PSYCHIATRY, 2

Author: SALMERON ALVAREZ MERCEDES.
Year: 2005.
University: OVIEDO.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD DE SALAMANCA.

Summary: Where feasible, it is preferable for the elderly with dementia to stay at home to enjoy a better quality of life but the overhead associated with caregivers often is excessive. It is unclear when the institutionalization becomes inevitable therefore it is important to identify the factors that motivate. With this object is a descriptive study on cross two populations: a random sample obtained from the EU population aged 65 and over in the district statistical 5 Langreo and another obtained from the institutionalized population in the Sanatorium Adaro (Residences elders of the same locality ) to observe differences in the profile of the patient with dementia in both areas and to identify possible causes that led to the institutionalization. Demographic data were obtained from population census on an initial sample of 167 elderly, which had to discard 14 exitus and 73 people who could not be interviewed. We finally 80 interviews domicilarias involving the administration MEC (Wolf) for the detection of older people with cognitive impairment. The cutoff point used was recommended by the author, so that those elderly whose score was less than 24 and meet clinical criteria for dementia DSM IV were selected as cases. This same procedure was performed on 77 patients older than 65 years institutionalized in the Sanatorium Adaro The prevalence of dementia gained in the EU population was 25% compared to 71% in l institutionalized population reaching statistical significance difference. When comparing the two groups with dementia residential community and found that patients with dementia who lived in the community had a higher cultural level, their occupations were more qualified, had a lesser degree of cognitive impairment and functional disability dependence personal and family that institutionalized patients with dementia and estadiaje of dementia was less advanced. But we found no statistically significant differences with regard to the subtypes of dementia, disruptive behavior and the previous study with additional tests in both groups. Of the group's informal caregivers of dementia Community 47% were overloaded and it was intense. Factors relating to overload were disruptive behavior, functional dependence and the inability personal and family of the patient, the estadiaje advanced dementia and mental health problems carer. In the multivariate analysis, it was noticed that the only two variables were predictive of institutionalization education and the estadiaje of dementia obtained through the scale GDS-FAST (Reisberg) measuring the functional loss in Alzheimer's disease in parallel with the cognitive deficits. Ultimately the loss of functional capacity resulting in the progression of dementia affects about overloading the caregiver, state of health and the institutionalization of the same patient, and therefore all the factors that contribute to preserve the functional ability of elderly with dementia as well as individualized treatment of psychiatric disorders carer and disruptive behavior of the patient are essential to alleviate the overload and avoid institutionalization.

Author: GONZÁLEZ PIQUERAS JOSE CARLOS.
Year: 2005.
University: VALENCIA.
Place of defense: SALÓN DE GRADOS DE LA E.U. ENFERMERÍA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Hallucinations are one of the central themes in the history of psychopathology, with auditory hallucinations one of the most common symptoms and characteristics of patients with schizophrenia. In recent years there has been a growing interest in the auditory hallucinations for several reasons. First, it has been possible to capture this symptom with neuroimaging techniques. Secondly, we have designed scales to measure carefully the phenomenological features of these hallucinations. Thirdly, new models have been proposed for the understanding of its origin. Lastly, there is a significant percentage (about 30%) of patients with schizophrenia receiving antipsychotic treatment that are persistent hallucinations. We have examined several aspects: 1 .- The translation and validation of the scale of auditory hallucinations PSYRATS. 2 .- How psychotic patients are ranked according to their auditory hallucinations. 3 .- The clinical differences between alucinadores persistent and alucinadores episodic and 4 .- If there are correlations between certain dimensions of hallucinations and neurobiological substrates

Author: MARTINEZ LOPEZ JOSE PEDRO.
Year: 2005.
University: MURCIA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA DE MURCIA.

