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Humanize the treatment with the patient and understand the different dimensions of his pathology. This will be one of the objectives of current medicine which is taken into account in Lyon University Care Complex (Cole). There are various programs that currently address this approach for terminally ill people. Also professionals who choose a comprehensive approach to each case.
Liaison Psychiatric Unit Lyon Hospital has an outpatient clinic for patients who have any illness associated psychosis, It is structured through a series of programs in line with other specialties of the hospital centre. It was born in 2015 and since then it has been “dedicated to looking at the patient as comprehensively as possible, we provide a vision of psychotherapy in those aspects that can improve their functioning,” explains. Dr. Antonio SerranoDoctors and members of the unit Spanish Society of Psychiatry In psychosomatic therapy group.
“Illnesses have a physical, a psychological, and a social focus, and everything should be given importance.”
The various programs involved treated more than 1,500 patients in Lyon in 2022, and there were approximately 500 new referrals. Data presented by the unit showed that 409 people were assessed in the pain unit’s screening programs and more than 200 people were referred by anaesthetists. About 50 patients came from the spine programme, 32 from the bariatric surgery assessment unit, 21 from digestive mobility, five from immunology, another five from dermatology and 40 others from the persistent Covid unit. Additionally, there is a small group who have come from other areas “but this is not normal,” says the doctor.
Unit
The patient ‘arrives’ at the contact psychiatric unit from some of these experts“He usually has to go through multiple doctors when he comes here,” Serrano says. As he explains, it is “not a free referral unit” and people who join his practice do so because they fit into some of the programs he has open. they all arrive with one evaluation questionnaire They are associated and adapted to the specific pathology that they have dealt with before and which the therapist-psychiatrist uses to obtain information before the patient arrives: “There are no complementary tests in psychiatry and this type of testing gives us a lot All the information is available,” he says.
Unit consultations are taken with a certain calmness, “something that patients value greatly.” Scholar Serrano explains that it is “fundamental” that the person knows his process, knows what happens to him and understands it well. The unit seeks to solve patients’ problems or, sometimes, simply provide relief: “Today, in modern medicine, very little is cured and much is cured.”
“We try not to describe any type of medication as some can cause dependence”
understand medicine how of these two areas It is essential to understand the contact psychiatric unit. “We have to change the view that diseases are only physical,” says Dr. Serrano, adding that Cartesian dualism in medicine ended a long time ago. He himself gives the example of fractures of the tibia or femur, which can also have consequences for patients’ mood: “It will not affect a person who does a sedentary job in the same way as another person who does heavy-duty work. ” For this reason, doctors highlight that modern medicine is “biopsychosocial”, that is, it has a biological component, a psychological and a social component, “and all of these should be given importance.”
The unit in Lyon works exclusively with patients chronic pain“Pain and depression go hand in hand,” he explains. “The brain is the organ that senses pain old patients It’s a subjective perception,” Serrano explains, which is why “a person in pain is more unhappy and when he’s more unhappy he has more pain,” he adds. His take from the unit That by regulating this perception of the situation we can ensure that the patient gets “a better quality of life and some relief,” says the doctor. “When the pain becomes chronic it can be caused by injuries. becomes independent, supposing somehow the brain goes away.” When an illness becomes chronic ”the changes in life are very significant” and only then ”a depressive disorder or an anxious disorder may appear, ” says the doctor.
Although most patients come from this unit, contact psychiatry Lyon Hospital Collaborates with other departments. evaluation of high risk obesity It also requires diagnosis that links psychological, endocrine, general surgery and digestive systems. Similarly, they work on what they call “deprescribing” drugs. “We try to keep it as small as possible, not just psychotropic medications that affect the body, but any medication,” he says. And the thing is, many patients who begin treatment with an analgesic drug, as is the case with opioids or benzodiazepines, “may develop dependence on them” and they also interfere with them: “Some of the drugs There are a lot of social problems as well.”
professional
The Liaison Psychiatry Unit is a full consultation that operates five days a week and the person running it is Dr. Antonio Serrano. “Well, it’s me, but not the only one,” he clarifies. The doctor works with a traumatologist, endocrinologist, pain unit specialist, immunologist, internist or dermatologist. Similarly, it is counseling psychologist With whom he cooperates in the evaluation of obesity. Serrano is the one who deals with the mental part, but he has to rely “on the knowledge and help of others.”
The Kaul Contact Psychiatry Unit is “a good model” that requires “a lot of willpower and study”.
All these professionals work in coordination and communication is essential to make their work successful. There are weekly meetings to discuss cases in different areas, and increase prospects for inpatient or referral. Serrano also consults other specialists directly to reach complementary diagnoses: “It’s different eyes working together.” “This is perhaps a bit contrary to the current structure of services, which are divided into specialities, but there are also patients who don’t fit into any of them,” he explains.
Thus, and through various programs and requests from experts, the department, “Primarily Spine Specialists,” was born. They are created according to the requirements: “The latest continuous covid This arose as a result of the pandemic,” he explained.
This unit also supports research on pain. He Cowell Psychiatric Service Was awarded in early November last year for Castilian and Leonese Association of Psychiatry (ACILP) for the poster “Study on family functioning in patients suffering from factitious disorder and its difference from other patients suffering from unexplained medical symptoms” developed by Isabel González in which Dr. Antonio Serrano also collaborated. It examines how the patient uses his illness, how he makes it the pivot of his life “and how he doesn’t know how to function outside that area,” explains the doctor. He further said, “So we have seen that family systems have changed a lot.” And it is that, everything is included within the global assessment of the patient: “No person is an island, they have their own family and their own system of relationships.” For this reason, although the consultations in the contact psychiatric unit take place mainly with patients, Antonio Serrano also talks with family members “if possible”.
The service is under ongoing development and research and, although it may grow further, “consultations are currently full.” “Programs are opened as needed, but if you create too many programs you create a waiting list,” says Dr. Serrano.
However, even if the service does not expand within the hospital itself, it may expand outside. In medium-sized hospitals such as Lyon the liaison psychiatric unit is a Reference, “They have called us from Huesca, Salamanca, Ourense, many places… It is a good program to export,” explains Serrano, “I have also received calls from specialized experts and I went to Valencia to present it . Units like Lyonesse exist in larger hospitals and there are individual programs in smaller hospitals. For Serrano, the liaison psychiatric unit is “a good model”, but it also requires “a lot of study and willpower”. He highlights that patients are “complex” with different mixed pathologies, so the vision, as he emphasizes from the beginning, must be global: “If you touch something in one place, So you can break it in another place.”
The latest report published by Antonio Serrano of the Liaison Psychiatry Unit states, the patient is a “whole person whose mind and body are interconnected,” and it is this view of the person, reinforced by research findings, that The key is to increase your chances. Improvement and, above all, relief.
