- Argentina
juan carlos stagnaro
Universidad de Buenos Aires, Historia, Faculty Member
- Profesor consulto titular, UBAedit
OBJECTIVE to estimate structural and attitudinal reasons for premature discontinuation of mental health treatment, socio-demographic and clinical correlates of treatment dropout due to these reasons, and to test country differences from... more
OBJECTIVE to estimate structural and attitudinal reasons for premature discontinuation of mental health treatment, socio-demographic and clinical correlates of treatment dropout due to these reasons, and to test country differences from the overall effect across the region of the Americas. METHODS World Health Organization-World Mental Health (WMH) surveys were carried out in six countries in the Americas: Argentina, Brazil, Colombia, Mexico, Peru and USA. Among the 1991 participants who met diagnostic criteria (measured with the Composite International Diagnostic Interview (WMH-CIDI)) for a mental disorder and were in treatment in the prior 12-months, the 236 (12.2%) who dropped out of treatment before the professional recommended were included. FINDINGS In all countries, individuals more frequently reported attitudinal (79.2%) rather than structural reasons (30.7%) for dropout. Disorder severity was associated with structural reasons; those with severe disorder (versus mild disorder) had 3.4 (95%CI=1.1-11.1) times the odds of reporting a structural reason. Regarding attitudinal reasons, those with lower income (versus higher income) were less likely to discontinue treatment because of getting better (OR=0.4; 95%CI= 0.2-0.9). Country specific variations were found. LIMITATIONS Not all countries, or the poorest, in the region were included. Some estimations couldn´t be calculated due to cell size. Causality cannot be assumed. CONCLUSION Clinicians should in the first sessions address attitudinal factors that may lead to premature termination. Public policies need to consider distribution of services to increase convenience. A more rational use of resources would be to offer brief therapies to individuals most likely to drop out of treatment prematurely.
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Preceded by an introduction that highlights the importance of acknowledging those who spoke out and led the Argentinian psychiatric field for more than a century, thirty Argentinian psychiatrists are presented and their ideas are... more
Preceded by an introduction that highlights the importance of acknowledging those who spoke out and led the Argentinian psychiatric field for more than a century, thirty Argentinian psychiatrists are presented and their ideas are summarized in this manuscript. These psychiatrists include: Arturo Ameghino, René Arditi Rocha, Gregorio Bermann, José T. Borda, Gonzalo Bosch, Exequías Bringas Nuñez, Domingo Cabred, Raúl Camino, Lanfranco Ciampi, Juan Dalma, Francisco De Veyga, Noel Feldman, R. Horacio Etchegoyen, Jorge García Badaracco, Mauricio Goldenberg, José Ingenieros, Cristofredo Jakob, Alejandro Korn, Enrique Eduardo Krapf, Osvaldo Loudet, Lucio Meléndez, Braulio Moyano, Juan M. Obarrio, Elpidio R. Olivera, Carlos Rodolfo Pereyra, Enrique Pichón Rivière, José María Ramos Mejía, Telma Reca, Carolina Tobar García, Guillermo Vidal.
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Since the late 19th century, Argentinean psychiatrists have been developing classifcations of psychiatric disorders. Their work has had local originality and fruitful exchange with international controversies on the subject. The thinking... more
Since the late 19th century, Argentinean psychiatrists have been developing classifcations of psychiatric disorders. Their work has had local originality and fruitful exchange with international controversies on the subject. The thinking of some Argentinean psychiatrists transcended the borders of the country and was adopted in the South American region, as was the case with the classifcation proposed by José T. Borda. There were also historical anticipations of concepts that were not known in other latitudes: "oligotimia", a category created by Enrique Pichon-Rivière, preceded the characterization of early childhood autism by Leo Kanner. In recent decades, Argentinean psychiatrists have adopted current international classifcations (DSM and CIE), but also actively participated in the elaboration of an original regional proposal: the Latin American Guide to Psychiatric Diagnosis (GLADP-VR 2012), and collaborated with the surveys carried out by the World Health Organization (WHO) for the revision of the future ICD 11. This article provides a detailed description of Argentinian classifcations, extensively quoting each author to provide a clear understanding of their thinking, as well as critical reviews of their proposals.
