RESUMO
OBJECTIVE: Communication between patients and mental health professionals by means of messaging platforms in the interval between synchronous encounters became a kind of asynchronous teleconsultation (AT) whose usefulness and effect on providers' workload have not been explored. Method: Mental health providers working in Argentina were invited to answer a survey exploring the intensity and usefulness of AT, and the resulting overload. RESULTS: A total of 527 responses from professionals working throughout the country were received. As much as 69% of respondents exchanged messages with a mean of 1-10 patients/day and 31% with more than 10 patients/day; 75% answered messages over mobile phones on weekends. While 68% rated these interactions as positive for clinical follow-up, 47% considered them as a source of work overload. CONCLUSIONS: The generalized adoption of AT may require additional self-regulation by clinicians and regular monitoring of overload levels (particularly, among psychiatrists) to make their daily clinical practice efficient and sustainable.
OBJETIVOS: La comunicación entre pacientes y profesionales de la salud mental mediante plataformas de mensa- jería en el intervalo entre encuentros presenciales o virtuales se convirtió en una modalidad de teleconsulta asincrónica (TA) cuya utilidad y efecto en la carga de trabajo de los profesionales de salud mental no se han explorado. Método: Profesionales del campo de la salud mental que trabajan en Argentina fueron invitados a responder a una encuesta que exploraba la intensidad y utilidad de la TA, y la sobrecarga resultante. RESULTADOS: Se recibieron un total de 527 respuestas de profesionales que trabajan en todo el país. El 69 % de los encuestados mensajes con un promedio de 1-10 pacientes/día y el 31 % con más de 10 pacientes/día; el 75 % respondió mensajes por teléfono móvil los fines de semana. Mientras que el 68 % calificó estas interacciones como positivas para el seguimiento clínico, el 47 % las consideró una fuente de sobrecarga laboral. CONCLUSIONES: La adopción generalizada de la TA puede requerir una autorregulación adicional por parte de los profesionales y un seguimiento regular de los niveles de sobrecarga (especialmente, entre los psiquiatras) para que su práctica clínica diaria sea eficiente y sostenible.
Assuntos
Psiquiatria , Psicologia , Argentina , Humanos , Aplicativos Móveis , Masculino , Feminino , Adulto , Serviços de Saúde Mental , Pesquisas sobre Atenção à Saúde , Pessoa de Meia-Idade , PsiquiatrasRESUMO
Several authors have taken up the challenge of demonstrating the influence of the social environment on mental health and questioning the hegemonic, individual and organicist psychiatric gaze, with the intention of constructing critical models of professional practice in which the subject is prime. This work proposes to study, on the one hand, the fundamental concepts of the sociologist Erving Goffman and, on the other, in the light of them, to expose the current operation of a psychiatric inpatient ward in a general hospital.
Varios autores han tomado el desafío de demostrar la influencia del medio social en la salud mental para cuestionar la mirada psiquiátrica hegemónica, individual y organicista, con la intención de construir modelos críticos de práctica profesional centrados en el sujeto. Este trabajo propone estudiar por un lado, los conceptos fundamentales del sociólogo Erving Goffman y por el otro a la luz de los mismos, exponer el funcionamiento actual de una sala de internación psiquiátrica en un hospital general.
Assuntos
Hospitalização , Hospitais Gerais , Humanos , Estudos RetrospectivosRESUMO
BACKGROUND AND OBJECTIVE: The analysis of Editorials is a little explored topic, which can facilitate the understanding of historical processes and changes in Psychiatry. In the case of de Vertex Revista Argentina de Psiquiatría, the Editorials were written by the same person for 30 years. The most frequently used thematic areas were studied, using graph theory, to characterize the orientation of the editorial lines. This analysis was complemented with semi-structured interviews with the Editor. METHOD: The most significant words of the Editorials were determined and analyzed through a system of graph theory, divided by lustrums. RESULTS: The thematic areas of the journal were concentrated in five main themes that were reiterated in each lustrum: Ethics, History, Mental Health, Psychiatry and, in the last two, Politics. The editorials showed different degrees of complexity, being those of the first 15 years simpler than the last ones. The recurrence tendencies of the thematic areas of the Editorials were related to expressions arising from the interviews. CONCLUSION: The analysis with graph theory has made it possible to visualize aspects of the de Vertex Revista Argentina de Psiquiatría Editorials, their degree of thematic complexity and how some themes were reiterated over and over again throughout the 30 years of the journal.
Assuntos
Psiquiatria , Argentina , Humanos , Saúde Mental , RedaçãoRESUMO
In this work we critically reflect on psychiatry and its various possibilities in a world in permanent change. We make a brief tour of some of the changes it has undergone through narrative, philosophical and epistemological contributions, asking ourselves the question of the future of the specialty in times when information takes away our freedom, making us feel, at the same time, falsely free. Finally, we propose a "rephilosophization" that places us once again in the world of those who think and think, of those who worry about asking themselves daily about the tools available for the clinic, without considering any of them as something already given, turned into doctrine or religion.
