Background: The effect of the Colombian armed conflict on the mental health of adolescents is still poorly understood. Aims: Given social interventions are most likely to inform policy, we tested whether two potential intervention targets, family functioning and social capital, were associated with mental health in Colombian adolescents, and whether this was moderated by experience of violence and displacement. Methods: We examined the cross-sectional association between family functioning, cognitive social capital, structural social capital and 12-month prevalence of Composite International Diagnostic Interview (CIDI) diagnosed psychiatric disorder, using data on 12 to 17-year-old adolescents ( N = 1,754) from the 2015 National Mental Health Survey of Colombia, a nationally representative epidemiological study. We tested whether associations survived cumulative adjustment for demographic confounders, experience of non-specific violence and harm and displacement by armed conflict. Results: Neither structural nor cognitive social capital were associated with better mental health. Better family functioning was associated with reduced risk of poor mental health in an unadjusted analysis (OR 0.90 [0.85–0.96]), and after cumulative adjustments for demographic confounders (OR 0.91 [0.86–0.97]), non-specific violence and harm (OR 0.91 [0.86–0.97]) and social capital variables (OR 0.91 [0.85–0.97]). In the final model, each additional point on the family APGAR scale was associated with a 9% reduced odds of any CIDI diagnosed disorder in the last 12 months. Conclusions: Better family functioning was associated with better mental health outcomes for all adolescents. This effect remained present in those affected by the armed conflict even after accounting for potential confounders.
Background: The effect of the Colombian armed conflict on the mental health of adolescents is still poorly understood. Given social interventions are most likely to inform policy, we tested whether two potential intervention targets, family functioning and social capital, were associated with mental health in Colombian adolescents, and whether this was moderated by experience of violence and displacement. Methods: We examined the cross-sectional association between family functioning, cognitive social capital, structural social capital and 12-month prevalence of Composite International Diagnostic Interview (CIDI) diagnosed psychiatric disorder, using data on 12-17-year-old adolescents (N = 1754) from the 2015 National Mental Health Survey of Colombia, a nationally representative epidemiological study. We tested whether associations survived cumulative adjustment for demographic confounders, experience of non-specific violence and harm, and displacement by armed conflict. Results: Neither structural nor cognitive social capital were associated with better mental health. Better family functioning was associated with reduced risk of poor mental health in an unadjusted analysis (OR 0.90 [0.85 - 0.96]), and after cumulative adjustments for demographic confounders (OR 0.91 [0.86 - 0.97]), non-specific violence and harm (OR 0.91 [0.86 - 0.97]) and social capital variables (OR 0.91 [0.85 - 0.97]). In the final model, each additional point on the family APGAR scale was associated with a 9% reduced odds of any CIDI diagnosed disorder in the last 12 months. Conclusions: Better family functioning was associated with better mental health outcomes for all adolescents. This effect remained present in those affected by the armed conflict even after accounting for potential confounders.
Uno de los cuestionamientos más recurrentes durante la pandemia ha girado alrededor de la toma de decisiones y el tipo de evidencia que las respalda. Comparada con otras crisis como la económica del 2008, que principalmente afectó al sector financiero; o el escenario de malas decisiones durante la epidemia de la gripe aviar en la década de los setenta (1), la pandemia por COVID-19 ha afectado todo el sistema socioeconómico y generando incertidumbre ha aumentado la percepción de riesgo. Esto ha hecho que se requieran tiempos de respuesta más cortos, así como una reflexión del sistema de valores de las sociedades en el proceso de toma de decisiones. En este contexto, las evidencias provienen de diferentes sectores y de diferentes ramas del conocimiento. La pregunta que razonablemente surge entonces es: ¿A quién escuchar? La rapidez con que se deben tomar las decisiones en tiempos de pandemia requiere un ajuste al modelo de toma de decisiones basado en evidencia que demanda información con alta credibilidad y libre de sesgos. Por ejemplo, el resultado de investigación científica de calidad. Supone además que la información disponible sea el resultado de un exhaustivo análisis y una evaluación metódica, además de accesible y fácil de entender. En la actual coyuntura estos estrictos requerimientos son casi imposibles de atender. Se ha pasado de utilizar exclusivamente información de alta credibilidad, a aceptar información razonablemente creíble; de priorizar la información mediante una evaluación sistemática, se ha pasado a hacer una valoración desde la subjetividad del juicio profesional y la experiencia de quienes evalúan la información disponible.
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