[Mental disorders and their underdiagnosis in primary care]. / Los trastornos mentales y su infradiagnóstico en atención primaria.

Despite its high prevalence, mental disorders are often underdiagnosed. OBJECTIVE: To determine the magnitude of the underdiagnosis mental disorders and its associated characteristics. METHODOLOGY: A descriptive cross-sectional study performed in Lanzarote (2011) on 310 patients selected by cluster random sampling. A self-completed questionnaire was used that contained the General Health Questionnaire-28, as well as structured interview using the Mini International Neuropsychiatric Interview to confirm the diagnosis of mental disorder. The current diagnosis registered in the DRAGO-AP electronic medical record was also recorded. RESULTS: Of the 75 patients detected with the interview, 14 (18.67%) had a diagnosis recorded in the medical record (sensitivity=0.19; IC 95% CI; 0.09-28). The positive predictive value of being in the medical record was 0.56. With respect to sensitivity, only the "number of visits made to the health centre in the last 3 months" was significantly higher in the group of patients also with a diagnosis of any mental disorder in the medical record (5 vs. 2.77; p=.002). CONCLUSIONS: There is an important underdiagnosis of the mental disorders in our environment. More visits to the health centre are associated with this diagnosis.

Prevalencia del síndrome metabólico en pacientes esquizofrénicos hospitalizados en Gran Canaria / Prevalence of the metabolic syndrome among schizophrenic patients hospitalized in the Canary Islands

Introducción. Los pacientes esquizofrénicos tienen una tasa estandarizada de mortalidad más elevada que la esperada para el resto de la población. El síndrome metabólico tiene una alta prevalencia entre ellos, que aumenta entre dos y cuatro veces el riesgo coronario. El objetivo del presente estudio es conocer la prevalencia del síndrome metabólico en pacientes con esquizofrenia y trastorno esquizoafectivo ingresados en una unidad de agudos y las variables sociodemográficas, evolutivas y psicofarmacológicas que se relacionan con ella. Se pretende también conocer el riesgo coronario y su relación con el síndrome metabólico. Método. Estudio observacional transversal. Se incluyen 136 pacientes mayores de 18 años ingresados durante el año 2004 en el Hospital Universitario de Gran Canaria Dr. Negrín con diagnóstico de esquizofrenia o trastorno esquizoafectivo validado mediante el SCID-I. Síndrome metabólico y riesgo coronario se han definido según criterios del NCEP-ATP III. Resultados. La prevalencia de síndrome metabólico en la población estudiada es del 36 % (intervalo de confianza [IC] del 95 %: 29,4 a 45,6). El síndrome metabólico se asocia con una mayor edad (p < 0,05). La obesidad abdominal se asocia con el sexo femenino (p<0,05). El riesgo coronario en los próximos 10 años es moderado en el 52,3 % de los casos y alto en el 2,9 %. El incremento del riesgo se asocia con la toma de antipsicóticos y con el padecimiento del síndrome metabólico (p<0,05). Conclusiones. La prevalencia del síndrome metabólico en la población de pacientes esquizofrénicos estudiados es alta y supone un riesgo coronario moderado-alto

Introduction. Schizophrenic patients have a higher standardized mortality rate than that expected for the rest of the population. The prevalence of the metabolic syndrome is high among them, this increase coronary risk twofold to fourfold. This study aims to find out the prevalence of the metabolic syndrome among patients with schizophrenia and schizoaffective disorder who have been admitted to an acute psychiatric ward and the sociodemographic, evolutive and psychopharmaceutical variables related to it. We also hope to establish the extent of coronary risk and its relationship with the metabolic syndrome. Method. Cross-sectional observational study including 136 adult patients over 18 years of age. They were admitted in the year 2004 to the Hospital Universitario de Gran Canaria Dr Negrín, with the diagnosis of schizophrenia or SCID-I validated schizoaffective disorder. The metabolic syndrome and coronary risk were defined according to NCEP-ATP III criteria. Results. The prevalence of the metabolic syndrome in the population studied is 36 % (95 % CI: 29.4 to 45.6). The metabolic syndrome is associated to an older age (p < 0.05). Abdominal obesity is more prevalent among women (p < 0.05). Coronary risk in the next 10 years is moderate in 52.3 % of cases and high in 2.9 %. Increase in risk is associated to antipsychotic intake and to suffering metabolic syndrome (p<0.05). Conclusions. The prevalence of the metabolic syndrome among schizophrenic patients is high and it entails moderate to high coronary risk

Prevalence of the metabolic syndrome among schizophrenic patients hospitalized in the Canary Islands.

INTRODUCTION: Schizophrenic patients have a higher standardized mortality rate than that expected for the rest of the population. The prevalence of the metabolic syndrome is high among them, this increase coronary risk twofold to fourfold. This study aims to find out the prevalence of the metabolic syndrome among patients with schizophrenia and schizoaffective disorder who have been admitted to an acute psychiatric ward and the sociodemographic, evolutive and psychopharmaceutical variables related to it. We also hope to establish the extent of coronary risk and its relationship with the metabolic syndrome. METHOD: Cross-sectional observational study including 136 adult patients over 18 years of age. They were admitted in the year 2004 to the Hospital Universitario de Gran Canaria Dr Negrín, with the diagnosis of schizophrenia or SCID-I validated schizoaffective disorder. The metabolic syndrome and coronary risk were defined according to NCEP-ATP III criteria. RESULTS: The prevalence of the metabolic syndrome in the population studied is 36 % (95 % CI: 29.4 to 45.6). The metabolic syndrome is associated to an older age (p<0.05). Abdominal obesity is more prevalent among women (p<0.05). Coronary risk in the next 10 years is moderate in 52.3% of cases and high in 2.9 %. Increase in risk is associated to antipsychotic intake and to suffering metabolic syndrome (p<0.05). CONCLUSIONS: The prevalence of the metabolic syndrome among schizophrenic patients is high and it entails moderate to high coronary risk.

Intervención familiar en la esquizofrenia: su diseminación en un área de salud / Family intervention in schizofhrenia: expanding the programme in a health area

Se presenta el proceso de diseminación de un programa de intervención familiar en la esquizofrenia en un área de salud, integrado en la asistencia habitual de la red de salud mental. Se discuten las razones que han hecho posible su implantación

It is here submitted the dissemination process of a family intervention program in schizophrenia in a health area, implemented in ordinary mental health settings. We discuss the reasons for its implantation