher, and self-reports.

U.S. mainland and Puerto Rican nonreferred samples were compared via the Child Behavior Checklist (ages 4 to 16), Teacher's Report Form (ages 6 to 16), and Youth Self-Report (ages 12 to 16). Problem scores were significantly higher in parent and teacher ratings of Puerto Rican than mainland subjects, but were significantly lower in self-ratings by Puerto Rican adolescents. Adolescents in both cultures reported significantly more problems than their parents or teachers did. Most of the significant cross-cultural differences in parent, teacher, and self-ratings of competencies showed more favorable scores for the mainland subjects. High referral rates, a high prevalence of DSM diagnoses, and low scores on the Children's Global Assessment Scale are consistent with the high problem rates reported by Puerto Rican parents and teachers but not with the lower rates reported by adolescents. Different clinical cutoffs may be needed for all assessments in the mainland versus Puerto Rico.

Adolescent↗

Impairment in the epidemiological measurement of childhood psychopathology in the community.

The desirability of incorporating a measure of impairment to the categorization of childhood psychopathology in the community is examined. The use of the Children's Global Assessment Scale (CGAS) for this purpose is recommended. The choice of 61 (definite case) and 71 (probable case) as cutpoints on the Children's Global Assessment Scale is supported empirically by the data on service utilization, parental perceived need, and behavior problem scores obtained in the Puerto Rico Child Psychiatry Epidemiological Study.

Adolescent↗

[Projections for the prevalence of psychiatric disorders. Puerto Rico, year 2000].

Projections for the prevalence of psychiatric disorders were calculated for the estimated population between 17 and 64 years of age in Puerto Rico for the year 2000. These projections were based on the results of an epidemiologic research study conducted in 1984 using a community based sample and the population estimate for the year 2000. The psychiatric disorders included affective and anxiety disorders, somatization, schizophrenic disorders, and alcohol abuse and/or dependence. The prevalence of each of these disorders will increase by the year 2000. The prevalence of affective and anxiety disorders, in particular, will have a relative increase of 5%. The simultaneous increase in the prevalence of psychiatric disorders and the increase in the population will have the combined effect of increasing the number of expected psychiatric cases by 25%.

Adolescent↗

[Thrombocytopenia with bilateral absence of the radius (TAR syndrome). Reports of 2 clinical cases].

Thrombocytopenia with bilateral absent radii (TAR syndrome) is a hereditary condition with a recessive autosomic character. It is characterised by a series of hematological, skeletal and cardiac alterations, and also by various clinical manifestations. The frequency of this syndrome is very low. During the first months of life, prognosis is related to the severity of hemorrhage, but it improves after two years. Diagnosis is at times complex owing to the similarity between this and other syndromes. Therapy, especially during the first year of life, is based on blood transfusion. The paper describes clinical findings in two subjects admitted to the Istituto di Clinica Pediatrica. The two cases presented diverse degrees of hematological and skeletal involvement and followed different clinical evolutions.

Female↗

Ataques de nervios in the Puerto Rican Diagnostic Interview Schedule: the impact of cultural categories on psychiatric epidemiology.

This paper examines the effect of the cultural category ataques de nervios on responses to the Puerto Rican Diagnostic Interview Schedule (DIS), a Spanish version of structured psychiatric diagnostic interview developed for the NIMH Epidemiologic Catchment Area study. An ataque de nervios scale was created from the Somatization items of the DIS to explore the effect of this culturally meaningful category of distress on responses to a standard psychiatric interview. Analysis of 1,513 cases from a representative sample of the island of Puerto Rico indicated that people reporting ataque symptoms fit the social characteristics described for ataques sufferers in the ethnographic literature. Qualitative data indicated that Puerto Ricans were reporting ataques de nervios in the panic section of the DIS. Questions are raised about the validity of the somatization and panic sections of the DIS in cross-cultural research with Hispanics.

Adolescent↗

Risk factors for maladjustment in Puerto Rican children.

Data are presented on risk factors for childhood psychopathology derived from a study of an island-wide probability sample of children in Puerto Rico aged 4 through 16 years. Analyses estimated the effects of 12 demographic, health, and family variables on the probability of being a "case," using two different operational definitions of caseness, as well as on the probability of receiving the diagnoses of oppositional disorder, attention deficit disorder, separation anxiety, depression, functional enuresis, and adjustment disorder. When compared to other findings, the results from these analyses indicate that the relationship between maladjustment and the risk factors evaluated does not appear to be culturally specific.

Adolescent↗

Somatic symptom index (SSI): a new and abridged somatization construct. Prevalence and epidemiological correlates in two large community samples.

An abridged somatization construct (the Somatic Symptom Index) derived from the Diagnostic Interview Schedule's somatization disorder items was tested on community epidemiological samples to examine its prevalence, risk factors, and predictive value. The construct had a high prevalence (range, 4.4% to 20% compared with .03% to 0.7% for the full DSM-III somatization disorder diagnosis), was related to low socioeconomic status, female gender, older chronological age, and Hispanic ethnic background. The presence of this construct determined preferential use of medical services and predicted high indices of disability. The Somatic Symptom Index may have practical utility for clinical and community studies of somatoform phenomena.

Adolescent↗

Medically unexplained physical symptoms, somatization disorder and abridged somatization: studies with the Diagnostic Interview Schedule.

This paper reviews recent research that used the Diagnostic Interview Schedule (DIS) to characterize medically unexplained symptoms and their clustering in clinical and community populations. While the type of symptom(s) differed little across samples, the distribution of a less restrictive construct of somatization ('abridged' somatization) showed interesting differences across the various groups. The authors propose that in view of its relatively high prevalence, abundant psychiatric comorbidity and the simple and unintrusive nature of the assessment, use of the abridged construct may have practical value particularly when exploring psychopathology among medical and community populations.

Fatigue Syndrome, Chronic↗

Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico. The use of combined measures.

A two-stage epidemiologic survey was carried out on a probability sample of the population aged 4 through 16 years in Puerto Rico. The survey used the Child Behavior Checklist as a screening instrument, and prevalence rates were estimated on the basis of clinical diagnoses and other measures provided by child psychiatrists during the second stage. Maladjustment was operationally defined through the use of combined measures, including DSM-III diagnosis and a scale of functional impairment. Data were provided on the demographic correlates of maladjustment and on the comorbidity of DSM-III diagnostic domains. The prevalence rates obtained vis-à-vis the availability of mental health services on the island reflected a major public health problem.

Adjustment Disorders↗

Further measures of the psychometric properties of the Children's Global Assessment Scale.

The Children's Global Assessment Scale (CGAS), a measure of overall severity of disturbance, is an adaptation of the Global Assessment Scale for adults. Data obtained on the CGAS during a pilot study in Puerto Rico demonstrate high interrater reliability and both concurrent and discriminant validity. A discriminant function was generated that highly correlates with other measures of impairment. Use of the CGAS can be of heuristic value to complement other methods of diagnostic categorization.

Adolescent↗