[Health consequences of violence against women by the couple]. / Consecuencias para la salud de la violencia contra la mujer por la pareja.

Intimate partner violence against women (IPV) has devastating effects on the healthcare and well-being of women and their children. Physical, psychological, and social consequences, a worse perception of their own health, and loss of quality of life are well-documented, while aftereffects persist in time even after the end of abuse. Psychological consequences of abuse last longer and are more serious. IPV also affects sons and daughters, disabled people, family, and the attacker himself. Many health problems, both physical and mental, that lead women to go to healthcare services in search of help have an origin in the violence they experience. Treatment of the symptoms without awareness of its relation to such violence favours medicalization, iatrogenesis, and chronification. Psychological violence poses a threat that is invisible, subtle, cumulative, and difficult to detect; it is, however, the most destructive.

[Tree decision analysis of the therapeutic alternatives for Panic Disorders in Primary Care]. / Análisis de las alternativas terapéuticas del trastorno de pánico en atención primaria mediante un árbol de decisión.

AIMS: To analyse the different therapeutic alternatives for Panic Disorders to make it easier to make collaborative treatment decisions between patients and doctors in a Primary Care setting. DESIGN: Quantitative analysis by a decision tree. DATA SOURCES: Time period reviewed; 1990-2008 in Med-line, Embase, Cochrane-plus Library and Tripdatabase. Terms used "panic disorder", "psychotherapy" and "drug therapy". METHODS: I) A decision tree was prepared with only one therapeutic option in each arm; II) The same procedure with two sequential therapeutic options; III) Sensitivity analysis to test the robustness of the model. STUDY SELECTION: Evidence summary, systematic reviews, meta-analysis and clinical guidelines. RESULTS: Cognitive-Behavioural Therapy (CBT) obtains the highest usefulness (UME=0.58), followed by the Selective serotonin reuptake inhibitors (SSRI) (UME=0.53) and by the tricyclic antidepressants (UME=0.44). CBT followed by SSRI is the therapeutic sequence with the highest usefulness (0.62). The sensitivity analysis suggests the model is not robust enough. CONCLUSIONS: The CBT in monotherapy or followed by SSRI in a sequential strategy would be the options with the highest usefulness. The results are not robust enough because they can clearly vary with changes in the most important variables in a reasonable range.