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J Santo-Domingo

Publications and source records attributed to J Santo-Domingo.

18 recordsLinked to original sources

Patients who attempted suicide and failed to attend mental health centres.

Different studies report non-attendance to treatment of between 20 to 70% of patients after a suicide attempt. However, few studies have analyzed the characteristics of this non-attending population. To determine therefore the characteristics or profile of individuals who do not attend outpatient centres to which they are referred after a suicide attempt, we performed this study. A total of 232 patients who had attended the Emergency Department of our general hospital were interviewed. Instruments used included the suicide risk scale, the violent behaviour scale, the impulsivity scale, the hopelessness scale, and the Beck's depression scale. Seventy-three percent of the sample did not attend the mental health centre to which they had been referred. In comparison to the attending group, the non-attending group had the following characteristics: unmarried, residing in an urban area, took less precautions not to be discovered, were more critical of the attempt, and the purpose of the attempt was to resolve a conflict. Our data emphasize the importance of social and interpersonal aspects in determining the nature of the psychiatric care required by these types of patients.

Adult↗

Clinical significance of Cloninger's classification in a sample of alcoholic Spanish men.

AIMS: To evaluate Cloninger's classification in a sample of alcoholic Spanish men. DESIGN: A cross-sectional study was carried out on subjects diagnosed as alcoholics. SETTING: Out-patient units specializing in the treatment of alcoholics and the psychiatry unit of a general hospital. PARTICIPANTS: One hundred and ninety-eight males diagnosed as alcoholics. The mean age was 44.4 +/- 11.6 years and 98% were from urban areas. MEASUREMENTS: Participants were interviewed using the Structured Clinical Interview for DSM-III-R(SCID). They were classified using type 1 and type 2 criteria of Cloninger's classification. FINDINGS: Only one-third of our sample could be classified by Cloninger's type 1 and type 2 criteria. Patients classified as belonging to type 2 had an earlier onset of regular drinking compared to type 1 patients. Type 2 subjects presented a higher percentage of alcohol-related problems as well as problems related to drugs other than alcohol and they also presented a higher percentage of antisocial personality disorder. No differences in alcoholism family history were found between the groups. Criteria showing the poorest discriminative ability between both groups were "failure to keep abstinent" and "benders lasting at least two days". CONCLUSIONS: Our results do not support Cloninger's etiological hypotheses for alcoholism. Cultural differences may be responsible for the different drinking patterns observed.

Adult↗

[Carbohydrate deficient transferrin and other markers of alcohol consumption in the general hospital].

BACKGROUND: The ascertainment of patients who consume important amounts of alcohol admitted to a hospital is essential to prevent medical and psychological complications. Carbohydrate deficient transferrin (CDT) is a new marker of alcohol consumption which requires validation in the hospital setting. METHODS: The values of carbohydrate deficient transferrin (CDT), glutamic oxalacetic transaminase (GOT), gamma glutamil transpeptidase (GGT) and mean corpuscular volume (MCV) were measured in 101 consecutive patients admitted to the Internal Medicine and Surgery Departments. Considering amounts higher than 60 g/day of ethanol for male patients and higher than 40 g/day for female patients as risk consumption, the values for sensitivity, specificity and area under the curve were calculated for the different biological tests. RESULTS: Twenty-six percent of patients reported a consumption of risk. The sensitivity of the tests were lower than 50% and specificities higher than 77%. CDT had the lowest sensitivity (15%) but it was very specific (98%). CDT had a better sensitivity among women than among men. None of the tests had an area under the curve with adequate efficiency levels. CONCLUSIONS: CDT among the hospitalized patients and other biological markers of alcohol consumption have a low efficiency.

Adult↗

Readiness to change questionnaire: reliability study of its Spanish version.

The present study explored the reliability and validity of a Spanish version of the Readiness to Change Questionnaire (RCQ) (12-item short form) as it might be used for opportunistic intervention. The test has three scales to allocate patients to a stage of change: pre-contemplation (P), contemplation (C) or action (A). The RCQ was translated and back-translated prior to pilot administration to 15 patients. From two settings (a general hospital ward and a primary health care centre), 201 patients were identified as excessive drinkers on the Alcohol Use Disorders Identification Test. Patients known to be alcohol-dependent and attending for alcohol-related reasons were excluded. Patients completed the RCQ. Test-retest reliability after 2 days was assessed in 35 patients. A components analysis was performed. Patients were classified on RCQ scores to a stage of change. Two experts separately interviewed the patients and made an allocation to stage of change, blind to the RCQ score. Test-retest reliability was good (P: r = 0.81; C: r = 0.87; A: r = 0.86). Within the three scales, RCQ items showed fair consistency in terms of Cronbach's alpha (P: 0.58, C: 0.75, A: 0.80). Component analysis showed that together the scales accounted for 57. 4% of the variance. The experts agreed between themselves on patients' stage of change (weighted kappa 0.92) but much less with the stage of change according to RCQ (expert A, kappa = 0.44; expert B, kappa = 0.52). Omitting patients with low consumption did not improve internal reliability, and omitting those with low educational level who might have filled in the questionnaire wrongly did not improve internal reliability or agreement between RCQ and the experts. We conclude that the Spanish RCQ did not function efficiently in a population of opportunistically identified excessive drinkers.

Adult↗

[Psychiatric disorders and cognitive deterioration in Friedreich ataxia].

The present study was designed with the aim of examining the presence of psychiatric diagnosis and intellectual impairment in a sample of patients with Friedreich's ataxia. A consecutive sample of 21 patients presenting with Friedreich's Ataxia were evaluated by means of a neuropsychiatric interview. Only one patient was diagnosed as mentally retarded. Out of the 15 patients of the sample who were evaluated with be WAIS, all of them fell within a normal intellectual range. The idea that Friedreich's Ataxia produces cognitive impairment and serious psychiatric symptoms came from the earliest descriptions of the disease at the beginning of this century, which probably included many patients in their samples who had other diseases.

Adolescent↗

[Psychiatric disorders and consumption of ecstasy drug (MDMA): review of published case reports].

BACKGROUND: Ecstasy use have raised in recent years and it have been related to psychopathological symptoms. The comsumption pattern associated with psychiatric complications is unknown. METHOD: Thirty-six case reports about psychiatric complications due to ecstasy and published from 1985 to 1997 were studied. RESULTS: The disorders with higher prevalence were psychosis (n = 21), panic attacks (n = 12) and depressive symptoms (n = 3). Seventy two per cent were substance abusers. Urinary drugs screening were present in 28%, only in two subjects might detect amphetamine. Men had higher MDMA doses compsumption and higher prevalence of background psychiatric disorders than women. Subjects with psychotic symptomatology had more psychiatric background, higher doses of MDMA comsumption and for a long time than individuals with depressive or panic attacks symptomatology. CONCLUSIONS: The review of the case reports of psychiatric complications related to ecstasy use do not allow to conclude that ecstasy use was the main responsible factor for psychiatric symptoms. They could be related to an individual vulnerability and or to lasting of comsumption.

Adolescent↗