Assuntos
Psiquiatria , ConhecimentoRESUMO
Review of the book: The bell jar, of Sylvia Plath. Random House, 2020.
Reseña del libro: La campana de cristal, de Sylvia Plath. Literatura Random House, 2020.
Assuntos
Pessoas Famosas , Suicídio , HumanosRESUMO
Objectives: To explore the frequency of sociodemographic, clinical, and therapeutic variables of the Inpatient Psychiatric Unit at the Italian Hospital of Buenos. Introduction: Considering that the Inpatient Psychiatric Unit functions within a General Metropolitan Community Hospital, referent both at the local and the international level, we deem it relevant to perform an updated characterization of the population admitted into our Unit. This is especially important given the changes presented since the approval of the National Mental Health Law N° 26.657. Materials and Methods: We performed an observational descriptive and analytic cross-sectional study, studying the patients admitted into the Inpatient Psychiatric Unit for a period of 12 consecutive months (from October 1st, 2018, to September 30th, 2019). Results: During the study period a total of 254 hospitalizations were registered. Mean Age: 51,85 years (S.D.=21,23), Median hospitalization time 22 days [IQR=14.00, 34.00], 31.5% of the admissions were involuntary. The most frequent cause of hospitalization was due to depressive episodes (32.7%), psychosis (22.8%), and dementia/behavioral symptoms (13%). 10.6% of the patients were admitted into our Unit after a suicide attempt. Discussion: The present study provides an updated analysis of the hospitalized population. It contributes to outlining the changes that have taken place over the last years, because of the new legislation. Conclusions: The description of the epidemiologic characteristics of the inpatient population in our setting is crucial to have a current situation diagnosis that allows us to develop health-policy strategies and an adequate allocation of resources.
Objetivo: Explorar la frecuencia de diferentes variables sociodemográficas, clínicas y terapéuticas en los pacientes internados en la Sala de Psiquiatría del Hospital Italiano de Buenos Aires (HIBA). Introducción: Considerando que la Sala de Psiquiatría del HIBA se encuentra emplazada en un hospital general privado metropolitano de comunidad, referente a nivel nacional e internacional, resulta relevante realizar una descripción actualizada de la población usuaria de dicho dispositivo a la luz de los cambios producto de la sanción de la Ley Nacional de Salud Mental N° 26.657. Materiales y métodos: Se realizó un estudio observacional descriptivo y analítico de corte transversal de pacientes que fueron internados en la Sala de Psiquiatría del HIBA durante el período comprendido entre el 1 de octubre de 2018 hasta el 30 de septiembre de 2019 inclusive. Resultados: Durante el período del estudio se valoraron 254 internaciones. Edad promedio de 51,85 años (D.E.=21,23), Mediana de la duración de internación correspondió a 22 días [IQR=14.00, 34.00], siendo el 31.5% de las mismas de carácter involuntario. Los motivos de ingreso más frecuentes fueron: cuadros depresivos (32.7%), descompensación psicótica (22.8%) y demencia/síntomas conductuales (13%). El 10.6% de los pacientes ingresaron tras haber realizado una tentativa suicida. Discusión: El presente trabajo permite tener una noción actualizada de las características de los pacientes que atendemos en la Sala de Internación teniendo en cuenta los cambios en la legislación vigente y en la sociedad en su conjunto. Conclusiones: Caracterizar los determinantes epidemiológicos del patrón de internaciones psiquiátricas permite realizar diagnóstico de situación local y actualizado que favorecerá el desarrollar y repensar estrategias de planificación y gestión informadas.
Assuntos
Transtornos Mentais , Humanos , Argentina , Pacientes Internados , Hospitais Comunitários , Hospitais Gerais , HospitalizaçãoRESUMO
Vertex, Revista Argentina de Psiquiatría es una de las pocas publicaciones de la especialidad editadas en español que está incluida en PubMed. Durante los 30 años de existencia (1990 hasta el presente) ha sido dirigida por el Dr. Juan Carlos Stagnaro, quien es el autor exclusivo de los editoriales. Mediante el análisis de sus palabras clave y de extensas entrevistas semiestructuradas, este trabajo indaga sobre aspectos biográficos del joven Stagnaro para comprender la génesis de la revista, su impronta científico-política y las líneas editoriales que abordó. Se trabajó sobre los años de formación en la Argentina, el exilio en Francia durante la última dictadura militar y aspectos formativos en psiquiatría que le permitieron, al regreso a la Argentina, fundar la revista. (AU)
Vertex, Revista Argentina de Psiquiatría is one of the few journal of this specialty published in Spanish that is included in PubMed. During its 30 years of existence (1990 to present) it has been directed by Dr. Juan Carlos Stagnaro, who is the exclusive author of the editorials. Through the analysis of their keywords and extensive semi-structured interviews, this work investigates the biographical aspects of the young Stagnaro in order to understand the genesis of the journal, its scientific-political imprint and the editorial linesit addressed. The work describes the formative years in Argentina, the exile in France during the last military dictatorship and formative aspects in psychiatry that allowed him, upon his return to Argentina, to create the journal. (AU)
Assuntos
História do Século XX , História do Século XXI , Publicações Periódicas como Assunto/história , Psicologia/história , Saúde Mental/história , ArgentinaRESUMO
COVID-19 has accelerated the transformations of teleworking, generating conditions of great opportunities and terrible threats. The digital divide deepens inequities and exploitation, where the most unprotected countries and the most vulnerable populations are closer to the abyss Digital changes have formatted new modes of care, which are constantly changing and present new challenges to find their scope and limits.
