Background: Simple and brief questionnaires with adequate psychometric properties are useful for the early detection of depressive disorders. Aim: To analyze the psychometric behavior of the Patient Health Questionnaire (PHQ-9) in Chile. Material and Methods: Data were collected from 1,738 adult patients, consulting in primary health care centers. The values obtained in the PHQ-9 were compared with those of the Composite International Diagnostic Interview (CIDI). Results: The mean score of PHQ-9 was 4.85 ± 5.57. Internal consistency indices were high. McDonald´s ω coefficient of was 0.90 and Cronbach alpha 0.89. A confirmatory factor analysis showed a good fit of the one-dimensional model. Using a cutoff score of seven determined with the receiver operating characteristic (ROC) curve, the sensitivity and specificity of the instrument were 0.8 and 0.7, when compared with CIDI diagnoses. Conclusions: PHQ-9 is a useful instrument for the screening of depressive disorders in primary health care centers in Chile.

Background: This study aimed to assess the measurement properties (reliability, factor structure, and criterion validity) of the Patient Health Questionnaire (PHQ-9) as an instrument for screening major depressive disorder (MDD) in elderly primary care users in Chile. Method: About 582 participants aged between 65 and 80 years were enrolled from primary care centers. They completed the Composite International Diagnostic Interview (CIDI), a survey with sociodemographic characteristics and the PHQ-9. Results: The PHQ-9 revealed an acceptable internal consistency (ω = 0.79 [95% CI: 0.75–0.80] and α = 0.78 [95% CI: 0.75–0.81]); confirmatory factor analysis demonstrated a good fit for both 1- and 2-factor solutions. The chi-square difference test (χ 2 = 0.61, gl = 1, p = 0.43) and correlation between the somatic and the cognitive-effective latent factors were very high ( r = 0.97, p < 0.001), indicating that the 1 factor model was more parsimonious. Utilizing the CIDI as the gold standard, the area under the curve (AUC) was 0.88 (SE = 0.04, 95% CI: 0.84–0.90). The optimal cut-off score of ≥ 6 yielded good sensitivity and specificity for detecting MDD (0.95 and 0.76, respectively). However, considering the clinical utility index, the cut-off score of ≥9 proved to be a more effective marker for discarding cases of MDD. Conclusion: The PHQ-9 has adequate psychometric properties for elderly primary care users. In clinical settings, it showed its greatest utility in ruling out the presence of an MDD, however, its clinical value for identifying possible cases of MDD is limited. In cases above the cut-off point, it is recommended to perform a more thorough evaluation.

Resumenel inventario de conductas infantiles 1.5-5 años (cBcl /1.5-5 por su acrónimo en inglés) y el informe del cuidador/educador (c-trF por su acrónimo en inglés), son de los instrumentos más ampliamente reconocidos internacionalmente para evaluar conductas desadaptativas que pueden afectan el desarrollo presente y futuro de niños y niñas preescolares. se evaluó el comportamiento psicométrico de ambos instrumentos en una muestra diversa socioeconómicamente de 550 preescolares chilenos. en general, ambos mostraron un comportamiento psicométrico análogo al obtenido con estudios en otras sociedades. los análisis factoriales confirmatorios mostraron un ajuste adecuado del modelo bifactorial original. Sin embargo, en el CBCL /1.5-5 los puntajes obtenidos son más altos que en la mayoría de los países y, comparativamente, en ambos instrumentos, se observó un mayor efecto de género. se analizan los hallazgos obtenidos, y se dan sugerencias normativas y conceptuales para el empleo de ambos instrumentos en niños y niñas preescolares en nuestro país. Key words: comportamientos externalizados e internalizados-aFc-preescolares-evaluación. Abstractthe child Behavior checklist/1.5-5 and the caregiver /teacher report Form are one of the most widely internationally recognized instruments to evaluate desadaptative behaviors which may affect the current and future development of preschool children. the psychometric behavior of both instruments was evaluated in a socioeconomically diverse sample of 550 chilean preschool children. in general, it was observed an analog behavior of both compared to the one obtained with studies in other societies. The confirmatory factor analysis showed a suitable adjustment of the original bifactor model. However, in the CBCL, the scores obtained are higher than in most of the countries and, comparatively, in both instruments, a greater effect of gender was observed. The findings obtained are analyzed and, normative and conceptual suggestions are given for the use of both instruments in preschool children in our country. Key words: internalizing and externalizing behaviors-cFa-preschools children-assesment.

Background: Evidence for the effectiveness of parental training as a strategy for promotion of positive parental practices and prevention of child behavior problems in low and middle income countries is not conclusive. This study aims to assess the effectiveness of a universal positive parental training program designed for this context, “Día a Día” UdeC © (“Day by Day” University of Concepción), in Chilean preschoolers’ families (3–6 years old children).Methods: A cluster randomized controlled trial (cRCT) was carried out in 19 preschool education centers. There were two treatment arms: 10 centers (including 178 families) were randomly assigned to the intervention group and nine centers (including 154 families) were assigned to the waiting list control condition. Intervention groups received Day by Day UdeC, a six group sessions program for parents, including two group sessions for preschool educators, focused in affective communication; daily and child-directed play; directed attention; routines and transitions; reinforcement and incentive programs; planned inattention-ignore and time out; and logical consequences. Parental practices, parental satisfaction, and presence of children behavioral problems were examined at two-time points: T1 (4 weeks before intervention) and T2 (5–6 weeks after intervention).Results: Intention-to-treat analysis shows a reduction in physical punishment and an increase in parental involvement, as well as a reduction in children behavioral problems. A per-protocol analysis revealed an additional effect: increase in observed parental practices.Conclusion: This cRCT provided evidence for the effectiveness of a parental training program for the promotion of positive parental practices in low and middle income countries. The observed effects of the program in decreasing physical punishment and children’s behavioral problems make it a promising strategy for prevention purposes.Trial Registration: This study was registered under ISRCTN.com (ISRCTN90762146; https://doi.org/10.1186/ISRCTN90762146).

Background: Parenting training is a proven strategy for the promotion of positive parenting practices and for the prevention and treatment of behavior problems in children. The processes that explain this efficacy are less clear. The aim of this study was to assess the mediating role of parenting practice modification, encouraged through the implementation of a universal parenting training program, for the decrease of behavior problems in 3- to 6-year-old children. Method: A cluster randomized trial was carried out in 19 educational centers in low and middle socioeconomic areas. A total of 178 families received the program and 154 of them were the control group. The following parenting practices were assessed: positive reinforcement, involvement, inconsistency, unsuitable treatment behaviors and physical punishment, as well as hostility and humiliation behaviors. Parent–child interaction was also assessed using an observational instrument. A multiple mediation analysis was carried out, identifying the indirect effects. Results: Reduction of harsh discipline and physical punishment, and parental inconsistency mediated the effects observed in the reduction of child behavior problems during the program. Conclusion: Within Chilean families, harsh discipline, physical punishment, and parental inconsistency are important aspects to be considered in the implementation of universal parenting training programs.