RESUMEN

In primary health care only chronic pain surpass depression and anxiety in loss of quality-adjusted life years. More than 70% of people suffering from common mental disorders consulted their GPs for this reason. However, 'the declining halves rule' is a reality: less than 50% of primary care attendees with common mental disorders were correctly diagnosed, of these less than 50% received adequate treatment (pharmacological or psychological) and of these less than 50% patients were adherent. Collaborative models of common mental disorders care in primary health care have demonstrated their effectiveness through clinical trials; however, its implementation in a more general and real context is difficult and its effectiveness remains unclear. Risk algorithms have been developed and validated in primary health care to predict the onset and prognosis of common mental disorders; which are useful for their treatment and prevention. There is evidence that psychological and psychoeducational interventions (and possibly those of physical exercise) are effective for the primary prevention of common mental disorders, even in primary health care; although their effects are small or moderate. These interventions have a high potential to be scalable in schools, workplace and primary health care; in addition, when they are administered through information and communication technologies (e.g. by App), in self-guided or minimally guided programs, they have demonstrated their effectiveness for the treatment and prevention of common mental disorders. They are also very accessible, have low cost and contribute to the massive implementation of these interventions in different settings.

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RESUMEN

Los trastornos de salud mental como depresión y ansiedad tienden a coexistir frecuentemente con los trastornos de somatización, siendo estos últimos una causa frecuente de consulta en especialidades médicas en niños y adolescentes. Es necesario poder pesquisarlos y diagnosticarlos para poder tratarlos adecuadamente. En la actualidad se cuenta con tratamientos eficaces y seguros para estos cuadros, ya sea estén aislados o en comorbilidad. Tanto la terapia cognitivo conductual como los inhibidores selectivos de recaptura de serotonina, solos o combinados, han demostrado ser intervenciones exitosas en estos niños y adolescentes. En el presente artículo se realiza una revisión de cómo se conceptualizan como una dimensión psicopatológica actualmente estos trastornos y cómo se relacionan entre ellos.

Psychiatric disorders such as depression and anxiety are frequently comorbid with somatization disorders, the latter ones are a common cause for medical specialties consultation in the pediatric population. It is thus necessary to identify and diagnose these disorders in order to be able to treat them. Currently, there are safe and effective treatments for these disorders, whether they are isolated or comorbid. Both cognitive behavioral therapy and selective serotonin reuptake inhibitors, alone or combined, have proven to be successful in treating these children and adolescents. This is a review of the current conceptualization of this psychopathologic dimension and how these disorders are interrelated.

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RESUMEN

El objetivo del trabajo realizado fue evaluar la utilidad del “Cuestionario de Salud del Paciente” como posible instrumento de tamizaje para Trastornos por somatización. La metodología consistió en la validación de lenguaje del instrumento, mediante su traducción doble ciego. Posteriormente se realizó su validación de contenido con un panel de expertos. El cuestionario fue aplicado en una muestra aleatoria de100 personas en la atención primaria de salud del Hospital El Pino. Se aplicó de forma anónima y se excluyeron los síntomas de los pacientes producidos por enfermedades médicas ya diagnosticadas previamente. Al analizar los resultados se constató una sospecha de un 34,15 por ciento para trastornos por somatización según el “cuestionario de salud del paciente”, la cual sería 12 veces mayor a la indicada con los criterios del CIE-10 y casi 4 veces mayor que la indicada por los criterios de Escobar. Esto podría explicarse porque los síntomas pesquisados por el cuestionario se deban a otras enfermedades orgánicas o psiquiátricas, que no se discriminan bien por esta herramienta, o a errores en su aplicación.

The objective of the work performed was to evaluate the usefulness of the “Patient Health Questionnaire” as a possible somatization disorders screening tool. The methodology consisted in validating the language of the instrument, using a double blind translation. Then the questionnaire was presented to health professionals who gave us their impressions. The questionnaire was applied to a random sample of 100 people at the primary attention health service of Hospital El Pino. It was applied anonymously, and the symptoms of patients caused by medical diseases previously diagnosed were excluded. When the results were analyzed , a suspicion of 34.15 percent in somatization disorders was found according to the “patient health questionnaire”, which would be 12 times greater than that indicated in the criteria of the CIE-10, and almost 4 times greater than the one indicated by the criteria of Escobar. This could be explained if the symptoms investigated were caused by other organic or psychiatric diseases, that had not been discriminated by this tool or errors in its application.

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