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Evaluación y Tto de Esquizofrenia Revisión Actual PDF
Evaluación y Tto de Esquizofrenia Revisión Actual PDF
Artculo original
SUMMARY RESUMEN
Schizophrenia is a severe and chronic disorder affecting children, La esquizofrenia es un trastorno prevalente, crnico e incapacitante
adolescents and adults. The international recommendations for the en nios, adolescentes y adultos. Las recomendaciones internacio-
treatment of pediatric patients with this disorder point to a nales para su tratamiento en edad peditrica incluyen programas
comprehensive management which includes early detection de deteccin temprana y tratamiento farmacolgico y psicosocial. El
programs, pharmacological and psychosocial treatment. A review presente trabajo muestra una revisin actualizada de la eficacia y la
of current information regarding the efficacy and safety of seguridad de los antipsicticos en nios y adolescentes, as como el
antipsychotics in children and adolescents, as well as the effect of efecto de las intervenciones psicosociales en el funcionamiento aca-
psychosocial interventions on the academic and social functioning of dmico y social en pacientes con esquizofrenia de inicio temprano.
patients with early onset schizophrenia is presented. La meta del tratamiento farmacolgico es lograr un resultado
The pharmacological treatments goal is to achieve optimal ptimo a dosis mnimas efectivas del antipsictico y tener el menor
outcome with the lowest effective dose and the fewest side effects. It nmero de efectos secundarios. Deben de considerarse los
should be started with an antipsychotic that has been evaluated on antipsicticos evaluados en estudios controlados en edad peditrica.
its efficacy and safety in this age group. Risperidone, olanzapine and La risperidona, la olanzapina y el aripiprazol han sido aprobados
aripiprazole have been approved for the treatment of schizophrenia por la FDA para el tratamiento de la esquizofrenia en adolescentes;
in adolescents, clozapine has shown greater efficacy for the treatment la clozapina ha mostrado mayor eficacia en el tratamiento de la
resistant condition. The side effects of these drugs must be monitored psicosis resistente, sus efectos adversos deben de ser monitorizados
during treatment. durante su uso.
The psychosocial treatment objectives are to provide El tratamiento psicosocial brinda informacin al paciente y su
information, to promote the patients adaptation, to reduce familia, promueve la adaptacin y disminuye la comorbilidad para
comorbidity and to prevent relapses through psychoeducation, prevenir recadas, por medio de programas de psicoeducacin,
psychotherapy and rehabilitation programs. The psychoeducation psicoterapia y rehabilitacin. Los programas de psicoeducacin
programs include information about the characteristics and causes incluyen la informacin acerca de la enfermedad y sus causas, los
of the illness, the available treatment choices and the factors tratamientos disponibles y los factores asociados a las recadas. La
associated to recovery or relapse. Psychotherapy in schizophrenia psicoterapia puede darse en el contexto individual, familiar o grupal,
has been examined in individual, group and family modalities, the de acuerdo a las necesidades del paciente. La terapia cognitivo
cognitive behavioral therapy has demonstrated efficacy on cognition, conductual ha mostrado eficacia en la adaptacin social, cognitiva
social adjustment and quality of life. The rehabilitation programs y en la calidad de vida. Los programas de rehabilitacin incluyen
include the training on social skills, cognitive remediation therapy entrenamiento en habilidades sociales, rehabilitacin cognitiva y un
and exercise programs, which would increase the wellbeing of patients programa de acondicionamiento fsico para promover el bienestar
and reduce metabolic alterations associated to the use of general del paciente y evitar la aparicin de los efectos secundarios
antipsychotics. sobre el metabolismo.
In conclusion, the treatment of patients with early onset En conclusin, la esquizofrenia en nios y adolescentes requiere
schizophrenia must be multimodal and directed to improve their long de tratamiento multidisciplinario a fin de mejorar el pronstico de
term outcome. los pacientes.
Key words: Child, adolescent, early- onset schizophrenia, Palabras clave: Esquizofrenia, tratamiento, nios, adolescentes,
antipsychotics, treatment. antipsicticos.
1
Psicofarmacologa del Desarrollo, Hospital Psiquitrico Infantil Dr. Juan N. Navarro.
2
Servicios de Atencin Psiquitrica, Secretara de Salud.
3
Divisin de Ciencias del Comportamiento, Universidad de las Amricas.
Correspondencia: Dra. Rosa Elena Ulloa. Hospital Psiquitrico Infantil Dr. Juan N. Navarro, San Buenaventura 86, 14080, Mxico, DF. Fax: (52 55)
5573 9161. E.mail: eulloa@hotmail.com
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