el tratamiento de pacientes psicóticos. Las personas que participaron en este estudio eran pacientes externos que estaban siendo tratados en el Centro de Salud Mental «Delicias», situado en Valladolid (España). Todos ellos estaban diagnosticados de esquizofrenia según la CIE-10. La primera evaluación fue llevada a cabo el 15 de Octubre del 2.002. Se compararon los grupos experimental y control en cuanto a psicopatología, habilidades sociales y capacidades cognitivas. El grupo experimental recibió el tratamiento psicológico, además del farmacológico, durante nueve meses. Mientras tanto, el grupo control recibió tratamiento farmacológico. La siguiente evaluación fue llevada a cabo el 30 de Junio del 2.003. Los resultados mostraron que se produjeron importantes mejoras en el funcionamiento social y capacidades cognitivas en los miembros del grupo experimental. Por tanto, este estudio apoya la idea de que el programa IPT es eficaz en el tratamiento de pacientes psicóticos.
IntroductionOpioids are the most powerful drugs commercialised for acute and chronic pain relief. The main emerging problem in our midst is the abuse and addiction to synthetic opioids iatrogenically established in general population.ObjectivesWe report the case of a female patient aged 48 admitted to the Acute Psychiatric Unit after a suicide attempt. She refers she finds herself more irritable and depressed since she began a treatment with oxycodone after she was diagnosed with fibromyalgia. She has lost a lot of weight, is not able to get to sleep and has become socially isolated.MethodologyDuring the first few days, the patient is uncooperative and shows a marked self-referentiality and verbalises delusional ideation related to her immediate surroundings. Once the treatment with opioids was withdrawn and we had prescribed paliperidone ER, she seemed more cooperative and calmed. She was discharged from the Psychiatric Day Hospital showing a good evolution.ResultsParanoid personality disorder (F60); mental and behavioural disorders due to use of opioids (F11); recurrent depressive disorder, current episode moderate (F33.1); fibromyalgia (M79.7).ConclusionsThe use of synthetic opioids (tramadol, fentanyl, oxycodone) in easy-to-use formats (patches, pills, dispersible tablets, lollipops) and their dissemination in pain treatment, is leading to an increase of problems related to it, both their side effects (psychotic symptoms) and the generation of misuse and addiction. We should pay greater attention to the prescription of opioids to patients with dysfunctional personality traits.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionDysthymia is defined as a chronic mood disorder that persists for at least two years in adults, and one year in adolescents and children. It is important to distinguish it from other types of depression, as early as possible. The therapeutic management of dysthymia is similar to the one used in major depressive disorder.ObjectivesWe report the case of a female patient aged 45, diagnosed with depressive disorder not otherwise specified since she was 20. Her psychopathological progress has gradually become aggravated, having now longer periods of depressive mood and an important tendency towards isolation.MethodologyThe patient is admitted to the Psychiatric Day Hospital presenting with important depressive symptoms. After various antidepressants were withdrawn, lithium salts were introduced. It is then that the patient starts improving her mood.Results– Dysthymia (F34.1).– Mixed and other personality disorders (F61.0).ConclusionsIn spite of having an appropriate pharmacological, unfortunately, antidepressants improve dysthymia just in 50–70% of patients. Antidepressants resistant dysthymia cases have been studied. In those cases, it has been necessary to add lithium or thyroxine. This confirms that, when it comes to this disorder, there are many neurochemical mechanisms involved, given the positive response to the combination of drugs, notwithstanding the severity of the adverse effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionIn prospective and controlled studies followed up until adult age of patients diagnosed with ADHD in their childhood, the most frequent comorbid disorders were major depressive disorder, personality disorder (borderline and antisocial), substance use disorder and, less frequently, panic disorder and obsessive compulsive disorder.ObjectivesWe report the case of a male patient aged 60, diagnosed with obsessive-compulsive disorder from his adolescence. His psychopathological progress has become aggravated over the years. Nowadays, he presents an important restlessness, which has led him to social isolation and family claudication.MethodologyOur patient is admitted to the Psychiatric Day Hospital with an appropriated treatment for his OCD (sertraline and aripiprazole). After several days under observation, we used the scales ASRS-V1.1 y WURS finding results that suggested adult ADHD. Extended release methylphenidate was prescribed, with a fast improving of our patient's symptoms of restlessness, insecurity and impulsion phobia. He was discharged from the Centre for Psychosocial Rehabilitation showing a good evolution.Results– Anankastic personality disorder (F60.5);– Dependent personality disorder (F60.7);– Hyperkinetic disorders (F90).ConclusionsSeventy-five percent of adults diagnosed with ADHD have comorbid disorders that should be used as severity rates, since they may cover up the ADHD symptoms or complicate the response to treatment. Adults with ADHD present high score on the scales “social maladjustment” and an often concomitant and polymorphic psychiatric pathology, object of varied diagnoses.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Introduction:It is well known that mental illneses are associated with higher prevalence of somatic disorders when compared to the general population. We observed that, at the time of admission to the Acute Psychiatric Unit (APU) at our Hospital, many patients have associated urinary tract infection.Objectives:To determine the characteristics of patients that present with urinary tract infection on admission to the APUMethods:From all admissions to the APU during 2011, patients with urinalysis, sediment and culture suggesting urinary tract infection were recruited for this study.Results:83 out of the 229 patients admitted to the APU had urinary tract infection at the moment of admission. Most common psychiatric diagnoses in patients with urinary tract infection were: mood disorders (37.35%), psychotic disorders (22.89%) and personality disorders (14.46%) Of these 83 patients, 72.29% had a history of previous psychiatric admissions and 91.67% had a new admission with an associated urinary tract infection.Figure[readmissions]Conclusions:A high percentage of patients admitted to our APU have recurrent urinary tract infections. Urinary tract infections may play a negative impact on their psychopathological evolution and may be associated with the need for hospital admission.
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