Revista Colombiana de Psiquiatria最新文献

Introduction

Objective

Methodology

Results and discussion

Conclusions

Objective

Methods

Results

Conclusions

Introduction

Objectives

Methods

Results

Conclusions

Introduction

It is known that non-adherence to psychiatric medications has harmful consequences for both patients and society.

Objective

To collect information on the incidence of non-adherence, and the factors and causes affecting adherence to psychopharmacological treatment in patients with severe and persistent mental disorders.

Methods

A systematic review of scientific articles on adult patients (>17 years) published in the last five years (2015-2020) on specialised databases such as PubMed, Scopus, Scielo and BioMed. Original articles from indexed journals with an impact factor >0.5, in English or Spanish, with an analytical, prospective, retrospective, cross-sectional and randomised design were included. Once the articles were identified, they were analysed, extracting the information necessary to answer the research questions.

Results

Fifteen articles were included. Of these, 40% (n = 6) were published in 2020, 20% (n = 3) were produced in China and 53.3% (n = 8) had an observational design. A total of 5,837 patients were included, of which 50.6% were men (n = 2,955), with moderate adherence (n = 10; 66.7%) reported in 10 investigations. Non-adherence varies from 7.7% to 60.6%. The factors that affect adherence are specific to the patient (age and sex), their family support network, and related to the disease or the treatment. The main cause of non-adherence is lack of insight.

Conclusions

Adherence to treatment with psychotropic drugs is multifactorial. Access to mental health services should be improved, with an emphasis placed on patient education and providing greater knowledge of mental illness. Interventions to promote education and interaction with the psychiatrist could be beneficial.

Introduction

Problematic Internet use has become a growing problem worldwide; several factors, including personality, play an essential role in understanding this disorder. The Big Five personality traits and their association with problematic Internet use were examined in a large and diverse population.

Methods

A survey was applied to a total of 1,109 adults of working age. Each answered the Big Five Inventory and the Internet Addiction Test.

Results

Problematic Internet use was found in 10.6% of them (n = 112). The personality traits extraversion and openness to experience were significantly associated with those with the disorder. With adjustment models, a positive association was found between these traits and being single and higher education.

Conclusions

This study represents the largest of its kind in the Spanish-speaking population, highlighting the importance of recognising the factors involved in problematic Internet use.

Background

Catatonia is a rare neuropsychiatric condition; it is estimated that around 10% of patients with mood disorders present signs and symptoms of catatonia. A catatonic syndrome is characterised by mutism, negativism, rigidity, and stupor.

Case report

We report the case of a 59-year-old patient with a medical history of bipolar disorder who was admitted to the internal medicine service due to a seizure episode. During hospitalisation, the patient presented significant worsening of her clinical condition, showing marked symptoms of stupor and catatonia. Once the neurological and metabolic etiologies of altered mental status had been ruled out, pharmacological treatment with high doses of lorazepam was started. The patient had a complete clinical remission, and her evolution was favourable without any complications. Electroconvulsive therapy was recommended as a definitive treatment.

Conclusions

The diagnosis of catatonia is a challenge for both hospitalists and psychiatrists due to the clinical presentation of catatonia. In reporting this clinical case, we want to emphasise the importance of taking into account the catatonic syndrome in our differential diagnoses in patients with altered mental status.

Introduction

Major depressive disorder is related to unfavourable outcomes in patients with severe comorbidities. In transplant patients, major depression is associated with worse clinical outcomes.

Case report

We present the case of a 55-year-old man with a heart transplant due to heart failure of ischaemic origin. Six months after the transplant he developed depressed mood, anhedonia and suicidal ideation with a score of 20/27 on the PHQ-9 depression screening scale. After receiving mirtazapine 30 mg/night for a week and persisting with a high suicide risk, it was decided to administer ketamine infusion for 24 hours, with which a significant improvement in mood was observed, and the disappearance of suicidal ideation 24 hours after the infusion.

Discussion

Depression in transplant patients is a factor associated with graft loss and post-transplant mortality, in addition to favouring other negative outcomes such as deep vein thrombosis.

Conclusions

Ketamine infusion was shown to be an effective and safe option to treat major depression with suicidal risk in a heart transplant patient.

Background

Depression represents one of the leading causes of disability due to illness worldwide. Previous studies have demonstrated the significant heterogeneity of the diagnosis of depression, making it necessary to develop new diagnostic approaches. Network analysis is a perspective that considers symptoms as constituents of the psychiatric disorder itself. The objective was to determine the structure of depressive symptoms using the CES-D and ZDS depression scales.

Methods

Cross-sectional study of secondary analysis of 194 patients using the CES-D and ZDS scales. Correlation matrices and regularised partial correlation networks were constructed from the database. Centrality measures were estimated, and a network stability analysis was performed.

Results

On the CES-D scale, the most central item was “Sad”; while on the ZDS scale, the most central items were “Sad” and “Live”. On the CES-D scale, the connection between “Enjoy” and “Happy” was the strongest. On the ZDS scale, the strongest connection was between the items “Live” with “Useful”. The item “Morning” was the least connected on the ZDS.

Conclusions

The most central symptom from the CES-D scale was sadness, while from the ZDS scale, was sadness and anhedonia.