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Objective: Communication between patients and mental health professionals by means of messaging platforms in the interval between synchronous encounters became a kind of asynchronous teleconsultation (AT) whose usefulness and effect on providers’ workload have not been explored. Method: Mental health providers working in Argentina were invited to answer a survey exploring the intensity and usefulness of AT, and the resulting overload., Results: A total of 527 responses from professionals working throughout the country were received. As much as 69% of respondents exchanged messages with a mean of 1-10 patients/day and 31% with more than 10 patients/day; 75% answered messages over mobile phones on weekends. While 68% rated these interactions as positive for clinical follow-up, 47% considered them as a source of work overload., Conclusions: The generalized adoption of AT may require additional self-regulation by clinicians and regular monitoring of overload levels (particularly, among psychiatrists) to make their daily clinical practice efficient and sustainable., (CC BY NC ND)

COVID-19 has accelerated the transformations of teleworking, generating conditions of great opportunities and terrible threats. The digital divide deepens inequities and exploitation, where the most unprotected countries and the most vulnerable populations are closer to the abyss Digital changes have formatted new modes of care, which are constantly changing and present new challenges to find their scope and limits., Competing Interests: The authors have no conflicts of interest to declare.

In this paper we report the findings of the first "Epidemiological study of mental health in the general population of Argentina" in the framework of the World Mental Health Survey Initiative WHO / Harvard, in collaboration with the Faculty of Medicine of the University of Buenos Aires and the Asociación de Psiquiatras Argentinos (APSA) with funding from the Ministry of Health. Methodology: A multistage probabilistic household survey was conducted using the Composite International Diagnostic Interview (CIDI). The survey was conducted on 3,927 people aged 18 and over (no age limit), with fixed residence in one of the eight largest urban areas in the country (Buenos Aires, Córdoba, Corrientes-Resistencia, Mendoza, Neuquén, Rosario, Salta and Tucumán), representing approximately 50.1% of the adults living in the country. The response rate was 77%. Results: The lifetime prevalence of any mental disorder in the general population of Argentina over 18 years of age was 29.1% and the projected life risk up to 75 years of age was 37.1%. The disorders with the highest life prevalence were Major Depressive Disorder (8.7%), Alcohol Abuse Disorder (8.1%) and Specific Phobia (6.8%). Anxiety Disorders were the most prevalent group (16.4%), followed by Mood Disorders (12.3%), Substance Disorders (10.4%), and Impulse Control Disorders (2.5%). The prevalence in the last 12 months of any mental disorder was 14.8%, a quarter of wich were classified as severe. 11.6% received treatment in the previous 12 months and only 30.2% of those who suffered a severe disorder received it. The results provide essential data for health planning and implementation and the training of the mental health workforce.

We show the results of a survey on bipolar depression treatment using a sample of 359 argentine psychiatrists in the context of The National Psychiatry Congress that took place in the City of Buenos Aires, between September 26th and 29th, 2007. The objective was to study the attendant psychiatrists' prescribing habits in the treatment of bipolar depression. The discussion is based on the comparison between the answers and the recommendations taken from the main consensus, guidelines and from articles published by experts. The differences found point to the distance often present between guidelines and expert consensus series (based on patients meeting the strict criteria used in randomized controlled studies) on one hand, and a clinician's everyday real world practice, on the other hand.

The present paper discusses the concepts of category and dimension in the field of Psychiatry. As the need for a taxonomy is widely accepted, a broad review is offered of the present debate in its historical background, revolving around what mostly appears as a dichotomy between category and dimension. The classical descriptions of psychiatric entities, of categorial linneage, have had and still have unquestionable weight in clinical practice and even in the construction of Psychiatry as a medical speciality. Its limitations, especially since the most recent versions of the DSM appeared, have given lieu both to objections and to new proposals, themselves not extent of conflict and limitations of their own. Lastly, the authors suggest that the problem is wrongly posed when presented in terms of an "either/or" disjunctive.

