Como alguns já sabem, fizemos uma comunicação oral no Congresso abaixo citado.
Posto aqui o handout da referida comunicação.
WORLD PSYCHIATRY ASSOCIATION
INTERNATIONAL CONGRESS - PRAGUE- 2012
Focusing
on Access, Quality and Human Care
COMORBIDITY: ANXIETY,
PSYCHIATRIC and PSYCHOSOMATIC DISORDERS (ID 192)
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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