Somatizaciones en Atención Primaria. Oportunidades de intervención

Somatizations are one of the mental problems, with a higher prevalence among the population, generating high levels of suffering, reducing the quality of life and contributing to the functional disability of the people who suffer from it. However, there are still certain difficulties, both at conceptual and diagnostic level. This implies limitations in carrying out studies to clarify the nature of this disorder and in allowing the development of effective interventions. The objective of this work is to show, in a synthetic way, the knowledge collected to date on somatizations. It includes problems regarding its own denomination, diagnostic criteria, existing situation in Primary Care at the time of addressing this type of symptomatology, assessment tools and the latest advances in intervention.Las somatizaciones constituyen uno de los problemas mentalescon mayor prevalencia entre la población, generando elevados niveles de sufrimiento, reduciendo la calidad de vida y contribuyendo a la discapacidad funcional de las personas que lo padecen. Sin embargo, siguen existiendo ciertas dificultades, tanto de tipo conceptual como a la hora de realizar el diagnóstico, que implican limitaciones para llevar a cabo estudios que clarifiquen la naturaleza de este trastorno y permitan desarrollar intervenciones eficaces.El objetivo de este trabajo consiste en mostrar, de forma sintética, el estado de la cuestiónsobre las somatizaciones, aludiendo a la problemática presente respecto a su propia denominación, criterios diagnósticos, la situación existente en Atención Primaria (AP)a la hora de atender este tipo de sintomatología, su detección en AP y los últimos avances en intervenció

A Pharmacovigilance Study in First Episode of Psychosis : Psychopharmacological Interventions and Safety Profiles in the PEPs Project

The characterization of the first episode of psychosis and how it should be treated are principal issues in actual research. Realistic, naturalistic studies are necessary to represent the entire population of first episode of psychosis attended in daily practice. Sixteen participating centers from the PEPs project recruited 335 first episode of psychosis patients, aged 7 to 35 years. This article describes and discusses the psychopharmacological interventions and safety profiles at baseline and during a 60-day pharmacovigilance period. The majority of first episode of psychosis patients received a second-generation antipsychotic (96.3%), orally (95%), and in adjusted doses according to the product specifications (87.2%). A total of 24% were receiving an antipsychotic polytherapy pattern at baseline, frequently associated with lower or higher doses of antipsychotics than the recommended ones. Eight patients were taking clozapine, all in monotherapy. Males received higher doses of antipsychotic (P=.043). A total of 5.2% of the patients were being treated with long-acting injectable antipsychotics; 12.2% of the patients received anticholinergic drugs, 12.2% antidepressants, and 13.7% mood stabilizers, while almost 40% received benzodiazepines; and 35.52% reported at least one adverse drug reaction during the pharmacovigilance period, more frequently associated with higher antipsychotic doses and antipsychotic polytherapy (85.2% vs 45.5%, P<.001). These data indicate that the overall pharmacologic prescription for treating a first episode of psychosis in Spain follows the clinical practice guideline recommendations, and, together with security issues, support future research of determinate pharmacological strategies for the treatment of early phases of psychosis, such as the role of clozapine, long-acting injectable antipsychotics, antipsychotic combination, and the use of benzodiazepines