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1.
Clin Psychol Psychother ; 25(1): 173-180, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28924984

RESUMO

The Body Investment Scale (BIS) assesses body image feelings, body care, protection of the body, and comfort in touch, in order to identify and distinguish participants with self-harming and self-destructive tendencies. However, the psychometric properties of the BIS were not analysed in participants diagnosed with eating disorders. The main objective of the present study is to confirm the factor structure of the Spanish version of the BIS and analyse its psychometric properties in a sample composed of women diagnosed with eating disorders. Participants were 250 Spanish women between 12 and 60 years old (M = 26.05, SD = 11.97) diagnosed with eating disorders. A confirmatory factor analysis showed a poor fit of the original BIS. The final model showed an acceptable 4-factor structure (Body Feelings, α = .88; Body Touch, α = .82; Body Protection, α = .77; Body Care, α = .68), with a good fit to the data (SBχ2(246)  = 393.21, CFI = .906, IFI = .908, RMSEA = .049). The relationships between the BIS and both the Purpose-In-Life Test-10 Items and Beck Hopelessness Scale were analysed, as well as differences in the BIS score according to nonsuicidal self-injuries and suicidal ideation in the past year. The BIS is an appropriate instrument to assess the body investment dimension of body image in women with eating disorders.


Assuntos
Imagem Corporal/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Comportamento Autodestrutivo/complicações , Comportamento Autodestrutivo/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Criança , Análise Fatorial , Feminino , Humanos , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Espanha , Adulto Jovem
2.
Neurología (Barc., Ed. impr.) ; 30(1): 23-31, ene.-feb. 2015.
Artigo em Espanhol | IBECS | ID: ibc-132645

RESUMO

Introducción: La depresión post ictus (DPI) es el trastorno afectivo más frecuente tras un ictus y el principal factor que limita la recuperación y rehabilitación de los pacientes, además de poder incrementar su mortalidad hasta 10 veces. Desarrollo: La DPI se presenta en uno de cada 3 pacientes con ictus y en más de la mitad de los casos no se diagnostica ni se trata. En su etiopatogenia son varios los mecanismos implicados: biológicos, conductuales y sociales. Los síntomas suelen aparecer en los primeros 3 meses tras el ictus (DPI «precoz») y menos frecuentemente más tarde (DPI «tardía»). Los síntomas son similares a los de otras depresiones, aunque con algunas diferencias, como presentar más trastornos del sueno, síntomas vegetativos e introversión para las relaciones sociales. Para su diagnóstico se recomienda mantener una actitud vigilante y emplear herramientas diagnósticas específicas, como el Patient Health Questionaire-2 (PHQ-2). Finalmente, el tratamiento de elección son los inhibidores selectivos de la recaptación de serotonina (ISRS). No obstante, aún son muchas las cuestiones por resolver en el tratamiento de la DPI, como cuándo es el mejor momento para iniciar el tratamiento o el efecto de los antidepresivos sobre la cognición y la función motora, entre otros. Conclusiones: Los neurólogos desempenan un papel fundamental en la recuperación de los enfermos con ictus. Es necesario que estén familiarizados con la detección temprana y el tratamiento de la DPI, para así facilitar la recuperación funcional del paciente, su reinserción social y la mejora en la calidad de vida del enfermo y su familia


Introduction: Post-stroke depression (PSD) is the most common mood disorder following a stroke, and also the main factor limiting recovery and rehabilitation in stroke patients. In addition, it may increase mortality by up to ten times. Development: PSD occurs in 1 in 3 stroke patients and more than half of all cases are neither diagnosed nor treated. Several mechanisms, including biological, behavioral, and social factors, are involved in its pathogenesis. Symptoms usually occur within the first three months after stroke (early onset PSD), and less frequently at a later time (late onset PSD). Symptoms resemble those of other types of depression, although there are some differences: PSD patients experience more sleep disturbances, vegetative symptoms, and social withdrawal. For PSD diagnosis, we recommended vigilance and use of specific diagnostic tools such as the Patient Health Questionnaire-2 (PHQ-2). The treatments of choice are selective serotonin reuptake inhibitors (SSRI). However, there are still many unanswered questions in the treatment of PSD, such as the best time to start treatment or the effects of antidepressants on cognition and motor function, among others. Conclusions: Neurologists play a pivotal role in the care and management of patients recovering from stroke. They must be familiar with methods for early detection and treatment ofPSD, as this can facilitate a patient’s functional recovery and social reintegration, and improve quality of life for patients and their families


