RESUMO
Particular issues concerning the meeting between psychiatrists and psychotherapists in patients' treatments are developed. Standing conceptions of mental illness, its etiopathogeny, the place of each therapist, and split transferences induced by combined treatment are discussed.
Assuntos
Comunicação Interdisciplinar , Relações Interprofissionais , Transtornos Mentais/terapia , Psiquiatria , Psicoterapia , HumanosRESUMO
Pharmacotherapy and psychotherapy have become fragmented from one another creating an artificial separation. We suggest that combining psychotherapy and pharmacotherapy may have advantages over either treatment alone in certain clinical situations, specially concerning bipolar patients' psychopatology. The one or two persons model remains controversial, but we emphasize the need for dialogue between the team or inside the clinician's mind in order to put together the self-fragments into a continuous narrative in the patients-life, avoiding the splitting tendencies. We think that a bilingual therapeutical way is desirable to improve treatment outcome.
Assuntos
Antimaníacos/uso terapêutico , Transtorno Bipolar/terapia , Psicoterapia , Terapia Combinada , HumanosRESUMO
Pharmacotherapy and psychotherapy have become fragmented from one another creating an artificial separation. We suggest that combining psychotherapy and pharmacotherapy may have advantages over either treatment alone in certain clinical situations, specially concerning bipolar patients psychopatology. The one or two persons model remains controversial, but we emphasize the need for dialogue between the team or inside the clinicians mind in order to put together the self-fragments into a continuous narrative in the patients-life, avoiding the splitting tendencies. We think that a bilingual therapeutical way is desirable to improve treatment outcome.
RESUMO
Pharmacotherapy and psychotherapy have become fragmented from one another creating an artificial separation. We suggest that combining psychotherapy and pharmacotherapy may have advantages over either treatment alone in certain clinical situations, specially concerning bipolar patients psychopatology. The one or two persons model remains controversial, but we emphasize the need for dialogue between the team or inside the clinicians mind in order to put together the self-fragments into a continuous narrative in the patients-life, avoiding the splitting tendencies. We think that a bilingual therapeutical way is desirable to improve treatment outcome.
RESUMO
UNLABELLED: The epidemiological projections show that the problems of Mental Health were the main health challenge during the last decade. This situation is particularly worring in our region. The poor operative data in relation to the care of the mental disorders prevent the elaboration of plans on the basis of secure data. METHODOLOGY: Records of externation were analized during the period between 1994-1998 in the men Psychiatric Internation Unity in the Psychopatology Service of the Hospital Piñero in Buenos Aires, which is part of the public health service of the city. RESULTS: an average time of internation of 42.8 days was reported (SD 40,3), which was higher than the 11 days reported in institutions of the private health services. An increasing proportional diagnosis of Bipolar Disorder was reported (chi square corresponding to tendencies P<0.01, lineality P<0.001) and a significative decline in the number of diagnosis of Schizophrenia (chi square corresponding to tendencies P<0.05; lineality P<0.05). In this way, the ratio of the diagnosis of Schizophrenia and Bipolar Disorder changed from 7:1 in 1994 to 1,7:1 in 1998. CONCLUSIONS: A variation in the diagnostic habits was observed, suggesting that affective disorders were underdiagnosticated. This tendency was corrected latter. Similar remarks made by other services in the same region support this interpretation of the data.
Assuntos
Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/reabilitação , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Adolescente , Adulto , Idoso , Argentina/epidemiologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/reabilitação , Área Programática de Saúde , Feminino , Hospitais Gerais/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Esquizofrenia/epidemiologia , Esquizofrenia/reabilitaçãoRESUMO
The epidemiological projections show that the problems of Mental Health were the main health challenge during the last decade. This situation is particularly worring in our region. The poor operative data in relation to the care of the mental disorders prevent the elaboration of plans on the basis of secure data. METHODOLOGY: Records of externation were analized during the period between 1994-1998 in the men Psychiatric Internation Unity in the Psychopatology Service of the Hospital Piñero in Buenos Aires, which is part of the public health service of the city. RESULTS: an average time of internation of 42.8 days was reported (SD 40,3), which was higher than the 11 days reported in institutions of the private health services. An increasing proportional diagnosis of Bipolar Disorder was reported (chi square corresponding to tendencies P<0.01, lineality P<0.001) and a significative decline in the number of diagnosis of Schizophrenia (chi square corresponding to tendencies P<0.05; lineality P<0.05). In this way, the ratio of the diagnosis of Schizophrenia and Bipolar Disorder changed from 7:1 in 1994 to 1,7:1 in 1998. CONCLUSIONS: A variation in the diagnostic habits was observed, suggesting that affective disorders were underdiagnosticated. This tendency was corrected latter. Similar remarks made by other services in the same region support this interpretation of the data.
RESUMO
The epidemiological projections show that the problems of Mental Health were the main health challenge during the last decade. This situation is particularly worring in our region. The poor operative data in relation to the care of the mental disorders prevent the elaboration of plans on the basis of secure data. METHODOLOGY: Records of externation were analized during the period between 1994-1998 in the men Psychiatric Internation Unity in the Psychopatology Service of the Hospital Piñero in Buenos Aires, which is part of the public health service of the city. RESULTS: an average time of internation of 42.8 days was reported (SD 40,3), which was higher than the 11 days reported in institutions of the private health services. An increasing proportional diagnosis of Bipolar Disorder was reported (chi square corresponding to tendencies P<0.01, lineality P<0.001) and a significative decline in the number of diagnosis of Schizophrenia (chi square corresponding to tendencies P<0.05; lineality P<0.05). In this way, the ratio of the diagnosis of Schizophrenia and Bipolar Disorder changed from 7:1 in 1994 to 1,7:1 in 1998. CONCLUSIONS: A variation in the diagnostic habits was observed, suggesting that affective disorders were underdiagnosticated. This tendency was corrected latter. Similar remarks made by other services in the same region support this interpretation of the data.