Flora De La Barra - Academia.edu (original) (raw)
Papers by Flora De La Barra
![Research paper thumbnail of [Fragile X syndrome: report of the 1st case confirmed cytogenetically in Chile]](https://attachments.academia-assets.com/108952415/thumbnails/1.jpg)
](PubMed, Nov 1, 1983
We report a 10 11/12 years old male referred for genetic evaluation because of mental retardation... more We report a 10 11/12 years old male referred for genetic evaluation because of mental retardation of unknown cause, behavioral problems, testicular asymetry and other phcnotypic characteristics suggestive of a genetic disorder. On clinical grounds the Fragile-X syndrome was suspected. This diagnosis was confirmed through a chromosomal study in folic acid deficient medium (TC 199 4-2%FCS). The frequency of Xq 28 fragiles sites increased from 2.46% to 7% when an improved technique (TC 199 + 5 %FCS + FUdR 0-05 JJM) was used. Clinical, psychological and cytogenctical aspects of this syndrome are disscuscd.
Revista chilena de pediatría, Apr 1, 1995
Revista chilena de neuro-psiquiatría, Jun 1, 2010
The role of developmental scientifi c epidemiology in understanding causes and risk for psychiatr... more The role of developmental scientifi c epidemiology in understanding causes and risk for psychiatric disorders, proposing preventive strategies and monitoring treatment effi cacy is stressed. Studies of age of onset of disorders, risk and protective factors, causal research, solving controversies about secular changes in prevalence are summarized. Aspects that need to be highlighted in future developments are outlined.
Adhd Attention Deficit and Hyperactivity Disorders, Aug 11, 2012
ADHD prevalence, associated factors, comorbidity and service use are reported for a sample of 1,5... more ADHD prevalence, associated factors, comorbidity and service use are reported for a sample of 1,558 children and adolescents, belonging to four provinces in Chile. The sample is weighted in each step for selection bias. Psychiatric disorders and impairment are assessed with computerized in-home DISC-IV interviews, and a questionnaire regarding socioeconomic and family variables and service use. Estimates of prevalence rates are obtained by means of STATA 11.0 software, with complex sample design. Multivariate logistic regression is used to determine which factors were the best predictors for mental disorders. Participation rate is 82.4 %. The prevalence of ADHD is 10 %, and the most prevalent subtype is the hyperactive/impulsive, with no gender differences. Both hyperactive/impulsive and combined subtypes are more prevalent in children 4-11 than in adolescents. The most prevalent comorbidities are anxiety disorders and oppositional disorder. Anxiety is the more prevalent comorbid disorder in girls and correlated with a combined subtype. Perception of good family functioning, adolescent age and school dropout have a negative association with ADHD diagnosis, while maltreatment shows a positive correlation. Over 50 % of children and adolescents diagnosed with ADHD have used services in the last year. This is the first comprehensive community study of psychiatric disorders in children and adolescents in a South American country. It yields information for child and adolescent mental health programmes in Chile and contributes to cross-cultural epidemiological research.
Revista chilena de neuro-psiquiatría, 2009
The main findings on the literature about inpatient psychiatric treatment of children and adolesc... more The main findings on the literature about inpatient psychiatric treatment of children and adolescents is reported. The trend towards shorter lengths of stay and more intensive treatment has produced several changes and encouraged research on more effective treatments for severe cases undergoing decompensations in their illness. Brief hospitalization is seen as part of a continuum of specialized care. New models of treatment and outcome studies are reviewed, as well as treatment guidelines and recommendations.
Revista Médica Clínica Las Condes, Oct 1, 2005
Revista chilena de neuro-psiquiatría, 2009
Intensive short stay psychiatric hospitalization modality within a private general hospital is di... more Intensive short stay psychiatric hospitalization modality within a private general hospital is discussed as a part of a continuum of care for severe cases undergoing a decompensation of their illness. Diagnosis and treatment of 38 children and adolescents is described. Results and follow up are reported. All acute crisis were resolved and some new diagnoses were formulated. Patients received treatment for their acute symptoms, and started treatment for their core disorders. Coordinations for continuation of ambulatory treatment were implemented. Lessons learned from the experience and implications for future treatment programs are discussed.