Summary: SUMMARY: Objectives:% & / The purpose of the study would seek to deepen the knowledge of these patients, at the level of psychosocial development, dominant personality factors and the possible existence of pathology premórbida, trying to distinguish common factors or diferenciativos either as a group or well according to the different evolutionary courses at diagnosis continue over time of the study, figuring out the influence causing his current life in the consumption of substances, as well as the potential prophylactic or therapeutic action. % & / Material v methods: &% / performed a follow-up study among patients who came to an emergency Psychiatric and selected those who had a table psychotic and who counted among their recent record consumption or normal substance abuse, compiling clinic patients, symptomatic evolution, diagnostic, consumption habits of substances, medical history and psicobiográfico, he administered personality tests and psychiatric symptoms. % & / Once the patient selection for inclusion in the study, we developed a data collection affiliation, medical history, personal history, employment, legal, research, either directly from personal interview or interview performed their familiares.Si the clinical situation permits, builds a table of consumption of toxic, in a personal interview with the patient and if not permitting, takes place after the stabilization of sintomas.Una time that has been achieved stabilization symptomatic patient, perform a battery of tests, in successive summonses outpatient for three or four occasions, with a duration of 60 to 90 minutes each, including: el16 PF and ellPDE personality and SCL 90R, symptoms general. Subsequently ranscurridos between 9 and 12 months, citing again the patient to check their clinical outcome. From then tracked through clinical interviews and review of medical records for a period of between two and five years, for the collection of evolution and its clinical diagnosis, the number of hospital admissions , treatments that are kept, as well as the continuing use of toxic substances. In patients in the sample shows a pattern of daily consumption of snuff and cannabis at high doses for long periods and one weekend of alcohol, cocaine and amphetamines. &% / Result:% & / The population is composed 50 patients, who are treated in emergency visits a psychiatrist, because of a psychotic table and have their antecedents in the consumption of substances abuse, of them 42 men and 8 women. His marital status is single, in 46 cases, the same number who live with their parents. Their training is primary studies in 42 cases and only 2 college. At the working level 47 have played unskilled jobs and now 13 are off work and 24 in paro.A judicial 21 have been charged with any crime, 20 have been arrested and 7 have joined prisión.Con medical history, only 14 have submitted relevant diseases' the past 4 has been operated and 9 have obstetric complications in its history. They had already been seen by a psychiatrist 20 of them. Only 10 presented psychiatric family history. The age of onset of clinical ranges between 17 and 25 years in 41 patients. Among the most frequent diagnosis is after. Psicótico induced by cannabis with crazy ideas, F 12.51, with 19 cases, followed by T. Psychotic unspecified F29, with 15 cases, T. Esquizofreniforme, with 7 cases, 1. Cocaine-induced psychosis with hallucinations, 5 cases, and the rest of schizophrenia subtypes. These data show a profile type of male patient, bachelor of 23.5 years of age, who lives with his parents, has primary, has desa 8 rrollado 1ff8 an unskilled profession, but is unemployed, has not been in jail and psychiatric has no family history or personal relevancia.La evolution of these initial diagnoses of the time factor, produced at the end of the study the following changes: Of the 25 patients with an initial diagnosis of substance-induced psychotic disorder, only 10 preserving it , contrasting with an increase of up to 22 patients diagnosed with schizophrenia, at the expense of the decrease of induced psychosis and psychotic disorder not specified. In terms of the number of hospital admissions, 28 have done so only once, 10 no, 6 twice and another 6 have spent several reingresas. They started treatment with atypical neuroleptics most, the most common being risperidone with 39 patients. The response to Using. In 31 cases was complete and partial 19.En relation to the consumption habits of toxic, reveals the following results:-Snuff: only 3 of them non-smokers and 62% started between 14 and 16 years, 44 who smoke daily .- Amphetamines: have consumed 33 patients of whom 23 started between 16-18 years, only 5 maintained its catchment consumption, 22 of consumed between 1 and 3 years, 21 on weekends and 12 sporadically, with a low consumption in 22 cases, the usual venue the nightclub for 32 of them, 33 in compañia-ía friends. For frequency of motivation include "encouraged" in 9 cases and "by the group" at 8 .- Cocaine: of 40 who have consumed, 26 started between los16-18 years and 12 maintained their consumption, which has gone from 1 - 4 years in 30 of them, 19 on weekends and 17 sporadically, 18 at low doses, 13 at half and 9 to high dose being the most frequent use of bars and nightclubs for 20 of them, performing with 36 of them. Being the most frequent reasons "cluster" in 12 cases and "encouraged" 11 .- LSD: 25 who had consumed, 21 started between 15 and 19 years y. 24 no longer consumed his capture. With duration of 1 year 9 cases and 2-3, 7 cases, sporadically 23 and 2 on weekends, consuming low-dose 24 of them being the most frequent nightclub for 14 of them, with 24 and motivation "curiosity" in 11 of them .- Opiates: only 8 had tested (16%), with no age prevailing between 15 and 28 years, for its inception, persisting sólo1 it, 4 to 1 - 3 years and 2 for more than 10 years, 4 daily and 4 sporadically, at his home 3 of them and 3 in nightclubs and on the grounds Start 2 f "curiosity" and 2 "fun" .