Papers by Guillermo Rivera Arroyo
International Journal of Social Psychiatry
Background: The Latin American prison population has grown faster than anywhere else globally ove... more Background: The Latin American prison population has grown faster than anywhere else globally over the past two decades, reaching a total of 1.7 million people at any given time. However, research on mental health prevention and treatment interventions in Latin American prisons remains scarce. Aims: This study aimed to systematically review and synthesize research on prison mental health interventions conducted in the region. Methods: We used a two-stage scoping review design guided by the JBI Manual for Evidence Synthesis. Searches took place in December 2021 in nine databases using descriptors and synonyms. First, all prison mental health research in Latin America was retained. Secondly, using title and abstract screening, all research possibly related to interventions was retained for full text evaluation. Studies reporting interventions were assessed by country, language, institution, population, intervention type, intervention focus and outcomes. Results: N = 34 studies were in...
Medicine, Science and the Law
International Journal of Social Psychiatry, 2023
Background:
The Latin American prison population has grown faster than anywhere else globally ove... more Background:
The Latin American prison population has grown faster than anywhere else globally over the past two decades, reaching a total of 1.7 million people at any given time. However, research on mental health prevention and treatment interventions in Latin American prisons remains scarce.
Aims:
This study aimed to systematically review and synthesize research on prison mental health interventions conducted in the region.
Methods:
We used a two-stage scoping review design guided by the JBI Manual for Evidence Synthesis. Searches took place in December 2021 in nine databases using descriptors and synonyms. First, all prison mental health research in Latin America was retained. Secondly, using title and abstract screening, all research possibly related to interventions was retained for full text evaluation. Studies reporting interventions were assessed by country, language, institution, population, intervention type, intervention focus and outcomes.
Results: N = 34 studies were included in this review. These were 13 case reports, seven expert consensus papers and 14 quantitative studies (four randomized controlled trials, nine cohort studies, one quasi-experimental study). Fourteen interventions were targeted at promoting prosocial behavior, seven studies each aimed to improve mental health and to treat substance use disorders. Six studies involved the treatment of sexual offending behavior, and 3 focused on reducing criminal recidivism. Psychoeducation (n = 12) and motivational interviewing (n = 5) were the most frequent intervention types studied. Promising data from trials showed that anger management, depression, substance use and reoffending could be successfully addressed through interventions.
Conclusions:
Implementation and effectiveness research of mental health interventions in Latin American prisons is scarce. Addressing mental health, substance use and prosocial behavior outcomes should be considered in future research. There is a particular dearth of controlled trials describing quantifiable outcomes.
A Dataset exploring suicide counts in South American Prisons. The set contains suicide and popula... more A Dataset exploring suicide counts in South American Prisons. The set contains suicide and population counts divided by female and male gender between 2000 and 2017 in the federal prisons of Argentina, the Palmasola prison in Bolivia, all public prisons in Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Perú, and Uruguay. The set also contains rates of occupancy, rates of incarceration, and suicide and population counts for the general population of the same countries.
Evidencia, actualizacion en la práctica ambulatoria, 2005
Tratamiento del síndrome de fatiga crónica 184 EVIDENCIA-Actualización en la Práctica Ambulatoria
BJPsych International
This paper compares across six nations the mental health systems available to prisoners with the ... more This paper compares across six nations the mental health systems available to prisoners with the highest acuity of psychosis and risk combined with the lowest level of insight into the need for treatment. Variations were observed within and between nations. Findings highlight the likely impact of factors such as mental health legislation and the prison mental health workforce on a nation's ability to deliver timely and effective treatment close to home for prisoners who lack capacity to consent to treatment for their severe mental illness. The potential benefits of addressing the resulting inequalities are noted.
BJPsych International, 2022
This paper compares across six nations the mental health systems available to prisoners with the ... more This paper compares across six nations the mental health systems available to prisoners with the highest acuity of psychosis and risk combined with the lowest level of insight into the need for treatment. Variations were observed within and between nations. Findings highlight the likely impact of factors such as mental health legislation and the prison mental health workforce on a nation's ability to deliver timely and effective treatment close to home for prisoners who lack capacity to consent to treatment for their severe mental illness. The potential benefits of addressing the resulting inequalities are noted.
