S. Fuentes Márquez

Premature ejaculation in Spanish men

The vast majority of men experience premature ejaculation at some point in their sexual life. It is the most common sexual problem in men, affecting between 25–40% of them. This disease has both organic and psychological causes so it is important to search an organic disorder in order to dismiss the organic causes. The following case is about a 56-year-old male, married and retired. He went to the USMC in Huelva relating a premature ejaculation problem from approximately two years ago. He relates feeling a great discomfort due to the inability to maintain a satisfactory sexual relationship with his partner. The patient was diverted from the Department of Urology at the Juan Ramon Jimenez hospital, so we dismissed an organic or physical disorder. He refers an intervention of a herniated disc, which made him staying in bed during a long season, as a precipitating event. After that appears a first episode of premature ejaculation, what produced him a great discomfort, presenting anticipatory anxiety symptoms to the sexual experience from then. These anticipatory anxiety symptoms were characterized by negative thoughts about the own sexual performance and the capability to satisfy the partner. After this first episode more episodes of the same type occurred, increasing the described anxiety and worsening his sexual performance. During the treatment, the basilar compression technique was practiced in addition a restructuration of the negative thoughts of the patient regarding to his sexual performance was made. Lastly, we worked together with his partner strengthening the relationship and the communication between them.

Access to mental health and immigration

In the present study, we certain demographic variables of immigrants accessing specialized mental health care at two points in time: 2013 and 2014. According to the National Institute of Statistics, the number of foreigners fell by 4% in 2013 and 3% in 2014 due to emigration and the acquisition of Spanish nationality. Among the objectives of the department of health is collected to ensure the right to health protection to immigrants through effective access to the health system and improve management capacity and performance of health centers in diverse contexts. Results Despite the overall decline in foreign an increase in first consultations requested for immigrants was observed. At both time points, higher demand for foreign women is observed. With respect to age greater demand seen in middle adulthood, however in 2014 there is a greater homogeneity with respect to this variable. The greatest demand comes from Morocco, Romania and Poland, although most Latin American countries are increasingly observed. Conclusions Better access and better quality health care to both the immigrant population and of citizens in amount from acceptance and commitment to this complex and diverse and its approach will be achieved.

EPA-0609 – This time was serious

The potential suicide is a person with intense suffering and is always a serious patient, for whom by their despair, future expectations do not exceed a painful present. Expose more carefully try this idea by describing a case of a patient with highly lethal suicide attempts, severe, recurrent (repeated blows with a hammer to the skull, incised wound in the abdomen after a knife stab, multiple cuts with a knife upper and lower limbs …). Besides these aspects, point out the risk factors found in this patient and further foster suicide problem. Borderline personality disorder and depressive disorder, in which we highlight a high difficulty in solving problems and hopelessness, the harmful use of cocaine and alcohol, and demographic factors such as age, gender and part of socially minority group. The profile of temperament and personality point out a tendency to novelty seeking and harm avoidance, coupled with aggressive and impulsive behavior, without a clear definition of objectives and targets, and low capacity for cooperation which is observed by manipulative attitude posing in repeated hospital admissions. Therefore, we emphasize that suicide is a complex entity and their pricing strategies, risk detection and prevention, are hampered by the lack of a definition and classification operative. That said, and considering that you have to work in a comprehensive manner, we considered what we should prioritize in the treatment of this patient to prevent another attempted suicide, is the psychiatric disorder, substance use, social status risk that found, or suicidal symptoms itself?

