Publications

  • Alejandra Caqueo-Urízar, Joshua Breslau, Stephen E Gilman
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    ABSTRACT: The aim of this study is to investigate differences in the beliefs about the causes of schizophrenia between Aymara and non-Aymara patients with schizophrenia and their primary caregivers. Ethnic background plays an important role in the formation of beliefs regarding the causes of schizophrenia, and there have been no prior studies on such beliefs among the Aymara, an indigenous community with a population of about 2 million people living in the Andes. We focused on three systems of beliefs distinguished in the literature: biological, psychosocial and magical-religious.
    International Journal of Social Psychiatry 08/2014; · 1.15 Impact Factor
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    ABSTRACT: Background: Schizophrenia is a debilitating mental illness that has a significant impact not only in the patient but also in the entire family as well. Caregivers assume almost the totality of the patient care. This responsibility exposes caregivers to an intense burden with negative consequences for them and the rest of the family system. This is an updated review of existing literature about burden on families with schizophrenia patients. Method: An electronic search of articles from MEDLINE, EMBASE, APA, EBSCO, and Cochrane databases was conducted for articles published between 2008 and 2013. Results: A systematization of information and frequency analysis revealed the existence of eight factors related to burden that were present in almost all the reviewed literature: Programs of family treatment, Ethnic group, Expressed Emotion, Stress and Burden, Preoccupations of the caregiver, Kind of caregiver, Social networks, Social support, Finances and Coping Strategies. Conclusions: This study supports the statements of different theories reflecting the complexity of schizophrenia caregivers' burden and these, in turn, may be related to the above factors.
    Psicothema 05/2014; 26(2):235-43. · 0.96 Impact Factor
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    Alejandra Caqueo-Urízar, Alfonso Urzúa, Koen De Munter
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    ABSTRACT: Anxiety and depressive disorders occur in all stages of life and are the most common childhood disorders. However, only recently has attention been paid to mental health problems in indigenous children and studies of anxiety and depressive disorders in these children are still scarce. This study compares the prevalence of anxiety and depressive symptoms in Aymara and non-Aymara children. Among the Aymara children, the study examines the relations between these symptoms and the degree of involvement with Aymara culture. We recruited 748 children aged 9 to 15 years from nine schools serving low socioeconomic classes in the city of Arica, in northern Chile. The children were equally divided between boys and girls and 37% of the children were Aymara. To evaluate anxiety and depressive symptoms we used the Stress in Children (SiC) instrument and the Children Depression Inventory-Short version (CDI-S), and used an instrument we developed to assess level of involvement in the Aymara culture. There was no significant difference between Aymara and non-Aymara children on any of the instrument scales. Dividing the Aymara children into high-involvement (n = 89) and low-involvement (n = 186) groups, the low-involvement group had significantly higher scores on the Hopelessness subscale of the CDI-S (p = 0.02) and scores of marginally higher significance in overall Anxiety on the SiC (p = 0.06). Although Aymara children have migrated from the high Andean plateau to the city, this migration has not resulted in a greater presence of anxiety and depressive symptoms. Greater involvement with the Aymara culture may be a protective factor against anxiety and depressive symptoms in Aymara children. This point to an additional benefit of maintaining cultural traditions within this population.
