The state of psychiatry in Spain

The 1986 General Health Act and the so-called 'psychiatric reform' were key issues in the development of the mental healthcare system (MHCS) in Spain. The World Health Organization Declaration and Action Plan on Mental Health in 2005 gave it a revitalizing impetus and resulted in the first National Health System (NHS) Mental Health Strategy in 2006. A literature search was performed using MEDLINE, Spanish journals, reference lists, national databases, and European and Spanish official documents to describe the current state of the MHCS in Spain. The main results were: (1) existence of great variability among the autonomous communities with respect to mental health resources and provision of…

Treatments for Opioid Dependence and Methadone

Abstract This chapter is focused on opioid dependence treatment and is framed in a holistic perspective. Specifically, there are three main approaches to pharmacological treatment of opioid dependence: opioid detoxification, agonist maintenance, and antagonist maintenance. There is a great amount of evidence supporting the efficacy of methadone and buprenorphine or the combination of buprenorphine–naloxone for the treatment of opioid withdrawal and their clinical utility as pharmacotherapy in long-term maintenance programs. Secondary or adjunctive medications such as heroin, naltrexone, and alpha-2-adrenergics are also reviewed. The need for further research and to overcome nonscientificall…

Consensus guideline for the evaluation of physical health in patients with schizophrenia

Subjective Perception of Cognitive Deficit in Psychotic Patients

The objective of this study is to evaluate the subjective perception of cognitive deficit and how it relates to the perception of patients' relatives. Differences between the subjective perception of cognitive deficits in 107 DSM-IV-diagnosed psychotic patients and that of their relatives or caregivers were evaluated using the GEOPTE Scale. Fair agreement was observed between patient and family perception of cognitive functions, although there were important differences on those items that correspond to social functioning. A high degree of correlation was detected between the scores on this scale and clinical global impression scores, as well as the physicians' global impression of cognitiv…