RESUMEN
OBJECTIVE: To study effects of the implementation of joint-crisis plans (JCP) on health-care users and professionals. METHODS: The first 3 years of the implementation of JCP were followed with structured interviews with health-care users and professionals. Legal and administrative complications were documented. RESULTS: 36 of 44 subjects with JCP were assessed. Most of them had learned of JCP through other users or self-help. 55 % had prior experience with compulsory treatment. Better communication and self-determination were main goals of JCP. A relevant change in hospital treatment through JCP was not observed. Only few professionals had made direct experience with JCP. They valued JCP mildly positive. No legal and administrative complications were documented. CONCLUSIONS: Only a small minority of users signed JCP. JCP were easily employed and improved communication and self-determination.
Asunto(s)
Conducta Cooperativa , Intervención en la Crisis (Psiquiatría)/organización & administración , Implementación de Plan de Salud/organización & administración , Comunicación Interdisciplinaria , Trastornos del Humor/rehabilitación , Trastornos Neuróticos/rehabilitación , Grupo de Atención al Paciente/organización & administración , Trastornos de la Personalidad/rehabilitación , Relaciones Médico-Paciente , Trastornos Psicóticos/rehabilitación , Asistencia Social en Psiquiatría/organización & administración , Adulto , Internamiento Obligatorio del Enfermo Mental/legislación & jurisprudencia , Servicios Comunitarios de Salud Mental/legislación & jurisprudencia , Servicios Comunitarios de Salud Mental/organización & administración , Intervención en la Crisis (Psiquiatría)/legislación & jurisprudencia , Femenino , Alemania , Implementación de Plan de Salud/legislación & jurisprudencia , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Humor/psicología , Trastornos Neuróticos/psicología , Evaluación de Procesos y Resultados en Atención de Salud , Grupo de Atención al Paciente/legislación & jurisprudencia , Readmisión del Paciente , Autonomía Personal , Trastornos de la Personalidad/psicología , Trastornos Psicóticos/psicología , Ajuste Social , Asistencia Social en Psiquiatría/legislación & jurisprudencia , Suicidio/psicología , Intento de Suicidio/prevención & control , Intento de Suicidio/psicología , Prevención del SuicidioRESUMEN
AIM: The aim was to follow-up a group of persons who were considered severely and persistently mentally ill (SMI) at the time of the 1995 Swedish mental health-care reform but not so ten years later. METHODS: Surveys were conducted in 1995/96 and 2006 in an area of Sweden. Of 602 persons surveyed as SMI in 1995/96, 321 were not found to be so in a similar survey in 2006. These persons were followed up concerning death rates and causes, as well as concerning recovery and present care. Comparisons between subgroups were made using the results of interviews conducted in 1995/96. RESULTS: Nineteen percent of the persons considered SMI in 1995/96 were recovered in 2006 in the sense that they no longer were considered SMI. The only variable found to predict recovery was diagnosis. Half of the persons in the sample given a diagnosis of neurosis were recovered but only 6% of those given a diagnosis of psychosis. Death rates and death causes seemed to be in line with previous research. CONCLUSIONS: Relatively few persons were considered recovered after ten years. Most persons in the sample were still in contact with care and services.
