5 de novembro de 2012

Como alguns já sabem, fizemos uma comunicação oral no Congresso abaixo citado.
Posto aqui o handout da referida comunicação.

Focusing on Access, Quality and Human Care


Federal University of Juiz de Fora - Brazil                                             Rodrigues, A.; Rodrigues, E.

Introduction: The results of this research suggest a close relation between Anxiety Disorders (AD), the onset of new psychiatric symptoms - neurotic or psychotic ones - and the manifestation of Psychosomatic Diseases (PD). The prevailing emotion in the anxiety condition is fear. As correlated researches point out that one of  the triggers of stress response is fear, we can assume that the AD elicits the same physiological response of stress, causing PD. The neural pathways involved in AD appear to be the same that are activated in the chronic stress. When the patient remains chronically fearful, physiological overload persists, causing organic damage leading to the emergence of PD, also worsening pathophysiological processes of several diseases.

Methodology - Case analysis: Anamnesis, semi-structured questionnaire for somatic complaints, rating scales for AD, clinical examination and previous laboratory tests were collected. New tests were ordered as needed. Somatic illnesses referred to in the last ten years were identified and the possible correlation of those conditions with the current complaints evaluated.

Neurotic patients: Among 221 outpatients, 50 men and women of middle class, middle to upper education, between 21 and 72 years old were selected, when the AD preceded the onset of PD.
Results: The studied patients presented isolate or simultaneously the following somatic conditions: Gastrointestinal disorders (80%); muscle and joint diseases (76%), hypertension, cardiovascular and coronary artery disease (54%); eating and weight disorders (52%); endocrinopathies (50%); allergic, skin diseases (44%); respiratory disorders (40%); addiction (18%); sexual impairment (14%); herpes simplex (10%); migraine (6%). 56% of patients had one or two more subtypes of AD associated.

Psychotic patients:  Among 84 outpatients, 17 men and women of low classes, lower to middle education, between 18 and 53 years old with diagnosis of schizophrenia were selected when the symptoms  of a new acute event of psychotic manifestation - hallucination, delusion, blunted affect, alogia or avolution - and somatic complaints, followed the occurrence of acute anxiety symptoms.
Results: Although on proper medication, the studied patients presented isolate or simultaneously the following somatic conditions: Irritable bowel syndrome (41%); gastritis (35%); gastric ulcer (18%) skin diseases (24%); endocrinopathies (18%), autoimmune diseases (12%).

Conclusion: The present study highlights the importance of anxiety disorders in the origin and evolution of psychiatric disorders and acute or chronic psychosomatic disorders, as well as degenerative and autoimmune diseases suggesting their careful evaluation and their proper therapeutic management in order to achieve more favorable clinical outcomes.

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Rodrigues E. elimarjacobsalzer@gmail.com

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