Revista Colombiana de Psiquiatria最新文献

{"title":"Revisión Sistemática del Tratamiento del Trastorno Bipolar con Características Mixtas","authors":"","doi":"10.1016/j.rcp.2022.06.003","DOIUrl":"10.1016/j.rcp.2022.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The mixed states of bipolar disorder (BD) are typified as a subtype of mania or depression. Mixed episodes respond worse to monotherapy treatment, imply a higher risk of relapse, a chronicity of 15% at five years and an associated suicide risk similar to that of patients with depression.</div></div><div><h3>Objective</h3><div>To evaluate and compare the different therapeutic strategies for BD with mixed characteristics.</div></div><div><h3>Methods</h3><div>A systematic bibliographic review was carried out. Those studies carried out in patients with bipolar disorder with mixed characteristics and who were receiving treatment were selected.</div></div><div><h3>Results</h3><div>The initial search showed a total of 228 articles, of which 28 met the inclusion criteria. We included 19 randomised clinical trials (RCTs) comparing an antipsychotic with placebo.</div></div><div><h3>Discussion</h3><div>According to the data evaluated, antipsychotics —especially second-generation ones— represent a first-line tool for the treatment of manic symptoms with mixed characteristics. ECT should be considered as a secondary intervention strategy in the case of acute mania when an adequate response has not been obtained after the administration of first-line drugs.</div></div><div><h3>Conclusions</h3><div>The review found that the therapeutic recommendations for bipolar disorder with mixed characteristics are limited.</div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 364-375"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46839085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La fenomenología en la psiquiatría contemporánea","authors":"Hernando Santamaría-García","doi":"10.1016/j.rcp.2024.09.002","DOIUrl":"10.1016/j.rcp.2024.09.002","url":null,"abstract":"","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Page 218"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explorando los factores de riesgo de la depresión: un análisis de red","authors":"","doi":"10.1016/j.rcp.2023.01.005","DOIUrl":"10.1016/j.rcp.2023.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Depression is a frequent psychological problem in the general population. There are no single conclusive causes for its development; on the contrary, it arises from the interaction of other emotional disorders. Determining risk factors is a primary objective to identify vulnerable individuals and optimize prevention.</div></div><div><h3>Objective</h3><div>To analyze risk factors of the depression through network analysis in Peruvian adults from the general population.</div></div><div><h3>Methods</h3><div>Cross-sectional study with a quantitative approach. A total of 567 Peruvian adults who answered several instruments assessing depressive symptoms, insomnia, suicidal ideation and anxiety participated. An undirected network model with all psychological variables and a predictive path diagram was estimated to identify risk factors for depression. Measures of centrality, precision and stability were also analyzed.</div></div><div><h3>Results</h3><div>The network structure showed that depression, insomnia, suicidal ideation, and anxiety were mutually associated. In terms of expected influence and predictability, depression obtained the highest value, followed by anxiety. In the prediction plot, all psychological variables were directly connected with depression, with anxiety having the highest connection. The tests of accuracy and stability (CS<!--> <!-->=<!--> <!-->0.75), were robust.</div></div><div><h3>Conclusions</h3><div>The results of the study suggest that problems with insomnia, suicidal ideation, and anxiety, are considerable risk factors for depression. Identifying and intervening early on those risk factors in adults in the general population could help to prevent the development of depressive symptoms.</div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 347-354"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48768951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El cuidado obstétrico y neonatal crítico en tiempo de pandemia, desde la perspectiva de psiquiatría y psicología de enlace. Reporte de Caso","authors":"","doi":"10.1016/j.rcp.2023.06.001","DOIUrl":"10.1016/j.rcp.2023.06.001","url":null,"abstract":"<div><h3>Introduction</h3><div>This case presents from the perspective of psychiatry and liaison psychology, the clinical problems and the emotional and psychological needs faced by a pregnant woman with COVID infection.</div></div><div><h3>Case report</h3><div>Thirty-six-year-old woman with severe SARS-CoV-2 pneumonia which requires ventilatory support, ECMO, emergent cesarean section for her 29-week-gestation daughter, and a complex rehabilitation process in intensive care.</div></div><div><h3>Conclusion</h3><div>The management of severe disease due to SARS-CoV-2 during pregnancy requires interdisciplinary management that includes the active participation of liaison psychology and psychiatry to respond appropriately to the complex emotional and psychosocial demands that they have the mother–daughter dyad and the family, seeking the best biopsychosocial outcomes.</div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 396-398"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43922200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Se Podrá Recomendar el Tratamiento con Litio Para el Deterioro Cognitivo Leve y la Demencia por Enfermedad de Alzheimer? Falta Evidencia Sobre su Eficacia y su Seguridad: Revisión Sistemática y Metanálisis","authors":"","doi":"10.1016/j.rcp.2022.04.006","DOIUrl":"10.1016/j.rcp.2022.04.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Alzheimer's disease is the most prevalent neurodegenerative disease worldwide. Currently available treatments are scarce and have modest effects. Lithium has been shown to decrease cognitive impairment in people with bipolar affective disorder. However, studies evaluating lithium for cognitive impairment in Alzheimer's disease remain controversial.