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F Lana

Publications and source records attributed to F Lana.

7 recordsLinked to original sources
PubMedDate not supplied

[ICD-9 versus DSM-III in the psychoses: anamnestic and catamnestic implications].

We pretend with our study to compare the DSM-III diagnostic criteria with ICD-9 diagnostic criteria for psychotic episodes and to look for the diagnostic stability for both classifications. We studied 79 first psychotic episodes following ICD-9 and retrospectively we applied the DSM-III diagnostic criteria to the same patients. The mean follow up time was 46.6 +/- 6.7 months. In the ICD-9 the schizophrenic psychoses represented the main diagnostic group, not only the day they were discharged from the hospital 31.6% but also in the follow up 39.2%. On the other hand in the DSM-III, in the discharge day the schizophreniform disorder was the more frequent diagnostic 24%, while in the follow up the schizophrenic disorder came to the first position 32.9%. In the ICD-9 there was a 15.1% of diagnostic changes and in the DSM-III nearly the double 30.3%. In both classifications the unspecified and the atypical suffered a great diagnostic mobility; in both nosologies the schizophrenia was the most unchangeable diagnosis, no patient discharged with this diagnosis changed to another in the follow up. ICD-9 could be said that has a great sensitivity and an acceptable specificity for this entities, and DSM-III would have a moderate sensitivity but a very diagnostic specificity for these disorders.

Adult↗
PubMedDate not supplied

[Variability in psychiatric medical practice evaluated by studying short-term psychiatric rehospitalization].

INTRODUCTION: Variability in medical practice can detect deficiencies in medical care quality. This study was designed to determine variations in psychiatric practice by studying short-term rehospitalization (SRH) that could result in differences in quality of psychiatric care. METHODS: Data on 894 consecutive admissions to an inpatient unit from March to December 2001 were collected. Readmissions over the next 90 days or less (SRH) were analyzed. The database was reviewed in order to extract information about several variables: age, gender, period from the first admission, number of previous admissions, interval between initial discharge and readmission, psychiatric diagnosis, aftercare provided by the mental health centers (MHC) and psychiatrist-associated variables. Differences between SRH and the other admissions were examined. RESULTS: There were significant variations in the aftercare provided by the MHC (p = 0.028). There were also variations in the psychiatrist responsible for the inpatient unit (p = 0.03), in the reference psychiatrist in a MHC (p = 0.007), but not in the emergency unit. CONCLUSIONS: This short-term rehospitalization study showed variations in quality of aftercare and in psychiatrist associated variables. Both these findings warrant further investigation that pays specific attention to staff attitudes, system barriers and facilitators of psychiatric care.

Adolescent↗
PubMedDate not supplied

[Impulsive suicidal behavior and serotonin].

In a group of 17 suicidal patients which either had previous suicidal attempts or presented other impulsive behaviors, response to Prl, cortisol and GH to the serotonergic dl-fenfluramine agonist were studied. Suicidal patients suffering from depressive disorders were previously excluded, as well as those with psychotic disorders. The results were compared with those of a control group (n = 17) matched for sex (76.5% females and 23.5% males in both groups) and age (25.1 years old, sd: 10 for the suicidal group and 25.3 years old, sd: 8.7 for controls; t = -0.07, df = 32, p. = .47). The most significant finding were the following: 1) Response to Prl in the suicidal group was significantly lower to that of controls, as much as in absolute terms (Prl = max-baseline): 7.4 ng/ml. (sd: 10.3) vs 15.5 ng/ml (sd: 14.1) (t = -1.9, df = 32, p less than .03) as percentage wise (Prl % = max-baseline): 106.6% (sd: 108.8) vs 214% (sd: 167.6) (t = -2.22, df = 32, p. less than .02). 2) The response of cortisol in the suicidal group was significantly lower to that of controls as much as in absolute terms (Cor = max-baseline): 1.7 ng/ml (sd: 2.8) vs 5 ng/ml (sd 5.4) (t = -2.25, df = 32, p less than .02) as percentage wise (Cor % max-baseline: 11.6% (sd: 19.8) vs 47.1% (sd: 56.7) (t = -2.44, df = 32, p less than 01). Baseline concentration of cortisol in suicidal patients was significantly higher to that of the controls (17.8 ng/ml (sd: 5.6) vs 13.3 ng/ml (sd: 5.3) (t = 2.41, df = 32, p less than .01). These results are in concordance with previous ones which suggest that a serotonergic dysfunction is present in patients which carry out impulsive suicidal attempts. Besides those patients have also higher indexes of stress and of an inefficiency of coping with acute stressful situations.

Acting Out↗