Objective: To investigate the prevalence of anxiety and depression in patients admitted for acute coronary syndrome to a university hospital and to examine associations with use of psychotropic drugs. Methods: Ninety-one patients who had had an acute coronary event were enrolled on this cross-sectional prevalence study. Characteristics of the study population and the prevalence rates of depression and anxiety in the sample were assessed using the Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) psychiatric consultation protocol, which includes clinical and sociodemographic data, and the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of symptoms of anxiety was 48.4% (44 patients) and the prevalence of depressive symptoms was 26.4% (24 patients). Of these, 19 patients (20.9% of the whole sample) had scores indicative of both types of symptoms concomitantly. Considering the whole sample, just 17 patients (18.7%) were receiving treatment for anxiety or depression with benzodiazepines and/or antidepressants. Conclusions: Anxiety and depression are disorders that are more prevalent among patients with acute coronary syndrome than in the general population, but they are generally under-diagnosed and under-treated. Patients with anxiety and depression simultaneously had higher scores on the HADS for anxiety and depression and therefore require more intensive care.
A variety of new psychotherapy modalities has arisen in which the contact between patient and therapist takes place via the internet. The main objective of this systematic review is to investigate the types of online psychotherapy (OP) conducted nowadays, and to describe their main characteristics to psychodynamic psychotherapists who may wish to better understand the current scientific literature on the subject. The review used two databases, EMBASE and PsycINFO. Fifty-nine studies were retrieved and the main online psychotherapy modalities identified were self-therapy programmes using contact via email or chat; videoconference; and therapy exclusively via chat or email. The result of these studies suggests that OP is more effective than a waiting list control group. When compared with face-to-face therapies, OP showed similar effects. Most studies involved cognitive behavioural therapy; only two studies involved a form of psychodynamic psychotherapy. Different forms of communication allow patient and therapist to establish different relationships and therapeutic possibilities. OPs may be feasible treatment alternatives; however, it remains unclear, especially in relation to psychodynamic treatments, if therapeutic technique in OP, which involves changes in comparison with face-to-face therapies, would be useful in severe cases. Psychodynamic psychotherapists should adopt a posture of constant reflection on the changes taking place in the world and their impact on the minds of individuals, without, nevertheless, idealizing the 'new'. the therapist's location. Many people with mental health disorders fail to seek assistance or cannot afford to visit a doctor's office or mental healthcare centre, and the internet offers access to different therapeutic interventions.These studies throw light on the phenomenon, but online psychotherapies are considered new treatment modalities and are a rapidly expanding field. Most of the data presented in the aforementioned studies are contradictory and inconclusive. Systematic reviews on the subject assist the clinician and the researcher in knowing the state of the art on the subject and in positioning themselves more critically in terms of incorporating online treatment modalities in their practices. For psychodynamic psychotherapy in particular, it is necessary to critically discuss the effect of these technologies on the pillars of this theoretical approach, such as transference, countertransference and the analytic field. These concepts constitute the basis of psychodynamic practice and may be profoundly affected by a virtual relationship (Sfoggia et al., 2014). Therefore, we need to keep questioning the impact of online treatments in a psychodynamic psychotherapy setting.The main objective of this systematic review was to investigate the types of OP conducted nowadays, and to describe their main characteristics to psychodynamic psychotherapists who may wish to better understand the current scientific literature on the subject. The secondary objective was to describe the mai...
Suicide is a major public health problem. Preventive measures have been sought by identifying risk factors. This study evaluates the association of childhood abuse and neglect with suicidal behavior at the time of psychiatric hospital admission. A total of 120 subjects (72 females; mean age 42.5 +/- 15.6 years old) admitted from August 2006 to July 2007 completed the Childhood Trauma Questionnaire (CTQ) to assess severity of exposure to childhood maltreatment. Thereof 62 (51.6%) patients presented with suicidal behavior at admission. Patients who had attempted suicide had significantly higher CTQ scores. Regression analysis indicated that shorter illness duration and severity of childhood maltreatment were predictors of suicidal behavior at admission. The study showed that inpatients of a psychiatric unit of a general hospital who experienced severe childhood abuse or neglect were significantly more likely to present with suicidal behavior. History of childhood maltreatment should be evaluated as an associated risk factor of suicidal behavior at admission of psychiatric inpatients.
-Although most children with human immunodeficiency virus (HIV) infection have neurological dysfunction, in childhood the incidence of symptomatic cerebrovascular disease is low. Cerebral aneurysmal arteriopathy in childhood AIDS has been reported in the past and considered to have a relatively long latency following the primary infection. We report a 1 month-old infant with congenitally acquired HIV infection, and herpes encephalitis; she presented a sudden cardiorespiratory arrest followed by coma and was found to have a giant saccular aneurysm of the left basilar artery. Literature review showed that cerebral aneurysmal artheriopathy is an unusual manifestation in newborns and infants and this case is possibly the youngest patient reported with aneurysma, herpes encephalitis and AIDS. The role of HIV and herpes simplex infections in the pathogenesis of this lesion is discussed.KEY WORDS: AIDS, herpes simplex, cerebrovascular disease, infancy.Aneurisma cerebral sintomático precoce em lactente com infecção congênita por HIV e encefalite herpética RESUMO -A maioria das crianças com síndrome da imunodeficiência adquirida (SIDA) apresenta complicações neurológicas, mas a incidência de doença cerebrovascular sintomática nesta faixa etária é baixa. Existem relatos prévios de arteriopatia aneurismática em crianças com SIDA, mas a latência entre a infecção primária e o desenvolvimento dos sintomas geralmente é longa. Relatamos lactente com infecção congênita por HIV, que apresentou encefalite herpética e apresentou subitamente parada cardiorespiratória, seguida de coma. A investigação através de neuroimagem demonstrou aneurisma sacular gigante da artéria basilar. A revisão da literatura demonstra ser a arteriopatia aneurismática uma entidade rara no perído neonatal e em lactentes, sendo possivelmente este o caso mais jovem até o presente relatado com doença cerebrovascular aneurismática associada a herpes e SIDA. A relação da associação entre SIDA e infecção por herpes vírus na gênese da doença cerebrovascular é discutida.
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