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    Implicatii Psihomedicale in Alcoolism

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    © All Rights Reserved
    Download as PDF or read online from Scribd
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    15 views13 pages

    Implicatii Psihomedicale in Alcoolism

    Uploaded by

    Popescu Ana-Maria
    Implicatii Psihomedicale in Alcoolism

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 13
    IMPLICATIL PSIHOMEDICALE IN ALCOOLISM Pe rin iors aot yee tn i tne pe sl ss cnr ala cece ite SLE ES iMate Slconicks prin ate malin persnatiate pesto veka a sferortiae rena oe re Geta inmrcenaaeele arto ceed ee a ee de a mice urmarese puneres In evidenja a” wnor Trasit fit, Ag ot acs teens Ft a ee a en an rea 132 Aepresia sparutd inainiea alcoolismulul poste fio sta teal eiferta. Totus! pind in present nic o teore de personalitate nu a dlfeentiat coracteristiile sau sin cle centrale de cele perience si de datele psinostrue les constitutions. iu etiologic} plurfacoriale 2 personaltit alcool lude sl cereclarea Tactorilor eresitari sl soiologel larile rivind ‘creditaten —alcooismulals ‘comport Femiliate sl invesigafit pe gement st adoptiune, tn ie Tactrior genetic! in atcollsm este stall de familia» Scestor_cercelar, de concord sem iy met mare a gementior (aenitea Tai dela i de existenfa unui rise’ce patru ont maf mare pe ill alconteiior, chiar 9h tm tus cind stall dist dupa nasere, Se pate ch estho relate dee Cesterea vale riseulat pentru aloo), numarul de ieoolce si inimitates relat entice. Sloysogeas alsallamall ipetana inueneor i generfad un onume nivel de rise, de vulnerable ta emoesta, dar semificativio pentru sicollsm, rani Tarr moat hss sar atze ce influenleatt eiologiaslcoolismulu, exp abilintes eliologldadioneie cu relevarea uel Tnlerna(ional multifactorial care sa ofere.careteris: “personatiatealcooiea. posml i aspecele sale particl i juverie, sai a Teme anmile. calogort rote Canilte ced generessd multe din urgenjele med Fn aan huteroagrenivitale, rcfearhanstnfa pa i tubal asipen situate ents An wegen, ae vali gf Toctorilliiit cangtlinfel tn risealunor mente psologie smut, a patra problema de sAndtste publica, este i'n genoraren comportamentulal sutoite la apron tretine din caaurls In ccea ce priveste freeventa jor ttle im raport de oats pied Inside falusth In 329 tm perconaltaite. Avsrmonien, oi pind, 15% —epilepte, 11% —sleoolizm, 10% ie i eliruri sintematfzate, 33) — sie. demenia Gligotrente. Se apreciach de asemenea cl 20% din de alcoolism eronie recurg la tentative autoitice. 130 se va apela Ia inlernare si continuarea ambulatorie 2 el complote de reabiliacs Setieaay profesional ad, precum sf extinderes psihoterapii indinidusle. Gut comport ae inigrare nm etfe. wht le face NecesaTapreluares sl continuares une ip iri aclive in vetenu ce medicind gensrsliy Ls ficet: fatea urmér!ectiv de itee rare cs Tactori comin tn aleoolisn problema comportamentulul autoagresiv 2, aealtons pia’ geestates sh tract se toner Elsa de ei fe de 200 fl ma mare La popula ms tdee‘edlliice ttl Ge cole mat mufie ori dramatic pig Seales No gpa urven! att in hea depress Pet alcootce, eff stn slaren depresiva reactiva dup pi. {otal intonicatel Sete, cind.bolnavul realizeaza stores Situafia sa. Total dcteriorarea progresiva somato-psihcy Siimmat-socisls a personalfa( indusd prin aleolism ea 5 Eigonele dtr cu cotinl teria aeraveas Eomperamontulaberant 31 auioagrestitatea in slcoolismt fone se pot manifests rin automutlare, captus suickar, liza ta episeadele ontroconfasive, suiidul depresiy st Shdig/ sau omucldere Buevoltsres comportamentului sutoitc este Tavorizts de aeflunce unos {acert negativt