Efficacy of cognitive behavioural therapy for bipolar disorder: A systematic review.

INTRODUCTION: Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1%-1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behavioural therapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature. METHODS: The main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18-65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". RESULTS: A total of 1531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8 to 30, with a total duration of 45-120 min. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia. CONCLUSIONS: The use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.

Eficácia de la Terapia Cognitiva Conductual Para el Trastorno Bipolar: una Revisión Sistemática

Introducción: El trastorno bipolar (TB) es una enfermedad mental grave con un curso crónico y una morbimortalidad importante. El TB tiene una tasa de prevalencia a lo largo de la vida del 1 al 1,5% y se caracteriza por episodios recurrentes de manía, depresión o una mezcla de ambas fases. Aunque tiene tratamiento farmacológico y psicoterapéutico, la terapia cognitiva conductual (TCC) ha mostrado efectos beneficiosos, pero no se cuenta con suficiente información clínica en la literatura actual. Métodos: El objetivo principal es determinar la eficacia de la TCC sola o como complemento del tratamiento farmacológico para el TB. Se realizó una revisión sistemática de 17 artículos. Los criterios de inclusión fueron: investigación cuantitativa o cualitativa dirigida a examinar la eficacia de la TCC en pacientes con TB con/sin medicación, publicaciones en idioma inglés y tener 18-65 anos de edad. Los criterios de exclusión fueron: artículos de revisión y metanálisis, artículos que incluían a pacientes con otros diagnósticos además de TB y no separaban los resultados basados en dichos diagnósticos y estudios con pacientes que no cumplían los criterios de TB del DSM o ICD. Se realizaron búsquedas en las bases de datos PubMed, PsycINFO y Web of Science hasta el 5 de enero de 2020. La estrategia de búsqueda fue: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". Resultados: Se incluyó en total a 1.531 pacientes de ambos sexos. La media de edad ponderada fue 40,703 arios. El número de sesiones varió de 8 a 30, con una duración total de 45-120 min. Todos los estudios muestran resultados variables en la mejora del nivel de depresión y la gravedad de la manía, mejora de la funcionalidad, disminución de recaídas y recurrencias, reducción de los niveles de ansiedad y reducción de la gravedad del insomnio. Conclusiones: Se considera que la TCC sola o complementaria para pacientes con TB muestra resultados prometedores después del tratamiento y durante el seguimiento. Los beneficios incluyen niveles reducidos de depresión y manía, menos recaídas y recurrencias y niveles más altos de funcionamiento psicosocial. Se necesitan más estudios.

Introduction: Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1% to 1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behaviouraltherapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature. Methods: The main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18-65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". Results: A total of 1,531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8-30, with a total duration of 45120 minutes. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia. Conclusions: The use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.

Efficacy and Safety of Aripiprazole in Borderline Personality Disorder: A Systematic Review.

Aripiprazole is an atypical antipsychotic medication, and its use in treating borderline personality disorder (BPD) is debatable because it is not FDA-approved for treating BPD. This study aimed to investigate the efficacy and safety of aripiprazole in patients with BPD. On July 2, 2021, the protocol (CRD42021256647) was registered in PROSPERO. PubMed, Scopus, Web of Science, Ovid-Medline, Embase, PsycINFO, and Cochrane (CENTRAL) were searched without regard for language or publication date. We also searched trial registries on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Randomized clinical trials with adult patients diagnosed with BPD met the inclusion criteria. The Cochrane risk of bias for randomized trials (RoB-2) method was used to assess the quality of the included studies. We included two previously published randomized clinical trials. There were 76 patients with BPD, with 38, 12, and 26 assigned to the aripiprazole, olanzapine, and placebo groups, respectively. Most patients (88.16%) were females, with ages ranging from 22.1 to 28.14 yr. Aripiprazole has been proven to reduce anxiety, depression, anger, hostility, clinical severity, and obsessive-compulsive behavior, insecurity, melancholy, anxiety, aggressiveness/hostility, phobic anxiety, paranoid thinking, psychoticism, and somatization. The adverse effects were headache, insomnia, restlessness, tremor, and akathisia. The risk of bias was considerable in both trials, which is somewhat problematic considering that prejudice can lead to incorrect outcomes and conclusions. Aripiprazole has demonstrated encouraging outcomes in the treatment of patients with BPD. More randomized controlled studies are needed.

