Changing trends of services used as first contact by patients with mental health problems.

Background. In the past, traditional faith healers and practitioners of alternative medicine have often been reported to be the first source of contact for Indian patients with mental health problems. However, over the past few decades, this trend seems to be changing. Method. Using a semi-structured questionnaire, we assessed 200 new patients at a psychiatric outpatient service in a general hospital for the first service contact used by them for their mental health problems. Results. Psychiatrists, non-psychiatric physicians, traditional faith healers and practitioners of alternative medicine were the first service contact for 91 (45.5%), 88 (44%), 16 (8%) and 5 (2.5%) patients, respectively. Patients suffering from severe mental illnesses were more likely to choose a psychiatrist as the first contact, whereas those with neurotic, stress-related and organic mental disorders contacted a non-psychiatric physician. Conclusion. In the current scenario, psychiatrists and nonpsychiatric physicians serve as the first service contact for most patients with mental health problems in India, though traditional faith healers and practitioners of alternative medicine are contacted by a minority.

Espiritualidade no paciente em diálise: o nefrologista deve abordar? / Spirituality for dialysis patients: should the nephrologist address?

Introdução: os trabalhos que tratam da relação entre espiritualidade e saúde têm se disseminado pelas publicações internacionais, mostrando associações entre menores níveis de depressão e ansiedade, melhor qualidade de vida, menor número de internações e mortalidade. Objetivos: Avaliar a relação da espiritualidade, religiosidade e saúde em pacientes em diálise. Métodos: por meio de consulta nos bancos do SciELo, LILACS, Medline e PsycINFO foi feita revisão de literatura. Foram selecionados e discutidos os artigos que discutiam a relação entre espirituali dade e saúde em pacientes dialíticos. resultados: Os estudos que abordam o tema demonstram uma relação entre maior espiritualidade e maior religiosidade com melhor qualidade de vida, menor prevalência de depressão, maior suporte social, mais satisfação com a vida e mais satisfação com o tratamento médico provido pelo nefrologista. Da mesma forma, verificou-se que pacientes dialíticos que possuíam menor espiritualidade solicitavam mais tratamentos para estímulo de vida (intubação orotraqueal, por exemplo) e que a espiritualidade foi fator de enfrentamento 9coping) para os familiares dos pacientes em diálise. Na literatura consultada, não foi encontrada associações entre espiritualidade e qualidade do sono, aderência aos medicamentos e mortalidade. Conclusão: A espiritualidade e a religiosidade possuem um papel importante para o paciente em diálise. mostra-se relacionada com pontos importantes na própria relação médico paciente, na qualidade de vida e enfrentamento à doença, devendo ser considerada pelos profissionais que assistem a esse tipo de paciente.

Introduction: the works that address the relationship between spirituality and health have been spread by international publications, showing associations between lower levels of depression and anxiety, improved quality of life, fewer hospitalizations and mortality. Objectives: To evaluate the relationship between spirituality, religiosity and health in dialysis patients. Methods: Through consultation on the banks of SciELO, LILACS, MEDLINE and PsycINFO was conducted literature review. Were selected and discussed the articles that discuss the relationship between spirituality and health tion in dialysis patients. Results: The studies that address show a relationship between increased spirituality and religiosity with higher quality of life, lower prevalence of depression, greater social support, life satisfaction more and more satisfaction with the medical treatment provided by a nephrologist. Likewise, it was found that dialysis patients who had less spirituality requesting more treatments for stimulation of life (intubation, for example) and that spirituality was a factor of coping 9coping) for relatives of dialysis patients. In the literature, we found no association between spirituality and quality of sleep, drug adherence and mortality. Conclusion: The spirituality and religiosity have an important role for patients on dialysis. appears to be related to important points in the physician-patient relationship itself, the quality of life and coping with the disease and should be considered by the professionals who attend this type of patient.