ABSTRACT
Psychosomatic medicine explores the psychological, behavioral, and social elements that influence people's health and quality of life. This discipline develops skills and knowledge used in the evalua tion and management of psychosocial elements interfering in the process of illness and healing. The Child and Adolescent Consultation-Liaison Psychiatry (CACLP) is a discipline that has been empi rically installed in order to favor adherence to treatments and recovery of children and teenagers du ring the process of illness. There is a need for developing this discipline in Chile, but so far there are limited national and international records and literature dedicated to it. The objective of this article is to update the concepts of structure and describe how a CACLP unit in a high complexity teaching hospital works in general, discussing the clinical challenges involved in these issues.
Subject(s)
Adolescent Psychiatry/organization & administration , Child Psychiatry/organization & administration , Hospitals, University/organization & administration , Mental Disorders/diagnosis , Mental Disorders/therapy , Psychosomatic Medicine/organization & administration , Referral and Consultation/organization & administration , Adolescent , Adolescent Psychiatry/methods , Child , Child Psychiatry/methods , Child, Preschool , Chile , Female , Humans , Infant , Infant, Newborn , Male , Psychosomatic Medicine/methodsABSTRACT
RESUMEN La condición neurológica definida por la aparición de alteraciones en la percepción, usualmente interpretada como fenómenos extraños de metamorfosis y despersonalización, se reconoce como síndrome de Alicia en el país de las maravillas. Se presenta el caso de una paciente femenina de 9 años de edad, con el diagnóstico de síndrome de Alicia en el país de las maravillas secundario a medicación crónica con montelukast. El diagnóstico del síndrome psiquiátrico se realizó teniendo en consideración los antecedentes patológicos personales y el examen físico. El síndrome de Alicia en el país de las maravillas tiene un carácter benigno, sumamente infrecuente, y aunque su etiología no es del todo conocida, su aparición como reacción adversa a medicamentos es una opción que debe ser siempre considerada por el médico actuante (AU).
ABSTRACT The neurological condition defined by the appearance of alterations in perception usually interpreted as strange phenomena of metamorphosis and depersonalization is recognized as Alice in wonderland syndrome. The case of a 9-year-old female patient is presented, with the diagnosis of Alice in Wonderland syndrome secondary to chronic medication with montelukast. The diagnosis of the psychiatric syndrome was made taking into account personal pathological history and physical examination. Alice in Wonderland syndrome has a benign, extremely rare character and although its etiology is not fully known, its appearance, as an adverse reaction to medications, is an option that should always be considered by the acting physician (AU).
Subject(s)
Humans , Male , Female , Child , Drug-Related Side Effects and Adverse Reactions/complications , Alice in Wonderland Syndrome/chemically induced , Asthma/drug therapy , Case Reports , Child , Child Psychiatry/methods , Child Psychiatry/standards , Alice in Wonderland Syndrome/diagnosis , Alice in Wonderland Syndrome/etiology , Alice in Wonderland Syndrome/pathology , Alice in Wonderland Syndrome/psychologyABSTRACT
OBJECTIVE: to identify the knowledge of professionals of mental health services and social work on Behavior Disorders (BD) in childhood and adolescence, and to analyze their actions in care for children and adolescents with such disorders. METHOD: a qualitative, descriptive-exploratory study with 13 professionals from two mental health services and two tutorial councils. The data were collected in interviews and submitted to thematic content analysis. RESULTS: three categories emerged from the interviews: "Knowledge about behavior disorders", which defines BD as deviations from normality and lack of limits. "Integrated and group care", which explains the integrated, multidisciplinary and group actions. "Specialized and legal care", which explains the actions through specialized, medical and judicial care. FINAL CONSIDERATIONS: the results point out weaknesses and knowledge gaps of professionals, causing potential harm in the programming of effective actions, such as identification, referral and therapeutic planning.
