Browsing by Author "Vogel, Melina"

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    Actualizaciones en el manejo intrahospitalario de la anorexia nerviosa : recomendaciones prácticas
    (2017) Vásquez, N.; Urrejola Noguera, Pascuala; Vogel, Melina
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    Exploration of barriers to treatment for patients with eating disorders in Chile
    (2024) Castañeda Caro, Felipe; Cerda, Jaime; Jara Latorre, Raúl Hernán; Riestra, Francisca; Urrejola Noguera, Pascuala; Vogel, Melina; Gumucio, María E.; Irribarra Pastenes, Verónica; Álvarez, Jorge; Díaz, María A.; Kompatzki, Paula; Costa, Daniela
    Background Eating disorders (EDs) are associated with high morbidity and mortality, affecting predominantly young people and women. A delay in starting treatment is associated with chronic and more severe clinical courses; however, evidence on barriers and facilitators of access to care in Latin America is scarce. We aimed to identify barriers and facilitators of ED treatment in Chile from the perspective of patients, relatives, and health professionals. Methods Qualitative approach through semi-structured interviews with patients, their relatives, and health professionals. Participants were recruited from two ED centers in Santiago, Chile (one public and one private). Analysis was mainly based on Grounded Theory, using MAXQDA software. Results 40 interviews were conducted (n = 22 patients, 10 relatives, and 8 health professionals). The mean age of patients was 21.8 years, while the mean duration of untreated ED was 91.4 months (median 70 months). Five categories emerged with intersections between them: patient (P), family and social environment (FSE), health professionals (HP), healthcare system (HCS), and social and cultural context (SCC). Relevant barriers appeared within these categories and their intersections, highlighting a lack of professional knowledge or expertise, cultural ignorance or misinformation regarding EDs, and patient’s ego-syntonic behaviors. The main facilitators were patients’ and relatives’ psychoeducation, recognition of symptoms by family members, and parents taking the initiative to seek treatment. Conclusions This study provides information regarding access to treatment for patients living with EDs in Chile. A practical public health approach should consider the multi-causality of delay in treatment and promoting early interventions. Plain English Summary Eating disorders (EDs) may severely affect the daily functioning of people enduring them. A delay in starting treatment is associated with a disease that is more difficult to treat. To our knowledge, there are no published studies carried out in Latin America exploring factors influencing treatment initiation in EDs patients. This study aimed to identify facilitators of and barriers to treating patients with EDs in Chile. We interviewed patients (n = 22), their relatives (n = 10), and health professionals (n = 8) from a private and a public center in Santiago, Chile. Our analysis showed that the main barriers to starting treatment were the lack of professional knowledge in ED, the monetary cost of illness, and cultural misinformation. Facilitators were related to the role of the family in recognizing and addressing the disease while being educated in EDs by professionals. This study helps to provide data about treatment access in developing countries. While facilitators and barriers were similar to others reported in the literature, the untreated ED’s duration was longer. It is essential to address these barriers to provide access to treatment more efficiently and prevent severe and enduring forms of disease.