- Alcohol: all what have consumed, they began to drink on a regular basis between 14-18 years 40 of them (7 between 11-13), while maintaining their consumption 27 of them, using weekends in 41 cases and bars and the usual place discos for 43 of them, remain the most common motivation "cluster" in 27 cases .- Cannabis: consumed by el1 00% on occasion, 35 of them began their consumption between 14-17 years (70%) and 17 it maintained its catchment (34%) at 2 years in 11 cases and between 3-6 years 20 cases, with a frequency of daily consumption in 35 of them (70%) and sporadic in 12. At doses aja, 18 of them, 15 to medium dose and 17 at high doses. Used in many places by 29 and in his home by 9, 31 with and 18 alone. For motivation, "the group" in 18 cases and 9 with "satisfaction." Among the reasons for consumption, striking that the highest percentages are warranted for fun (33% starting in alcohol, 20% in cannabis, 17% amphetamines and 15% for cocaine) or mimic the activity of individuals engaged in a group (39% alcohol, 26% of cannabis, 17% or 12% of cocaine on amphetamines) or simple curiosity (46% at the start LSD or 17% in both cocaine and amphetamines). This dominance makes us think of a social consumption and inherent to a lifestyle with its peculiar use of leisure time (as well as confirming the graphic crusade motivation place with consumption and motivated by the company), rather than characteristics intrinsic to the individual, when it comes to choosing start in the consumption of a sustancia.Por Furthermore, a detailed analysis by substances differ by finding activation in amphetamine users (35%) and cocaine (40%) or the beginning of cannabis consumption in a group of patients who blame depression (35%), as a means of relating (38%) or to calm down (8%), profile that suggests a shortfall in the area or emotional possible negative symptoms. With regard to social consumption, all substances are consumed predominantly in the company, except that in addition cannabis consumed alone (36%). Place Its consumption is linked to the dominant entertainment places (nightclubs, bars), for all the substances, but also the cannabis consumed in multiple sites and to a lesser extent cocaine, especially in the wake of the boom being experienced consumption. The frequency of consumption, we found cannabis as the only substance consumed by a large number of patients on a daily basis and for long periods of time and a pattern of alcohol, cocaine and amphetamines in late semana.La sequence startup consumption by age is as follows: snuff, alcohol, cannabis, amphetamines, cocaine, LSD and finally a small percentage, opiáceos.Cabe highlight an early onset of alcohol use, even less than 13 years in some of snuff and cannabis between 12-14 years and two key age groups between 15-16 years, which started in the majority of alcohol, amphetamines and cannabis and 17-18 with start of polisustancias, which could try two different approaches: type in the first prophylactic to prevent escalating doses and variety of substances and another with a screening of consumption for a more therapeutic. Since its inclusion in the study, 15 of them attending psychiatric hospital readmission in 2 times, 9 to 1, 9 to 3, 4 to 4, and only 3 more than 5 times, with psychotic decompensation by consumption of substances cause most frequently, as they continue to consume on a regular cannabis 18 of them, 8 cocaine, 10 alcohol and LSD case. % & / Scale personality 16PF get some personality profiles within the ranges and normality for the general population, with the lowest value in the factor G and the highest in O and Q4. Scale is IPDE get diagnosing personality disorder in 19 patients, with a number of them who have more than one disorder, this means a percentage of 38%. Stress disorders such as more frequent antisocial and unspecified, with 6 cases each, with 4 cases and paranoid esquizoide and evitativo with 3 cases, IEn Scale SCL90R obtained an average low levels of symptomatology, introducing the highest values for obsesividad and paranoidismo.En monitoring of these patients over, we see two subgroups, those diagnosed with schizophrenia and those without. Below is a statistical analysis of the possible differences between the two subgroups and not get statistically significant differences. In connection with ages starting on consumption, the subgroup that evolves not osquizofrenia, ages take a normal distribution curve, with some peaks around the 16 and 17 years; hand in the subgroup of evolution schizophrenia the ages of onset are more homogeneous, with greater frequency between 15 and eighteen years and a peak of 16 years. This could explain different distribution in the population not expected psychotic as a distribution with two standard deviations on the average, which is collapsed on the population psychotic by the blockade posed peak age for the start Frequently outbreaks of psychotic with consequent interruption in all spheres of life including the home in the consumption of toxic substances. Without and 8 mbargo, 641 there is no statistically significant difference between the two grupos.A over time, maintain the consumption of substances: as a percentage close to 50% in both groups, continue to consume alcohol and cannabis, cocaine also something else in the no group E (60/40%), with only one patient continues consuming LSD, which is included in group E and not consumed on a regular basis any amphetamines or opiáceos.Comparando both groups regarding the 16PF the results are fairly homogeneous in both groups , With respect to personality disorders have not been found statistically significant differences between the two groups. The results of the SCL-90R also differences are observed between the two groups that are significant to the statistical analysis. Both the overall index of symptoms (GSI), and the indexes of somatization, obsesividad, interpersonal sensitivity, depression and phobia, score the same in both groups.

