Historia clínica en psiquiatría infanto-juvenil.
Introduction: The training of future specialists in child and adolescent psychiatry involves the acquisition of the skills required for interacting with the patient, their parents and teachers. These techniques help to direct the anamnesis within in structured manner which focuses on achieving, as e...
| Publicado en: | Actas Espanolas de Psiquiatria Vol. 48; no. 6; pp. 229 - 251 |
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| Autores principales: | , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Maria Lopez-Ibor
nov/dic2020
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=147800248&site=ehost-live header: @attributes: shortDbName: lth uiTerm: 147800248 longDbName: MedicLatina uiTag: AN controlInfo: bkinfo: jinfo: jid: 11399287 IVZ jtl: Actas Espanolas de Psiquiatria issn: 11399287 maglogo: N pubinfo: dt: nov/dic2020 vid: 48 iid: 6 pid: 80014 pub: Maria Lopez-Ibor artinfo: ui: 147800248 ppf: 229 ppct: 22 formats: fmt: @attributes: type: P size: 792KB tig: atl: Historia clínica en psiquiatría infanto-juvenil. aug: au: Jiménez-Hernández, José Luis López-Sanchez López, Jimena Moreno-Arias, Cristina Santamaría-Rubio, Elvira Juárez-Calvo, Victoria Crespo-Hervás, Dolores Muñoz-Villa, Arturo López-Rico, Mercedes affil: Unidad de Salud Mental Infanto-Juvenil, CSM Arganzuela; Hospital Doce de Octubre. Madrid Dpto. Fisiología y Farmacología, Facultad de Medicina, Universidad de Salamanca Servicio de Psiquiatría, Hospital Gómez Ulla, Madrid su: History of medicine Adolescent psychiatry Child psychiatry Mental health School health services Community psychiatry Social psychiatry Psychiatric diagnosis sug: subj: History of medicine Adolescent psychiatry Child psychiatry Mental health School health services Community psychiatry Social psychiatry Psychiatric diagnosis keyword: Child and adolescent psychiatry medical history school health programs Social and Community Psychiatry anamnesis coordinación escolar historia clínica Psiquiatría infanto-juvenil salud mental comunitaria ab: Introduction: The training of future specialists in child and adolescent psychiatry involves the acquisition of the skills required for interacting with the patient, their parents and teachers. These techniques help to direct the anamnesis within in structured manner which focuses on achieving, as early as possible, a proper diagnosis and treatment. Objetives: 1) To describe the medical history model we have used in our clinical practice during initial consultations with children and adolescents, and to contribute to the design of a common framework to be used by specialists of child and adolescent psychiatry. 2) To analyze the diagnostic and therapeutic results obtained by retrospectively reviewing clinical histories taken using the same medical history model presented. Materials And Methods: In relation to the materials used, our medical history model and a school report form are described in detail. With regards to the methodology, we reviewed the medical histories of 147 patients who were attended to over a period of time spanning from November 2007 and April 2008 by the child and adolescent mental health team at the Arganzuela Mental Health Center in Madrid. To evaluate the systematic model of questions and answers that we present, we have compared the results obtained for variables related to the psychiatric diagnosis, treatment and coordination with the patients' schools with those reported in recent literature. Results: In 80 patients (54.4%) we observed difficulties in adapting to stressful situations, where 66 individuals (44.8%) were diagnosed with Adjustment disorder and the other 14 with Post-traumatic stress disorder (9.5%). Attention deficit disorder with hyperactivity (ADDH) was diagnosed in 36 patients (24.4%) and Conduct disorder in another 14 (9.5%). Depression was recognized in 31 cases (21%) and Anxiety disorder in 23 (15.6%). Treatment was psychological in 144 cases (97.9%), pharmacological in 68 (46.2%), social in 25 (17%) and educative in 144 children and adolescents (97.9%). A request for a school report was made for all of the patients included in the sample. As each school report was sent back, a coordination meeting was set up with the teachers associated with 113 cases (76.8%). Conclusions: 1) The protocols referred to in this work have proven to be effective at facilitating diagnose, treatment and prevention in childhood and adolescent mental health. Coordination with schools helps to teach the essential skills needed for child psychiatric work within a community. Introducción: La formación de los futuros especialistas en psiquiatría infanto-juvenil necesita el aprendizaje de técnicas específicas de interacción con el paciente, sus padres y profesores que ayuden a focalizar la anamnesis dentro de un marco homogéneo encaminado a conseguir, cuanto antes, un diagnóstico y un tratamiento adecuados. Objetivos: 1º Mostrar el modelo de anamnesis que hemos usado habitualmente en primeras consultas de niños y adolescentes, a lo largo de nuestra práctica clínica, para colaborar en un diseño curricular común de la especialidad. 2º Analizar los resultados diagnósticos y terapéuticos obtenidos al revisar, retrospectivamente, historias clínicas realizadas con el mismo modelo de anamnesis que se presenta. Material y método: En relación al material utilizado, se describe, pormenorizadamente, nuestro modelo de anamnesis y de coordinación escolar. En relación a la metodología, hemos revisado 147 historias clínicas de pacientes atendidos, previamente, con el mismo modelo de anamnesis, durante el periodo de noviembre del 2007 a abril del 2008, por el equipo de salud mental infanto-juvenil del CSM Arganzuela de Madrid. Para valorar el modelo sistemático de preguntas y respuestas que presentamos, hemos comparado, con la bibliografía reciente, los resultados de las variables de diagnóstico psiquiátrico, tratamiento y coordinación escolar de la muestra. Resultados: Respecto al diagnóstico, en 80 historias clínicas (54,4%) se observaban dificultades de adaptación a situaciones estresantes del entorno, coincidiendo 66 casos con trastorno adaptativo (44,8%) y otros 14 con trastorno por estrés postraumático (9,5%). El trastorno por déficit de atención e hiperactividad (TDAH) se daba en 36 pacientes (24,4%) y el trastorno de comportamiento (TC) en 14 (9,5%). El trastorno depresivo se confirmaba en 31 casos (21%) y el trastorno de ansiedad en 23 (15,6%). Respecto al tratamiento, la intervención había sido psicoterapéutica en 144 casos (97,9%), farmacológica en 68 (46,2%), social en 25 (17%) y educativa en 144 niños y adolescentes (97,9%). Respecto a la coordinación escolar se realizaron entrevistas en el centro académico, con los tutores de los pacientes, en 113 casos (76,8% del total). Conclusiones: 1ª Los modelos de anamnesis referidos en este artículo muestran su utilidad para precisar el diagnóstico, el tratamiento y la prevención en salud mental infanto- juvenil. 2ª Nuestras actividades de coordinación escolar enseñan habilidades imprescindibles para el trabajo psiquiátrico comunitario. pubtype: Academic Journal doctype: Article src: R language: Spanish refInfo: copyright: @attributes: flag: Y custom: Copyright of Actas Espanolas de Psiquiatria is the property of Maria Lopez-Ibor and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. item: Actas Espanolas de Psiquiatria holder: Maria Lopez-Ibor dt: @attributes: year: 2020 holdings: @attributes: islocal: N |
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