Asunto(s)
Reforma de la Atención de Salud/estadística & datos numéricos , Trastornos Mentales/mortalidad , Trastornos Mentales/rehabilitación , Adulto , Causas de Muerte , Enfermedad Crónica , Comorbilidad , Femenino , Estudios de Seguimiento , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Humanos , Masculino , Trastornos Mentales/diagnóstico , Servicios de Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Trastornos Neuróticos/diagnóstico , Trastornos Neuróticos/mortalidad , Trastornos Neuróticos/rehabilitación , Pronóstico , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/mortalidad , Trastornos Psicóticos/rehabilitación , Ajuste Social , Tasa de Supervivencia , Suiza , Revisión de Utilización de Recursos/estadística & datos numéricosRESUMEN
BACKGROUND: It is increasingly acknowledged that satisfaction with sexual relations forms an important aspect of people's lives, but little is known of factors associated with this phenomenon among people with mental illness. AIM: This study aimed to investigate how demographic, social, clinical, and health-related factors were related to satisfaction with sexual relations. METHODS: Patients with persistent mental illness (N = 103), recruited from an outpatient unit, were assessed regarding the target variables. RESULTS: No clinical variable, and only one demographic factor, namely being a cohabitant, was found to be important to satisfaction with sexual relations. Several social factors, pertaining to how everyday occupations were valued and how the social network was perceived, were shown to be of importance. General quality of life, but not self-rated health or interviewer-assessed psychopathology, was also important for satisfaction with sexual relations. A multivariate analysis showed that the most significant factor for satisfaction with sexual relations was how everyday activities were valued, and being a cohabitant explained some additional variation. CONCLUSION: Previous research indicates that the mental health care services largely neglect sexual problems among people with mental illness, and the findings may provide additional knowledge that may be used in the support of this target group.
Asunto(s)
Trastornos Mentales/psicología , Trastornos Mentales/rehabilitación , Satisfacción Personal , Conducta Sexual , Disfunciones Sexuales Psicológicas/rehabilitación , Actividades Cotidianas/psicología , Adulto , Síndrome de Asperger/diagnóstico , Síndrome de Asperger/psicología , Síndrome de Asperger/rehabilitación , Discapacidades del Desarrollo/diagnóstico , Discapacidades del Desarrollo/psicología , Discapacidades del Desarrollo/rehabilitación , Femenino , Humanos , Control Interno-Externo , Masculino , Trastornos Mentales/diagnóstico , Persona de Mediana Edad , Trastornos del Humor/diagnóstico , Trastornos del Humor/psicología , Trastornos del Humor/rehabilitación , Trastornos Neuróticos/diagnóstico , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Apego a Objetos , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/psicología , Trastornos de la Personalidad/rehabilitación , Inventario de Personalidad , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Trastornos Psicóticos/rehabilitación , Calidad de Vida/psicología , Esquizofrenia/diagnóstico , Esquizofrenia/rehabilitación , Psicología del Esquizofrénico , Autoimagen , Disfunciones Sexuales Psicológicas/diagnóstico , Disfunciones Sexuales Psicológicas/psicología , Apoyo Social , Adulto JovenRESUMEN
BACKGROUND: Activities of daily living, play a key role in the measurement of functional health as defined by the International Classification of Functioning, Disability and Health (ICF) and in prevention and treatment of mental or somatic illnesses. From a clinical context it is important to discriminate between basic "activities of daily living, ADL", "intentional activities of daily living, IADL", and "recreational activities of daily living, RADL". While ADL and IADL have gained much attention in dementia, the elderly, or severe somatic illnesses, there is a lack of research on RADL, which are important in depression, anxiety, or other neurotic disorders. SUBJECTS AND METHODS: 154 unselected inpatients of a department of behavioral and psychosomatic medicine filled in the "Check List of Recreational Activities" to assess the rates and profiles of RADL. RESULTS: Patients reported on average 19.3 (s.d. 7.0) activities (range 4 - 40), i.e. males 21.3 (s.d. 6.5, 9 - 34) and females 18.9 (s.d. 7.1, 4 - 40). Most frequent RADL were passive and unspecific activities like "watching tv" (93.4%). Least frequent were activities which need special skills or preparation like "horse back riding" (0.7%). Low rates were also found for activities which are in the centre of inpatient occupational therapy like "ceramics" (4.7%) or "silk-painting" (2.6%). There are differences between sexes but not in respect to age (18 to 60), sick leave and unemployment, or diagnostic status. When patients were asked what they would like to do in the future, the same activity profile emerged as when looking at what they had done in the last month CONCLUSION: The data give a reference profile for recreational activities, help to define what can be considered a normal frequency and spectrum of RADL, and, by this, can guide therapeutic interventions.
