ABSTRACT
Objective: To assess the effectiveness of a cognitive-behavioral therapy-based intervention (Superwellness Program) on weight gain compared with a treatment-as-usual (TAU) approach in patients treated with antipsychotics, and to evaluate the relationship between body mass index (BMI) variation and clinical variables. Method: Eighty-five patients treated with antipsychotics were allocated across two groups, experimental (n=59) and control (n=26). The Superwellness Program (experimental group) consisted of 32 twice-weekly 1-hour sessions, conducted by a psychologist and a nutritionist/nurse, concurrently with moderate food intake and moderate physical activity plans. Sociodemographic, clinical, and biological variables were collected at baseline, at the end of intervention (16 weeks), and after 6 months. Results: BMI change from baseline differed significantly between the experimental and control groups, with a larger decrease in the experimental group (F = 5.5, p = 0.021). Duration of illness moderated the effect of treatment on BMI (p = 0.026). No significant (p = 0.499) effect of intervention during the follow-up period was found. Interestingly, the intervention indirectly induced a significant (p = 0.024) reduction in metabolic risk by reducing BMI. Conclusion: A cognitive-behavioral therapy-based intervention could be useful in reducing weight in a clinical population taking antipsychotics, with consequent benefit to physical and mental health.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Psychotherapy, Group/methods , Antipsychotic Agents/adverse effects , Cognitive Behavioral Therapy/methods , Weight Reduction Programs/methods , Health Promotion/methods , Schizophrenia/therapy , Body Mass Index , Prospective Studies , Follow-Up Studies , Obesity/etiology , Obesity/therapyABSTRACT
OBJECTIVE:: To assess the effectiveness of a cognitive-behavioral therapy-based intervention (Superwellness Program) on weight gain compared with a treatment-as-usual (TAU) approach in patients treated with antipsychotics, and to evaluate the relationship between body mass index (BMI) variation and clinical variables. METHOD:: Eighty-five patients treated with antipsychotics were allocated across two groups, experimental (n=59) and control (n=26). The Superwellness Program (experimental group) consisted of 32 twice-weekly 1-hour sessions, conducted by a psychologist and a nutritionist/nurse, concurrently with moderate food intake and moderate physical activity plans. Sociodemographic, clinical, and biological variables were collected at baseline, at the end of intervention (16 weeks), and after 6 months. RESULTS:: BMI change from baseline differed significantly between the experimental and control groups, with a larger decrease in the experimental group (F = 5.5, p = 0.021). Duration of illness moderated the effect of treatment on BMI (p = 0.026). No significant (p = 0.499) effect of intervention during the follow-up period was found. Interestingly, the intervention indirectly induced a significant (p = 0.024) reduction in metabolic risk by reducing BMI. CONCLUSION:: A cognitive-behavioral therapy-based intervention could be useful in reducing weight in a clinical population taking antipsychotics, with consequent benefit to physical and mental health.
Subject(s)
Antipsychotic Agents/adverse effects , Cognitive Behavioral Therapy/methods , Health Promotion/methods , Psychotherapy, Group/methods , Weight Reduction Programs/methods , Adult , Aged , Body Mass Index , Female , Follow-Up Studies , Humans , Male , Middle Aged , Obesity/etiology , Obesity/therapy , Prospective Studies , Schizophrenia/therapyABSTRACT
Se efectúa evaluación psiquiátrica de los pacientes en hemodiálisis en la Unidad de Diálisis del Hospital San Juan de Dios (Septiembr 1986). Se apreciaron diferencias estadísticamente significativas entre los puntajes obtenidos en el cuestionario de Sistemas generales (GHQ-28) según sexo. Las mujeres obtuvieron los mayores puntajes, lo que se asoció a un menor tiempo de tratamiento, inestabilidad de pareja y edad. En los hombres se estableció una estrecha correlacción con el apoyo del grupo familiar, la edad y el grado de neuroticidad. Se analizan los resultados de acuerdo a los antecedentes aportados por la literatura y se plantean estrategias terapéuticas
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Renal Dialysis/psychology , Evaluation StudyABSTRACT
Se presentan 5 casos de neurosífilis diagnosticados en el Servicio A del Hospital Psiquiátrico entre los años 1983 y 1986. Todos eran hombres con edades entre 33 y 67 años. Tres de ellos eran alcohólicos crónicos. Sus diagnósticos de ingreso fueron psicosis exógena o psicosis paranoidea. Las manifestaciones clínicas más frecuentes fueron alteraciones del lenguaje y de la memoria, desorientación temporoespacial y compromiso importante del estado general con marcado enflaquecimiento. En todos los casos hubo serología positiva y reacciones para lúes también positivas en el LCR en el cual también se detectaron alteraciones citoquímicas. El electroencefalograma y los exámenes de imágenes demostraron compromiso cerebral difuso con atrofia cortical de predominio frontal. El tratamiento recomendado es penicilina sódica en dosis de 12 a 24 millones de unidades por 20 a 40 días. Los controles de LCR deben hacerse a los 20 días; entre los 3 y 6 meses y luego una vez al año por 5 años
Subject(s)
Adult , Middle Aged , Humans , Male , Hospitals, Psychiatric , Neurosyphilis/diagnosis , Serologic Tests , Alcoholism , Chile , Electroencephalography , Cerebrospinal Fluid/analysis , Neurosyphilis/drug therapy , Paranoid Disorders/diagnosis , Penicillins/therapeutic useABSTRACT
Se estudiaron 10 pacientes portadores de alopecia areata mediante evaluación clínica y tests proyectivos de personalidad con el propósito de determinar si la alopecia areata cumple con los requisitos definidos por Mc Dougall para considerar una enfermedad como psicosomática. Se concluye que la alopecia areata cumple con dichos criterios, por tratarse de un cuadro con manifestaciones orgánicas desarrolladas en el contexto de un determinado modo de ser, que se ha visto sometido a la sobrecarga de acontecimientos biográficos pertubadores que han llevado a un estado conflictual no superado