PSYCHIATRY, 3

Author: ALVAREZ ARIZA MARIA.
Year: 2005.
University: SANTIAGO DE COMPOSTELA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: DEPARTAMENTO DE PSIQUIATRIA. UNIVERSIDAD DE SANTIAGO DE COMPOSTELA.

Summary: The epidemiology of mania in the elderly is not completely clear yet, some studies suggest that the manic phase of bipolar affective disorder is not common in this age group (Wertham 1929; Roth 1955) and others that the percentages are similar or even older (Spicer 1973; Eagles 1985). Although this disparity in results can be derived from the various diagnostic criteria employed, there is also the possibility that a hidden factor is changing the figures, we could call it change in the format and frequency of manic symptoms in the elderly possibly connected with age The coexistence of neurological disorders or medical comorbidity. The mania in the elderly has been qualitatively described as less intense, more hostility and features mixed. Methodology of Clinical occasion of the Thesis: A first indirect cross-sectional study in England 8 shows English 220 patients with the diagnosis of mania). An instrument, battery symptoms, in order to facilitate and improve the collection of demographic data both as psicopatológicos. It was subsequently made a second direct cross-sectional study, during 5 years in Spain. It collected 67 income except with the diagnosis of mania in the unit's Treble Hospital Complex of Pontevedra in the period 2000-2004. The same data were collected in the sample English. CONCLUSIONS The following are the findings clearly coincident with the published literature and also matched two samples of study: English and Spanish. SCENARIO 1 1 - There sub-síndromas inside the peanut. CONCLUSION 1 Done factorial analysis of the two samples separately and then a joint analysis of both, it gets to the confirmation of the first working hypothesis. Appear the following factors: 1-Mania pure 2-Irritability / aggressiveness, 3-Deficit cognitive 4-Mania mixed 5-Psychosis 6-language data support the existence in the "manic episodes" excitation psíquica-psicomotriz , irritability, symptoms of depression and psychotic symptoms. It shows the weight of possible cognitive around after the patients, which is an important factor in mania. HIPOTESIS 2 Differences exist demographic and clinical (in the intensity and frequency) of manic symptoms in patients older and younger than 65 years. CONCLUSION 2 are detectable differences in the mania for the elderly and the young adult. HIPOTESIS 3 Differences exist demographic and clinical (in the intensity and frequency) of manic symptoms in patients with early or late onset of mania. CONCLUSION 3 No. confirms the part relating to the clinic for the third hypothesis. There exist differences in the clinical profile within the group of elders. The results suggest several lines of future research: 1 - Develop methods best suited for the diagnosis of bipolar disorder in the elderly to help identify the etiology, risk factors. 2-pharmacological studies of efficacy in this age group to help develop a guide to treatment of bipolar disorder in the elderly. 3-To deepen the study of comorbidity of bipolar disorder for the elderly. 4 - The mania in the elderly represent a significant use of the services and medical costs both now and in future. There is therefore a need to plan easier access to health care and social service in this age group.

Author: GARCIA FERNÁNDEZ M. EUGENIA.
Year: 2005.
University: COMPLUTENSE DE MADRID.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The aging population is heightening the need for care of elderly emerging figure disabled patient and primary caregiver. The objective of this paper is to describe the quality of life of the caregiver from a sample of 240 patients included in the Program of Care for Disabled four teams for Primary Care and the municipality of Parla a team of Getafe, through a semi-structured interview, the Health Profile Nottingham and the scale Barthel. The resutlados obtained are that the caregiver is predominantly women (85%), married (80%), with an average age of 56 years, housewives (75%), with a level of primary school complete (40%), which she cares for his father or mother (60%) and living with the patient, her partner and children (47%). The caregiver male (15%) is also married (81%) of 66 years of average age, retired (73%), which cares for his wife (57%) and lives alone with her (35%). Both engaged in patient care disabled between 12 and 24 hours, and aid they receive are mainly from other family members and had no free time for leisure activities. The caregiver is regular health (46%), and the problems faced most often is: insomnia 53%, OA 55% and depression 39%. A 23% took medication for sleep and 45% had consulted any problem to his general practitioner in the past month. The dimensions of the Nottingham Health Profile (NSP) with higher scores (worst health status) are: emotional reaction, sleep and pain. The measures scoring in caregivers of patients with disabilities are superior in all respects to that of the general population. The perception of health status is related to gender (more sleep and pain in women), age (all dimensions less social isolation can increase their scores measure with age), and educational level (inverse relationship with all dimensions ) and the employment situation (average scores in older retirees and housewives). The variables that describe the health of the caregiver relates to resutlados of NSP, especially mental illness. The dimension less related to these variables is the social isolation (intake of medication and medical consultation generally not related to eta dimension). The patient characteristics disabled that are associated with a poorer perception of health status of the caregiver are disabled man and severely disabled (with the latter dimension n mobility and social isolation). The time spent caring also relates to the PSN, the number of months of the year with social isolation and the number of hours per day with all dimensions. In several works have been studied both clinical and sociodemographic characteristics of caregivers and the disabled. This paper aims to provide something more on those points and shape the quality of life of these patients caregiver in the field of Primary Care.