Assuntos
Humanos , Masculino , Feminino , Acidente Vascular Cerebral/congênito , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/patologia , Depressão/complicações , Depressão/diagnóstico , Antidepressivos/análise , Antidepressivos , Antidepressivos/uso terapêutico , Neurologia/educação , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/prevenção & controle , Depressão/prevenção & controle , Antidepressivos/química , Antidepressivos/provisão & distribuição , Neurologia/organização & administração
3.
Neurologia ; 30(1): 23-31, 2015.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22901370

RESUMO

INTRODUCTION: Post-stroke depression (PSD) is the most common mood disorder following a stroke, and also the main factor limiting recovery and rehabilitation in stroke patients. In addition, it may increase mortality by up to ten times. DEVELOPMENT: PSD occurs in 1 in 3 stroke patients and more than half of all cases are neither diagnosed nor treated. Several mechanisms, including biological, behavioral, and social factors, are involved in its pathogenesis. Symptoms usually occur within the first three months after stroke (early onset PSD), and less frequently at a later time (late onset PSD). Symptoms resemble those of other types of depression, although there are some differences: PSD patients experience more sleep disturbances, vegetative symptoms, and social withdrawal. For PSD diagnosis, we recommended vigilance and use of specific diagnostic tools such as the Patient Health Questionnaire-2 (PHQ-2). The treatments of choice are selective serotonin reuptake inhibitors (SSRI). However, there are still many unanswered questions in the treatment of PSD, such as the best time to start treatment or the effects of antidepressants on cognition and motor function, among others. CONCLUSIONS: Neurologists play a pivotal role in the care and management of patients recovering from stroke. They must be familiar with methods for early detection and treatment of PSD, as this can facilitate a patient's functional recovery and social reintegration, and improve quality of life for patients and their families.


Assuntos
Depressão/diagnóstico , Acidente Vascular Cerebral/psicologia , Antidepressivos/uso terapêutico , Depressão/tratamento farmacológico , Depressão/etiologia , Humanos , Qualidade de Vida , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Inquéritos e Questionários
4.
Med Mal Infect ; 40(9): 548-51, 2010 Sep.
Artigo em Francês | MEDLINE | ID: mdl-20018472

RESUMO

The nasal septoplasty is a very current intervention in otorhinolaryngology surgery. The infectious complications of this intervention are rare and mostly mild. We report here the case of a patient hospitalized in ambulatory surgery within a fracture of the nose with luxation of the septum in the nasal fossa. This patient was operated for a reduction of this fracture with septoplasty. Twelve hours after the intervention the patient presented septic arthritis due to Streptococcus pyogenes. The tracks of prevention are presented.


Assuntos
Artrite Infecciosa/microbiologia , Septo Nasal/cirurgia , Complicações Pós-Operatórias/microbiologia , Cuidados Pré-Operatórios/normas , Infecções Estreptocócicas , Streptococcus pyogenes , Artrite Infecciosa/prevenção & controle , Descontaminação , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Infecções Estreptocócicas/prevenção & controle
6.
Med Mal Infect ; 37(5): 293-4, 2007 May.
Artigo em Francês | MEDLINE | ID: mdl-17257794

RESUMO

Pet-rat bite fever is a relatively rare disease consecutive to a rat bite or scratch. The authors report a case of septic arthritis following a pet rat bite. Streptobacillus moniliformis was identified in the knee synovial fluid and identified by 16S rRNA sequencing. This is a rapid and efficient tool for identification of fastidious bacterium. The patient was cured by an amoxicillin treatment.