[Factors Associated With Delirium In Patients Hospitalized During The COVID-19 Pandemic]. / Factores Asociados A Delirium En Pacientes Hospitalizados Durante Pandemia De COVID-19.

OBJECTIVES: To determine the risk factors associated with delirium in patients admitted to a COVID-19 Hospitalization of a general hospital during the first year of the COVID-19 pandemic. METHODS: An observational, analytical, case-control study was conducted. We analyzed 50 medical records of patients who presented delirium and 50 who did not present delirium in a COVID Hospitalization area during the period from March 2020 to March 2021. The Odd Ratio of sociodemographic and clinical factors for presenting delirium was evaluated. The logistic regression statistical test was performed using STATA 17.0 software. The protocol was approved by the Research Ethics Committee of the Villa El Salvador Emergency Hospital. RESULTS: Ventilatory support (p=0.04), especially the use of a reservoir mask (OR=0.34, CI 0.12-0.88) and the presence of systemic complications (p=0.03) such as metabolic acidosis (OR=12.9, CI 1.45-115.58) were statistically significant variables associated with a higher risk of presenting delirium. CONCLUSIONS: The type of ventilatory support and the presence of systemic complications were significant risk factors for delirium in patients hospitalized in a COVID area. Further studies are required in this field to obtain more evidence in this regard.

Síndrome neuroléptico maligno en un hospital general

Describimos la presentación clínica y dificultades diagnósticas de un caso de síndrome neuroléptico maligno en un hospital general. El paciente fue un varón de 18 años con diagnóstico de retraso mental grave e historia de convulsiones que recibía tratamiento irregular con risperidona y fenitoína. Tras presentar irritabilidad, agresividad y agitación psicomotriz acude a hospital psiquiátrico en donde le indican incremento de dosis de risperidona. Posteriormente por persistencia de agresividad, acude a hospital psiquiátrico en donde se indicó haloperidol, midazolam y levomepromazina, a los pocos días presentó distonía oro mandibular, alza térmica y distonía generalizada con dificultad para la deglución de alimentos, motivo por el cual acudió a hospital general y fue diagnosticado de síndrome neuroléptico maligno. El paciente recibió tratamiento con bromocriptina y diazepam durante hospitalización y tuvo evolución favorable de síntomas neuropsiquiátricos. El síndrome neuroléptico maligno es un evento adverso raro y fatal. Está asociado al uso de psicotrópicos, especialmente antipsicóticos.

We describe the clinical presentation and diagnostic difficulties of a case of Neuroleptic Malignant Syndrome in a general hospital. The patient was an 18-year-old male with severe mental retardation and a history of seizures who received irregular treatment with risperidone and phenytoin. After presenting irritability, aggressiveness, and psychomotor agitation, he went to a psychiatric hospital where received an increase in the dose of risperidone. Subsequently, due to persistence of aggressiveness, he went to a psychiatric hospital where haloperidol, midazolam and levomepromazine were indicated, after few days developed oromandibular dystonia, temperature rise and generalized dystonia with difficulty swallowing food, which is why he went to hospital general and was diagnosed with Neuroleptic Malignant Syndrome. Patient received treatment with bromocriptine and diazepam during hospitalization with favorable evolution of neuropsychiatric symptoms. Neuroleptic Malignant Syndrome is a rare and fatal adverse event. It is associated with the use of psychotropics, especially antipsychotics.

Síntomas psicóticos y consumo de bebidas energizantes: reporte de caso / Psychotic symptoms and consumption of energy drinks: case report

RESUMEN: El consumo de bebidas energizantes y su rápida expansión ha creado preocupación desde el punto de vista científico y comunitario. Estas son bebidas que contienen cafeína como su principio activo más común. Se presenta el caso de un paciente sin antecedentes psiquiátricos con presentación clínica de síntomas psicóticos tras incremento del consumo de bebidas energizantes. Se realiza una revisión de literatura existente sobre otros casos de aparición de psicosis tras el consumo de estas bebidas en personas sin y con antecedentes psiquiátricos, así como casos en que predomina la presentación de otros síntomas psiquiátricos con la finalidad de discutir el impacto clínico. El consumo de bebidas energizantes podría representar un problema de salud pública mundial debido a los posibles efectos adversos graves y aún poco estudiados en la salud física y mental.

