Antecedente de trastorno mental en la UCI e interconsulta a psiquiatría / History of mental disorder in an ICU and referrals to psychiatry

Objetivo Determinar la prevalencia de pacientes con trastorno mental (TM) ingresados en la UCI. Comparar las características clínicas según la presencia de antecedentes psiquiátricos. Revisar la pertinencia de las interconsultas realizadas a psiquiatría. Diseño Estudio descriptivo retrospectivo. Ámbito UCI del Hospital General del Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España. Pacientes Pacientes ingresados entre enero de 2016 y junio de 2018. Intervenciones Ninguna. Variables de interés principales Nivel de gravedad (APACHEII), motivo de ingreso, días de ingreso, días de ventilación mecánica, antecedentes psiquiátricos y motivo de interconsulta a psiquiatría. Resultados Se incluyeron 1.247 pacientes; 194 (15,5%) cumplían criterios de TM, siendo su media de edad más joven (59 vs 68, p<0,001) y con menor puntuación media en la escala APACHEII (12 vs 14, p≤0,003). Se realizaron 64 interconsultas a psiquiatría (5,1% de los ingresos), 59 de las cuales fueron en pacientes con TM (92,1%). En cuanto a los motivos de la interconsulta, el 22,6% fueron por intento autolítico, el 61,3% para ajuste farmacológico, el 11,3% para descartar TM y el 4,8% para valoración de competencia. La posibilidad de que se realizara una interconsulta estando indicada fue del 89,1%, mientras que la posibilidad de no realizarla no estando indicada fue del 99,4%. Conclusiones Este estudio respalda la necesidad de ampliar las recomendaciones específicas para realizar interconsulta a psiquiatría, más allá de la valoración tras intento autolítico, puesto que un gran porcentaje (77,5%) de las interconsultas pertinentes fueron por otros motivos (AU)

Objective To describe the prevalence of patients with mental disorders (MD) admitted to the ICU. To compare the clinical characteristics according to the presence of psychiatric history. To review the relevance of the consultations made to Psychiatry. Design Retrospective descriptive study. Setting ICU of the General Hospital of the Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain. Patients Patients admitted between January 2016 and June 2018. Interventions None. Main variables of interest Severity level (APACHEII), reason for admission, days of admission, days of mechanical ventilation, psychiatric history and reason for psychiatric consultation. Results A total of 1,247 patients were included; 194 (15.5%) met MD criteria, their mean age being younger (59 vs 68, P<.001) and with a lower mean score on the APACHEII scale (12 vs 14, P≤.003). There were 64 consultations to Psychiatry (5.1% of admissions), 59 of which were in patients with TM (92.1%). Regarding the reasons for the consultation, 22.6% were for attempted suicide, 61.3% for pharmacological adjustment, 11.3% to rule out mental disorder, and 4.8% for competence assessment. The probability of a consultation being carried out while it was indicated was 89.1%, while the probability of not carrying it out when it was not indicated was 99.4%. Conclusions This study supports the need to expand the specific recommendations for consultation to Psychiatry, beyond the assessment after a suicide attempt, since a large percentage (77.5%) of the pertinent consultations were for other reasons (AU)

History of mental disorder in an ICU and referrals to psychiatry.

OBJECTIVE: To describe the prevalence of patients with mental disorders (MD) admitted to the ICU. To compare the clinical characteristics according to the presence of psychiatric history. To review the relevance of the consultations made to Psychiatry. DESIGN: Retrospective descriptive study. SETTING: ICU of the General Hospital of the Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain. PATIENTS: Patients admitted between January 2016 and June 2018. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: Severity level (APACHE II), reason for admission, days of admission, days of mechanical ventilation, psychiatric history and reason for psychiatric consultation. RESULTS: A total of 1,247 patients were included; 194 (15.5%) met MD criteria, their mean age being younger (59 vs 68, P < .001) and with a lower mean score on the APACHE II scale (12 vs 14, P ≤ .003). There were 64 consultations to Psychiatry (5.1% of admissions), 59 of which were in patients with TM (92.1%). Regarding the reasons for the consultation, 22.6% were for attempted suicide, 61.3% for pharmacological adjustment, 11.3% to rule out mental disorder, and 4.8% for competence assessment. The probability of a consultation being carried out while it was indicated was 89.1%, while the probability of not carrying it out when it was not indicated was 99.4%. CONCLUSIONS: This study supports the need to expand the specific recommendations for consultation to Psychiatry, beyond the assessment after a suicide attempt, since a large percentage (77.5%) of the pertinent consultations were for other reasons.

