Changes in Body Weight and Psychotropic Drugs: A Systematic Synthesis of the Literature

<div><h3>Introduction</h3><p>Psychotropic medication use is associated with weight gain. While there are studies and reviews comparing weight gain for psychotropics within some classes, clinicians frequently use drugs from different classes to treat psychiatric disorders.</p> <h3>Objective</h3><p>To undertake a systematic review of all classes of psychotropics to provide an all encompassing evidence-based tool that would allow clinicians to determine the risks of weight gain in making both intra-class and interclass choices of psychotropics.</p> <h3>Methodology and Results</h3><p>We developed a novel hierarchical search strategy that made use of systematic reviews that were already available. When such evidence was not available we went on to evaluate randomly controlled trials, followed by cohort and other clinical trials, narrative reviews, and, where necessary, clinical opinion and anecdotal evidence. The data from the publication with the highest level of evidence based on our hierarchical classification was presented. Recommendations from an expert panel supplemented the evidence used to rank these drugs within their respective classes. Approximately 9500 articles were identified in our literature search of which 666 citations were retrieved. We were able to rank most of the psychotropics based on the available evidence and recommendations from subject matter experts. There were few discrepancies between published evidence and the expert panel in ranking these drugs.</p> <h3>Conclusion</h3><p>Potential for weight gain is an important consideration in choice of any psychotropic. This tool will help clinicians select psychotropics on a case-by-case basis in order to minimize the impact of weight gain when making both intra-class and interclass choices.</p> </div

Quem são os egressos de internação psiquiátrica? ¿Quiénes son los pacientes que obtuvieron el alta de la internación psiquiátrica? Who are the patients who have been discharged from psychiatric hospital care recently?

Objetivo: Conhecer quem são, hoje, as pessoas com transtornos mentais que tiveram alta hospitalar de internação psiquiátrica recente, e quais suas características comuns. Método: Pesquisa quantitativa descritiva realizada no período: 17/12/2007 a 17/04/08, através de questionário acerca das variáveis sociodemográficas, internações anteriores e conhecimento de 48 pacientes quanto ao diagnóstico e tratamento psicofarmacológico. Resultados: A média de idade foi 39 anos e 30 pacientes eram mulheres. Diagnósticos de Esquizofrenia e Transtornos Esquizotípicos foram prevalentes em 33,3% da amostra. Não souberam dizer qual era seu diagnóstico 56% da amostra, e apenas 43,8% souberam dizer corretamente nomes e dosagens dos medicamentos. Tinham pelo menos uma internação psiquiátrica anterior 62,5% deles. Conclusões: Conhecer quem são esses pacientes possibilita identificar características que podem fomentar a determinação do melhor tratamento, suporte profissional e elaboração de intervenções psicoeducativas que demonstraram ser necessárias a essa população.<br>Objetivo: Conocer quiénes son, hoy, las personas con trastornos mentales que obtuvieron el alta hospitalaria de internación psiquiátrica reciente, y cuáles son sus características comunes. Métodos: Investigación cuantitativa descriptiva en el período: 17/12/2007 a 17/04/08, a través de cuestionario acerca de las variables sociodemográficas, internaciones anteriores y conocimiento de los pacientes en lo que se refiere al diagnóstico y tratamiento psicofarmacológico. Resultados: Fueron entrevistados 48 pacientes. El promedio de edad fue 39 años y 30 pacientes eran mujeres. Diagnósticos de Esquizofrenia y Trastornos Esquizoides prevalecieron en 33,3% de la muestra. No supieron decir cuál era su diagnóstico 56% de la muestra, y apenas 43,8% supieron decir correctamente nombres y dosis de los medicamentos. Tenían por lo menos una internación psiquiátrica anterior 62,5% de ellos. Conclusiones: Conocer quienes son esos pacientes posibilita identificar características que pueden ayudar a determinar el mejor tratamiento, el soporte profesional y la elaboración de intervenciones psicoeducativas que demuestran ser necesarias en esa población.<br>Objective: To describe the characteristics of persons with mental illnesses who have been discharged from psychiatric hospital care recently. Methods: Descriptive study conducted with a sample of 48 patients between December 17 2007 and April 17 2008. Data were collected through the economic and social questionnaire that gathers socio-demographic information including psychiatric hospitalizations and patient's knowledge of diagnosis and psychopharmacological treatment. Results: The mean age of the participants was 39 years. The majority were women (n = 39), had at least one previous hospitalization (62.5%), and did not know the diagnosis of their mental illness. Schizophrenia and/or Schizotypic Disorders were the most common types of mental illnesses (33.3%). Less than half of participants (43.8%) were able to verbalize the name and dosage of their medications correctly. Conclusion: Knowing those patients characteristics may be helpful in planning and implementing the best mental health treatment that includes professional support and effective psycho educational intervention

Os grupos na atenção básica de saúde de Porto Alegre: usos e modos de intervenção terapêutica Groups in basic health attention in Porto Alegre: uses and forms of therapeutic intervention

Esse artigo trata dos grupos como modalidade assistencial utilizada pelos serviços de atenção básica de saúde. Oficinas, grupos de educação em saúde e palestras constituem atividades diferenciadas em relação aos demais atendimentos tradicionais. O estudo que subsidia essa discussão teve como objetivo conhecer o perfil da assistência, sob a forma de grupos, prestada nas unidades que compõem a rede básica de saúde de Porto Alegre. Foram abordados 116 profissionais, de um total de 124 serviços de saúde, entre os quais 96 desenvolviam grupos. Evidenciou-se que os mesmos têm relevância terapêutica por favorecerem a troca de informações e o aprendizado sobre aspectos relacionados à saúde/doença. Constituem práticas inclusivas, capazes de vincular os usuários aos serviços e de reformular o modelo assistencial vigente. Assim, constatou-se que a compreensão dessas práticas remete a sua dimensão de qualificação da assistência coletiva e também a uma dimensão estratégica de compensação de atendimento às crescentes demandas de saúde.<br>This article deals with groups as an assistential modality used by the services of basic health attention. Workshops, health education groups, as well as, lectures are different activities done in relation to other traditional attendances. The study that is behind this discussion had as its main aim to know the profile of assistance, under groups' organization, offered in the Units which make part of the Basic Health Network in Porto Alegre. Within a total of 124 health services, 116 professionals were approached, among them, 96 developed groups. We could verify that the groups have therapeutic relevance because they favor the sharing of information and the learning about aspects which are related to the topic health-sickness. They constitute inclusive practices, which are able to create a link with the users and the service, as well as, to reformulate the existing assistential model. Therefore, it was verified that the understanding of these practices reflects on its dimension of the group assistance qualification and also the strategic dimension of compensation in the attendance of the increasing demand of health