Author: SÁNCHEZ-ARAÑA MORENO TOMÁS.
Year: 2005.
University: LAS PALMAS DE GRAN CANARIA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: CENTRO SUPERIOR DE CIENCIAS DE LA SALUD.

Summary: INTRODUCTION: The schizophrenic patients have a comorbidity ill âmédicasâ that exceeds 50%. Today, the prevalence of the so-called metabolic syndrome in these patients is very high increase between two and four times the risk of coronary and diabetes. OBJECTIVES: The thesis aims to detect the prevalence of this syndrome in schizophrenic patients admitted to a psychiatric unit in a general hospital, and what are the socio-demographic variables, evolutionary, anthropometric, clinical and psicofarmacológicas that relate to it. It is also intended to publicize the coronary risk and the quality of life of these patients, as well as their relationship with the metabolic syndrome. MATERIALS AND METHODS: Observational cross. Population: 136 patients admitted during the year 2004 at the University Hospital in Gran Canaria Dr. Negrín diagnosed with schizophrenia more than two years of development and validated through SCID-I. Metabolic syndrome defined by the criteria of NCEP-ATP III and quality of life measured with the EuroQol 5D. RESULTS: The prevalence of metabolic syndrome in the schizophrenic population studied is of 36%, representing an increase of 11% compared to the general population. The prevalence of the different components of metabolic syndrome in schizophrenics studied is distributed in a manner similar to the general population of Gran Canaria. In women highlights the high prevalence of obesity abdominal (78.7%), resulting partnership with the female significant. We found no relationship between metabolic syndrome and the various socio-demographic variables, evolutionary and clinics. Neither the metabolic syndrome is associated with the consumption of different types of toxic or different treatments psicofarmacológicos. The coronary risk in the next 10 years for the study population is moderate in 52.3% of cases and high in 2.9%. The increased risk associated with the suffering of metabolic syndrome and taking antipsychotics. Metabolic syndrome is associated with a worse score on the dimensions of EuroQol 5D âestado health hoyâ and âmovilidad'. CONCLUSIONS: The schizophrenic population is a group where there is a need for detection of metabolic syndrome. It is timely to conduct a routine, daily monitoring of these patients, measurements relevant to the screening of the metabolic syndrome and thus be able to identify those subjects to a greater cardiovascular risk.

Author: Rejón Altable Carlos.
Year: 2005.
University: AUTÓNOMA DE MADRID.
Place of defense: Facultad de Medicina.
Place of preparation: UAM, Facultad de medicina.

Summary: We are studying and comparing the properties of the sign semióticas medical and psychiatric realizing their diferncias and the need to reconcebir sign psychiatric deployment as a place of mediation occurs in subjectivity between symbolic and biological exteriority. This is done based on the synthetic nature of the role semiotics, respecting the diversity of empirical signs psychiatric and showing, finally, that is the proceeds of a actvidad logic, and denial of establishment of determinations, organized in a moment perpeceptivo, one and one designativo practical.

Author: ALVAREZ LÓPEZ PILAR.
Year: 2005.
University: BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: OBJECTIVES 1-Determine if there are differences in the locations of union 3H-imipramina, places of union 3H-paroxetina and / or receivers 5-HT2 platelet between: A-T.depresivo higher (TDM) with melancholy and control group and B-TDM with melancholy with psychotic symptoms, TDM with melancholy without psychotic symptoms and control group. 2-To establish whether there was an association between places of union 3H-imipramina, places of union 3H-paroxetina and / or receivers 5-HT2 and variable clínico-evolutivas in melancholy, melancholy psychotic and non-psychotic melancholy. DESIGN 1-A cross-sectional study (case-control). 2-longitudinal and prospective study of the cohort of patients. FIELD Patients antendidos in the Service of Psychiatry at the University Hospital of Bellvitge (HUB) (Barcelona). SUBJECT OF STUDY, 1-Patients admitted if they met DSM-IV criteria for the diagnosis of unipolar major depressive episode with melancholy (n = 42), with psychotic symptoms (n = 20) or without psychotic symptoms (n = 22) -, presenting a higher score = 17 points in the scale of assessment of the Hamilton Depression of 21-items and after high hospitalria conducted follow-up consultations External HUB. 2-control group, consisting of 40 healthy volunteers well known by the investigators. INSTRUMENTALIZACIÓN the admission was made a washing pharmacological 2 weeks followed by the extraction was performed blood for determining loslugares union platelet-3H-imipramina and 3H-paroxetina and recipients 5-HTS. At this time also were collected variables and clinical course beforehand. During the follow-up post-alta clinical variables were collected and evolutionary. DETERMINATIONS 1-Patients: demographic variables, clinical course prior evolutionary collected instruments goals. 2, - Controls: demographic variables, clinical interview and administration "Goldberg Health Questionaire" and "Family History Research Diagnostic Criteria for Psychiatric discard personal and family background. The radioligando used to mark recipients 5-HT2 was 3H-ketanserina. RESULTS 1, melancholy - patients have a significant decrease in the Bmax of 3H-imipramina and the Kd-receptor 5-HT2 respect to the controls. 2, melancholy - patients with and without psychotic symptoms showed a decline in the Bmax of 3H-impiramina respect to the control group. Patients with psychotic symptoms melancholy also have a decrease in Kd of recipients 5-HT2 respect to the control group. 3-Patients melancholy early onset (under 60 years) and late-onset (less = 60 years) differ in the Bmax of 3H-impiramina and the Kd-receptor 5-HT2 (diminished only in the first ). In patients with psychotic symptoms melancholy there was a negative correlation between the Bmax of recipients 5-HT2 and the time required to achieve the emission partial and complete. CONCLUSIONS 1-melancholic unipolar depression is characterized by a marked decrease in the density of the binding sites of 3H-impiramina and an increase in the affinity of the receptor 5-HT2. 2 - Despite the greater specificity and affinity of the 3H-paroxetina by the rise of serotonin reuptake, 3H-impiramina presents greater diagnostic sensitivity for melancholic depression. 3 - The melancholy with psychotic symptoms and without psychotic symptoms appear to differ in terms of Kd-receptor 5-HT2 (diminished only in the first). 4, - profile partnerships between different biochemical parameters and variables clínico-evolutivas, said the convenience of using groups as homogeneous as possible in biological studies.

