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Perfil epidemiológico de los ingresos involuntarios en el Servicio de Psiquiatría del Hospital Universitario de Gran Canaria Doctor Negrín
Epidemiological profile of involuntary admission in the Psychiatry Service of The University Hospital of Gran Canaria Doctor Negrin
Naomi Fernández Hernández, Marina Martínez Grimal, Claudio Cabrera Velázquez
Autor para correspondencia
Cabreraclaudio@hotmail.com

Autor para correspondencia.
, Raquel Rodríguez Medina, Almudena Sánchez Villegas, José Luís Hernández Fleta
Hospital Universitario de Gran Canaria Doctor Negrín, Unidad de Salud Mental de Costa Ayala, Servicio de Psiquiatría, Las Palmas de Gran Canaria, España
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Sin embargo&#44; Espa&#241;a constituye una excepci&#243;n respecto al panorama legislativo europeo&#44; siendo la finalidad del ingreso exclusivamente terap&#233;utica&#44; no preventiva ni punitiva&#46; Aunque en ocasiones&#44; se contemplan medidas de seguridad privativas de libertad para aquellos que en condiciones de agudizaci&#243;n de la sintomatolog&#237;a cometen delito<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="p0015" class="elsevierStylePara elsevierViewall">Se considera&#44; muchas veces err&#243;neamente&#44; que el paciente afecto de un trastorno mental tiene una p&#233;rdida de su capacidad cognitiva&#44; del sentido de la realidad y&#44; en definitiva&#44; se dibuja como un ser incapaz de intervenir en la toma de decisiones&#46; Es esta situaci&#243;n de incapacidad atribuida &#40;real o ficticia&#41;&#44; la que suscita un intenso debate tanto en el campo de la medicina como del derecho&#44; siendo la hospitalizaci&#243;n involuntaria una de las medidas asistenciales m&#225;s controvertidas en este marco m&#233;dico-legal&#46; Al presentarse pues este conflicto y verse afectado un derecho fundamental&#44; como es el derecho a la libertad &#40;recogido en art&#237;culo 17 de la Constituci&#243;n Espa&#241;ola&#41;&#44; es de obligado mandamiento someter la decisi&#243;n a una garant&#237;a judicial&#44; la cual se limita exclusivamente a &#171;autorizar&#187; o a &#171;aprobar&#187; la medida en cuesti&#243;n<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a>&#46; Por otro lado&#44; es cierto que vulnera el principio de autonom&#237;a del paciente&#44; pero no es el fundamento de la intervenci&#243;n judicial<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">Se ha observado que existe una estrecha relaci&#243;n entre los individuos del sexo masculino y el diagn&#243;stico de esquizofrenia u otro trastorno psic&#243;tico&#44; siendo este grupo de pacientes el que conforma la mayor parte de ingresos en el r&#233;gimen de involuntariedad<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0015"><span class="elsevierStyleSup">3&#8211;11</span></a>&#46; Mientras que&#44; las mujeres tienen un mayor riesgo de ser internadas<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0060"><span class="elsevierStyleSup">12</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0065"><span class="elsevierStyleSup">13</span></a> debido a trastornos afectivos&#44; de la personalidad o el comportamiento<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0070"><span class="elsevierStyleSup">14&#8211;16</span></a>&#46; Esto probablemente se deba a que este grupo de la poblaci&#243;n tiene un mejor ajuste social y hace un mejor uso de los servicios de atenci&#243;n a la salud desde estadios m&#225;s tempranos de la enfermedad<a class="elsevierStyleCrossRef" href="#bb0070"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="p0025" class="elsevierStylePara elsevierViewall">El grupo de edad m&#225;s susceptible de ingresar involuntariamente es el conformado por sujetos de entre 45 y 65 a&#241;os&#46; Posiblemente&#44; esto sea debido a que un individuo en dichas d&#233;cadas de la vida sufre una serie de acontecimientos vitales a los que debe hacer frente&#44; incluy&#233;ndose entre ellos responsabilidades&#44; estr&#233;s o carga