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In almost all countries where reliable statistics researches are conducted, the rate of suicide among elderly people rises in people over 65 years old, reaching its highest point at 85 years old. Nevertheless, it seems that this phenomena... more
In almost all countries where reliable statistics researches are conducted, the rate of suicide among elderly people rises in people over 65 years old, reaching its highest point at 85 years old. Nevertheless, it seems that this phenomena is tended to be ignored. Although the evidence given by the epidemiology, many physicians and even of psychiatrits claim that the suicide among elderly is rare.
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In this paper the author analyzes the epidemiological data of the effects of the social crisis on the mental health against the background of the political and social events in Argentine in the last years. These effects are found both in... more
In this paper the author analyzes the epidemiological data of the effects of the social crisis on the mental health against the background of the political and social events in Argentine in the last years. These effects are found both in the general population and in the health care professionals. The article reviews the clinical and psychopathological approaches to understand the disorders of the patients during a social crisis.
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Historical researches focusing on the study of the ideas on madness and on psychiatry as a medical specialty in Argentina published until 1980 were few, and they were scattered throughout a time period covering more than a century. Some... more
Historical researches focusing on the study of the ideas on madness and on psychiatry as a medical specialty in Argentina published until 1980 were few, and they were scattered throughout a time period covering more than a century. Some of them, however, constituted sources of useful data that contributed to subsequent developments which are still, in great measure, under way. New collective projects adopting new methodological approaches to address the subject have emerged in recent years. In this respect, the establishment of a vast plan for the research and compilation of primary sources, the organization and development of a formation of human resources that may adequately meet future research work, and a more solid assurance of the publication and divulgement of this research work are still pending. This article, of an introductory nature and predominantly descriptive and panoramic, reviews the main works and authors and their theoretical conceptions, situating them in the context of their time.
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Teaching theoretical-technical knowledge aimed at training specialists in psychiatry at postgraduate level requires the explicitness of the theoretical model to which the curricula presented to students should be ordered. First, said... more
Teaching theoretical-technical knowledge aimed at training specialists in psychiatry at postgraduate level requires the explicitness of the theoretical model to which the curricula presented to students should be ordered. First, said model should be coherent with the general curricula for the medical training from which candidates to obtain the specialist degree graduate; second, it should serve to transmit theoretical elements, attitudes and skills that allow their work of excellence, which means acquiring the qualities considered relevant and necessary by the consensus among the members of a specialty, discipline or science (in our case, medical specialty in psychiatry) in the present historical moment. Reference points to meet them in the light of the present data concerning medical and psychiatric paradigms are developed. This article refers to those particular aspects with special emphasis on certain epistemological issues, from whose effects the same specialists do not escape, and which also condition their teaching practice, trying to show that an integrative pedagogical model is the one that best fits the contemporary historical conditions.
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The huge developments in the biological research and in the technics used in other spheres of science (physics, mathematics, chemistry, cybernetics, etc.) have a great influence on the constitution of the actual medical paradigm, as well... more
The huge developments in the biological research and in the technics used in other spheres of science (physics, mathematics, chemistry, cybernetics, etc.) have a great influence on the constitution of the actual medical paradigm, as well as other non strictly scientific factors. These external factors are economic, political and cultural ones -such as the pharmaceutical industry and the public health systems, the privatisation of health services, the large amount of professionals, the advances in the medical instruments, etc. The theoritician of the Heidelberg School, called this prevalent model "biomedical" or "natural-scientific", underlying this way the tendance to the biological reductionism in relation to the concept of "illness" thus excluding the subjectivity, the history and the sociability of the patient when dealing with the pain, the inability and the death. Since the middle of XXth Century a serious criticism of this medical paradigm has been raised. This criticism revolved around the so called anthropological or integral model. This article makes a revision of this problem from a historical and epistemological outlook, revisiting some specific features in the psychiatric field.
