2003, Number 1
Patrones de daños a la salud mental: psicopatología y diferencias de género
Granados CJA, Ortiz HL
Full text
Language: Spanish
References: 28
Page: 42-50
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ABSTRACT
Currently mental health risks represent one of the most important collective health problems. Their increasing trend in the last decades, as well as the changes in population structures indicate that mental diseases will be one of the main causes of morbidity in Mexico. The study of the relationship between social conditions and the health-illness process has been consolidated as a broad scientific field capable of contributing elements towards prevention and treatment. Different studies have reported that there is a relationship between industrialization processes, urbanization and the apparition and increase of mental diseases. At the same time, it has been documented that mental diseases are differentially distributed among the population and this is associated with specific conditions such as social class, occupation or gender.The purpose of the present study lies in the last category. To describe gender differences in a psychiatric hospital in Mexico City, the clinical records of patients admitted for the first time at the emergency room of the hospital between 1993 and 1995 were revised. In this population a frequency analysis was carried out and tests of statistical significance were performed. In each case the corresponding record was revised and the socioeconomic data and diagnosis were recorded, as well as its respective coding according to the International Classification of Diseases, ninth version (CIE-9). Globally, there were 1083 admissions of Federal District residents, among which 52% were women and 48% were men; the age limits were from 14 to 93 years. Four intervals were defined: 25 years old or less, from 26 to 40 years, from 41 to 60 years, 61 years or more. The agegroups more numerous were those from 26 to 40 years (38.4%) and from 41 to 60 years (31.1%). The average age among men was 40.3 years and among women 42.2 years, these differences were statistically significant (t=-2.00, p=0.045).
The changes with age and their contributions towards the makeup of each disease were later analyzed. This was done separately for men and women. To evaluate differences between groups regarding the percentage contribution of different diagnoses to the number of total cases, the X2 test was performed, with a statistical significance of α = 0.05.
From 30 codes comprising the mental diseases chapter of CIE-9 (chapter V), among the studied population 25 codes were found, one belonged to another chapter (suicidal attempts and ideas). The diagnoses contributing more cases were: other organic psychoses (CIE 294, 176 cases), schizophrenic psychoses (CIE 295, 149 cases), transitory organic psychoses (CIE 293, 112 cases) and neurotic disorders (CIE 300, 98 cases), these as a whole constituted 49.4% of the total cases. It was found that other less frequent diseases contributed significantly to the total, such as: suicidal attempt (CIE E-950, 95 cases), alcohol-dependence syndrome (CIE 303, 93 cases) and unclassified depressive disorder (CIE 311, 77 cases). These three diseases made up 24.5% of the total. In both men and women, “other organic psychoses” was the diagnosis contributing most of the cases (17.1% and 15.4%, respectively). Sex differences were found practically among all disorders, even though their magnitude varied according to the age groups. The specific mental disorder profiles for men and women can be configured using those diagnoses whose gender difference was more significant.
The profile for the female gender was different compared to that of men. Women contributed more cases in the following diagnoses: neurotic diseases (5.0% men and 13.5% women), suicidal attempt and ideas (7.1% men and 10.6% women), unclassified depressive disorder (4.4% men and 10.0% women), affective psychoses (2.5% men and 5.0% women) and other nonorganic psychoses (0.2% men and 1.9% women). A striking difference was observed in neurotic diseases (CIE 300), which among women occupies the second place, while among men holds the seventh place.
Meanwhile, the profile for the male gender was characterized by a greater contribution of men in the following diagnoses: alcohol-dependence syndrome (15.1% men and 1.5% women), drug dependency (7.6% men and 1.0% women) and alcoholic psychoses (3.0% men and 0.4% women). It is noteworthy that among men these diagnoses occupied places 3,5, and 9, respectively, whereas among women they were placed in ranks 13, 16 and 18, respectively.
The above posed the need to perform an analysis from the gender perspective, in order to gain insight into gender specificity for certain mental disorders. To do this the description of socialization patterns was proposed because they explain richly the modalities with which men and women manifest psychological disturbances. As a result of this analysis it was found out that the general features of gender socialization correlate strongly with the signs and symptoms conforming the psychopathology of the pathological profiles by gender.
The findings of this study confirm that social relationships correlate with the population profiles of mental disorders.
However, to corroborate the association between processes of a social nature and the type of mental disease manifested by individuals as a function of gender, it is necessary to perform accompanying studies that calculate measures of relative risk.
REFERENCES