Revista chilena de neuro-psiquiatría, Oct 1, 2004
vol. 42 número4 Alteraciones tiroideas en pacientes con depresión y trastorno de pánico consultan... more vol. 42 número4 Alteraciones tiroideas en pacientes con depresión y trastorno de pánico consultantes al Servicio de Psiquiatría del Hospital Regional de Concepción. Implementación de la Entrevista de Acceso Privilegiado para caracterizar consumidores ...
World Journal of Biological Psychiatry, Nov 23, 2015
The primary aim of these guidelines was to evaluate the role of pharmacological agents in the tre... more The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therapeutic challenge as compared to adults. In part, the challenge relates to adolescents being in various stages of puberty and development, which may limit the use of certain pharmacological agents due to their potential side effects. In addition, most of the published treatment programmes have used cognitive behavioural interventions, family therapies and psychoeducational interventions. Psychological treatment is predicated in adolescents on the notion that sexually deviant behaviour can be controlled by the offender, and that more adaptive behaviours can be learned. The main purposes of these guidelines are to improve the quality of care and to aid physicians in their clinical decisions. These guidelines brought together different expert views and involved an extensive literature research. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for efficacy, safety, tolerability and feasibility. An algorithm is proposed for the treatment of paraphilic disorders in adolescent sexual offenders or those who are at risk.
Psykhe, 2005
Se presentan los resultados preliminares de la aplicación de una estrategia de prevención de cond... more Se presentan los resultados preliminares de la aplicación de una estrategia de prevención de conductas disruptivas y agresivas en cuatro cursos de primero básico de escuelas municipalizadas de una comuna de la Región Metropolitana. Se aplicó el Programa del Juego del Buen Comportamiento (JBC) durante primero y segundo básico (grupo en estudio) y se lo comparó con un grupo no intervenido, de iguales características (grupo control) de acuerdo al perfil de riesgo psicosocial (Índice de Vulnerabilidad Escolar, JUNAEB, 2000). Se describe y fundamenta el programa del Juego del Buen Comportamiento y se presenta la comparación de los resultados del primer cohorte de seguimiento realizado a ambos grupos a fines del primero y segundo básico.<br>The preliminary results of an intervention with four first-grade classes from municipal schools of Santiago are presented. The Good Behavior Game (GBG) was implemented in first and second grade to a study group, and it was compared to a control g...
Revista chilena de neuro-psiquiatría
European Psychiatry, 2010
Objectives: To determine the prevalence of DSM-IV psychiatric disorders in a representative sampl... more Objectives: To determine the prevalence of DSM-IV psychiatric disorders in a representative sample of children and adolescents living in Santiago, Chile, as part of a national sample. Method: subjects from 4 to 18 years of age were selected in an aleatory stratified multistage fashion. As part of a national sample, 10 counties in Santiago were selected, then blocks, homes and the child or adolescent to be interviewed. Psychology graduate students applied the Spanish computer version of DISC-IV, as well as a questionnaire on family risk factors, socioeconomic index and service use. Results: a sample of 792 children and adolescents was evaluated, obtaining 76.7% of participation. Using the most stringent impairment algorithm, the prevalence for any psychiatric disorders was 25.4%, being 20.7% in boys and 30.3% in girls, mainly explained by anxious and affective disorders. Prevalence was higher in the 4-11 years of age than in the 12-18 (31.9% and 18.2% respectively). This difference was mainly accounted for by disruptive disorders. Prevalence of anxious disorders was the highest, but less associated with impairment, while most of the children and adolescents with affective disorders were impaired. Conclusions: prevalence of psychiatric disorders in Santiago is high in this age group, and this study will be used for improving mental health services.
