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Objective This study aimed to characterize the patients assisted at the general outpatient clinic of the Psychiatry Institute of Universidade Federal do Rio de Janeiro (IPUB-UFRJ) and to assess these patients’ clinical stability. Methods This cross-sectional study collected information using a structured questionnaire filled in by the patient’s physician. The questionnaire, specifically developed for this purpose, included sociodemographic data; the dwelling area; psychiatric diagnosis according to ICD-10; clinical stability assessment by means of five psychiatric instability criteria and the physician’s global clinical impression over the six previous months. Clinical stability was defined as a negative answer to all five pre-defined instability criteria. Results Overall, 1,447 questionnaires were filled in. The sample was composed of 824 (57%) women; with an average age of 49 years; 1,104 (76.3%) patients lived in the city of Rio de Janeiro and 343 (23.7%) lived outside the city; 983 (67.9%) patients had a severe mental disorder (SMD) diagnosis and 946 (65.3%) patients were considered stable. Statistically, the clinical stability by dwelling area did not differ. The most frequent clinical instability criterion was “exacerbation or emergence of acute manifestations of the disease”. Conclusion The major part of the patients displayed a SMD and was considered clinically stable.
ResumoTrata-se de pesquisa clínica acerca da experiência de ouvir vozes, centrada na análise do funcionamento de um grupo de ouvidores de vozes em um Centro de Atenção Psicossocial (CAPS). Verificamos que o exercício de construção de narrativas sobre o ouvir vozes aplicado em um dispositivo grupal produz como efeito um aumento do engajamento dos participantes nos desafios decorrentes de seu adoecimento, auxiliando na criação de alternativas que promovam a sustentação do cotidiano. O grupo se assevera, consequentemente, como um meio profícuo de avançar, coletivamente, na elaboração de soluções singulares e de criar uma comunidade de trabalho voltada para uma experiência que se caracteriza essencialmente por não ser passível de ser compartilhada.Palavras-chave: ouvir vozes; Saúde Mental; dispositivo grupal. AbstractClinical research in Mental Health: the pacients'point of view on the experience of hearing voices. This is a qualitative clinical research on the hearing voices experience, based on the analysis of a hearing-voices group functioning in a Psychosocial Care Center (CAPS). We verified that the practice of patients narratives construction about their hearing voices experiences, in a group context, provides the raise of participants engagement in coping with the challenges of the mental illness process and helping them to create alternative ways that gives support to daily life. Consequently, the group assures a proficuous way of, collectively, developing singular solutions and creating a voice-hearing network dedicated to an experience essentially characterized as not passible for being shareable. Keywords: hearing voices; mental health; hearing-voices groups.A s narrativas individuais têm sido tomadas, no campo da Saúde Mental, como forma privilegiada de acessar o ponto de vista das pessoas que vivem a experiência da psicose. No universo da pesquisa científica, observa-se, na via oposta, uma tendência em desconsiderar ou pelo menos em minimizar os relatos pessoais sobre o adoecimento psicótico, restringindo-os ao lugar secundário de mera ilustração da teoria (Geekie & Read, 2009). Esse tipo de abordagem tende a excluir aqueles que sofrem da discussão acerca de quais os recursos mais eficientes para sobrepujar suas consequências e implicações cotidianas, assim como da elaboração e planejamento de estratégias que tornem o cumprimento da rotina menos penosa.A prática demonstra que muitas dessas pessoas utilizam estratégias espontâneas e originais para estabelecer uma convivência apaziguada com a psicose e seus fenômenos e que estar advertido e atento a essas soluções é fundamental para o sucesso de um tratamento. Mostra, além disso, os efeitos positivos de suas contribuições para aqueles que ainda vivem a experiência de forma muito angustiante e pouco sistematizada. Ampliar o conhecimento acerca das soluções individuais encontradas por esses sujeitos para regular as relações com o mundo e mapear os contratempos com os quais costumam Estudos de Psicologia, 16(1),
Objective This study explores the relationship between patients’ self-assessment and physicians’ evaluation regarding clinical stability. Methods This cross-sectional study was carried out at the general outpatient clinic of the Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB-UFRJ) in a large sample (1,447) of outpatients, of which 67.9% were patients with severe mental disorders (SMD). We collected information using a structured questionnaire developed for this purpose, filled in by the patient’s physician. Clinical stability was assessed by means of five psychiatric instability criteria and by the physician’s global clinical impression over the six previous months. The patients’ self-assessment was based on a question about how they evaluated their health status: stable/better, worse, does not know. For the analyses, patients’ self-evaluation was considered as our standard. Results The sample was composed of 824 (57%) women with an average age of 49 years. The most prevalent diagnoses within the SMD category corresponded to 937 patients, of whom 846 (90.3%) assessed themselves as stable/better. The physicians’ evaluations agreed more with patients with bipolar disorders and less with schizophrenics regarding stability. As for patients with depressive disorder, physicians agreed more with them regarding instability. Conclusion The data analysis confirms our hypothesis that the self-assessment made by patients with SMD was accurate regarding their health condition, and that the self-assessment made by patients who considered themselves stable agree with the physicians’ evaluation.
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