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Burden of phychiatric diseases in Chile Chile has one of the highest disease burdens caused by neuropsychiatric illnesses in the world, according to WHO, reaching to 31%. Major depression and alcohol use disorders are ranked first and second in attributed disability among adults. Nearly one-third of the population has had a psychiatric disorder in their lifetime, and 22.2% in the past year. Anxierty disorders are the most prevalent conditions, followed by major depression and alcohol abuse. Currently, mental health accounts for 2.3% of the health care budget, which is less than some neighboring countries. The availability of 1.3 psychiatric beds per 10,000 inhabitants, is less than the mean of lower-income countries. Moreover, 81% are for chronic rather than acute care. Chile has 4.0 psychiatrist per 100,000 inhabitants, which is lower than other countries in Latin America. Only 38.5% of those patients with a psychiatric diagnosis receive any kind of mental health care, whether from a specialist or primary care. There is a perception among lay persons, that psychiatric treatments lack efficacy, despite evidence demonstrating the contrary. Not addressing the treament gap in mental health has serious public health implications (Rev Méd Chile 2007; 135: 1591-9).

Estrés académico, proceso multifactorial complejo que alcanza sus grados más elevados a nivel universitario y que para realizar intervenciones efectivas, necesita de instrumentos válidos y fiables para medirlo. El objetivo de este trabajo fue evaluar las propiedades psicométricas de una versión adaptada del inventario SISCO del estrés académico, denominada SISCO-II, destinada a medir estrés académico en estudiantes universitarios. Se aplicó el instrumento a 1.126 estudiantes universitarios de tres universidades chilenas. El análisis factorial confirmatorio mostró buen ajuste a la estructura propuesta de cuatro factores (Estresores, Reacciones físicas y psicológicas, Reacciones del comportamiento social y Afrontamiento). La medida de estrés académico queda constituida por estresores, reacción total (Reacciones físicas, psicológicas y del comportamiento social) y estrategias de afrontamiento. Los resultados avalan la utilidad de SISCO-II para uso diagnóstico y evaluación de intervenciones, siendo una escala válida y confiable.

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Introduction: In Chile there are scarce validated instruments in order to perform categorical psychiatric diagnosis both in children and adolescents. DISC-IV Spanish version validation indexes are presented. Method: A convenience sample was collected from outpatient psychiatric services as well as from private medical facilities and drug-dependence outpatient centres from Concepción, Chile. Subjects of both genders between 7 and 18 years of age, with a psychiatric diagnosis were included in the study (affective disorder, anxiety, drugs abuse and dependence, and behaviour disorder). In addition 18 subjects without psychiatric disorder were selected from a secondary school. Each selected subject that agreed to participate in the study was interviewed by a clinical experienced child psychiatrist, diagnose-blinded, using DSM-IV check list, in order to decide if the subject fulfilled DSM-IV criteria. Later, to patients 12 years old or older, or to their caregiver for children younger than 12 years DISC-IV was applied by some of the previously trained lay interviewers. Quality controls of the interviews were carried out. Data were entered to SPSS file to obtain DISC-IV validation indexes. Results: 144 subjects were incorporated in the study. Cohen's Kappa indexes, a statistical measure of inter-rater agreement, varied between 0.53 for anxiety disorders, and 0.88 for substance abuse and dependence. Every group presented high specificity ranging between 0.55 and 0.83. Interviews answered by adolescents were less sensitive for TDA (0.23) and anxiety (0.40), whereas in parents, sensitivity decreases for affective disorders (0.50). Conclusion: DISC-IV is a valid instrument to be used in the research about children and adolescent mental health.