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Abstract Introduction The demographic and epidemiological transition, as well as the aging population has changed how older adults are treated in our healthcare system. Objective To establish the sociodemographic and clinical characteristics of the patients from the Psychogeriatric Clinic (PC) of the Ramón de la Fuente Muñiz National Institute of Psychiatry (INPRFM) seen between January 1, 2011, and December 31, 2020. Method Descriptive, observational, cross-sectional, retrospective study. A database was created with the information from digital clinical records. No additional scales were used. Statistical analysis performed in SPSS 20.0. Results 2056 records were found, 1247 met the inclusion criteria. The mean age was 74.28 years, women 73.46% (n = 916), primary school 46.62% (n = 427), married 35.70% (n = 327), urban area 93.99% (n = 1172), home-based 78.28% (n = 717), low socioeconomic level 59.99% (n = 522). The most common psychiatric pathology was depressive disorders 62.07% (n = 774) and neurocognitive disorders 37.52% (n = 468) due to Alzheimer's disease 17.08% (n = 213), with Mini-Mental State Examination of 18.88 points (± 6.68). They had comorbidities such as arterial hypertension 52.85% (n = 659), diabetes mellitus 23.34% (n = 291) and had a geriatric syndrome in 64.42% (n = 218). Discussion and conclusion Aging in Mexico affects the female population the most. The analysis report from the prevalence for psychogeriatric pathologies of the PC it's for of its kind. The main goal is promoting research on dementias and highlighting the magnitude of the problem for Latin American governments. The results are not intended to be extrapolated to the general population.
Resumen Introducción La transición demográfica y epidemiológica, el subsecuente envejecimiento poblacional, produjeron cambios en los sistemas de salud y cómo se atiende a los adultos mayores. Objetivo Establecer las características sociodemográficas y clínicas de los pacientes de la Clínica de Psicogeriatría (CP) del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (INPRFM) que acudieron entre el 1 enero de 2011 y 31 diciembre de 2020. Método Estudio descriptivo, observacional, corte transversal, retrospectivo. Se creó una base de datos con la información de los expedientes clínicos digitales. No se utilizó ninguna escala adicional. Análisis estadístico realizado en SPSS 20.0. Resultados Se encontraron 2056 registros, 1247 cumplieron los criterios de inclusión. Edad media 74.28 años, mujeres 73.46% (n = 916), primaria 46.62% (n = 427), casadas 35.70% (n = 327), área urbana 93.99% (n = 1172), ocupación hogar 78.28% (n = 717), nivel socioeconómico bajo 59.99% (n = 522). La patología psiquiátrica más común fueron los trastornos depresivos 62.07% (n = 774) y trastorno neurocognitivo 37.52% (n = 468), por enfermedad de Alzheimer 17.08% (n = 213), con MMSE de 18.88 puntos (± 6.68). Con comorbilidades como hipertensión arterial 52.85% (n = 659), diabetes mellitus 23.34% (n = 291) y tenían síndromes geriátricos en 64.42% (n = 218). Discusión y conclusión El envejecimiento se observa principalmente en las mujeres mexicanas. Reporte del análisis de las prevalencias puntuales de las patologías psicogeriátricas de la CP. Primero en su tipo. Se intenta fomentar la investigación en las demencias y resaltar la magnitud del problema en los países latinoamericanos para sus gobiernos. Los resultados no pretenden ser extrapolados a la población general.
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Introduction Posttraumatic stress disorder (PTSD) may develop after exposure to stressful or life-threatening events and is linked to suicidal behavior. Personality is hypothesized to be a mediator of this risk though assessing factors influencing such findings has been difficult due to the psychiatric comorbidities of the disorder. Objective The aim of the study was to examine the relationship between personality and suicidal behavior in people with PTSD. Method This was a cross-sectional study with 67 participants diagnosed with PTSD who completed a structured interview (SCID-II), and an inventory (NEO-FFI) to gather personality characteristics. Data were collected and analyzed through statistical software, and the investigation period ranged from August 2020 to July 2021. Results Extraversion was correlated with suicide attempts, borderline traits predicted the number of these, and a negative relationship was found between conscientiousness and the same variable. Schizotypal traits were also positively correlated to self-harm. Extraversion, schizoid, borderline, and obsessive-compulsive traits were more likely to be diagnosed with either depressive and/or anxious disorders. Extraversion's association with suicidal attempts is inconsistent with previous studies, although the correlation of borderline traits with the same variable complies with existing knowledge. Schizotypal traits and their link with self-harm may be a novelty for this line of research, although the connection between extraversion, schizoid, borderline, and obsessive-compulsive traits along with depressive and anxious disorders echoes current literature. Conclusion Certain characteristics of personality are related to suicidal behavior in individuals with PTSD.
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The process of prescribing a medication is complex and includes: deciding whether it is indicated, choosing the best option, determining the dose and the appropriate management scheme to the physiological condition of the patient, and monitoring effectiveness and toxicity. We have to inform patients about the expected side effects and indications for requesting a consultation. Specific clinical questions were designed based on the acronym PICOST. The search was made in the specific websites of clinical practice guidelines, was limited to the population of older adults, in English or Spanish. We used 10 related clinical practice guidelines, eight systematic reviews and five meta-analyses. Finally, we made a search of original articles or clinical reviews for specific topics. The development and validation of clinical practice guidelines for "rational drug prescriptions in the elderly" is intended to promote an improvement in the quality of prescription through the prevention and detection of inappropriate prescribing in the elderly and, as a result of this, a decrease in the adverse events by drugs, deterioration of health of patients and expenditure of resources.
El proceso de prescribir un medicamento incluye decidir si está indicado, elegir el mejor, determinar una dosis y un esquema de administración adecuados a la condición fisiológica del paciente, el seguimiento de la eficacia y toxicidad. Debe informarse a los pacientes sobre los efectos secundarios esperados y las indicaciones para solicitar la consulta. Para la elaboración de esta guía se formularon preguntas clínicas específicas, con base en el acrónimo PICOST. La búsqueda se realizó en los sitios web específicos de guías de práctica clínica, en inglés o español, y se limitó a la población de adultos mayores. Se usaron 10 guías de práctica clínica relacionadas, ocho revisiones sistemáticas y cinco metaanálisis. Por último, se realizó una búsqueda de artículos originales o revisiones clínicas para aspectos específicos. La elaboración y validación de una guía de práctica clínica para "prescripción farmacológica razonada en el adulto mayor" tiene el propósito de promover una mejora en la calidad de la prescripción médica, mediante la prevención y detección de la prescripción inapropiada en el anciano y como resultado de esto disminuir los eventos adversos originados por fármacos, el deterioro de la salud de los pacientes y el gasto no justificado de los recursos.
