Prevalencia de enfermedad psiquiátrica entre los suicidios consumados en la provincia de Badajoz en el periodo 2015-2017 / Prevalence of psychiatric pathology among completed suicides in the province of Badajoz in the period 2015-2017

Se realiza un estudio en 157 sujetos que durante el periodo establecido entre el 1 de julio de 2015 y el 31 de diciembre de 2017 cometieron un suicidio consumado en la provincia de Badajoz, para investigar qué porcentaje de los suicidios consumados tenían antecedentes de enfermedad mental. Los resultados indican que existe una menor relación de la esperable entre el acto suicida y la presencia de antecedentes personales psiquiátricos, ya que estos solo aparecen en dos quintas partes de la muestra. Si existen estos, el diagnóstico más frecuente es el de trastorno depresivo y el tratamiento con mayor frecuencia, antidepresivos. Estos datos contrastan con otros recogidos en la literatura que hablan de porcentajes mucho más altos de enfermedad psiquiátrica en sujetos que cometen suicidio. (AU)

A study is carried out in 157 subjects who during the period established between July 01, 2015 and December 31, 2017 committed a consummated suicide in the province of Badajoz to investigate what percentage of consummated suicides had a history of mental pathology. The results indicate that there is a lower-than-expected relationship between the suicidal act and the presence of a personal psychiatric history, as these only appear in two-fifths of the sample. If they do exist, the most frequent diagnosis is depressive disorder and the most frequent treatment is antidepressants. These data contrast with other data collected in the literature that report much higher percentages of psychiatric pathology in subjects who commit suicide. (AU)

Comparativa entre Screening Cognitive Impairment in Psychiatry (SCIP-S) y Minimental State Examination (MMSE) en psiquiatría forense. Estudio piloto / Comparison between Screening Cognitive Impairment in Psychiatry (SCIP-S) and Minimental State Examination (MMSE) in Forensic Psychiatry. Pilot study

Objetivos: el objetivo es comparar MMSE y SCIP-S y determinar su utilidad en la valoración del estado cognitivo en los sujetos con patología psiquiátrica en el ámbito forense.Material y métodosestudio piloto de una serie de 33 casos procedentes de los Institutos de Medicina Legal de Catalunya y Andorra, cuyo criterio de inclusión fue la existencia de una enfermedad psiquiátrica categorizada en CIE-10. En todos los casos, además de la entrevista médico forense, se administró MMSE seguido de SCIP-S.Resultadosen MMSE, 31 de los 33 entrevistados obtuvieron una puntuación directa total ≥ 24 (rendimiento cognitivo normal). En SCIP-S, solo 5 de los 33 participantes se situaron en un percentil ≥ 15 (rendimiento cognitivo normal). La diferencia entre los resultados de ambas pruebas resultó estadísticamente significativa (p < 0,05).Conclusioneseste estudio sugiere una mayor utilidad del SCIP-S frente al MMSE en la detección de déficit cognitivos en los pacientes psiquiátricos. Por tanto, se recomienda el uso del primero en la práctica médico forense. (AU)

Objectives: The objective is to compare two brief cognitive screening tests, MMSE and SCIP-S, and determine their usefulness in assessing the cognitive status of subjects diagnosed with psychiatric pathology.Material and methodsPilot study of a series of 33 cases from the Institutes of Legal Medicine of Catalonia and Andorra, whose inclusion criterion was the existence of a psychiatric pathology categorized in ICD-10. In all cases, in addition, to the forensic medical interview, MMSE was administered followed by SCIP-S.ResultsIn MMSE, 31 of the 33 interviewees obtained a total direct score ≥ 24 (normal cognitive performance). In SCIP-S, only 5 of the 33 participants were in a percentile ≥15 (normal cognitive performance). The difference between the results of both tests was statistically significant (p<0.05).ConclusionsThis study suggests a greater usefulness of SCIP-S compared to MMSE in detecting cognitive deficits in psychiatric patients. Therefore, the use of the former is recommended in forensic medical practice. (AU)

Rhinotillexomania: A Manifestation of Psychiatric Illness.

OBJECTIVE: To increase the knowledge of rhinotillexomania, or compulsive nose picking, as a manifestation of psychiatric disease through the presentation of a case series and a review of the literature. MATERIAL: We present three clinical cases with self-destructive nasal injuries as a symptom of different psychiatric diseases. RESULTS: One patient presented amputation of the middle turbinate as a manifestation of an obsessive-compulsive disorder of bipolar disease. Two patients had a septal perforation. In the first patient it was the first symptom of factitious dermatitis and in the second it was during the course of schizophrenia. Only control with psychological treatment and psychotropic drugs stabilised the nasal injury. CONCLUSION: Self-induced injuries are a diagnostic and treatment challenge for the ENT specialist. A knowledge of psychiatric diseases related to destructive injuries to the nose will improve the approach to patients and prevent the progression of local damage and its complications.

