Pérez-Esparza R, Kobayashi-Romero LF, Fonseca-Perezamador A, Velásquez-Pérez L

Language: Spanish
References: 25
Page: 340-347
PDF size: 169.00 Kb.

ABSTRACT

Background: Neuropsychiatric disorders represent one of the first causes of disability worldwide. Recognizing the main causes for hospitalization may allow the implementation of interventions to prevent hospitalization and promote ambulatory care.
Objective: To describe the trends of mental disorders requiring hospitalization in a neuropsychiatric referral center of a middle-income country.
Material and methods: Observational, cross-sectional, and analytic study. Information was obtained from dismissal letters and from the Department of Epidemiology database in a 16-year period at a neuropsychiatric referral center. Diagnoses and trends through this period were obtained using Spearman’s correlation.
Results: Schizophrenia represented most of the cases (19%), followed by bipolar disorder (13%). Psychotic disorders (PD) were found to contribute the most to the length of stay (43.76%), followed by mood disorders (MD) (39.07%). Schizophrenia-related dismissals diminished through the years (r = −751; p = 0.001), whereas depression-related disorders increased (r = 0.857; p ‹ 0.001).
Conclusions: PD are the first cause of neuropsychiatric hospitalization. MD have an increasing frequency of hospitalization. Longer-stay disorders reflect global and economic burden of disease trends. These results might guide interventions that reduce hospital-based models of care, which represent a great burden in low and middleincome countries. Studies aiming to explain the trends reported are needed.

REFERENCES

1. Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PLoS One. 2015;10(2): e0116820.

2. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. Nov 09 2013;382(9904):1575-86.

3. Smith K. Trillion-dollar brain drain. Nature. 2011;478 (7367):15.

4. Patel V, Chisholm D, Parikh R, Charlson FJ, Degenhardt L, Dua T, et al. Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities, 3rd edition. Lancet. 2016;387(10028):1672-85.

5. Chong HY, Teoh SL, Wu DB, Kotirum S, Chiou CF, Chaiyakunapruk N. Global economic burden of schizophrenia: a systematic review. Neuropsychiatr Dis Treat. 2016;12:357-73.

6. Carniel W, Runte G A, Torres-González F, Bruce KM. Cuidado en salud mental: percepción de personas con esquizofrenia y cuidadores. Ciênc & Saúde Coletiva. 2011; 16(4):2077-87.

7. Pennington M, McCrone P. The Cost of Relapse in Schizophrenia. Pharmacoeconomics. 2017;35(9):921-36.

8. Hidalgo-Mazei D, Undurraga J, Reinarez M, del Mar BC, Sáez C, Mur M, Nieto E, Vieta E. Los costos y consumo de recursos sanitarios asociados a episodios maníacos en la práctica clínica diaria: el estudio MANACOR. Revista de Psiquiatría y Salud Mental. 2015;8(2):55-64.

9. Medina-Mora ME, Borges G, Lara C, Benjet C, Blanco J, Fleiz C, et al. Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: results from the Mexican National Comorbidity Survey. Psychol Med. 2005;35(12):1773-83.

10. Medina-Mora ME, Borges G, Benjet C, Lara C, Berglund P. Psychiatric disorders in Mexico: lifetime prevalence in a nationally representative sample. Br J Psychiatry. Jun 2007; 190:521-8.

11. Freyre-Galicia J, Castañeda-González CJ. Aspectos epidemiológícos de la práctica hospitalaria en México: la morbilidad atendida en el Hospital Psiquiátrico Fray Bernardino Alvarez 2003-2010. Rev Latinoam Psiquiatría. 2012;11(3):90-6.

12. Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Mahoney J, et al. Barriers to improvement of mental health services in low-income and middle-income countries. Lancet. 2007;370(9593):1164-74.

13. Irarrázaval M, Prieto F, Armijo J. Prevención e intervenciones tempranas en salud mental: una perspectiva internacional. Acta Bioeth. 2016;22(1):1-13.

14. Olivares JM, Sermon J, Hemels M, Schreiner A. Definitions and drivers of relapse in patients with schizophrenia: a systematic literature review. Ann Gen Psychiatry. 2013;12(1):32.

15. Gomez-Dantes H, Fullman N, Lamadrid-Figueroa H, Cahuana-Hurtado L, Darney B, Avila-Burgos L, et al. Dissonant health transition in the states of Mexico, 1990- 2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2016;388(10058):2386-402.

16. Santos-Preciado JI, Villa-Barragán JP, García-Avilés MA, León-Álvarez G, Quezada-Bolaños S, Tapia-Conyer R. La Transición epidemiológica de las adolescentes en México. Salud Publica Mex. 2003;45 Supl 1: S140-52.

17. Baxter AJ, Scott KM, Ferrari AJ, Norman RE, Vos T, Whiteford HA. Challenging the myth of an “epidemic” of common mental disorders: trends in the global prevalence of anxiety and depression between 1990 and 2010. Depress Anxiety. 2014;31(6):506-16.

18. Markkula N, Zitko P, Pena S, Margozzini P, Retamal CP. Prevalence, trends, correlates and treatment of depression in Chile in 2003 to 2010. Soc Psychiatry Psychiatr Epidemiol. 2017;52(4):399-409.

19. García-Pérez L, Aguiar-Ibáñez R, Pinilla-Domínguez P, Arvelo- Martín A, Linertová R, Rivero-Santana A. Revisión Sistématica de utilidades relacionadas con la salud en España: el caso de la salud mental. Gace Sanit. 2014;28(1):77-83.

20. Newman L, Harris V, Evans LJ, Beck A. Factors Associated with Length of Stay in Psychiatric Inpatient Services in London, UK. Psychiatr Q. 2018;89(1):33-43.

21. López-Fuentetaja AM, Iriondo Villlaverde O. Perspectivas teóricas. Intervención Psicológica en el ámbito hospitalario. Revista Clínica Contemporánea. 2019;1(10):1-31.

22. Moncrieff J, Crellin NE, Long MA, Cooper RE, Stockmann T. Definitions of relapse in trials comparing antipsychotic maintenance with discontinuation or reduction for schizophrenia spectrum disorders: A systematic review. Schizophr Res. 2019;S0920-9964(19)30391-3.

23. Ramírez-Bermúdez J, Aguilar-Venegas LC, Calero-Moscoso C, Ramírez-Abascal M, Nente-Chávez F, Flores-Reynoso S et al. [Neurology-psychiatry interface in central nervous system diseases]. Gac Med Mex. 2010;146(2):108-11.

24. Lyketsos CG, Dunn G, Kaminsky MJ, Breakey WR. Medical comorbidity in psychiatric inpatients: relation to clinical outcomes and hospital length of stay. Psychosomatics. 2002;43(1):24-30.

25. Rodrigues-Silva N, Ribeiro L. Impact of medical comorbidity in psychiatric inpatient length of stay. J Ment Health. 2017;1-5.