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An interview with Jorge Luis Pellegrini, psychiatrist, founder of Institutional Groups against Alcoholism. Among other distinctions, in 2005 he received the Geneva Prize for Human Rights in Psychiatry.
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Research Interests: Mental Health, Schizophrenia, Stigma, Logistic Regression, Biological Psychiatry, and 10 moreHealth related Quality of Life, Embarrassment, Odds ratio, Mental Health and Psychiatry Nursing, Odds, Cross sectional Study, Perceived Health, Psychotic Experiences, Psychology and Cognitive Sciences, and Medical and Health Sciences
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The asylum, the madhouse, the hospital for insane patients, the psychiatric hospital, whenever were the names given to these institutions in the XIX th century psychatric literature, have made a mayor contribution to the definition of the... more
The asylum, the madhouse, the hospital for insane patients, the psychiatric hospital, whenever were the names given to these institutions in the XIX th century psychatric literature, have made a mayor contribution to the definition of the psychiatry as a medical speciality. The legacy of the origins of the psychiatry as a speciality may be found at each stage of its historical evolution, articulate with the theoretical and clinical innovations.
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Resume Pendant deux siecles, la production ecrite des psychiatres francais a fait l’objet de traductions en espagnol, initialement en Espagne et posterieurement, et surtout plus systematiquement les dernieres decennies en Argentine et au... more
Resume Pendant deux siecles, la production ecrite des psychiatres francais a fait l’objet de traductions en espagnol, initialement en Espagne et posterieurement, et surtout plus systematiquement les dernieres decennies en Argentine et au Mexique. Les textes classiques de la psychiatrie francaise, ainsi que ceux de certains auteurs francais contemporains, constituent une reference toujours presente pour de nombreux psychiatres hispanophones. Dans cet article, nous effectuons une description de l’œuvre de la psychiatrie francaise traduite en langue espagnole, analysant son impact et sa diffusion dans le cadre de l’echange culturel dans cette espace linguistique.
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The use of bioethic concepts in the diagnosis and clinical psychiatry has been rare. Contrary to what happens with other specialities, it has been no easy for the psychiatrists to incorporate some criteria from the bioethics, given the... more
The use of bioethic concepts in the diagnosis and clinical psychiatry has been rare. Contrary to what happens with other specialities, it has been no easy for the psychiatrists to incorporate some criteria from the bioethics, given the difficulties of this discipline to meet the criteria of the contemporary biomedical model. It is possible that because of the particularities of the psychiatric practice, the bioethicists have not pay attention to the issues raised by the psychiatry and devoted almost exclusively to the burning problems of the other medical specialities. In this paper, some reflections on this problem are presented.
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Base de dados : LILACS. Pesquisa : 527082 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos... more
Base de dados : LILACS. Pesquisa : 527082 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 527082. ...
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Background Posttraumatic stress disorder (PTSD) is associated with significant morbidity, but efficacious pharmacotherapy and psychotherapy are available. Data from the World Mental Health Surveys were used to investigate extent and... more
Background Posttraumatic stress disorder (PTSD) is associated with significant morbidity, but efficacious pharmacotherapy and psychotherapy are available. Data from the World Mental Health Surveys were used to investigate extent and predictors of treatment coverage for PTSD in high-income countries (HICs) as well as in low- and middle-income countries (LMICs). Methods Seventeen surveys were conducted across 15 countries (9 HICs, 6 LMICs) by the World Health Organization (WHO) World Mental Health Surveys. Of 35,012 respondents, 914 met DSM-IV criteria for 12-month PTSD. Components of treatment coverage analyzed were: (a) any mental health service utilization; (b) adequate pharmacotherapy; (c) adequate psychotherapy; and (d) effective treatment coverage. Regression models investigated predictors of treatment coverage. Results 12-month PTSD prevalence in trauma exposed individuals was 1.49 (S.E., 0.08). A total of 43.0% (S.E., 2.2) received any mental health services, with fewer receiv...
