RESUMO

A comparison of safety, and efficiency of Alprazolam, Imipramine, and placebo in the treatment of panic disorder shows that both active drugs are significantly superior to placebo as regards therapeutic effectiveness. On a 77 patient sample, 62 completed an 8-week treatment, and 66 were considered as "assessable" for efficiency results after completing a 3-week treatment. Significantly, more placebo-treated patients than either Alprazolam, or Imipramine-treated patients dropped out trial, while the number of panic attacks was significantly reduced in both Alprazolam-, and Imipramine-treated groups. When trial was over, 96% of patients in Alprazolam group, and 95% of patients in Imipramine group were free from panic attacks, if compared to 65% in the placebo group. Generally speaking, drugs were well tolerated, and no serious adverse effects or life-threatening events were observed.

Assuntos

RESUMO

A comparison of safety, and efficiency of Alprazolam, Imipramine, and placebo in the treatment of panic disorder shows that both active drugs are significantly superior to placebo as regards therapeutic effectiveness. On a 77 patient sample, 62 completed an 8-week treatment, and 66 were considered as [quot ]assessable[quot ] for efficiency results after completing a 3-week treatment. Significantly, more placebo-treated patients than either Alprazolam, or Imipramine-treated patients dropped out trial, while the number of panic attacks was significantly reduced in both Alprazolam-, and Imipramine-treated groups. When trial was over, 96

of patients in Alprazolam group, and 95

of patients in Imipramine group were free from panic attacks, if compared to 65

in the placebo group. Generally speaking, drugs were well tolerated, and no serious adverse effects or life-threatening events were observed.

RESUMO

As part of the WHO Collaborative Study on Strategies for Extending Mental Health Care 259 families in four developing countries (Colombia, India, Sudan and the Philippines) were screened with regard to the social burden caused by mental illness of one of its members. Levels of subsistence, previous illness, financial burden, personal relations and social acceptance were studied. The social burden was greatest in the urban areas.

Assuntos

RESUMO

Two simple screening instruments for mental disorders in adults and children respectively were developed in the course of an evaluative study on mental health care in developing countries. Two research teams have attempted to use these same instruments as training tools for primary health care workers. Their experience has shown that the design of the instruments with short, easily understandable questions to which an answer "yes" or "no" can be given is also highly appropriate in the training situation and in daily work. The adaptation and use of these new training tools for primary health care workers in Manila (Philippines) and Cali (Colombia) is described.

Assuntos

Assuntos

RESUMO

About 90% of the 40 million victims of mental disorders in the developing countries receive no treatment, and little progress is being made in this respect. This article examines the use of new strategies for solving the problem. It is obvious that the traditional methods of mental health care have been ineffective and that new programs should now be undertaken that can ensure proper service within the coming decades for those being neglected. Based on the results of a practical experiment carried out in Colombia, the authors, without making any definitive recommendations, point to the usefulness of training auxiliary staff of urban and rural health centers to work as a team (under the supervision of a physician or a graduate nurse) in the care and management of psychiatric patients. They enumerate the advantages offered by training programs on various aspects of mental health for general practitioners (who usually have little interest in psychiatry), psychiatry residents, nurses, and auxiliaries.

Assuntos

RESUMO

To ascertain the frequency of mental disorders in Sudan, Philippines, India, and Columbia, 925 children attending primary health care facilities were studied. Rates of between 12% and 29% were found in the four study areas. The range of mental disorders diagnosed was similar to the encountered in industrialized countries. The research procedure involved a two-stage screening in which a ten-item "reporting questionnaire" constituted the first stage. The study has shown that mental disorders are common among children attending primary health care facilities in four developing countries and that accompanying adults (usually the mothers) readily recognize and report common psychologic and behavioral symptoms when these are solicited by means of a simple set of questions. Despite this, the primary health workers themselves recognized only between 10% and 22% of the cases of mental disorder. The result have been used to design appropriate brief training courses in childhood mental disorders for primary health workers in the countries participating in the study.

