entrevista e historia clÍnica en ancianos.docx

7/26/2019 ENTREVISTA E HISTORIA CLNICA EN ANCIANOS.docx

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PSICOLOGA VIIUNIVERSIDAD CATLICA DE TRUJILLO BENEDICTO XVIPACIENTES ANCIANOS

PSICOPATOLOGA II

ALUMNOS:- HARO FLORIN, Diego- LAVI LOZANO, A!oio- SANCHO FERNNDEZ, P"#e$"- SANTOS CASTILLO, A$e%"&'"- ULLOA ESPINOZA, Fe'"&o


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PACIENTES ANCIANOS

I. INTRODUCCIN:E$ e(e)e*i#ie!o +#"o e- .e/#eo i(e'-"$ e ie(i!"0$e1 E-!&io- &e#og'2.i*o-

'e(e$" "#e!o -igi.i*"!i(o &e $" 3o0$"*i/ &e 45 "6o-, o -/$o e $o- 3"7-e-

&e-"''o$$"&o- e &o&e e$ 3o'*e!")e &e $" 3o0$"*i/ &e e-!" "$*"8" +"-!" e$ 9:;

e Seg'i&"& So*i"$ @ e-!2 e#3e8"&o e $o- Ho-3i!"$e- &e$ ii-!e'io &e S"$&1L" &e#"&" &e "i-i/ +o-3i!"$"'i" &e "&$!o- #"@o'e- "$*"8" +"-!" 5;:= e

e-!'o- +o-3i!"$e- "*io"$e- @ $" #o'!"$i&"& $$eg" " -e' +"-!" &e < " (e*e- #"@o' e

$o- #eo'e- &e 45 "6o-


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e 3e&e 3'e-e!"' e$ 3"*ie!e, *o e$ .i &e "$*"8"' 3$" &e !'"!"#ie!o g$o0"$,

o3!i#i8"' $" !i$i8"*i/ &e 'e*'-o- @ g"'"!i8"' e$ -egi#ie!o &e $o- *"-o-1 E-

#$!i&i#e-io"$, 3o'e ""$i8" $"- &i.e'e!e- e-.e'"- e i!eg'" "$ i&i(i&o e

i!e'&i-*i3$i"'i" 3o'e e >$ 3"'!i*i3" &i.e'e!e- 3'o.e-io"$e- #>&i*o- @ e.e'#e'"-,

"-i-!e!e- -o*i"$e-1 A*!"$#e!e -e *o-i&e'" e $" VG9 e- $" !e*o$og7" 02-i*" &e $"

Ge'i"!'7"1 N#e'o-o- e-!&io- +" -e6"$"&o $"- (e!")"- &e VGI, &e#o-!'"&o e #e)o'"

$o- i&i*"&o'e- &e *"$i&"& &e *i&"&o &e$ "&$!o #"@o' .*io"$i&"&, #eo' #o'!"$i&"&,

&i-#i*i/ &e +o-3i!"$i8"*ioe-, #eo' -o &e .2'#"*o- 9M,9:,94,9?,91

II. ESTRUCTURA DEL FORMATO DE LA HISTORIA CLNICA EN PACIENTES ANCIANOS:

II.1. DATOS GENERALES: Apellidos y No!"es:E-*'i0i' *o $e!'" #"@-*$" e i#3'e!" $o- "3e$$i&o- @ o#0'e-

*o-ig"&o- e e$ DNI1 Se#o:"'*"' *o X e e$ 'e*"&'o -eg *o''e-3o&"1 Ed$d:Ao!"' $" e&"& e "6o- *#3$i&o-, (e'i.i*"' *o .e*+" &e "*i#ie!o1 Fe%&$ de N$%iie'(o:E-*'i0i' ""1 Si o 'e*e'&" $" .e*+" e%"*!" *o$o*"' *"&o

#eo- e$ "6o i&i*"' e e- " .e*+" "3'o%i#"&" -i e- e$ *"-o1 L)*$" de N$%iie'(o:A3!"' e$ &i-!'i!o @o 3'o(i*i" *o''e-3o&ie!e1 P"o%ede'%i$: Di-!'i!o @o 3'o(i*i" &e &o&e 3'o*e&e1 G")po S$'*)+'eo y R&:Ao!"' &e -e' *oo*i&o @ (e'i.i*"0$e Si -e &e-*oo*e e-!o- &"!o-

&e0e'2 i*$i'-e e e$ 3$" &e "!e*i/1 G"$do de I's(")%%i,':Se &e0e "o!"' e$ !>'#io *o''e-3o&ie!e ""$."0e!o, 3'i#"'i",

-e*&"'i", !>*i*" o -3e'io', e-3e*i.i*"' -i e- *o#3$e!" o i*o#3$e!"1 E-!"&o Ci(i$1; Se&e0e "o!"' e$ !>'#io *o''e-3o&ie!e *"-"&"o, *o(i(ie!e, (i&"o, &i(o'*i"&"o,

-e3"'"&"o o -o$!e'"o1 O%)p$%i,':Se &e0e *o-ig"' - e-!"&o "*!"$ )0i$"&o, &e-o*3"&o o*3"*i/ "*!"$1

De -e' 3e'!ie!e "o!"' $" o*3"*i/ 3'e&o#i"!e1 Doi%ilio:Di'e**i/ &e 'e-i&e*i" "*!"$ *o-ig"&o *"$$e, )i'/ o "(ei&" @ #e'o o

$o!e, #"8"" o 0$o*Q @o '0"i8"*i/ o $o*"$i&"& -eg *o''e-3o&"1 Te$>.oo1; e $o

3o-i0$e "o!"' e$ #e'o &e !e$>.oo &e 'e.e'e*i", 3e&e -e' ."#i$i"' o *o#i!"'io1

F"#i$i"' o *i&"&o' 'e-3o-"0$e1; Ao!"' e$ o#0'e &e$ ."#i$i"' @o *i&"&o' 'e-3o-"0$e @

g'"&o &e 3"'e!e-*o1

II.-. ANTECEDENTES:II.-.1. A'(e%ede'(es Pe"so'$les: 3'e-e*i" o o &e e.e'#e&"&e- !'"-#i-i0$e- @ o