EPA-0514 – Suicidal patient profile

Introduction Suicide is a public health problem of the first magnitude for both its costs and its implications for the population. The attention to suicide attempts is itself one of the first reasons for psychiatric consultation, if not the first, in hospitals. Among the risk factors for suicide is the presence of mental disorders on Axis I and II, and the existence of previous attempts. Objectives Studying the behavior of some of the risk factors for suicide known (psychiatric history and previous attempts) in a sample from service Emergency Hospital Juan Ramon Jimenez Methods Performed a retrospective analysis (for a period of 6 months of 2013) of the risk factors associated with suicidal behavior of patients seen in the emergency department of our hospital for attempted suicide. Results In an interim analysis found that up to 50% of patients treated for attempted suicide had made ??previous attempts. Most of them had any axis I disorder (> 75%) and were or had been in outpatient psychiatric follow. Extensive treatment with psychotropic drugs performed most (> 80%) Conclusions The high number of cases with previous attempts provides a clear example of the problem of suicidal behavior relapse. The importance of this is increased when you consider that most were receiving or had received psychiatric treatment, reflecting the limitations in our daily clinical practice we have to control this pubic health problem.

EPA-0508 - Suicide risk in group therapy

Introduction Suicidal behavior is a serious public health problem, being one of the leading causes of death in our country. Therefore, the identification of factors that increase or decrease the level of suicidal risk is of great importance for the close link with the conduct. There are several risk factors, including family and contextual, among which are the loss of significant others, including those that have been produced by suicide. Objectives In this paper, we analyze these factors in a group of patients performing a Group Therapy. Aims Several studies point to the existence of a moderate correlation between the BDI item 9 (‘suicidal impulse’) with a higher score on the SSI. Another goal is to check whether this relationship is between the members of our group. Methods To this end, two scales were administered prior to the start of Therapy: Beck Depression Inventory, a self-report scale, and the Scale of Suicide Ideation Beck (hetero). Results Our study confirms the existence of a moderate correlation between BDI item 9 (‘suicidal impulse’) and SSI. Therefore, item 9 of the BDI predicts a moderate way the result of the SSI that is related to suicidality. Similarly there is a significant correlation between total BDI SSI. We conclude that the intensity of the symptoms of depression is related to suicidality. Conclusions Consider necessary after evaluation and detection of these high-risk individuals, conducting therapeutic work aimed at the prevention of suicidal behavior within the individual treatment plan for these patients.

EPA-0517 – Immigration and psychosis

Introduction Immigration in Spain is from the early ‘90s phenomenon of demographic and economic importance, according to INE, in January 2011 first residing in the country nearly 6.7 million people born outside our borders. In recent years, many immigrants are living in especially difficult circumstances. Objectives Show that these people undergo a series of very specific stressors and duels: precarious and harsh working conditions, poor diet, loneliness and lack of social support… This would enhance the appearance of psychiatric symptoms in various areas, closely related to lifestyles that maintain and in some cases precipitate substance use in this group, primarily those that have a sedative profile. Methods We will present the clinical case of a 34 year old Nigerian male. No somatic or psychiatric history of interest. Cannabis smoker since adolescence. A year after his arrival in Spain admitted to our inpatient unit due to clinical psychotic. Was a challenge from the point of view of psychopharmacological have many side effects with low doses of typical antipsychotics Results Disappearance of psychotic and affective symptoms to approach the case from a pharmacological perspective, social and cultural. Conclusions Addressing the relationship between life stressors and cannabis as a trigger or catalyst for psychotic episodes in individuals predisposed. Pathological elaborations of cultural integration of an immigrant (whether by denial of the original culture or over-identification with the host culture) facilitates the use of toxic either for blending with Western consumer culture or cultural consumption radicalization toxic in some East African countries.

EPA-0561 – Manic symptoms in patients with head injury

Introduction Given the high prevalence, severity and difficulty recognizing psychiatric disorders in patients with TBI, it is necessary to conduct a detailed history, gathering information on the location of the lesion and its relationship with the table in the psychopathological examination. Objectives Illustrated by a clinical case, the close relationship between the injury of specific brain areas and the emergence of psychopathology that allows us to deepen the understanding of the biological substrate of mental disorders. Methodology Exposure of a clinical picture and brief literature review of the existing literature. Results We report the case of a man of 49 years old, no personal or family history was admitted to the hospital after a traffic accident with severe TBI. Computed tomography (CT) scan shows intraparenquematoso right temporal hematoma, subarachnoid hemorrhage, subdural hematoma right, pneumocephalus front right, front left fracture of both orbits and right maxillary sinus. Conclusions The interest in the study and the relationship of psychiatric symptoms with the location of the lesions, we can provide improved understanding of the biological basis of mental disorders.