familiar&#44; lo cual puede ser un desencadenante de la enfermedad que desemboca el ingreso<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="p0030" class="elsevierStylePara elsevierViewall">Una pobre situaci&#243;n socioecon&#243;mica&#44; la ausencia de servicios comunitarios adaptados o pertenecer a minor&#237;as &#233;tnicas&#44; son tambi&#233;n factores de un mal pron&#243;stico<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0060"><span class="elsevierStyleSup">12</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0070"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0080"><span class="elsevierStyleSup">16</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0095"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="p0035" class="elsevierStylePara elsevierViewall">La hospitalizaci&#243;n involuntaria a menudo resulta una experiencia traum&#225;tica para el paciente y&#44; a ra&#237;z de ella&#44; ser&#237;a posible que se extrapolara esta visi&#243;n negativa a todos los servicios asistenciales de salud mental<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0085"><span class="elsevierStyleSup">17</span></a>&#46; Este hecho puede significar que un paciente que ha sido ingresado previamente&#44; eluda todo tipo de intervenciones comunitarias preventivas&#44; desencadenando&#44; por tanto&#44; en un mayor riesgo de reingreso<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0070"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a>&#46;</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0070">Marco Legal</span><p id="p0040" class="elsevierStylePara elsevierViewall">Pueden darse 2 tipos de internamiento&#58;<ul class="elsevierStyleList" id="l0005"><li class="elsevierStyleListItem" id="li0005"><span class="elsevierStyleLabel">-</span><p id="p0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Voluntario o consentido&#58;</span> no judicial&#44; establecido por contrato directo entre el paciente y la instituci&#243;n m&#233;dica&#44; y que ambas partes pueden rescindir&#46;</p></li><li class="elsevierStyleListItem" id="li0010"><span class="elsevierStyleLabel">-</span><p id="p0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Involuntario&#44; no consentido o compulsivo&#58;</span> en este hay que distinguir&#44; a su vez&#44; penal y civil&#46;</p></li></ul></p><p id="p0055" class="elsevierStylePara elsevierViewall">El internamiento involuntario est&#225; regulado a trav&#233;s del art&#46; 763 de la Ley de Enjuiciamiento Civil&#58;</p><p id="p0060" class="elsevierStylePara elsevierViewall">&#171;El internamiento&#44; por raz&#243;n de trastorno ps&#237;quico&#44; de una persona que no est&#233; en condiciones de decidirlo por s&#237;&#44; aunque est&#233; sometida a la patria potestad o a tutela&#44; requerir&#225; autorizaci&#243;n judicial&#44; que ser&#225; recabada del tribunal del lugar donde resida la persona afectada por el internamiento&#46; La autorizaci&#243;n ser&#225; previa a dicho internamiento&#44; salvo que razones de urgencia hicieren necesaria la inmediata adopci&#243;n de la medida&#46; En este caso&#44; el responsable del centro en que se hubiere producido el internamiento deber&#225; dar cuenta de &#233;ste al tribunal competente lo antes posible y&#44; en todo caso&#44; dentro del plazo de veinticuatro horas&#44; a los efectos de que se proceda a la preceptiva ratificaci&#243;n de dicha medida&#44; que deber&#225; efectuarse en el plazo m&#225;ximo de setenta y dos horas desde que el internamiento llegue a conocimiento del tribunal &#91;&#8230;&#93; &#40;art&#46; 763&#46;1 LEC&#41;&#187;</p><p id="p0065" class="elsevierStylePara elsevierViewall">El criterio de internamiento involuntario es que &#171;una persona no est&#233; en condiciones de decidirlo por s&#237;&#187;&#44; esto se refiere a la validez del consentimiento o a la capacidad para emitir un consentimiento v&#225;lido&#46; Puede ocurrir que una persona tenga riesgo para s&#237;&#44; un trastorno mental grave&#44; que necesite tratamiento urgente &#40;indicaciones de ingreso&#41; y