Psychological Medicine, 2020
BackgroundIn 1990, Latin American countries committed to psychiatric reforms including psychiatri... more BackgroundIn 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America.MethodsWe searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela.ResultsThe number of psychiatric beds decreased in 15 out of 17 Latin American countries (median −35%) since 1991. Our findings indicate th...
Alzheimer's & Dementia, 2020
Background: The pandemic of SARS-CoV-2 is focusing all energies on the impact on survival of affe... more Background: The pandemic of SARS-CoV-2 is focusing all energies on the impact on survival of affected individuals, treatment and prevention, but increasingly attention is focusing on its enduring consequences. We established a global consortium to study a longitudinal representative cohort of individuals, to characterize neurological and neuropsychiatric sequalae from direct viral, immune-, vascular-or accelerated neurodegenerative injury to the central nervous system (CNS). Method: We propose to characterize the neurobehavioral phenomenology associated with SARS-CoV-2 in a large, multinational, longitudinal cohort of post COVID-19 infection patients following three sampling strategies: 1) Opportunity sample of patients discharged after hospital admission for COVID-19 related symptoms. 2) A stratified random sample from COVID-19 testing registries (including asymptomatic and negative participants). 3) Ascertaining COVID-19 exposure (antibody) status in ongoing longitudinal, community-based cohort studies that are already collecting biosamples, cognitive, behavioral and neuroimaging data. We will obtain core data within 6 months of discharge or testing. Core characterization will include interviews with the Schedules of Clinical Assessment in Neuropsychiatry (SCAN), neurological exams, emotional reactivity scales and a neurocognitive assessment. Wherever feasible, we will also collect neuroimaging, biosamples and genetic data. Longitudinal follow up will be conducted at 9 and 18 months of the initial evaluation. An mHealth keeping-in-touch process will be set up to minimize attrition rates. The population cohorts provide a large, unbiased, normative and validation sample, albeit with more heterogenous outcome ascertainment. They also permit examination of pre-and post-COVID trends in symptoms and biomarkers. Since some ethnic groups, as well as in individuals with blood type A, are at higher risk of COVID-19 infection and death, a role of genetics in determining susceptibility to infection and poor outcomes seems well supported. We will collect genome-wide genotypes from our cohort individuals to address the role of ancestry and genetic variation on susceptibility to neuropsychiatric sequelae. High rates of mutation in COVID-19 strongly suggest that viral infectivity, including neurotropism, may not be uniform across countries affected by the pandemic. Results: Pending. Conclusion: Our consortium is in a unique position to address the interaction between genetics (including ancestral DNA), and viral strain variation on CNS sequelae of SARS-CoV-2.
BJPsych. International, 2015
Bolivia's mental health plan is not currently embedded in mental health legislation or a lega... more Bolivia's mental health plan is not currently embedded in mental health legislation or a legal framework, though in 2014 legislative change was proposed that would begin to provide protection and support for the hospital admission, treatment and care of people with mental disorders in Bolivia. Properly resourced, regulated and rights-based mental health practice is still required. Mental healthcare in the primary care setting should be prioritised, and safeguards are needed for the autonomy of all patients, including all those in vulnerable and cared-for groups, including those in prisons.
European Psychiatry, 2016
The problemLess than half of the more than 250 adolescents and young adults who are estimated to ... more The problemLess than half of the more than 250 adolescents and young adults who are estimated to experience a first episode of psychosis in the city of Santa Cruz each year are ever diagnosed and receive treatment.Of those patients who are eventually diagnosed, the average duration of their symptoms of psychosis prior to receiving treatment is estimated to be over 2 years.The opportunityMultiple psychosocial variables, such as the reaction of patients and their families to symptoms of psychosis, which play a vital role in determining long-term outcomes, demonstrate their highest degree of flexibility during the period of early psychosis. Psychological, social and evidence-based pharmacological interventions undertaken during this time frame can have a profound impact on the life-course of an individual with psychosis.Our solutionWe propose to establish a pilot early psychosis intervention program that will provide age appropriate biopsychosocial treatment and support for 15–25 years...