Rinotilexomanía: manifestación de enfermedades psiquiátricas / Rhinotillexomania: a manifestation of psychiatric illness

Objetivo: Incrementar el conocimiento de la rinotilexomanía o manipulación compulsiva intranasal como manifestación de enfermedades psiquiátricas mediante la exposición de una serie de casos y revisión de la literatura.MaterialPresentamos 3 casos clínicos con lesiones autodestructivas nasales como síntoma de diferentes enfermedades psiquiátricas.ResultadosUn paciente presentó una amputación del cornete medio como manifestación de un trastorno obsesivo-compulsivo de una enfermedad bipolar. Dos pacientes tuvieron una perforación septal. El primero como primer síntoma de una dermatitis facticia y el segundo en el transcurso de una esquizofrenia. Solo el control con tratamiento psicológico y fármacos psicótropos consiguió la estabilización de la lesión nasal.ConclusiónLas lesiones autoinducidas son un reto diagnóstico y de tratamiento para el otorrinolaringólogo. El conocimiento de las enfermedades psiquiátricas relacionadas con lesiones destructivas centradas en la nariz mejora el abordaje del paciente evitando la progresión de la destrucción local y sus complicaciones. (AU)

Objective: To increase the knowledge of rhinotillexomania, or compulsive nose picking, as a manifestation of psychiatric disease through the presentation of a case series and a review of the literature.MaterialWe present three clinical cases with self-destructive nasal injuries as a symptom of different psychiatric diseases.ResultsOne patient presented amputation of the middle turbinate as a manifestation of an obsessive-compulsive disorder of bipolar disease. Two patients had a septal perforation. In the first patient it was the first symptom of factitious dermatitis and in the second it was during the course of schizophrenia. Only control with psychological treatment and psychotropic drugs stabilised the nasal injury.ConclusionSelf-induced injuries are a diagnostic and treatment challenge for the ENT specialist. A knowledge of psychiatric diseases related to destructive injuries to the nose will improve the approach to patients and prevent the progression of local damage and its complications. (AU)

Tendencia de las hospitalizaciones en la Unidad de Corta Estadía de Psiquiatría del Hospital Clínico Herminda Martin durante 14 años / Trend of hospitalizations in the Short Stay of Psychiatry Unit of Herminda Martin Clinical Hospital for 14 years

INTRODUCCIÓN: La hospitalización psiquiátrica de corta estadía es un recurso necesario para tratar trastornos mentales con descompensación severa que no pueden resolverse ambulatoriamente. El conocimiento de sus resultados ayuda en la gestión clínica y administrativa. Este estudio tiene por objeto evaluar la evolución de indicadores hospitalarios, características sociodemográficas y clínicas de pacientes hospitalizados en unidad de corta estadía de psiquiatría. MATERIAL Y MÉTODO: Estudio longitudinal, retrospectivo, de tendencia, realizado sobre el universo constituido por 4.563 egresos de UCEP de Hospital de Chillán, Chile, durante 14 años, desde el 01/07/2005 al 30/06/2019. Se evaluaron variables hospitalarias, sociodemográficas y clínicas. RESULTADOS: en el período en estudio: Disminuyeron los egresos, se prolongó el promedio días estada, aumentó el índice ocupacional y disminuyó el índice de rotación. Un bajo número de pacientes, con predominio de adversidades socioeconómicas y psicosociales, se re-hospitalizó frecuentemente. A mayor número de internaciones mayor estadía. Se incrementaron las hospitalizaciones administrativas y judiciales; éstas últimas con mayor promedio de estada. Aumentó la hospitalización de varones, adolescentes, jóvenes y adultos mayores. Predominaron comunas y consultorios con mayor población, cercanía y acceso. Se mantuvo frecuencia de esquizofrenia y otros trastornos psicóticos y trastorno de personalidad, se duplicaron los trastornos afectivos, triplicaron los trastornos por sustancias, duplicó la patología dual, y el trastorno de personalidad fue frecuente en comorbilidad con trastorno por sustancias y trastornos afectivos. CONCLUSIONES: se requerirían estrategias con Sistema Judicial y Servicio de Salud, implementar unidad de adolescentes y unidad de adicción, y fortalecer atenciones multidisciplinarias para adultos mayores.

BACKGROUND: Short-stay psychiatric hospitalization is a necessary resource to treat mental disorders with severe decompensation that cannot be resolved outpatiently. Knowledge of your results helps in clinical and administrative management. This study aims to evaluate the evolution of hospital indicators, sociodemographic and clinics characteristics of inpatients in a short-stay unit of psychiatry. MATERIAL AND METHODS: Longitudinal, retrospective, trend study was conducted in a universe of 4,563 egress of short-stay psychiatric unit of Chile, for 14 years, from 01/07/2005 to 30/06/2019. Hospital indicators, sociodemographic and clinical variables were evaluated. RESULTS: during the period under study: The egress decreased, the average days were prolonged, the occupational index increased and the turnover rate decreased. A low number of patients, predominantly socioeconomic and psychosocial adversities, were frequently re-hospitalized. The greater the number of hospitalizations longest stay. Administrative and judicial hospitalizations were increased; the latter with the highest average stay. Hospitalization of males, adolescents, young people and older adults increased. Communes and primary care center with a greater population, proximity and access predominated. It remained frequency of schizophrenia and other psychotic disorders and personality disorders, doubled affective disorders, tripled substance disorders, doubled dual pathology, and personality disorder was common in comorbidity with substance disorder and affective disorders CONCLUSIONS: strategies would be required with the Judicial System and Health Service, implement adolescent unity and addiction unit, and strengthen multidisciplinary care for older adults.

Rhinotillexomania: a manifestation of psychiatric illness. / Rinotilexomanía: manifestación de enfermedades psiquiátricas.

OBJECTIVE: To increase the knowledge of rhinotillexomania, or compulsive nose picking, as a manifestation of psychiatric disease through the presentation of a case series and a review of the literature. MATERIAL: We present three clinical cases with self-destructive nasal injuries as a symptom of different psychiatric diseases. RESULTS: One patient presented amputation of the middle turbinate as a manifestation of an obsessive-compulsive disorder of bipolar disease. Two patients had a septal perforation. In the first patient it was the first symptom of factitious dermatitis and in the second it was during the course of schizophrenia. Only control with psychological treatment and psychotropic drugs stabilised the nasal injury. CONCLUSION: Self-induced injuries are a diagnostic and treatment challenge for the ENT specialist. A knowledge of psychiatric diseases related to destructive injuries to the nose will improve the approach to patients and prevent the progression of local damage and its complications.