    BMC Psychiatry 01/2014; 14(1):11. · 2.23 Impact Factor
  • Alejandra Caqueo-Urízar, Laurent Boyer, Mohamed Boucekine, Pascal Auquier
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    ABSTRACT: Objective The aim of this study was to adapt the Schizophrenia — Quality of Life short-version questionnaire (SQoL18) for use in three middle-income countries in Latin America and to evaluate the factor structure, reliability, and external validity of this questionnaire. Methods The SQoL18 was translated into Spanish using a well-validated forward–backward process. We evaluated the psychometric properties of the SQoL18 in a sample of 253 patients with schizophrenia attending outpatient mental health services in three Latin American countries. For participants in each country (Bolivia, N = 83; Chile, N = 85; Peru, N = 85), psychometric properties were compared to those reported from the reference population (507 patients with schizophrenia) assessed in the validation study. In addition, differential item functioning (DIF) analyses were performed to see whether all items behave in the same way in each country. Results Factor analysis performed in the 3 countries showed that the questionnaire's structure adequately matched the initial structure of the SQoL18. The unidimensionality of the dimensions was preserved, and the internal/external validity indices were close to those of the reference population. However, one dimension of the SQoL18 (resilience) presented some unsatisfactory properties including low Cronbach's alpha coefficients, one INFIT value higher than 1.2, and one item showing DIF between the 3 countries. Conclusions These results demonstrate the satisfactory acceptability and psychometric properties of the SQoL18, suggesting the relevance of this questionnaire among patients with schizophrenia in these 3 Latin American countries.
    Schizophrenia Research 01/2014; · 4.59 Impact Factor
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    Alfonso Urzúa M, Alejandra Caqueo-Urízar
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    ABSTRACT: Background: The real value of quality of life instruments must be tested in local populations before recommending their widespread use. Aim: To assess the factorial structure of the quality of life questionnaire proposed by the World Health Organization (WHO), WHOQoL-Bref. Material and Methods: The questionnaire was answered by 2016 individuals aged between 20 and 59 years, from diverse public and social organizations of a city in Northern Chile. The confidence and factorial structure of the instrument were evaluated. Results: The internal consistency of the instrument, according to Cronbach's alpha was 0.89. The adjustment of values to a model with four factors proposed by the WHO was moderate. The root mean square (RMS) and root mean square error of approximation (RMSEA) values of0.043 and 0.061, indicate a good adjustment of the model. Conclusions: Although an absolute adjustment for the theoretical four factor model is not supported by these results, the WHOQoL-Bref is able to discriminate the perception of quality of life and the influence of age, gender and disease on this perception.
    Revista medica de Chile 12/2013; 141(12):1547-1554. · 0.36 Impact Factor
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    ABSTRACT: There is a growing concern about caregivers of individuals with schizophrenia who assume almost the totality of the patient care. This responsibility exposes them to an intense burden with negative consequences for them and indirectly for patients' health. The aim of this study was to provide an overview of the content and psychometric properties of instruments assessing the experience of caregivers of individuals with schizophrenia. Of the 460 articles screened from 1990 to 2013, 16 instruments were identified focusing on caregivers' burden (8), coping strategies (3), perception of need (3) and quality of life (2). These instruments were based primarily on experts' opinions, except two which were based exclusively on caregivers' view. The psychometric properties were poorly documented for a number of them and no information was published about responsiveness. Future works are needed to involve caregivers in the development of instruments and to explore psychometric properties of these instruments.
    Expert Review of Pharmacoeconomics & Outcomes Research 10/2013; · 1.67 Impact Factor
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    ABSTRACT: Background: Usually quality of life self-reports are standard and consider that all the areas evaluated are equally important. Aim: To explore the influence of specific domains on the overall quality of life self-assessment. Material and Methods: The brief version of the quality of life questionnaire developed by the World Health Organization (WHOQoL bref) was applied to 1229 participants aged 19 to 60 years (53% women). The questionnaire explores four domains: physical and psychological health, social relationships and environment. At the end of each domain a new question asking the participant to assess the importance of the domain, using a scale of 1 (not important) to 5 (very important), was added. The analysis of data considered the assessment of the importance of each domain made by participants. The weight of each domain was analyzed using regression equations. Results: The physical health had the best evaluation followed by the social domain. The environmental domain received the lower evaluation. Among women, social domain was the best evaluated domain and among men, the physical health domain. According to participants, physical and psychological health had the higher weight. The environmental domain had the higher weight on the overall assessment of quality of life. Conclusions: According to participants, physical and psychological health are the most important aspects that influence overall quality of life.
