RESUMO
INTRODUCCIÓN: El empleo es uno de los componentes centrales de la recuperación en personas con trastornos mentales severos y un aspecto clave en la validación social. El objetivo del estudio fue conocer la experiencia laboral, el interés por trabajar, las conductas específicas de búsqueda laboral, el estatus ocupacional y las actitudes frente al trabajo en esta población. MÉTODOS: Un total de 103 personas en tratamiento en una institución de salud mental de la ciudad de Buenos Aires completaron un cuestionario censal en 2018 con preguntas abiertas y cerradas. El análisis fue mixto, con cálculo y comparación de frecuencias según grupos y análisis temático. RESULTADOS: La mayoría de los participantes tenía experiencia laboral, aunque solo el 29% estaba trabajando. El 93% de quienes no trabajaban dijo tener interés en hacerlo. Solo un 33% de quienes no tenían trabajo realizaban actividades para conseguirlo. Un 85% consideró que podría tener problemas en caso de trabajar y el 15% señaló que podría hacerle mal. No se observaron diferencias significativas según diagnóstico o género. DISCUSIÓN: El elevado interés por trabajar de las personas con trastornos mentales severos contrasta con un porcentaje considerable que, pese a ello, no busca trabajo y anticipa dificultades laborales. El estigma podría ser uno de los mayores obstáculos para la búsqueda y la inclusión laboral. Los programas de apoyo al empleo deben considerar algunos de los problemas hallados en este estudio.
Assuntos
Desemprego , Emprego , Recuperação da Saúde Mental , Transtornos MentaisRESUMO
Studies regarding stigma towards mental illness in Argentina blossomed after the first National Mental Health Law was passed in 2010. Methodological limitations and contradictory results regarding community perceptions of stigma hinder comparisons across domestic and international contexts but some lessons may still be gleaned. We examine this research and derive recommendations for future research and actions to reduce stigma. These include tackling culture-specific aspects of stigma, increasing education of the general population, making more community-based services available and exposing mental health professionals to people with mental illness who are on community paths to recovery.
RESUMO
The objective of this article is to highlight the complexity of the phenomenon of self-mutilation, or self-injury, among individuals with Borderline Personality Disorder. The practice of self-mutilation in this population is strikingly common, with some authors estimating the prevalence to be up to 75%. Particularly noteworthy is the high percentage of patients with Borderline Personality Disorder who state that the act of self-injury has an analgesic effect. This article lays out a few theories that support this finding. Frequently, patients who self-mutilate do not aim to commit suicide but rather, to relieve internal tension. However, clinical interventions are often largely centered on interpreting the self-injurious act as a suicide attempt, with complex therapeutic consequences. A clinical vignette is presented to highlight the aforementioned issues.
Assuntos
Transtorno da Personalidade Borderline , Automutilação , Adulto , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/terapia , Feminino , Humanos , Dor , Automutilação/etiologiaRESUMO
The objective of this article is to highlight the complexity of the phenomenon of self-mutilation, or self-injury, among individuals with Borderline Personality Disorder. The practice of self-mutilation in this population is strikingly common, with some authors estimating the prevalence to be up to 75
. Particularly noteworthy is the high percentage of patients with Borderline Personality Disorder who state that the act of self-injury has an analgesic effect. This article lays out a few theories that support this finding. Frequently, patients who self-mutilate do not aim to commit suicide but rather, to relieve internal tension. However, clinical interventions are often largely centered on interpreting the self-injurious act as a suicide attempt, with complex therapeutic consequences. A clinical vignette is presented to highlight the aforementioned issues.
Assuntos
Automutilação , Transtorno da Personalidade Borderline , Adulto , Automutilação/etiologia , Dor , Feminino , Humanos , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/terapiaRESUMO
The objective of this article is to highlight the complexity of the phenomenon of self-mutilation, or self-injury, among individuals with Borderline Personality Disorder. The practice of self-mutilation in this population is strikingly common, with some authors estimating the prevalence to be up to 75
. Particularly noteworthy is the high percentage of patients with Borderline Personality Disorder who state that the act of self-injury has an analgesic effect. This article lays out a few theories that support this finding. Frequently, patients who self-mutilate do not aim to commit suicide but rather, to relieve internal tension. However, clinical interventions are often largely centered on interpreting the self-injurious act as a suicide attempt, with complex therapeutic consequences. A clinical vignette is presented to highlight the aforementioned issues.
Assuntos
Transtorno da Personalidade Borderline , Automutilação , Adulto , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/terapia , Feminino , Humanos , Dor , Automutilação/etiologiaRESUMO
The diagnosis of "hysteria" has recently become part of the history of Psychiatry. Although fully trained dynamic psychiatrists, followers of psychoanalytic theories, still make use of some clinical and theoretical production upon hysteria, for many of the young psychiatrists this term has disappeared from their scope. They only know of dissociative disorders, somatoform disorders and histrionic personality disorders, or they rather distinguish other diagnosis with which hysteria could be mistaken for. Despite the diagnosis of hysteria has been removed from the DSM, the difficulties these patients frequently imposed to physicians still prevail.