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ImportanceUnderstanding the association of civil violence with mental disorders is important for developing effective postconflict recovery policies.ObjectiveTo estimate the association between exposure to civil violence and the... more
ImportanceUnderstanding the association of civil violence with mental disorders is important for developing effective postconflict recovery policies.ObjectiveTo estimate the association between exposure to civil violence and the subsequent onset and persistence of common mental disorders (in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV]) in representative surveys of civilians from countries that have experienced civil violence since World War II.Design, Setting, and ParticipantsThis study used data from cross-sectional World Health Organization World Mental Health (WMH) surveys administered to households between February 5, 2001, and January 5, 2022, in 7 countries that experienced periods of civil violence after World War II (Argentina, Colombia, Lebanon, Nigeria, Northern Ireland, Peru, and South Africa). Data from respondents in other WMH surveys who immigrated from countries with civil violence in Africa and Latin America were also included. ...
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Patient‐reported helpfulness of treatment is an important indicator of quality in patient‐centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major... more
Patient‐reported helpfulness of treatment is an important indicator of quality in patient‐centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post‐traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys – 17 in high‐income countries (HICs) and 13 in low‐ and middle‐income countries (LMICs) – carried out as part of the World Health Organization (WHO)’s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cu...
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Editorial.
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Aims Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to... more
Aims Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to examine mental disorders that preceded 12-month MDD diagnosis and the impact of these disorders on depression outcomes. Methods Data came from 29 cross-sectional community epidemiological surveys of adults in 27 countries (n = 80 190). The Composite International Diagnostic Interview (CIDI) was used to assess 12-month MDD and lifetime DSM-IV disorders with onset prior to the respondent's age at interview. Disorders were grouped into depressive distress disorders, non-depressive distress disorders, fear disorders and externalising disorders. Depression outcomes included 12-month suicidality, days out of role and impairment in role functioning. Results Among respondents with 12-month MDD, 94.9% (s.e. = 0.4) had at least one prior disorder (including pr...
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Aims To provide cross-national data for selected countries of the Americas on service utilization for psychiatric and substance use disorders, the distribution of these services among treatment sectors, treatment adequacy and factors... more
Aims To provide cross-national data for selected countries of the Americas on service utilization for psychiatric and substance use disorders, the distribution of these services among treatment sectors, treatment adequacy and factors associated with mental health treatment and adequacy of treatment. Methods Data come from data collected from 6710 adults with 12 month mental disorder surveys across seven surveys in six countries in North (USA), Central (Mexico) and South (Argentina, Brazil, Colombia, Peru) America who were interviewed 2001–2015 as part of the World Health Organization (WHO) World Mental Health (WMH) Surveys. DSM-IV diagnoses were made with the WHO Composite International Diagnostic Interview (CIDI). Interviews also assessed service utilization by the treatment sector, adequacy of treatment received and socio-demographic correlates of treatment. Results Little over one in four of respondents with any 12 month DSM-IV/CIDI disorder received any treatment. Although the v...
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The appearance of Day Hospitals operated as a model to inspire the different ways of partial time psychiatric care (night hospitals, weekend hospitals, long hour activities in hospitalization services or general hospitals, etc.) and came... more
The appearance of Day Hospitals operated as a model to inspire the different ways of partial time psychiatric care (night hospitals, weekend hospitals, long hour activities in hospitalization services or general hospitals, etc.) and came to complement or replace complete hospitalization in classic psychiatric hospitals. This article presents the history and origins of Day Hospitals and their initial propagation in different countries, and especially in Argentina. Social and political conditions that set their emergence as a therapeutic resource in psychiatry, their models of functioning and variants of application according to the diagnoses of patients admitted, age groups, etc., the theories put into play to report their effects, several studies and technical results, and ideological views related to mental disorders and their treatment in the society are also being studied.