Sofía Santos-Simancas

The rise in mental health issues among youth in Colombia is a critical public health concern. This study examined factors associated with baseline resilience in 4,361 children and adolescents participating in the “Conmigo, Contigo, Con Todos” program across three conflict-affected Colombian departments (Amazonas, Boyacá, Vaupés). This cross-sectional study analyzed participants aged 8–17 years from 56 schools. Resilience was measured using the CD-RISC. Socioemotional competencies were assessed using validated instruments. Due to systematic missing data in children's mental health screenings, complete-case multivariable linear regression (supported by multiple imputation sensitivity analyses) evaluated associations between resilience and sociodemographic, emotional, and familial factors. Male gender identity (β = 3.46), compassion (β = 0.35), and prosocial behavior (β = 0.38) were associated with higher resilience. Family dynamics emerged as robust correlates; youth "very satisfied" with family relationships showed significantly higher resilience (β = 8.26) versus those dissatisfied. Crucially, an absolute lack of perceived family support ("never") was associated with a severe reduction in resilience (β = -9.56) compared to youth who "almost never" felt supported. Geographic disparities were significant; residence in Vaupés correlated with lower resilience (β = -4.75) than Boyacá. Positive family dynamics are profoundly associated with higher baseline resilience in conflict-affected youth, whereas an absolute lack of support constitutes a severe vulnerability. Place-based disparities highlight the intersection of structural inequity and adaptation, emphasizing the necessity for culturally responsive interventions and longitudinal research.

Depression is a prevalent psychiatric disorder among adults aged 65 and older, significantly impacting their well-being. With an aging global population, effective interventions delivered in community settings are vital to combat this issue. This review provides an overview of the characteristics of interventions addressing depression in community-dwelling older adults, identifying knowledge gaps by synthesizing current data. The search strategy entails a systematic database search across PubMed, EMBASE, Ovid, and PsycNet, without any time or language restrictions. Studies were included if they reported interventions delivered in community settings that aimed to improve depressive symptoms or reduce the prevalence of depression in older adults. A total of 20 studies met the inclusion criteria. Interventions were grouped into four main types (discussion groups, individual contact, social engagement activities, and skills courses), often combined. Most reported short-term reductions in depressive symptoms, but evidence was limited by small samples, reliance on self-reported outcomes, and scarce long-term follow-up. Interventions delivered in community settings show promise for supporting older adults’ mental health, especially when they are adapted to local needs. Improving recruitment strategies and tackling cultural and logistical barriers could expand their reach and accessibility, and strengthen the contribution of these programs alongside specialist mental health care.

Purpose of review: Hypoactive delirium is a frequently underrecognized subtype associated with increased morbidity and mortality, yet it lacks clearly established pharmacologic treatment strategies. This scoping review aimed to map and critically examine the existing evidence on pharmacological interventions specifically evaluated for hypoactive delirium in hospitalized adults, focusing on symptom severity and clinical outcomes. Recent findings: The available literature is limited and heterogeneous. Identified studies included randomized controlled trials, observational studies, and recent systematic reviews evaluating agents such as antipsychotics, dexmedetomidine, melatonin, flumazenil, and methylphenidate. However, most trials were small, methodologically diverse, and not specifically powered for the hypoactive subtype. Evidence supporting atypical antipsychotics remains inconsistent, and no high-quality randomized trials demonstrate clear benefit for routine use in hypoactive delirium. Alternative agents such as flumazenil and methylphenidate have been explored in limited or exploratory contexts, without consistent improvement in clinically meaningful outcomes. Summary: Current evidence does not support the routine use of any pharmacologic agent as a standard treatment for hypoactive delirium. Existing studies are constrained by small sample sizes, heterogeneity in diagnostic criteria and outcome measures, and overlap across systematic reviews and primary trials. Further well-designed, subtype-specific randomized controlled trials are needed to determine whether targeted pharmacologic strategies can improve outcomes in this vulnerable population.