Asunto(s)
Actividades Cotidianas/psicología , Trastornos Mentales/psicología , Recreación , Adolescente , Adulto , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/rehabilitación , Terapia Conductista , Conducta de Elección , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Trastorno Depresivo/rehabilitación , Femenino , Hospitalización , Humanos , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/rehabilitación , Persona de Mediana Edad , Trastornos Neuróticos/diagnóstico , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Terapia Ocupacional , Adulto JovenRESUMEN
The aim of this study was to get an idea of the need of psychiatric therapy in a prison. We report on the period May 2000 to January 2002. 60 medical files with the sociodemographic variables and the psychiatric diagnosis were evaluated. 45 % of the examined prisoners had a diagnosis of drug- or alcohol dependency and 31.3 % had a diagnosis of a schizophrenia. In 26.7 % the therapy was successful and the prisoners improved. This results show a great need of psychiatric therapy in a prison. Also in a prison improvements in the course of psychic disturbances are possible.
Asunto(s)
Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Trastornos Mentales/epidemiología , Prisioneros/psicología , Prisiones , Psiquiatría/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Adulto , Anciano , Alcoholismo/diagnóstico , Alcoholismo/epidemiología , Alcoholismo/rehabilitación , Estudios Transversales , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/epidemiología , Trastorno Depresivo/rehabilitación , Alemania/epidemiología , Humanos , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/rehabilitación , Persona de Mediana Edad , Trastornos Neuróticos/diagnóstico , Trastornos Neuróticos/epidemiología , Trastornos Neuróticos/rehabilitación , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/epidemiología , Trastornos de la Personalidad/rehabilitación , Prisioneros/estadística & datos numéricos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/rehabilitación , Psicotrópicos/efectos adversos , Psicotrópicos/uso terapéutico , Recurrencia , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiología , Esquizofrenia/rehabilitación , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/rehabilitación , Resultado del TratamientoRESUMEN
AIMS: Psychiatric disorders are common among substance dependants. The objectives of this study were to assess the rate of neurotic disorders among opioid addicts, and reassess the rate of those neurotic disorders two weeks after complete detoxification of the patients. MEASUREMENTS: Data were gathered from 500 (496 men and 4 women) opioid dependants, using DSM-IV criteria. The Middlesex Hospital Questionnaire (MHQ) was used to measure free-floating anxiety, depression, phobia, obsession, hysteria and somatization. RESULTS: Four hundred and ninety-six (99.2%) of the subjects were men of whom the majority (65.2%) were married, 26.4% single and the others were divorced or separated. Three hundred and thirty-four (66.8%) were in age range of 20 to 39 years. Of the subjects 154 (30.8) were self-employed, 116 (23.2%) were factory workers, 100 (20%) unemployed, 64 (12.8%) employees and 32 (6.4%) retailers. The majority, 322 (64.4%), reported elementary and high school as their level of education and only 20 (4%) were illiterate. The means for neurotic disorders (using the MHQ) before and two weeks after detoxification were 10.12 and 9.98 for anxiety, 7.54 and 7.41 for phobia, 10.10 and 9.76 for depression, 11.11 and 11.05 for obsession, 8.47 and 8.49 for hysteria and 9.82 and 9.46 for somatization, respectively. The mean difference was significant only for depression. CONCLUSIONS: Present findings indicated that the rate of neurotic disorders in opioid dependants is high and (except for depression) was not significantly different before detoxification and two weeks after detoxification. Opium was found to be the most prevalent form of opioid used. Also it can be concluded that during the last years some demographic characteristics of Iranian opioid addicts in this sample have changed. Cultural attitudes toward substance use quite likely affect the pattern of substance use. These findings can be considered when planning preventive and therapeutic programs.
