PSIQ - Artigos publicados em revistas não indexadas
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Browsing PSIQ - Artigos publicados em revistas não indexadas by Subject "Alcoolismo"
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- Depression, Anxiety and Alcohol Abuse in a Gastroenterology Intensive Care Unit: Prevalence and DetectionPublication . Cardoso, G; Alexandre, J; Rosa, AObjectives: To assess depression, anxiety, and alcohol abuse in a Gastroenterology ICU, and the level of its detection by the staff. Method: All patients consecutively admitted to the ICU during a six-month period, 18 or above, and staying 24 hours, were assessed with the Hospital Anxiety and Depression Scale (HADS) and the CAGE. Doctors and nurses assessed the type and severity of patients’ morbidity. Data were analyzed with Student’s t-test, Pearson’s and Spearman’s correlations for ordinal variables, chi-square for nominal variables, and multiple logistic regression. Results: The 65 patients assessed had a mean age of 57, and were predominantly male (58.5%), married (72.3%), and retired (53.8%); 27.7% had a psychiatric history, 24.6% were on psychotropic drugs, and 32.3% had an alcohol intake above standards. Anxiety and depression HADS scores 8 were present in 29.2% and 35.4% of the patients, respectively; 20%, mainly men, scored positive on the CAGE. Women had significantly higher anxiety scores (=.012) than men but did not differ in depression. A psychiatric history was significantly associated with higher anxiety (p<.001) and depression (p=.007) scores, as well as being on psychotropic drugs regularly (p<.001; p=.03, respectively). Doctors diagnosed somatic illness in 48.8%, and somatic illness with psychiatric co-morbidity in 51%; for nurses the rates were, respectively, 41.5% and 58.6%. Doctors’ and nurses’ detection of psychiatric disorders were significantly associated with the HADS anxiety scores (p=.013; p=.001, respectively), and doctor’s detection with depression (p=.046) scores. There were no significant associations between nurses’ detection of psychiatric disorders and depression, and between both professional groups detection and alcohol abuse. Conclusion: High prevalence of depression, anxiety, and alcohol abuse in Gastroenterology ICU was confirmed. However, the level of detection by the staff was low and mainly when anxiety symptoms were present.
- Mental disturbances and perceived complexity of nursing care in medical inpatients: results from a European studyPublication . Jonge, P; Zomerdijk, M; Huyse, F; Fink, P; Herzog, T; Lobo, A; Slaetz, J; Harolt, V; Balogh, N; Cardoso, G; Rigatelli, MAIMS AND OBJECTIVES: The relationship between mental disturbances - anxiety and depression, somatization and alcohol abuse - on admission to internal medicine units and perceived complexity of care as indicated by the nurse at discharge was studied. The goal was to study the utility of short screeners for mental disturbances to select patients for case-management on admission. DESIGN: The study had a cohort design: patients were included on admission and followed through their hospital stay until discharge. The study was conducted within the framework of the European Biomed 1 Risk Factor study. RESEARCH METHODS AND INSTRUMENTS: In the first 3 days of admission the patients were interviewed by a trained health care professional, who scored the SCL-8D, a somatization questionnaire based on the Whiteley-7 and the CAGE. At discharge, nurses rated the complexity of the patient's care. RESULTS: Patients with high scores on anxiety and depression (SCL-8D) and on somatization received higher ratings on perceived nursing complexity than those with low scores, with and without control for age, severity of illness and chronicity. The actual nursing intensity and medical care utilization, as measured daily by means of a checklist, could not explain these relations. No differences were found between patients with high or low scores on alcohol abuse. CONCLUSIONS: The study shows a potential use of screeners for mental disturbances to detect patients for whom nurses might need additional help. However, mental disturbance is not the sole criterion: functional status and other variables that predict medical and nursing care utilization should be included in a screening strategy for case-management programmes
- Tratamento de dependências – perspectivas clínica e jurídica: breve reflexão a propósito de dois casos clínicosPublication . Fonseca, S; Morins, M; Fraga, M; Pereira, JO consumo de substâncias psicoactivas, conhecidas vulgarmente por drogas, incluindo o consumo de álcool, de modo esporádico ou crónico, está directamente relacionado com alterações na conduta do consumidor e pode espoletar estados psicopatológicos de evolução subaguda ou crónica. O consumo excessivo de álcool ou consumo de substâncias ilícitas por indivíduos sem doença mental, são actos praticados de livre vontade, o que os torna criminalmente responsáveis pelos seus actos, mesmo quando optam voluntariamente por um estado de intoxicação e durante esse estado praticam uma acção criminosa. Da prática clínica reconhece-se que qualquer tipo de tratamento em doentes que sofram destas patologias só é eficaz quando o doente a ele adere voluntariamente e o internamento compulsivo apenas é desencadeado quando o quadro psicopatológico associado justifica os pressupostos do artigo 12.º da Lei de Saúde Mental. Por outro lado, se o tratamento compulsivo tiver um carácter de imposição judicial, o indivíduo é obrigado a tratar-se, independentemente de ser portador ou não de doença mental. A propósito de 2 casos clínicos, um de toxicodependência e um de alcoolismo, as autoras reflectem sobre as perspectivas, clínica e jurídica, relacionadas com o tratamento destas entidades clínicas.