Author: BONÉ PINA IGNACIO.
Year: 2005.
University: AUTÓNOMA DE MADRID.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The theory suggests that the model can provide more vulnerable to psychopathology of what has made so far. To prove it discusses two main modes of submission of this model. It looks, on the one hand, the line of Zubin & Spring with their followers, and in contrast, the line more phenomenological followed by Giovanni Stanghellini. After detecting the shortcomings of these visions is proposed to complement intuitions present in the works of two psicopatológos classics: Ludwig Binswanger and Karl Jaspers. Your contributions help to rebuild a sense of vulnerability most appropriate for the theory and practice psicopatológica current and not reduced vision or mental illness or that of the human being suffers.

Author: SAHÚN ABIZANDA IGNACIO.
Year: 2006.
University: AUTÓNOMA DE BARCELONA.
Place of defense: CENTRE DE REGULACIÓ GENÓMICA.
Place of preparation: CENTRO DE REGULACIÓN GENÓMICA.

Summary: The Doctoral Thesis presented Ignasi Sahún Abizanda is included in the online study of the mechanisms of genetic disorders anxiety / panic that is developed in my laboratory and has been a pioneer in proposing the participation of TrkC in pathological processes associated with the system fear, like panic disorder. It shares structural elements with reward systems, they change in the brain as a result of acute or chronic consumption of substances of abuse. The results presented in mice with sobrexpresión of isoform wild TrkC suggest that changes in the levels of expression of this modulate the development and function of certain brain areas. The thesis demonstrates that the sobrexpresión of isoform wild TrkC in vivo produces changes in cellularity in different nuclei catecolaminérgicos associated with the system of fear as the ventral tegmental area, the black substance or locus coeruleus, but the amygdala and hippocampus (Dierssen et al, 2006; Sahún et al, in preparation). In the mouse with sobrexpresión of TrkC look forward to a phenotype and increased reaction of panic, and these changes in systems catecolaminérgicos decrease the threshold of emotional excitement of the individual and alter the regulatory regime of fear and alarm (Dierssen et al., 2006; Sahún et al, in press). In addition, the transgenic mice for TrkC show a worse associative learning and LTP most persistent and important controls synapse CA1-CA3 hippocampal (Sahún et al, 2006 subject). In any case, the thesis has followed the line of argument outlined in the original project, and not only that, but it has borne fruit important, in the form of three publications and several projects underlying this initial investigation.

Author: GARCÍA ÁLVAREZ MARÍA JESÚS.
Year: 2006.
University: SANTIAGO DE COMPOSTELA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULDADE DE MEDICINA.