EPA-0544 - Dementia in patients with obsessive compulsive disorder (OCD)

Introduction Despite the high prevalence of obsessive-compulsive symptoms located around 2-3% of the population, there continue to be cases where the characteristics of the patient or the circumstances of their environment, they fall short queries mental health or when they do not for the disorder itself, but for another reason obsessional symptoms worsen. Objectives Expose using clinical case, the existence of patients with obsessive pathology whose characteristics do not seek mental health consultation, until this is associated with a new disease that interferes significantly in vital organization. Results We report the case of a man of 88 years old, married at 60, was admitted to the psychiatric consultation at the request of his wife 29 years his junior, for behavioral disorders several years of evolution and history of obsessive symptoms compulsive, which did not interfere with their daily lives by the lack of insight and poor social environment Conclusions OCD is included in anxiety disorders. It is characterized by the presence of obsessions and compulsions that interfere with personal, work and / or patients social. There are cases that own personality traits of the patient, this disorder is not diagnosed early and choose to go only when associated with worsening cognitive impairment rituals and interfere with family life.

EPA-0547 - Do you look at me?

Introduction Delusional ideas disorder is characterized by the appearance of a single delusional theme or a group of related ideas together, which normally are very persistent. This, plus the fact that the definition of the disorder have been changing and that these patients rarely seek psychiatric help, makes it difficult to accurately assess their epidemiology, but it is estimated that delirious take between 1 and 4% of psychiatric entries and its prevalence in the general population is 0.03%. Objectives Analyze the variables that influence the clinical evolution. - Risk factors - Protective Factors Rate the treatments tested in Mental Health since the patient is diagnosed. Method Analysis of the clinical history of the patients mental health. Results-Case report Male, 36, who was diagnosed with delusional disorder at the age of 21, after starring an episode of hetero-aggressiveness to objects. From the beginning is characterized by delusional interpretations of referential character, gradually reaching a systematic structure delusional. Secondarily, this causes episodes of behaviour disorders with occasional psychomotor agitation, important social isolation and withdrawal, seriously affecting their daily functioning. During a year, he required four hospitalizations for exacerbation of clinical psychotic delusional self-referential and prejudice delusional ideation, with intense feelings of hopelessness and suicidal ideation. Conclusion Since the possibilities of treatment of this disorder are limited by little or no disease awareness and that his delusions are usually highly structured, we find it important continue investigating the keys to achieving higher therapeutic adherence and successful social adaptation despite continue with chronic delusional ideation.

EPA-0526 - The weight of a group

Introduction Currently the Eating Behavior Disorders have become a social and health problem of the first kind that requires a specialized and interdisciplinary approach to these disorders. These clinical conditions are characterized by their complexity and diversity symptomatology, which implies a significant interference in their functioning in different areas of life and clinically significant distress. Objectives Given the high burden of care in the USMC that difficult to monitor these patients at appropriate intervals, as well as the seriousness of the clinical and physical complications that can result, ultimately, in death, it seems necessary to implement group interventions to ensure greater continuity of care. Aims In all forms of group therapy underlying common advantages which advocate their implementation. Recent studies show that group therapy for eating disorders is equally effective as individual treatment. So in the USMC - Huelva conducted a psychotherapeutic group aimed at people with these clinical pictures. The present work is to analyze the impact of the intervention group in the eating disorder symptoms, anxiety and depression, comparing the results obtained in the tests applied before and after treatment. Methods Psychometric tests used were: - Beck Depression Inventory (BDI) - Inventory of State-Trait Anxiety Inventory (STAI) - Inventory of Eating disorders (EDI) Results The results reflect a clinically relevant improvement in both psychometric testing quality indicators (no hospitalizations, no emergency service attendance, adherence, etc.) Conclusions We should consider that group psychotherapy has unique properties that offer individual psychotherapy.