Author: BAEZA PERTEGAZ INMACULADA.
Year: 2005.
University: BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Author: MONRAS ARNAU MIQUEL.
Year: 2005.
University: AUTÓNOMA DE BARCELONA.
Place of defense: U.AUTONOMA DE BARCELONA.
Place of preparation: HOSPITAL CLINICO DE BARCELONA.

Summary: The number of interconsultas (CI) at the Hospital Clinic in Barcelona due to alcohol consumption represents 0.5% of total hospital admissions during the time period studied, taking into account all the rooms entering adults. This detection is clearly below 15 to 35% indicate that existing studies and confirms the great infradetección existing alcohol abuse in general hospitals. There are major differences between the various divisions: Psychiatry and Hepatology request IC by more than 2% of their income, while other rooms are not reaching 0.1%, despite the existence of evidence to support the existence of many patients with consumption abuse of alcohol in Chambers eg Otolaryngology. This leads to think that the differences in the detection not so by the type of disease or ill, for the different historical sensitivity compared with alcoholism that have developed medical teams Patients in this study are older, more psychopathology and greater frequency of neuropsychological deterioration than patients of similar sociodemographic half but treated at outpatient or with income and programmed specifically for his alcoholism. At 2 years of hospitalization compliance that make the treatment alcohológico is very low. Only about 1% of patients achieve high therapeutic and a 9% still undergoing treatment, while a 36% had dropped out and 31% have not begun ever. In the case of treatments médico-orgánicos the situation is similar, being related withdrawals of either treatment, which indicates that patients alcoholics who do not follow a treatment for his alcohol dependency do not comply with visits indicated for tracking their functional diseases. What we can not say is whether an abandonment because the other or both failures due to personal factors of the patients. The lack of awareness of the disease and treatment or explicit rejection have, in the whole sample as a whole, a significant prognostic value. In contrast between patients who actually carried out any visit post-alta, factors that favor the failure are lack of psychosocial disorders, or the existence of fewer interconsultas prior. The survival of the sample to 4 years old is 70%, much lower than other studies analyzed, both heroin addicts, as with alcoholics. The existence of hospitalizations, emergency room and pre interconsultas corresponds to a greater chance of having new hospitalizations, emergency room and interconsultas later. The only alterations psychosocial predict new interconsultas to 4 years. Almost half of patients had been admitted earlier in HCB and 3 / 4 parties had come to Emergencies, being intercorrelacionados both facts and with the completion of new revenue. To sum up, very few patients are detected alcohol in general hospitals, there is an overall specificity and sensitivity to change very little, and the cases are detected presents a much greater severity than patients treated ambulatoriamente. In general compliance with the therapeutic indications to 2 years is very bad and it also affects other diseases functional, so that suffer a mortality of 30% at 4 years, in addition to several emergencies and readmissions. Faced with a late detection and biased treatment ineffective and a bad prognosis crucial, efforts should be directed to the early detection of patients still potentially treatable, who are younger and less damaged. These patients come to the hospital because of emergencies or earnings before having developed an irreversible disorder. At this time is when proactive strategies through search and 8 screeni 364 ng can be localized and alcoholism treated successfully. Should reconciled what has been learned and the means provided in research studies with the systematization of clinical practice through routine procedures

Author: COULLAUT-VALERA GARCÍA JUAN.
Year: 2005.
University: COMPLUTENSE DE MADRID.
Place of defense: UNIVERSIDAD COMPLUTENSE DE MADRID - FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: In this Doctoral Thesis we tried to understand the changes neuropsicofisiológicas in the occipital lobe in depressed patients, using evoked potentials, in particular the wave P300 faced with a task of stimulation and visual memory. The results corroborate multiple studies conducted so far in this direction finding latency delayed in that component and a decrease in the amplitude of the same. Here we must mention the inversely proportional relationship between the amplitude of the wave and the severity of depression scores extent proportional between the amplitude of the wave and the severity of depression extent scores in the Hamilton test , so that a larger component P300, the lower severity of depression and vice versa. Other results in this Doctoral Thesis are related to the reaction time tasks and visual memory. Our results in terms of reaction times in the visual task we have significant data, comparing the average of two samples indicating that the reaction time is faster in the control group as compared to pathological group. On the contrary with respect to response time in the memory task, we appreciate not significant differences in this group. However, once analyzed here influence on the type of work performed on reaction times in general saw as the task of memory it produced statistically significant data in both groups, because in our opinion the greatest breadth of the same and the increased use cognitive suited to take this kind of task. As for the memory This study demonstrates the alteration experienced by patients in this regard both in memory and logic type I in type II thereby showing an increase in the rate of oblivion. Referring to the results obtained in the scale Minimental State Examination (MMSE) leave demonstrated the existence of statistically significant differences in this respect between the two groups, control and depressive This suggests that the relationship between cognitive impairment and depression. As a final conclusion, this study leaves open the door to further studies on perceptual world occipital lobe and depression but by the time the results of this thesis is not conclusive nor definitive.