ABSTRACT The consumption of energy drinks and their rapid expansion has created concern from a scientific and community point of view. These are drinks that contain caffeine as their most common active ingredient. We present the case of a patient with no psychiatric history with clinical presentation of psychotic symptoms after increased consumption of energy drinks. A review of existing literature is carried out on other cases of the appearance of psychosis after the consumption of these beverages in people without and with a psychiatric history, as well as cases in which the presentation of other psychiatric symptoms predominates in order to discuss the clinical impact. The consumption of energy drinks could represent a global public health problem due to the possible serious and still little studied adverse effects on physical and mental health.

Efficacy of Cognitive Behavioural Therapy for Bipolar Disorder: a Systematic Review. / Eficacia de la Terapia Cognitiva Conductual Para el Trastorno Bipolar: una Revisión Sistemática.

INTRODUCTION: Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1% to 1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behavioural therapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature. METHODS: The main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18-65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". RESULTS: A total of 1,531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8-30, with a total duration of 45-120minutes. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia. CONCLUSIONS: The use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.

Uso de psicofármacos para síntomas neuropsiquiátricos en pacientes hospitalizados con COVID-19

La pandemia por la COVID-19 es la actual crisis sanitaria mundial que, hasta la fecha, ha cobrado miles de vidas en la mayoría de los países. Desde inicios del 2020 se estudia el comportamiento epidemiológico y clínico de este virus, así como también se han planteado esquemas terapéuticos que logren eliminar el virus, per se, y sus complicaciones a nivel sistémico. Sin embargo, los pacientes hospitalizados por esta infección también presentan síntomas neuropsiquiátricos, por lo que el manejo farmacológico requiere de consideraciones especiales al momento de su prescripción. Los síntomas neuropsiquiátricos secundarios más comunes en un cuadro de COVID-19 son ansiedad, insomnio, ánimo deprimido, delirio y agitación. La elección de psicofármacos debe basarse en el principio de no generar más daño, y valorar el riesgo-beneficio, el perfil farmacológico, las posibles interacciones y condiciones médicas previas del paciente.

COVID-19 pandemic is the current global health crisis that, to date, has claimed thousands of lives in most countries. Since the beginning of 2020, the epidemiological and clinical behavior of the SARS-CoV-2, as well as proposals for therapeutic schemes that address the elimination of this virus per se and its complications at the systemic level, have been studied. However, neuropsychiatric symptoms also occur in patients hospitalized for this infection, so pharmacological management requires special considerations at the time of prescription. The most common neuropsychiatric symptoms secondary to COVID-19 infection are anxiety, insomnia, depressed mood, delirium and agitation. The choice of psychotropic drugs requires to be based on the principle of not generating more harm, and assessing the risk-benefit, pharmacological profile, possible interactions and previous medical conditions of the patient.

Hepatopatía inflamatoria asintomática asociada a uso de mirtazapina: reporte de caso / Asymptomatic inflammatory liver disease associated with mirtazapine use: case report

Resumen La mirtazapina es un antidepresivo atípico con características complejas, que incluye actividad agonista/antagonista en una amplia variedad de receptores que produce efectos terapéuticos en la ansiedad, depresión y el sueño. Sin embargo, se han reportado casos de lesión hepática inducida por antidepresivos con ausencia de sintomatología, bajo la forma de variantes hepatocelular, colestásica y mixta. Este es el caso de una paciente que de carácter incidental presenta cambios en la analítica hepática tras el uso de mirtazapina a partir del cual se hace una breve revisión de la evidencia encontrada hasta el momento.

Mirtazapine is an atypical antidepressant with complex characteristics, including agonist/antagonist activity at a wide variety of receptors that produces therapeutic effects on anxiety, depression and sleep disorder. However, cases of antidepressant-induced liver injury with no symptoms have been reported, in the form of hepatocellular, cholestatic, and mixed variants. This is the case of a patient who incidentally presents changes in liver analysis after the use of mirtazapine, from which a brief review of the evidence found so far is made.