Revista médica de Chile (Impresa), Nov 26, 2010
The knowledge about prevalence of psychiatric disorders in all age groups is fundamental to plan ... more The knowledge about prevalence of psychiatric disorders in all age groups is fundamental to plan an adequate mental health care. To determine the prevalence of DSM-IV psychiatric disorders in a representative sample of children and adolescents living in the province of Cautin, Chile. Subjects aged between 4 and 18 years were selected in an aleatory stratified multistage fashion. As part of a national sample, four counties in Cautín were selected, then blocks, homes and the child or adolescent to be interviewed. Psychology graduate students applied the Spanish computer version of DISC-IV, as well as a questionnaire on family risk factors, socioeconomic index and service use. A sample of 272 children and adolescents was evaluated, obtaining 93,4% of participation. Using the most stringent impairment algorithm, the prevalence rate for any psychiatric disorder was 16.8%, being 16.5% in boys and 17.1% in girls and mainly explained by anxiety and affective disorders. Prevalence was practi...
1. Medico psiquiatra de ninos y adolescentes. Profesor Adjunto Depto. Salud Mental Oriente Facult... more 1. Medico psiquiatra de ninos y adolescentes. Profesor Adjunto Depto. Salud Mental Oriente Facultad de Medicina. Universidad de Chile. Departamento de Psiquiatria Clinica las Condes.Recibido el 20 de diciembre de 2012, aceptado para publicacion el 18 de enero de 2013.Correspondencia a:Flora de la Barra Mac DonaldE-mail: torbarra@gmail.com
Veronica Perez, Facultad de Psicologia, Universidad del Desarrollo. Ana Maria Fernandez, Escuela ... more Veronica Perez, Facultad de Psicologia, Universidad del Desarrollo. Ana Maria Fernandez, Escuela de Psicologia, Universidad de Santiago de Chile. Jorge Rodriguez, Escuela de Salud Publica, Universidad de Chile. Flora De la Barra, Escuela de Medicina, Universidad de Chile. La correspondencia relativa a este articulo debera ser enviada a Veronica Perez, Facultad de Psicologia, Universidad del Desarrollo, Avda. La Plaza 700 (San Carlos de Apoquindo), Las Condes, Santiago. Fono/Fax: 2999130. E-mail:vperezv@ vtr.net Este proyecto fue realizado gracias al patrocinio de la Municipalidad de Lo Barnechea y la Facultad de Psicologia de la Universidad del Desarrollo. Efectividad de una Estrategia Conductual Para el Manejo de la Agresividad en Escolares de Ensenanza Basica
Background: The importance of epidemiological studies lies in recognition of cases that do not co... more Background: The importance of epidemiological studies lies in recognition of cases that do not come to treatment settings. The increasing focus on child adolescent mental health in India points to the necessity of epidemiological studies on children. Although there are a few such studies done in different parts of India in different socio-cultural settings, data from those cannot be generalized to the entire country. This need can be served by meta-analysis. There has been no meta-analysis reported from India for the child and adolescent psychiatric epidemiology. Aim: To review and do the meta-analysis of epidemiological studies on child and adolescent psychiatric disorder from India. Methods: Sixteen community based studies on 14594 children and adolescents; and seven school based studies on 5687 children and adolescents, reporting prevalence of child and adolescent psychiatric disorder were analyzed and overall prevalence was calculated. Results: The prevalence rate of child and adolescent psychiatric disorders in the community has been found to be 6.46% (95% confidence interval 6.08%-6.88%) and in the school it has been found to be 23.33% (95% confidence interval 22.25%-24.45%). Conclusions: This is the first meta-analysis determining the epidemiology of child and adolescent psychiatric disorders in India. It has been found that the reporting systems of psychiatric disorders in children are inadequate.
Se investiga el efecto que tiene una intervencion conductual aplicada en la sala de clases, en el... more Se investiga el efecto que tiene una intervencion conductual aplicada en la sala de clases, en el desarrollo de conductas disruptivas entre primero y tercero basico. Para esto, se diseno un estudio cuasi-experimental longitudinal que permitio evaluar los efectos de la aplicacion del programa del Juego del Buen Comportamiento (JBC) en las conductas disruptivas de 45 ninos de dos colegios municipalizados del sector Oriente, en comparacion con un grupo equivalente que no recibio la intervencion (compuesto por 104 escolares). Los resultados indicaron que la aplicacion del JBC en 1o y 2o basico, se relaciona con una disminucion de los problemas de desobediencia y/o agresion, deficiencia cognitiva e inmadurez emocional en 3o basico. Ademas, el programa se relaciona con una proteccion y/o prevencion de la ocurrencia de estos problemas en el grupo intervenido. Se discuten algunos desafios metodologicos del presente estudio y las implicancias de estos resultados para investigaciones futuras,...
