Duelo prolongado y factores asociados / Prolonged grief and related factors

Objetivo: Describir factores asociados a la presencia de Duelo Prolongado (DP) medido con el cuestionario Prolonged Grief Disorder-13 (PG-13) en pacientes que han perdido a un ser querido entre 6 y 18 meses. Método: Estudio transversal. Dolientes mayores de edad procedentes de atención primaria, hospitales de cuidados paliativos y un equipo de soporte a la atención domiciliaria paliativa en Madrid. Se recogieron variables del fallecido y del doliente: sociodemográficas, socioeconómicas, antecedentes psiquiátricos, utilización de recursos sanitarios, Trastorno por Ansiedad Generalizada (TAG), apoyo social, percibido y duelo prolongado con PG-13 y el Inventario Texas Revisado de Duelo (ITRD). Se calcularon medidas de tendencia central y distribución de frecuencias, se calculo asociación entre variables con c2 y t-student, se ajustó modelo multivariante. Resultados: La prevalencia de DP fue de 7,023%. La presencia de DP se asoció significativamente con ser mujer, no tener trabajo, ingresos familiares bajos, fallecido más joven, enfermedad no susceptible de recibir cuidados paliativos, historia de ansiedad y/o depresión antes y después de la pérdida, haber consultado a un psiquiatra, haber tomado psicofármacos, una mayor frecuentación de los servicios de urgencias, medicina y enfermería de atención primaria, con TAG, EDM, apoyo social percibido bajo y DP según los criterios del ITRD. En el análisis multivariante se asoció con haber visitado al psiquiatra, EDM y con ingresos mensuales inferiores a 2.000 euros. Conclusiones: Podemos modificar pocos de estos factores, pero conocerlos e identificar con prontitud a estos pacientes nos permitirá derivarlos a tratamientos apropiados como terapia específica de duelo

Objective: To describe associated factors with the presence of Prolonged Grief Disorder (PGD) diagnosed by the Prolonged Grief Disorder-13 (PG-13) questionnaire between 6 and 18 months after the loss of a loved one. Method: Cross-sectional study. Adults chosen from a sample coming from primary-care services, hospices, and a home care team, all of them in Madrid. Variables from the deceased and the bereaved were collected: demographic, socioeconomic, psychiatric records, medical visits, Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), social perceived support and PGD diagnosed by PG-13 and Texas Revised Inventory of Grief (TRIG). Multivariate linear regression analysis was used to identify factors associated with PGD. Results: Prevalence of PGD was 7.023%. PGD was associated with female gender, joblessness, low family incomes, a younger deceased, an illness not suitable for palliative care, anxiety or depression records before and after the loss, psychiatrist support, the use of psychotropic medication, increasing visits to emergency and primary care services, GAD, MDD, low social perceived support and the diagnosis of PGD using the TRIG. Multivariate linear regression showed that PGD was associated with psychiatrist support, MDD and an income under 2000 euros. Conclusions: Just a few of these risk factors can be modified by us (psychiatrist support, treatment of anxiety or depression) but by knowing them we will be able to have an early diagnosis and refer them to the appropriate resources like specific grief therapy as soon as possible

[Use of psychoactive drugs and family dysfunction]. / Consumo de psicofármacos y disfunción familiar.