!'"-#i-i0$e- Hi3e'!e-i/ A'!e'i"$

Di"0e!e- Di-$i3i&e#i"- *o$e-!e'o$ "$!o

O-!eo"'!'i!i- o-!e"'!'o-i-

A**i&e!e- *e'e0'o ("-*$"'e- &e''"#e *e'e0'"$ A!"e- i->#i*o- !'"-i!o'io-

TIA, i."'!o-, +e#o''"gi"-, +e#"!o#"- -0&'"$e-, e!*1


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E.e'#e&"& *"'&io ("-*$"' E.e'#e&"& Co'o"'io i->#i*o "g&o o *'/i*o

Agi"- ie-!"0$e- o e-!"0$e-, i."'!o- &e #io*"'&io, "''i!#i"- *"'&i"*"-

.i0'i$"*i/ "'i*$"', i-.i*ie*i" *"'&i"*" *oge-!i(", o!'"-C2*e' Seg g>e'o 3'eg!"' -o0'e *2*e' &e *e'(i% @o #"#" e $"- #)e'e-

@ &e 3'/-!"!" e $o- ("'oe-He3"!i!i- Si +" -i&o *o.i'#"&o #e&i"!e e%"#e &e $"0o'"!o'ioT0e'*$o-i-Ho-3i!"$i8"&o $!i#o "6o Po' *"$ie' &i"g/-!i*oT'"-.-ioe-I!e'(e*i/e- i''gi*"-A**i&e!e- E-3e*i.i*"'1

II.-.-. A'(e%ede'(es F$ili$"es:Re"$i8"' 3'eg!"- *o 'e-3e*!o " e.e'#e&"&e- e +" 3"&e*i&o o 3"&e*e ."#i$i"'e-

!"$e- *o#o T0e'*$o-i- E-3e*i"$ >."-i- e $"- 3e'-o"- e *o(i(e *o e$ "&$!o

#"@o'1 E- i#3o'!"!e *o-ig"' "!e*e&e!e- &e e.e'#e&"&e- o !'"-#i-i0$e- e

."#i$i"'e- &i'e*!o- 3"&'e-, +e'#"o-, !7o- +i3e'!e-i/ "'!e'i"$, &i"0e!e-, i."'!o &e

#io*"'&io, &e#e*i", *2*e' 3'eg!"' 3'i*i3"$#e!e 3o' *2*e' &e #"#", e-!/#"go @

*o$o1

II.-.. Des%"ip%i,' De A'(e%ede'(es / O("os:E%3$i*"' 0'e(e#e!e o!'o- "!e*e&e!e- 3o-i!i(o-

@ "&e#2- e- i#3o'!"!e i!e''og"' -o0'e 3"!o$og7"- 3'e("$e!e- e e-!e g'3o e!2'eo

O-!eo3o'o-i-, A'!'i!i- Re#"!oi&e, e!*1

II.. CONSUMO DE MEDICAMENTOS: No#0'e &e$ #e&i*"#e!o So$i*i!"' "$ "&$!o #"@o' e #e*ioe e$ o#0'e @ &o-i- &e

$o- #e&i*"#e!o- e e-!2 !o#"&o @ *o-ig"' e $" .i*+"1 I&i*"' "$ -"'io e e e$

-igie!e *o!'o$ !'"ig" !o&o- $o- #e&i*"#e!o- e e-!2 !o#"&o, i*$i&"- $"- @e'0"-,

#e&i*"#e!o- +o#eo32!i*o- @ o!'o-1Do-i- P'eg!"' 3o' $" &o-i- e e-!2 !o#"&o "*!"$#e!e 3o' *"&" .2'#"*o,

*o-ig"' e $" .i*+" @ (e'i.i*"' -i *o''e-3o&e " $" i&i*"*i/ #>&i*"1 Si o

*o''e-3o&e, *o''egi' &e i#e&i"!o1O0-e'("*ioe- P'eg!"' e$ !ie#3o e (iee !o#"&o e$ .2'#"*o, &7"-, #e-e-, e

"$go- *"-o- "6o- @ "o!"' -i .e i&i*"&o 3o' e$ #>&i*o !'"!"!e, "!o#e&i*"&o,

i&i*"&o 3o' $" ."'#"*i", 3o' "#igo, 3o' $" '"&io o !e$e(i-i/, e!*1 T"#0i> -e

*o-ig"'2 &"!o- e -e *o-i&e'e 'e$e("!e- #e*io"'1 Re"**ioe- "&(e'-"- "

#e&i*"#e!o- RA1; E e-!e 7!e# "o!"' -i e$ "&$!o #"@o' e- "$>'gi*o " "$go-

#e&i*"#e!o- @ "o!"'$o-1

II.0. ALORACIN CLNICA DEL ADULTO MA/OR 2 ACAM:II.0.1. ALORACIN FUNCIONAL:


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P'o*e&i#ie!o 3o' e$ *"$ -e o0!iee e i!e'3'e!" &"!o- 'e.e'e!e- "$ i(e$ &e *"3"*i&"&

.*io"$ &e " 3e'-o", 3"'" e$$o -e "3$i*"'2 e$ &i*e &e A*!i(i&"&e- B2-i*"- &e $" Vi&"

Di"'i" ; ABVD ATZ1 "'*"' *o " X -i e$ "&$!o #"@o' e- i&e3e&ie!e 'e"$i8" $"-

.*ioe- -i "@&" o &e3e&ie!e e 'e$"*i/ " $"- -ei- .*ioe- " -e' e("$"&"-

B"6"'-e, (e-!i'-e, -"' e$ 0"6o, #o(i$i8"'-e, *o!ie*i" @ "$i#e!"*i/1 Lego &e $"