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of the literature using PubMed, EMBASE, the Cochrane Library, LILACS, and Google Scholar between 30 April and 10 May 2021. Randomised controlled clinical trials (RCTs) conducted to evaluate the efficacy and safety of lithium as a treatment for cognitive impairment in people with dementia and mild cognitive impairment due to Alzheimer's disease were included. The primary outcome was the difference in cognitive functioning at the end of the study. Two authors selected the studies and extracted the data. We calculated the standardised mean differences (SMD) for continuous variables and the relative risk (RR) for dichotomous variables. Review Manager 5.4 software was used for data processing.</div></div><div><h3>Results</h3><div>2,078 reports were identified and 3 studies with data from 248 participants were included. A fourth report was included for safety analysis. Compared to placebo, no significant difference was found in the cognitive performance of patients with mild cognitive impairment or dementia due to Alzheimer's disease receiving lithium treatment (SMD<!--> <!-->=<!--> <!-->–0.39; 95%<span>C</span>I, –0.82 to 0.04; I² <!-->=<!--> <!-->53%; n<!--> <!-->=<!--> <!-->195). Also, significant differences were not found in the rate of discontinuation for any cause (RR<!--> <!-->=<!--> <!-->0.90; 95%CI, 0.46-1.78; I² <!-->=<!--> <!-->0%), and the rate of adverse effects between lithium and placebo (RR<!--> <!-->=<!--> <!-->1.29; 95%CI, 0.83-2.03; I² <!-->=<!--> <!-->0%).</div></div><div><h3>Conclusions</h3><div>The current evidence is insufficient to assume any effect of lithium as a treatment for cognitive impairment in Alzheimer's disease dementia. It is necessary to continue building better quality studies to justify the use of lithium in this population in clinical practice. Given the toxicity of lithium, adequate pre-selection of patients and close monitoring should be ensured.</div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 327-339"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43599862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalencia y factores asociados al síndrome de burnout y engagement en estudiantes de ciencias de la salud en una universidad pública (2019)","authors":"","doi":"10.1016/j.rcp.2022.10.002","DOIUrl":"10.1016/j.rcp.2022.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the prevalence and factors associated with burnout syndrome and engagement in health sciences students at a public university in the different semesters of their career.</div></div><div><h3>Methods</h3><div>A cross-sectional study was carried out and included university students of health sciences. A stratified random sampling with proportional allocation was carried out. A descriptive analysis was carried out calculating frequencies, proportions and percentages, as well as measures of central tendency. The proportions of burnout and engagement were estimated with their corresponding 95% Confidence Interval (95% CI). For the bivariate analysis, the Chi² test was performed and a p value &lt;<!--> <!-->0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>314 students were included (220 undergraduate and 94 graduate) with a mean age of 25<!--> <!-->±<!--> <!-->5 years (18-48 years), 112 were men (35.7%) and 202 women (64.3%). The presence of burnout was detected in 26 students (8.3%, 95% CI 5.2-11.4%). 73.9% presented high levels of exhaustion. A lower percentage of classification between high, medium-high and very high was found in those with a job (p<!--> <!-->=<!--> <!-->0.02); and greater evidence of exhaustion (high and very high) in the medicine and postgraduate programs (p<!--> <!-->=<!--> <!-->0.01). There were no significant differences for the cynicism subscale. In the engagement evaluation, 29.4% presented high levels in the three subscales, 56.2% medium levels and 14.4% low levels. In the vigor subscale, there was a lower percentage of classification between low and very low in graduate students (p<!--> <!-->=<!--> <!-->0.01), along with similar values in high and very high. In the absorption subscale, there was a lower percentage of classification between high and very high in graduate students (p<!--> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusions</h3><div>There was a low prevalence of burnout and a high prevalence of engagement in our population (total, undergraduate and graduate). However, a large proportion of students are at risk due to high levels of exhaustion. It is necessary to employ measures to reduce the levels of burnout and exhaustion, and to promote engagement, as well as to increase the investigation of the syndrome in university students.</div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 310-317"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47058714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encefalitis autoinmune contra receptores NMDA con manifestaciones neuropsiquiátricas en el adulto. Reporte de caso y revisión de la literatura","authors":"","doi":"10.1016/j.rcp.2022.11.005","DOIUrl":"10.1016/j.rcp.2022.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Anti-NMDA encephalitis is an autoimmune disease characterized by autoantibodies against NMDA receptors, confused with a primary psychiatric condition. There is a broad spectrum of neuropsychiatric symptoms, including refractory psychosis, impaired consciousness, and catatonia. Signs of autonomic instability, abnormal movements, seizures, and coma have also been associated. Patients may improve with immunotherapy and, if necessary, tumor removal.</div></div><div><h3>Objective</h3><div>To present the case of a 24-year-old woman with a diagnosis of anti-NMDA encephalitis without evidence of a tumor and with predominant psychiatric symptoms.</div></div><div><h3>Methods</h3><div>Case report and literature review.