ambiental, atunst cin ip Gur Fameiatn nel cia alas edaplatie pelnoiiglogice corespinzatoare exlzenjcior ctica-ocie Biniee facet ccologiel pe primul loc se sityeaza dezorge Dlearea mediulat familial ty care alcoolismal joact wn 0 nportant, Tentativele autolitice survin tntr-un ama nent de convergenta a Tscloror extern situational sa Fectorir tera egal de srueura personal, Pier sin sort subeculexte a aut sta adlesss {allan prin “inne su some ‘Slcoolisi). Be-asemened nu este megliat Taptal esc sieeelccalce favoraeas® teceres Tn acta suctdar 9 1: fal de aces consumalabuniy de biuturl alcootice gi, ol ‘le, alcolismul cronte reprezinta factort Importanf fa © ieree riculul suiaidar global vshuoren comportamentail utogaesty In oleols rin terclares i interpretsrad nor date de observate Mie gone condice ia apreeren psn a fei ae rae Tncldenta eres gh gravitate" comportamen' ‘Sutosgresie tn afeoolism sfal felevate tn literatura. do SP uuMttiie ere consemnenza C8 20% cintre alcoolich sco, H'tentatve autolitice ce represiats [a rndal Jor 10% 4 {otalal tentailvelor sticks ‘Constatarue cinice senjionesed uowpra, mcceiti tie proflectice a comportamentulal autoitic 31 © Hecutal suleidar in aleoolism Aceasta implica icpen Saved acolicitor rin intermediul LSM. In raport de &™ 1 ful "de crcumacriptie, in eo intograren fami rile poriodice'palbatece’ sl patnologicey inaicatle ice Fevin in garcina specallgtor in LSM. In pare fu ec{funt fa lorem care vizessa. ameliorares factor dig, retuperarea gl proflaxia, Recomanaarile stati atinese Fedral metogotoge. soil caaberrey fh fnuare rejele! de medicing general, wilt tn inal gael propuseprdjtn gc e compere SEMNIFICATII PSIHOLOGICE IN DISPENSARIZAREA AMBULATORIE le he’ proceutl ‘cones de fociperate s DOIld sistent cinco trapetick evine in primal ind baie piisatie ce ee wetouciae af Rerea eats fin preusts ‘9 exlaed tt mbulvior Ne tara de Saniate minisa prin arieteres si or SiapensariziitholnavlorPsbi De metfons 135 cy centrul de sinatate mintals se diferentiar® in, fen. Sheen ode! multifunctional de asamblore streclursls sinks tien il extrapitaicestt care 38 inclad la femtveat de stnatate aminalaalaturl de serviiul dc, Sekfomar ct paturt serve de relat costal Woe efaurative-profilectice 9 recuperatori, ca si cele de diapenserivare, Inia In spital se protectesz3, 1m, 2 2 AEP ESA care preta si continua aff sareinile £e dlsper viatee tMgaiatenla recuperstore tn dlmensiunil= ore SHELLS Srestonste si soctoe, eit of sistent proilatick in sical, Broprimaras Secundard sau terfiara. Aste) Sartre BENG Rerstorit de sanatafe mintalay upring Tehat'a Qroblemaieit de ambulator ea: stusiat fast: HES? (ihorarea_achunilor de profilaxc primards depiss TEE 2a gt presoce a blllor pathice ea 4 mAsuror de en TeNNe Scbndard; dlepensarizarea activa’ sl uemdrires Breilmantufal. de Tntretinere:rezolvarea, problemelor de ‘Cadel aeumilor Se ‘ae pavoigient Boing a clea tamer ec rernapr et medicing general, Tmplementorcs cercetarl cy eerChapice on asistentapsthiatriea porneste de Te neces HOR celterologit nosologice prin validares melo, Hae, Ue ccrcelare a boilor peice Ia nivel eonestinflor SK ‘cespre natura i state, islemolel Peter ale deSPT recut sf prin beneficul adus fn eumonsirts partement®y; earecaler ‘natolowelpslhice, a” disteibt resists, ‘preleiel sf Ststenfet Te nivel tne! pope “Orientatea asistenfe) paiblatrice tn raport, de fail it inclaenls prevalent face necesarao corecta evéen|e dpsidenls ack elnavllorpsibil prin intermediul TSH Giedral carcini sint stipulate de cempletaren 'rmcor fnregistrare, oedonstea pr ‘erapeatie st ocupsli= lnreicaelé de Tefen cm gh stabliren unt logit ert nal eS Et tela ad mutes 3 ulepeaserte mee teritorate. PPasiria ca disciplin§ medicalé integrativis acon ok i aoctals ol earel object de studiu si inietvenile 6 Heche mental destnal color fecal de aceasta, 1 221 pia competentele 3i protectia sa interdisciptinar’ ie ta compensa de prea sal = Farr e promuvae « aamaiayit vie, In Farm optima de afirmate = capacitiil ex valor fund, (ojenbie"socitafi, Laboratorul de sinatate mintsls Sa asa necesiaie de pretungice contactutut direst 198 nav pte, de stb yl cealzare 4 unar masut pro peice si de recuperare, consttuind Totodata 0 veriga de se dau ‘iret coninay in care dispensarearea re ned o supraveghere, medicals. aciva curailve-profilat Rs, cetogori de ball patie. Luar fat Se feee supa, stadia aint wt SI sibilies chignostculul, proces dlspensariaaril eux giatndaetuni desfepistare. Ware in evideniae urmsrire visi scoaterea din’ evidents. Melodologta dispenseriz ecerith figares eazutlor prin carmel de dispensarizare, ide cvidesay anchett sociala 31 anexarea examina lor fhologice. Astiel Hevare ety dispensariat poate benelica rags dl orale eign, Dsihelerapi, examindrt medieale 91 psielosice| pro sae aristarca"etnituatenattonor noe “jocul de muned, reducerca sau modiicares programulii Thcru, reorentres sau, pensionarea)_9t-sosialamello furor Tactorl negativy social sh familial) — prin in edit unel echipe formate din medic psihiatry,” pedo- atu, peltolog, asistente sociale ew concursul Impl ms aiorlor Ge competenja comuntara Colaborarea dintre medicul de miedicind generalé si ps erate teat meee ‘ff ta arenes jet boli, cit sf tn slabilirea metodeor terapeutice di ste de la.caz a Caz. Pslologull fi revine srcina de sminare si_adnotare in carnelul-de dspeasarizare, moc gtd" examinarepattotogies, sma dese i eceruisarit Telodea in casitle Indicate de me oh insite gedinge de psinoterapi, prin care se urm Tecuperaree. (Pe funchi sl tendinje. de le caz Ta ci2). Asie examinazea patoogicd. contibuie le muaiares ignostcolst pathic, seopul_psthodlagno- fepfiucatat de felletares’unor date reertoore Sramersiaa it yf medlearior sue strumentaral metodalogic de examinare psitologics, at sl valigat de Taborstorul line de psihologie a falulll Clinic de. Paihiatrie «Socolae — lagi, euprinde: ‘melodie de investigare si valiare: anarmneza sf ob teste psitulugice: este de efcienfa sl performanta: proba de corecturi, Bourdon-Antimov, proba de cal- wr ‘cul Kragpelin, proba de beraj Toulouse-Pieron, ae Sten daha Praga: = fetta Ee'probe celor 15 cuvinte (Rey A), seala de smemorie Wessie bateia A. Dnt mor fyaluarea nivel tateleclual; = feierla WATS, metrice progresiva Raven, bate KUT, at care se stablese Ql aan gradul de deteriorare isisis ) chestionare de 2 Ghestignarul AUP LS Tie proictive: TAT, Testol Szondl, testul Roser swe ‘Slabitires psihodiagnosticslut 1s bolnavi_dispensarizay ae'tn vedere investigatia de, evalume "simptoalologict Pailatrca.(regres~progees) in funclie de care se stablese Blegeea gsraeniarati etal concoraoni. dom ama procesitar psinie (periurbares procession peice wu Five, ‘ole alectivtai, personally. precizarea nivel Tide scolorizare si integrarea socio prolesiona1a Piteraia se cilerenfiad in fancied starea prec ta qi'de dura evolufiel Voll cu stabilires eecomandarilor Medicale, peihocomportementate, atitudinale. Tn cadrul PSM se pot apliea psihoterapie: “individuals. (noadies ive copays anlisnatoned; antfobles qt compotamen's: In Puholerapis familie are i rol important tn influcn\ yea favorabile-@ boli vind familia st meaful ambiant, si femut ie comusicare‘al famille intern—estern, organizarce Siictarhizsrea farmiiel, vlatarea: st contactarea family Salten‘tadlon de structrare’ jamie cx Seow pathic in cedrul uid progeamn care urmareste Peadaplaret Sffeinserarea boinsvutal med famil, Tnlegrarea pathologulut