Tras la reforma psiquátrica el tratamiento de los pacientes con enfermedad mental se realiza a nivel comunitario, siendo necesaria la coordinación entre Salud Mental y Atención Primaria. Nuestro objetivo es analizar las características de la demanda de Atención Primaria a Salud Mental. Se realiza un estudio observacional, analítico y prospectivo en el que se analizan variables recogidas en una base de datos con formato Access mediante el programa SPSS 19.0. contando con una muestra de 1645 pacientes atendidos en 29 meses, seleccionando aquellos derivados desde Atención Primaria. La distribución fue de un 60% mujeres y un 40% hombres, edad media de 48.41 años (desviación típica 18.025). El 40,8% procedía de Ciudad Real. Derivación más frecuente: Normal (79,8%). 73% de hombres y 76% de mujeres acudieron a cita. El Trastorno Adaptativo fue el más frecuente en ambos sexos, seguido por el Trastorno de ansiedad (10,2%) en hombres y Trastorno Depresivo (17,11%) en mujeres. Destino al alta más frecuente tras primera consulta: USM (61,8%), siendo Trastorno Adaptativo (24,2%), Trastorno Depresivo (21,1%), Trastorno Mixto (12,5%). Las variables permanecen prácticamente iguales respecto a análisis previos, concluyendo que la coordinación con primaria sigue siendo un objetivo a fomentar para una mejor asistencia a los pacientes.
Kleine-Levin syndrome is a rare disorder whose diagnosis is clinical, today there is no clinical test or pathognomonic symptoms feature that facilitates diagnosis. It is necessary to rule out any organic cause etiology to make the diagnosis.We report a case of a 13 year old patient presented multiple hospitalizations (up to 12) in pediatrics because of behavior and cognitive disturbances: hypersexuality, compulsive eating behavior, hypersomnia, amnesia, and confusion, with the initial diagnosis suspected anti NMDA encephalitis. Throughout its evolution is also studied by psychiatry service. Through this case we explain how finally through the clinical characteristics, the medical test totally normal and the characteristics of the disease patterns (in the form of episodes, absence of symptoms between them …) who our patient is diagnosed with this rare disorder that usually occurs in the second period of life and especially in males.it is very important to learn about it and be able to identify the characteristics in our work place because in spite of is a rare disorder can have repercussions on a personal (school, family, friends…) environment.
In 1995 was celebrated the first consensus conference of abuse in the elderly population. In this consensus, abuse was defined as 'any act, or omission, that causes damage (intentional or not) practiced on people with 65 years or older, that can appear: in family, community or institutional environment, that can harm or endanger the physical and/or mental state, and the principle of autonomy or other fundamental rights of the individual, subjectively perceived or objectively verifiable. There are different types of abuse: physical, sexual, emotional or psychological, abandonment, neglect and financial.The abuse in the elderly is a little known phenomenon at all levels (legal, medical, social), it is very important to learn about it and be able to identify the characteristics (signs of abuse, vulnerabilities of victims ...) in our work place to protect themWe are going to talk (with two clinical cases) about one of the most unknown kind of financial abuse: the undue influence. It is a legal concept in which, the dominant part (through various tactics: adulation, insistence, deceit... and with a relationship of trust) takes advantage of its influence for economic purposes. The undue influence does not occur in a single act, it consists in a pattern of behaviors, a process of manipulation etc...An effective assessment can prevent needless emotional and financial losses of the victims and help them maintain their autonomy.
The ECT it continues being one of the principal treatments available and used in Psychiatry for the serious mental illnesses. A considerable variability exists between physicians and between geographical regions with regard to the use of the ECT as treatment of the first line or only of secondary form when the patients do not answer to other interventions.The ‘therapeutic inhibition’ largely can be due to a stigma that is based on antiquated and old-fashioned beliefs to near the treatment, in spite of that the utilization of the ECT has been supported by numerous studies.This practice can deprive the patients of an effective treatment, delay the response and prolong the suffering and possibly contribute to the resistance to the treatment.With this study one tries to know the characteristics and diagnostic indications of all the patients who have been attended in the unit of Mental Health of the hospitable complex of Albacete, which they have needed treatment with ECT.A descriptive study is realized, observacional, restrospectivo by a group of patients who have been necessary the ECT in a period of study understood between 3/4/2008 to 31/10/2013. Variables will be analyzed sociodemográficas and diagnostic as; Distribution for age, sex and marital status, number of meetings of received ECT, hospitable needed stay, indications for diagnosis, response to the ECT and side effects.
Introduction: The psychiatric emergency would be one situation or medical condition that a given moment generates a demand for attention and resolution assistance immediately as requested by the patient, family, other specialists ... In the last decade has objectified a change in the profile of patients attending psychiatric emergencies in Spain. Research papers published recently on this subject have an overwhelming agreement to maintain a change in the demand for care at psychiatric emergency units, characterized not only by the increase in these, but also by a series experienced as negative aspects (patients ´frequent repeaters´). (Teijeiro 2003, Centeno 2002, Vila Grifoll 2002). Objectives: Measure the importance of psychiatric problems in the emergency services of the CHUA and to describe the characteristics of patients who have access to these emergency services for the purpose of psychiatric treatment. Methods: 634 patients (52% females, mean age 35.4 +/-12.8 years) consecutively attended in June and July 2011 in emergency psychiatric service were assessed to sociodemographic variables, diagnosis and treatment plan. Results: 62.4% were referred from primary care, 65.4% were domiciled in Albacete, 42.1% had a psychiatric history. 21.3% not included in DSMIV diagnosis. 9.62% were admitted for observation, 12.61% admitted to an inpatient psychiatric ward. 1.1% came to more than 4 times the psychiatric emergency service. Treatment plan was not significantly related to the sociodemographic variables studied. Conclusions: An average of 10.39 patients per day is attended in emergency psychiatry CHUA. 1.1% would qualify as "frequent repeaters"
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