RESUMO
Exposure to traumatic events is frequent in the general population and psychiatric sequelae such as post-traumatic stress disorders are common. The symptoms of psychiatric sequelae after trauma are vague, with multiple psychological and physical symptoms, which can confuse the health care professional. This paper seeks to facilitate the work in primary care, providing practical information about the diagnosis, initial management and referral of patients who have suffered traumatic experiences. Some early interventions and treatments are suggested.
Assuntos
Humanos , Atenção Primária à Saúde , Transtornos de Estresse Pós-Traumáticos/terapia , Trauma Psicológico/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Gerenciamento Clínico , Trauma Psicológico/psicologiaRESUMO
One of the most important topics mentioned by people from places affected by the February 27th, 2010 earthquake to the Presidential Delegation for the Reconstruction, was the urgent need of mental health care. Given the enormous individual and social burden of mental health sequelae after disasters, its treatment becomes a critical issue. In this article, we propose several actions to be implemented in Chile in the context of the process of recovery and reconstruction, including optimization of social communication and media response to disasters; designing and deployment of a national strategy for volunteer service; training of primary care staff in screening and initial management of post-traumatic stress reactions; and training, continuous education and clinical supervision of a critical number of therapists in evidence-based therapies for conditions specifically related to stress.
Assuntos
Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia , Serviços Comunitários de Saúde Mental/organização & administração , Planejamento em Desastres/organização & administração , Terremotos , Transtornos de Estresse Pós-Traumáticos/reabilitação , Voluntários/educação , Chile , Serviços Comunitários de Saúde Mental/normas , Intervenção em Crise , Capacitação em ServiçoAssuntos
Humanos , Medicina de Desastres/educação , Planejamento em Desastres , Educação Médica , Medicina de Emergência/educação , Saúde Pública/educação , Desastres/economia , Desastres/estatística & dados numéricos , América Latina , Faculdades de Medicina/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Universidades/estatística & dados numéricosAssuntos
Humanos , Terremotos , Programas Nacionais de Saúde , Apoio Social , Transtornos de Estresse Pós-Traumáticos , Chile/epidemiologia , Programas Nacionais de Saúde/organização & administração , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Estresse Psicológico/terapiaRESUMO
A search for meta analyses and systematic reviews on psychological support to disaster victims was carried out to devise a local support model. Based on 36 meta analyses and systematic reviews, the support should be carried out in five echelon levels: diffusion, social support, general medical care, general psychiatric care and psychiatric care carried out by experts. Only victims with well-established formal psychiatric disorders should receive psychotherapy or psychotropic medication. The rest should only receive psychological first aid. According to the best evidence available, a model for psychological care is proposed.