Summary: THE HOSPITAL PSYCHIATRIC DETENTION REBULLÓN IS THE LAST PSIQUIÁTRICA INSTITUTION THAT WITH THE CHARACTER OF HOSPITAL CASE, A CHARGE OF A PROVINCIAL DIPUTACIÓN, INAUGURATION IN THE COMMUNITY GALICIAN. WHILE THE FIRST REFERENCES LE PRONOSTICARON THE FAILURE, ORAL HISTORY AND REFERENCES OF THIS CENTURY CONVIRTIERON TO THIS HOSPITAL IN AN INSTITUTION PIONEER IN THE FIELD CARE, TEACHING AND ORGANIZATIONAL ALCANZANDO WELL THE CATEGORY OF A MYTH. UP THIS STUDY NOT PUDO DOCUMENTAR WHAT CHARACTERISTICS OF ITS OPERATING CONVIRTIERON TO THIS INSTITUTION IN ANY DIFFERENT OR WHAT FACTORS CONDICIONARON ITS DEVELOPMENT FUNCTIONAL. ARISING TWO SCENARIOS FOR RESEARCH: -EL MODEL CARE TO DEVELOP IN THIS INSTITUTION IS REGÍA BY THE RECOMMENDATIONS OF COMMITTEES OF EXPERTS WHO - PERFORMANCE OF THIS HOSPITAL DEPENDIÓ ONLY THE IMPLEMENTATION OF LEGISLATIVE TERMS FOR WHAT IS JUST ONE EXAMPLE OF ITS IMPLEMENTATION. GENERAL PURPOSE AS ARE PROPOSED FOR RESEARCH CUESTIONAR THE MYTH FROM A HISTORICAL PERSPECTIVE, DESCRIBIENDO And ANALIZANDO OPERATION OF THIS INSTITUTION FROM 1975 TO 1995, THE YEAR THAT OCCURS IN TRANSFER TO YOUR HEALTH SERVICE GALICIAN. AFTER FURNISH THE CONTEXT CARE, SOCIOPOLÍTICO AND LEGISLATIVE OF THE PERIOD, HE ANALYSIS AND DESCRIBES, USING WRITTEN SOURCES AND ORAL SOURCES, THE OPERATION OF HOSPITAL PSYCHIATRIC DETENTION REBULLÓN OBTENIÉNDOSE THE FOLLOWING CONCLUSIONS: 1-EL STUDY OF OPERATION OF THIS HOSPITAL MAKES INFERIR THAT IT IS BASÓ, UNTIL 1990 IN THE RECOMMENDATIONS MADE BY THE COMMISSIONS OF EXPERTS WHO IN ITS THIRD REPORT (1957) 2-EN THIS HOSPITAL THE LEGISLATIVE TERMS ARE SUBORDINÓ, UP 1990, APPROACH TO CARE. 3-SINCE 1990, HE LED OUT A PROJECT CARE BASED ON THE IMPLEMENTATION OF LEGAL AUTONÓMICO, HAVING CONTRIBUTED TO THIS PROFESSIONAL ADSCRITOS A HOSPITAL IN THE DEFINITION OF SAME 4-EL DEVELOPMENT ASSISTANCE PSIQUIÁTRICA REACHED BY THE PUBLIC IN THE PROVINCE OF PONTEVEDRA IS ATRIBUIBLE THE COMMITMENT OF PROFESSIONAL TEAM ADSCRITO TO HOSPITAL PSYCHIATRIC DETENTION REBULLÓN 5-EL MYTH OF HOSPITAL PSYCHIATRIC DETENTION REBULLÓN PRESERVÓ TO THE INSTITUTION AND LE PERMITIÓ DEVELOPMENT PROJECT CARE OF A DIFFERENT TO BE LED OUT IN OTHER INSTITUTIONS PSIQUIÁTRICAS GALLEGAS

Author: JIMÉNEZ LÓPEZ M. TERESA.
Year: 2006.
University: COMPLUTENSE DE MADRID.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD COMPLUTENSE - FACULTAD DE MADRID.

