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Biomedical subjects

J de Pablo

Publications and source records attributed to J de Pablo.

27 records · Page 2Linked to original sources
PubMedDate not supplied

Psychogenic pain and depressive disorders: an empirical study.

A sample of 31 patients of both sexes suffering from psychogenic pain disorder (DSM-III) were studied in order to test if their clinical and biological features as well as their response to antidepressant treatment support the hypothesis that relates this syndrome to depressive disorders. Biological variables were basal cortisol and dexamethasone suppression test, and treatment consisted of daily administration of 100-175 mg of imipramine for a period of 5 months. Mood state was evaluated by the Hamilton scale and pain was assessed through visual analogue scales immediately before starting treatment and 3 months later. There was a low prevalence of non-suppressors (9.6%) and all patients significantly improved in mood and pain after antidepressant treatment. However, general results support both the hypothesis linking psychogenic pain to depressive disorders and its possible understanding in terms of failed adjustment processes.

Circadian Rhythm↗
PubMedDate not supplied

Instrument for detection of delirium in general hospitals: adaptation of the confusion assessment method.

Delirium is a common and severe disorder that is often misdiagnosed. The use of screening instruments is advisable for its early detection and treatment. In this study, the authors present an adaptation of the Confusion Assessment Method in order to improve its psychometric properties. One hundred fifty-three elderly inpatients were assessed in a four-phase procedure. Interrater reliability was high (kappa = 0.89). Sensitivity was 90%, and specificity was 100%; the value for negative predictive accuracy was 97%, and the value for positive predictive accuracy was 100%. The adaptation has convergent agreement with two other mental status tests, the Mini-Mental Status Examination and the Delirium Rating Scale. Our results suggest that the adaptation of the Confusion Assessment Method is sensitive, specific, reliable, and easy to use by clinicians.

Adaptation, Psychological↗
PubMedDate not supplied

[Analysis of comorbidity between alcohol dependence syndrome and pathological gambling in patients receiving treatment in mental health centres].

BACKGROUND: A study is made of the comorbidity, observed in the clinical practice in public mental health centres, between the disorders caused by the use of alcohol and those caused by gaming. METHODS: A sample of 132 patients who showed a diagnosis of "Alcohol dependence syndrome", receiving treatment in the mental health centres of the Autonomous Community of Navarra was studied. Once the diagnosis of Alcohol Dependence Syndrome was confirmed, the "South Oaks Gambling Screen" was employed in Spanish validated version. RESULTS: 23.5% of the patients studied, with confirmed alcohol dependence, achieved scores within the range indicating "Probable problem player" (5.3%) and "Probable pathological player" (18.2%). The association was confirmed between problems of gambling and civil status. Separated and divorced persons and widows showed more problems with gaming. CONCLUSIONS: Almost a quarter of the patients who showed "Alcohol dependence syndrome" have, or have had problems with gaming. It is important to bear this reality in mind, as well as the possible presence of other associations, when dealing with the problem of alcohol (from prevention, through evaluation and up to treatment).

English Abstract↗
PubMedDate not supplied

[Nocturnal eating syndrome].

AIM: A clinical and polysomnographic study of two patients with nocturnal eating syndrome (recurrent awakenings associated with the need to eat and difficulty in returning to sleep it the patient does not eat). PATIENTS AND METHODS: Two patients, one 36-year-old male and one 41-year-old woman underwent clinical tests (including a psychopathological study based on a structured interview and a series of psychometric tests) and polysomnographical tests with audiovisual recording. RESULTS: The two patients presented a history since adolescence and insidious, progressive course of multiple nocturnal episodes associated with the need to eat and difficulty in returning to sleep if they did not do so. The polysomnographic study with video demonstrated awakenings in all the phases of sleep which were rapidly followed by food intake discarding other diseases. The biochemical, hormonal and neuroimaging studies were normal. The two patients showed alterations in alimentary habits characterized by gorging and a psychiatric profile of obsessive and compulsive traits. Bulimia and anorexia nervosa were excluded. CONCLUSIONS: The association of nocturnal eating syndrome with a compulsive alimentary pattern and the presence of obsessive-compulsive features in exception and suggests a common mechanism characterized by compulsive acts. Polysomnographic recording allows confirmation of the clinical diagnosis of nocturnal eating syndrome and discards other diseases.

Adult↗
PubMedDate not supplied

[Delirium in a consultation liaison psychiatry unit of a general hospital].

INTRODUCTION: Delirium is an organic mental disorder defined as a confusional state, attention deficit and disorganized thinking, with a fluctuating course and acute development. Underlying causes are numerous, but the most common are multiple medical problems and drug side effects. SUBJECTS AND METHOD: We present a descriptive and transversal study of 62 inpatients with delirium diagnosis (ICD-10 criteria) attended by a Liaison Psychiatric Department in a General Hospital during a year. The data included demographic, somatic and psychiatric variables. RESULTS: The overall referral rate from the general hospital was 0.2%. No significant differences, were found in sex distribution. The age average was 64.46 years. The majority of patients were referred by Surgery (19.4%) and Medicine (17.7%). The most common medical diagnosis was cancer (25%) and respiratory failure (15.9%). Haloperidol was the most frequent psychiatric treatment. The greatest number of referred patients were included in the serious medical state and the 23.9% of patients with delirium diagnosis deceased. CONCLUSION: Data supports the statement that delirium is most often found in hospitalized patients with a diagnosis of cancer and respiratory failure, and that this diagnosis is associated with mortality in a high proportion. Furthermore, this study suggest an increase in cost-containment since the average stay are increased in comparison with the rest of hospitalized patients.

Delirium↗
PubMedDate not supplied

[Psychiatric disease in patients with psychogenic non-epileptic seizures referred from an epilepsy unit in a general hospital].

INTRODUCTION: We evaluate psychiatric disease associated with psychogenic non-epileptic seizures (PNES) and study the role played by previous traumatic experiences, dissociative episodes and personality disorders. METHOD: After diagnosing PNES in our epilepsy unit, we obtained a sample of 46 patients and carried out a structured psychiatric interview (SCID) following DSM-III-R criteria. We looked for previous dissociative episodes and prepared a questionnaire for traumatic experiences and basic clinical data. RESULTS: The most frequent psychiatric disorders were depression, anxiety and somatoform disorders. Personality disorders were found in 16 patients (34.78%), dissociative episodes in 17 (36.95%), and previous traumatic experiences in 14 (30.43%). No statistically significant differences were found in regards to PNES, with respect to presence or absence of previous traumatic experiences, dissociative episodes, and personality disorders. CONCLUSIONS: As in previous studies, our research project confirms the co-existence of PNES with other mental disorders, and although we do find a higher frequency of seizures, the role played by traumatic experiences and dissociative disorders in CNEP remains unclear.

Adult↗