("$o'"*i/ -e &e!e'#i" e$ Di"g/-!i*o F*io"$ &e $" -igie!e #"e'"

9 Nig 7!e# 3o-i!i(o &e &e3e&e*i"


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E$ *e-!io"'io "0'e(i"&o &e P.ei..e' *o-!" &e 95 3'eg!"-, @ -e &e0e #"'*"' *o 9

3!o 3o' *"&" 3'eg!" e''"&" E, @ 5 3o' *"&" 3'eg!" !o!"$#e!e "*e'!"&"1 Se

-#" e$ #e'o !o!"$ &e 3'eg!"- e''"&"-, @ $ego 'e"$i8"#o- $" ("$o'"*i/ *ogi!i("

&e $" -igie!e #"e'"

< E No &e!e'io'o *ogi!i(o : " ? E De!e'io'o Cogi!i(o o&e'"&o " M E De!e'io'o Cogi!i(o $e(e " 95 E De!e'io'o Cogi!i(o -e(e'o No!" L"- 3e'-o"- *o 3'i#"'i" i*o#3$e!" @ ""$."0e!" -e 'e-!"'2

3!o " $" -#" !o!"$ @ -e 3'o*e&e " $" ("$o'"*i/ &e "*e'&o *o

$" ("$o'"*i/ 'e-3e*!i("1ESTADO AFECTIO:

E-*"$" A0'e(i"&" &e Ke-"("ge1; E-!" e-*"$" &e!e'#i" -i $" 3e'-o" "&$!" #"@o'

3'e-e!" o o #"i.e-!"*ioe- &e3'e-i("-1 L" ("$o'"*i/ &e$ e-!"&o ".e*!i(o -e

&e!e'#i"'2 #"'*"&o *o " X -i $" 'e-3e-!" &e $" e-*"$" *oi*i&e *o $" &e$

e!'e(i-!"&o1 No -e #"'*"'2 -7 $" 'e-3e-!" o e- *oi*i&e!e1 Se *e!" $"- X

*oi*i&e!e- @ &e!e'#i"#o- $" ("$o'"*i/ ".e*!i(" &e $" -igie!e #"e'" 5 " 9 X Si #"i.e-!"*ioe- &e3'e-i("- < " #2- X Co #"i.e-!"*ioe- &e3'e-i("-

II.0.. ALORACIN SOCIO FAMILIAR:

E("$"

g'3o &e

"-3e*!o- e

3e'#i!e


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*oo*e' &e #"e'" gee'"$ $" -i!"*i/ ."#i$i"', -o*i"$ @ e*o/#i*" &e$ e!'e(i-!"&o1 L"-

3'eg!"- e-!2 "g'3"&"- e : '0'o- Si!"*i/ ."#i$i"' Si!"*i/ e*o/#i*" Vi(ie&"

Re$"*ioe- -o*i"$e- A3o@o &e 'e& -o*i"$

A $"- 'e-3e-!"- &e *"&" g'3o $e *o''e-3o&e 3!")e &e!e'#i"&o e (" &e 9 " : 3!o-1

Se #"'*"'2 *o " X $" 'e-3e-!" *o''e-3o&ie!e 3o' *"&" o &e $o- : g'3o-

#e*io"&o-1 Lego -e -#" $o- 3!o- &e *"&" 'e-3e-!" #"'*"&" *o X, &e!e'#i2&o-e $"

("$o'"*i/ -o*io;."#i$i"' &e $" -igie!e #"e'"

: " 3!o- Be""*e3!"0$e -i!"*i/ ."#i$i"' 95 " 9M 3!o- E%i-!e 'ie-go ."#i$i"' 9: 3!o- E%i-!e 3'o0$e#" -o*i"$

II.3. H45ITOS: T"0"*o @ A$*o+o$ P'eg!"' -i +"@ o o *o-#o &e !"0"*o @ "$*o+o$, !ie#3o, .'e*e*i" @

*"!i&"&1 Ao!"' $" 'e-3e-!" *o''e-3o&ie!e1 A*!i(i&"& F7-i*" P'eg!"' -i 'e"$i8" o o "*!i(i&"& .7-i*"1 Co$o*"' $" 'e-3e-!" 'e-3e*!i("1

II.6. CATEGORAS DEL ADULTO MA/OR:E-!"- *"!ego'7"- -e e-!"0$e*e "$ .i"$ &e $" 3'i#e'" *o-$!" @ *o-!i!@e e$ 3i$"' .&"#e!"$

&e$ P$" &e A!e*i/ I!eg'"$ @" e 3e'#i!i'2 i&e!i.i*"' " $"- Pe'-o"- A&$!"- "@o'e- e $"-

*"$e- e- e*e-"'io 'e&o0$"' $o- e-.e'8o- 3"'" #e)o'"' - *"$i&"& &e (i&" @ "e$$"- e iee-

e- e*e-"'io e-!"0$e*e' "*!i(i&"&e- 3'e(e!i("-1 Pe"so'$ Ad)l($ M$yo" A%(i7$ S$l)d$!le:E- "e$$" *@"- *"'"*!e'7-!i*"- .7-i*"-

.*io"$e-, #e!"$e- @ -o*i"$e- e-!2 &e "*e'&o *o - e&"& *'oo$/gi*"1 E- $" PA -i

"!e*e&e!e- &e 'ie-go-, -i -igo- i -7!o#"- &e "!'i0i0$e- " 3"!o$og7"- "g&"- o

*'/i*"-, @ *o e%"#e .7-i*o o'#"$1 No 3'e-e!" 3"!o$og7", e-!2 -"$&"0$e1 Pe"so'$ Ad)l($ M$yo" E'8e"$:E- "e$$" e 3'e-e!" "$g" ".e**i/ "g&" o *'/i*",

e &i.e'e!e g'"&o &e g'"(e&"&, +"0i!"$#e!e o i("$i&"!e, @ e o *#3$e $o- *'i!e'io-

&e Pe'-o" "@o' F'2gi$ o P"*ie!e Ge'i2!'i*o Co#3$e)o (e' 7!e# @ M1 Pe"so'$ Ad)l($ M$yo" F"9*il:E- "e$$" e *#3$e *o < / #2- &e $"- -igie!e-