Assuntos
Transtorno Bipolar/diagnóstico , Transtornos Dissociativos/diagnóstico , Transtorno da Personalidade Histriônica/diagnóstico , Histeria/diagnóstico , Psiquiatria/história , Transtornos Somatoformes/diagnóstico , Adulto , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , História do Século XIX , História do Século XX , HumanosRESUMO
BACKGROUND: although psychopharmacotherapy and psychotherapy are very frequent in Buenos Aires city and its surroundings, there is no data about their combination. METHOD: an anonymous survey was used to bring up psychiatrists and psychotherapists opinions upon combined, integrated and split treatments. RESULTS: 411 persons answered the survey; 95% of all psychiatrists and 91% of the psychotherapists had any kind of experience sharing treatments; 63% of psychiatrists' patients received a combination of psychopharmacological and psychological treatments; the condition of being a biological or dynamical psychiatrist showed to be related to the percentage of patients to which they only prescribed medication and to the percentage of patients under integrated treatments; on a 1 to 5 points Likert scale, the psychiatrist and psychotherapists assigned an average of 4,2 and 4,1 points respectively to the utility of shared treatments. 35% of the patients treated by psychotherapists also received medication; criticisms to how the psychiatrists do their job were different depending on the psychotherapists theoretical orientation. CONCLUSIONS: triangular devices (between patients, psychiatrists and psychotherapists) are very frequent in Buenos Aires city and its surroundings, presenting important differences depending on the theoretical orientation of psychiatrists and psychotherapists. Their understanding and the preparation for the performance within them will have to be a priority in the curriculum of these professionals.
Assuntos
Transtornos Mentais/terapia , Equipe de Assistência ao Paciente , Psiquiatria , Psicologia , Psicoterapia , Argentina , Terapia Combinada , Feminino , Humanos , Masculino , Padrões de Prática Médica , População UrbanaRESUMO
Introducción: si bien el consumo de psicofármacos y de psicoterapias está muy extendido en la ciudad de Buenos Aires y sus alrededores, no hay datos sobre su combinación. Método: por medio de una encuesta anómina a los psiquiatras y psicoterapeutas que recolectaron datos de los tratamientos compartidos. Resultados: de los 411 encuestados obtuvimos que el 95 de los psiquiatras y el 91 de los psicoterapeutas tienen alguna participación en tratamientos compartidos con otro profesional (psiquiatra o psicoterapeuta); el 63 de los pacientes de los psiquiatras reciben tratamiento combinados de medicación y psicoterapia; la condición de psiquiatra biológico o dinámico y la antigüedad en la profesión inciden en el porcentaje de pacientes a quienes solo les prescriben medicación; en una escala de 1 al 5 ven una utilidad de 4,2 a este tipo de dispositivos compartidos, casi igual a la asignada por los psicoterapeutas. El 35 de los pacientes de los psicoterapeutas forma parte de tratamientos compartidos; las críticas al accionar del psiquiatra serían diferentes según la orientación teórica del psicoterapeuta/psicoanalista. Conclusiones: los dispositivos triangulares (entre pacientes psiquiatras y psicoterapeutas) presentan un elevado grado de difusión en la Ciudad de Buenos Aires y sus alrededores, y tendrían modalidades diferenciales según la orientación de psiquiatra y del psicoterapeuta, de lo cual deriva que su estudio deba ser una prioridad en el currículum de estos profesionales.
BACKGROUND: although psychopharmacotherapy and psychotherapy are very frequent in Buenos Aires city and its surroundings, there is no data about their combination. METHOD: an anonymous survey was used to bring up psychiatrists and psychotherapists opinions upon combined, integrated and split treatments. RESULTS: 411 persons answered the survey; 95 of all psychiatrists and 91 of the psychotherapists had any kind of experience sharing treatments; 63 of psychiatrists' patients received a combination of psychopharmacological and psychological treatments; the condition of being a biological or dynamical psychiatrist showed to be related to the percentage of patients to which they only prescribed medication and to the percentage of patients under integrated treatments; on a 1 to 5 points Likert scale, the psychiatrist and psychotherapists assigned an average of 4,2 and 4,1 points respectively to the utility of shared treatments. 35 of the patients treated by psychotherapists also received medication; criticisms to how the psychiatrists do their job were different depending on the psychotherapists theoretical orientation. CONCLUSIONS: triangular devices (between patients, psychiatrists and psychotherapists) are very frequent in Buenos Aires city and its surroundings, presenting important differences depending on the theoretical orientation of psychiatrists and psychotherapists. Their understanding and the preparation for the performance within them will have to be a priority in the curriculum of these professionals.
