Article

A epidemiologia da esquizofrenia

Revista Brasileira de Psiquiatria (Impact Factor: 1.86). 01/2000; DOI: 10.1590/S1516-44462000000500006
Source: DOAJ

ABSTRACT A epidemiologia estuda a ocorrência e a distribuição de uma doença, ou condição relacionada à saúde, nos diversos gru- pos populacionais, procurando investigar os fatores determinantes em sua etiologia e prognóstico. Para o cálculo da freqüência da esquizofrenia na população, devem-se con- siderar o numerador (número de doentes) e a população (nú- mero de habitantes da área estudada) em determinada faixa etária. Em uma dada população, todos os casos devem ser incluídos no numerador. Alguns estudos epidemiológicos identificam seus casos a partir do contato com os serviços de atendimento, enquanto outros são desenvolvidos na comuni- dade, incluindo ou não os pacientes eventualmente institucionalizados. Prevalência A prevalência é a medida da proporção de indivíduos que apresentam um determinado transtorno no momento da avalia- ção (ponto-prevalência) ou em um período de tempo estabele- cido (prevalência em um mês, no ano, na vida etc). Em uma revisão de vários estudos epidemiológicos conduzidos na Eu- ropa e nos Estados Unidos, Dohrenwend et al 1 estimaram a prevalência de esquizofrenia com base na tendência central dos resultados (mediana) em 0,59%, com variação de 0,6% a 3%, dependendo dos critérios diagnósticos utilizados, não haven- do evidência de diferença entre os sexos. Eaton 2 revisou 25 estudos de prevalência de transtornos mentais realizados em

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    ABSTRACT: RESUMO A esquizofrenia é uma psicose crônica com graves conseqüências sociais e funcionais, exigindo múltiplas formas de cuidado no seu tratamento. Este artigo objetivou descrever a evolução de um paciente acometido por esquizofrenia paranóide, mediante a adoção do processo de Relacionamento Terapêutico, como uma modalidade de cuidado de enfermagem psiquiátrica, registrada em um diário de campo sob a forma de narrativas de vivências, durante dez encontros em um serviço psiquiátrico de Fortaleza. Percebeu-se que o emprego do Relacionamento Terapêutico permitiu, gradativamente, ao cliente estudado o enfrentamento de conflitos pessoais (dinâmica familiar complicada, rejeição e depressão) e a satisfação de necessidades básicas como a comunicação e interação grupal. Dessa forma considera- se o Relacionamento Terapêutico uma técnica de cuidado primordial na reintegração e reorganização do cliente esquizofrênico, assim como na busca de uma melhor qualidade de vida. ABSTRACT The schizophrenia is a chronic psychosis with serious social and functional consequences, demanding multiples ways of care in its treatment. This research aimed at describing the evolution of a patient taken ill with paranoid schizophrenia, by means of the adoption of the Therapeutic Relationship process, as a modality of nursing psychiatric care, registered in a field diary as narratives of life experiences, during ten meeting days in one psychiatric service of Fortaleza. It was perceived that the application of the Therapeutic Relationship, gradually, enabled to the studied client the confrontation of personal conflicts (complicated family dynamics, rejection and depression) and the satisfaction of basic needs such as the communication and group interaction. Therein, the Therapeutic Relationship is considered a primordial care technique in the reintegration and reorganization of the schizophrenic client, as well as in the search of a better quality of life.
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    ABSTRACT: A case series to study factors related to family expectation regarding schizophrenic patients was conducted in an out-patient setting in the city of S. Paulo, Brazil. Patients diagnosed as presenting schizophrenia by the ICD 9th Edition and having had the disease for more than four years were included in the study. Family Expectation was measured by the difference between the Katz Adjustment Scale (R2 and R3) scores based on the relative's expectation and the socially expected activities of the patient (Discrepancy Score), and social adjustment was given by the DSM-III-R Global Assessment Scale (GAS). Outcome assessments were made independently, and 44 patients comprised the sample (25 males and 19 females). The Discrepancy mean score was twice as high for males as for females (p < 0.02), and there was an inverse relationship between the discrepancy score and social adjustment (r = -0.46, p < 0.001). Moreover, sex and social adjustment exerted independent effects on the discrepancy score when age, age at onset and number of psychiatric admissions were controlled by means of a multiple regression technique. There was an interaction between sex and social adjustment, the inverse relationship between social adjustment and discrepancy score being more pronounced for males. These findings are discussed in the light of the potential association between the family environment, gender and social adjustment of schizophrenic patients, and the need for further research, i.e. ethnographic accounts of interactions between patient and relatives sharing households particularly in less developed countries.
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    ABSTRACT: Occupational therapy as a psychosocial approach based on cognitive rehabilitation among clients with schizophrenia is discussed in this chapter. For these clients it is demonstrated that psychopharmacologic treatment combined with psychosocial interventions is more effective than solely psychopharmacologic treatment. This strategy improves cognitive aspects and social functioning and consequently counteracts the deterioration caused by the illness (Huxley et al., 2000). There is a clear evidence that clients with schizophrenia have an intensive impairment of their executive functions (Morrice and Delahunty, 1996; Velligan and Bow-Thomas, 1999; Wykes et al., 1999). This deficit is defined as the “negative syndrome” of schizophrenia (Crow, 1980) and, in treatment-resistant schizophrenia, the syndrome exhibits great intensity. Thus, occupational therapy is a complementary treatment, which enables improvement in clients’ executive functions. KeywordsCognitive rehabilitation–Psychosocialintervention–Schizophrenia
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