Summary: INTRODUCTION The demographic phenomenon of the aging population has raised an important concern about the expected increases in the needs of care caused by the epidemiological shift from multiple diseases and the dramatic increase in degenerative diseases of the brain associated with aging (dementia and Alzheimer's disease) . POPULATION AND KIND OF STUDY About 520 subjects older than 85 years participating in the study baseline Nedices (Neurological Disorders in Central Spain), designed for the study of neurological diseases associated with aging, work was carried out five years of prospective follow-up ( 1994-1999). The sub-muestra (cohort) included in this longitudinal study, was constituted by 326 participants (62.69%, (326-520) than in 1994, were screened for dementia "face to face" through the MMSE WHO and Functional Activities Questionnaire of Pfeffer (FAQ). DEFINITION OF VARIABLES The initial assessment collected socio-demographic variables (age, sex, marital status, educational level and type of coexistence), lifestyle (hours of sleep, physical activity, ligera-diaria, consumption to snuff), health status (self-perception of health, chronic diseases and sensory deficits). For the cognitive level, three possible categories: insane (medical qualification with DSM-IV), abnormal cognitive psychometric (lower percentile 20 for the camera school) and without dementia (less than or equal percentile 20 for school level). FAQ Pfeffer was used to categorize the subject as a dependent (or less equal 5) or independent (less 5) for instrumental activities of daily living (IADL). In the event that the person had died during the 5 years of follow-up, were collected at what time the deaths occurred and the root cause of it. RESULTS During the five years of follow-up killed 161 individuals (49.39% ). not be obtained information on vital status in a 9.82% of the subjects. deceased dominated women (61.5%). 68.32% belonged to the age group 85-90 years. Mean age death was 91.93 years. circulatory diseases were the leading cause of death (45.5%). mortality was associated with lower levels but cognitive and functional capacity. information was obtained valid for the analysis of survival in 290 cases (161 (49.4%) events and 129 (39.6%) censored). Unable to get valid information for 36 elderly participants, 11% of the original sample. The average time of survival was 3.99 years ( 95% CI 3.83-4.14). were found as factors of improved survival with statistical significance not suffer anemia or bronchial diseases. only two of the surveyed neurological diseases (Parkinson's Disease and Clinical Dementia) were so significant prognostic factors such as a worse survival at five years. Lastly, remained as factors in the model, independent predictors of significantly in overall survival. The age group 90-94 years (HR, 1.98) (p greater 0001), the clinical diagnosis of dementia (HR: 2.38) (p less 0001), and functional unit (HR: 1.62) (p less 0.05). CONCLUSIONS Factors level cognitive and functional capacity have proved to be good predictors of mortality and survival in the very elderly. KEYWORDS mortality, survival, cognitive level, functional and very elderly.

Author: PEREDA VICANDI MIKEL.
Year: 2006.
University: PAÍS VASCO.
Place of defense: FACULTAD DE MEDICINA UPV/EHU.
Place of preparation: UPV/EHU.

Summary: With this Doctoral Thesis seeks ascertain alexitimia, reactivity to stress and mental health of university students guipuzcoanos, as well as their possible links with socio-demographic variables and university. In addition to the above comparing these data with those attending university vizcaínos and in the general population. This is a cross-sectional study descriptive and analytical with a sample of more than 750 academics and other samples from more than 400 subjects Youngs university. To compare with the university vizcaínos used data already published a thesis on the subject earlier. Among the findings can be highlighted: * There are no differences alexitimia or reactivity to stress among different races, but among some in the level of mental health. * They are more alexitímicos boys, not academic subjects and boys university vizcaínos. * Women have a higher reactivity to stress. * Mental health and reactivity to stress positively correlated. * Alexitimia and reactivity to stress negatively correlated.

Author: HIDALGO ROMERO ANA MARIA.
Year: 2006.
University: EXTREMADURA.
Place of defense: FACULTAD DE MEDICINA DE BADAJOS. DEPARTAMENTO DE FARMACOLOGÍA Y PSIQUIATRÍA.
Place of preparation: FACULTAD DE MEDICINA DE BADAJOZ. DEPARTAMENTO DE FARMACOLOGÍA Y PSIQUIATRÍA.

Summary: It examines the evolution of health food and media legal, administrative and institutional that have made this possible. Stresses support municipal control of sacrifice and health status of meat and the importance of butchers in the meat supply, as well as the lack of development of the food industry in the city during the period studied. There is a parallel between evolutionary institutions involved in public health in Badajoz and in the rest of Spain. The provincial institute of hygiene brought to the subject studied, an important crucible for advances in public health, overcoming outdated structures and performances. Finally fit profiles of persons exercising their profession in the field covering the subject of this work.