*o&i*ioe-o E&"& 5 "6o- " #2-o De3e&e*i" 3"'*i"$, -eg V"$o'"*i/ F*io"$ &e$ &i*e &e "!81o De!e'io'o *ogi!i(o $e(e o #o&e'"&o, -eg V"$o'"*i/ Cogi!i(" Te-! &e P.ei..e'1o "i.e-!"*ioe- &e3'e-i("-, -eg V"$o'"*i/ &e$ E-!"&o A.e*!i(o E-*"$"

"0'e(i"&" &e Ke-"("ge11


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o Rie-go -o*i"$, -eg $" E-*"$" &e V"$o'"*i/ So*io ."#i$i"'1o C"7&"- U" *"7&" e e$ $!i#o #e- o #2- &e " *"7&" e e$ "6o1o P$'i3"!o$og7" T'e- o #2- e.e'#e&"&e- *'/i*"-1o E.e'#e&"& *'/i*" e *o&i*io" i*"3"*i&"& .*io"$ 3"'*i"$ E)1 &>.i*i! (i-"$,

"&i!i(o, o-!eo"'!'i!i-, -e*e$" &e ACV, e.e'#e&"& &e P"'Qi-o, EPOC,

i-.i*ie*i" *"'&i"*" 'e*ie!e, @ o!'o-o Po$i."'#"*i" To#" #2- &e !'e- .2'#"*o- 3o' 3"!o$og7"- *'/i*"- @ 3o' #2- &e 4

-e#""-o Ho-3i!"$i8"*i/ e $o- $!i#o- 9< #e-e-o &i*e &e "-" Co'3o'"$ IC ig"$ o #eo' &e 3!i*o- @ $i!io1 L"- e3i$e3-i"- &e0e !'"!"'-e e .o'#" *o(e*io"$ !eie&o

e *e!" e, " e &o-i- !e'"3>!i*"-, e$ .eo0"'0i!"$ @ $"- +i&"!o7"- 3'o&*e &>.i*i!

*ogo-*i!i(o- @ !'"-!o'o- &e$ ei$i0'io &e0i&o " -7&'o#e *e'e0e$o-o -0*$7i*o e e-!o-


9/18

*"-o-, -e 3'e.e'i'2 e$ ("$3'o"!o -/&i*o o $" *"'0"#"8e3i"1 Si $o- *"#0io- &e 3e'-o"$i&"& -o

3'i#"'io-, e- &e*i', 3"'e*ie'" -e' " e%"ge'"*i/ &e '"-go- *"'"*!e'o$/gi*o- 3'e(io-, -e

&e0e'2 o.'e*e' !'"!"#ie!o- 3-i*o$/gi*o- @ "3o@o ."#i$i"'1

III.-.ANSIEDAD GENERALI;ADA< F5ICA / ATA=UES DE P4NICO:E- e%!'e#"&"#e!e '"'o e "3"'e8*" 3o' 3'i#e'" (e8 e $" (e)e81 Co#o e e$ *"-o &e $o-

!'"-!o'o- &e 3e'-o"$i&"&, $"- *"-"- #2- .'e*e!e- -o $" &e3'e-i/ @ $" &e#e*i" !e#3'""1

Po' $o !"!o, e- #"$" 3'2*!i*" *$7i*" e$ 'e*e!"' 0e8o&i"*e37i*o- o 0e!";0$oe"&o'e-

3"'!i*$"'#e!e $o- o e-3e*7.i*o-1 I*$-o *"&o o -e e*e!'e -7!o#"- &e3'e-i(o-, e-

-e-"!o e e$ "*i"o "-io-o o ./0i*o "ii-!'"' 3'i#e'o &'og"- "!i&e3'e-i("-1

III..CUADROS O5SESIOIDES:L" e.e'#e&"& o0-e-i(o;*o#3$-i(" e- e%!'e#"&"#e!e '"'" e e$ (ie)o, #2- o $o- -7!o#"-

o0-e-i(oi&e-1 2- e e%"ge'"*ioe- &e '"-go- 3'e#/'0i&o-, !"$e- -7!o#"- !ie&e " 'e.$e)"'

3"!o$og7" .*io"$ o'g2i*" 3o' e)e#3$o, $"- &e#e*i"-, !#o'e- *e'e0'"$e- @ "**i&e!e-

*e'e0'o;("-*$"'e- $i0e'" *o&*!"- ""*2-!i*"-1 A *"&o e-!"- *o&*!"- -e 3e&e

i!e'3'e!"' 3-i*o&i2#i*"#e!e *o#o e-.e'8o- 3"'" *o!'o$"' e$ e!o'o -o*i"$ @ .7-i*o, e- #2-

3'o0"0$e e 'e-$!e &e " &e-i+i0i*i/ &e 3'og'"#"- *e'e0'"$e- (e-!igi"$e-1 Si e$ *"&'o &e

0"-e e- &e3'e-i(o, -o &e g'" !i$i&"& $o- "!i&e3'e-i(o- *o 0"-e -e'o!oi>'gi*" e1g1

*$o#i3'"#i", .$(o%"#i"1 A *"&o +" +"0i&o 3o*" i(e-!ig"*i/ .2*!i*" -o0'e e$ ("$o'

3o-i!i(o &e $"- !e'"3i"- 3-i*o$/gi*"- e $o- -7!o#"- o0-e-i(oi&e- &e $" !e'*e'" e&"&, >-!"-