IMPORTANCE In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose h... more IMPORTANCE In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose hypothesized that the numbers of psychiatric hospital beds and the sizes of prison populations were inversely related; 75 years later, the question arises as to whether the hypothesis applies to recent developments in South America. OBJECTIVE To explore the possible association of changes in the numbers of psychiatric hospital beds with changes in the sizes of prison populations in South America since 1990. DESIGN, SETTING, AND PARTICIPANTS We searched primary sources for the numbers of psychiatric hospital beds in South American countries since 1990 (the year that the Latin American countries signed the Caracas Declaration) and compared these changes against the sizes of prison populations. The associations between the numbers of psychiatric beds and the sizes of prison populations were tested using fixed-effects regression of panel data. Economic variables were considered as covariates. Sufficiently reliable and complete data were obtained from 6 countries: Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay. MAIN OUTCOMES AND MEASURES The numbers of psychiatric beds and the sizes of prison populations. RESULTS Since 1990, the numbers of psychiatric beds decreased in all 6 countries (ranging from −2.0% to −71.9%), while the sizes of prison populations increased substantially (ranging from 16.1% to 273.0%). Panel data regression analysis across the 6 countries showed a significant inverse relationship between numbers of psychiatric beds and sizes of prison populations. On average, the removal of 1 bed was associated with 5.18 more prisoners (95% CI, 3.10-7.26; P = .001), which was reduced to 2.78 prisoners (95% CI, 2.59-2.97; P < .001) when economic growth was considered as a covariate. The association between the numbers of psychiatric beds and the sizes of prison populations remained practically unchanged when income inequality was considered as a covariate (−4.28 [95% CI, −5.21 to −3.36]; P < .001). CONCLUSIONS AND RELEVANCE Since 1990, the numbers of psychiatric beds have substantially decreased in South America, while the sizes of the prison populations have increased against a background of strong economic growth. The changes appear to be associated because the numbers of beds decreased more extensively when and where the sizes of prison populations increased. These findings are consistent with and specify the assumption of an association between the numbers of psychiatric beds and the sizes of prison populations. More research is needed to understand the drivers of the capacities of psychiatric hospitals and prisons and to explore reasons for their association.
Social Psychiatry and Psychiatric Epidemiology
Purpose Although suicide rates of prison populations and incidence factors have been reported for... more Purpose Although suicide rates of prison populations and incidence factors have been reported for high-income countries, data from low- and middle-income regions are lacking. The purpose of the study was to estimate suicide rates among prison populations in South America, to examine prison-related factors, and to compare suicide rates between prison and general populations. Methods In this observational study, we collected the numbers of suicides in prison, rates of prison occupancy, and incarceration rates from primary sources in South America between 2000 and 2017. We compared suicide rates among prisoners with incidence rates in the general populations by calculating incidence rate ratios. We assessed the effect of gender, year, incarceration rates and occupancy on suicide rates in the prison populations using regression analyses. Results There were 1324 suicides reported during 4,437,591 person years of imprisonment between 2000 and 2017 in 10 South American countries. The mean suicide rate was 40 (95% CI 16–65) per 100,000 person years for male and female genders combined. The pooled incidence rate ratio of suicide between prison and general populations was 3.9 (95% CI 3.1–5.1) for both genders combined, 2.4 (95% CI 1.9–3.1) for men and a higher ratio in women (13.5, 95% CI 6.9–26.9). High occupancies of prisons were associated with lower incidence of suicide ( β = − 58, 95% CI − 108.5 to − 7.1). Conclusions Suicides during imprisonment in South America are an important public health problem. Suicide prevention strategies need to target prison populations.