Assuntos
Animais Domésticos , Antibacterianos/uso terapêutico , Febre por Mordedura de Rato/diagnóstico , Febre por Mordedura de Rato/tratamento farmacológico , Streptobacillus , Animais , Quimioterapia Combinada , Humanos , Articulação do Joelho , Masculino , Pessoa de Meia-Idade , RNA Bacteriano/genética , RNA Bacteriano/isolamento & purificação , RNA Ribossômico 16S/genética , RNA Ribossômico 16S/isolamento & purificação , Febre por Mordedura de Rato/microbiologia , Ratos , Streptobacillus/genética , Streptobacillus/isolamento & purificação , Líquido Sinovial/microbiologia
7.
Rev. Soc. Esp. Dolor ; 14(1): 26-35, ene. 2007. ilus, tab
Artigo em Es | IBECS | ID: ibc-055724

RESUMO

Objetivo El objetivo de este trabajo es estudiar variables del dolor crónico, concretamente la intensidad, el tiempo o la etiología, e identificar su relación con el estado de ánimo del paciente, en una muestra de pacientes con dolor crónico heterogéneo y sin antecedentes personales de depresión. Material y método La muestra está compuesta por 106 pacientes con dolor crónico que acuden a la Unidad del Dolor del Servicio de Anestesia del Hospital Clínico Universitario de Salamanca en consulta ambulatoria. Los participantes completaron una batería de cuestionarios donde, en una primera parte, se recogían los datos sociodemográficos, el diagnóstico clínico, el tiempo de padecimiento del dolor y la intensidad del mismo a través del EVA (escala visual analógica), con tres valoraciones por parte del paciente: durante la entrevista y en los momentos de máxima y mínima intensidad. Posteriormente cumplimentaron el Inventario de Depresión de Beck (BDI) para evaluar su estado de ánimo. La muestra se dividió en tres grupos de estudio en función de la etiología: oncológico, neuropático y nociceptivo, y se efectuaron análisis de control de las variables intensidad y tiempo de dolor mediante ANOVAS unifactoriales, comprobándose que los grupos eran homogéneos. Resultados y conclusiones Los resultados indican que la intensidad del dolor y el tiempo que llevan sufriendo el mismo no influyen sobre el estado anímico, y tan sólo el tipo de dolor tiene efecto sobre la depresión, apreciándose que el grupo oncológico es el que ofrece puntuaciones correspondientes a niveles clínicos. Los pacientes con dolor neuropático y nociceptivo conforman dos grupos muy homogéneos en la repercusión afectiva (oscilando entre niveles leves y moderados) derivada del padecimiento álgico. Los resultados refuerzan la teoría de la multiplicidad de variables intervinientes en la percepción dolorosa, alejándonos de la unidireccionalidad del axioma que indica que la reacción psicológica es proporcional a la severidad y al tiempo padecido de dolor


Objective The present study aims to assess chronic pain, an attempt is made to study variables such as intensity, time and origin (nature) of pain and to identify their relationship to the patient’s state of mind. A heterogenous sample of patients suffering from chronic pain is used and results are discussed. Material and method 106 patients with chronic pain participated in the study. Subjects were recruited from the Pain Unit of the Department of Anesthesia of the University Hospital Clinic of Salamanca, Spain. First, participants were asked to fill out a number of questionnaires which included socio- demographic data, clinical diagnosis, duration of suffering across time and pain intensity through VAS (Visual Analogical Scale). Second, they were asked to rate a series of statements a) during the interview and b) during moments of high and low intensity. Finally, the Beck Depression Inventory (BDI) was used to assess their state of mind. Participants were divided in three groups, according to the nature of their pain: oncological, neuropathic and nociceptive. Control analyses of pain intensity and time of suffering were conducted (using uni-factorial analyses: ANOVAS) to assure homogeneity among the participants. Results and conclusions Results show that neither pain intensity nor duration of suffering across time affect one’s state of mind. The nature of the pain seems to have an impact on depression, therefore the oncology group gave higher ratings on the clinical scale. Ratings of patients with neuropathic o nociceptive pain fluctuated between low and moderate levels of emotional impact. In the present study, the uni-directional axiom which implies that psychological reactions are closely related to the severity and the duration of pain is seriously questioned. The results seem to reinforce the theory of the existence of a wide range of variables that affect the perception of pain