clinician in echipa de asistents a USM, prinvelaborsres pstodiagnosticulut st psiter Bit, exinderen acti fy tetra arondl repress ErSpe" importante in. complexitstea aclumiber de dispen=2 Flabre care contlbule Is wlevares calla asistenfet mes CosocialeIiplicarea in programele psiboprofiactie gi 1% Stperatoritconduee 1a Tirgires postion de iterert® faPetistenta ambulatarle, Sourviren diferce{iala at com? tent a fieedrut-caz tn parte, evaluarea epldcmioiogic® ‘Sslimares.predictivs 2 tmplicalilor-comportamentale volufia bal psihice. Considerdm c& aceste date sint probe sonalitate, fcdworts (WM), Javentaral de pe. Skectanaedl ae” anata Cat 138 tive In reflectaten comportamentalé 1 ridicd_ problema enlariasistenel prollactemrearative ea 3 1 clontasior Tecuperare, cae este scopul-aetanlor de dispenstzy ail alopt ste in Bese erg aie integrate Tamia Sif sau productivs. Totodata se atene coal esupra configure! "epidemiologist isc portamentt patalogc cu diraea in Sonselna a ass: [et ecuperatoril ca sha predtclimpitcsilr. medics. ale in incidents experts” Asta ortertarie de perspec: i privind dispensaricarea bolilor aisice subliniaal ‘pertectonaepostitaglon terapeutie 31 amendarea yun actoritormbientalt patogent pr itathsres er alt diferetise recuperator ca aciune.asupra st lor psthopsiologice Indase de. procesualiscs bel RELATII MEDICO-PSIHOLOGICE, IN PSIHOPARMACOLOGIE Sarena cl een cca de ined Sree dr ene Slee Laer Get Ect lath Aaanat es Sta Hs eae pint natu Go te Ee SEAS Saha acl Si 139 ‘atcoolul, hoyigul si serpentina rauwoltia, dupé nul 1825 Sarurile de brom si coralhigrata, Tar din anal 1909 se ine iguresed seria urhtunicelor_ prin descoperirea. barbital a lerir 2 Sengarhtatael yh alloy pro arr diucerea tn terapeuiica’s lorpromazine! ie eatre Daley) Dentker. Ulterior medicajia psihotermscologicd s-a dezvel fat prin descopesizes a muimeroase: preparate celeste ps hotrope (sedative, anailotce, hipaoee, etikipnotice, ant depresive, psihostimulente sau paiiodestructursnte) ere Aclioneara a nivel SINC. si exerci o aatune farmoco. ‘anor functit police lementare ca vigiliatea constinel, se Uitatea pulstonala sau afectivitatea, Cu referire a med tata sntidepresivi, de Ia confirmarea in saul 193? 2 pro Dritajlor antidepresive ale tprontaciel sl imipreminet 5-0 Introdus in terapeutica serie de no) preparate. Menlio: ‘im dntre acess, nto jalonare temporal, prepasicle mins), amiriptiing, teinipramina, solpirida, anidepresve Te eu siructura originals (nomlfensing, vlloxazina, fix mina), antidepresivele telraciclice (mianserina, maprotl aj. La fel gh te cazul-medicafieltranchilizante (anol fe), de la inirodaceren in linied a meprebametulut (1951). Slordiszepesidulut (1964), dlazepamutul 1962), gama aces fern eon potine ca tapliitae. cle repeezetied erupares ‘Teamentoasd etl mat bogat istrsta tm domental substan felor neuroleptic consemmam deseoperiresneurolepticel fre reprezins un real progres in lerapia bolllor psthiee frolufle prelungita, God considerate a tela vevolufle. (2 puihistries datoritdcaractristielfor farmacoclinice st svat {jeter oferite prin eregteres. complianjel Ia. teatament, el cents clinics, ceritudinea sl spatlalizarea administrirl ‘cum sf moriiceren favorabild 2 ela mesiepacien prin incivievaliares si contimuttatea tratamentulul condi {le dispenserizere: Dintre.substanfele psitoanaleptice "< cma heneficisl lerapeatic al psthotonelor de reglare iabolied de fipul piritoxinel (encephatel, peilaol) sau =u anfelor nootroptee ca piracetamut (neotropil,pyrame'y plracetam) ‘La tncercarea de cuprindere a tuluror | medicamentelot psthotrope sau elaboret numeroase clasmieart (V. Predes= Sl eolab., 1976; D. Ginestet, P. Peron-Magnan, E Zaria M0 E, Chevalier, 