Author: ROJO PANTOJA AGUEDA.
Year: 2005.
University: COMPLUTENSE DE MADRID.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: With this research we intend to conduct a historical study of a concept psicopatológico with two remarks, a temporary, fin-de-siècle, and the other referring to two authors: Pierre Janet and Sigmund Freud. First, it describes the historical, socio-cultural and philosophical, and explores the etymology and the aura semantics of the word dissociation. Secondly, he examines the work of these two authors, Janet and Freud, in regard to their studies and to complete decoupling, outlines the vision of other contemporary authors (Binet, Myers, Blondel, McDougall and Jackson) the concept dissociation of importance because of the reciprocal influences more than likely with the works of Janet and Freud. Following the proposal of theoretical Berrios, one can say that dissociative disorders are from the "convergence" referred to by Pierre Janet, who included a neologism, désagrégation, a champion behavioral anaesthesias systematized, catalepsias partial, or cleavage and a concept, which union theories philosophical, psychological and psychodynamic prevalent during fin-de-siècle. The work of P. Janet thrives on the concept of désagrégation Moreau de Tours, and the dynamic of Maine Biran. For Janet the hysterical suffer a "narrowing" of the concept of conscience, because of their psychological weakness, which would affect the role of synthesis. While interest Freud by the dissociation was very short, he developed a theory of self-hysterical attack, which underscored the importance of dissociation and the isolation of certain psychic phenomena in the hysterical paralysis. First Breuer shared the theory about the existence of "states hipnoides" as the basis and condition of hysteria, but not quickly abandon this position, with the creation of histerias "defense." Proper calibration symptom decoupling leads to a forced analysis histórico-conceptual to give epistemological discipline.

Author: RAMIREZ RUIZ BLANCA.
Year: 2005.
University: BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Parkinson's disease (PD) is a neurodegenerative disorder that is characterized by motor symptoms and no engines. Among the non-motor symptoms, the presence of cognitive impairment and psychotic symptoms, including hallucinations complications are among the most prevalent. Both complications have a major impact on the degree of disability suffered by the patient and hence their quality of life. The presence of cognitive impairment and dementia were identified as risk factors most often associated with the development of alucionaciones visual (AV) in PD. In addition, most studies have found a higher prevalence of psychosis in patients with PD insane to non insane. However, although the relationship between cognitive dysfunction and AV is well established, it appears that the emergence of AV is not directly caused by the presence of cognitive impairment because not all patients with dementia experience AV and association studies supports a nature mutlifactorial phenomenon . The overall purpose of this thesis was to achieve a better understanding of the base of the brain and neuropsychological deficits associated with the presence of dementia and AV in PD. The overall objectives of the studies that formed this thesis were: 1, - The study of the structural brain changes associated with the presence of dementia and visual hallucinations in Parkinson's disease. 2-Characterization cognitive through a cross-sectional study and follow-up to a group of PD patients without dementia whom had history alucionaciones visually complex. To accomplish these goals were designed five studies that examined cognitive function and brain structural features in PD patients using standardized neuropsychological tests and different structural magnetic resonance techniques. The first and the second study evaluated a sample of PD patients with and without dementia. The three following studies were carried out on a group of PD patients without dementia whom had history VA complex. The results showed that the pattern of brain structural changes in patients with PD and dementia extended beyond circuits frotno-estriatales described as classically responsible for the cognitive deficits of PD. They found changes atroficos affecting the temporal and occipital cerebral cortex in patients with PD and dementia and PD patients without dementia with a history of AV. These findings emphasize the importance of cortical structures subsequent explanation for the presence of visual hallucinations and progressive cognitive impairment. The cognitive impairment in patients with visual hallucinations was observed in visual functions and complex semantic processing (perceptual interpretation of the information). This pattern neuropsychological would agree with our findings magnetic resonance structural changes which were apparent brain type atrophic areas in secondary visual areas and tertiary latter involved in the integration of information semantics.

Author: SALVÀ COLL JOAN.
Year: 2005.
University: BARCELONA.
Place of defense: FACULTAT DE MEDICINA.
Place of preparation: FACULTAT DE MEDICINA.