Severidad Clínica En Trastorno Bipolar, Trastorno Límite De La Personalidad Y Su Comorbilidad / Clinical Severity In Bipolar Disorder And Borderline Personality Disorder And Its Comorbidity

Resumen Introducción: El trastorno bipolar y trastorno límite de personalidad son diagnósticos que poseen gran variedad de síntomas, sin embargo, se describe que la comorbilidad de ambos intensifica la severidad clínica como la aparición de mayor número de intentos suicidas o autolesiones. El objetivo del estudio fue determinar y comparar las características sociodemográficas, severidad clínica y síntomas de gravedad en pacientes dentro de estos 3 grupos. Método: El tipo de estudio fue descriptivo y diseño cualitativo, observacional y transversal. Se empleó una muestra de 92 historias clínicas de pacientes atendidos en el Hospital Nacional Víctor Larco Herrera durante los periodos de enero 2010 hasta mayo 2018. Se identificaron variables sociodemográficas (edad, sexo, estado civil, religión, grado de instrucción y ocupación) y de severidad clínica (número de hospitalizaciones, intentos suicidas, rechazo a medicación, respuesta al tratamiento, abuso de sustancias, hospitalización actual y síntomas de gravedad) utilizando una ficha de recolección de datos. Resultados: Las variables sociodemográficas con significancia estadística y mayor frecuencia fueron el sexo femenino (p=0,049), estado civil soltero (p=0,003), religión católica (p=0,009), así como también las variables de severidad clínica con significancia estadística fueron el número de hospitalizaciones (p=0,015), síntomas psicóticos (p=0,009), irritabilidad (p=0,038), disfuncionalidad (p=0,000) y número de síntomas de gravedad (p=0,030) en TB, TLP y su comorbilidad. Conclusiones: La severidad clínica está asociada a número de hospitalizaciones, la presencia de síntomas psicóticos, irritabilidad, disfuncionalidad y el número de síntomas de gravedad en los pacientes con diagnóstico único de TB, TLP y su comorbilidad.

Introduction: Bipolar disorder and borderline personality disorder are diagnoses that have a wide variety of symptoms, however, it is described that the comorbidity of both intensifies the clinical severity as the appearance of a greater number of suicide attempts or self-harm. The objective of the study was to determine and compare the sociodemographic characteristics, clinical severity and symptoms in patients within these 3 groups. Method: The type of study was descriptive and qualitative, observational and transversal design. A sample of 92 clinical records of patients treated at the National Hospital Víctor Larco Herrera during the periods of January 2010 to May 2018 was used. Sociodemographic variables (age, sex, marital status, religion, level of education and occupation) and clinical severity (number of hospitalizations, suicide attempts, refusal of medication, response to treatment, substance abuse, current hospitalization and severity symptoms) using a data collection form. Results: The sociodemographic variables with statistical significance and higher frequency were female sex (p = 0.049), single marital status (p=0.003), catholic religion (p = 0.009), as well as the variables of clinical severity with statistical significance were the number of hospitalizations (p = 0.015), psychotic symptoms (p = 0.009), irritability (p = 0.038), impairment (p = 0.000) and number of symptoms of severity (p = 0.030) in TB, BPD and their comorbidity. Conclusions: The clinical severity is associated with the number of hospitalizations, the presence of psychotic symptoms, irritability, dysfunctionality and the number of severe symptoms in patients with only TB diagnosis, BPD and their comorbidity.

