RESUMO
BACKGROUND: Mental disorders may interfere, aggravate or mimic medical conditions. AIM: To study the prevalence of psychiatric disorders among patients hospitalized in a medical ward of a general hospital. PATIENTS AND METHODS: A structured interview for DSM-III, devised for "non patients", was applied to 203 men and 203 women, aged 11 to 90 years old, hospitalized in an internal medicine service of a public hospital. Thirty four psychiatric conditions that can be discriminated with the instrument and others that complied with DSM-III criteria, were investigated. RESULTS: There was a 60% prevalence of mental disorders among men (alcohol dependency in 26%, delirium or dementia in 10.8%, anxiety disorders in 10.4%, major depression in 7.8% and adaptation disorders in 3%). Among women, the prevalence of mental disorders was 65% (major depression in 23.2%, anxiety disorders in 14.3%, adaptation disorders in 8.4%, dementia in 5.6%, delirium in 3% and alcohol dependency in 2.5%). Most conditions were of moderate or mild intensity. Two or more conditions coexisted in 40% of cases. Only in 8% of these subjects, a psychiatric consultation was requested. CONCLUSIONS: There is a high frequency of psychiatric disorders among medical patients. These must be adequately diagnosed and treated.
Assuntos
Hospitalização , Transtornos Mentais/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Chile/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Entrevista Psiquiátrica Padronizada , Pessoa de Meia-Idade , PrevalênciaRESUMO
The biomedical model has successfully reduced mother and child mortality and diseases during the labor and puerperal period. In the perinatal period, the mother and her offspring can also have psychosocial problems, that have been insufficiently studied and that we propose considering. Based on neurobiological information, on bonding theory and on a focus change in the everyday work of human behavior experts in maternity hospitals, we propose that perinatal mental health should have an important place and can be harmoniously articulated with the biomedical model. This mental health work should aim at generating safe mother-child bonds. It should be maintained Thereafter through social networks to prevent child abuse, to promote healthy development and to prevent psychopathology. We review some of the programs carried out in the ten year period in which we have worked as a mental health team in the maternity ward of a public hospital in Santiago, Chile.
Assuntos
Parto Obstétrico/psicologia , Recém-Nascido/psicologia , Saúde Mental , Mães/psicologia , Apego ao Objeto , Período Pós-Parto/psicologia , Adulto , Feminino , Humanos , Assistência Perinatal , Gravidez , Apoio SocialRESUMO
The purpose of this work was to construct and assess a scale aimed to detect risky relationships between mothers and newborns that could predict future child abuse and neglect. The instrument was applied in two opportunities, by a trained midwife and by an expert in mental health, to a sample of 106 mother-newborn dyads. When both assessments were compared, the concordance to assess relationship risk was 99.3%. The reliability of the scale, measured with the Crombach, an internal consistence index, was 0.88. Those items with a low discriminative capacity were eliminated. The massive use of the resultant scale, that is easy to apply and highly reliable, could help to prevent child abuse and neglect.