IntroductionPsychosocial interventions are an essential part of the treatment of schizophrenia and are aimed at promoting the social, family and occupational functioning of the patient and relapse prevention. They are considered proven clinical measures whenever necessary, however they tend to be underused.ObjectiveAnswer the question on psychosocial therapies available today for schizophrenia.MethodsReview through PubMed by entering the following keywords: psychosocial therapy; schizophrenia; cognitive behavioral therapy, and clinical practice guidelines.DiscussionThere are several psychosocial therapies used in clinical practice. The main points of approach focus on self-management of the disease, everyday problems, education, crisis intervention, and acquiring insight. The cognitive impairment is an important aspect of schizophrenia to consider. It seems that cognitive remediation therapy has been associated with both neurobiological and cognitive improvement.ConclusionsThe combination of different therapies along with psychopharmacological treatment appears to provide better results in the reduction of negative symptoms, positive symptoms and reduced hospital stay.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The aim of the study was to describe the psychopharmacological treatments received by inpatients diagnosed with spectrum disorders schizophrenia and other psychotic disorders in Dr. Rodriguez Lafora Hospital. It is an observational, descriptive and retrospective study. We collected information about patients aged 18 to 64 who were hospitalized during the month of January of 2015 in the acute psychiatric hospitalization by Selene software. We reviewed treatments and number of psychiatric re-hospitalization six months later and we analyzed the results by SPSS software. From a sample of 51 inpatients, 15 of them were diagnosed with disorders of the spectrum of schizophrenia and other psychotic disorders. Of the patients, 13.3% was treated with haloperidol, 26.7% with olanzapine, 26.7% with risperidone although it was modified by paliperidone in mental health center, 6.7% with quetiapine, 6.7% with amisulpride, 13.3% with oral paliperidone and 13.3% patients with intramuscular paliperidone. Of these, 40% are readmitted to hospital. Patients were readmitted due to ineffectiveness and adverse effects of haloperidol, olanzapine, risperidone. 73.3% of inpatients were treated with monotherapy. Of the patients, 26.7% were treated with polytherapy, who received olanzapine, risperidone and amisulpride. It would be important to use psychoactive substances that allow monotherapy to reduce adverse effects and psychiatric re-hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionThe diagnosis of hypochondria has disappeared in the new classification of mental illness. About 25% of patients who were diagnosed with hypochondria now fall into the category illness anxiety disorder. This disorder constitutes a new diagnostic category in DSM5 and is included within the somatic symptom and related disorders.ObjectivesWe propose to carry out a bibliographic review off the new diagnostic category of illness anxiety disorder.MethodsWe present the clinical case of a 27-year-old man in the context of the Covid19 pandemic.Results The illness anxiety disorder is characterized by being concerned about having or acquiring a serious illness. Somatic symptoms are not present, but if they are, they are of mild intensity. The level of concern is excessive or disproportionate if there is any disease or if there is a high risk of developing it. There is a high level of health anxiety and the individual is easily alarmed by personal health status. It is a disorder that tends to be chronic and recurrent. The exact comorbidity is still unknown. However, it is important to keep in mind that hypochondria concurs with anxiety disorders and depressive disorders. Treatment is based on the cognitive restructuring of bodily symptoms. In addition, exposure therapy and acceptance and commitment therapy are also effective. Regarding pharmacological treatment, SSRIs are useful in relation with comorbidity.ConclusionsIllness anxiety disorder is characterized by significant attention to somatic concerns in medical places, making it very useful for primary care professionals.
IntroductionPsychogenic Polydipsia is defined as the desire to drink liquid in big quantities with an inappropriate activation of the mechanisms of thirst without loss of liquid for urine. This disorder is frequent enough and can derive in a water poisoning, a clinical presentation of high mortality.ObjectiveReview of the Psychogenic Polydipsia in patients with schizophrenia and theoretical discussion of a case report.MethodsA case report of a 58-year-old male, admitted in hospital with a clinical presentation of hyponatremia with severe low serum osmolarity secondary to Psychogenic Polydipsia. As psychiatric history he has a diagnosis of Paranoid Schizophrenia for forty years in treatment with Paliperidone 6 mg: 1-0-0, Haloperidol 10 mg: 0-0-0.5, Quetiapina 300 mg: 0-0-1, Trazodona 100 mg: 0-0-1, Ketazolam 30 mg: 0-0-1, Diazepam 10 mg: 0-0-1.DiscussionPsychogenic Polydipsia is not included in any section of current psychiatric classifications as specific diagnosis. There are several psychiatric disorders that may present with psychogenic polydipsia; however, the most common cause appears to be schizophrenia.ConclusionsMechanisms of hyponatremia in patients with schizophrenia are not well clarified; nevertheless, dopamine seems to be the common link between psychogenic polydipsia and schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Many patients with severe mental illness are admission in hospital; but little is known about psychiatric re-hospitalization in this population. Our objective was to identify motives of psychiatric re-hospitalization in Dr. Rodriguez Lafora hospital. It is an observational, descriptive and retrospective study. We collected information about patients aged 18 to 64 who were hospitalized during the month of January of 2015 in the acute psychiatric hospitalization by Selene software. We reviewed psychiatric re-hospitalization for 6 months later and the results were analyzed by SPSS software. The percentage of inpatients with a diagnosis of schizophrenia spectrum and other psychotic disorders was 29.4%, 13.7% bipolar disorders, 13.7% personality disorders, 11.8% depressive disorders, 9.8% alcohol use disorders, 3.9% schizoaffective disorders, 3.9% intellectual disabilities, 3.9% adjustment disorders with depressed mood, 3.9% obsessive-compulsive and related disorders, 2% substance-related and addictive disorders, 2% feeding and eating disorders and 2% adjustment disorders with mixed anxiety and depressed mood. The percentage of psychiatric re-hospitalization in patients with alcohol use disorders was 60%, 57.1% personality disorders, 50% obsessive-compulsive and related disorders, 50% schizoaffective disorders, 28.6% bipolar disorders, 26.7% schizophrenia spectrum and other psychotic disorders and 0% in the other inpatients. Why the percentage of psychiatric re-hospitalization is higher in patients diagnosed with personality disorder and alcohol use disorders? It would be important to establish an approach through more appropriate units as alcoholic detoxification unit and personality disorders unit.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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