PubMed, Nov 1, 1983
We report a 10 11/12 years old male referred for genetic evaluation because of mental retardation... more We report a 10 11/12 years old male referred for genetic evaluation because of mental retardation of unknown cause, behavioral problems, testicular asymetry and other phcnotypic characteristics suggestive of a genetic disorder. On clinical grounds the Fragile-X syndrome was suspected. This diagnosis was confirmed through a chromosomal study in folic acid deficient medium (TC 199 4-2%FCS). The frequency of Xq 28 fragiles sites increased from 2.46% to 7% when an improved technique (TC 199 + 5 %FCS + FUdR 0-05 JJM) was used. Clinical, psychological and cytogenctical aspects of this syndrome are disscuscd.
Revista chilena de pediatría, Apr 1, 1995
Revista chilena de neuro-psiquiatría, Jun 1, 2010
The role of developmental scientifi c epidemiology in understanding causes and risk for psychiatr... more The role of developmental scientifi c epidemiology in understanding causes and risk for psychiatric disorders, proposing preventive strategies and monitoring treatment effi cacy is stressed. Studies of age of onset of disorders, risk and protective factors, causal research, solving controversies about secular changes in prevalence are summarized. Aspects that need to be highlighted in future developments are outlined.
Adhd Attention Deficit and Hyperactivity Disorders, Aug 11, 2012
ADHD prevalence, associated factors, comorbidity and service use are reported for a sample of 1,5... more ADHD prevalence, associated factors, comorbidity and service use are reported for a sample of 1,558 children and adolescents, belonging to four provinces in Chile. The sample is weighted in each step for selection bias. Psychiatric disorders and impairment are assessed with computerized in-home DISC-IV interviews, and a questionnaire regarding socioeconomic and family variables and service use. Estimates of prevalence rates are obtained by means of STATA 11.0 software, with complex sample design. Multivariate logistic regression is used to determine which factors were the best predictors for mental disorders. Participation rate is 82.4 %. The prevalence of ADHD is 10 %, and the most prevalent subtype is the hyperactive/impulsive, with no gender differences. Both hyperactive/impulsive and combined subtypes are more prevalent in children 4-11 than in adolescents. The most prevalent comorbidities are anxiety disorders and oppositional disorder. Anxiety is the more prevalent comorbid disorder in girls and correlated with a combined subtype. Perception of good family functioning, adolescent age and school dropout have a negative association with ADHD diagnosis, while maltreatment shows a positive correlation. Over 50 % of children and adolescents diagnosed with ADHD have used services in the last year. This is the first comprehensive community study of psychiatric disorders in children and adolescents in a South American country. It yields information for child and adolescent mental health programmes in Chile and contributes to cross-cultural epidemiological research.
Revista chilena de neuro-psiquiatría, 2009
The main findings on the literature about inpatient psychiatric treatment of children and adolesc... more The main findings on the literature about inpatient psychiatric treatment of children and adolescents is reported. The trend towards shorter lengths of stay and more intensive treatment has produced several changes and encouraged research on more effective treatments for severe cases undergoing decompensations in their illness. Brief hospitalization is seen as part of a continuum of specialized care. New models of treatment and outcome studies are reviewed, as well as treatment guidelines and recommendations.
Revista Médica Clínica Las Condes, Oct 1, 2005
Revista chilena de neuro-psiquiatría, 2009
Intensive short stay psychiatric hospitalization modality within a private general hospital is di... more Intensive short stay psychiatric hospitalization modality within a private general hospital is discussed as a part of a continuum of care for severe cases undergoing a decompensation of their illness. Diagnosis and treatment of 38 children and adolescents is described. Results and follow up are reported. All acute crisis were resolved and some new diagnoses were formulated. Patients received treatment for their acute symptoms, and started treatment for their core disorders. Coordinations for continuation of ambulatory treatment were implemented. Lessons learned from the experience and implications for future treatment programs are discussed.