Subject(s)
Clinical Competence/standards , Health Personnel/standards , Mental Disorders/therapy , Social Work/standards , Adolescent , Child , Child Psychiatry/methods , Clinical Competence/statistics & numerical data , Female , Health Personnel/statistics & numerical data , Humans , Male , Mental Disorders/psychology , Mental Health Services , Qualitative Research , Social Work/methods , Social Work/statistics & numerical dataABSTRACT
ABSTRACT Objective: to identify the knowledge of professionals of mental health services and social work on Behavior Disorders (BD) in childhood and adolescence, and to analyze their actions in care for children and adolescents with such disorders. Method: a qualitative, descriptive-exploratory study with 13 professionals from two mental health services and two tutorial councils. The data were collected in interviews and submitted to thematic content analysis. Results: three categories emerged from the interviews: "Knowledge about behavior disorders", which defines BD as deviations from normality and lack of limits. "Integrated and group care", which explains the integrated, multidisciplinary and group actions. "Specialized and legal care", which explains the actions through specialized, medical and judicial care. Final considerations: the results point out weaknesses and knowledge gaps of professionals, causing potential harm in the programming of effective actions, such as identification, referral and therapeutic planning.
RESUMEN Objetivo: identificar los conocimientos de los profesionales de los servicios de salud mental y asistencia social en Trastornos de la Conducta (TC) en la infancia y la adolescencia, y analizar sus acciones en la atención a niños y adolescentes con tales trastornos. Método: estudio cualitativo, descriptivo-exploratorio con 13 profesionales de dos servicios de salud mental y dos consejos de tutoría. Los datos fueron recolectados en entrevistas y sometidos a análisis de contenido temático. Resultados: de las entrevistas surgieron tres categorías: "Conocimiento sobre trastornos de conducta", que define la TC como desviaciones de la normalidad y la falta de límites. "Atención integrada y grupal", que explica las acciones integradas, multidisciplinares y grupales. "Atención especializada y jurídica", que explica las acciones a través de la atención especializada, médica y judicial. Consideraciones finales: los resultados señalan las debilidades y las brechas de conocimiento de los profesionales, causando un daño potencial en la programación de acciones efectivas, como la identificación, la referencia y la planificación terapéutica.
RESUMO Objetivo: identificar o conhecimento dos profissionais de serviços de saúde mental e assistência social sobre os Transtornos de Comportamento (TC) na infância e adolescência, e analisar suas ações na atenção a crianças e adolescentes com tais transtornos. Método: estudo qualitativo, descritivo-exploratório com 13 profissionais de dois serviços de saúde mental e dois conselhos tutelares. Os dados foram coletados em entrevistas e submetidos à análise de conteúdo temático. Resultados: três categorias emergiram das entrevistas: "Conhecimentos acerca dos transtornos de comportamento", que define os TC como desvios da normalidade e falta de limites. "O cuidado integrado e em grupo", que explica as ações integradas, multidisciplinares e através de grupos. "O cuidado especializado e jurídico", que explica as ações através do cuidado especializado, medicamentoso e judicial. Considerações finais: os resultados apontam fragilidades e lacunas de conhecimento dos profissionais acarretando potenciais prejuízos na programação de ações eficazes, como identificação, encaminhamento e planejamento terapêutico.
Subject(s)
Adolescent , Child , Female , Humans , Male , Social Work/standards , Clinical Competence/standards , Health Personnel/standards , Mental Disorders/therapy , Social Work/statistics & numerical data , Social Work/methods , Child Psychiatry/methods , Clinical Competence/statistics & numerical data , Health Personnel/statistics & numerical data , Qualitative Research , Mental Disorders/psychology , Mental Health ServicesABSTRACT
OBJECTIVES: Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that consists of applying a weak electric current over the scalp to modulate cortical excitability. tDCS has been extensively investigated in adults with psychiatric disorders. The aim of this study was to review the current literature regarding the use of tDCS in children and adolescents with psychiatric disorders. METHODS: We searched MEDLINE and EMBASE databases for studies evaluating the safety and efficacy of tDCS in children and adolescents from age 0 to 18 years with psychiatric disorders. RESULTS: We found six studies that evaluated patients with different psychiatric disorders, with diverse study designs and stimulation parameters, including three small randomized clinical trials (RCTs), one evaluating childhood-onset schizophrenia, one RCT with patients with autism spectrum disorders (ASD), and one study in attention-deficit/hyperactivity disorder (ADHD); three open-label studies, two evaluating patients with ASD, and one study of feasibility of the technique in children and adolescents with language disorders and diverse psychiatric disorders, including ASD, intellectual disability, and ADHD. We also found three studies of dosage considerations in the general pediatric population. The technique was well tolerated, with no reports of serious side effects. CONCLUSION: Preliminary research suggests that tDCS may be well tolerated and safe for children and adolescents with psychiatric and neurodevelopmental disorders. Nevertheless, because the literature regarding tDCS in child and adolescent psychiatry is scarce and there exist limited numbers of randomized controlled trials, it is not possible to draw definite conclusions. Future studies should investigate the technique with regard to specific psychiatric conditions in comparison with standard treatments. In addition, long-term efficacy and safety should be monitored.