Author: ALVAREZ SAN MIGUEL CARLOS.
Year: 2005.
University: SALAMANCA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The methodology consisted of a longitudinal study design with two moments of measure: pretreatment, treatment, and three months later, post-tratramiento. The sample consisted of 82 subjects of MSC 1Â º (Valladolid) with a diagnosis of Major Depressive Disorder (F32.xy F33.x). The questionnaires used were 16PF (Cattell), STAI (Spielberger), BDI (Beck), QCA (Legeron) Objective: To investigate the effectiveness of treatment with SSRIs and analyze the possible influence of personal and socio-cultural variables. Assumptions: a)

Author: PRIETO MESTRE NIEVES.
Year: 2005.
University: SALAMANCA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Author: REY SANCHEZ FRANCISCO.
Year: 2005.
University: SALAMANCA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Author: MEDINA VAZQUEZ M. DOLORES.
Year: 2005.
University: EXTREMADURA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: This is a research project to explore possible malfunctions of eating behavior in adolescent population clinic ay not to try to identify risk factors that lead to the emergence of such failures, and to try to integrate these data, in a preventive program apply glue in the area. We both types of studies, a cross and longitudinal another. The sample consisted of 170 adolescents, 102 women and 68 men. The results confirm that adolescence is a period of high risk for the occurrence of malfunctions alimentarais therefore an appropriate forum for the early detection and prevention of women in the academia, in secondary schools. It shows that teenage girls score higher in all scales that initially appear to be predictors of dysfunction food. In addition feel more pressured for aesthetic values imposed by the society. We find that there is a great need for such work by the amount of information on the genesis of you eating disorders that can be obtained.

Author: DUARTE GONZÁLEZ ISABEL M..
Year: 2005.
University: EXTREMADURA.
Place of defense: FACULTAD DE MEDICINA DE BADAJOZ.

Summary: OBJECTIVES Knowing the characteristics of women attended at a Center for Family Planning (COF) in terms of personality, stress level / social support, and level of psychopathological symptoms and gynecological, to analyze the influence of the result in cytological psychopathological variables, gynecological and environmental in the short and medium term and to assess whether some of the factors studied could adversely affect the psychological response in the short or medium term. METHOD We conducted a cross-sectional study and another longitudinal (292 and 124 women respectively), women who went to COF for the first time and that was done cytology. The longitudinal study included women who returned to the center to control annual him. The instruments used were the Eysenck Personality Questionnaire-form A (EPQ), the Symptom Checklist (SCL-90-R), the State Trait Anxiety Inventory (STAI), the symptom questionnaire, attitudes and emotional disorder in clinical gynecology (Salvatierra) and questionnaire stress and social support at the University of California. The statistical analysis was used for one sample t-test for independent samples and samples paired, Chi, correlation, and multiple regression. RESULTS 1-profile women who came to COF was: young woman, a student or housewife, unmarried, with varying levels of training, which requires naticoncepción. It is a woman extroverted, low-neurotism and psicoticismo, which supports low stress levels and is protected by a high level of social support, with both psicopatológica as gynecological symptoms low. 2 - The neurotism, hardness, trait anxiety and the global index of the intensity of symptoms psicopatológicos and scales hipoestronismo, vasolabilidad and pelvic algias, showed a high correlation with each other. 3, - Women from the program early diagnosis was greater than the family planning program, they were tired in greater numbers, were less educated, less extrovertidas exhibited a higher degree of somatization, fear of pregnancy and contraception more and rejection of the traditional female role, and tended to show higher levels of algias pelvic and hipoestromismo. 4-At the start of the study, women who had a positive result of cytology (inflammatory / displástico) did not differ in any of the variables of having a normal outcome. 5-In our sample undergo a screening of cervical cancer not caused a significant increase in levels of anxiety or other symptoms psicopatológicos, but on the contrary, there was a decrease in short-term psychopathology in women with positive outcome, and in the medium term in women with positive results, and in the medium term in all women, regardless of the outcome. 6 - The level of neurotism and stress at baseline were found to be predictors of psychological discomfort medium plazio for women included in the program of screening for cancer of cervix.

Author: JIMÉNEZ SÁENZ JUANA.
Year: 2005.
University: ZARAGOZA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: OBJECTIVES Define and identify the side effects that occur in the Department of Internal Medicine. To estimate the incidence, causes attributable, the impact of health care in the adverse effects documented and quantify the adverse effects avoidable and their associated costs. METHODS observational study prospective cohort convertible predictive in which followed 936 patients admitted to the Department of Internal Medicine in 2004. The information on adverse effects was collected from the documentation of the medical history. RESULTS There were adverse effects associated with healthcare at 7.3% delos hospitalized patients. The biggest associated comorbidity and the presence of a larger number of extrinsic factors, studied in unison, were associated with more adverse events during hospitalization (p less 0.05). This effect desapreció to analyze these two factors separately. The 53% of the documented adverse effects were evaluated as preventable. The reasons most often associated with adverse effects were, first, adverse drug reaction reports, second, effects associated with the handling and monitoring of patients, third and fourth nosocomial infections, effects related procedures . In over 80% of cases that occurred side effects, patients required additional procedures and treatments that resulted increased workload and increased costs. The information in the medical record was inadequate or inappropriate in more than half the cases in which there were avoidable adverse affections, being the most inappropriate As was the most preventable adverse effect. CONCLUSIONS The adverse effects of healthcare affect a significant percentage of patients, sometimes pose significant risks to patients, increasing the burden of care and increase the costs associated with the episode. A large proportion of these effects are preventable. Knowing the causes of adverse effects is the starting point to prevent and / or reduce the adverse effects considered preventable, reduce the severity of injuries resulting therefrom and maximize their understanding on the part of patients. KEYWORDS: adverse effects, prevention, clinical safety.