Assuntos
Humanos , Dor Intratável/psicologia , Transtorno Depressivo/epidemiologia , Clínicas de Dor/estatística & dados numéricos , Medição da Dor/psicologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos
8.
Rev Med Interne ; 26(12): 921-3, 2005 Dec.
Artigo em Francês | MEDLINE | ID: mdl-16253395
9.
J Clin Psychiatry ; 62 Suppl 3: 10-21, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11229449

RESUMO

BACKGROUND: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently associated with sexual dysfunction. Other antidepressants (nefazodone, mirtazapine, bupropion, amineptine, and moclobemide) with different mechanisms of action seem to have fewer sexual side effects. The incidence of sexual dysfunction is underestimated, and the use of a specific questionnaire is needed. METHOD: The authors analyzed the incidence of antidepressant-related sexual dysfunction in a multicenter, prospective, open-label study carried out by the Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The group collected data from April 1995 to February 2000 on patients with previously normal sexual function who were being treated with antidepressants alone or antidepressants plus benzodiazepines. One thousand twenty-two outpatients (610 women, 412 men; mean age = 39.8 +/- 11.3 years) were interviewed using the Psychotropic-Related Sexual Dysfunction Questionnaire, which includes questions about libido, orgasm, ejaculation, erectile function, and general sexual satisfaction. RESULTS: The overall incidence of sexual dysfunction was 59.1% (604/1022) when all antidepressants were considered as a whole. There were relevant differences when the incidence of any type of sexual dysfunction was compared among different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9% (100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208); citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine, 24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and moclobemide, 3.9% (1/26). Men had a higher frequency of sexual dysfunction (62.4%) than women (56.9%), although women had higher severity. About 40% of patients showed low tolerance of their sexual dysfunction. CONCLUSION: The incidence of sexual dysfunction with SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared with serotonin-2 (5-HT2) blockers (nefazodone and mirtazapine), moclobemide, and amineptine.


Assuntos
Assistência Ambulatorial , Antidepressivos/efeitos adversos , Transtornos Mentais/tratamento farmacológico , Disfunções Sexuais Psicogênicas/induzido quimicamente , Disfunções Sexuais Psicogênicas/epidemiologia , Adolescente , Adulto , Idoso , Antidepressivos/uso terapêutico , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/psicologia , Feminino , Humanos , Incidência , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Transtorno de Pânico/tratamento farmacológico , Transtorno de Pânico/psicologia , Piperazinas , Estudos Prospectivos , Remissão Espontânea , Índice de Gravidade de Doença , Fatores Sexuais , Comportamento Sexual/fisiologia , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e Questionários , Resultado do Tratamento , Triazóis/efeitos adversos , Triazóis/uso terapêutico
10.
Actas Esp Psiquiatr ; 28(3): 141-50, 2000.
Artigo em Espanhol | MEDLINE | ID: mdl-11000695