Schizophrenia Bulletin
approaches to address barriers to behavior change (cognitive behavioral therapy, interpersonal th... more approaches to address barriers to behavior change (cognitive behavioral therapy, interpersonal therapy and dialectic behavior therapy). Defining Criteria for Illness Severity & Engagement: We evaluated factors hypothesized to be associated with change in weight, including illness severity and treatment engagement. "Severe" psychiatric symptoms were defined as baseline Clinical Global Impression (CGI) Severity score of >5. Criterion engagement was defined as text messaging response rate of >80% over the first 4 weeks of treatment. Disordered eating, assessed with the Loss of Control Over Eating Scores (LOCES), was also evaluated. Analytic Approach: Repeated measures ANCOVA was used to test for the effect of time on weight change, including 2-level factors for membership in included/excluded participant group and treatment setting, as well as an exploratory covariate representing score on the LOCES. Finally, we evaluated whether treatment setting had an effect on weight change over time. Significance was set at p<0.05 using a two-tailed test. Results: A total of 26 participants were recruited for the study (24% schizophrenia, 68% mood disorder). The mean age of the population was 48.5 years (SD=15.67); 60% were white and 60% female. Eight participants met the exclusion criteria under evaluation (CGI >5 and response rate <80%). A significant interaction was observed between included/ excluded participant group and time (F[1,23]=17.98, p<0.0001), explained by participants with lower symptom severity and criterion level engagement exhibiting a significant decrease in weight (F[1,16]=22.54, p<0.0001). Participants with high symptom severity and low treatment engagement had a trend-level increase in weight (F[1,7]=4.33, p=0.08). Next, we tested the interactive effect of time and treatment setting on weight change and found no significant interaction (F[1,23]=2.22, p=0.15). Finally, no significant interaction between time and baseline LOCES score on weight change was detected (F[1,22]=0.02, p=0.90). Discussion: These results demonstrate the feasibility of delivering an adapted iOTA to SMI patients receiving care in CMHC and Clubhouse settings and suggest testable criteria for defining sufficient treatment engagement and psychiatric symptom severity. These data are relevant to future study design considerations and support the use of specific exclusion criteria for treatment engagement and psychiatric symptom control. More comprehensive symptom assessments may be needed to understand the effect of eating disorder symptoms on weight change outcomes in this populations.
Revista Latinoamericana de Psiquiatría, 2021
Identificar a aquellas personas que tienen un mayor riesgo para desarrollar trastornos psiquiátri... more Identificar a aquellas personas que tienen un mayor riesgo para desarrollar trastornos psiquiátricos severos e intervenir precozmente para evitar el desarrollo de éstos o mejorar su pronóstico en el largo plazo, ha sido el motor principal de los programas de intervención temprana. Hoy sabemos que existen estrategias de intervención sistematizadas que permiten disminuir la transición a psicosis en esta población. Asimismo, sabemos que las intervenciones clínicas en los primeros años desde el inicio de los síntomas, mejoran la respuesta al tratamiento y el pronóstico funcional en el largo plazo de nuestros pacientes. Sin embargo, estas intervenciones son complejas y requieren de grupos interdisciplinarios con un enfoque flexible, para dar respuestas apropiadas a cada etapa de la enfermedad, que incluyan a los pacientes, familiares y a la comunidad. Esta revisión narrativa tiene como objetivo revisar el conocimiento actual sobre la intervención temprana desde una perspectiva clínica y proponer un acercamiento contingente y progresivo en la población de alto riesgo y psicosis temprana.
Alzheimer’s & Dementia, 2020
Background: The pandemic of SARS-CoV-2 is focusing all energies on the impact onsurvival of affec... more Background: The pandemic of SARS-CoV-2 is focusing all energies on the impact onsurvival of affected individuals, treatment and prevention, but increasingly attention isfocusing on its enduring consequences. We established a global consortium to study alongitudinal representative cohort of individuals, to characterize neurological and neu-ropsychiatric sequalae from direct viral, immune-, vascular- or accelerated neurode-generative injury to the central nervous system (CNS).
