La atmósfera psicosocial en la UHTR y su relación teórica con la alianza terapéutica de los pacientes con el equipo multidisciplinar / No disponible

El estudio de la atmósfera de las Unidades de Internamiento Psiquiátrico es una forma de conocer las características de la 'personalidad' de estos lugares; entendida como el conjunto de elementos que las definen y que nacen de las relaciones que se dan entre las personas que permanecen en ellas, en el marco de un tratamiento y en una determinada estructura. La escala de Moos es propiamente un cuestionario (WAS). Consta de 100 peguntas a las que pacientes y personal responden en sentido afirmativo o negativo. La Unidad Hospitalaria de Tratamiento y Rehabilitación, situada en el Complejo Asistencial Benito Menni de Ciempozuelos, es un centro de las Hermanas Hospitalarias, concertado con la Consejería de Sanidad de la Comunidad de Madrid. Es un dispositivo hospitalario especializado en la atención psiquiátrica integral de pacientes con trastorno mental grave, cuya complejidad imposibilita su tratamiento y rehabilitación desde un régimen ambulatorio o de hospitalización breve. El objetivo del presente estudio es relacionar las variables medidas de la atmósfera psicosocial (medida con la WAS) de la UHTR con formulaciones actuales de la Alianza Terapéutica, tomando a los colectivos de pacientes y profesionales como entidades singulares, con el propósito de reflexionar acerca de nuestro programa asistencial de rehabilitación, así como acerca de calidad de las interacciones interpersonales entre los individuos implicados

The study of the atmosphere of Psychiatric Inpatient Units is a way to know the characteristics of the 'personality' of these places; understood as the set of elements that define and born of the relationships that exist between people who stay in them as part of a treatment on a particular structure. Moos scale (WAS) is actually a questionnaire. Comprising 100 questions to which patients and staff respond in the affirmative or negative. The Hospital Treatment and Rehabilitation Unit, located in the Complejo Asistencial Benito Menni de Ciempozuelos, is a center of the Hermanas Hospitalarias, concluded with the Ministry of Health of the Community of Madrid. It is a specialized device in comprehensive hospital psychiatric care of patients with severe mental disorder, whose complexity precludes their treatment and rehabilitation from a brief outpatient or inpatient. The aim of this study is to relate the measures of psychosocial variables atmosphere (measured with WAS) of UHTR with current formulations of the Therapeutic Alliance, taking groups of patients and professionals as singular entities, in order to reflect on our clinical rehabilitation program as well as about quality of interpersonal interactions between the individuals involved

Effectiveness and risks of combining antipsychotic drugs with electroconvulsive treatment.

INTRODUCTION: The simultaneous application of electroconvulsive therapy (ECT) and psychotropic drugs is based on sparse data. Despite this, and the restrictive approach of the Guidelines and Consensus is widespread in the usual care, it is widely practiced in routine clinical. METHOD: We reviewed the results of search on the topic in MEDLINE, PsychINFO, EMBASE and Cochrane, and the main guidelines on the subject and analyzed for drug groups. RESULTS: Except some reservation with regard to classical MAOIs, antidepressants are safe and effective enhancers of the TEC. It is desirable to discontinuation of BZD whenever clinically possible before the course of ECT for risk of interference, if not possible will have to use proper technique to ensure effective incentives. It is advisable to stop or reduce the dose of lithium prior to ECT based on a cost-benefit analysis of the risk of relapse, if maintained will be adjusted lower levels and cognitive effects minimizing techniques. The combination with "classic" and "atypical" antipsychotics power positive clinical effects and the risk of combined use is low. The positive data are collected with clozapine and ECT-resistant psychosis, with little presence of effects of the decrease of seizure threshold by clozapine, and important effect of empowerment, but of limited duration. CONCLUSIONS: Although it is strictly necessary to identify situations in terms of drugs, patient and ECT technique, and care necessary to develop tests that provide methodologically sound data, the combined use of ECT and psychotropic drugs in general presents an acceptable risk level and efficacy data by encouraging empowerment.