Severidad clínica en trastorno bipolar, trastorno límite de la personalidad y su comorbilidad / Clinical severity in bipolar disorder and borderline personality disorder and its comorbidity

Resumen Introducción: El trastorno bipolar y trastorno límite de personalidad son diagnósticos que poseen gran variedad de síntomas, sin embargo, se describe que la comorbilidad de ambos intensifica la severidad clínica como la aparición de mayor número de intentos suicidas o autolesiones. El objetivo del estudio fue determinar y comparar las características sociodemográficas, severidad clínica y síntomas de gravedad en pacientes dentro de estos 3 grupos. Método: El tipo de estudio fue descriptivo y diseño cualitativo, observacional y transversal. Se empleó una muestra de 92 historias clínicas de pacientes atendidos en el Hospital Nacional Víctor Larco Herrera durante los periodos de enero de 2010 hasta mayo de 2018. Se identificaron variables sociodemográficas (edad, sexo, estado civil, religión, grado de instrucción y ocupación) y de severidad clínica (número de hospitalizaciones, intentos suicidas, rechazo a medicación, respuesta al tratamiento, abuso de sustancias, hospitalización actual y síntomas de gravedad) utilizando una ficha de recolección de datos. Resultados: Las variables sociodemográficas con significancia estadística y mayor frecuencia fueron el sexo femenino (p = 0,049), estado civil soltero (p = 0,003), religión católica (p = 0,009), así como también las variables de severidad clínica con significancia estadística fueron el número de hospitalizaciones (p = 0,015), síntomas psicóticos (p = 0,009), irritabilidad (p = 0,038), disfuncionalidad (p = 0,000) y número de síntomas de gravedad (p = 0,030) en TB, TLP y su comorbilidad. Conclusiones: La severidad clínica está asociada a número de hospitalizaciones, la presencia de síntomas psicóticos, irritabilidad, disfuncionalidad y el número de síntomas de gravedad en los pacientes con diagnóstico único de TB, TLP y su comorbilidad.

Introduction: Bipolar disorder and borderline personality disorder are diagnoses that have a wide variety of symptoms, however, it is described that the comorbidity of both intensifies the clinical severity as the appearance of a greater number of suicide attempts or self-harm. The objective of the study was to determine and compare the sociodemographic characteristics, clinical severity and symptoms in patients within these 3 groups. Method: The type of study was descriptive and qualitative, observational and transversal design. A sample of 92 clinical records of patients treated at the National Hospital Víctor Larco Herrera during the periods of January 2010 to May 2018 was used. Sociodemographic variables (age, sex, marital status, religion, level of education and occupation) and clinical severity (number of hospitalizations, suicide attempts, refusal of medication, response to treatment, substance abuse, current hospitalization and severity symptoms) using a data collection form. Results: The sociodemographic variables with statistical significance and higher frequency were female sex (p = 0.049), single marital status (p = 0.003), catholic religion (p = 0.009), as well as the variables of clinical severity with statistical significance were the number of hospitalizations (p = 0.015), psychotic symptoms (p = 0.009), irritability (p = 0.038), impairment (p = 0.000) and number of symptoms of severity (p = 0.030) in TB, BPD and their comorbidity. Conclusions: The clinical severity is associated with the number of hospitalizations, the presence of psychotic symptoms, irritability, dysfunctionality and the number of severe symptoms in patients with only TB diagnosis, BPD and their comorbidity.

Neurociencias y psicoterapia: mecanismo top-down y bottom-up / Neuroscience and psychotherapy: mechanism top-down and bottom-up

Existe amplia evidencia actual en relación a resultados favorables de la aplicación de distintas intervenciones psicoterapéuticas. Estos avances se han acompañado, aunque en menor medida, de estudios acerca de correlatos neurobiológicos. La presente revisión intenta dar una visión integral de las bases neurobiológicas de la psicoterapia, a punto de partida de estudios de neuroimágenes, electroencefalografía y otros recursos tecnológicos. Se resumen los principales modelos explicativos de la conducta humana y su relación con la psicoterapia, haciendo énfasis en los modelos de regulación top-down (a través de estudios en terapias cognitivas) y bottom-up (mediante la meditación o mindfulness).

Currently, there is ample evidence about favorable results of different psychotherapeutic interventions, advances that have been accompanied, although to a lesser extent, by studies on neurobiological correlates. This review aims at providing a comprehensive view of the neurobiological basis of psychotherapy, based on neuroimaging studies, electroencephalography, and other technological resources. The main explanatory models of human behavior and its relationship with psychotherapy are summarized, with emphasis on top-down (through cognitive therapy studies) and bottom-up (through mindfulness meditation) models.

