Diálogos Interdisciplinares em Psiquiatria e Saúde Mental

Clinical and territorial profile of care in a psychiatric emergency

Alberico Prado Neto — 2024-06-05

Objective: to characterize the clinical and territorial profile of psychiatric emergency care in Ceará - Brazil. Methodology: quantitative observational study on psychiatric emergency care, over five years (2018 to 2022), linked to a hospital specializing in mental health, a reference for the entire state of Ceará. The data includes patients' sociodemographic information, such as age, gender, address, diagnosis and follow-up. Results: of the 91,555 registered consultations, corresponding to an average of 18,311 per year and 50.16 per day, the most prevalent ICD-10 diagnoses were: F20-F29 (schizophrenic and delusional disorders) and F30-F39 (mood disorders). Of these, only 11.7% (n=10,697) ended in psychiatric hospitalization. Regarding the hours of care, 55.71% (n=51,005) took place between 7 am and 5 pm, with times compatible with the operation of other services in the Psychosocial Care Network. The majority of consultations were from users who lived in the capital of Ceará, with only 22.9% (n=20,985) coming from all other municipalities in the state, corresponding to 3.0 consultations/1000 inhabitants. Furthermore, Regional VI of Fortaleza-Ceará, which corresponds to the same territory as the emergency analyzed, presented a number of visits relative to the general population enrolled (48.2 visits/1000 people) with values greater than double that of almost all other regions. Conclusion: these data demonstrate a situational diagnosis of a psychiatric emergency that is still centralized, in which the main demand for care is aimed at residents of the assigned area. Therefore, it is important to strengthen the attribute of regionalization and decentralization of mental health services so that patients from other areas have access to services according to their severity profile.

From transsexualism to gender incongruity

Luis Lopes Sombra Neto — 2024-06-05

Objective: To contribute to the knowledge about the historical evolution of diagnostic classifications related to trans identities. Methods: This is an update article carried out through a bibliographic review of the editions of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), in addition to other scientific publications about the history and the evolution of diagnostic classifications regarding trans identities. Results: Trans identities have already been named in different ways in the manuals that determine the diagnostic criteria that make up medical nosology. In the DSM, there was a certain gradation: what was defined as “Transsexualism” initially became “Gender identity disorder” and, more recently, “Gender dysphoria”. In the ICD, the change was more direct: from “Transsexualism”, a category of a subgroup of psychiatric disorders known as “Sexual identity disorders”, to “Gender incongruence”, a category of a group not belonging to psychiatric disorders, named as “Conditions related to sexual health”. Conclusion: The depathologization of trans identities is part of the process of evolution of human knowledge that, in this way, contributes to overcoming old prejudices and discrimination related to this group.

Bases for the training of psychiatrists through Medical Residency Programs in Psychiatry in the State of Ceará: contribution of the Ceará Society of Psychiatry - SOCEP.

Eugênio de Moura Campos — 2024-07-01

In this technical note, the Ceará Society of Psychiatry (SOCEP) presents its contribution to support the establishment of guidelines and competencies necessary for the training of psychiatry specialists in medical residency programs in the state of Ceará, highlighting the importance of inter-institutional partnerships that allow for diversified and collaborative training, aimed at qualifying professionals to work at different levels of mental health care. It was drawn up by the authors, psychiatrists full members, at the request of SOCEP, then discussed and approved by the board of directors, before being officially adopted by the society.

Recommendations for Child Psychosocial Care Centers about the use of oral health services by children on the autism spectrum

Maximiliano Loiola Ponte de Souza — 2024-06-05

This is a technical note with recommendations to promote the use of oral health services by children on the autism spectrum treated at a Children's Psychosocial Care Center.