Revista chilena de neuro-psiquiatría, Oct 1, 2004
vol. 42 número4 Alteraciones tiroideas en pacientes con depresión y trastorno de pánico consultan... more vol. 42 número4 Alteraciones tiroideas en pacientes con depresión y trastorno de pánico consultantes al Servicio de Psiquiatría del Hospital Regional de Concepción. Implementación de la Entrevista de Acceso Privilegiado para caracterizar consumidores ...
World Journal of Biological Psychiatry, Nov 23, 2015
The primary aim of these guidelines was to evaluate the role of pharmacological agents in the tre... more The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therapeutic challenge as compared to adults. In part, the challenge relates to adolescents being in various stages of puberty and development, which may limit the use of certain pharmacological agents due to their potential side effects. In addition, most of the published treatment programmes have used cognitive behavioural interventions, family therapies and psychoeducational interventions. Psychological treatment is predicated in adolescents on the notion that sexually deviant behaviour can be controlled by the offender, and that more adaptive behaviours can be learned. The main purposes of these guidelines are to improve the quality of care and to aid physicians in their clinical decisions. These guidelines brought together different expert views and involved an extensive literature research. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for efficacy, safety, tolerability and feasibility. An algorithm is proposed for the treatment of paraphilic disorders in adolescent sexual offenders or those who are at risk.
Psykhe, 2005
Se presentan los resultados preliminares de la aplicación de una estrategia de prevención de cond... more Se presentan los resultados preliminares de la aplicación de una estrategia de prevención de conductas disruptivas y agresivas en cuatro cursos de primero básico de escuelas municipalizadas de una comuna de la Región Metropolitana. Se aplicó el Programa del Juego del Buen Comportamiento (JBC) durante primero y segundo básico (grupo en estudio) y se lo comparó con un grupo no intervenido, de iguales características (grupo control) de acuerdo al perfil de riesgo psicosocial (Índice de Vulnerabilidad Escolar, JUNAEB, 2000). Se describe y fundamenta el programa del Juego del Buen Comportamiento y se presenta la comparación de los resultados del primer cohorte de seguimiento realizado a ambos grupos a fines del primero y segundo básico.<br>The preliminary results of an intervention with four first-grade classes from municipal schools of Santiago are presented. The Good Behavior Game (GBG) was implemented in first and second grade to a study group, and it was compared to a control g...
Revista chilena de neuro-psiquiatría
European Psychiatry, 2010
Objectives: To determine the prevalence of DSM-IV psychiatric disorders in a representative sampl... more Objectives: To determine the prevalence of DSM-IV psychiatric disorders in a representative sample of children and adolescents living in Santiago, Chile, as part of a national sample. Method: subjects from 4 to 18 years of age were selected in an aleatory stratified multistage fashion. As part of a national sample, 10 counties in Santiago were selected, then blocks, homes and the child or adolescent to be interviewed. Psychology graduate students applied the Spanish computer version of DISC-IV, as well as a questionnaire on family risk factors, socioeconomic index and service use. Results: a sample of 792 children and adolescents was evaluated, obtaining 76.7% of participation. Using the most stringent impairment algorithm, the prevalence for any psychiatric disorders was 25.4%, being 20.7% in boys and 30.3% in girls, mainly explained by anxious and affective disorders. Prevalence was higher in the 4-11 years of age than in the 12-18 (31.9% and 18.2% respectively). This difference was mainly accounted for by disruptive disorders. Prevalence of anxious disorders was the highest, but less associated with impairment, while most of the children and adolescents with affective disorders were impaired. Conclusions: prevalence of psychiatric disorders in Santiago is high in this age group, and this study will be used for improving mental health services.
Revista médica de Chile (Impresa), Nov 26, 2010
The knowledge about prevalence of psychiatric disorders in all age groups is fundamental to plan ... more The knowledge about prevalence of psychiatric disorders in all age groups is fundamental to plan an adequate mental health care. To determine the prevalence of DSM-IV psychiatric disorders in a representative sample of children and adolescents living in the province of Cautin, Chile. Subjects aged between 4 and 18 years were selected in an aleatory stratified multistage fashion. As part of a national sample, four counties in Cautín were selected, then blocks, homes and the child or adolescent to be interviewed. Psychology graduate students applied the Spanish computer version of DISC-IV, as well as a questionnaire on family risk factors, socioeconomic index and service use. A sample of 272 children and adolescents was evaluated, obtaining 93,4% of participation. Using the most stringent impairment algorithm, the prevalence rate for any psychiatric disorder was 16.8%, being 16.5% in boys and 17.1% in girls and mainly explained by anxiety and affective disorders. Prevalence was practi...