Objective: The objective of this study was to examine the prescribing practices of Argentinean psychiatrists in the treatment of major depression and to observe similarities and/or differences with some consensus or treatment guidelines., Methodology: Four hundred two psychiatrists were surveyed during a specialty meeting in October 2005., Results: A total of 88.2 % of psychiatrists surveyed considered that every depressed patient must be treated with medication. The most prescribed antidepressants for outpatients were paroxetine, sertraline and fluoxetine. Venlafaxine was included for inpatients. The majority of psychiatrists indicated antidepressant therapy lasting from 12 to 24 months after remission of the first depressive episode. Antidepressant dosages remained unchanged during that period. A low percentage had used lithium or thyroid hormones as augmentation medications, the addition of other antidepressant being the most used augmentation strategy. The most prescribed antidepressant combination was dual antidepressants and SSRIs. Prescribing practices differed according to personal factors of the physicians., Conclusions: Discrepancies between clinical practice and treatment guidelines were observed. Further research over the underlying causes of these discrepancies and mechanisms to reduce them are necessary.

The aim of this paper is to discuss aspects linked to the assessment of sexual activity in mental health patients. Traditionally, and to this day, this assessment has received insufficient consideration by intervening professionals. Emphasis is made on determining the onset of sexual dysfunction with respect to the disorder prompting the visit. Schizophrenia is taken as the paradigm of the pathology least considered as regards assessment of the sexual activity of those suffering from this disorder.

Unlabelled: Borderline personality disorder (BPD) is a frequent mental disorder whose affected present high levels of stress and suffering. Diverse diagnostic criteria exist for this disorder., Objective: The objective of our study was to establish which are the most sensitive symptoms to diagnose BPD at the present time together with the expectations and treatments of choice of mental health professionals of Buenos Aires city., Methods: A voluntary auto survey was completed by 116 mental health professionals from private and public institutes of Buenos Aires city ., Results: Impulsivity, affective instability and boredom or emptiness were the symptoms referred as the most important to make the diagnosis of BPD. More than half of the people polled reported that the DSM IV was useless to establish the diagnosis of this disorder. Individual psychoanalytic psychotherapy was chosen by the majority of the surveyed as the most important treatment for these patients. Mood stabilizers are the drugs of choice for the pharmacological treatment of impulsivity., Conclusions: It is important to elaborate in our country diagnostic criteria and treatment guidelines that consider the knowledge and local experience with these patients.

Objective: This paper addresses the issue of monitoring the features of the psychiatric inpatient population of a Prepaid Medical System in Buenos Aires City, paying special attention to its length of stay, diagnosis and readmission rate., Method: Between april 1 2000 and march 31 2002 all the psychiatric admissions have been registered and readmission rates and diagnosis prevalence were studied in a naturalistic setting., Results: There were 244 admissions (0.8 per thousand enrollees per year) and 17% was readmitted during this period (1 out of every 4 readmissions in the month following discharge). Their length of stay was an average of 11,8 days. 66% was admitted due to a suicidal attempt or suicidal thoughts. 42% had a discharge diagnosis of Mood disorder, 34% Personality disorder and 12% Schizophrenia or other psychosis., Conclusions: Inpatients belonging to this Prepaid Medical System seem to be different from other inpatient populations making the comparison among them hard to analyze. Future research should bring more data in order to perform further matching and benchmarking. This kind of information should be no secret and every System should be requested to show its results to allow users' and buyers auditory as well as State's control.

Once the parameters to design and assess a Mental Health System have been put forward it's necessary to operationalize them into quality indicators and outcome measures. These indicators allow us to compare processes and results with other systems and services, they let us do the economic assessment and the allotment of resources, they give way to treatment guidelines and external evaluation, generating a new type of organizations evidence-based. This paper reviews the conceptual aspects of performance indicators and its use in some developed countries. It also discusses their usefulness, at the input, the process and the outcome level, to treat patients and to organize Mental Health Services and Systems. Despite therapists not benefiting directly from the use of this type of indicators, its importance should not be disregarded in order to organize a Mental Health System for large populations.