Características personales, clínicas y sociales en pacientes con estancia hospitalaria prolongada en los pabellones de pacientes agudos del Hospital Víctor Larco Herrera / Personal, clinical and social characteristics of inpatients with long hospital stay in the acute wards of the Hospital Víctor Larco Herrera

Objetivo: Identificar las características generales que influyen en la estancia hospitalaria prolongada en los pabellones de pacientes agudos y su comparación sobre el motivo de ingreso en una institución de Salud Mental. Materiales y métodos: Estudio descriptivo, retrospectivo, y transversal, realizado en el Hospital Víctor Larco Herrera. Con una población entre 18 a 65 años con una estancia mayor a 60 días en los pabellones de pacientes agudos. Se realizó revisión de historias clínicas, recolección de datos en ficha estructurada y análisis estadístico mediante SPSS 22.0. Principales medidas de resultados: frecuencias, media y valor de p mediante chi cuadrado en las variables características personales, clínicas y sociales. Resultados: Fueron 52 % de pacientes internados que cumplían estancia mayor a 60 días, cuyas edades fueron: jóvenes y jóvenes adultos 45 %, mediana 35,89, DE=10,45. Mujeres, un 60 %; instrucción secundaria, 61 %; solteros, 81 %; desocupación laboral, 74 %. Ingresados por Emergencia, 74 %, reingresos,55 %, de Lima, 53 %. El diagnóstico más frecuente fue esquizofrenia en 62 %; comorbilidad, 61 %; presentación con agresividad, 64 %; evolución estacionaria, 63 %; ingreso por motivo judicial,47 % y clínico en 47 %. El tratamiento brindado a los pacientes fue principalmente de combinación de fármacos en 74,2 %. Sin abandono sociofamiliar, el 52 %; acompañados por familiares, 66 %; acompañados por policía, 71,4 %; familia disfuncional, 72,6 %; soporte por padres, 51,6 % y pertenencia al SIS el 92 %. Existe mayor significancia estadística en el sexo, estado civil, procedencia, vía de ingreso, tipo o condición de paciente (nuevo o reingreso), acompañamiento de familiares y de otras personas al ingreso. Conclusiones: La estancia hospitalaria está afectada por factores personales como el sexo y estado civil en pacientes judicializados. La procedencia, factores clínicos como la vía y la condición de ingreso; y también sociales como el acompañamiento de familiar y de otros no emparentados, influyen en pacientes ingresados por motivo clínico.

Objective: To identify the general characteristics that influence a long hospital stay in the acute wards of a mental health institution and to compare them with the reason for admission. Materials and methods: A descriptive, retrospective and cross-sectional study was conducted at the Hospital Víctor Larco Herrera in patients between 18 and 65 years of age staying longer than 60 days in the acute wards. Medical records review, data collection in structured files, and statistical analysis through IBM SPSS Statistics Base 22.0 were performed. Main outcome measures were the frequencies, mean and p value (obtained by chi square test) in the variables of personal, clinical and social characteristics.Results: Out of the total number of inpatients, 52 % were staying longer than 60 days, 45 % were youths and young adults (median = 35.89, SD = 10.45), 60 % were women, 61 % had secondary education, 81 % were single, 74 % were unemployed, 74 % were admitted through the emergency department, 55 % were readmitted, 53 % were from Lima, 62 % had schizophrenia which was the most frequent diagnosis, 61 % showed comorbidities, 64 % presented an aggressive behavior on admission, 63 % showed a stable progression, 47 % were admitted due to legal reasons, 47 % were admitted due to clinical reasons, 74.2 % mainly received combination therapies, 52 % did not experience social or family abandonment, 66 % were accompanied by their relatives, 71.4 % were accompanied by the police, 72.6 % had a dysfunctional family, 51.6 % were supported by their parents, and 92 % were covered by the Comprehensive Health Service (SIS). There is greater statistical significance in gender, marital status, origin, admission route, patient type or condition (new or readmitted), and company of relatives and other persons at admission. Conclusions: Hospital stay is affected by personal factors such as gender and marital status in patients admitted due to legal reasons. The origin, clinical factors such as the admission route and condition, and social factors such as the company of relatives and other persons, have influence on patients admitted due to clinical reasons.