&e0e !i$i8"'-e *"&o $" #e&i*"*i/ 3'o&*e e.e*!o- *o$"!e'"$e- i"*e3!"0$e-1

III.0.CUADROS HIST>RICOS E HIPOCONDRACOS:So *"-i -ie#3'e -e*&"'io- " $" &e3'e-i/ @ " $o- e-!"&o- o'g2i*o-1 Co&*!"- +i-!'i/i*"- @

&i-o*i"*ioe- +i-!>'i*"- -o " *o#e- e "*i"o- *@o .*io"#ie!o i!e$e*!"$

3'e#/'0i&o @ e&*"*i/ .e'o $i#i!"&o- @ - o'ige -o*i"$ e- 0")o1 L"- e)"- +i3o*o&'7"*"-

3e'-i-!e!e- 3e&e &o#i"' $"- &e3'e-ioe- &e $" !e'*e'" e&"&1 L"- #2- .'e*e!e- -o

&o$o'e- gee'"$i8"&o-, #ie&o " !ee' *2*e', *"7&"-, !'"-!o'o- &e$ -e6o @ e-!'e6i#ie!o1 U"

(e8 #2- -e &e0e "-#i' e +"@ " &e3'e-i/ &e .o&o @ 'e*e!"' "!i&e3'e-i(o-1 E e-!o-

*"-o- $"- &'og"- #2- e.e*!i("- -o $o- i+i0i&o'e- &e $" #oo"#io%i&"-" Fee$8i" @T'"i$*i3'o#i", @ *"&o >-!"- o -e e*e!'", #o*$o0e#i&"1 E-!"- -0-!"*i"- -e &e0e

"ii-!'"' *o *i&"&o &e0i&o " -- i!e'"**ioe- *o ("'io- "$i#e!o- @ o!'"- &'og"-1 Si +"@

&e$-ioe- +i3o*o&'7"*"- #"'*"&"- o -7&'o#e &e Co!"'& $" *'ee*i" &e e-!"' #e'!o, o o

!ee' e!'"6"-, e!*1 e- #e)o' "ii-!'"' i#e&i"!"#e!e !e'"3i" e$e*!'o*o($-i("1

III.3.ES=UI;OFRENIA DE INICIO TARDO:E$ &i"g/-!i*o &e $o- *"&'o- 3-i*/!i*o- 3e&e -e' &i.7*i$ e $" !e'*e'" e&"&, 3"'!i*$"'#e!e

3o'e $"- &e$-ioe- @ "$*i"*ioe- i&i*"&o'e- i#3o'!"!e- &e e-!"- e.e'#e&"&e- -e

3'e-e!" e " ("'ie&"& &e -i!"*ioe- *$7i*"-1 Po' e)e#3$o, $"- "$*i"*ioe- (i-"$e- -e3e&e &"' e e-!"&o- o'g2i*o- *e'e0'"$e- -7&'o#e &e C+"'$e- Boe! @ e &e3'i("*i/


10/18

-e-o'i"$ !"$ *o#o $" *"-"&" 3o' $" *i'g7" o*$"'1 A$*i"*ioe- "&i!i("- @ #-i*"$e- -o

*o#e- e -o'&e'", !ii!- @ o!'"- 3"!o$og7"- &e$ o7&o i!e'o1 T"#0i> -e &" e$ *"-o e

-o'&e'" @ *ege'" 3"'*i"$ 3e&e $$e("' " &e$-ioe- 3"'"oi&e-1 Po' $o !"!o, -ie#3'e +"@ e

*e'*io'"'-e &e e "*i"o- *o &e$-ioe- @o "$*i"*ioe- o -.'" &e 3"!o$og7" o'g2i*",

e $"- *"'"*!e'7-!i*"- .eo#eo$/gi*"- &e -- -7!o#"- *o''e-3o&" " "e$$"- &e $"-

3-i*o-i- .*io"$e- 3o' e)e#3$o, -i *o*ie*i" &e e.e'#e&"&, -i-!e#"!i8"*i/ &e $"-

&e$-ioe-, e!*1E $" 3'2*!i*" *$7i*" -e e*e!'" "*i"o- *o -7!o#"- 3o-i!i(o- .'e*e!e- @ eg"!i(o-

i.'e*e!e- &e e-i8o.'ei"1 E "$go- *"-o- e$ e.e'#o +" !ei&o - 3'i#e' 0'o!e +"*e

(ei!e o !'ei!" "6o- e o!'o- #@ '"'o- e$ ii*io e- 'e*ie!e1 E$ &i"g/-!i*o &i.e'e*i"$ &e $"

e-i8o.'ei" &e *o#ie8o !"'&7o -e &e0e +"*e' *o $o- *"&'o- 3"'"oi&e- &e $" (e)e8, $o-

e-!"&o- *o.-io"$e- -0;"g&o-, $"- 3-i*o-i- o'g2i*"- -i !'"-!o'o &e $" *o*ie*i" @ $"-

#"7"- "!73i*"-1

III.6.ESTADOS PARANOIDES: Lo- #2- *o#e- *o-i-!e e &e$-ioe- 3e'-e*!o'i"- $i#i!"&"- "

!e#" 3o' e)e#3$o, -e' (7*!i#" &e 'o0o o!'o-, #2- .$o'i&o-, i*$@e e e$ -i-!e#" 3"'"oi&e

" "!o'i&"&e- @ 3e'-o")e- 30$i*o-1 L"- e'o!o#"7"-, e- &e*i', $" &e$-i/ &e -e' "#"&o e

-e*'e!o 3o' "$g" 3e'-o" i#3o'!"!e, -o *o#e- e #)e'e- #"&'"- 3e'o &e(iee '"'o-

e $" -ee*!&1 S/$o "$go- &e e-!o- *"&'o- -o 3'i#"'io- $" #"@o'7" -o -e*&"'io- "

&e3'e-i/, -o'&e'" @ *ege'" 3"'*i"$e- @ &e#e*i"1 E-!" $!i#" *'e" &e-*o.i"8" @ "*!i!&e-