Author: TOMAS ARAGONES LUCIA.
Year: 2005.
University: ZARAGOZA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: This work is a longitudinal study, randomized, blinded comparison between patients and doctors and depressed patients without psychiatric comorbidity. The data come from patients older than 18 years, admitted plants Internal Medicine Clinical Hospital of Zaragoza, between February 2002 and June 2004. The objective of this study was to validate the scale Hospital Anxiety and Depression Scale (HADS), Spanish version, to detect depression in patients admitted in a Department of Internal Medicine of a General Hospital. To make this validation study has been used as a "Gold Standard" a standardized psychiatric interview. In addition, some have been implemented and demanding full inclusion and exclusion criteria of depressed patients, has assessed the cognitive impairment through a reliable and reproducible, and have excluded all patients presenting with any illness or psychiatric disorder concurrently. Specific objectives were: Know the reliability of the scale, knowing the validity of the cutoff point in our sample, and make a descriptive analysis of the performance of the depression subscale depending on the variables of the sample validation (sociodemographic, and psychopathological Somatic disease). The findings were as follows: - The Spanish version of the HADS scale has been shown to be a reliable scale, which presents a high internal consistency (Cronbach alpha = 0'88 for the subscale of depression, 0'82 to the anxiety subscale and 0'90 to full scale). - Has shown, in addition, be a valid instrument to detect probable cases of depression (with criteria ICD-10 for patients doctors): a. The optimal cutoff point is greater than or equal to 6 in the sample studied. B. Presents some indexes of efficiency adequate, with a sensitivity of 72'86%, a specificity of 82'56%, a positive predictive value of 62'96%, a negative predictive value of 88'20% (for an approximate prevalence of depression the 20%), and a percentage of poorly rated the 20'25%. C. The area under the ROC curve obtained (0'851) also is considered adequate to detect depression. D. With regard to the construct validity, the scale provides a structure that allows bifactorial discriminate between depression and anxiety. - Confirm the assumptions made may say that score more often as "probable cases" of depression: a. Women (24'5%), compared with men (11'1%) b. The geriatric patients (18'4%), compared to non-geriatric patients (10.5%) c. Patients living alone (25'7%), compared to those living with partner (11'7%); d. Patients illiterate (28'2%), compared to those with studies (13'9%).

Author: QUINTANILLA LOPEZ MIGUEL LOPEZ.
Year: 2005.
University: ZARAGOZA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Objectives: To assess the degree of dependence on the daily activities in a representative sample of the population above 55 years of the city of Zaragoza. Studying its relationship with socio-demographic variables, physical health and psychopathological. Materials and Methods: We conducted a cross-sectional study. It appreciates a community representative sample of the reference population. It used the interview ZARADEMP-I designed for this study, which includes tools for reliable and valid measure for assessing cognitive performance, the presence of psychopathology and functional assessment (Review Cognitive Mini-Mental, Geriatric Mental State, Katz and index scale for Lawton and Brody). Results and conclusions: the initial sample (9739 subjects) is achieved by interviewing 4803 people, which is the sample of the study. The prevalence of dependence varies core activities of 8.4% for the continuity of esfínteres to 3.7% for food, with a unit for any activity everyday basic from 12.8% in instrumental activities varies from 13.3% to use public transport to 6.9% for family oriented streets, with a unit for any daily activity instrumentation of 18.4%. This produces an effect on the overall social sphere of 19.8%. As expected, and in support of the validity of the results, it confirms that there is more dependence as older and in relation to certain socio-demographic variables (gender, marital status, educational level ,...). We note that there is already an agency to develop the daily activities even in the younger age groups studied. The prevalence of dependency is increased by age ranges from 2.7% for core activities, 3.5% for instrumental and 6.9% of involvement in the social sphere in people from 55 to 64 years at 37, 9% for core activities, at 57.8% for instrumental and 47.4% of involvement in the social sphere in people 85 or older. There is more dependence in women than in men. Those widows have higher rates of dependency that married or unmarried. People who live alone or with their spouse have lower rates of dependency than those living with their children or institutionalized. It confirms the relationship between level of education, income level or the general state of health and dependency. We found increased reliance on the lower educational levels, the dependency ratio is lower in people with higher income and when there is a good general state of health. The unit deals with the plight of psychiatric pathology. Predictably dementia which is associated with increased dependence. We emphasize how depression (depression greater than the minor) is related to unit for carrying out the daily tasks, both as a basic instrumental, and, more important with the allocation of the social sphere. The unit increases under worse cognitive performance as measured by scores on the Review Cognitive Mini-Mental, so that this simple tool can be an indirect indicator of disability. Following the multivariate logistic regression analysis, confirms that the following variables are associated independently and controlled the rest of the variables studied, with a higher risk of dependence to perform daily activities (basic and instrumental) and impairment of field social age from 75 years, different types of coexistence, not possess good general health status, performance cognitive deficit and the presence of psychopathology (dementia, major depression, minor depression).