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Within the context of a country with high levels of violence, as is Colombia, this paper intends to show how--besides all forms of open violence against children (battering, compulsory work, tortures) more frequently detected in specific social milieus--there exist other forms of violence--more insidiously widespread--which supply a basis for extreme types of violent behavior. Starting from the assumption that every physical or psychological way of pressure on children is a demonstration of violence, the article aims at clarifying how the violent elements to be found in parental behaviors intend hindering both the development and independence of children. Seductive behaviors are also seen as a form of violence, as well as all mechanisms aiming at turning children into an instrument in conflicts between adults.

The present paper offers a summary description of the findings from the 10 year follow-up of a group of 101 schizophrenics who where included in the W.H.O. International Pilot Study of Schizophrenia. It is based on a prospective study conducted with the use of standardized instruments and with clinical evaluations performed by the same examiners at the beginning and end phases. A classificatory outline of the varieties of clinical course observed throughout the follow-up period is presented, as well as a description of several aspects of the social and clinical condition of cases at the time of the final observation. The possibility of finding predictors of the outcome of the disorder is explored through the use of multivariate methods and a series of comments and conclusions are formulated.

Seven to eight months after the disastrous volcanic mudslide that destroyed the town of Armero, Colombia, 200 victims were screened up by means of the Self-Reporting Questionnaire (SRQ) for emotional disorders identification. In order to assess disorders' specific nature, a 104-victim subsample was interviewed by psychiatrists. The most frequent diagnosis ranged among (a) Post-traumatic stress syndrome, (b) Depressión, and (c) Generalized anxiety disorder. Our findings help us to point out that (1) In a developing country a higher prevalence of well-defined emotional disorders among victims of any first-magnitude disaster is to be detected at such a level it can safely be said a real epidemic is to be tackled with, (2) Basically, the identified symptomatology confines itself to anxiety-depression disorders, (3) SRQ is indeed an apt instrument for disasters victims screening, and (4) Mental health specialized resources proved to be insufficient for an adequate coverage of the needs of the affected communities to be performed. As far as mental health is concerned, if the necessary services are to be offered so that all aspects involved are taken care of, it is imperative that victims be attended to by primary care workers. So far, mental health primary care area is still lacking a systematical research within a disaster situation framework. We understand that our paper may serve as an initial orientation for this care strategy being duly implemented and furthered up.

In order to understand "ideological democracy" and its consecuences for therapy it is important to study the ideology of group members from the psychodynamic standpoint. Ideology is understood as a system of rules to interpret reality, although from a theoretical point of view, we contend reality itself is free from ideology. Ideology is thus defined as a cognitive system, stemming from emotional matrices of the psychosexual development of personality. The understanding of how the members of the Therapeutic Community attain "ideological democracy" is, to our mind, essential in order to be able to attain therapeutic goals. After a brief introduction the paper deals with ideology and its relationship with different personality structures: hysteric, phobic, psychopatic, depressive, paranoid and schizoid. Several common mechanisms for building ideology are set forth. The final conclusion is that such an analysis helps to ascertain the best strategies for community therapy.

This paper briefs a research on the influence of stressing environmental factors upon mental health conditions of university students. The study was undertaken at the Student Psychiatric Service, Universidad del Valle, Cali, Colombia. Three equal periods are compared. The first is a normal one; the others are disorderly and riotous, up to the point of foreing the discontinuance of academic activities for several months. As compared with the period of academic stability, the rates of mental disturbances show a steep rise in the periods of agitation. Schizophrenia, depression, anxiety, all kinds of difficulties in interpersonal relations, and somatic disturbances, are sharply increased, whereas complaints of less severe disturbances, like transient situational disorders, level up or decrease. Another significant rise is registered in the use of drugs for therapeutic purposes. The study leads to the conclusion that stress due to environmental disorders or social upheavals is an important factor in the aethiology of severe mental disturbances.

The outstanding Latin-American poet Porfirio Barba-Jacob (1883-1942) was a heavy user of marihuana. In this paper the author provides some data concerning historical antecedents of marihuana--mainly in Latin America--and he discusses its influence upon Barba-Jacob's life and poetry. The hypothesis that consumption of marihuana is used by some hyperkinetic adults as self-induced pharmacotherapy is outlined.

The paper describes the experience acquired during more than 8 years in carrying out primary mental health care in Cali, Colombia. It had already been shown that the use of trained paramedical personnel achieved some advantages to that of traditional approaches. The present programme is carried out in two different geographical areas (rural and urban) which provide care to about 10 per cent of their population. Although final clinical results are still not available, the basic approach entails the use of primary mental health agents (auxiliary nurses and health promotors) as the first step of assistance, ending in the top of the hierarchy, where a doctor and/or a trained nurse are responsible for the diagnoses. A trained psychiatrist acts only as a periodic consultant and as the main source for training. There is evidence to suggest that these primary mental health care agents have more time to talk to the patients and are more able to understand their local psycho-social circumstances. This system enables cheaper and more effective care services. Its advantages, risks and related problems are discussed, and mention is made for the need to maintain regular clinical assessment. The various training techniques are also discussed.

The consumption of alcohol by the population becomes a theme of medical-social relevance in so far as the excessive or problematic habit of drinking alcohol leads to the syndrome of alcoholism and may affect substantially the mental health of the population. This paper tries to introduce the theoretical and practical study of the psychocultural development of the alcohol drinking behaviour, based on some exemplary cases of Chile, Columbia and Mexico, in Latin America. Essential themes are: Which kind of relations does exist between the socio-economic conditions and the alcohol consumption behaviour in each particular case? Which are the social and/or age groups with greater propensity towards problematic drinking habits? Which of the autochthnous cultural elements are available for preventive activities inside the community?