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Titolo:
Psychiatric considerations in the primary medical care of the patient withrenal failure
Autore:
Levy, NB;
Indirizzi:
Coney Isl Hosp, Dept Psychiat, Emergency Serv, Brooklyn, NY 11235 USA Coney Isl Hosp Brooklyn NY USA 11235 ergency Serv, Brooklyn, NY 11235 USA SUNY Hlth Sci Ctr, Dept Psychiat & Med, Brooklyn, NY 11203 USA SUNY Hlth Sci Ctr Brooklyn NY USA 11203 iat & Med, Brooklyn, NY 11203 USA
Titolo Testata:
ADVANCES IN RENAL REPLACEMENT THERAPY
fascicolo: 3, volume: 7, anno: 2000,
pagine: 231 - 238
SICI:
1073-4449(200007)7:3<231:PCITPM>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
DIALYSIS DISCONTINUATION; DEPRESSED-PATIENTS; FLUOXETINE;
Keywords:
biopsychosocial; psychonephrology; depression; anxiety; delirium; sexual dysfunction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
8
Recensione:
Indirizzi per estratti:
Indirizzo: Levy, NB Coney Isl Hosp, Dept Psychiat, Emergency Serv, 2601 Ocean Pkwy, Brooklyn, NY 11235 USA Coney Isl Hosp 2601 Ocean Pkwy Brooklyn NY USA 11235 NY 11235 USA
Citazione:
N.B. Levy, "Psychiatric considerations in the primary medical care of the patient withrenal failure", ADV RENAL R, 7(3), 2000, pp. 231-238

Abstract

The adequate primary care of patients with renal failure, from the choice of the modality of treatment down to the everyday answering of questions ofpatients, relatives, and staff, requires a knowledge of the major psychological stresses of the illness and the psychiatric complications resulting from these stresses and their treatment. Among the major stresses of dialysis are the procedure itself, the overall medical treatment which includes medications and diet, and dependency-independence issues arising from the unique and almost abject dependency of patients on a machine, a procedure, anda group of medical professionals. As a result of these physical and psychological stresses, the disorders seen include delirium, depression, anxiety,suicide, uncooperative behavior, sexual dysfunctions, and psychosis. In their treatment, one should first consider what prophylactic steps should be taken to avoid their occurrence. It is best that a behaviorally trained professional be involved in the initial evaluation of all prospective patients. Ideally this should be a consultation-liaison psychiatrist. Such involvement may help in the selection of a modality of treatment best suited for the psychosocial background of the patient and help identify those most susceptible to psychiatric symptoms and disorders. Patients should be told of the possibility of complications such as sexual dysfunctions and, in the caseof dialysis patients, that they may at some point in the course of their treatment consider voluntary withdrawal from it. Medications have an important role in the treatment of anxiety, insomnia, depression, psychosis, and sexual dysfunctions. Concerning the latter, behavioral techniques of Mastersand Johnson have been found to be useful. Talking therapies seem to be of value for only to a limited number of motivated patients. (C) 2000 by the National Kidney Foundation, Inc.

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Documento generato il 22/01/20 alle ore 12:46:10