Guía de práctica clínica para el tratamiento de depresión en adultos / Clinical practice guideline for the treatment of depression in adults

La guía trata de temas relacionados al tratamiento de la depresión, tocando temas como: las perspectivas y experiencias de los pacientes con depresión y sus familiares; evaluación y cribado de la depresión; los modelos de atención; tratamiento psicoterapéutico, tratamiento farmacológico; estrategias psicoterapéuticas y farmacológicas en la depresión resistente.

[Risk and protective factors in adolescents' drug use, and differences by age and sex]. / Factores de riesgo y de protección en el consumo de drogas en adolescentes y diferencias según edad y sexo.

Adolescents' drug use has huge social and personal implications, so it is essential to identify risk and protective factors. In this research, the CTCYS was used with 2440 adolescents to detect risk and protective factors for drug use in the community, family, school and peers/individual; differences in risk and protective factors by age and sex; and relationships between risk and protective factors and substance use. Protective factors are high. Risk factors are high in the community, the school and the individual. Older adolescents have more risks and less protection than the youngest; and there are sex differences, because males have less protection and more risks. The risk factors more closely related to drug use are availability of drugs in the community, family attitudes favourable to drug use, family history of antisocial behaviour, early start and use of drugs by friends, perceived risk and attitudes favourable to drug use. In the protective factors, the role played by social skills for alcohol use is important.

Factores de riesgo y de protección en el consumo de drogas en adolescentes y diferencias según edad y sexo / Risk and protective factors in adolescents’ drug use, and differences by age and sex

El consumo de drogas en adolescentes tiene considerables implicaciones sociales y personales, por lo que es esencial la identificación de factores de riesgo y protección. En esta investigación se aplicó el cuestionario CTCYS a 2.440 adolescentes para detectar los factores protectores y de riesgo en la comunidad, la familia, la escuela y el grupo de iguales/individuo; diferencias en protección y riesgo según edad y sexo, y relación entre dichos factores y consumo. Los factores de protección son elevados. Los factores de riesgo son altos en comunidad, escuela e individuo. Los mayores tienen más riesgos y menos protección que los pequeños; y se dan diferencias según el sexo, contando los chicos con menos protección y más riesgos que las chicas. Los factores de riesgo más relacionados con el consumo de sustancias son la disponibilidad de drogas, las actitudes familiares favorables al consumo, la historia familiar de conducta antisocial, el inicio temprano y el consumo de los amigos, el riesgo percibido con respecto al consumo y las actitudes favorables al consumo. En los factores de protección destaca el papel de las habilidades sociales frente al consumo de alcohol (AU)

Adolescents’ drug use has huge social and personal implications, so it is essential to identify risk and protective factors. In this research, the CTCYS was used with 2440 adolescents to detect risk and protective factors for drug use in the community, family, school and peers/individual; differences in risk and protective factors by age and sex; and relationships between risk and protective factors and substance use. Protective factors are high. Risk factors are high in the community, the school and the individual. Older adolescents have more risks and less protection than the youngest; and there are sex differences, because males have less protection and more risks. The risk factors more closely related to drug use are availability of drugs in the community, family attitudes favourable to drug use, family history of antisocial behaviour, early start and use of drugs by friends, perceived risk and attitudes favourable to drug use. In the protective factors, the role played by social skills for alcohol use is important(AU)

Estudio de evaluación de resultados en terapia familiar / No disponible

En las últimas décadas se ha asistido a una proliferación de las investigaciones de resultados en psicoterapia; hasta tal punto, que se cuenta en la actualidad con una nada desdeñable, aunque insuficiente, base empírica, que avala los tratamientos psicoterapéuticos. Sin embargo, hay aún muchos aspectos controvertidos, por lo que sigue siendo necesario que las diferentes escuelas que coexisten en el mercado de las psicoterapias, desarrollen pruebas en las que basar sus prácticas clínicas. El objeto de esta investigación es la evaluación de los resultados que se generan de la aplicación de un modelo de Terapia Familiar Breve en la Consulta de Psicología de una Unidad de Salud Mental enclavada en un Hospital Comarcal. Se aplica un modelo de Terapia Familiar Sistémica -Terapia Familiar Breve-, guiado por la teoría y las prácticas de MRI de Palo Alto y del BFTC de Milwaokee. Se analiza el resultado de todos los casos atendidos con psicoterapia en la Consulta de Psicología del Hospital "Virxe da Xunqueira" durante los años 1999, 2000 y 2001 -N = 785-. Los resultados -Abandonan 18% y continúan tratamiento 82%; se "enganchan" 16% y terminan 84%; de los cuales son Éxito 77% y Fracaso 23%- confirman los resultados de investigaciones previas. Tras un seguimiento a 20 meses, se registra un 19% de recaídas; mientras que han resuelto el problema 66% de los casos de abandono y el 46 % de los fracasos. Además 66 % de los casos informan de haber mejorado en áreas no tratadas -efecto irradiación-. No se encuentran diferencias entre el grupo de abandonos y los que continúan tratamiento; los casos de éxito en comparación con los fracasos, se caracterizan por ser pacientes más jóvenes, con menos tiempo de evolución de su queja y que afecta menos a su actividad global; las sesiones son más cortas y la mejoría empieza tras la primera sesión. El grupo de casos que se "enganchan" al tratamiento presentan características similares a los fracasos (AU)

