E como estão os familiares cuidadores dos pacientes psiquiátricos internados? / And what about the family caregivers of hospitalized psychiatric patients? / ¿Y cómo están los familiares cuidadores de los pacientes psiquiátricos hospitalizados?

Com a Reforma Psiquiátrica, os familiares passaram a ser considerados protagonistas nos cuidados dos pacientes psiquiátricos. O presente estudo teve como objetivo investigar a experiência emocional de familiares cuidadores de pacientes psiquiátricos internados. Para isso, foram realizadas entrevistas com dez familiares de pacientes que se encontravam internados numa unidade psiquiátrica de hospital geral de uma cidade mineira. Elas foram mediadas pela apresentação de quatro ilustrações criadas especialmente para a pesquisa para facilitar a comunicação. Após cada entrevista, foi redigida uma narrativa transferencial. O material foi analisado segundo o método psicanalítico e organizado conforme a Teoria dos Campos. Foram identificados três campos por meio dos quais os participantes expressaram temporalmente produções imaginativas sobre os antecedentes à crise, o mal-estar vivido naquele período e o futuro a ser descortinado. Conclui-se que a experiência emocional dos familiares é marcada por sofrimento emocional profundo, indicando a insuficiência das intervenções que lhes vêm sendo dispensadas, pelo menos por ocasião da internação de seus familiares.

With the Psychiatric Reform, relatives were considered protagonists in the care of psychiatric patients. This study aimed at investigating the emotional experience of family caregivers of hospitalized psychiatric patients. Interviews have been conducted with ten relatives of patients who were admitted to a psychiatric unit of a general hospital in a town in the state of Minas Gerais, Brazil. They were mediated by the presentation of four illustrations created especially for the research to facilitate communication. A transferential narrative was drawn up after each interview. The material was analyzed according to the psychoanalytical method and organized according to the Theory of Fields. Three fields were identified through which the participants temporally expressed imaginative productions about what had happened before the crisis, the discomfort experienced in that period and the future to be unveiled. It is concluded that the emotional experience of relatives is marked by profound emotional distress, indicating the insufficiency of the interventions that have been provided to them, at least when they hospitalize their relatives.

Con la Reforma Psiquiátrica, los familiares comenzaron a ser considerados protagonistas en el cuidado de pacientes psiquiátricos. El presente estudio tuvo como objetivo investigar la experiencia emocional de los cuidadores familiares de pacientes psiquiátricos hospitalizados. Para ello, se realizaron entrevistas con diez familiares de pacientes que fueron ingresados en una unidad psiquiátrica de un hospital general en una ciudad del estado de Minas Gerais, Brasil. Fueron mediados por la presentación de cuatro ilustraciones creadas especialmente para la investigación para facilitar la comunicación. Después de cada entrevista, se redactó una narración transferible. El material fue analizado según el método psicoanalítico y organizado de acuerdo con la Teoría de los Campos. Se identificaron tres campos a través de los cuales los participantes expresaron temporalmente producciones imaginativas sobre los antecedentes de la crisis, las molestias experimentadas en ese período y el futuro a revelarse. Se concluye que la experiencia emocional de los familiares está marcada por profunda angustia emocional, lo que indica la insuficiencia de las intervenciones que se les han dispensado, al menos en el momento de la hospitalización de sus familiares.

Efectividad de la terapia conductual dialéctica en pacientes con trastorno de personalidad limítrofe en Santiago de Chile / Dialectical behavior therapy effectiveness for borderline disorder personality in Santiago de Chile

Resumen Más de la mitad de los pacientes con trastorno de personalidad limítrofe (TPL) han realizado al menos un intento suicida durante su vida y el 70% ha tenido al menos una hospitalización psiquiátrica. La presente investigación tiene como objetivo evaluar la efectividad de la Terapia Conductual Dialéctica (TCD) en pacientes con trastorno de personalidad limítrofe. Método: A través de un diseño observacional retrospectivo se evaluó el número de intentos suicidas, el número de hospitalizaciones psiquiátricas y el impacto clínico previo al tratamiento con TCD y posterior a éste. Se analizó la información disponible de 144 pacientes de la Unidad de Terapia Conductual Dialéctica del Servicio de Psiquiatría del Hospital del Salvador, de Santiago de Chile, entre los años 2006-2012. Los datos fueron recolectados a través de registros electrónicos, análisis de ficha clínica, mediante el cuestionario OQ-45.2 y contacto telefónico. Resultados: En cuanto a los resultados, a través del método estadístico de Wilcoxon, se demostró una diferencia significativa (p = 0,000) en el número de hospitalizaciones psiquiátricas pre y post tratamiento, una disminución (p = 0,000) del número de intentos suicidas posterior al tratamiento y mejoría en los puntajes del cuestionario OQ-45.2. Conclusión: La TCD fue efectiva en disminuir las 3 variables estudiadas en la población escogida.

More than half of patients diagnosed with borderline personality disorder have made at least one suicide attempt during their lifetime and 70% have been admitted to an inpatient psychiatric unit. This research aims to assess the effectiveness of Dialectical Behavior Therapy (DBT) in patients with borderline personality disorder. Methods: Using a retrospective observational design, the number of suicide attempt and psychiatric hospitalizations was measured pre and post DBT treatment. Data from 144 patients from Dialectical Behavior Therapy Unit at Hospital Salvador in Santiago de Chile was analyzed during 2006 and 2012. The data were gathered from electronic files of clinical records, a OQ-45.2 questionnaire and telephone calls. Results: The Wilcoxon statistical test showed a significant difference (p = 0.000) in the number of psychiatric hospitalizations pre and post-treatment, as well as a reduction (p = 0.000) in the number of post-treatment suicide attempt. Conclusion: The Dialectical Behavior Therapy was effective in the 3 studied events in the selected population.