pueda decidirlo por s&#237; misma&#44; es decir&#44; que tenga capacidad para emitir un consentimiento v&#225;lido&#46;</p><p id="p0070" class="elsevierStylePara elsevierViewall">El precepto ser&#225; aplicable tanto a adultos&#44; como a menores e incapaces&#44; sin que en el caso de menores de edad baste el consentimiento de los padres&#44; ni en el de personas incapaces bastase el del tutor&#46; No obstante&#44; este &#250;ltimo concepto ha desaparecido con la Ley 8&#47;2021&#44; de 2 junio por la que se reforma la legislaci&#243;n civil y procesal para el apoyo a las personas con discapacidad en el ejercicio de su capacidad jur&#237;dica&#44; quedando modificado el <span class="elsevierStyleItalic">art&#46; 271 C&#243;digo Civil</span> de la siguiente manera&#58; &#171;cualquier persona mayor de edad o menor emancipada&#44; en previsi&#243;n de la concurrencia de circunstancias que puedan dificultarle el ejercicio de su capacidad jur&#237;dica en igualdad de condiciones con las dem&#225;s&#44; podr&#225; proponer en escritura p&#250;blica el nombramiento o la exclusi&#243;n de una o varias personas determinadas para el ejercicio de la funci&#243;n de curador&#46; Podr&#225; igualmente establecer disposiciones sobre el funcionamiento y contenido de la curatela y&#44; en especial&#44; sobre el cuidado de su persona&#44; reglas de administraci&#243;n y disposici&#243;n de sus bienes&#44; retribuci&#243;n del curador&#44; obligaci&#243;n de hacer inventario o su dispensa y medidas de vigilancia y control&#44; as&#237; como proponer a las personas que hayan de llevarlas a cabo&#187;&#46;</p><p id="p0075" class="elsevierStylePara elsevierViewall">Seg&#250;n el momento en que tiene lugar la autorizaci&#243;n judicial se dan tambi&#233;n 2 tipos de internamiento&#58;<ul class="elsevierStyleList" id="l0010"><li class="elsevierStyleListItem" id="li0015"><span class="elsevierStyleLabel">-</span><p id="p0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Ordinario&#58;</span> con autorizaci&#243;n previa del Juez de Primera Instancia del lugar de residencia de la persona que precise el internamiento&#46;</p></li><li class="elsevierStyleListItem" id="li0020"><span class="elsevierStyleLabel">-</span><p id="p0085" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Urgente&#58;</span> decidido por el profesional sanitario y posteriormente ratificado por el Juez que corresponda al lugar donde radique el centro hospitalario&#46;</p></li></ul></p><p id="p0090" class="elsevierStylePara elsevierViewall">Los tr&#225;mites para acordar el internamiento o ratificarlo son los mismos en ambos procedimientos&#58; audiencia de la persona afectada por la decisi&#243;n&#44; del Ministerio Fiscal y de cualquier otra persona cuya comparecencia estime conveniente el juez&#44; o le sea solicitada por el afectado por la medida&#44; examen directo por parte del juez de la persona de cuyo internamiento se trata y audiencia del dictamen de un facultativo designado por el juez&#46; Siendo&#44; por supuesto&#44; la decisi&#243;n tomada por el jurista&#44; susceptible de apelaci&#243;n&#46; Para ratificar el ingreso ya producido&#44; se establece un plazo de 72 horas&#44; dado que el interno ya est&#225; privado de libertad&#46;</p><p id="p0095" class="elsevierStylePara elsevierViewall">Consta tambi&#233;n en el art&#46; 763 la obligaci&#243;n de los facultativos que atiendan al paciente&#44; de informar peri&#243;dicamente al tribunal sobre la necesidad de mantener la medida&#46; Existiendo&#44; adem&#225;s&#44; la posibilidad de alta directa y la posterior comunicaci&#243;n al juez&#46; En el art&#46; 211 del C&#243;digo Civil &#40;el cual regulaba el internamiento involuntario previo a la elaboraci&#243;n del art&#46; 763 LEC&#41; no se hac&#237;a referencia a la posibilidad de alta directa&#44; siendo esta modificaci&#243;n considerada un gran avance y claro exponente de que nos hallamos ante un problema claramente m&#233;dico&#44; en el que la salud del paciente es el punto de referencia&#44; por tanto&#44; la finalizaci&#243;n del