Vertex (Buenos Aires, Argentina)最新文献

Suicide represents a critical public health challenge. The present narrative review aimed to update the available evidence on risk detection and prevention, to promote lines of action for the early and comprehensive approach to this complex and multi-causal problem; evaluate the possibility of strengthening policies, programs, and actions to enhance existing resources and promote the creation of new ones. Prevention highlights the need for personalized strategies and interdisciplinary collaboration. Early detection involves identifying risk profiles, especially in those who have tried multipletimes, which can guide more effective interventions. Training health professionals is crucial to detect and address risk. Using web technologies, co-production in prevention, telephone support and brief contact are promising strategies. Emergency services and outpatient follow-up are essential after consultation at emergency centers. Postvention actions contribute to harm reduction and mitigation of negative impacts on survivors.

Attention Deficit Hyperactivity Disorder (ADHD) has traditionally been understood as a condition primarily associated with childhood. However, growing evidence indicates that ADHD persists into adulthood, manifesting in various ways. Despite its prevalence and significant impact on daily life, adult ADHD has been considerably underestimated and underdiagnosed, resulting in a substantial burden for affected individuals, as well as their families and social environment. This comprehensive review aims to explore the complexity of ADHD in adulthood by addressing its etiology, definition, clinical presentation, risk factors, common comorbidities, evaluation methods, and neuropsychological aspects, alongside both pharmacotherapeutic and non-pharmacotherapeutic approaches for treatment. Additionally, the implications for diagnosis and treatment are examined, emphasizing the need for a thorough understanding of this condition. Through this document, the Argentine Association of Biological Psychiatry (Asociación Argentina de Psiquiatría Biológica, AAPB) not only seeks to compile and analyze the evidence on adult ADHD but also to provide a practical guide for healthcare professionals treating this disorder. The ultimate goal of this article is to contribute to the development of effective strategies for the evaluation and management of ADHD, ultimately improving the quality of life for patients.

Reseña de la obra: Salud Mental y Psiquiatría en la práctica de Atención Primaria de la Salud, editada por Juan Pablo Giménez y Julia Acuña y Albert Botto. Instituto Milenio para la Investigación en Depresión y Personalidad, MIDAP, Santiago de Chile, 2024.

Introduction: delirium is a prevalent syndrome in clinical practice. The objective of this study was to identify the knowledge, attitudes and practices about delirium among medical professionals in a tertiary referral hospital, as well as to evaluate the validity of the instrument created for this purpose.

Methods: A 3 phase cross sectional study was carried out: 1- content validation, 2- application of the instrument and 3- Construct validation.

Results: After satisfactory content validation, the instrument was applied to 148 participants. Regarding knowledge about delirium, there was an average of 57.8% correct answers (95% CI 52.5-63.1) with no significant difference between attending physicians, residents and final year medical students. 25% (n=37) reported using the Confusion Assessment Method, 31.1% (n=46) reported feeling confident in the use of antipsychotics in the management of delirium, and 86.5% (n=128) reported using at least one non-pharmacological measure.

Conclusions: Deficiencies in knowledge and management of delirium were evident in healthcare workers. The instrument had optimal content validation but unsatisfactory construct validation. Emphasizing the importance of doing a psychometric analysis with individuals prior to applying the instrument.

Introduction: The purpose of the current research is to know the status of self-harm behavior and its associations withdifferent aspects of emotional dysregulation.

Materials and methods: A non-experimental, observational, descriptive and transversal research took place in three different high-schools of Río Cuarto city, Córdoba, Argentina, during the realization of an extension program conducted by Siglo 21 University. DERS scale was applied looking for information relative to emotional dysregulation and CRA scale to assess self-harm behavior.

Results: In total, 107 students were enquired, of which 43% manifested that they had harmed themselves at least once; in this group, 5,35% expressed that “frequently” or “always” did it with suicidal intention. Discussion: Results indicates that self-harm behavior is growing up between adolescent’s population, that the start age tends to be lower than current literature suggests and that subjects with bigger emotional dysregulation difficulties presents more frequency of thoughts and self-harm behavior. In this study, self-harm behavior and suicidal attempts tend to overlap.

Conclusion: The current research finds a high frequency of adolescents with self-harm behavior, confirming a growing up tendency and a strong influence of emotional elements at the moment of deciding whether self-harm or not, specially difficulties in impulse control.

The spectrum of neurodegenerative diseases that primarily affect cognition and behavior ranges from asymptomatic preclinical disease to very mild cognitive impairment and frank dementia. This article reviews the current criteria for the diagnosis of Lewy body dementia, the second most common cause of neurodegenerative dementia in people over 65 years of age after Alzheimer's disease (AD) and Primary progressive aphasias, which are characterized by early and isolated impairment of linguistic functions, and whose evolution develops a complex syndrome characterized, in addition to language impairment, by the presence of progressive cognitive impairment, behavioral disorders and motor system involvement. They can also be the presentation syndrome of an atypical variant of Alzheimer's disease (AD), but mixed or uncharacterizable forms are not rare.

Reseña del libro: Lectura de los primeros escritos de Lacan sobre psicosis, de Elena Levy Yeyati. Grama, 2024.

Introduction: There are scarce studies about why patients dropout addiction treatments.

Methods: A mixed analysis about data from 55 patients who discontinued an intensive outpatient approach between June 2019 and November 2021 and their responses to a questionnaire were evaluated.

Results: The dropout rate was 29.2%, with a median [95% CI] of 113 days [47-255]. Of the total, 40/55 responded to the questionnaire, 12.5% reported an increase in use and 75% were under mental health treatment. The main reason for dropout was personal, related to ambivalence and the perception of not having a problem. Reasons associated with the program approach included global abstinence and group therapy.

Conclusions: Admission strategies, diversification of proposals and inclusion of bond therapy could improve the effectiveness of outpatient addiction programs.