Revisión crítica sobre los intrumentos para la evaluación psiquiátrica en atención primaria

Publicado

2014-01-01

Revisión crítica sobre los intrumentos para la evaluación psiquiátrica en atención primaria

Critical revision of Mental health Assessment Tools in Primary Care

Palabras clave:

Atención Primaria de Salud, Salud Mental, Escalas de Valoración Psiquiátrica, Diagnóstico, Cribado (es)
Primary Care, Mental Health, Psychiatric Status Rating Scales, Diagnosis, Straining (en)

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Autores/as

Paola Andrea Tejada University of Chester
Luis Eduardo Jaramillo Universidad Nacional de Colombia - Sede Bogotá - Facultad de Medicina - Departamento de Psiquiatría
Ricardo Sánchez-Pedraza Universidad Nacional de Colombia - Sede Bogotá - Facultad de Medicina - Departamento de Psiquiatría
Vimal Sharma University of Chester

Resumen (es)
Resumen (en)

Antecedentes. Actualmente existen múltiples escalas y guías de entrevista en atención primaria en salud mental. Sin embargo, estas tienen limitaciones en la práctica clínica diaria. Muchas fueron creadas para realizar investigación, otras requieren gran entrenamiento de quien las aplica y en su gran mayoría cubren un rango limitado de síntomas, por ejemplo ansiedad y depresión. Escalas de gran uso clínico para síntomas ansiosos y depresivos permiten evaluar la presencia o ausencia de síntomas más que dar un diagnóstico específico y deja por fuera un espectro amplio de trastornos psiquiátricos como la demencia y la psicosis. Por estas razones, se han propuesto múltiples alternativas que permitan superar los problemas mencionados.

Objetivo. Revisar de forma crítica los instrumentos utilizados para la evaluación psiquiátrica en atención primaria.

Materiales y métodos. Revisión de la literatura.

Resultados. Dentro de las herramientas desarrolladas y más utilizadas se encuentran la Primary Care Evaluation of Mental Disorders (PRIME-MD) y el Patient Health Questionnaire (PHQ). Otra estrategia es la Herramienta Mundial de Evaluación en Salud Mental (GMHAT). Esta herramienta permite hacer tamizajes amplios y diagnósticos de problemas mentales por personas con poco entrenamiento en psiquiatría y en poco tiempo.

Conclusiones. Se recomiendan los instrumentos breves que realizan una valoración global del estado mental sobre aquellos que son específicos para un solo trastorno.

Background. There are many instruments to use in primary care in Mental Health. However, the overall limitations found are that some instruments were developed specifically for research purposes and scales cover a limited range of symptoms and mental disorders like anxiety and depression. Scales used in clinical settings for anxiety and depressive symptoms usually assess the presence or absence of symptoms rather than give a specific diagnosis and leaves out a broad spectrum of psychiatric disorders such as dementia and psychosis. For this reasons, multiple alternatives to overcome these problems have been proposed worldwide.

Objective. To review in a critical way the instruments used in primary care.

Materials and methods. Literatury review.

Results. Among the tools developed and used are the Primary Care Evaluation of Mental Disorders (PRIME-MD) and the Patient Health Questionnaire (PHQ). Another instrument is the Global Mental Health Assessment Tool (GMHAT). This tool allows broad screening and diagnosis of mental health problems for people with little training in psychiatry and in a short time.

Conclusion. Short Instruments that perform an overall assessment of the mental state are preferred over those that are specific to a single disorder.

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