ABSTRACT
No disponible
Subject(s)
Humans , Clinical Protocols , Alcohol-Related Disorders/therapy , Primary Health Care/methods , Education, Medical, Continuing/trendsABSTRACT
No disponible
Subject(s)
History, 20th Century , Mental Health , Mental Disorders/history , Mental Disorders/epidemiology , Psychiatry/history , Hospitals, Psychiatric/history , Hospitals, Psychiatric/organization & administration , Orthopsychiatry/methods , Orthopsychiatry/history , Spain/epidemiologyABSTRACT
The results of the validation for the AUDIT (Alcohol Use Disorders Identification Test) in Primary Care are here reported. A total of 326 patients who attended two primary care centers were interviewed. In a first interview they answered the AUDIT questions and later were classified on the basis of disturbances caused by alcohol use: abuse or dependency. The diagnosis of abuse or dependency was obtained with the structured interview for DSM-III-R. Reliability was determined by the test-retest correlation and internal consistency by Cronbach's alpha coefficient. Efficacy was calculated by means of the area under the curve (receiver operating characteristics). A quarter of the interviewed patients were diagnosed of some disturbance caused by alcohol use. The internal reliability of the test was acceptable (Cronbach's alpha coefficient 0.86). The test-retest correlation coefficient was 0.90. All the questions acceptably correlated with the total in the scale. A cut-off point of 8 was the most efficient for the whole sample (90% sensitivity and 90% specificity). For females, the most efficient cut-off point was 6. For patients aged over 60 years, the most efficient cut-off point was 5 for both sexes. This study confirms the usefulness of AUDIT for screening alcohol-related problems in Primary Care.
Subject(s)
Alcoholism/diagnosis , Mass Screening/methods , Adult , Aged , Family Practice , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Surveys and QuestionnairesABSTRACT
Sixty-five acute burned inpatients were evaluated prospectively by structured questionnaire and clinical interview. All of the subjects hospitalized in a Burn Unit were referred for psychiatric examination to a psychiatric consultation-liaison programme. Most of the patients suffered adjustment disorders (n = 40), and post-traumatic stress disorder (PTSD) was diagnosed in 5 cases. The carefully assessment of PTSD was an objective of the Study. There were no significant differences among patients with PTSD and Adjustment Disorder for severity and type of burn injuries. The discussion deals with PTSD is a frequent missed disorder by the medical staff of burn units, and also the importance of the patients subjective appraisal of the stressor as a factor precipitating PTSD.
Subject(s)
Burns/psychology , Psychiatry , Referral and Consultation , Stress Disorders, Post-Traumatic/etiology , Adjustment Disorders/psychology , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Severity of Illness IndexABSTRACT
The treatment of intermittent explosive disorder is still empirical, although it tries to use drugs according to present knowledge on neurobiology of aggression. We report three patients in which a good control of aggressive behavior was achieved using inhibitors of serotonin reuptake and carbamazepine. We review the literature on pharmacologic treatment of aggressive behavior.
Subject(s)
Carbamazepine/therapeutic use , Depressive Disorder/drug therapy , Fluoxetine/therapeutic use , Impulsive Behavior , Lithium Carbonate/therapeutic use , Propranolol/therapeutic use , Adult , Humans , Male , Middle AgedABSTRACT
AIDS has acquired a growing importance for psychiatry because of the number of infected people and the increasing attention that these patients need. The major risk group in Spain is the drug users one. These patients share management problems when they are in general hospitals settings, both for their psychiatric aspects and for the consequences of drug abusing. A consultation liaison psychiatry service system improves the attention to these patients and reduces the emergency interventions and the hostility against the staff. The consultation liaison psychiatry system has generated an overall improvement in our hospital to fulfil the patients need and the relations and atmosphere among the therapeutic team.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Psychiatry , Referral and Consultation , Substance-Related Disorders/complications , Substance-Related Disorders/psychology , Adolescent , Adult , Female , Humans , Male , Middle Aged , SpainABSTRACT
The results of a study about psychiatric morbility in patients suffering from HIV infection treated in a psychiatric consulting department of a general hospital are presented. Out of one hundred of individuals studied, 93 showed a diagnosis in Axle I according to DSM-IIIR criteria for mental disorders classification. The diagnosis most frequently found was the one of disorders due to drugs dependence, in 41%; organic mental disorder in 29%; adaptation disorders in 15% and affective one in 5% of cases. In sixteen patients of the sample a follow-up was carried out finding ad evolution towards dementia. Diagnostic difficulties of this population and usefulness of carrying out a revision of diagnostic classifications usually employed are debated.
Subject(s)
HIV Infections/complications , Mental Disorders/complications , Adolescent , Adult , Female , Humans , Male , Mental Disorders/epidemiology , Middle AgedABSTRACT
The study describes the psychiatric disorders found in 100 HIV-positive patients, in different stages of the illness, at the psychiatric consultation service of a general hospital in Madrid. Eighty-five percent of the sample fell within the intravenous drug addicts risk group, which coincides with the epidemiological characteristics of Spain's HIV-positive population. The most frequently noted psychiatric diagnosis was substance dependence disorder (41%), followed by organic mental disorder (29%), adjustment disorder (15%), and affective disorder (5%). Fifteen percent of the subjects had depressive symptoms, and 11% expressed suicidal ideation. A follow-up conducted on part of the sample showed a development towards dementia, emphasizing diagnostic difficulties in the initial evaluation of these patients.
Subject(s)
Adaptation, Psychological , HIV Infections/psychology , Hospitalization , Sick Role , AIDS Dementia Complex/psychology , Adjustment Disorders/psychology , Adolescent , Adult , Female , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
The paper reports on the clinical characteristics, treatment and results of a group of 41 patients suffering from anorexia nervosa. All patients were diagnosed according to DSM-III criteria. Mean age was 18.6 years, within a range from 12 to 33 years. The group was formed by 40 female patients and 1 male. Twenty-nine percent of the patients had previously received treatment. Duration of treatment fell within a range of 10-36 months, 18-24 being the most frequent. Forty-four and a half percent of the patients were admitted to hospital with a 59-day mean time of hospitalization and treatment was positive in over 80% of cases. Two patients suffered a relapse during the first 2 or 3 years, but later recovered. Five years after the beginning of treatment, 1 patient suffered a relapse and received supplementary treatment.
Subject(s)
Anorexia Nervosa/therapy , Adolescent , Adult , Anorexia Nervosa/psychology , Body Weight , Bulimia/therapy , Combined Modality Therapy , Feeding Behavior , Female , Follow-Up Studies , Humans , Internal-External Control , Male , Psychoanalytic TherapyABSTRACT
Cardiovascular symptoms are often present in descriptions of patients with panic disorder, and are considered a central element in current diagnostic criteria. These patients often visit emergency wards complaining of chest pain or discomfort. In many cases, a possible psychiatric diagnosis is not considered, and these patients are often incorrectly diagnosed and treated. The aim of this study is to examine the presence of panic disorder in those patients who visit a general hospital emergency ward with chest pain, and are then released after no organic pathology is found. We present the results obtained from the examination of 112 patients with these characteristics who were given a structured interview developed for the diagnosis of affective and anxiety disorders. In the sample studied, panic disorder was found in 47.3% of the subjects.