internamiento debe darse en el mismo momento que su utilidad terap&#233;utica desaparezca<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0100"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="p0100" class="elsevierStylePara elsevierViewall">Seg&#250;n el Estudio Europeo de Epidemiolog&#237;a de los Trastornos Mentales &#40;ESEMeD&#41;&#44; la prevalencia de los trastornos mentales graves &#40;TMG&#41; en Europa entre la poblaci&#243;n adulta es del 27&#37; &#40;83 millones de personas&#41;&#46; Por ello&#44; el abordaje de los TMG en la regi&#243;n europea se ha convertido en uno de los principales desaf&#237;os de la salud p&#250;blica en todos y cada uno de los niveles asistenciales<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="p0105" class="elsevierStylePara elsevierViewall">Este estudio tiene como prop&#243;sito establecer un perfil epidemiol&#243;gico acorde a la poblaci&#243;n psiqui&#225;trica hospitalizada en el r&#233;gimen de involuntariedad del Hospital Universitario de Gran Canaria Doctor Negr&#237;n&#46;</p></span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0075">Material y m&#233;todos</span><p id="p0110" class="elsevierStylePara elsevierViewall">A partir de una muestra de 380 pacientes ingresados involuntariamente en el Hospital Doctor Negr&#237;n por raz&#243;n de trastorno ps&#237;quico en un per&#237;odo de tiempo de 2 a&#241;os &#40;2019 y 2020&#41;&#44; se realiz&#243; un estudio observacional&#44; descriptivo y retrospectivo&#44; analiz&#225;ndose las siguientes variables&#58;<ul class="elsevierStyleList" id="l0015"><li class="elsevierStyleListItem" id="li0025"><span class="elsevierStyleLabel">&#8226;</span><p id="p0115" class="elsevierStylePara elsevierViewall">Edad</p></li><li class="elsevierStyleListItem" id="li0030"><span class="elsevierStyleLabel">&#8226;</span><p id="p0120" class="elsevierStylePara elsevierViewall">G&#233;nero</p></li><li class="elsevierStyleListItem" id="li0035"><span class="elsevierStyleLabel">&#8226;</span><p id="p0125" class="elsevierStylePara elsevierViewall">Estado civil</p></li><li class="elsevierStyleListItem" id="li0040"><span class="elsevierStyleLabel">&#8226;</span><p id="p0130" class="elsevierStylePara elsevierViewall">Situaci&#243;n laboral</p></li><li class="elsevierStyleListItem" id="li0045"><span class="elsevierStyleLabel">&#8226;</span><p id="p0135" class="elsevierStylePara elsevierViewall">Diagn&#243;stico fundamental &#40;de acuerdo al sistema de clasificaci&#243;n CIE&#41;</p></li><li class="elsevierStyleListItem" id="li0050"><span class="elsevierStyleLabel">&#8226;</span><p id="p0140" class="elsevierStylePara elsevierViewall">Duraci&#243;n del ingreso</p></li><li class="elsevierStyleListItem" id="li0055"><span class="elsevierStyleLabel">&#8226;</span><p id="p0145" class="elsevierStylePara elsevierViewall">N&#176; total ingresos previos</p></li><li class="elsevierStyleListItem" id="li0060"><span class="elsevierStyleLabel">&#8226;</span><p id="p0150" class="elsevierStylePara elsevierViewall">Uso de drogas</p></li><li class="elsevierStyleListItem" id="li0065"><span class="elsevierStyleLabel">&#8226;</span><p id="p0155" class="elsevierStylePara elsevierViewall">Agitaci&#243;n manifiesta</p></li><li class="elsevierStyleListItem" id="li0070"><span class="elsevierStyleLabel">&#8226;</span><p id="p0160" class="elsevierStylePara elsevierViewall">Necesidad de contenci&#243;n mec&#225;nica</p></li><li class="elsevierStyleListItem" id="li0075"><span class="elsevierStyleLabel">&#8226;</span><p id="p0165" class="elsevierStylePara elsevierViewall">Abandono del tratamiento previamente al ingreso</p></li><li class="elsevierStyleListItem" id="li0080"><span class="elsevierStyleLabel">&#8226;</span><p id="p0170" class="elsevierStylePara elsevierViewall">Comportamiento autol&#237;tico manifiesto en el momento del ingreso</p></li><li class="elsevierStyleListItem" id="li0085"><span class="elsevierStyleLabel">&#8226;</span><p id="p0175" class="elsevierStylePara elsevierViewall">Necesidad de intervenci&#243;n de las fuerzas del orden