Assuntos
Humanos , Masculino , Feminino , Psicologia , Psicoterapia , Psiquiatria , Terapia Combinada , Argentina , Equipe de Assistência ao Paciente , Padrões de Prática Médica , População Urbana/estatística & dados numéricos , Psicofarmacologia , Transtornos Mentais/terapiaRESUMO
The present paper analyzes the combination of psychiatric and psychological treatments, exploring the clinical aspects that turn them into split or collaborative treatments. A historical sketch is presented and the current state of the psychiatrist-psychotherapist relationship is depicted, putting special emphasis on the frequent causes of tension usually hard to resolve. Two case vignettes are put forward to shed light on how combined treatments are much more than a simple addition of medication and psychotherapy, including subtle and complex aspects of both professionals work and a particular relationship between them.
Assuntos
Transtornos Mentais/terapia , Equipe de Assistência ao Paciente , Psiquiatria , Psicoterapia , HumanosRESUMO
UNLABELLED: Borderline personality disorder (BPD) is a frequent mental disorder whose affected present high levels of stress and suffering. Diverse diagnostic criteria exist for this disorder. OBJECTIVE: The objective of our study was to establish which are the most sensitive symptoms to diagnose BPD at the present time together with the expectations and treatments of choice of mental health professionals of Buenos Aires city. METHODS: A voluntary auto survey was completed by 116 mental health professionals from private and public institutes of Buenos Aires city . RESULTS: Impulsivity, affective instability and boredom or emptiness were the symptoms referred as the most important to make the diagnosis of BPD. More than half of the people polled reported that the DSM IV was useless to establish the diagnosis of this disorder. Individual psychoanalytic psychotherapy was chosen by the majority of the surveyed as the most important treatment for these patients. Mood stabilizers are the drugs of choice for the pharmacological treatment of impulsivity. CONCLUSIONS: It is important to elaborate in our country diagnostic criteria and treatment guidelines that consider the knowledge and local experience with these patients.
Assuntos
Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/terapia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Ocupações , Inquéritos e Questionários , Adulto , Terapia Cognitivo-Comportamental , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Borderline personality disorder (BPD) is a frequent mental disorder whose affected present high levels of stress and suffering. Diverse diagnostic criteria exist for this disorder. OBJECTIVE: The objective of our study was to establish which are the most sensitive symptoms to diagnose BPD at the present time together with the expectations and treatments of choice of mental health professionals of Buenos Aires city. METHODS: A voluntary auto survey was completed by 116 mental health professionals from private and public institutes of Buenos Aires city . RESULTS: Impulsivity, affective instability and boredom or emptiness were the symptoms referred as the most important to make the diagnosis of BPD. More than half of the people polled reported that the DSM IV was useless to establish the diagnosis of this disorder. Individual psychoanalytic psychotherapy was chosen by the majority of the surveyed as the most important treatment for these patients. Mood stabilizers are the drugs of choice for the pharmacological treatment of impulsivity. CONCLUSIONS: It is important to elaborate in our country diagnostic criteria and treatment guidelines that consider the knowledge and local experience with these patients.
RESUMO
Borderline personality disorder (BPD) is a frequent mental disorder whose affected present high levels of stress and suffering. Diverse diagnostic criteria exist for this disorder. OBJECTIVE: The objective of our study was to establish which are the most sensitive symptoms to diagnose BPD at the present time together with the expectations and treatments of choice of mental health professionals of Buenos Aires city. METHODS: A voluntary auto survey was completed by 116 mental health professionals from private and public institutes of Buenos Aires city . RESULTS: Impulsivity, affective instability and boredom or emptiness were the symptoms referred as the most important to make the diagnosis of BPD. More than half of the people polled reported that the DSM IV was useless to establish the diagnosis of this disorder. Individual psychoanalytic psychotherapy was chosen by the majority of the surveyed as the most important treatment for these patients. Mood stabilizers are the drugs of choice for the pharmacological treatment of impulsivity. CONCLUSIONS: It is important to elaborate in our country diagnostic criteria and treatment guidelines that consider the knowledge and local experience with these patients.
RESUMO
Combined therapy, that is psychotherapy plus pharmacological treatment in the management of bipolar disorder proved higher efficacy than each individual treatment. This article reviews situations that may interfere with such treatment.
Assuntos
Transtorno Bipolar/terapia , Terapia Combinada , HumanosRESUMO
Combined therapy, that is psychotherapy plus pharmacological treatment in the management of bipolar disorder proved higher efficacy than each individual treatment. This article reviews situations that may interfere with such treatment.
RESUMO
Combined therapy, that is psychotherapy plus pharmacological treatment in the management of bipolar disorder proved higher efficacy than each individual treatment. This article reviews situations that may interfere with such treatment.