RESUMO

BACKGROUND: The presence of sexual function impairment in patients with psychiatric disorders is very common and could be an effect of the medication (mainly antidepressant and neuroleptics). The patient frequently has difficulties to communicate this adverse effect and the assessment of these changes by the physician should be encouraged. The real SD incidence is underestimated and the use of a specific questionnaire is needed. METHODS: The authors analyse psychometric characteristics of the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ) that includes questions about libido, orgasm, ejaculation, erectile function and general sexual satisfaction. The questionnaire was applied to 62 patients who were taking nefazodone "de novo" (n = 18) or were switched to nefazodone (n = 44) due to bad tolerated sexual dysfunction secondary to other antidepressant. RESULTS: The PRSexDQ has shown an excellent feasibility with nil percentage of patients with missing responses on all items except on items 1 and 2 (1.7% and 15.5% of patients with missing response). Cronbach's alpha value was 0.93, which indicates adequate reliability. The PRSexDQ also showed adequate construct validity. As it may be expected, the PRSexDQ showed a high correlation with a Clinical Global Impression scores on Sexual Dysfunction (r = 0.79) and moderate correlation with Hamilton Depression scores (r = 0.63). PRSexDQ also showed good discrimination between naive and pretreated depressed or dysthymic patients, with statistically significant differences between those groups of patients. Finally, the instrument showed adequate sensitivity for detecting clinical changes on sexual dysfunction with greater changes in the patients treated previously with antidepressants and who were switched to nefazodone than in naive patients (SES = -3.77 in patients switching to nefazodone; SES = -0.64 in naive patients).


Assuntos
Antidepressivos de Segunda Geração/efeitos adversos , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Fisiológicas/diagnóstico , Inquéritos e Questionários , Triazóis/efeitos adversos , Adulto , Transtorno Depressivo/tratamento farmacológico , Feminino , Humanos , Masculino , Piperazinas , Psicometria/estatística & dados numéricos
11.
Actas esp. psiquiatr ; 28(3): 141-150, mayo 2000.
Artigo em Es | IBECS | ID: ibc-1752

RESUMO

El empeoramiento en la función sexual en pacientes con trastornos psiquiátricos es muy frecuente y con frecuencia es secundario a la medicación (fundamentalmente antidepresivos y neurolépticos). Los pacientes tienen dificultad para comunicar este efecto adverso y debe alentarse la evaluación de estos cambios por el médico. Estudios anteriores demuestran que se necesitan cuestionarios específicos para medir este efecto adverso, ya que la incidencia real de disfunción sexual suele estar subestimada. Material y métodos: Los autores analizan las propiedades psicométricas del Cuestionario de Disfunción Sexual Secundaria a Psicofármacos que incluye preguntas acerca de la líbido, orgasmo, eyaculación, función eréctil (lubrificación vaginal en mujeres) y satisfacción sexual general. El cuestionario fue aplicado en 62 pacientes que tomaron nefazodona de novo (n= 18) o que fueron cambiados a nefazodona (n= 44) debido a disfunción sexual mal tolerada secundaria a otro antidepresivo. Resultados: El cuestionario mostró excelente factibilidad con un porcentaje nulo de pacientes sin respuesta excepto en los ítems 1 y 2 (1,7 por ciento y 15,5 por ciento de pacientes sin respuesta respectivamente). El valor * de Cronbach fue de 0,93, indicando adecuada fiabilidad. El cuestionario también mostró una adecuada validez de constructo. Tal y como se esperaba, existió una alta correlación con las puntuaciones de la impresión clínica global de disfunción sexual (r= 0,79) y moderada correlación con las puntuaciones de la escala de Hamilton de depresión (r= 0,63). También discriminó adecuadamente entre los pacientes nuevos y pretratados diagnosticados de depresión o distimia con diferencias significativas entre estos grupos. Finalmente el instrumento mostró adecuada sensibilidad para detectar cambios clínicos en la función sexual con cambios más grandes en el grupo tratado previamente con antidepresivos comparado con los pacientes que iniciaron tratamiento de novo (SES= 3,77 en pacientes cambiados a nefazodona; SES= 0,64 en pacientes nuevos). (AU)


