: Historical and conceptual issues related to community psychiatry as an innovative approach to clinical assistance across the world, precede a more or less detailed examination of its presence, role and current accomplishments in Latin America, particularly related to child and adolescent subpopulations. Information about transition processes from the traditional hospital-centered model to the community-based approach, applicable mental health policies, levels of implementation and quality of the available reports in different countries, are duly evaluated. The situation in Perú, a country considered representative of the Low and Middle Income (LMIC) group in the subcontinent, is studied, with particular emphasis on a recently established community-based mental health centers program across its territory. Encouraging results about personal, family and identity empowerment, focus on integrated care, clinical outcomes and community relations, need to be carefully followed-up to avoid extremes of rigidity and reductionisms. Adolescents represent the unique future of socio-culturally diverse Latin American countries, and must be the target population of well-conceived, cohesive community mental health policies and programs.
The present study examined the prevalence and correlates of psychosocial impairment in a large, national sample of Peruvian children and adolescents (ages 5.0–17.9) during the COVID-19 pandemic in late 2020. A sample of 8263 online questionnaires were completed by caregivers in Peru between October 23rd–November 26th, 2020. In addition to sociodemographic and pandemic-related factors, the survey administered the Peruvian Spanish version of the Pediatric Symptom Checklist (PSC-17) to assess child psychosocial risk. The Patient Health Questionnaire (PHQ-9), Kessler-6 (K-6), and Brief Resilience Scale (BRS-6) assessed caregiver depression, psychological distress, and resilience, respectively. In this case, 33% of the children were at overall risk on the PSC-17. In adjusted models, caregiver distress, depression, and low resilience, as well as having a family member with a health risk factor were the strongest predictors of child psychosocial risk, accounting for nearly 1.2 to 2.1 times the likelihood of risk individually and 2.4 to 3.4 times the likelihood of risk when summed. Due to the opt-in sampling method, the obtained sample was likely skewed toward more advantaged families, suggesting that the study’s high prevalence of PSC-17 positivity might have been even higher in a more economically representative sample. Given the prevalence of psychosocial problems in Peruvian youth during COVID-19, preventive interventions, with a special focus on family-level approaches that involve and support parents as well as children, are clearly warranted.
Objetivo: Adaptación cultural para uso en la población peruana de la Lista de Verificación de Síntomas Pediátricos (Pediatric Symptoms Checklist, PSC-17), un cuestionario que asiste en la identificación de problemas emocionales y conductuales en individuos de 6 a 17 años. Método: Sobre la base de los textos originales del PSC-17 en inglés y español y de la versión chilena, un comité de cinco expertos llevó a cabo la adaptación de los 17 ítems para la versión de padres y cuidadores y para la de adolescentes. Resultados: Algunos ítems se conservaron idénticos a una de las dos versiones en español; otros se mantuvieron similares a la versión chilena y algunos tuvieron que modificarse ligeramente para ajustarse al idioma español de uso en Perú. Conclusiones: La versión peruana final del PSC-17 facilitaría la detección de problemas de salud mental en niños y adolescentes en nuestro país, aun cuando es necesario llevar a cabo posteriormente estudios sobre sus propiedades psicométricas.
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