During the last decades a proliferation in the investigation on therapy results has taken place. This has allowed to count today with a big, although insufficient, empiric basis, which guarantees the psicotherapy treatments. However, there are still many controversial aspects that make necessary the that the different schools which coexist in the psicotherapy market develop suitable methods to evaluate their treatments. The aim of this investigation was to evaluate the results generated during the application of a Brief Family Therapy model in a psychologist’s desk in the Mental Health Unit of a Rural Area Hospital. A Systemic Family Therapy is used - Brief Family Therapy- following Palo Alto’s MRI and Milwaukee’s BFTC theory and practices. All the clinical cases analysed dealt with psicotherapy in the psychologist’s desk between 1999 and 2001 -N = 785- are analysed. Results obtained: 18% droped out and 82% continued the treatment; among these, 16% continue and 84% finished treatment showing 77% success and 23% failure. These results confirm previous investigations results. After a 20 months monitoring period, there are 19% of relapses, the problem has been solved for 66% of drop out cases and for 46% of failure cases. Moreover 66% inform that they have improved in areas without treatment -irradiation effect-. No differences are found between drop out cases and patients who continue treatment; success cases are patients younger than failures cases, with a shorter term evolution problem, affecting less their global activity, sessions are shorter and improvement starts after the first session. The group of cases that adhere to the treatments shows similar characteristics to the failure group cases (AU)

A preliminary report on multiple family discussion groups for patients with chronic medical illness and its repercussions in the management of the hemodialysis process.

The hemodialysis (HD) process involves an important degree of stress, not only for the patient but also for the family. The available data suggest that the quality of the family's performance predicts the degree of commitment that the patient acquires with the dialysis center. The establishment of a program of multiple family discussion groups allows exploration of the effect of the treatment on the patient in their context, not only regarding the illness, but also regarding the quality of life related to health, satisfaction and functional state. After the startup in the Hospital Virxe da Xunqueira of the multiple family discussion group (MFDG) for patients with chronic medical illness, the objective of this work was to evaluate the repercussions of the MFDG over the therapeutic fulfillment, the quality of life and the expectations of the patients in the chronic HD program, through the assessment of these indicators before and after their participation in this group. The MFDG was performed for a total of eight people, the families of four patients in the chronic HD program. Six weekly 1.5 hour sessions were performed and structured according to the following general contents: chronic illness impact component (2 sessions), family development component (3 sessions) and family illness integration component (1 session). Although no objectives were made for changes in relation to the therapeutic fulfillment, the average auto-effectiveness, locus of control, success and family general expectations went up slightly after the participation in the MFDG. The average specific self-effectiveness and family expectations in the presence of the illness reflected a modest increase, while the specific expectations of control locus and success in the presence of the illness decreased slightly. The scores obtained regarding the general state of health reflected a small decrease, while the evaluation of the quality of life of patients and family members showed a slight increase. We can conclude in the first place highlighting the viability of the MFDG, since no impediments were found either in recruitment of the families of the participants, or in preventing their excellent participation in the beginning and through the course of the group. Although no objectives were made for changes in relation to the therapeutic fulfillment, the high indices of satisfaction which the group obtained indicate that the discussion group is useful for the patients to find more support from their families, to change their view of the illness, to learn from other families new ways to resolve the difficulties and to increase their perception of capacity in the presence of the illness. The obtained data are preliminary and derived from only four families, but are encouraging as far as the improvement in the quality of life and the adjustment of the participants to the illness. Studies with the inclusion of more families are still pending in order to be able to arrive at conclusions based on a greater empiric basis. The records of MFDG for the families of HD patients are scarce. With this work it is attempted to reveal that these types of groups can be applied with these patients and their families, and they seem to prove beneficial for all those involved: patients, family and health professionals.