Assuntos
Adulto , Masculino , Feminino , Humanos , Inquéritos e Questionários , Triazóis , Antidepressivos de Segunda Geração , Psicometria , Transtorno Depressivo , Disfunções Sexuais Fisiológicas
13.
Actas Esp Psiquiatr ; 27(1): 23-34, 1999.
Artigo em Espanhol | MEDLINE | ID: mdl-10380144

RESUMO

UNLABELLED: Sexual dysfunction secondary to the use of antidepressants, especially clomipramine or SSRI's is an adverse effect that is often underestimated and according to earlier studies, this can affect approximately 60% of the patients. This presents as a decrease in libido, alterations in the ability to reach orgasm/ejaculation, and an erectile dysfunction or a decreased vaginal lubrication. This dysfunction appears to be related with the resulting increase in serotonin and with the stimulation of serotonin 5HT2 receptors. OBJECTIVES: 1) Evaluate the effect of amineptine, a drug with an increased dopamine transmission and scant serotonin transmission, on the sexual function of depressed patients who begin treatment, and 2) evaluate whether the change to amineptine improves the sexual function in patients who presented sexual dysfunction after beginning treatment with a SSRI. MATERIAL AND METHODS: Prospective, observational, open and multicentric design. 111 patients with an average age of 41.3 years (36 men, 75 women) were distributed into three groups: Group 1 (n= 26): patients with depression (DSM IV) who begin de novo treatment with amineptine 200 mg/day. Group 2 (n= 47): depressed patients undergoing treatment with a SSRI who show a favorable response and who present sexual dysfunction secondary to a poorly tolerated treatment, so the treatment is changed to 200 mg/day of amineptine. Group 3 (n= 38): patients with the same characteristics as those of group 2, but whose treatment was changed to 20 mg/day of paroxetine. The <> (Montejo et al, 1996) was used together with the Hamilton Depression Scale, the IGC Scale, and an adverse events scale, over a 6 months follow up period during which visits took place at: baseline, month 1, month 2, month 3, and month 6. RESULTS: In group 1, treated with amineptine from the beginning, of the 5 patients who showed a decrease in the libido at the beginning of the treatment, only one still presented this in the 6th month. The Hamilton Scale decreased from 23.12 (baseline) to 5.25 after 6 months. After substituting amineptine for SSRI's in patients with sexual dysfunction, the incidence of any type of sexual dysfunction decreased significantly from 100% (baseline) to 55.3% after 6 months. (P< 0.001). The incidence of delayed orgasm dropped to 15.8%, anorgasmia to 17.4%, and impotence dropped to 15.8% in this group, with the antidepressant effect that had already been achieved with the SSRI being maintained. However, in group 3 there was barely any improvement on the sexual function after changing to paroxetine (20 mg/day), with the baseline incidence being 100% and the incidence after 6 months being 89.7%. In this last group the antidepressant effect present at the baseline level, was maintained. CONCLUSIONS: Amineptine was shown to be an effective antidepressant in the patients studied, and did not cause secondary sexual dysfunction, and even improved the dysfunction that was present in some patients. In those patients previously treated with SSRI's, amineptine is able to significantly improve the sexual dysfunction and yet maintain the efficacy of the antidepressive treatment used before these 6 months. On the other hand, Paroxetine did not improve the sexual dysfunction of the people in whom this drug substituted another SSRI, as this is an adverse effect common to the entire group of selective serotonin re-uptake inhibiting drugs. Amineptine showed a good safety and tolerance profile. Its most common side effect (anxiety/restlessness) disappeared 2 months after the beginning of the treatment.


Assuntos
Dibenzocicloeptenos/efeitos adversos , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Disfunções Sexuais Fisiológicas/induzido quimicamente , Adulto , Feminino , Humanos , Masculino
15.
Artigo em Espanhol | MEDLINE | ID: mdl-9595827

RESUMO

Use of BMT (bone marrow transplatation) has rapidly grown in the last few years. It extends to a variety of neoplastic illnesses and hematological malignancies. This procedure includes implicit appearance of many and important stressors, both physical and psychological, due to the illness and to chemotherapy treatments, among which the appearance and severe colateral effects during the stay in hospital has a special relevance. The need to consider the influency of predictive variables like, prior experiences, optimistic vs. pesimistic expectancies and the strategies of coping used in the adaptation through the treatment, are a central point in the study of the fluctuations of the different psychological responses and their interrelation with the physiology symtomatology which are present during the different phases of the process of BMT.