History of mental disorder in an ICU and referrals to psychiatry. / Antecedente de trastorno mental en la UCI e interconsulta a psiquiatría.

OBJECTIVE: To describe the prevalence of patients with mental disorders (MD) admitted to the ICU. To compare the clinical characteristics according to the presence of psychiatric history. To review the relevance of the consultations made to Psychiatry. DESIGN: Retrospective descriptive study. SETTING: ICU of the General Hospital of the Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain. PATIENTS: Patients admitted between January 2016 and June 2018. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: Severity level (APACHEII), reason for admission, days of admission, days of mechanical ventilation, psychiatric history and reason for psychiatric consultation. RESULTS: A total of 1,247 patients were included; 194 (15.5%) met MD criteria, their mean age being younger (59 vs 68, P<.001) and with a lower mean score on the APACHEII scale (12 vs 14, P≤.003). There were 64 consultations to Psychiatry (5.1% of admissions), 59 of which were in patients with TM (92.1%). Regarding the reasons for the consultation, 22.6% were for attempted suicide, 61.3% for pharmacological adjustment, 11.3% to rule out mental disorder, and 4.8% for competence assessment. The probability of a consultation being carried out while it was indicated was 89.1%, while the probability of not carrying it out when it was not indicated was 99.4%. CONCLUSIONS: This study supports the need to expand the specific recommendations for consultation to Psychiatry, beyond the assessment after a suicide attempt, since a large percentage (77.5%) of the pertinent consultations were for other reasons.

[Transcultural validation to spanish of the Patient Evaluation of Emotional Care During Hospitalisation Questionnaire]. / Validación transcultural al español del cuestionario Patient Evaluation of Emotional Care During Hospitalisation.

INTRODUCTION: The emotional experience of patients must be ascertained to ensure patient-centred care during hospitalisation. Improving this experience has a positive impact on patient prognosis. Therefore, in order to provide comprehensive care, therefore, patient emotional care needs must be known. The objective of this study was to produce a transcultural translation and validation of the Patient Evaluation of Emotional Care during Hospitalisation (PEECH) questionnaire. MATERIAL AND METHOD: The PEECH consists of three sections resulting in four subscales: level of security, level of knowledge, level of personal value, and level of connection. The questionnaire was translated into Spanish. An expert panel revised the translation until they were satisfied with the outcome. It was then back-translated and submitted to the author for approval. For its validation, 132 hospitalised patients completed the questionnaire. Expert judgement was used to analyse the content validity and factor analysis in order to confirm the construct validity. The Cronbach alpha coefficient was used to measure the internal consistency of the four subscales. RESULTS: In the confirmatory factor analysis of the four subscales, the weights of all questions were significant (>0.5), with the exception of Q7 (0.416) and Q18 (0.439), which nevertheless met the minimum interpretation level for the structure. In accordance with this criterion, the four subscales were justified. CONCLUSION: The Spanish version of the PEECH questionnaire is a valid and reliable tool to evaluate the perception of emotional care in hospitalised patients. The information gathered can contribute to providing comprehensive care for patients in hospital.

Poly I:C induces Mx transcription and promotes an antiviral state against sole aquabirnavirus in the flatfish Senegalese sole (Solea senegalensis Kaup).

Mx is an interferon-induced protein that protects against viral infections. In this study the absolute number of Mx transcripts after poly I:C injection (a synthetic dsRNA) or sole aquabirnavirus (solevirus) inoculation in Senegalese sole (Solea senegalensis Kaup) has been quantified. Mx expression profiles differed clearly in both experimental conditions; the induction response was faster and more intense after poly I:C injection than after solevirus inoculation. Moreover, pre-injection of soles with poly I:C prior to solevirus infection eliminated the induction of Mx expression associated with this virus. To evaluate the possible interference of poly I:C treatments on solevirus replication, the mRNA levels of the virus capsid protein (VP2) were determined by RT-PCR. VP2 transcripts were hardly detected in poly I:C pre-injected animals from 12 to 72 h after solevirus inoculation. All these data suggest that poly I:C is able to induce an antiviral state that interferes with solevirus replication, and support the suitability of Mx expression analysis as a marker to study the defensive response against solevirus.