1. Medico psiquiatra de ninos y adolescentes. Profesor Adjunto Depto. Salud Mental Oriente Facult... more 1. Medico psiquiatra de ninos y adolescentes. Profesor Adjunto Depto. Salud Mental Oriente Facultad de Medicina. Universidad de Chile. Departamento de Psiquiatria Clinica las Condes.Recibido el 20 de diciembre de 2012, aceptado para publicacion el 18 de enero de 2013.Correspondencia a:Flora de la Barra Mac DonaldE-mail: torbarra@gmail.com
Veronica Perez, Facultad de Psicologia, Universidad del Desarrollo. Ana Maria Fernandez, Escuela ... more Veronica Perez, Facultad de Psicologia, Universidad del Desarrollo. Ana Maria Fernandez, Escuela de Psicologia, Universidad de Santiago de Chile. Jorge Rodriguez, Escuela de Salud Publica, Universidad de Chile. Flora De la Barra, Escuela de Medicina, Universidad de Chile. La correspondencia relativa a este articulo debera ser enviada a Veronica Perez, Facultad de Psicologia, Universidad del Desarrollo, Avda. La Plaza 700 (San Carlos de Apoquindo), Las Condes, Santiago. Fono/Fax: 2999130. E-mail:vperezv@ vtr.net Este proyecto fue realizado gracias al patrocinio de la Municipalidad de Lo Barnechea y la Facultad de Psicologia de la Universidad del Desarrollo. Efectividad de una Estrategia Conductual Para el Manejo de la Agresividad en Escolares de Ensenanza Basica
Background: The importance of epidemiological studies lies in recognition of cases that do not co... more Background: The importance of epidemiological studies lies in recognition of cases that do not come to treatment settings. The increasing focus on child adolescent mental health in India points to the necessity of epidemiological studies on children. Although there are a few such studies done in different parts of India in different socio-cultural settings, data from those cannot be generalized to the entire country. This need can be served by meta-analysis. There has been no meta-analysis reported from India for the child and adolescent psychiatric epidemiology. Aim: To review and do the meta-analysis of epidemiological studies on child and adolescent psychiatric disorder from India. Methods: Sixteen community based studies on 14594 children and adolescents; and seven school based studies on 5687 children and adolescents, reporting prevalence of child and adolescent psychiatric disorder were analyzed and overall prevalence was calculated. Results: The prevalence rate of child and adolescent psychiatric disorders in the community has been found to be 6.46% (95% confidence interval 6.08%-6.88%) and in the school it has been found to be 23.33% (95% confidence interval 22.25%-24.45%). Conclusions: This is the first meta-analysis determining the epidemiology of child and adolescent psychiatric disorders in India. It has been found that the reporting systems of psychiatric disorders in children are inadequate.
Se investiga el efecto que tiene una intervencion conductual aplicada en la sala de clases, en el... more Se investiga el efecto que tiene una intervencion conductual aplicada en la sala de clases, en el desarrollo de conductas disruptivas entre primero y tercero basico. Para esto, se diseno un estudio cuasi-experimental longitudinal que permitio evaluar los efectos de la aplicacion del programa del Juego del Buen Comportamiento (JBC) en las conductas disruptivas de 45 ninos de dos colegios municipalizados del sector Oriente, en comparacion con un grupo equivalente que no recibio la intervencion (compuesto por 104 escolares). Los resultados indicaron que la aplicacion del JBC en 1o y 2o basico, se relaciona con una disminucion de los problemas de desobediencia y/o agresion, deficiencia cognitiva e inmadurez emocional en 3o basico. Ademas, el programa se relaciona con una proteccion y/o prevencion de la ocurrencia de estos problemas en el grupo intervenido. Se discuten algunos desafios metodologicos del presente estudio y las implicancias de estos resultados para investigaciones futuras,...