OBJECTIVE: To find out the relationship between the use of psychoactive drugs in women and the results of the APGAR and stressful life events (SLE) questionnaires. DESIGN: Cross-sectional, descriptive study. SETTING: General Fanjul Health Centre in Area 7 of the Community of Madrid. PARTICIPANTS: All the women between 25-65 years who were seen in Primary Care clinics in one week in March, 2005. METHOD: Validated surveys validated of family dysfunction (Apgar) and stressful life events (additive scale of evaluation of social readjustment) were carried on women between 25-65 years who took psychoactive drugs. RESULTS: Of the 625 women who were seen in the clinics, 121 (19.36%), with a mean age of 46.8+/-12.7 years, were interviewed. Of these, 90% were Spanish, 55.4% were married, 67% had children, 3.3% had not received schooling, 75.2% had a primary school education, 21.5% with university studies, and 57.9% work outside the home. Antidepressants were used by 24% of the women, with 30.6% taking benzodiazepines. The use of benzodiazepines increases with the age (p<0.001). On having look at the relationship between the use of benzodiazepines or antidepressants and the existence of major family dysfunction or major stressful life events (SLE) we verify that statistically significant differences do not exist. CONCLUSIONS: Although it was intuitively possible to believe that SLE and family dysfunction lead to a higher use of psychoactive drugs, we could not find a statistically significant relationship. We have shown that there is a higher use of benzodiazepines in older women.

Consumo de psicofármacos y disfunción familiar / Use of psychoactive drugs and family dysfunction

ObjetivoConocer la relación entre el consumo de psicofármacos en mujeres y los resultados de los test Apgar y acontecimientos vitales estresantes (AVE).DiseñoEstudio descriptivo transversal.EmplazamientoCentro de Salud General Fanjul (Área 7 de la Comunidad de Madrid).ParticipantesTodas las mujeres de entre 25–65 años de edad que acuden a las consultas de atención primaria durante una semana del mes de marzo de 2005.Mediciones principalesEncuestas validadas de disfunción familiar (Apgar) y acontecimientos vitales estresantes (escala aditiva de evaluación de reajuste social).ResultadosAcudieron 625 mujeres, de las que se entrevistó a 121 (19,36%), con una media de edad de 46,8±12,7 años. El 90% son españolas. El 55,4% están casadas, el 67% tiene hijos, el 3,3% no tiene estudios y el 75,2% ha cursado estudios primarios y el 21,5%, estudios universitarios. Trabaja fuera de casa el 57,9%. Los antidepresivos son utilizados por el 24% de las mujeres y las benzodiacepinas, por un 30,6%. El consumo de benzodiacepinas aumenta con la edad (p<0,001). Al relacionar el consumo de benzodiacepinas o antidepresivos y la existencia de mayor disfuncionalidad familiar o AVE, no se observan diferencias estadísticamente significativas.ConclusionesAunque de manera intuitiva se podría pensar que los AVE y la disfunción familiar determinan un mayor consumo de psicofármacos, no hemos podido encontrar una relación estadísticamente significativa. Se detecta un mayor consumo de benzodiacepinas a mayor edad(AU)

ObjectiveTo find out the relationship between the use of psychoactive drugs in women and the results of the APGAR and stressful life events (SLE) questionnaires.DesignCross-sectional, descriptive study.SettingGeneral Fanjul Health Centre in Area 7 of the Community of Madrid.ParticipantsAll the women between 25–65 years who were seen in Primary Care clinics in one week in March, 2005.MethodValidated surveys validated of family dysfunction (Apgar) and stressful life events (additive scale of evaluation of social readjustment) were carried on women between 25–65 years who took psychoactive drugs.ResultsOf the 625 women who were seen in the clinics, 121 (19.36%), with a mean age of 46.8±12.7 years, were interviewed. Of these, 90% were Spanish, 55.4% were married, 67% had children, 3.3% had not received schooling, 75.2% had a primary school education, 21.5% with university studies, and 57.9% work outside the home. Antidepressants were used by 24% of the women, with 30.6% taking benzodiazepines. The use of benzodiazepines increases with the age (p<0.001). On having look at the relationship between the use of benzodiazepines or antidepressants and the existence of major family dysfunction or major stressful life events (SLE) we verify that statistically significant differences do not exist.ConclusionsAlthough it was intuitively possible to believe that SLE and family dysfunction lead to a higher use of psychoactive drugs, we could not find a statistically significant relationship. We have shown that there is a higher use of benzodiazepines in older women(AU)