    Revista medica de Chile 08/2013; 141(8):1010-8. · 0.36 Impact Factor
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    Revista medica de Chile 08/2013; 141(8):1010-1018. · 0.36 Impact Factor
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    ALFONSO URZÚA M, ALEJANDRA CAQUEO-URÍZAR, NELIA ALBORNOZ B, CRISTINA JARA S
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    ABSTRACT: Background: The quality of life in children is associated with their experiences, family and their socio-cultural environment. Objective: To identify the significant components in assessing quality of life from the children's perception. Participants and Method: Using a cross-sectional design, the Child Life Quality Scale was applied to a total of 200 children aged 8-12 years, from an urban and a rural area located in northern Chile. Three open questions were presented about experiences of satisfaction, dissatisfaction and desire for change, classifying the answers in six categories. Results: No significant differences in the perception of quality of life in children from urban and rural areas were found, however, the evaluation of the content of the answers allowed us to establish some differences between the two groups. Conclusion: In the urban area, the greatest experiences of satisfaction level were associated with interpersonal relationships, while in the rural area, with leisure and recreational activities.
    Revista chilena de pediatría 06/2013; 84(3):276-284.
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    ABSTRACT: Introduction. There are no studies that enable to explore the impact that might have the scoring of the importance that children assign to each dimension that encompass the assessment of their quality of life (QoL). Objective. To analyze the influence of the importance assigned by children to the different spheres of their lives when having to assess their quality of life. Material and Methods. Correlational, crosssectional design. The modified KIDSCREEN-27 questionnaire was used to evaluate the importance assigned by the child to each dimension. Results. A total of 300 schoolboys and 300 schoolgirls, with an average age of 12 years old, were evaluated. The dimension with the highest score was Peers, and the one with the lowest was Psychological well-being, both in the raw evaluation as in the weighted by importance ranking. In girls, the Physical well-being dimension scored the lowest. The dimensions Parent relations and School environment scored the highest in younger students. In girls, differences were found in the dimension that scored the lowest when they weighted the importance of the dimension; shifting the dimension with the lowest score from Psychological well-being to Physical well-being. Conclusion. There are differences in the perception of quality of life between boys and girls, the types of schools they attend and the different ages, which do not change when being weighted by importance.
    Archivos argentinos de pediatría 04/2013; 111(2). · 0.32 Impact Factor
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    ABSTRACT: Introduction: This study evaluated the impact of the primary caregiver on the quality of life (QL) of patients with advanced cancer. Method: The research design is exploratory descriptive-correlational with non-probabilistic sampling for convenience with error not exceeding 5%. The sample was composed of 34 patients diagnosed with advanced cancer and their respective primary caregivers, all of whom from a hospital unit specialized in palliative treatment. The instruments FACT-G, SF-36 and Zarit's caregiver overload scale were used. Results: The results show that the overall QL of cancer patients is perceived negatively, which suggests that physical and emotional health problems deteriorate the patient's daily physical and social activities. With regard to caregivers, these rate their own QL positively; however those who provide care to patients with a more advanced state of cancer present a slight amount of overload in the physical, social, psychological and economic aspects of their lives. As such, the study concluded that the patient's functional state dimension is positively affected by the caregivers's social functions, welfare and vitality. Conclusions: it can be observed that indeed, the level of deterioration in the functional and physical dimensions of the patient has an influence on the perception that they have of Resumen
    Psicooncologia 01/2013;
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    ABSTRACT: Achieving social functioning and achieving social competence are two main objectives of psychosocial interventions for people suffering from schizophrenia. The present preliminary study presents a novel approach of social skills training (SST) based on the proposals of Kopelowicz et al. (Kopelowicz, A., Liberman, R. P., and Zarate, R., 2006. Schizophr. Bull. 32 (1): S12-23) that link the treatment to seven specific target behaviours: social perception, social information processing, responding and sending skills, affiliative skills, interactional skills, and behaviour governed by social norms. Thirty-one stabilised outpatients were randomly assigned to one of two groups, SST (n=13) or treatment-as-usual (n=18) (TAU; case management, medication adherence, psychotherapy, leisure engagement, and family support) and were assessed at baseline in cognitive performance, clinical symptomatology, social cognition, and psychosocial functioning. These outcomes were evaluated across post-treatment and at the 6-month follow-up appointment. SST subjects showed improvements in psychopathology, social discomfort, social cognition (self-regulation statements during interactions), social withdrawal, interpersonal communication, and quality of life compared with the TAU group. At the 6-month follow-up, results were maintained for negative symptoms, social discomfort, and some functioning outcomes. Neuropsychological variables were also examined, as mediators of benefit from skills training. Results support the efficacy of the brief SST for outpatients with schizophrenia and show the need to implement empirically supported interventions in mental health services to enhance patients' social functioning and quality of life.