Assuntos
COVID-19 , Comunicação , Humanos , Pandemias , SARS-CoV-2 , TeletrabalhoRESUMO
Introducción: el siguiente estudio tuvo como finalidad explorar algunas características demográficas asociadas al dolor crónico y el desarrollo de ideas de suicidio en una población de pacientes mayores de 65 años. Método: se realizó un estudio observacional y analítico de corte transversal mediante el relevamiento de datos a partir historias clínicas de pacientes mayores de 65 años que concurrieron a los consultorios externos del equipo de geriatría del Servicio de Psiquiatría del Hospital Italiano de Buenos Aires, entre junio de 2018 y diciembre de 2018. Resultados: se incluyó en el estudio un total de 222 pacientes, de los cuales 50 (23%) presentaron indicadores de dolor crónico y 33 pacientes (14,6%) lo hicieron de ideación suicida. Mediante estudio de correlación se estableció que estar ocupado, padecer dolor crónico y haber tenido más de una internación psiquiátrica son factores que incrementan el riesgo de presentar ideación suicida. Las variables ideación suicida, edad, y el estado civil âseparado o divorciado en comparación con estar casadoâ son factores asociados a la presencia de dolor crónico. Conclusiones: el dolor crónico y la ideación suicida son factores que contribuyen a aumentar la fragilidad en personas mayores y deben ser estudiados en mayor profundidad para comprender los distintos modos de expresión de la patología psiquiátrica en esta población. (AU)
Introduction: the following study aimed to explore some demographic characteristics associated with chronic pain and the development of suicidal ideas in a population of patients over 65 years. Method: an cross-sectional observational and analytical study was carried out by collecting data from clinical histories of patients over 65 years of age who attended the external offices of the geriatrics team of the Psychiatry service of the Italian Hospital of Buenos Aires between June 2018 and December 2018. Results: a total of 222 patients were included in the study, of which 50 (23%) presented indicators of chronic pain and 33 patients (14.6%) had suicidal ideation. A correlation study established that being employed, suffering from chronic pain and having had more than one psychiatric hospitalization are factors that increase the risk of presenting suicidal ideation. The variables suicidal ideation, age, and separated or divorced marital status compared to being married are factors associated with the presence of chronic pain. Conclusions: chronic pain and suicidal ideation are factors that contribute to increasing frailty in elderly patients and should be studied in greater depth to understand the different modes of expression of psychiatric pathology in this population. (AU)
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Ideação Suicida , Dor Crônica/epidemiologia , Argentina/epidemiologia , Psicotrópicos/uso terapêutico , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Pesar , Estudos Transversais , Fatores de Risco , Fatores Etários , Estado Civil/estatística & dados numéricos , Demência/psicologia , Dor Crônica/psicologia , Disfunção Cognitiva/psicologia , Fragilidade/psicologia , Psiquiatria Geriátrica/estatística & dados numéricosRESUMO
In this paper some ideas about the possible relationships between literature and psychiatry are presented. To carry out this task, the work "The initial form: conversations in Princeton" by the argentine writer Ricardo Piglia is analyzed, with the aim of installing a reflection on the current moment of the specialty.
Assuntos
Narração , PsiquiatriaRESUMO
This article analyzes various aspects of elder abuse. Subtypes of abuse, neglect and self-neglect are defned. The phenomenon is analyzed in the context of geriatric institutions, people with dementia, and among the gay, lesbian and trans people. The narrative model is used to exemplify various situations, using authors such as Irving, Ford and Lodge.
Assuntos
Abuso de Idosos , Idoso , Abuso de Idosos/classificação , Abuso de Idosos/prevenção & controle , Humanos , Fatores de TempoRESUMO
The aim of this work is to analyze the application of the concepts that originate in the narrative, to the learning and teaching of psychiatry. We will also explore how the reading and writing processes in the specialty are developed.
Assuntos
Narração , PsiquiatriaRESUMO
En esta presentación describiremos la aplicación de los siete principios de aprendizaje pleno, ideados por David Perkins, al trabajo y al aprendizaje en una sala de internación de psiquiatría en un hospital general. (AU)
This presentation will describe the application of David Perkins seven principles of teaching in the psychiatric unit of a General Hospital. (AU)
Assuntos
Humanos , Psiquiatria/educação , Educação Médica/métodos , Estudantes de Medicina , Conhecimento , AprendizagemRESUMO
In this presentation we will develop some ideas about possible relationships between literary narratives and psychiatry. To carry out this task we will analyze the work of some authors (Vila Matas, Guerriero, Kleinman, Franzen and others) in order to share a reflection on the current situation of psychiatry and medicine.