1978; W. Poldinger, 1982: R. Spector, H. Ro: 5, De Hoy, 1987), care au lar béza claslcafea propa citre Delay si Beniher 31 in care sstanete pslnabope at grupate inet mari categorpsiholeplice "(sedate Rife). Dalioenaletce Cann! pace) pss iprturbatoare ale ativitatit peice). Pulholarmaeotogia are apical in muite domenii ale me inci, deschistaat in palate. portania beneficiior aduse fn terapia boltlr psinic, ‘Ay Fe8_psihotropelor tn elinica implica o complesa selofo. fe pornind de La aecesitaten testrii medicameitelon ie enuoluaul fac esc Telbarspetice™ eee estares de [uborator a acfluall qi eiestelor _medicaiet Ihotrope Include experimenisres pe saumnale prin. elec aren nor teste de tosiciate seat subaculd st cvcni, laren clecilor neurodinumic, teste de moiilfate, sor, Deratura. entry ceretaren biecsiar est sleptizsny ra nity determinares proliulut de actiune prin me e-spetice (cind se cunoaste east din este fee pars) it mefode- generate Win cazul anor structurt not ine ute) Geresterea chica experimentala psihofarmacotogicd im i" ultple sensuri relajtonale ce vieeasdinvetigaree eta a” pacientulul, precizaren disgnosticuly urna volute bol st eleceior diverse, examinarea psltalo Tn dinamied sf! abordares pshoterapcutica Ta acest ne vom referi la sere de Creetat psihotermacologice ie comparative a spur slay let fs clinica te peibisri, ut ricrrs partculord lo Semnt file ce decury_ ul eaplordrile peboiogice tlt ca psio th Hemizata st eienta Experten{a acumuleth ne permite reteriri la medical, ilizant(siudl In dublt-orb asupra preparateor: to im, diazepam si nitrazepan versus placebo), medice- piencai (ernar tre iui compra iy si Gublucery ssupra\preparalelor miancering, ms lind, vilozarind, sulpiride, imopraning, "amirpling, ol, melitacea}, Studll asupra aplicajllor 3h licen ut clinie 4 neuroleptictor depot. Metodologi,stuilor lec- fle slandardieaa in raport de. preparsicle cereeate Constat, n abservatie dined, notares-momentulel prime’ Smeliorat st a amelioret maxime, determinsrea constant inehiningee, FRCL EKG st examenul FO. initial tla str fil tratamentul, misurarea TA. 9 putsulat pe Yoatt du Fatt ‘Gheervetielclinie. ji" investiga pihologied Is OER te Cadeul metodologie al studilor ntreprinse reevaune te sbecvail semmlestive privind (plese, ‘Felatonsi i ratumentulpatalrmecdogte sport psinlgi! me ficale Ferapeute. Aste) studlal medial teanch {ieanfel pe nud exldenferesliclenge anmottice Tl iter cifie,sfenfioneats st asuprs sefeeulut placebo», clad eligrares aner elements pahapatologice survine ca Feil ist ar pehoterapiel mediate prin adniaistcarea” unui “pre faral elicomentose 9 pin efectuerea examin pel Rogie a investiga{lofclinice ste Taborator, ‘Observatin linia gi dispensarizarea uput lot debe nay Sancelent trata cl meurubetice Sopot. eeicfewed Svantajele terapetice sl posoiltateadminstrarii ams iNgri intro abordare psihoterapeutica, sbsorblie ocupalo nila 9 cooperare comealtas ‘Medicaia antidepresivs oferA um cadrw optim cercets ‘xperimentae. dateritl postbiiatiio: de-bservatie Usistentaslinie, Investigate pathologies 9t eslimare a re Ginter Imre’ pertowN Hsulela ue imp, Ta cere ‘enfionate st procedat Ia aplicares dinamicS fa O—T—1t— Bi alte a sale Hermit pentru depresie (HAMD) fav Finnts 21 de ftemt st scalarea 0—4, concomitent cu chest harcle de evalusre DEAN (40 items) 41 AMCLE Tlemi) $1 an supliment disposi testi” (ISDAN, W—%. [Bgcenls chestionar ansilate test [yl Rawen) apicate EB eaperincata an "ocopulsurprindert! intent Siplamatslogiel depresive dulife de eraminare psibologied probate tn curl cerctrlor inieo-experimentale sugereaza cette benetich fm complexa relaje a terapel pstotrape eu psihologia

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