[Depressive syndromes in the immigrant population]. / Síndromes depresivos en la población inmigrante.

Migrations are currently one of the most important sociocultural and political phenomena. As a rule, immigrants are in good health, although the immigration is by itself a mental health risk factor. This population shows common specific problems as adaptation processes, depressive syndromes, or other psychiatric problems. "Ulises' syndrome", depression, and dysthymia are the most common mental health conditions among unlawful non-european community immigrants cared in specific facilities. Similarly to the spanish indigenous population, anxiety disorders and readjustment disorders are the most common diagnoses among legal immigrants cared by Mental Health Services (MHS). Given the impact of sociocultural aspects in the development and clinical manifestations of mental health problems, it is necessary to know the demands of the immigrant population and to adjust current facilities for their care.

Síndromes depresivos en la población inmigrante / Depressive syndromes in the immigrant population

Las migraciones constituyen actualmente uno de los más importantes fenómenos socioculturales y políticos. En general, los inmigrantes gozan de buena salud, aunque la inmigración es un factor de riesgo para la salud mental. Esta población presenta problemas específicos comunes como procesos de adaptación, síndromes depresivos u otros problemas psiquiátricos. El «síndrome de Ulises», la depresión y la distimia son las patologías más frecuentes entre los inmigrantes extracomunitarios no regularizados atendidos en dispositivos específicos. Entre los atendidos en Servicios de Salud Mental en situación regular, los diagnósticos más frecuentes son trastornos de ansiedad y trastornos adaptativos de forma semejante a la población autóctona española. Dada la repercusión de los aspectos socioculturales en el desarrollo y manifestación de los problemas de salud mental es necesario el conocimiento de las demandas de los pacientes inmigrantes y la adecuación de los dispositivos actuales para su atención

Migrations are currently one of the most important sociocultural and political phenomena. As a rule, immigrants are in good health, although the immigration is by itself a mental health risk factor. This population shows common specific problems as adaptation processes, depressive syndromes, or other psychiatric problems. «Ulises’ syndrome», depression, and disthymia are the most common mental health conditions among unlawful non-european community immigrants cared in specific facilities. Similarly to the spanish indigenous population, anxiety disorders and readjustment disorders are the most common diagnoses among legal immigrants cared by Mental Health Services (MHS). Given the impact of sociocultural aspects in the development and clinical manifestations of mental health problems, it is necessary to know the demands of the immigrant populatin and to adjust current facilities for their care

Tratamiento del insomnio en las demencias / Treatment of insomnia in dementias

No disponible

Aspectos legales de la atención médica a drogodependientes / Legal aspects of medical care to drug addicts

No disponible

Guía docente en psiquiatría de enlace / Consultation-Liaison Psychiatry Training Guidelines

En esta revisión, se trata de exponer unos criterios básicos que puedan servir como guía para la formación en Psiquiatría de Enlace. Con este objetivo se revisan las bases docentes de este campo y se describen las características que debería tener la rotación por los Servicios o Unidades de Interconsulta y Enlace; todo ello en base a cuatro coordenadas fundamentales: asistencia, docencia, investigación y gestión. Asimismo se propone el contenido curricular del proyecto docente en Psiquiatría de Enlace. La pedagogía de la Psiquiatría de Enlace ha de ser reflexionada; dada la ausencia de publicaciones españolas en este campo, es deseable que la aportación en este trabajo sirva para abrir el debate. Por otra parte, siendo el futuro de esta rama de la Psiquiatría prometedor, en España son pocos los Servicios o Secciones desarrollados y muchos menos los que tienen articulada la docencia; se espera que este panorama asistencial cambie en un futuro no lejano. (AU)

Encuesta de docencia en psiquiatría de enlace / Consultation-Liaison Psychiatry. Teaching survey for C-L Psychiatry in Spain

Introducción: La Psiquiatría de enlace constituye una parte fundamental de la formación y la actividad asistencial del médico residente de Psiquiatría. A pesar de ello, el programa oficial de la residencia no define objetivos ni actividades propias de esta rotación. Metodología: Con objeto de conocer la situación actual de la misma en los centros docentes acreditados en nuestro país, y la opinión que sobre ella tienen los médicos residentes, se elaboró una encuesta dirigida a ellos, concretamente a los de tercer y cuarto año, con 41 ítems que valoraban aspectos organizativos de los Servicios de Psiquiatría de Enlace, las características de la rotación, la calidad de la misma según la percibían los residentes y las necesidades subjetivas de formación. Resultados: Se recibió respuesta de al menos un residente de 40 de los 67 centros docentes acreditados. La información recogida reveló, tal como sospechábamos, una gran heterogeneidad en los diversos aspectos estudiados pero además, una insatisfacción por parte de los residentes en cuanto al grado de supervisión y a la rotación en general. Conclusiones: habrá que profundizar sobre todos estos aspectos en futuros estudios con objeto de mejorar la calidad de la rotación en Psiquiatría de Enlace y con ello la del propio Servicio, favoreciendo así, además, la formación de futuros especialistas en esta área de la Psiquiatría (AU)

[Teaching survey for consultation-liaison psychiatry]. / Encuesta de docencia en psiquiatría de enlace.

