Search

Resumen: Objetivo: El objetivo es estimar la prevalencia de consumos de riesgo de drogas y patrones de consumo en atención primaria. Diseño: Estudio multicéntrico descriptivo transversal. Emplazamiento: Cinco centros de salud del área Sur de Madrid. Participantes: Población consultante en atención primaria entre 16-100 años. Mediciones: Se utilizó el test ASSIST validado al castellano de la Organización Mundial de la Salud para el cribado de consumo de drogas. Se calculó la puntuación total para cada droga. Resultados: Se realizaron un total de 441 cribados. La edad media fue de 51,3 años y un 56,1% presentó algún consumo de riesgo moderado o grave para alguna de las 9 sustancias cribadas. Las drogas con cribado de riesgo más consumidas fueron el tabaco (41,7%), el alcohol (15,4%), los sedantes o los hipnóticos (13,7%) y el cannabis (5,7%), encontrándose algunas diferencias: los hombres consumían más alcohol y cannabis; las mujeres tenían mayor consumo de sedantes/hipnóticos que los hombres. Se observó policonsumo en un 16% de los sujetos. Conclusiones: Existen riesgos derivados del consumo tabaco, alcohol, sedantes y cannabis en atención primaria. Existe una mayor prevalencia de sedantes e hipnóticos. Abstract: Objective: The aim of this study is to estimate risky-drug use patterns of consumption of primary care patients. Design: Multicentric descriptive cross-sectional study. Setting: five primary health care centers of the South of Madrid. Participants: all patients between 16-100 year-old consulting with their family physician. Measurements: Spanish-validated World Health Organization ASSIST test was use to screen risky drug use in primary care. Total points scored at the test were obtained. Results: A sum of 441 screening test were collected. Mean age was 51,3 years and 51.6% of patients presented a moderate-severe risky drug use out of the nine drugs tested. The more frequent drug use screened were tobacco (41.7%) followed by alcohol (15.4%), hypnotics (13.7%) and cannabis (5.7%). Differences were found between genders in the patterns: men had higher risky drug uses compared to women regarding alcohol and cannabis. Women had higher sedatives/hypnotics consumption prevalence. A 16% of patients presented with polyconsumption drug use patterns. Conclusions: There is risk derived from drug misuse in primary care for tobacco, alcohol, hypnotics and cannabis as detected by the ASSIST test. There is a higher rate of hypnotics than expected. Palabras clave: Cribado, Trastornos relacionados con sustancias, Atención Primaria, Alcohol, smoking and substances involvement screening test, Keywords: Screening, Substances-Related disorders, Primary Care, Alcohol, smoking and substances involvement screening test

Since Classical Antiquity numerous authors have linked the origin of some mental disorders to physical and functional changes in the pineal gland because of its attributed role in humans as the connection between the material and the spiritual world. The pineal organ was seen as a valve-like structure that regulated the flow of animal spirits through the ventricular system, a hypothesis that took on more vigour during the Middle Ages and the Renaissance. The framework for this theory was "the three cells of the brain", in which the pineal gland was even called the "appendix of thought". The pineal gland could also be associated with the boom, during this period, of certain legends about the "stone of folly". But the most relevant psychopathological role of this organ arrived with Descartes, who proposed that it was the seat of the human soul and controlled communications between the physical body and its surroundings, including emotions. After a period of decline during which it was considered as a mere vestigial remnant of evolution, the link between the pineal gland and psychiatric disorders was definitively highlighted in the 20th century, first with the use of glandular extracts in patients with mental deficiency, and finally with the discovery of melatonin in 1958. The physiological properties of melatonin reawakened interest in the relationship between the pineal gland and mental disorders, fundamentally the affective and sleep disorders, which culminated in the development of new pharmacological agents acting through melatonergic receptors (ramelteon and agomelatine).

The relationship between the "passions" (emotions or feelings) and psychopathology has been a constant throughout the history of medicine. In this context, melancholy was considered a perversion of the soul (corruption of the passions). One of the most influential authors on this subject was René Descartes, who discussed it in his work The Treatise on the Passions of the Soul (1649). Descartes believed that "passions" were sensitive movements that the soul experienced due to its union with the body (res extensa). According to this theory, the soul was located in the pineal gland, where it was actively involved in overseeing the functions of the "human machine" and kept its dysfunctions under control, by circulating animal spirits. Descartes described sadness as one of "the six primitive passions of the soul", which leads to melancholy if not remedied. Cartesian theories had a great deal of influence on the way that mental pathologies were considered throughout the entire 17th century (Spinoza, Willis, Pitcairn) and during much of the 18th century (Le Cat, Tissot). From the 19th century onwards, emotional symptomatology finally began to be used in diagnostic criteria for mood disorders. Sadness as a passion of the soul: A psychopathological.... Available from: https://www.researchgate.net/publication/49830961_Sadness_as_a_passion_of_the_soul_A_psychopathological_consideration_of_the_Cartesian_concept_of_melancholy [accessed Jun 06 2018].