IntroductionConcurrent with the recent global economic crisis there is a rising concern about the effect of recession on suicide mortality rates.AimTo record patients treated urgently in community mental health unit of Motril, Granada (Spain) by attempted suicide.MethodsDescriptive study recording patients treated urgently in Motril community mental health unit who have done any suicide gesture from February 2015 until December of that year.ResultsIn total, 39 urgent assessments were recorded during the observational period.The month of highest incidence was November, with 6 visits followed by August and October (5).The most common method was voluntary drug intake.Origin:– 59% were remitted from the general hospital emergency department;– critical care and emergency ambulatory devices: 1;– primary care: 10;– another specialist: 2;– own initiative: 2.Discharge diagnosis:– 35.8% individuals did not meet criteria for any mental disorder, although some of them were classified with V or Z diagnosis according to ICD-10 for making a reactive gesture to a emotional crisis, couple breakups or economic problems;– 11 of them meet criteria for various anxiety disorders, obsessive compulsive and adaptative crisis.DiscussionKnowing some peculiar characteristics in suicidal populations as well as the most prevalent pathologies, it could be adapted both the profile of nurse attendance and the type of resources needed to ensure effective patient care.ConclusionProfile of patients attended for suicide attempt in an outpatient setting in a semi-rural coastal area is variated. It is worth to mention that one-third of this population did not meet criteria for any mental disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionThis is the case of a 73 year old woman with a late onset, severe and refractory obsessive-compulsive disorder who experimented a sudden remission after a frustrated suicide attempt.ObjectiveOur target is to make a reflection about the relation between traumatic closeness to own death and neurosis spontaneous remission.MethodPatient has been interviewed and her medical record studied.ResultsPatient's psychiatric history shows major depressive disorder, recurrent (ICD 10 CM-F33). Patient is a housewife with primary education. In her psychobiography distinguish a conflictive relationship which probably acted as a trigger for obsessive-compulsive symptoms. These symptoms include obsessive thoughts of contamination, ritual hand washing and avoid contact with others people. In the course of the last 10 years, since the OCD (ICD 10 CM-F42.2) diagnose, the patient has been through a wide therapeutic arsenal, from cognitive-behavioural psychotherapeutic interventions to psychopharmacological treatment, resulting with limited effectiveness. The last treatment was fluoxetine 200 mg (0–0–1) and pregabalin 300 mg (1–0–1). Subsequently, the patient underwent a failed suicide attempt by hanging. After physical recovery, all OCD symptoms had subsided.ConclusionsTraditionally, literature and philosophy considered catharsis as a purifying experience, and Breuer and Freud introduced this concept in modern psychology as a therapeutic method. More recent authors as Yalom have correlated the closeness to death as a stress factor with radical change in life's perspective and attitude. Although current research presents contradicting data about healing effectiveness through a catharsis processes, this case exposes a clear example of positive outcomes in this assumption.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionMedical record, general examination, laboratory findings, neuropsychological interview and multidisciplinary consideration are essential to establish differencial diagnosis and correct approach in amnesic episodes.AimTo describe differences between organic and psychogenic anterograde amnesia.MethodsSingle case report and literature review.ResultsA 51-year-old man with only diagnosis of DM I, single, a good relationship with his family, without any personal or familiar psychiatric or neurological history, came to the hospital emergency department brought by his sisters referring disorientation, acute memory loss and mood changes, prevailing indifference to the situation for the last three days. After general exploration, including psychopatological examination and higher brain functions study, we arrived to the conclusion that the patient suffered from anterograde short-term severe amnesia as the only symptom, with evident conservation of autobiographic memory. The family referred as a possible stressor factor his mother's recent transfer to a different city, which had caused constant repeated questions about her location. Given the questionable presentation and trigger we shared the case with the neurologist, who ordered an array of tests to rule out any organic cause (LP, CT, MRI…), obtaining as a final result a diagnosis of limbic encephalitis, treated and effectively solved in two weeks with high-dose glucocorticoids.ConclusionCertain features of the symptoms exploration in amnesic episodes such as reiterative questioning about a specific topic, a non-modified autobiography or the absence of a clear traumatic precipitant factor, are essential for a correct approach and may lead the clinic to an organic evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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