Asunto(s)
Emociones , Psicodrama , Desempeño de Papel , Pacientes/psicología , Relaciones Médico-PacienteRESUMEN
After some introductory remarks about consultation and liaison psychiatry, the psychiatric consultation and liaison service in the general university hospital of Bern is presented. It has a statistically expressable exterior activity and an interior activity. It gives its contribution to holistic medical thinking in the fields of patient care, teaching, research, expertising and public relations. Problems of integration of consultation and liaison psychiatry and their possible overcoming are discussed on the base of two other studies of this author. The importance of creating psychiatric services in general hospitals is emphasized.
Asunto(s)
Psiquiatría , Trastornos Psicofisiológicos/terapia , Derivación y Consulta , Rol del Enfermo , Salud Holística , Hospitales Generales , Humanos , Trastornos Psicofisiológicos/psicología , SuizaRESUMEN
Of the 14 cases of suicide during the decade 1969-1978 in the General University Hospital, Bern, 10 were by jumping from windows, 2 by hanging and 2 by drowning (1 outside the hospital area). The typical picture of the suicidal patient is characterized by an accumulation of the following factors: male sex; advanced age; serious illness; psychiatric history (previous suicide attempts); personal, occupational and family problems; social isolation; psychic tension; anxiety; depression; confusion; suicidal talk; suicidal behaviour. The concrete possibilities for suicide prevention are recalled; they consist chiefly in better psychological preparation of therapeutic teams, and can be summarized under three headings: observe, discuss, care.
Asunto(s)
Prevención del Suicidio , Adulto , Anciano , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Riesgo , Estadística como Asunto , Suicidio/psicologíaRESUMEN
It has been postulated that hyperparahyroidism is in part responsible for sexual dysfunction in dialyzed patients and that this could improved by 1,25(Oh)2D3. In a single blind study patients on maintenance hemodialysis were treated after a control period with 1,25 (OH)2D3 and with placebo in random order. Sexual performance was assessed with a detailed semistructured psychiatric interview protocol in 14 and several endocrine parameters were analyzed in 15 patients. Under control conditions sexual function was disturbed in 11/14 patients. Plasma testosterone was moderately decreased in men, PRL and PTH levels were distinctly elevated in both sexes. 1,25(OH)2D3 raised serum calcium levels significantly from 9.6 to10.6 mg/100 ml ( P < 0.01) and lowered PTh from 1.39 to 0.82 ng/ml ( P < 0.01). However, no improvement in sexual function (such as libido, frequency of intercourse or masturbation) was found, and apart from a slight rise of testosterone in men and moderate fall of PRl in men and women endocrine parameters remained unchanged. It is concluded that in spite of an improvement of secondary hyperparathyroidism, treatment with 1,25(OH)2D3 for 2 to 4 months was of no value in improving sexual dysfunction in these hemodialysis patients.