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    HEALTH-RELATED QUALITY OF LIFE OF EATING DISORDERS IN CHILEAN ADOLESCENTS
    (ELSEVIER SCIENCE INC, 2019) Inostroza, Carolina; Urrejola, Pascuala; Zubarew, Tamara; Loreto Correa, Maria; Gil, Aurora A.; Bedregal, Paula; Vogel, Melina
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    Predictores de severidad en trastornos de conducta alimentaria en población clínica adulta
    (2021) Letelier Vuskovic, Matías Daniel; Behn Berliner, Alex Joseph; Vogel, Melina; Pontificia Universidad Católica de Chile. Escuela de Psicología
    Debido a la baja tasa de prevalencia y las complicaciones clínico/prácticas de su naturaleza, los trastornos de la conducta alimentaria (TCA) son patologías mentales difíciles de estudiar e investigar. Esto es en particular cierto en el contexto Latinoamericano, donde la evidencia internacional no necesariamente se corresponde con las características de esta población. Lo mismo ocurre con casos en la adultez, ya que la mayoría de la investigación se centra en la edad de mayor riesgo, que sería la pubertad y la adolescencia. Sin embargo, existen personas adultas en países sudamericanos como Chile que sufren de estas enfermedades y muy poco se conoce de la naturaleza, características y factores que predicen un mejor o peor pronóstico. Debido a esto, el presente estudio se plantea explorar e identificar posibles predictores de severidad y deterioro en adultos atendiéndose en una unidad clínica especializada en tratamiento de TCA. En este estudio se espera que, en primer lugar, el IMC; el diagnóstico de AN; el inicio temprano de los síntomas; comorbilidades psiquiátricas; y la duración entre el inicio de síntomas y búsqueda de tratamiento, deberían predecir una mayor severidad de los TCA. En segundo lugar, se espera que una mayor cronicidad/duración de los síntomas no debería implicar mayores niveles de severidad. Y tercero, se hipotetiza que un mayor puntaje obtenido en las escalas del EDE-Q sobre preocupación sobre peso, comida y forma corporal impliquen mayores niveles de severidad. Para este fin, se realizó un muestreo de 220 pacientes adultos a quienes se les fue enviado un set de encuestas con el fin de detectar estos factores, compuesto de una encuesta de datos sociodemográficos, la Clinical Impairment Assessment (CIA) y el Eating Disorder Examination Questionnaire (EDE-Q). De este número, se obtuvo un N de 109 participantes (97.2% del sexo femenino), que padecían de anorexia nerviosa (AN= 32.1%), bulimia nerviosa (BN=17.4%), trastorno por atracones (TPA=34.9%) y TCA no especificado (TCANE=15.6%). Por medio del análisis estadístico, mediante un modelo multivariado de regresión lineal, se encontró que el índice de masa corporal (IMC) al ingreso, conductas restrictivas y preocupaciones por la alimentación/figura corporal predijeron un mayor nivel de severidad y deterioro. Se discuten al final las implicancias de estos resultados en relación con la literatura y se hacen referencia a otros resultados que no se tenían contemplados al inicio del estudio, como diferencias en variables clínicas según el diagnóstico específico de TCA. Se concluye que aún se necesitan investigaciones en pacientes con TCA para determinar predictores de severidad, tanto para el espectro en general, como para cada diagnóstico de este espectro. No obstante, este estudio tendría utilidad científica como información preliminar en una población poco estudiada; y clínica, al determinar algunos factores a tener en mente durante el tratamiento de esta patología.
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    Pronounced inhibition-related hypofrontal dysfunction in early-onset schizophrenia as indexed by NoGo-P300 amplitude
    (2017) Sharma, Anuradha; Vogel, Melina; Weisbrod, Matthias; Roesch-Ely, Daniela; Oelkers-Ax, Rieke
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    Severity and endurance in eating disorders: an exploration of a clinical sample from Chile
    (2020) Dapelo, M. M.; Gil, A. A.; Lacalle, L.; Vogel, Melina
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    Virtually Accompanied Eating in the Outpatient Therapy of Anorexia Nervosa
    (2023) Vogel, Melina; Gil, Aurora; Galaz, Camila; Urrejola Noguera, Pascuala; Lacalle, Lucas; Jara, Raúl; Irribarra Pastenes, Verónica; Letelier, Matias; Costa, Daniela; Espinoza, Gabriela
    Background: Normalizing the eating pattern and weight recovery are the main objectives in treating anorexia nervosa (AN). Eating accompaniment through shared mealtimes is a common strategy in eating disorder management programs. This study aims to examine the impact on weight gain of an internet-delivered meal support group on patients with AN who were under ambulatory treatment with the Eating Disorders Unit of the UC Christus Health Network, Chile. Methods: An observational study of 54 female patients with AN diagnosis who participated in Online Meal Support Groups (OMSGs) three times a week was performed. Their weight, BMI and BMI%, was reviewed at the beginning of the sessions and at 45- and 90-day follow-up. Results: Patients showed significant weight gain during follow-up. At the 90-day follow-up, patients had gained 4.41 (SD ± 2.82) kg with an effect size of −1.563. Conclusions: Statistically significant differences were found between the weight at the beginning of the intervention and at the 45- and 90-day follow-up, meaning that eating support online groups may be an effective intervention for weight gain and maintenance in patients with AN. These findings highlight the viability of developing cost-effective and more accessible interventions for AN and thus help reduce the duration of untreated disease and its consequences.