ABSTRACT
Introducción: El objetivo del estudio fue analizar la evolución del estrés en las familias de niños o adolescentes que comienzan tratamiento psicofarmacológico, tras ser diagnosticados de un trastorno por déficit de atención con hiperactividad (TDAH), y la capacidad de detección de este cambio mediante el cuestionario Family Strain Index (FSI). Metodología: Cuarenta y ocho especialistas en psiquiatría infanto-juvenil o neuropediatría incluyeron 429 familias de niños diagnosticados de TDAH, representadas por el padre, la madre o el tutor del niño. En la visita basal, a los 2 y 4 meses, se evaluó la intensidad de los síntomas del TDAH mediante la escala de Conners abreviada, y el estrés familiar mediante el cuestionario FSI. Resultados: Se observó: a) mejoría en la puntuación global del FSI y en todas sus dimensiones (p<0,001); b) mejoría en la intensidad de los síntomas de hiperactividad (Conners, p<0,0001);c) una buena concordancia entre las 2 escalas, a los 2 meses (R-intraclase 0,825, p<0,0001) y a los 4 meses de seguimiento (R-intraclase 0,784, p<0,0001). El 97,9% de los niños (420) recibieron tratamiento con metilfenidato de liberación modificada. Conclusiones: Se observó una correlación significativa entre la evolución positiva de los síntomas de los niños con TDAH y la reducción del estrés familiar evaluado mediante el cuestionario FSI, tras la instauración del tratamiento psicofarmacológico. Este estudio demostró una gran sensibilidad al cambio de la situación clínica de los pacientes con TDAH evaluado a través del estrés producido sobre sus familias. Se recomienda el uso de este cuestionario como medida indirecta de la repercusión del trastorno sobre el entorno del niño con TDAH en términos de estrés familiar (AU)
Introduction. The objective of this study was to assess the evolution of stress in families of children and adolescents who start psychopharmacological treatment after being diagnosed with attention deficit hyperactivity disorder (ADHD), and the ability to detect this change using the FSI (Family Strain Index) questionnaire. Methodology: Forty eight (48) specialists in child-adolescent psychiatry or neuropediatrics included 429 families of children diagnosed with ADHD, represented by the father, mother or guardian of the child. In the baseline visit, and at two and four months, the intensity of the symptoms of ADHD was evaluated using the abbreviated Conners scale, and family stress was evaluated using the FSI questionnaire. Results: The following was observed: a) an improvement in the overall FSI score and in all its dimensions (P<.001); b) an improvement in the intensity of the symptoms of hyperactivity (Conners, P<.0001); c) good agreement between these two scales at two months (R-intraclass 0.825, P<.0001) and at four months of follow-up (R-intraclass 0.784, P<.0001). Ninety seven point nine percent (97.9%) of the children or adolescents (420) received treatment with modified-release methylphenidate. Conclusions: There was a significant relationship between the positive evolution of symptoms in children with ADHD and the reduction of family stress, as evaluated by the FSI questionnaire, after starting psychopharmacological treatment. This study showed a great sensitivity to change in the clinical situation of patients with ADHD, evaluated through the stress it produces on its families. It is recommended to use this questionnaire as an indirect measurement of the repercussions of the disorder on the environment of the child with ADHD in terms of family stress (AU)
Subject(s)
Adolescent , Child , Female , Humans , Male , Stress, Psychological/pathology , Stress, Psychological/psychology , Attention Deficit Disorder with Hyperactivity/genetics , Attention Deficit Disorder with Hyperactivity/psychology , Quality of Life/psychology , Diagnosis, Dual (Psychiatry)/methods , Diagnosis, Dual (Psychiatry)/psychology , Surveys and Questionnaires/classification , Observational Study , Stress, Psychological/complications , Stress, Psychological/metabolism , Attention Deficit Disorder with Hyperactivity/metabolism , Attention Deficit Disorder with Hyperactivity/pathology , Diagnosis, Dual (Psychiatry)/classification , Diagnosis, Dual (Psychiatry)/standards , Surveys and Questionnaires/standardsABSTRACT
INTRODUCTION: The objective of this study was to assess the evolution of stress in families of children and adolescents who start psychopharmacological treatment after being diagnosed with attention deficit hyperactivity disorder (ADHD), and the ability to detect this change using the FSI (Family Strain Index) questionnaire. METHODOLOGY: Forty eight (48) specialists in child-adolescent psychiatry or neuropediatrics included 429 families of children diagnosed with ADHD, represented by the father, mother or guardian of the child. In the baseline visit, and at two and four months, the intensity of the symptoms of ADHD was evaluated using the abbreviated Conners scale, and family stress was evaluated using the FSI questionnaire. RESULTS: The following was observed: a) an improvement in the overall FSI score and in all its dimensions (P<.001); b) an improvement in the intensity of the symptoms of hyperactivity (Conners, P<.0001); c) good agreement between these two scales at two months (R-intraclass 0.825, P<.0001) and at four months of follow-up (R-intraclass 0.784, P<.0001). Ninety seven point nine percent (97.9%) of the children or adolescents (420) received treatment with modified-release methylphenidate. CONCLUSIONS: There was a significant relationship between the positive evolution of symptoms in children with ADHD and the reduction of family stress, as evaluated by the FSI questionnaire, after starting psychopharmacological treatment. This study showed a great sensitivity to change in the clinical situation of patients with ADHD, evaluated through the stress it produces on its families. It is recommended to use this questionnaire as an indirect measurement of the repercussions of the disorder on the environment of the child with ADHD in terms of family stress.