    Schizophrenia Research 12/2012; · 4.59 Impact Factor
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    ABSTRACT: The introduction of anti-psychotic medication and the de-institutionalization have placed on the hands of their relatives the responsibility for their informal care. Many times, this role carries a high level of burden for all family members. There exist a few studies that approach this subject matter in groups of ethnic minority. The aim of this research was to describe the levels of burden in Aymaras caregivers (aborigines who are located on the highlands of Northen Chile) from Schizophrenia patients. The sample corresponds to 45 caregivers of patients with schizophrenia that receive treatment at the Mental Health Services in the city of Arica, Chile. RESULTADOS: Zarit Burden Scale classifies all Aymara relatives in the category of "Intense Burden", unlike not Aymara relatives, which classified as "Low Burden". Significant differences are observed in the subscale of incompetence where the Aymara Cargivers perceive not to feel able of taking care of the patient with the available resources. It is concludes that belonging to this ethnic minority would increase the psychopathological risk that caregivers of psychiatric patients experience.
    Revista de psiquiatrí́a y salud mental. 07/2012; 5(3):191-6.
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    ABSTRACT: To our knowledge, no study has examined quality of life (QoL) among caregivers of individuals with schizophrenia between a developing and a developed country. The aim of this study was to assess QoL of the caregivers of individuals with schizophrenia in two countries characterized by different social, economic and cultural conditions, namely Chile and France. Data were collected from public mental health outpatient services in Arica (Chile), and in Marseille (France). QoL was measured with the short-form health survey scale - 36 items (SF36). QoL of 41 Chilean caregivers was firstly compared with 245 French caregivers. Univariate and multivariate analyses using linear regression were then performed to determine variables potentially related to QoL scores. The caregivers were primarily mothers in the two groups, but Chilean caregivers were younger, and lived more frequently with the individual with schizophrenia than French caregivers. The SF36 scores were globally low in the two groups, especially on the mental QoL scores. Chilean caregivers reported lower physical SF36 scores than French caregivers. In the multivariate analysis, being mother and Chilean caregivers were the most regular features associating to a lower QoL. Despite differences between Chile and France, especially in terms of quality and quantity of mental health services and economic supports, caregivers' QoL levels remain particularly low for both countries. Future support programmes should address the specific needs of caregivers.
    BMC Family Practice 05/2012; 13:42. · 1.61 Impact Factor
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    ABSTRACT: Perception of social support and functioning of patients with schizophrenia and their primary caregivers and its relationship to quality of life are described. Forty-five patients and their 45 relatives, treated at the Mental Health Services in Arica, Chile, participated. Both patients and caregivers in the study have a poor perception of social support with regard to extra-family people, as well as a low social integration. However, patients showed adequate capacity to function within their immediate family. Unlike what was found in developed countries, these patients showed moderate levels of quality of life, with a strong relationship with perceptions of the social support they receive from family and significant others and the ability to establish and maintain social contacts. Quality of life of primary caregivers is linked to patients' ability to establish and maintain social contacts within the family group, as in other social instances, such as keeping a job. The results of the study suggest the need to consider the design and application of programs of support for these patients and their caregivers, with the central aim of the social functioning of the above-mentioned patients and their familiar and community integration.