Asunto(s)
Trastornos Neuróticos/epidemiología , Trastornos Relacionados con Opioides/epidemiología , Adulto , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/rehabilitación , Comorbilidad , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/epidemiología , Trastorno Depresivo/rehabilitación , Diagnóstico Dual (Psiquiatría) , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Estudios de Seguimiento , Humanos , Histeria/diagnóstico , Histeria/epidemiología , Histeria/rehabilitación , Irán , Masculino , Persona de Mediana Edad , Trastornos Neuróticos/diagnóstico , Trastornos Neuróticos/rehabilitación , Trastorno Obsesivo Compulsivo/diagnóstico , Trastorno Obsesivo Compulsivo/epidemiología , Trastorno Obsesivo Compulsivo/rehabilitación , Trastornos Relacionados con Opioides/diagnóstico , Trastornos Relacionados con Opioides/rehabilitación , Evaluación de Resultado en la Atención de Salud , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/epidemiología , Trastornos Fóbicos/rehabilitación , Trastornos Somatomorfos/epidemiología , Trastornos Somatomorfos/psicología , Trastornos Somatomorfos/rehabilitaciónRESUMEN
OBJECTIVE: The aim of the study was to show, trough the calculation of the direct costs of supports and treatments actually provided by a NHS Mental Health Department, the presence of associations between four diagnostic groups (schizophrenia, affective psychosis, paranoia and neurotic disorders) and their overall and items (community care, rehabilitation facilities and in-patients services) costs. SETTING: Mental Health Department and CSM "Scalo" (NHS Mental Centre), AUSL "Città di Bologna", Emilia-Romagna Region. DESIGN: Yearly direct costs were calculated for a sample (n = 75) of all patients (N = 745) who during 365 days had more than four contacts with CSM and also for four randomised diagnostic groups (n = 30 per group). MAIN OUTCOME MEASURES: We calculated unit costs of 15 types of services provided by CSM, selected according to the yearly number of services provided and the time spent by each health professional, and the in patient-cost per all days spent in a public or private sector hospital for psychiatric care. RESULTS: The statistic analysis, performed with the help of the Kruskal-Wallis test, showed significantly higher overall costs for the schizophrenic patients than the sample-group and the neurotic disorders-group; besides a significant difference in the item costs for rehabilitation facilities was found between the schizophrenic group and the paranoia, neurotic disorders groups and the sample one, whereas no significant differences in costs of inpatients services and drugs administration were tested between the groups. CONCLUSIONS: The results of our study allow to demonstrate that there are cost differences between the diagnosis (direct costs are highest for schizophrenic patients and lowest for those with neurotic disorders) and that the costs evaluation can be used to ensure appropriate provisions to Mental Health Department for support and treatment of a wide range of psychiatric disorders.
Asunto(s)
Costo de Enfermedad , Costos de la Atención en Salud/estadística & datos numéricos , Servicios de Salud Mental/economía , Trastornos del Humor/economía , Trastornos del Humor/terapia , Trastornos Neuróticos/economía , Trastornos Neuróticos/terapia , Trastornos Paranoides/economía , Trastornos Paranoides/terapia , Trastornos Psicóticos/economía , Trastornos Psicóticos/terapia , Esquizofrenia/economía , Esquizofrenia/terapia , Femenino , Humanos , Italia , Masculino , Servicios de Salud Mental/estadística & datos numéricos , Trastornos del Humor/rehabilitación , Trastornos Neuróticos/rehabilitación , Trastornos Paranoides/rehabilitación , Trastornos Psicóticos/rehabilitación , Esquizofrenia/rehabilitaciónAsunto(s)
Psicoterapia/métodos , Sugestión , Inconsciente en Psicología , Adulto , Biorretroalimentación Psicológica/métodos , Rehabilitación Cardiaca , Enfermedades Cardiovasculares/psicología , Trastornos de Combate/psicología , Trastornos de Combate/rehabilitación , Humanos , Masculino , Persona de Mediana Edad , Personal Militar/psicología , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Federación de Rusia , GuerraAsunto(s)
Rehabilitación Cardiaca , Trastornos Neuróticos/rehabilitación , Premenopausia , Anciano , Enfermedades Cardiovasculares/etiología , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Trastornos Neuróticos/etiología , Educación del Paciente como Asunto , Clase Social , Resultado del TratamientoRESUMEN
Administration of rehabilitation psychotherapy, including pathogenetic and symptomatic psychotherapy, raises efficacy of combined sanatorium treatment of early stages of such cardiological diseases as ischemic heart disease, angina of effort class I, essential hypertension stage I. Psychotherapy also promotes relief of psychoemotional stress, anxiety, frustration, rigidity, aggression, alexithymia, asthenia being primary and secondary prophylaxis of psychosomatic disorders.