BACKGROUND: Consultation-Liaison Psychiatry plays a major role in the training and clinical activity during the General Psychiatry Residency. Nevertheless, our national residency program for Psychiatry does not define either goals or distinct activities for the C-L Psychiatry rotation. METHODS: In order to: a) assess its current situation within the official teaching centers in Spain and b) determine the perceived opinion of the residents; a 41 item survey was mailed to 253 third and fourth year residents in Psychiatry to evaluate organizational issues of the C-L services, main aspects of this rotation, perceived quality, level of satisfaction and training needs. RESULTS: At least one resident from 40 out of the 67 accredited training centers answered the survey. The information gathered shown, as it was foreseen, that C-L training within the general psychiatry residency is very heterogeneous; furthermore it was documented some unsatisfaction regarding both the level of supervision and the rotation itself. CONCLUSIONS: Future studies are needed to get a closer look at all these aspects in order to improve the quality of both the rotation in C-L psychiatry and the standards of the C-L service itself. This endeavour shall benefit the training in C-L Psychiatry of the future spanish general psychiatrists.

[Training guidelines for linkage psychiatry]. / Guía docente en psiquiatría de enlace.

This review is aimed to provide some basic criteria intended to be useful as a C-L training guideline. Teaching foundations for C-L Psychiatry are reviewed and the main features of the training schemes in C-L Psychiatry Services or Units are outlined taking in to considerations the four main perspectives such as clinical, teaching, research and management activities. Furthermore, a core curriculum for a teaching is recommended. Teaching principles for C-L Psychiatry should be meditated; due to the absence of national publications in this specific area, this article might give the opportunity to get started in an open debate. In spite of a worldwide promising future for C-L Psychiatry, in Spain there are still few Services or units developed and fewer of those providing a formal teaching program, so an opportunity for a major shift is served.

[Late onset schizophrenias: a case of chronic hallucinatory psychosis]. / Las esquizofrenias de inicio tardío: a propósito de un caso de psicosis alucinatoria crónica.

The present case report is an example of a Chronic Hallucinatory Psychosis described by Ballet. Since this syndrome is excluded on the operational diagnostic manuals we would like to emphasize its discussion and possible inclussión on the group of late-onset schizophrenias.

[Pharmacological treatment of the intermittent explosive disorder. Report of three cases and literature review]. / Tratamiento farmacológico del trastorno explosivo intermitente. Presentación de tres casos y revisión de la literatura.

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.

[Psychiatry for cardiologists: psychological care for the coronary patient]. / Una psiquiatría para cardiólogos: la atención psicológica al paciente coronario.

During the different post-infarction stages, the coronary patient can show different profiles of adaptation, requiring adequate therapeutic approaches. In the acute phase, anxiety and irritability are a common response. The handling of information and the use of anxiolytics are the therapeutic alternatives that can best improve the possible psychic instability of the patient. During the rehabilitation phase, it is frequent to find the presence of denial mechanisms as a defence against anxiety or depression. The use of antidepressant drugs will depend on the clinical situation of each patient. It is also necessary in this phase to deal with problems such as possible sexual disorders, as well as with the control of risk factors and the reintegration into family life. It is a question, in short, of achieving a healthier lifestyle and a better quality of life. In the long term, the aim would be focused on the return to work and on the follow-up of the patient, so as to avoid that he may come back to the lifestyle he was leading before his disease. Nowadays, as clinical cardiology has lost importance, giving way to invasive cardiology, it is necessary to restore the humanistic and psychological role of the cardiologist, focused on the cardiologist-patient relationship. The object of this paper is to underline the importance of the cardiologist in the psychiatric-psychological attention of the coronary patient.

[Rehabilitation in ischemic cardiopathy. Results at the level of quality of life and prognosis]. / Rehabilitación en la cardiopatía isquémica. Resultados a nivel de calidad de vida y sobre el pronóstico.

Cardiac rehabilitation programs, by means of physical, psychosocial and risk control factors, intend to improve the life style and prognosis of coronary patients. In this study, we analyzed the results obtained from 349 patients, 310 with acute myocardial infarction and 39 after coronary artery surgery. The average follow up period was 36 months and the average age was 53.9 years. The results showed that 84.3% stopped smoking, 60% returned to work after a heart attack and 51.36% after coronary artery bypass. Functional capacity improved significantly with p < 0.001. Although 50% of the patients considered themselves sexually incapacitated, the number of coitus per month is similar to that of healthy people of the same age. There were 12 new infarctions (1.28 por 100 patients per year), and 11 cardiac-related deaths (1.18 per 100 patients per year). All the deaths occurred in the group of patients with myocardial infarction, and with a significant increase in the elevation of the ST in the necrosis area, during an exercise testing, indicating extensive areas of dyskinesis. Based on these results, we have reached the conclusion that steps must be taken to reduce the high percentage of patients who leave the program. In our study this was significantly low at 21.5%.