Subject(s)
Attention Deficit Disorder with Hyperactivity/epidemiology , Family Health , Stress, Psychological , Adolescent , Attention Deficit Disorder with Hyperactivity/drug therapy , Child , Humans , Methylphenidate/therapeutic use , Surveys and QuestionnairesABSTRACT
In the limits between dementia and depression we find a clinical entity in permanent controversy; Depressive Pseudodementia. Depressive pseudodementia is defended by some authors and criticised by others and set us in the diagnostic frontier palced between the cognitive and the affective, between neurology and psychiatry. The entity is not well delimited and reaches diagnostic relevance clinical, evolution and response aspects. In the present issue, we realize a reflection on the term depressive pseudodementia with a review of the scientific literature with special attention in clinical and diagnostic subjets. We conclude that depressive pseudodementia although considering diagnostic limitations is still a valid term in clinical practice, and it eases the approximation, diagnosis and treatment of patients with mixed symptoms of cognitive and depressive type.
Subject(s)
Brain/physiopathology , Cognition Disorders , Dementia , Depressive Disorder, Major/complications , Cognition Disorders/diagnosis , Cognition Disorders/etiology , Cognition Disorders/physiopathology , Dementia/complications , Dementia/diagnosis , Dementia/physiopathology , Diagnosis, Differential , Humans , Neuropsychological Tests , Severity of Illness Index , Terminology as TopicABSTRACT
En los límites que separan la demencia de la depresión nos encontramos con una entidad permanentemente sujeta a controversia: la pseudodemencia depresiva. Defendida por unos autores y criticada por otros, nos sitúa en la frontera diagnóstica existente entre lo cognitivo y lo afectivo, entre la Neurología y la Psiquiatría, entidad no bien delimitada donde alcanzan relevancia diagnóstica tanto aspectos clínicos como evolutivos y de respuesta a tratamiento. Realizamos una reflexión sobre el término de pseudodemencia depresiva revisando la literatura científica, prestando atención especial a aspectos clínicos y diagnósticos. Concluimos que la pseudodemencia depresiva, a pesar de las opiniones en contra y limitaciones diagnósticas, continúa siendo un término válido en el ejercicio de la práctica clínica, que facilita la aproximación, diagnóstico y tratamiento de los pacientes que manifiestan sintomatología mixta; afectiva y cognitiva. (AU)
Subject(s)
Humans , Cognition Disorders , Dementia , Terminology , Diagnosis, Differential , Severity of Illness Index , Neuropsychological Tests , Telencephalon , Depressive Disorder, MajorABSTRACT
The aim of this study was to provide an update of the epidemiology of eating disorders (anorexia nervosa and bulimia nervosa), focusing on incidence and prevalence as well as other factors as age and sex. We made a review of the existing literature in the matter in the last decades. Likewise, we made an extent evaluation of the hypothetical pathogenic impact that exerts mass media (television and printed mass media) in these pathologies. We found an evident increase in incidence as well as prevalence of these disorders though it's far from being considered epidemic. We also found an undeniable influence of mass media in the genesis and maintenance of these disorders. However, mass media would exert a positive influence in the popularization of these entities to the general population that would result in a higher demand in general practice.
Subject(s)
Feeding and Eating Disorders/epidemiology , Mass Media , Adolescent , Adult , Child , Female , Humans , Incidence , Male , Prevalence , Spain/epidemiologySubject(s)
Depressive Disorder, Major/complications , Depressive Disorder, Major/therapy , Factitious Disorders/complications , Factitious Disorders/therapy , Brain/diagnostic imaging , Brain/pathology , Depressive Disorder, Major/psychology , Diagnosis, Differential , Electroencephalography , Factitious Disorders/diagnosis , Humans , Magnetic Resonance Imaging , Memory Disorders/diagnosis , Radiography , Sleep, REM/physiology , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-PhotonABSTRACT
El propósito de este trabajo es realizar una actualización sobre la epidemiología de los trastornos de la conducta alimentaria (anorexia nerviosa y bulimia nerviosa). Prestamos especial atención a la incidencia y prevalencia de los mismos, así como a los factores edad y sexo. Para ello realizamos una revisión de la literatura existente al respecto en las últimas décadas. Realizamos, del mismo modo, una amplia valoración del hipotético impacto patogénico que ejercen los medios de comunicación (televisión y medios de comunicación impresos) en estas patologías. Encontramos un evidente aumento tanto en la incidencia como en la prevalencia de estos trastornos, aunque distan mucho de poder ser considerados como una 'epidemia'. Del mismo modo, apreciamos una innegable influencia mediática en la génesis y mantenimiento de estos trastornos. Sin embargo, los medios de comunicación ejercerían una acción beneficiosa facilitando la divulgación de estas entidades a la población general, lo que se traduciría en una mayor demanda de atención sanitaria (AU)