3"'"oi&e- " !'"(>- &e$ o$(i&o e e.e*!i("#e!e +"*e e e$ "*i"o 3ie'&" *o!'o$ &e -

e!o'o1 E o!'o- 3o*o- *"-o- e$ &e-"''o$$o 3"'"oi&e e- " 'e"*!i("*i/ &e '"-go-

3'e#/'0i&o-1 L" !'i.$o3e'"8i" @ $" 3i#o8i&" -o &e !i$i&"& e e-!o- *"-o- 3e'o &e0e 3'e-!"'-e

"!e*i/ " -- #"'*"&o- e.e*!o- *o$"!e'"$e-1 L" !e'"3i" e$e*!'o*o($-i(" e- &e 3o*" !i$i&"& @

#2- 0ie i*'e#e!" $o- #ie&o- 3"'"oi&e-1 Lo- "!i&e3'e-i(o- 3e&e "@&"' *"&o e$

*"&'o 3"'"oi&e e- -e*&"'io " $" &e3'e-i/1 L" "&i*i/ &e$ e.e'#o 3e&e #e)o'"'-e *o

$o- "3"'"!o- "*o-!#0'"&o-1 Si +"@ *"!"'"!"-, -e &e0e'2 o3e'"' 3o' $o #eo- o)o, 3e'o e-

e-e*i"$ e$ 3'e3"'"' "$ e.e'#o 3"'" 3'e(ei' *o.-i/ @ 'e-3e-!"- 3"'"oi&e- 3o-!o3e'"!o'i"-1

E e$ *"-o &e &e#e*i", e- 3o-i0$e !i$i8"' !>*i*"- &e 'eo'ie!"*i/ +"*i" $" 'e"$i&"& @ o!'"-.o'#"- &e "@&" " $" #e#o'i" e $$e(e "$ e.e'#o " *o!'o$"' - e!o'o1

III.?.PARASITOSIS DELIRANTE:E.e'#e&"& e *o#ie8" *o e)"- "$ 3'i*i3io 3$"-i0$e- &e e e$ &o#i*i$io &e$ e.e'#o

e-!2 i.e-!"&o *o 3"'2-i!o- "&e#2- &e 3e&i&o- 'e3e!i&o- " $"- "!o'i&"&e- -"i!"'i"- 3o'

.#ig"*ioe-, @, " (e*e-, *"#0io- &e *"-"1 E " -eg&" e!"3", $" e.e'#" $" e.e'#e&"&

e- #2- *o# e #)e'e- 3'o*e&e " ".i'#"' e $o- 3"'2-i!o- "+o'" (i(e @ 3oe +e(o-

&e0")o &e - 3ie$1 A-7, $" -i!o#"!o$og7", *o .'e*e*i", *o#0i" &e$-ioe- @ "$*i"*ioe-

!"*!i$e- " (e*e- (i-"$e-, *"&o $" e.e'#" ".i'#" (e' $o- 3"'2-i!o- @ !'"e " $" *o-$!" "*")" &e ./-.o'o- *o *o-!'"- @ o!'o- &e!'i!- e3i&>'#i*o-1 E$ #>&i*o 3e&e e*o!'"' &i.7*i$


11/18

e-!"0$e*e' " 'e$"*i/ !e'"3>!i*" 3o-i!i(" *o e-!o- e.e'#o- @" e o !iee *o*ie*i" &e

e.e'#e&"&1 E- i#3o'!"!e, -i e#0"'go, e%"#i"'$o- .7-i*"#e!e 3o'e " (e*e- 3"&e*e &e

e.e'#e&"&e- -i-!>#i*"- o &e *2*e' 3"'!i*$"'#e!e 3$#o"'1 E $o- *"-o- $$"#"&o-

i&io32!i*o- e$ !'"!"#ie!o *o Pi#o8i&" &" 0eo- 'e-$!"&o-1

[email protected] / MANA:De3'e-ioe- i3o$"'e- @ 0i3o$"'e-, #"7"- i3o$"'e- @ -e*&"'i"-, @ -7&'o#e- ".e*!i(o- &e

o'ige o'g2i*o, -o *o#e- e $" !e'*e'" e&"&, @ !o&o- 3e&e "*o#3"6"'-e &e &>.i*i!

i!e$e*!"$e- #2- o #eo- !'"-i!o'io-1 A-i#i-#o, +"@ e e$ "*i"o " !e&e*i" " $"-

'e*"7&"- .'e*e!e- @ 3'o$og"&"- @ 'e-i-!e*i"- "$ !'"!"#ie!o1 L"- &e3'e-ioe- @ #"7"- -e

*o#0i" " (e*e- *o i."'!o- *e'e0'"$e-, &e#e*i" !e#3'"", *"'*io#" &e 3$#/ @ &e

32*'e"-, !'"-!o'o- e&o*'io- @ e3i$e3-i" &e *o#ie8o !"'&7o *o .o*o !e#3o'"$ e e$

+e#i-.e'io o &o#i"!e1 L"- #e$"*o$7"- i(o$!i("- &e o!'o'" !e#i&"- 3o' - -e(e'i&"& @

*o#3$i*"*ioe- o -o #2- e &e3'e-ioe- 3-i*/!i*"- 'e.'"*!"'i"-1 E "$go- *"-o- e$

'e!"'&o 3-i*o#o!o' $$e(" "$ e-!3o' &e3'e-i(o, *"'"*!e'i8"&o 3o' " i+i0i*i/ !"!o &e $"

*o&*!" e-3o!2e" *o#o 'e"*!i("1 E$ "*i"o e-!3o'o-o &e)" &e *o#e' @ 0e0e' -e

&e-+i&'"!" '23i&"#e!e, -e (e$(e g"!o-o, !iee 'e-3i'"*i/ -3e'.i*i"$ @ (e!i$"*i/ i"&e*"&",