Conclusion: Our consortium is in a unique position to address the interaction betweengenetics (including ancestral DNA), and viral strain variation on CNS sequelae of SARS-CoV-2
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Papers by Guillermo Rivera Arroyo
The Latin American prison population has grown faster than anywhere else globally over the past two decades, reaching a total of 1.7 million people at any given time. However, research on mental health prevention and treatment interventions in Latin American prisons remains scarce.
Aims:
This study aimed to systematically review and synthesize research on prison mental health interventions conducted in the region.
Methods:
We used a two-stage scoping review design guided by the JBI Manual for Evidence Synthesis. Searches took place in December 2021 in nine databases using descriptors and synonyms. First, all prison mental health research in Latin America was retained. Secondly, using title and abstract screening, all research possibly related to interventions was retained for full text evaluation. Studies reporting interventions were assessed by country, language, institution, population, intervention type, intervention focus and outcomes.
Results: N = 34 studies were included in this review. These were 13 case reports, seven expert consensus papers and 14 quantitative studies (four randomized controlled trials, nine cohort studies, one quasi-experimental study). Fourteen interventions were targeted at promoting prosocial behavior, seven studies each aimed to improve mental health and to treat substance use disorders. Six studies involved the treatment of sexual offending behavior, and 3 focused on reducing criminal recidivism. Psychoeducation (n = 12) and motivational interviewing (n = 5) were the most frequent intervention types studied. Promising data from trials showed that anger management, depression, substance use and reoffending could be successfully addressed through interventions.
Conclusions:
Implementation and effectiveness research of mental health interventions in Latin American prisons is scarce. Addressing mental health, substance use and prosocial behavior outcomes should be considered in future research. There is a particular dearth of controlled trials describing quantifiable outcomes.
Conclusion: Our consortium is in a unique position to address the interaction betweengenetics (including ancestral DNA), and viral strain variation on CNS sequelae of SARS-CoV-2
The Latin American prison population has grown faster than anywhere else globally over the past two decades, reaching a total of 1.7 million people at any given time. However, research on mental health prevention and treatment interventions in Latin American prisons remains scarce.
Aims:
This study aimed to systematically review and synthesize research on prison mental health interventions conducted in the region.
Methods:
We used a two-stage scoping review design guided by the JBI Manual for Evidence Synthesis. Searches took place in December 2021 in nine databases using descriptors and synonyms. First, all prison mental health research in Latin America was retained. Secondly, using title and abstract screening, all research possibly related to interventions was retained for full text evaluation. Studies reporting interventions were assessed by country, language, institution, population, intervention type, intervention focus and outcomes.
Results: N = 34 studies were included in this review. These were 13 case reports, seven expert consensus papers and 14 quantitative studies (four randomized controlled trials, nine cohort studies, one quasi-experimental study). Fourteen interventions were targeted at promoting prosocial behavior, seven studies each aimed to improve mental health and to treat substance use disorders. Six studies involved the treatment of sexual offending behavior, and 3 focused on reducing criminal recidivism. Psychoeducation (n = 12) and motivational interviewing (n = 5) were the most frequent intervention types studied. Promising data from trials showed that anger management, depression, substance use and reoffending could be successfully addressed through interventions.
Conclusions:
Implementation and effectiveness research of mental health interventions in Latin American prisons is scarce. Addressing mental health, substance use and prosocial behavior outcomes should be considered in future research. There is a particular dearth of controlled trials describing quantifiable outcomes.
Conclusion: Our consortium is in a unique position to address the interaction betweengenetics (including ancestral DNA), and viral strain variation on CNS sequelae of SARS-CoV-2
Traducción libre de artículo original en inglés:
Mental health law in Bolivia
Anne Aboaja,1 Guillermo Rivera Arroyo,2 and Liz Grant3
Author information Copyright and License information Disclaimer
Copyright © 2015 The Royal College of Psychiatrists
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Tiene como objetivo empoderar a las personas con enfermedades mentales y aumentar su autonomía
Bolivia debe transformar sus sistema asilar a uno comunitario que respete los derechos humanos y ofrezca calidad en el servicio.