ABSTRACT
Background: Studies done in Chile and abroad report a high frequency of substance abuse among patients hospitalized in general medical services. Aim: To report the frequency of substance abuse in a sample of patients hospitalized in a public hospital of Santiago. Material and methods: A structured psychiatric interview for the Third Revised Version of The Diagnostic and Statistical Manual (DSM-III-R) was applied to 203 males, aged 58.5 years and 203 females, aged 52,9 years, hospitalized in an internal medicine Service of a public hospital. All subjects had a low educational and income level. Results: The discharge diagnoses of studied patients were digestive diseases in 32 percent, circulatory diseases in 19 percent, cancer, diabetes mellitus and genitourinary diseases in 11 percent respectively and mental or behavioral diseases in 5 percent. Thirty eight percent of males and 6 percent of females qualified for alcohol dependency or abuse in some moment of their lives. The figures for benzodiazepine dependency were 1 percent among males and 6 percent among females. The figures for cannabis, cocaine or stimulant abuse were 1.5 percent for males and 1 percent for females. Other conditions of the axis 1 of DSM-IIIR were diagnosed in 47 percent of males and 65 percent of females with substance abuse. Conclusions: Substance abuse underlies medical conditions in a high proportion of patients admitted to medical services in general hospitals
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Anxiety Disorders , Alcoholism , Depression/epidemiology , Cocaine-Related Disorders/epidemiology , Bipolar Disorder , Comorbidity , Marijuana Abuse , Prevalence , Alcoholism , Substance Abuse Detection , Socioeconomic Factors , Phobic Disorders/epidemiology , Cocaine-Related Disorders/psychologyABSTRACT
Background: Mental disorders may interfere, aggravate or mimic medical conditions. Aim: To study the prevalence of psychiatric disorders among patients hospitalized in a medical ward of a general hospital. Patients and methods: A structured interview for DSM-III, devised for "non patients", was applied to 203 men and 203 women, aged 11 to 90 years old, hospitalized in an internal medicine service of a public hospital. Thirty four psychiatric conditions that can be discriminated with the instrument and others that complied with DSM-III criteria, were investigated. Results: There was a 60 percent prevalence of mental disorders among men (alcohol dependency in 26 percent, delirium or dementia in 10.8 percent, anxiety disorders in 10.4 percent, major depression in 7.8 percent and adaptation disorders in 3 percent). Among women, the prevalence of mental disorders was 65 percent (major depression in 23.2 percent, anxiety disorders in 14.3 percent, adaptation disorders in 8.4 percent, dementia in 5.6 percent, delirium in 3 percent and alcohol dependency in 2.5 percent). Most conditions were of moderate or mild intensity. Two or more conditions coexisted in 40 percent of cases. Only in 8 percent of these subjects, a psychiatric consultation was requested. Conclusions: There is a high frequency of psychiatric disorders among medical patients. These must be adequately diagnosed and treated
Subject(s)
Humans , Male , Female , Hospital Departments , Mental Disorders , Depressive Disorder, Major/epidemiology , Interview, Psychological , Psychiatric Status Rating Scales/statistics & numerical data , Demographic IndicatorsABSTRACT
The biomedical model has successfully reduced mother and child mortality and diseases during the labor and puerperal period. In the perinatal period, the mother and her offspring can also have psychosocial problems, that have been insufficiently studied and that we propose considering. Based on neurobiological information, on bonding theory and on a focus change in the everyday work of human behavior experts in maternity hospitals, we propose that perinatal mental health should have an important place and can be harmoniously articulated with the biomedical model. This mental health work should aim at generating safe mother-child bonds. It should be maintained Thereafter through social networks to prevent child abuse, to promote healthy development and to prevent psychopathology. We review some of the programs carried out in the ten year period in which we have worked as a mental health team in the maternity ward of a public hospital in Santiago, Chile
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy/psychology , Mental Health , Postpartum Period/psychology , Perinatal Care/trends , Maternal Behavior/psychology , Maternal Health Services/trendsABSTRACT
Background: A previous suicide attempt is one of the strongest predictors of future suicidal behavior. Aim: To explore the evolution of suicidal tendencies in women who attempted suicide 5 to 7 years earlier. Patients and methods: Ninety two women aged 37 ñ 9 years old, that attempted suicide between 1989 and 1991 were followed and reassessed in 1997. Results: In the study period two women committed suicide and 30 attempted suicide. Forty three percent of new self harm behaviors occurred during the first year after the first suicide attempt and the harming method was similar. Conclusions: In this study, 34percent of women with previous suicide attempts, repeated this behavior, using similar methods
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Suicide, Attempted/statistics & numerical data , Recurrence , Suicide/statistics & numerical data , Suicide, Attempted/psychology , Risk FactorsABSTRACT
The purpose of this work was to construct and assess a scale aimed to detect risky relationship between mothers and newborns that could predict future child abuse and neglect. The instrument was applied in 2 opportunities, by a trained midwife and by expert in mental health, to a sample of 106 mother-newborn dyads. When both assessments were compared, the concordance to assess relationship risk was 99.3 percent. The reliability of the scale, measured with the Crombach, a internal consistence index, was 0.88. Those items with a low discriminative capacity were eliminated. The massive use of the resultant scale, that is easy to apply and highly reliable, could help to prevent child abuse and neglect