@ #e'e &e 0'o*oe#o7"1 E-!" e.e'#e&"& e-, 3o' $o !"!o, " 'ge*i" 3-ii2!'i*" e

'eie'e ig'e-o i#e&i"!o "$ +o-3i!"$ @ !e'"3i" e$e*!'o*o($-i("1A (e*e- e$ e.e'#o &e3'i#i&o -e &i*e e-!"' #e'!o, o !ee' *"0e8", o !ee' $o- i!e-!io-

3!'e."*!o-, e!*1, e- &e*i', !iee -7&'o#e &e Co!"'&1 Lo- &e$i'io- i+i$i-!"- o &e eg"*i/ *"-i

-ie#3'e 'e.$e)" " #e$"*o$7" 3'o.&" " -i o +"@ -7!o#"- e-3e*7.i*o- ".e*!"&o e$

+#o' @ 'eie'e !e'"3i" e$e*!'o*o($-i(" i#e&i"!" @" e e$ 'ie-go &e -i*i&io e-

e%!'e#"&"#e!e "$!o1 E gee'"$, "#e"8"- &e -i*i&io e e$ ("'/ "*i"o, 3"'!i*$"'#e!e -i

+"@ &e3'e-i/ o e.e'#e&"& .7-i*" *'/i*", &e0e !o#"'-e #@ -e'i"#e!e1 L"- &e3'e-ioe-

"-o*i"&"- *o i."'!o- &e$ $/0$o .'o!"$ " (e*e- 'e-3o&e " $" o'!'i3!i$i"12- *o#e- e $"- "!e'io'e- -o, -i e#0"'go, $"- &e3'e-ioe- *'/i*"- #o&e'"&"-, e o

-ie&o -.i*ie!e#e!e -e(e'"- *o#o 3"'" 'ee'i' +o-3i!"$i8"*i/, -o #@ i*"3"*i!"!e-1 E

e$ 3"-"&o -e $"- *o-i&e'/ *o#o e'/!i*"- @ -e "*o-e)"0" e$ #"e)o 3-i*o!e'"3>!i*o, 3e'o

+o@ e &7" o -e "*e3!" !"$ *o*e3!o1 *+"- (e*e- e-!o- e.e'#o- !iee +i-!o'i" ."#i$i"' &e!'"-!o'o- &e$ ".e*!o @ 'e-3o&e 0ie " $o- i+i0i&o'e- &e $" #oo"#io%i&"-"1L"- #"7"- -o *o#e- e e$ (ie)o @" -e" 3o'e $" e.e'#e&"& 0i3o$"' -e "g'"(" *o $" e&"&

o 3o'e +"@ "#e!o e!o e $e-ioe-, 3"'!i*$"'#e!e &e$ +e#i-.e'io o &o#i"!e, e

$$e(" " #"7"- -e*&"'i"-1 E gee'"$, $"- #"7"- !iee " 3'e-e!"*i/ *$7i*" "!73i*" e

e$ "*i"o *o i''i!"0i$i&"&, +i3e'"*!i(i&"&, &i-.o'i", *o.-i/ @ "*!o- !"$e- *o#o o.e-"-

-e%"$e- 0i8"''"- @ 'o0o- o0(io-1 E- .'e*e!e e$ i-o#io, $" ."!ig", @ $" &e-+i&'"!"*i/ e

#i" '23i&"#e!e e$ e-!"&o .7-i*o &e$ e.e'#o @ 3e&e $$e("' " $" #e'!e1 A (e*e- -

3'e-e!"*i/ *o-i-!e i*"#e!e e *o.-i/ @ &>.i*i! *ogo-*i!i(o, *o-i&e'2&o-ee''/e"#e!e *o#o &e#e*i"1 E$ &i"g/-!i*o &i.e'e*i"$ e e-!o- *"-o- -e &e0e +"*e' *o $"


12/18

3'e-0io.'ei", e- &e*i' " ("'i"!e *$7i*" &e $" e.e'#e&"& &e A$8+ei#e' e $" *"$ &e0i&o "

"!'o.i" #"'*"&" &e$ $o*- *e'$e- +"@ &e-i+i0i*i/, +i3e'"*!i(i&"& @ *o&*!" +i3o#"7"*" @

*o."0$"!o'i"1E$ !'"!"#ie!o &e $" #"7" &e$ "*i"o o e- .2*i$1 E$ +"$o3e'i&o$, e *o#0i"*i/ *o $i!io e- e$

!'"!"#ie!o &e e$e**i/, @" -e" e -e !'"!e &e " #"7" 3'i#"'i" o -e*&"'i"1 E$ "*i"o e-,-i e#0"'go, 3"'!i*$"'#e!e ($e'"0$e " $o- e.e*!o- *o$"!e'"$e- !"!o "g&o- &i-!oi" @

3"'Qi-oi-#o *o#o *'/i*o- &i-Qie-i" !"'&7"1 L"- &'og"- "!i#-*"'7i*"-, " *"&o

*o!'"''e-!" "$go- &e e-!o- -7!o#"-, !"#0i> i&*e -7&'o#e- "!i*o$i>'gi*o-

*o.-i/, +i3e'"*!i(i&"&, "$*i"*ioe- (i-"$e-, .ie0'e1 E$ $i!io &e0e 'e*e!"'-e *o *i&"&o e

(i-!" &e $" #e'#" 'e"$ e e$ "*i"o1 E- i#3o'!"!e &"' &o-i- 0")"- @ *o!'o$"' 'eg$"'#e!e $"

.*i/ 'e"$ @ !i'oi&e"1 E$ $i!io -e &e3o-i!" &e-3>- &e "$go- "6o- e $o- +e-o- @ 3e&e