Effects of Enneagram Program for Self-esteem, Interpersonal Relationships, and GAF in Psychiatric Patients / 정신간호학회지

PURPOSE: The purpose of this study was to develop an enneagram program and to investigate the effects of the enneagram program on self-esteem, interpersonal relationship and GAF(Global assessment of Functioning Scale) in psychiatric patients. METHODS: A nonequivalent control group pre-post test design was used. Participants were 46 psychiatric patients. Participants were assigned to the experimental group(n=21) or control group(n=25). The experimental group participated in the enneagram program for 12 hours through eight sessions. The control group(n=25) received a routine nursing activity program. RESULTS: The experimental group that participated in the enneagram program showed higher scores for self-esteem(t=3.73, p=.001), interpersonal relationship(t=2.63, p=.012) and GAF(t=2.43, p=.019) compared to the control group. CONCLUSION: The results indicate that an enneagram program for psychiatric patients is effective in improving self-esteem, interpersonal relationship and overall functioning skills. Therefore, it is suggested that an active use of this enneagram program as a nursing intervention for psychiatric patients would be beneficial.

A humongous intraorbital foreign body in a "possessed"patient / 国际眼科杂志(Guoji Yanke Zazhi)

A 39 years old gentleman presented with red painful right eye.He had self-inflicted an injury to his right eye with a wooden stick and he saw a vision of an old man indicating him to do so.Clinically,the right eye was moderately proptosed,complete ophthalmoplegia and the periorbital skin was severely swollen.Imaging showed right orbital cellulitis with inferior ophthalmic vein thrombosis,bilateral cavernous sinus syndromeandimpending cavernous sinus thrombosis.No intraorbital or intraocular foreign body was reported.Despite aggressive intraven ous antimicrobials,the patient's condition was not improved.Exploration done under anesthesia exposed a huge wooden stick at the inferior fornix.Patient showed a remarkable recovery after the removal of the foreign body may occur in psychiatry patient that a possibility of selfinflicted injury.A detailhistory,examinationand appropriate investigations are mandatory to reveal the correlated clinical findings with imaging studies are the most helpful guide in managing intraorbital foreign body could potentially prevent further serious morbidity or

Development of the Chinese age norms of CES-D in urban area / 中国心理卫生杂志

Objective: To test applicability of the Center for Epidemiological Studies Depression Scale (CES-D) in different age groups in urban China, and to develop age norms. Methods: In this cross-sectional study, the CES-D was administrated to 16047 community participants with average age of (37.7±21.3) years (age ranged 11～100) in 21 provinces, who were as the norming sample. Criterion validity was tested in 349 psychiatric patients with average age of (32.0±12.1) years (age ranged 16～81) in 4 cities. A subsample (199 workers, 100 col-lege students, and 30 teachers in Beijing, Dongguan, and Baotou) was drawn from the national sample to provide 8 week interval test-retest reliability. Results: The Cronbach α was 0.90 for the scale, and 0.68～0.86 for its fac-tors. The 8 week interval test-retest correlation was 0.49 for the scale (P <0.01) and 0.39～0.51 for factors (P<0.01) . The result of confirmatory factor analysis supported the original 4-factor structure (RMSEA=0.057, CFI =0.976, GFI=0.948) . Patients scored higher than community sample [(21.72±13.39 ) vs.(13.24±10.33),P <0.01], and depression patients scored the highest [(27.82±14.42), P<0.01] . Age difference was signifi-cant. Age groups over 60-year-old scored higher than all the other age groups under 60-year-old (P<0.01). Con-clusion: The Chinese version of CES-D shows good refiability and validity across all ages in urban population-

The Attitudes of the Inhabitants of Kwangju towards the Persons with Mental Illness / 신경정신의학

OBJECTIVES: This study was conducted for the purpose of identifying the attitudes of laypersons towards the mentally ill. METHODS: From the end of January to the beginning of February of 1999, the 709 subjects who lived in Kwangju were surveyed with a questionnaire regarding their attitude towards mental illness. RESULTS: 1) On the question requiring the subjective definitions of a person with mental illness, the subjects described a person with mental illness is a pitiful and weak person who became mentally ill due to severe stress, mental shock, or hurts in mind. And they responded on psychological and social factors more than biological or genetic ones to the question asking the causes of mental illness. 2) Positive attitudes were shown in 76.4% of the subjects on the question of awareness and attitudes towards the mentally ill, while about the possibility of their marriage and living together in the community, quite negative attitude was shown. In addition, even though the subjects considered that mental illness could be cured, they had quite negative thoughts on the treatment effects in psychiatric hospitals, especially, the attitude towards the psychiatric hospitals was very negative. On the examination by groups, the group of subjects who had never experienced mental illness replied more negatively in almost all items than the group of subjects who had direct experiences. 3) Compared with previous studies, it appeared that the overall awareness of the mentally ill was changed in a quite positive direction than the 1970s'. CONCLUSION: Even though the attitude towards the mentally ill has changed in a positive direction, many people still have negative attitudes if it is related to and affect their lives directly. To change the attitudes and to reduce the prejudice and misunderstanding against the mentally ill, it may be helpful to let people make direct contact with the mentally ill, as well as to make efforts with systematic public education or with the media based upon the facts.

Ethical Problems of Involuntary Hospitalization of Psychiatric Patients / 中国医学伦理学

There are some differences between psychiatric patients and others in the informed consent right. The article discussed some basic problems on the ethics of involuntary hospitalization of psychiatric patients.