Assuntos
Transplante de Medula Óssea/psicologia , Transtornos Mentais/etiologia , Humanos , Transtornos Mentais/diagnóstico , Estresse Psicológico/psicologia
16.
J Sex Marital Ther ; 23(3): 176-94, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9292833

RESUMO

The authors analyzed the incidence of sexual dysfunction (SD) with different selective serotonin reuptake inhibitors (SSRIs; fluoxetine, fluvoxamine, paroxetine, and sertraline) and hence the qualitative and quantitative changes in SD throughout time in a prospective and multicenter study. Outpatients (192 women and 152 men; age = 39.6 +/- 11.4 years) under treatment with SSRIs were interviewed with an SD questionnaire designed for this purpose by the authors and that included questions about the following: decreased libido, delayed orgasm or anorgasmia, delayed ejaculation, inability to ejaculate, impotence, and general sexual satisfaction. Patients with the following criteria were included: normal sexual function before SSRI intake, exclusive treatment with SSRIs or treatment associated with benzodiazepines, previous heterosexual or self-erotic current sexual practices. Excluded were patients with previous sexual dysfunction, association of SSRIs with neuroleptics, recent hormone intake, and significant medical illnesses. There was a significant increase in the incidence of SD when physicians asked the patients direct questions (58%) versus when SD was spontaneously reported (14%). There were some significant differences among different SSRIs: paroxetine provoked more delay of orgasm or ejaculation and more impotence than fluvoxamine, fluoxetine and sertraline (chi 2, p < .05). Only 24.5% of the patients had a good tolerance of their sexual dysfunction. Twelve male patients who suffered from premature ejaculation before the treatment preferred to maintain delayed ejaculation, and their sexual satisfaction, and that of their partners, clearly improved. Sexual dysfunction was positively correlated with dose. Patients experienced substantial improvement in sexual function when the dose was diminished or the drug was withdrawn. Men showed more incidence of sexual dysfunction than women, but women's sexual dysfunction was more intense than men's. In only 5.8% of patients, the dysfunction disappeared completely within 6 months, but 81.4% showed no improvement at all by the end of this period. Twelve of 15 patients experienced total improvement when the treatment was changed to moclobemide (450-600 mg/day), and 3 of 5 patients improved when treatment was changed to amineptine (200 mg/day).


Assuntos
1-Naftilamina/análogos & derivados , Fluoxetina/efeitos adversos , Fluvoxamina/efeitos adversos , Paroxetina/efeitos adversos , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Disfunções Sexuais Psicogênicas/induzido quimicamente , 1-Naftilamina/efeitos adversos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sertralina , Índice de Gravidade de Doença , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Inquéritos e Questionários
17.
Artigo em Espanhol | MEDLINE | ID: mdl-9054202

