ABSTRACT
En el artículo se revisa el concepto de refugios psíquicos, su origen y las bases teóricas que llevaron a Steiner a desarrollarlo. El autor toma la forma de refugio descrita por Steiner como "refugio ante ansiedades de las posiciones esquizoparanoide y depresiva", y plantea que es posible extender su uso también como refugio ante las ansiedades de lo que Ogden ha llamado posición autista-contigua. Se describen las ansiedades y defensas de esta posición autista-contigua, desarrollando especialmente la identificación adhesiva. Se examina el concepto de identificación adhesiva, comenzando por su autora E. Bick , para luego continuar con algunos de sus seguidores que han ampliado y enriquecido su teoría.Finalmente el autor fundamenta la existencia de refugios ante la posición autista -contigua mediante el uso de identificaciones adhesivas. Se discute sus posibles expresiones clínicas y los problemas teóricos que puede enfrentar el desarrollo de este concepto.
The paper reviews the concept of psychic retreat, its origin and the theoretical basis Steiner took to develop it. The author takes the form of retreat described by Steiner as "refuge from anxieties paranoid-schizoid and depressive positions," and suggests that it is also possible to extend its use as a retreat from the anxieties of what Ogden has called autistic-contiguous position. It describes the anxieties and defenses of the autistic-contiguous position, especially developing adhesive identification. He reviews the concept of adhesive identification, starting with its author E. Bick, then continue with some of his followers have expanded and enriched her theory.Finally, the author explains the existence of retreats to the autistic-contiguous position using adhesive identifications. Discussing the possible clinical expressions and theoretical problems that the development of this concept may face.
Subject(s)
Humans , Defense Mechanisms , Psychoanalysis , Autistic Disorder/psychology , Anxiety , Identification, Psychological , Physician-Patient RelationsABSTRACT
Background: Postpartum depression is a serious, common, treatable condition, with broad repercussions in mother and family life, but frequently under diagnosed. A screening tool, the Edinburgh Postnatal Depression Scale (EPDS) could improve the detection rate of depressive symptoms. Aim: To assess the efficacy of EPDS in the detection rates for depressive symptoms in the postpartum period. To evaluate the feasibility of routine use of this screening scale in a Family Medicine Center. Material and methods: The medical records of women attended during 2002, were reviewed to detect the registry of depressive symptoms or request for psychiatric consultations for depression. During 2003, the EPDS was applied to a sample of 110 women. To confirm the postpartum depression diagnosed using the instrument, a structured psychiatric interview was administered to these women. Results: The medical records of 110 women aged 24±7years were reviewed and the instrument was applied to 110 women aged 26±7years. In the first group, the spontaneous detection rate for depressive symptoms was 4.6 percent (5/110). In 26.4 percent of women in whom the instrument was applied, depressive symptoms were found and 15 percent had a postpartum depression. The application rate of the scale was 88 percent and the rate of acceptance by mothers was 100 percent. Conclusions: The EPDS improves significantly the detection rates of postpartum depressive symptoms, and it is well accepted by health professionals and mothers.