Adolescentes em situação de vulnerabilidade social e o continuum risco-proteçãoriesgo-protección

Este es un estudio de casos múltiples realizado después de la inserción ecológica de los investigadores en los contextos de desarrollo de cuatro adolescentes en situación de vulnerabilidad social. Estos fueron seleccionados de un estudio más amplio llevado a cabo con 98 adolescentes de Brasil de dos grupos diferentes (G1 en situación de calle, y G2 en condición de extrema pobreza). Los adolescentes seleccionados tenía las calificaciones más altas y las más bajas de ajuste en sus respectivos grupos. Los cuatro jóvenes fueron descritos en cuanto a indicadores de ajuste, factores de riesgo y factores de protección, utilizando datos cuantitativos y datos del diario de campo. Los resultados mostraron puntos comunes y divergentes entre los casos y la existencia de un continuo de vulnerabilidad social. Este se relaciona más con la forma en que factores de riesgo y protección interactúan en la vida de cada adolescente, que con el contexto en el que viven (calle o familia).

Description of the risk factors for relapse in patients diagnosed with severe mental disorders

Objective: The objective of this paper is to describe the population served in mental health institutionsfor mental illness relapse, and the process of identifying risk factors in relapsing patientsdiagnosed with severe mental illness. To this end a descriptive exploratory multicenter, multistageepidemiological study was carried out in mental health institutions of the Order of San Juan deDios Hospital (OHSJD) with hospitalized relapsing patients with a diagnosis of severe mentaldisorder. This study comes from a working network of Psychology professionals in the OHSJDnationwide. Materials and methods: The population sample was of 1005 patients diagnosed withsevere mental disorders, who had presented relapse during the last year. First, the characterizationof the general population was conducted; then, it was narrowed down to the centers, taking intoaccount similarities and differences found according to the clinical and demographic variables.Results: Major risk factors for relapse found in patients diagnosed with severe mental disorderswere: having between 38 and 58 years of age, being female, single, graduates, unemployed, witha prevalence of bipolar affective disorder diagnosis, number of hospitalizations between 2 and10, number of drugs at the time of leaving hospital 2 to 6, with severe difficulties relating withothers and difficulties in adherence to treatment. The need for a caregiver was also found, as wellas a limited number of received psychological interventions. How the system of beliefs affects thedisease and the poor adherence to treatment was identified. Conclusions: These results indicatethe requirement of a design of team intervention strategies, ranging from the assessment team(home), definition of therapeutic action plans (for) and the posthospitalizacion (egress) following.There is a poor support network and limited adherence to comprehensive treatment.