Psychotic symptoms following oxycodone withdrawal, case report and update.

Opiate withdrawal-induced psychosis is an uncommon clinical manifestation. We present a 36-year-old male patient, with no prior personal or familiar psychiatric history, in treatment with several analgesic drugs (including oxycodone) for non-inflammatory chronic rachialgia. The patient is hospitalized after exhibiting psychotic symptomatology (delusions of harm and contamination, olfactory hallucinations, and aberrant behavior). This psychotic symptomatology first manifested after abruptly interrupting his prescribed oxycodone intake. It had a fluctuating course over time (alternating between lucid states and delusional ones) and eventually subsided after the prescription of antipsychotic drugs. In this case report, we describe the follow-up of the patient and discuss the influence and relevance of oxycodone withdrawal on the psychotic symptomatology.

[Patient satisfaction as a quality indicator in mental health]. / Satisfacción del paciente como indicador de calidad en salud mental.

OBJECTIVE: To improve the quality of care in a Mental Health Hospital and identify the level of patient satisfaction. MATERIAL AND METHOD: A descriptive, longitudinal, and retrospective study was conducted on 666 patients who completed treatment in the Mental Health Day Hospital of Salamanca, during the period 1994-2012, using the Hospital Management Annual Reports. A questionnaire designed for this purpose was used as the measurement tool. RESULTS: Most of the patients satisfactorily valued aspects, such as the general impression of the treatment (90% said «good/fairly good¼) and perception of being helped (94% perceived «very/fairly helped¼); with 83% believing that the hospital is accessible. As regards empathy-understanding, it was noted that 14% feel discontent. While 18% of patients expected to be completely cured, the 83% of patients that finished their treatment have said that, in their opinion, the symptoms have subsided «very or somewhat¼. As regards the knowledge that they have about their disease, 30% believe it has advanced «a lot.¼ CONCLUSIONS: Based on the perceptions reported by patients, it may be said that in general, the level of user satisfaction in the Mental Health Day Hospital is high. Assessing quality through the user opinions helps control the quality, considering that patient satisfaction is a good indicator of result of the care received during their hospitalisation.

Incumplimiento en pacientes en tratamiento por depresión / Non adherence to treatment in depressive patients

Objetivo: Identificar variables clínicas y sociodemográficas asociadas al incumplimiento terapéutico en enfermos depresivos Material y método: Estudio descriptivo transversal mediante encuesta por entrevista personal a 134 pacientes que cumplen los criterios diagnósticos de la CIE 10 para trastornos del humor depresivos y que acuden a la consulta de Psiquiatría de un equipo de Salud Mental de Salamanca, durante los meses de marzo a noviembre de 2004. El instrumento de medida es un cuestionario que incluye aspectos sociodemográficos, clínicos y adherencia al tratamiento. Resultados: De los 134 pacientes incluidos, 26 (19,4%) son hombres y 108 (80,6%) son mujeres. Media de edad 46,22 años. En el 33,6% (45) de los pacientes incluidos en el estudio se produce incumplimiento. Conclusión: A mayor gravedad de la enfermedad depresiva, mayor incumplimiento del tratamiento. La ausencia de cambios y/o el empeoramiento, está relacionado con el incumplimiento. La propia sintomatología depresiva parece interferir en el propio cumplimiento

Objective: To identify clinical and social-demographic variables associated to the therapeutical non-adherence in depressive patients. Methodology and material: Descriptive transversal study through personal interviews to 134 patients that follow the CIE 10 criteria for depressive disorders that were treated by psychiatrists in Salamanca’s Mental Health Unit from March to November 2004. A questionnaire including adherence to the treatment, social-demographic, and clinical issues is used as a measurement tool. Results: Out of the 134 patients, 26 (19.4%) are male and 108 (80.6%) female. The average age is 46.22. 33.6% of the total non-adherent to the treatment. Conclusion: The greater the depressive illness the higher the non-adherence to the treatment. The absence of changes and/or the increase in the severity of the illness is related to the non-adherence of the treatment. The depressive clinic seems to interfere in the adherence to the treatment