Asunto(s)
Enfermedades Cardiovasculares/psicología , Colonias de Salud , Personal Militar/psicología , Trastornos Psicofisiológicos/rehabilitación , Psicoterapia/métodos , Adaptación Psicológica , Adulto , Rehabilitación Cardiaca , Enfermedades Cardiovasculares/diagnóstico , Terapia Combinada , Humanos , Masculino , Personal Militar/estadística & datos numéricos , Trastornos Neuróticos/diagnóstico , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Trastornos Psicofisiológicos/diagnóstico , Trastornos Psicofisiológicos/psicología , Federación de RusiaAsunto(s)
Trastorno Autístico/rehabilitación , Delfines , Discapacidad Intelectual/rehabilitación , Trastornos Neuróticos/rehabilitación , Psicoterapia/métodos , Adaptación Psicológica/fisiología , Adolescente , Animales , Trastorno Autístico/fisiopatología , Trastorno Autístico/psicología , Niño , Preescolar , Emociones/fisiología , Frecuencia Cardíaca , Humanos , Discapacidad Intelectual/fisiopatología , Discapacidad Intelectual/psicología , Neuropsicología , Trastornos Neuróticos/fisiopatología , Trastornos Neuróticos/psicología , Condicionamiento Físico Animal/métodosRESUMEN
AIM: Characterization of cerebral pathology in inactive phase of rheumatism. MATERIALS AND METHODS: Clinical, experimental psychological examinations were performed in 110 rheumatic patients with inactive disease. Computer tomography of the head was carried out in 45 patients. RESULTS: Psychic defects were absent only in 2.73% of the examinees. The rest had different neurotic symptoms manifest as panic attacks (> 50% of cases) or mildpsychoorganic shifts (60.91% of cases). Computer tomography of the brain has revealed hypodensive foci, deformed subarachnoid spaces and cerebral ventricles, hydrocephalia in 66.67% of the patients. These occurred more frequently in patients with psychoorganic syndrome or valvular heart diseases. CONCLUSION: Treatment and rehabilitation of rheumatic patients should also include measures to correct psychic and cerebral abnormalities frequently present in such patients.
Asunto(s)
Encefalopatías/complicaciones , Trastornos Neuróticos/complicaciones , Enfermedades Reumáticas/complicaciones , Adolescente , Adulto , Encefalopatías/diagnóstico , Encefalopatías/rehabilitación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Neuróticos/diagnóstico , Trastornos Neuróticos/rehabilitación , Pruebas Psicológicas , Enfermedades Reumáticas/diagnóstico , Enfermedades Reumáticas/rehabilitación , Tomografía Computarizada por Rayos XRESUMEN
In a large number of patients aortocoronary shunting often leads to persistent neurotic disorders' development. Taking into account the biological, psychological and social factors contributing to the disease pathogenesis, the authors tend to introduce some methods of active involvement of patients into a rehabilitation-prophylactic process to restore their mental health balance, behavioral standards, communicative habits etc.