Assuntos

RESUMO

The paper describes the experience acquired during more than 8 years in carrying out primary mental health care in Cali, Colombia. It had already been shown that the use of trained paramedical personnel achieved some advantages to that of traditional approaches. The present programme is carried out in two different geographical areas (rural and urban) which provide care to about 10 per cent of their population. Although final clinical results are still not available, the basic approach entails the use of primary mental health agents (auxiliary nurses and health promotors) as the first step of assistance, ending in the top of the hierarchy, where a doctor and/or a trained nurse are responsible for the diagnoses. A trained psychiatrist acts only as a periodic consultant and as the main source for training. There is evidence to suggest that these primary mental health care agents have more time to talk to the patients and are more able to understand their local psycho-social circumstances. This system enables cheaper and more effective care services. Its advantages, risks and related problems are discussed, and mention is made for the need to maintain regular clinical assessment. The various training techniques are also discussed.

Assuntos

RESUMO

The paper describes the experience acquired during more than 8 years in carrying out primary mental health care in Cali, Colombia. It had already been shown that the use of trained paramedical personnel achieved some advantages to that of traditional approaches. The present programme is carried out in two different geographical areas (rural and urban) which provide care to about 10 per cent of their population. Although final clinical results are still not available, the basic approach entails the use of primary mental health agents (auxiliary nurses and health promotors) as the first step of assistance, ending in the top of the hierarchy, where a doctor and/or a trained nurse are responsible for the diagnoses. A trained psychiatrist acts only as a periodic consultant and as the main source for training. There is evidence to suggest that these primary mental health care agents have more time to talk to the patients and are more able to understand their local psycho-social circumstances. This system enables cheaper and more effective care services. Its advantages, risks and related problems are discussed, and mention is made for the need to maintain regular clinical assessment. The various training techniques are also discussed.

RESUMO

Mental Disorders constitute a severe Public Health problem in developing countries due to inadequate resources specially in terms of trained personnel; furthermore, Mental Health care is given out only in specialized Institutions where it has not been possible to provide coverage for more than a small part of the population. In this context the Collaborative Study on Strategies for the Extension of Mental Health Care has been planned, using as its guiding principle the recommendations of the WHO Expert Committee on Organization of Mental Health Services in Developing Countries (W.H.O. 1975). The objectives of the study are to determine the feasibility of introducing Mental Health Care directed toward defined priority conditions into general health services, to develop methods of selection for interventions in Mental Health Care as well as methods for task oriented training for health workers, to evaluate effectiveness of alternative low cost methods and to develop and evaluate ways of simulating community response to problems related to mental disorders. The areas selected are representative of the range of environments in developing countries in terms of overall socioeconomic and health status. In each area, actions will be directed towards making baseline observations and towards provision of care (planning, training, supervision and provision of referral channels). Specific interventions in the Cali area are described in regard to the training of the Health Center personnel in Mental Health, the provision of psychotropic drugs at the peri-urban level and provision of Mental Health Care by Primary Health Workers under the supervision of Health Center physicians and nurses.

Assuntos

RESUMO

Mental Disorders constitute a severe Public Health problem in developing countries due to inadequate resources specially in terms of trained personnel; furthermore, Mental Health care is given out only in specialized Institutions where it has not been possible to provide coverage for more than a small part of the population. In this context the Collaborative Study on Strategies for the Extension of Mental Health Care has been planned, using as its guiding principle the recommendations of the WHO Expert Committee on Organization of Mental Health Services in Developing Countries (W.H.O. 1975). The objectives of the study are to determine the feasibility of introducing Mental Health Care directed toward defined priority conditions into general health services, to develop methods of selection for interventions in Mental Health Care as well as methods for task oriented training for health workers, to evaluate effectiveness of alternative low cost methods and to develop and evaluate ways of simulating community response to problems related to mental disorders. The areas selected are representative of the range of environments in developing countries in terms of overall socioeconomic and health status. In each area, actions will be directed towards making baseline observations and towards provision of care (planning, training, supervision and provision of referral channels). Specific interventions in the Cali area are described in regard to the training of the Health Center personnel in Mental Health, the provision of psychotropic drugs at the peri-urban level and provision of Mental Health Care by Primary Health Workers under the supervision of Health Center physicians and nurses.

