Trastornos de ansiedad en pacientes hospitalizados en Medicina Interna / Anxiety disorders among patients hospitalized in a medical ward

Background: Anxiety symptoms and anxiety disorders are common among medical patients, however few studies differentiate both and consider the psychiatric comorbidity of anxiety disorders among such patients. Aim: To evaluate the presence of anxiety disorders among patients admitted to a medical ward. Patients and methods: Random selection of 406 patients (mean age 56 years, 203 female), hospitalized in a medical ward of a public hospital, mainly for cardiovascular, genitourinary and digestive diseases. All were assessed using an structured interview for DSM-III-R. Results: Twenty six percent of women and 13% of men had anxiety disorders. Fifteen percent of women and 6% of men had specific phobias, 7% of women and 4% of men had generalized anxiety, 5% of women and 0.5% of men had agoraphobia, 3% of women and 0.5% of men had social phobia, 1% of men and 0.5% of women had panic disorders and 0.5% of women had a post traumatic stress. Specific phobias and social phobias started during childhood. Anxiety and agoraphobia started during adulthood. Among patients with anxiety disorders, 43% of women and 34% of men did not have other psychiatric ailment, 34% of women and 19% of men had an associated depression and 34% of men had disorders due to use of alcohol. Conclusions: A high proportion of patients hospitalized in medical wards have anxiety disorders, that once identified it may help to treat the medical ailments.

Psiquiatría de enlace en servicios médico-quirúrgicos de dos hospitales de Santiago / Liaison psychiatry in two public hospitals of Santiago

Background: Medical and surgical teams consult psychiatrists when abnormal behavior or psychopathological traits are observed in their patients. Aim: To describe the experience of liaison psychiatry teams in public hospitals. Material and methods: Analysis of 128 consultations, involving 110 patients. Eighty eight patients were subjected to the structured Clinical Interview for DSM-IV-TR Axis I Disorders - Patient Edition, the Mini Mental State score and to a search for personality disorders. Results: The most commonly consulted problems were depression in 44 patients, substance abuse in 29 and suicidal behavior in 21. The psychiatric study detected that 8 percent of patients were asymptomatic, 8 percent had stress reactions, 16.5 percent had substance abuse, 14.6 percent had alcohol abuse, 11 percent had a major depression, 10 percent had delirium or dementia, 9 percent had anxiety disorders, 4 percent schizophrenia, 18 percent personality disorders and 19 percent had suicidal behaviors. Conclusions: Psychiatric consultations in medical and surgical services are common and have a wide variety of severity (Rev Méd Chile 2004; 132: 725-32).

Relación médico-paciente: exploración en la interfase psicológica de la interacción de 29 internistas con sus pacientes / The doctor-patient relationship: searching into the psychological interphase of 29 internist'interactions with their patients

Con el propósito de conocer la visión que los médicos tienen acerca de la Relación Médico-Paciente, 29 médicos, hombres y mujeres con diversos tiempos de ejercicio como internistas o subespecialistas en un mismo Servicio de Medicina Interna, respondieron a una encuesta de 39 preguntas acerca de la comunicación, el uso del tiempo, las emociones y vivencias que perciben en la interacción con sus pacientes hospitalizados. Los resultados muestran que la comunicación se establece preferentemente en tópicos seguros y no conflictivos, el tiempo se consume más en labores administrativas que en la interacción directa con el paciente y que el médico percibe tanto en sí como el paciente una gran gama de emociones y vivencias. Sin embargo, desconoce cómo operar con ellas. Esto hace la Relación Médico-Paciente una variable de manejo azaroso. Se concluye que ello podría corregirse y llevar a una relación más eficaz y gratificante si se considera la comunicación, y la empatía como conceptos y habilidades a desarrollar

Formación de postgrado en psiquiatría, costo personal y fases críticas del proceso educativo para la atención psiquiátrica ambulatoria / Postgraduate training in psychiatry: personal cost and critical phases of the training process in ambulatory psychiatry

Participar en el proceso de formarse como psiquiatra competente se reconoce como complejo y con un alto costo personal. El candidato que toma el programa, vive experiencias emocionales y afectivas que pueden interferir con sus rendimientos y confundirlo hasta hacerlo dudar de sí, de su vocación y de la idoneidad de quienes lo forman. Estas vivencias las discutieron y analizaron 10 residentes en un taller ad hoc. En este informe los autores sistematizan sus experiencias y describen fases del proceso que, discriminados e integrados por los profesores que formulan programas, podrían mejorarlos, hacerlos menos costosos y obtener mejores productos