Asunto(s)
Puente de Arteria Coronaria/psicología , Puente de Arteria Coronaria/rehabilitación , Educación del Paciente como Asunto/métodos , Psicoterapia de Grupo/métodos , Adaptación Psicológica , Tolerancia al Ejercicio , Humanos , Personal Militar/psicología , Isquemia Miocárdica/psicología , Isquemia Miocárdica/rehabilitación , Isquemia Miocárdica/cirugía , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Federación de RusiaRESUMEN
We examined factors associated with psychosocial recovery in patients receiving specialist psychiatric treatment by means of a questionnaire directed at staff and patients (n = 1084) in an extensive study performed in North Savo, Kuopio, Finland. Psychosocial recovery was considered to have taken place if the Global Assessment Scale (GAS) score had increased from the lowest estimate obtained during the preceding year by at least 28 points at the time of the study (n = 102). The remaining cases (n = 982) served as controls. In the univariate analysis of all of the patients, the factors associated with good recovery were a high level of basic education, a diagnosis of major depression and adequate social support. The opportunity to contact a therapist outside fixed treatment visits was also a factor predicting psychosocial recovery. In the multivariate analysis, independent factors predicting recovery were the high frequency of treatment contacts in cases of schizophrenia, previous hospitalization in major depression, and a high level of basic education and hospitalization in personality disorders.
Asunto(s)
Trastornos Mentales/rehabilitación , Ajuste Social , Adaptación Psicológica , Adulto , Terapia Combinada , Trastorno Depresivo/psicología , Trastorno Depresivo/rehabilitación , Escolaridad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Trastornos Mentales/psicología , Persona de Mediana Edad , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Readmisión del Paciente , Determinación de la Personalidad , Trastornos de la Personalidad/psicología , Trastornos de la Personalidad/rehabilitación , Pronóstico , Psicoterapia , Psicotrópicos/uso terapéutico , Esquizofrenia/rehabilitación , Psicología del Esquizofrénico , Apoyo SocialRESUMEN
The concept of schizophrenic negative symptomatology consisting of primary, treatment-resistant negative symptoms associated with cognitive dysfunction and treatable secondary composite negative symptoms was tested by comparing a group with non-chronic schizophrenia and a neurotic group with negative symptoms before and 8 weeks after the start of treatment. Contrary to our hypothesis, we found no association between schizophrenic negative symptoms and cognitive dysfunction as measured by CPT and K-V-T either at the first or at the second assessment point, but did find a strong relation between depressive and negative symptomatology at both assessment points in both groups. Thus, we conclude that a chronic course, rather than primary negative symptomatology, may be associated with cognitive dysfunction. The concept of primary negative symptoms based on cognitive dysfunction versus secondary negative composite symptoms encompassing motivation and reactive attitudes is not supported by these results.
Asunto(s)
Trastornos del Conocimiento/diagnóstico , Depresión/diagnóstico , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Esquizofrenia/diagnóstico , Psicología del Esquizofrénico , Adulto , Antipsicóticos/uso terapéutico , Enfermedad Crónica , Trastornos del Conocimiento/psicología , Trastornos del Conocimiento/rehabilitación , Depresión/psicología , Depresión/rehabilitación , Femenino , Humanos , Masculino , Trastornos Neuróticos/diagnóstico , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Pronóstico , Rehabilitación Vocacional/psicología , Esquizofrenia/clasificación , Esquizofrenia/rehabilitaciónRESUMEN
A 14-year follow-up study was conducted on 214 patients from the diagnostic groups schizophrenia, affective psychosis, and neurosis to determine the relationships between various clinical and psychosocial variables and to assess their value as predictors of long-term course and outcome. Particular emphasis was placed on ascertaining the interrelationships between the variables within the individual diagnostic groups. The results indicate that for schizophrenia, severity of disease at discharge from index hospitalization was the principal predictor of the number and duration of further hospitalizations. Furthermore, it predicted the severity of illness and social functioning at follow-up. For affective psychosis, the Global Assessment Scale score predicted the number and duration of further hospitalizations. Severity of illness, social functioning, and age at first hospitalization were predictors of occupational development. For neurotic disorders, severity of disease and social adjustment at discharge from index hospitalization were each predictors of themselves at final follow-up. In addition, age at first hospitalization was an important predictor of most course and psychosocial variables. Among the endogenous course variables within the schizophrenic group, the number and duration of further hospitalizations had a substantial bearing on severity of illness and social functioning at follow-up. For affective psychoses, indicators of occupational development and number of hospitalizations had an impact on severity of illness and social functioning at follow-up. Our findings reveal a good overall predictive value for the clinical and psychosocial variables within each of the diagnostic categories studied.
