Somatic and psychiatric co-morbidity in Primary Care patients in Spain

No disponible

Background: There is limited information on the subject of co-morbidity of general medical conditions (GMCs) and general psychiatric disturbance in primary care (PC). Methods: A representative sample (n = 1559) of adult PC patients was examined in a two-phase screening. Standardized screening instruments were used, including the Standardized Polyvalent Psychiatric Interview (SPPI). ICD-10 research criteria were used for psychiatric diagnosis, and ICPC-2 for medical diagnosis. Results: Most co-morbidity cases had depressive (120 cases, 28.1%) or anxiety/neurotic disorders (217 cases, 50.9%). In support of the working hypothesis, the proportion of patients with several medical diagnoses was significantly higher among the cases, and logistic regression showed that the probability of being a psychiatric case increased with each medical diagnosis done by the primary care physician (OR = 2.46; IC 1.66-3.66, p < 0.001). Moderate/severe cases were significantly more frequent among the depressed group (91 cases, 75.9%), but were also common in the anxiety/neurosis group (52 cases,24%), the between groups differences in disability being non-significant. The distribution of both affective and neurotic disorders by specific ICPC-2 categories suggests preferential associations. Conclusion: In PC, the probability of having a co-morbid psychiatric diagnosis doubles with each medical diagnosis. Anxiety/neurotic disorders, and not only depressive disorders, are relevant co-morbid psychiatric categories in this setting (AU)

Distrofia simpático refleja: aspectos psicológicos y psicopatológicos / Reflex sympathetic dystrophy: psychological and psychopathological aspects

Clásicamente se ha admitido un terreno psicológico predisponente en la aparición de la distrofia simpático refleja. No obstante, no hay unanimidad en esta apreciación ya que existen estudios que abogan por el carácter reactivo de la afectación psicológica en la distrofia simpático refleja. En el presente trabajo revisamos la literatura publicada al respecto, discutimos sobre los test de evaluación psicológica utilizados hasta el momento, y planteamos la posibilidad de utilizar otros de más fácil manejo e interpretación. (AU)