RESUMO

UNLABELLED: The authors analyze the incidence of sexual dysfunction (SD) with different SSRIs (Fluoxetine, Fluvoxamine, Paroxetine and Sertraline) and hence the qualitative and quantitative changes in SD throughout time 308 outpatients (169 women, 139 men; mean +/- SD age = 41 +/- 7) under treatment with SSRIs were interviewed with an SD questionnaire designed for this purpose by the authors including questions about the following items decreased libido, delayed orgasm or anorgasmia, delayed ejaculation inability to ejaculation, impotence and general sexual satisfaction. Patients with the following criteria were included: normal sexual function before SSRIs intake, exclusive treatment with SSRIs or associated with benzodiazepines, previous heterosexual or self-orone current sexual practices. We excluded patients with previous sexual dysfunction, association of SSRIs with neuroleptics, recently hormone intake and significant medical illnesses. RESULTS: There is a significant increase in the incidence of SD when the physicians ask the patients direct questions (55.29%) versus spontaneous SD reported (14.2%). There are some significant differences among different SSRIs paroxetine provoked more delay of orgasm/ejaculation and more impotence than fluvoxamine, fluoxetine and sertraline (Chi square p < 0.05). Only 22.6% of the patients had a good tolerance about their sexual dysfunction. SD has positive correlation with the dose. The patients experienced substantial improvement in sexual function when the dose was diminished or the drug was withdrawn. Men showed more incidence of sexual dysfunction than women but women's sexual dysfunction was more intense than men. Seven of nine patients (77.7%) experienced total improvement when the treatment was changed to Moclobemide (450 mg/day) and two of four patients (50%) improved when treatment was changed to Amineptine.


Assuntos
1-Naftilamina/análogos & derivados , Fluoxetina/efeitos adversos , Fluvoxamina/efeitos adversos , Paroxetina/efeitos adversos , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Disfunções Sexuais Psicogênicas/induzido quimicamente , 1-Naftilamina/efeitos adversos , 1-Naftilamina/farmacologia , 1-Naftilamina/uso terapêutico , Adulto , Antidepressivos/administração & dosagem , Antidepressivos/uso terapêutico , Benzamidas/administração & dosagem , Benzamidas/uso terapêutico , Transtorno Depressivo/tratamento farmacológico , Dibenzocicloeptenos/administração & dosagem , Dibenzocicloeptenos/uso terapêutico , Relação Dose-Resposta a Droga , Ejaculação/efeitos dos fármacos , Feminino , Fluoxetina/farmacologia , Fluoxetina/uso terapêutico , Fluvoxamina/farmacologia , Fluvoxamina/uso terapêutico , Humanos , Masculino , Moclobemida , Orgasmo/efeitos dos fármacos , Paroxetina/farmacologia , Paroxetina/uso terapêutico , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Sertralina
18.
Artigo em Espanhol | MEDLINE | ID: mdl-8984852

RESUMO

Seasonal affective disorders (SAD) represents a subgroup of major depression with a regular occurrence of symptoms in autumn and winter and full remission in spring and summer. Light therapy or phototherapy has become the standard treatment of this type of depression. The phototherapy is affective therapy for depressive symptoms of SAD. However, the action mechanism of light therapy is uncertain. Finally, new lines of the investigation of light therapy are aforementioned.


Assuntos
Fototerapia , Transtorno Afetivo Sazonal/terapia , Ritmo Circadiano , Humanos , Luz , Escalas de Graduação Psiquiátrica , Transtorno Afetivo Sazonal/diagnóstico , Serotonina/fisiologia
19.
Rev Rhum Engl Ed ; 63(6): 421-6, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8817752

RESUMO

Specific features of upper lumbar disk herniations are reviewed based on data from the literature and from a retrospective study of 24 cases treated surgically between 1982 and 1994 (seven at L1-L2 and 17 at L2-L3). Clinical manifestations are polymorphic, misleading (abdominogenital pain suggestive of a visceral or psychogenic condition, meralgia paresthetica, isolated sciatica; femoral neuralgia is uncommon) and sometimes severe (five cases of cauda equina syndrome in our study group). The diagnostic usefulness of imaging studies (radiography, myelography, computed tomography, magnetic resonance imaging) and results of surgery are discussed. The risk of misdiagnosis and the encouraging results of surgery are emphasized.


Assuntos
Deslocamento do Disco Intervertebral/diagnóstico , Vértebras Lombares/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Deslocamento do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/cirurgia , Dor Lombar/diagnóstico , Dor Lombar/etiologia , Dor Lombar/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Mielografia , Prognóstico , Estudos Retrospectivos , Ciática/diagnóstico , Ciática/etiologia , Ciática/cirurgia
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