Asunto(s)
Trastornos Psicóticos Afectivos/diagnóstico , Trastornos Neuróticos/diagnóstico , Esquizofrenia/diagnóstico , Psicología del Esquizofrénico , Adulto , Trastornos Psicóticos Afectivos/psicología , Trastornos Psicóticos Afectivos/rehabilitación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Admisión del Paciente , Pronóstico , Escalas de Valoración Psiquiátrica , Rehabilitación Vocacional , Estudios Retrospectivos , Esquizofrenia/rehabilitación , Ajuste Social , Resultado del TratamientoRESUMEN
The border psychic disorders are the main cause of the personnel discharge. Its frequency for many years remains on the high level and has no tendency towards decrease. To solve the problem of maintaining psychic health of servicemen is possible by psychiatric care reorganization with participation of social and military psychologists, specialists in professional selection, psychotherapy, etc. For introduction of highly effective psychodiagnostic, corrective and therapeutic methods into practice it is reasonable to create the psychoprophylactic centers (main, district, army, divisional).
Asunto(s)
Personal Militar , Trastornos Neuróticos/prevención & control , Humanos , Personal Militar/psicología , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Prevención PrimariaRESUMEN
This paper summarizes how neurotic disorders affect working capability, with an emphasis on neurotic working disorders. According to official statistics neurotic disorders account for 5.5% of all disability pensions, but they figure less often as diagnoses in medical certificates issued prior to invalidation. The true impact of neurotic disorders may only be guessed, since the diagnosis is easy to miss and only reluctantly proffered when suspected. In contrast to other neurotic disorder afflicting working behaviour, the neurotic working disorder is thematically centered within the sphere of work and profession itself. The disorder is often treated inadequately and belatedly. Typical somatic complaints clusters, characteristic neurotic conflicts and personality traits often encountered with neurotic working disorder are outlined. Diagnosis requires the taking of a psychobiographic history and some knowledge of psycho- and soziotherapy. There are many options for therapy, and there are a few studies evaluating their efficacy. In order to install treatment early, a routine checkup by a psychotherapist is suggested for all patients exceeding a certain number of days off work per year.
Asunto(s)
Evaluación de la Discapacidad , Trastornos Neuróticos/diagnóstico , Enfermedades Profesionales/diagnóstico , Pensiones , Trastornos Somatomorfos/diagnóstico , Terapia Combinada , Humanos , Trastornos Neuróticos/psicología , Trastornos Neuróticos/rehabilitación , Enfermedades Profesionales/psicología , Enfermedades Profesionales/rehabilitación , Psicoterapia , Rehabilitación Vocacional/psicología , Trastornos Somatomorfos/psicología , Trastornos Somatomorfos/rehabilitación , Evaluación de Capacidad de TrabajoRESUMEN
Before admission to in-patient psychotherapeutic treatment 202 patients with schizophrenic or neurotic orders, partly with secondary alcohol or substance addiction, were investigated with a questionnaire concerning patients' expectations of psychotherapy: targets, expectations of therapeutic attitude and technique as well as therapeutic procedure (individuals or group therapy). The results are correlated with sociodemographic data and psychiatric disorders and compared with the patients who were not admitted to therapy and the results after discharge. Conclusions are made with regard to indication and adaptive patient-centered therapeutic proceeding.