RESUMO

Mental Disorders constitute a severe Public Health problem in developing countries due to inadequate resources specially in terms of trained personnel; furthermore, Mental Health care is given out only in specialized Institutions where it has not been possible to provide coverage for more than a small part of the population. In this context the Collaborative Study on Strategies for the Extension of Mental Health Care has been planned, using as its guiding principle the recommendations of the WHO Expert Committee on Organization of Mental Health Services in Developing Countries (W.H.O. 1975). The objectives of the study are to determine the feasibility of introducing Mental Health Care directed toward defined priority conditions into general health services, to develop methods of selection for interventions in Mental Health Care as well as methods for task oriented training for health workers, to evaluate effectiveness of alternative low cost methods and to develop and evaluate ways of simulating community response to problems related to mental disorders. The areas selected are representative of the range of environments in developing countries in terms of overall socioeconomic and health status. In each area, actions will be directed towards making baseline observations and towards provision of care (planning, training, supervision and provision of referral channels). Specific interventions in the Cali area are described in regard to the training of the Health Center personnel in Mental Health, the provision of psychotropic drugs at the peri-urban level and provision of Mental Health Care by Primary Health Workers under the supervision of Health Center physicians and nurses.

RESUMO

This paper briefs a research on the influence of stressing environmental factors upon mental health conditions of university students. The study was undertaken at the Student Psychiatric Service, Universidad del Valle, Cali, Colombia. Three equal periods are compared. The first is a normal one; the others are disorderly and riotous, up to the point of foreing the discontinuance of academic activities for several months. As compared with the period of academic stability, the rates of mental disturbances show a steep rise in the periods of agitation. Schizophrenia, depression, anxiety, all kinds of difficulties in interpersonal relations, and somatic disturbances, are sharply increased, whereas complaints of less severe disturbances, like transient situational disorders, level up or decrease. Another significant rise is registered in the use of drugs for therapeutic purposes. The study leads to the conclusion that stress due to environmental disorders or social upheavals is an important factor in the aethiology of severe mental disturbances.

Assuntos

RESUMO

This paper briefs a research on the influence of stressing environmental factors upon mental health conditions of university students. The study was undertaken at the Student Psychiatric Service, Universidad del Valle, Cali, Colombia. Three equal periods are compared. The first is a normal one; the others are disorderly and riotous, up to the point of foreing the discontinuance of academic activities for several months. As compared with the period of academic stability, the rates of mental disturbances show a steep rise in the periods of agitation. Schizophrenia, depression, anxiety, all kinds of difficulties in interpersonal relations, and somatic disturbances, are sharply increased, whereas complaints of less severe disturbances, like transient situational disorders, level up or decrease. Another significant rise is registered in the use of drugs for therapeutic purposes. The study leads to the conclusion that stress due to environmental disorders or social upheavals is an important factor in the aethiology of severe mental disturbances.

RESUMO

This paper briefs a research on the influence of stressing environmental factors upon mental health conditions of university students. The study was undertaken at the Student Psychiatric Service, Universidad del Valle, Cali, Colombia. Three equal periods are compared. The first is a normal one; the others are disorderly and riotous, up to the point of foreing the discontinuance of academic activities for several months. As compared with the period of academic stability, the rates of mental disturbances show a steep rise in the periods of agitation. Schizophrenia, depression, anxiety, all kinds of difficulties in interpersonal relations, and somatic disturbances, are sharply increased, whereas complaints of less severe disturbances, like transient situational disorders, level up or decrease. Another significant rise is registered in the use of drugs for therapeutic purposes. The study leads to the conclusion that stress due to environmental disorders or social upheavals is an important factor in the aethiology of severe mental disturbances.