Author: PRIETO VIVES JESÚS MARTÍ.
Year: 2006.
University: BARCELONA.
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: * Thesis presented as a compendium of six international publications conducted between the years 2002 to 2006, with a total impact factor of 35.9 according to the ISI and JCR of 2005. * The research presents a prospective design and was conducted from July 1994 to August 1997. The study sample included 220 patients suffering from blood cancer and who received a bone marrow transplant (BMT) at the Hospital Clinic in Barcelona. During hospitalization for realizing the TMO were evaluated weekly various aspects of quality of life and psychiatric pathology as psychiatric DSM-IV diagnostic criteria. It conducted a total of 1062 valuations psychiatric. * Among the major findings and conclusions of each publication include: 1-It proves the validity and reliability of the four scales of quality of life designed by our research group for use during hospitalization for realizing the TMO. 2 - The level of anxiety is highest at the time of admission while the level of depression is in the second week later. The evolutionary course during the hospitalization of physical parameters continues to develop in parallel with the levels of depression. Compared with the group of allogeneic transplant, the group transplanted autogénicos presents a more favorable course of evolution at the level seen without physical differences regarding depressive symptoms or anxiety. Based on these results can provide guidance in making certain decisions treatment coping with the process of TMO and improve the design of strategies for prevention and treatment. 3-Among many significant risk factors, the variable depressive symptoms is the factor that is associated with the highest level of significance and consistency with the variable fatigue during the TMO. It highlights the importance of undertaking a screening of depression in patients with cancer to pay complaints of fatigue. 4-During the TMO hospitalization for a 44.1% of the study population presents a psychiatric disorder according to DSM-IV criteria. The adaptive treatment is diagnosed in a 22.7% of patients, the mood disorder in a 14.1% anxiety disorder in a 8.2% and a 7.3% delirium. After adjustment for multiple risk factors of confusion, the diagnosis of psychiatric disorder (adaptive disorder, mood or anxiety) were significantly associated with an increase in duration of hospitalization. With regard to these results, it makes special mention of the need for early detection and effective treatment of psychiatric pathology. 5-After adjusting for multiple confounding variables, factors associated with an increased risk of suffering from a psychiatric disorder during the TMO hospital are: young age, women, a history of psychiatric history, low performance status, pain, withdrawal the consumption of snuff and high toxicity of the cytotoxic therapy. The results of this study may provide an improvement in the recognition of patients at risk of developing a psychiatric disorder during the TMO. 6 - Eighteen (9.0%) patients fulfilled DSM-IV criteria for major depression and seventeen (8.5%) minor depression during hospitalization for TMO. After controlling the effect of multiple confounding factors, major depression predicts a significant increase in mortality in the first and third year.

Author: FLOREZ MENENDEZ GERARDO.
Year: 2006.
University: OVIEDO.
Place of defense: CLINICA UNIVERSITARIA DE ODONTOLOGIA.
Place of preparation: UNIVERSIDAD DE SANTIAGO DE COMPOSTELA.

Summary: The search for prognostic factors related to the treatment of alcohol dependence has been, as in other disorders, a primary objective in recent years. Knowing these factors forecasters can adjust the intensity of the treatment of a basis. In this study we examined the relationship between changes in the treatment of alcohol dependence and the following factors: socio (age, sex, marital status, employment, educational attainment acquired, social class and housing / family support), and related clinical alcohol (personality disorders, nicotine consumption, family history of alcoholism, alcohol in the previous month, motivation to change alcohol consumption and desire to consume alcohol) and biological (polymorphisms serotonin and dopamine). Patients received treatment for detoxification and then a cessation treatment of 6 months, which included a psychological intervention based on the model of relapse prevention, and drug treatment. Half of the patients were treated with the anti-agent "craving" naltrexone, and the other half with the agent anti impulsiveness topiramate. The evolution was studied at the 3 and 6 months of treatment. The evolution was evaluated using the following instruments: biomarkers of alcohol consumption, EuropASI, OCDS, WHO / DAS and EQ-5D. Using the results obtained with these instruments was used to design consumer groups to assess the development in a holistic manner. At the end of the study arrived at the following conclusions: socio factors, and clinical related to alcohol had no predictive value, agents psicofarmacológicos is asociarion with a good prognosis and the alleles Stin2.10 VNTR and -141C Del also associated with a good prognosis.