[Impact of medical counseling to quit smoking during the process of dehabituation in patients with mental illness]. / El papel del consejo antitabaco en el proceso de deshabituación en enfermos mentales.

BACKGROUND: Cigarettes consumption is the most preventable cause of morbidity and mortality in developed countries. Several intervention trials have shown that medical counseling to quit smoking promotes 5-10 % of abstinence per year, which constitutes the most efficient preventable activity. This study aims to evaluate the presence and type of medical counseling to quit smoking in patients admitted to a long-stay unit of a psychiatric hospital. METHODS: This descriptive and cross-sectional study included 80 schizophrenic smoking in-patients. The presence of medical counseling to quit smoking was evaluated by a standardized questionnaire designed for this purpose. The Fagerström Test was used to measure nicotine dependence, the Richmond Questionnaire to measure motivation for smoking cessation and the Stages of Change Questionnaire to know the stage of change to give up smoking. RESULTS: A total of 60.3 % of the patients had previously received medical counseling to quit smoking, 50 % of which had been performed by the psychiatrist. The motivation for patients with medical counseling was moderate (mean score +/- SD of Richmond Questionnaire 4.4 +/- 3.5). A total of 77.1 % of these patients had tried to quit smoking on several occasions. CONCLUSIONS: Medical counseling on giving up smoking can modify the motivation to quit smoking in psychiatric patients. Systematic structured counseling, especially from psychiatry, can prevent the development of nicotine addiction or modify intensity.

El papel del consejo antitabaco en el proceso de deshabituación en enfermos mentales / Impact of medical counseling to quit smoking during the process of dehabituation in patients with mental illness

Introducción. El Tabaco constituye la principal causa de morbimortalidad susceptible de prevención en los países desarrollados. Diversos estudios de intervención han demostrado que un consejo mínimo estructurado promueve un 5-10% de abstinencias al año, constituyendo la actividad preventiva que mejor coste/beneficio presenta. El objetivo fu evaluar en los pacientes fumadores de una unidad de larga estancia de un hospital psiquiátrico la existencia y características del consejo antitabaco. Métodos. Estudio descriptivo transversal de 80 pacientes fumadores diagnosticados de esquizofrenia en los que se evaluó la presencia del consejo antitabaco mediante una entrevista diseñada a tal efecto. Se utilizó el Cuestionario de Fagerström para valorar la dependencia física e nicotina, el Cuestionario de Richmond para evaluar el grado de motivación para el abandono del consumo de tabaco y el Cuestionario de Estadios de Cambio para establecer el estadio de cambio en el que se encontraban respecto al proceso de abandono. Resultados. El 60,3% de los pacientes había recibido anteriormente consejo antitabaco, de los cuales un 50% había sido realizado por el psiquiatra. Aquellos pacientes que habían recibido consejo antitabaco tenían una puntuación media en el Cuestionario de Richmond de 4,4±3,5, correspondiente a una motivación media-alta. De éstos, el 77,1% había realizado algún intento de abandono. Conclusiones. El consejo antitabaco puede modificar la motivación del paciente psiquiátrico para el cese del consumo especialmente por parte del médico psiquiatra, puede prevenir el desarrollo de la adicción al tabaco o modificar la intensidad de la misma (AU)

Background. Cigarettes consumption is the most preventable cause of morbidity and mortality in developed countries. Several intervention trials have shown that medical counseling to quit smoking promotes 5-10% of abstinence per year; which constitutes the most efficient preventable activity. This study aims to evaluate the presence and type of medical counseling to quit smoking in patients admitted to a long-stay unit of a psychiatric hospital. Methods. This descriptive and cross-sectional study included 80 schizophrenic smoking in patients. The presence of medical counseling to quit smoking was evaluated by a standardized questionnaire designed for this purpose. The Fagerström Test was used to measure nicotine dependence, the Richmond Questionnaire to measure motivation for smoking cessation and the Stages of Change Questionnaire to know the stage of change to give up smoking. Results. A total of 60.3% of the patients had previously received medical counseling to quit smoking, 50% of which had been performed by the psychiatrist. The motivation for patients with medical counseling was moderate (mean score ± SD of Richmond Questionnaire 4.4±3.5). A total 77.1% of these patients had tried to quit smoking on several occasions. Conclusions. Medical counseling on giving up smoking can modify the motivation to quit smoking in psychiatric patients. Systematic structured counseling, especially form psychiatry, can prevent the development of nicotine addiction or modify intensity (AU)

Tratamiento farmacológico del alcoholismo / Pharmacologic treatment of alcohol dependence

Objetivo: revisar los distintos grupos farmacológicos actualmente disponibles en el tratamiento de la dependencia de alcohol a tenor de los avances producidos en los mecanismos neurobiológicos del alcohol a nivel del sistema nervioso central. Material y métodos: revisión de los estudios de eficacia del tratamiento psicofarmacológico en pacientes alcohólicos. Resultados: los primeros fármacos estudiados en el tratamiento del alcoholismo fueron los interdictores del alcohol. Desde entonces, ha aumentado el número de fármacos disponibles mejorando asimismo de forma considerable la metodología en los ensayos clínicos. Conclusiones: en la actualidad se dispone de distintos abordajes farmacológicos para el tratamiento de la dependencia de alcohol, que en combinación con los abordajes psicosociales permiten mejorar el grado de eficacia de los programas de tratamiento (AU)

[Influence of socioeconomic factors on the course and monitoring of pregnancy]. / Influencia de factores socioeconómicos en la evolución y seguimiento del embarazo.

OBJECTIVE: To analyse variations in monitoring the pregnancy programme (PP) and in the programme's development in three population groups distinguished by their socio-demographic characteristics. DESIGN: An observational, descriptive and retrospective study. SETTING: "Occidente" Health District, Córdoba. PARTICIPANTS: Women who finalised their pregnancy in 1994 or 1995 (n = 415) and who lived in three zones distinguished geographically and socially: an Urban Area (UA), with an average population socially and economically and urban environment; a Marginal Area (MA) with a low social and economic level, high rates of unemployment and drug addiction, and a mixed population (gypsy and latin); and a Rural Area (RA), which had a rural productive way of life. MEASUREMENTS: The area of residence was related to the socio-demographic variables, history, drug consumption, PP monitoring and identified pathology. RESULTS: PP coverage reached 73.8% (CI 69.2-77.8), Pregnant women living in the MA were younger (p < 0.001), and included more adolescents (p < 0.001) and more single women (p < 0.001). CONCLUSIONS: Poorer monitoring and adherence to the PP by the MA population could be confirmed.