3'o&*i' .'"*!'"- 3"!o$/gi*"-1 Si $" #"7" o *e&e, e- 3'e.e'i0$e &"' !'e- o *"!'o

e$e*!'o*+oe- e 3e'-i-!i' *o e$ !'"!"#ie!o ."'#"*o$/gi*o1 L" C"'0"#"8e3i" o e$ ("$3'o"!o-/&i*o -o 0eo- 'ee#3$"8o- 3"'" e$ $i!io, *"&o >-!e $!i#o 3'o&*e e.e*!o- *o$"!e'"$e- o o

*o!'o$" $" e.e'#e&"&1 E e$ *"-o &e $"- #"7"- -e*&"'i"-, e- i#3o'!"!e i&e!i.i*"' $"

e.e'#e&"& &e 0"-e1

III..SNDROMES MENTALES ORG4NICOS:E$ *o*e3!o &e -7&'o#e #e!"$ o'g2i*o +" &e-"3"'e*i&o &e$ DS IV, 3e'o -ige -ie&o !i$ e

3-i*oge'i"!'7" 3"'" 'e.e'i'-e " -7!o#"- 3-ii2!'i*o- e 'e-$!" &e e.e'#e&"& e'o$/gi*"1

E gee'"$, $" 'e&**i/ e 'e-e'(" *e'e0'"$ &e $" -ee*!& "#e!" $" 3'o0"0i$i&"& &e e-!"&o-

*o.-io"$e- "g&o- &e$i'i#, &e#e*i"-, -7&'o#e- "#>-i*o-, -7&'o#e- o'g2i*o-

".e*!i(o-, &e$i'"!e-, "$*i"!o'io- @ "-io-o-1 T"#0i> e$ "$*o+o$i-#o @ e$ "0-o &e &'og"-

3"'!i*$"'#e!e &e 0"'0i!'i*o- @ 0e8o&i"*e37i*o- -o *"-" *o# &e &e$i'i#, !"!o

&'"!e $" i!o%i*"*i/ "g&" @ *'/i*" *"!o &'"!e $" "0-!ie*i" .o'8"&"1 L" #e&i*"*i/

*"'&7"*" (1g1 0e!" 0$oe"&o'e-, e&o*'i" (1g1 !i'o%i" o e'o$/gi*" (1g1

"!i3"'Qi-oi"o- *o!'i0@e !"#0i> "$ &e-"''o$$o &e$ &e$i'i# @, e e$ *"-o &e $o-

"!i*o$i>'gi*o-, 3e&e $$e("' " e-!"&o- 3'o$og"&o- &e &>.i*i! *ogo-*i!i(o1

DELIRIUM:A *"&o e- e$ -7&'o#e o'g2i*o #2- *o# e e$ "*i"o, e$ &e$i'i#3e&e 3"-"' i"&(e'!i&o &e0i&o " - *o'!" &'"*i/, " - *"'2*!e' .$*!"!e o 3o'e *o

.'e*e*i" -e *o#0i" *o &e#e*i"1 E e$ *"&'o *o#3$e!o &e &e$i'i#, e$ e.e'#o

#e-!'" &i-!'0io- &e $" *o*ie*i", &e-o'ie!"*i/ e e$ !ie#3o @ e e$ e-3"*io, i$-ioe- @

"$*i"*ioe- 3"'!i*$"'#e!e (i-"$e-, &e$i'io- 3"'"oi&e-, "-ie&"& " (e*e- !e''o',

e-!"&o- &e3'e-i(o- o e.o'i", @ *"#0io- e e$ *o#3o'!"#ie!o #o!o' e (" &e $" ie!&

" $" +i3e'"*!i(i&"&, "g'e-i/ @ e-.e'8o- 3o' e-*"3"' &e ee#igo- i#"gi"'io-1 Lo- *"&'o-

3"'*i"$e- -o #2- *o#e-1 E$ &e$i'i# e- .$*!"!e, #e)o'" e $" #"6"" @ e#3eo'" e $"

o*+e @ e- "*e!"&o 3o' e-!"&o- &e &e3'i("*i/ &e$ -e6o @ &e 'e&**i/ #"'*"&" e $"e-!i#$"*i/ -e-o'i"$1 E e$ "*i"o, e$ &e$i'i# !"#0i> 3e&e 'e-$!"' &e i.e**ioe-


13/18

i!e'*''e!e-, &'og"- !"!o #e&i*"*i/ *"!o &'og"- &e "0-o, @ *"#0io- "#0ie!"$e-

3o' e)e#3$o " #&"8"1 No 3"'e*e +"0e' " "-o*i"*i/ *$"'" e!'e 3e'-o"$i&"&,

-e(e'i&"& &e $" e.e'#e&"& @ e$ &e$i'i#1 A$ e.e'#o -e $e &e0e *i&"' e " 3ie8"

-e3"'"&", *o $8, (e!i$"*i/ @ e-!7#$o- "#0ie!"$e- "&e*"&o- .o!og'".7"- &e 3"'ie!e-,

!e$e(i-i/, '"&io, e!*1 @, &'"!e $o- #o#e!o- $*i&o-, -e $e &e0e 'e"-eg'"' e o -e

e-!2 (o$(ie&o $o*o1 Se &e0e 3'o*'"' e &e'#" 0ie e $"- o*+e- @ e-!> &e-3ie'!o

&'"!e e$ &7" " i(e'-i/ &e$ 'i!#o &e$ -e6o e- .'e*e!e e e$ &e$i'i#1 C"&o e$

e.e'#o -e 3oe "g'e-i(o, "#e"8" *o i!"'-e $" (i&" o i!e'.ie'e *o e$ !'"!"#ie!o

#>&i*o 3o' e)e#3$o, i#3i&ie&o $" i-!"$"*i/ &e (7"- i!'"(eo-"-, e- i#3e'"!i(o

!'"i$i8"'$o1 N*" -e &e0e 'e*e!"' 0e8o&i"*e37i*o- o 0"'0i!'i*o-1 Lo- e'o$>3!i*o-,

3"'!i*$"'#e!e e$ H"$o3e'i&o$ e &o-i- &e : " - &e " #e)o'7" 'e$"!i(", $o-

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