Subject(s)
Mental Disorders/therapy , Transcranial Direct Current Stimulation/methods , Adolescent , Adolescent Psychiatry/methods , Attention Deficit Disorder with Hyperactivity/therapy , Autism Spectrum Disorder/therapy , Child , Child Psychiatry/methods , Child, Preschool , Humans , Mental Disorders/physiopathology , Randomized Controlled Trials as Topic , Schizophrenia, Childhood/therapy , Transcranial Direct Current Stimulation/adverse effectsSubject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Child Development , Child Psychiatry/methods , Psychology, Child , Life Cycle Stages , Family/psychology , Human DevelopmentABSTRACT
O termo agitação pode englobar muitos comportamentos diferentes, geralmente associados a algum transtorno psiquiátrico, como transtorno de déficit de atenção e hiperatividade (TDAH), transtorno de conduta, transtorno afetivo bipolar (TAB). Uma dúvida frequente é quando considerar a agitação psicomotora parte do desenvolvimento normal infantil ou de alguma doença psiquiátrica. A patologia existe quando a fase de agitação persiste além do esperado para a idade e circunstância, há prejuízo funcional importante nas relações sociais dentro da família, com pares e no desempenho escolar, além da presença de outros sintomas. Apesar da influência genética, a grande capacidade de adaptação do cérebro na infância e adolescência permite que as experiências infantis tenham efeito duradouro nos circuitos neurais por toda a vida, reforçando a importância de um ambiente favorável e do tratamento medicamentoso e psicoterápico adequado, nesta faixa etária. O foco da intervenção deve ser ensinar comportamentos pró-sociais, para que a criança/adolescente lide adequadamente com as situações que anteriormente provocavam agitação, envolvendo a colaboração de pais, pares, escola e demais profissionais.
Subject(s)
Humans , Male , Female , Child , Adolescent , Psychomotor Agitation/diagnosis , Psychomotor Agitation/psychology , Psychomotor Agitation/therapy , Behavior , Child Psychiatry/methodsABSTRACT
La presencia de síntomas obsesivo-compulsivos en los niños con trastornos del espectro autista parece elevada. Dado que estos pacientes podrían beneficiarse con el tratamiento convencional del trastorno obsesivo-compulsivo, se requiere un importante índice de presunción para la detección de esta comorbilidad.
Subject(s)
Humans , Male , Female , Child , Child Psychiatry/instrumentation , Child Psychiatry/methods , Autistic Disorder/diagnosis , Autistic Disorder/rehabilitation , Autistic Disorder/therapy , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/therapyABSTRACT
Neste artigo apresentamos o método de trabalho desenvolvido em um ambulatório público especializado no atendimento psicanalítico de crianças, relatando o caso clínico de uma menina de cinco anos. Este estudo mostra a importância de uma metodologia específica para o tratamento psicanalítico da criança, onde a criança e os seus pais são atendidos pelo mesmo psicólogo, em horários diferentes. As conclusões apontam a relevância desta modalidade de atendimento para a saúde mental da criança.
Based in the case of a five-year-old girl, we present here a working method developed at a public clinic specialized in the psychoanalysis of children. We discuss the importance of a specific methodology for psychoanalytic treatment of children, whereby both children and parents are treated separately by the same psychologist. The conclusions indicate the usefulness of this approach for the childrens mental health.
En este artículo presentamos el método de trabajo desarrollado en un ambulatorio público especializado en la atención psicoanalítica de niños, relatando el caso clínico de una metodología específica, donde el niño y sus padres son atendidos por la misma psicóloga, en horarios diferentes. Los resultados muestran la relevancia de esta modalidad de tratamiento para la salud mental de los niños.