    Psicothema 05/2012; 24(2):255-62. · 0.96 Impact Factor
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    ABSTRACT: To describe the quality of life of patients of Aymaran descent with schizophrenia and analyse the differences with patients of non-Aymaran descent. The study included 45 patients who attended the Mental Health Services in Arica, Chile. The Positive and Negative Syndrome Scale (PANSS) and the Seville Quality of Life Questionnaire (SQoLQ) were used. The patients of the study showed moderate quality of life levels, with a strong association with the negative syndrome and the general psychopathology of the disorder. No significant differences were found in the quality of life dimensions as regards ethnic background. The results found demonstrate that the integration of patients in the Community Health Services is positively associated as regards their quality of life. The integration of the caregivers is considered essential in the treatments administered.
    Revista de psiquiatrí́a y salud mental. 04/2012; 5(2):121-6.
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    Alfonso Urzúa, Alejandra Caqueo-Urízar
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    ABSTRACT: The concept of quality of life has begun to be used increasingly in the field of health assessments or as a measure of well-being. Despite this, there is no single definition or a complete difference from other similar concepts often being misused. This paper presents a theoretical concept and a classification of the different models of definitions, including a proposed model based on cognitive assessment. They also develop major problems confronting research in the area of quality of life.
    Terapia Psicologica 02/2012; 30(1):61-71. · 0.61 Impact Factor
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    ABSTRACT: Objective To describe the quality of life of patients of Aymaran descent with schizophrenia and analyse the differences with patients of non-Aymaran descent.Method The study included 45 patients who attended the Mental Health Services in Arica, Chile. The Positive and Negative Syndrome Scale (PANSS) and the Seville Quality of Life Questionnaire (SQoLQ) were used.ResultsThe patients of the study showed moderate quality of life levels, with a strong association with the negative syndrome and the general psychopathology of the disorder. No significant differences were found in the quality of life dimensions as regards ethnic background.Conclusions The results found demonstrate that the integration of patients in the Community Health Services is positively associated as regards their quality of life. The integration of the caregivers is considered essential in the treatments administered.
    Revista de Psiquiatría Biológica y Salud Mental 01/2012; 5(2):121–126. · 0.31 Impact Factor
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    ABSTRACT: Schwartz defines cultural values as motivational types, where each value reflects goals and objectives to be achieved. According to Schwartz, cultural values are related to an orientation that is individualistic (values referred to as power, achievement, hedonism, stimulation and self-direction), collectivistic (benevolence, tradition and conformity) or mixed (security and universalism). Today, there is a theoretical consensus that cultural values are mediators in the evaluation of quality of life (QOL); nonetheless, there are few published studies to date relating them to QOL. To determine whether a significant relationship exits between cultural values and QOL in three Spanish-speaking countries. A total of 821 persons participated: 321 from Chile, 200 from Spain and 300 from Cuba. The Schwartz Cultural Values Survey and the WHOQOL-BREF Quality of Life Scale were used. Analysis of variance, and correlation and regression analyses were preformed after collecting data. Only hedonism was significantly correlated with the global evaluation of QOL in Spain and Chile. Few correlations were found in all three countries between cultural values and the QOL domains evaluated, with the exceptions of the value of self-direction, which was related to physical well-being, and the value stimulation, which was correlated with psychological as well as social well-being in all three countries. Certain values may be associated with a better perception of QOL, depending on the particular culture of the population evaluated.
    Social Indicators Research 01/2012; · 1.26 Impact Factor
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    ABSTRACT: IntroductionThe introduction of anti-psychotic medication and the de-institutionalization have placed on the hands of their relatives the responsibility for their informal care. Many times, this role carries a high level of burden for all family members. There exist a few studies that approach this subject matter in groups of ethnic minority. The aim of this research was to describe the levels of burden in Aymaras caregivers (aborigines who are located on the highlands of Northen Chile) from Schizophrenia patients.
    Precambrian Research - PRECAMBRIAN RES. 01/2012;

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