</div></div><div><h3>Results</h3><div>A brief review of the disorder is made with some data on its epidemiology, pathophysiology, therapeutic implications, and complex clinical expressions from the neuropsychiatric perspective, such as catatonic syndrome.</div></div><div><h3>Conclusion</h3><div>This case report exemplifies a clinical situation increasingly recognized in primary psychiatric practice and the general hospital; atypical psychiatric progression and catatonic symptoms indicated the possible presence of anti-NMDA encephalitis. Maintaining clinical suspicion of anti-NMDA encephalitis is considered essential, even when there is no evidence of tumor. Psychiatrists must be familiar with this entity to promote timely diagnosis and treatment.</div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 399-404"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43650673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language Disorders Among Non-Disabled Children After Perinatal Asphyxia: A Cross Sectional Descriptive Study Using Neurolinguistic Approach","authors":"","doi":"10.1016/j.rcp.2023.01.003","DOIUrl":"10.1016/j.rcp.2023.01.003","url":null,"abstract":"<div><div><span><span><span>Neonatal hypoxic-ischemic encephalopathy after perinatal asphyxia causes neurolinguistic disturbances in children without disabilities. Poor academic performance appears as a long-term result. Language intervention is sought to reduce harmful effects on children. The aim of this study is showing the relationship between clinical conditions of hypoxic-ischemic-encephalopathy (HIE) and </span>language disorders in children without disabilities. This cross-sectional study with a neurolinguistic approach was carried out in patients with perinatal asphyxia during </span>childbirth<span>, at the ZH Sikder Women's Medical College Hospital, Bangladesh. Respondents between 4 and 12 years, 76% underwent cranial computed tomography (CT); 82% underwent magnetic resonance imaging (MRI); and 70% underwent electroencephalogram (EEG). Among them were found positive results for </span></span>neonatal hypoxia<span> ischemic encephalopathy (EHI). These results are related to the following language disorders: reception/perception disorder (64%), sociolinguistic disorders (84%); metalinguistic competence disorder (66%); 86% of children had poor peer relationships and 72% had reading and writing disorders. Concluding, school-age children after perinatal asphyxia who developed Hypoxic-Ischemic Encephalopathy (HIE) had language disorders and poor school performance. There are still challenges to be overcome, as this is the first neurolinguistic approach in Bangladesh. More large-scale studies are needed.</span></div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 238-245"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42485312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issues Faced by General Practitioners in Managing Mental Health Disorders in Basic Health Units: a Cross-Sectional Study","authors":"","doi":"10.1016/j.rcp.2022.04.009","DOIUrl":"10.1016/j.rcp.2022.04.009","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate the main issues faced by general practitioners when managing mental health disorders in the primary care setting and evaluate their interest in continued medical training on mental health.</div></div><div><h3>Methods</h3><div>We carried out a cross-sectional survey which included general practitioners (n=94) working in primary care in São Bernardo do Campo, SP, Brazil.</div></div><div><h3>Results</h3><div>Participants reported challenging issues to be as follows: psychiatric emergency (44.7%), alcohol and drug use disorders (35.1%), psychopharmacology (29.9%), and suicide risk assessment (27.6%). About a third of the sample reported a lack of knowledge on criteria regarding referral to psychiatric services. Almost the entire sample reported the need for better interaction between general practitioners and psychiatrists and interest in continued medical training.</div></div><div><h3>Conclusions</h3><div>Our findings support the evidence that a network between general practitioners and psychiatrists is needed as well as the improvement of continued medical training on mental health.</div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 278-283"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45750889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPECT Cerebral en Pacientes con Síndrome de Cotard: a Propósito de dos Casos","authors":"","doi":"10.1016/j.rcp.2022.06.004","DOIUrl":"10.1016/j.rcp.2022.06.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Cotard's syndrome is a rare finding in psychiatry in which the denial of body parts, corporality and even existence, are the main features. In spite of the large number of reports and case series trying to elucidate the neurobiology of Cotard's syndrome, to date there are few studies with detailed descriptions of a possible neurobiological correlate.</div></div><div><h3>Methods</h3><div>Report of two cases and non-systematic review of the relevant literature.</div></div><div><h3>Case presentation</h3><div>The first case, a 24-year-old female patient with symptoms of Cotard's and Capgras syndrome, stated that she was dead, rotting inside her and that her family was supplanted by clones. The second case was a 50-year-old woman who mentioned being dead, not having arteries and veins. In functional neuroimaging studies, hypoperfusion was found in the frontal, parietal-temporal and basal ganglia regions.</div></div><div><h3>Literature review</h3><div>There is little literature regarding the relationship between Cotard's syndrome and functional neuroimaging studies. As reported in the literature, in our patients we found a decrease in cerebral perfusion at the frontal, parietal and temporal levels.</div></div><div><h3>Conclusions</h3><div>We found frontal, parieto-temporal and basal ganglia hypoperfusion in our patients with Cotard's syndrome.</div></div>","PeriodicalId":52477,"journal":{"name":"Revista Colombiana de Psiquiatria","volume":"53 3","pages":"Pages 405-410"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48922511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}