Dans cet article, nous présentons la méthode de travail développé dans une clinique publique specialisée dans le soin psychanalytique des enfants à travers le rapport du cas clinique dune fille de cinq ans. Cette étude montre limportance dune méthodologie spécifique au traitement psychanalytique de lenfant, où elle et ses parents sont accueillis par même psychologue à des moments différents. Les résultats montrent la pertinence de cette modalitpe de traitement pour la santé mentale de lenfant.
Subject(s)
Humans , Child , Parent-Child Relations , Child Psychiatry/methodsABSTRACT
Neste artigo apresentamos o método de trabalho desenvolvido em um ambulatório público especializado no atendimento psicanalítico de crianças, relatando o caso clínico de uma menina de cinco anos. Este estudo mostra a importância de uma metodologia específica para o tratamento psicanalítico da criança, onde a criança e os seus pais são atendidos pelo mesmo psicólogo, em horários diferentes. As conclusões apontam a relevância desta modalidade de atendimento para a saúde mental da criança.AU
Based in the case of a five-year-old girl, we present here a working method developed at a public clinic specialized in the psychoanalysis of children. We discuss the importance of a specific methodology for psychoanalytic treatment of children, whereby both children and parents are treated separately by the same psychologist. The conclusions indicate the usefulness of this approach for the childrens mental health.AU
En este artículo presentamos el método de trabajo desarrollado en un ambulatorio público especializado en la atención psicoanalítica de niños, relatando el caso clínico de una metodología específica, donde el niño y sus padres son atendidos por la misma psicóloga, en horarios diferentes. Los resultados muestran la relevancia de esta modalidad de tratamiento para la salud mental de los niños.AU
Dans cet article, nous présentons la méthode de travail développé dans une clinique publique specialisée dans le soin psychanalytique des enfants à travers le rapport du cas clinique dune fille de cinq ans. Cette étude montre limportance dune méthodologie spécifique au traitement psychanalytique de lenfant, où elle et ses parents sont accueillis par même psychologue à des moments différents. Les résultats montrent la pertinence de cette modalitpe de traitement pour la santé mentale de lenfant.AU
Subject(s)
Humans , Child , Child Psychiatry/methods , Parent-Child RelationsSubject(s)
Humans , Male , Female , Child , Education, Medical/history , Education, Medical/methods , Mental Health/history , Child Psychiatry/methodsABSTRACT
Puesto que la sintomatología más evidente de este síndrome está dada por la falta o perturbación de la comunicación, habla, lenguaje y sensopercepción, su estudio y tratamiento constituyen un desafío que ha sido recogido por numerosos científicos de distintas disciplinas. Esta circunstancia y la diversidad de escuelas en las que ellos se basan han permitido la introducción de criterios diversos en el manejo del niño autista, los que son vertidos en el presente trabajo de modo que el terapeuta de la voz pueda inferir sus propias conclusiones. La opinión de la autora, por su parte, se basa sobre 15 años de experiencia adquirida a partir de los primeros pacientes estudiados en el Hospital Fernández y de los numerosos diagnósticos de niños autistas efectuados en el CEMIFA durante los últimos 12 años
Subject(s)
Humans , Child , Child Psychiatry/methods , Autistic Disorder/rehabilitation , Communication Disorders , Language Disorders , Pediatrics , Psychiatry , Autistic Disorder/psychology , Autistic Disorder/therapy , Mental Disorders/diagnosis , Communication Disorders/etiology , Communication Disorders/psychology , Communication Disorders/rehabilitation , Language Disorders/etiology , Language Disorders/physiopathology , Language Disorders/therapyABSTRACT
Puesto que la sintomatología más evidente de este síndrome está dada por la falta o perturbación de la comunicación, habla, lenguaje y sensopercepción, su estudio y tratamiento constituyen un desafío que ha sido recogido por numerosos científicos de distintas disciplinas. Esta circunstancia y la diversidad de escuelas en las que ellos se basan han permitido la introducción de criterios diversos en el manejo del niño autista, los que son vertidos en el presente trabajo de modo que el terapeuta de la voz pueda inferir sus propias conclusiones. La opinión de la autora, por su parte, se basa sobre 15 años de experiencia adquirida a partir de los primeros pacientes estudiados en el Hospital Fernández y de los numerosos diagnósticos de niños autistas efectuados en el CEMIFA durante los últimos 12 años