p&#250;blico</p></li></ul></p><p id="p0180" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio epidemiol&#243;gico con an&#225;lisis descriptivo de las variables cualitativas a trav&#233;s del c&#225;lculo de porcentajes y de las variables cuantitativas a trav&#233;s de la media y la desviaci&#243;n est&#225;ndar&#46; La asociaci&#243;n entre 2 variables cualitativas fue determinada a trav&#233;s de la prueba Ji-cuadrado o test exacto de Fisher cuando no se cumpl&#237;an condiciones de aplicaci&#243;n de la primera&#46; Se consider&#243; un resultado estad&#237;sticamente significativo aquel con p &#60; 0&#44;05&#46;</p></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0080">Resultados</span><p id="p0185" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas socio-demogr&#225;ficas de la poblaci&#243;n a estudio se recogen en la <a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a><span class="elsevierStyleBold">&#46;</span></p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0190" class="elsevierStylePara elsevierViewall">Se compone en su mayor&#237;a por varones &#40;56&#44;8&#37;&#41;&#44; con una media de 43 a&#241;os de edad &#40;15-80&#41; siendo los sujetos de entre 40 y 60 los que conforman los grupos etarios m&#225;s prevalentes en nuestra muestra&#44; con excepci&#243;n de los sujetos que padec&#237;an un &#171;trastorno org&#225;nico&#187;&#44; donde la mayor prevalencia se encontr&#243; en los pacientes mayores de 60&#44; estableci&#233;ndose una asociaci&#243;n estad&#237;sticamente significativa &#40;p &#60; 0&#44;001&#41; entre el incremento de la edad y este grupo de enfermedades&#46; En cuanto al estado civil&#44; existe predominio de pacientes solteros &#40;67&#44;4&#37;&#41;&#44; sin hijos &#40;67&#44;6&#37;&#41; y en situaci&#243;n de desempleo &#40;90&#44;5&#37;&#41;&#46; No se han encontrado variaciones respecto a la frecuencia de ingresos a lo largo de los meses del a&#241;o&#46;</p><p id="p0195" class="elsevierStylePara elsevierViewall">M&#225;s del 50&#37; de los pacientes que forman el estudio se han clasificado como no consumidores de drogas&#46; De entre las diferentes sustancias la m&#225;s consumida es el <span class="elsevierStyleItalic">cannabis</span> &#40;35&#37;&#41;&#44; seguida del alcohol &#40;13&#37;&#41; y la coca&#237;na &#40;12&#37;&#41;&#46; El 17&#37; de pacientes constituyen el fenotipo &#171;policonsumo&#187;&#44; en el cual se incluyen aquellos que consumen diferentes combinaciones de sustancias&#46; Para todas las sustancias se encuentra una mayor prevalencia en el sexo masculino&#44; siendo este resultado estad&#237;sticamente significativo &#40;p &#60; 0&#44;05&#41; en todos los grupos excepto &#171;consumidores de coca&#237;na&#187;&#46; Esto queda reflejado en la <a class="elsevierStyleCrossRef" href="#t0010">tabla 2</a><span class="elsevierStyleBold">&#46;</span></p><elsevierMultimedia ident="t0010"></elsevierMultimedia><p id="p0200" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#t0015">tabla 3</a> se exponen caracter&#237;sticas de la muestra de acuerdo al tipo de trastorno que origin&#243; el ingreso&#46; Cabe destacar que en todos los grupos diagn&#243;sticos se evidenci&#243; una mayor prevalencia de hombres&#44; excepto en &#171;trastornos de la conducta alimentaria&#187; y &#171;trastornos de personalidad&#187;&#44; categor&#237;as con una mayor proporci&#243;n de mujeres en la muestra &#40;80 y 83&#44;3&#37;&#44; respectivamente&#41;&#46;</p><elsevierMultimedia ident="t0015"></elsevierMultimedia><p id="p0205" class="elsevierStylePara elsevierViewall">La carencia de hijos y el desempleo sigui&#243; la tendencia de nuestro estudio en todos los grupos diagn&#243;sticos&#46; Mientras que el policonsumo solo se hizo evidente en el grupo de afectos de un &#171;trastorno por abuso de sustancias&#187;&#44; llegando a estar presente en un 71&#44;4&#37; de los casos siendo este resultado estad&#237;sticamente significativo nuevamente &#40;p &#60; 0&#44;002&#41;&#46;</p><p id="p0210" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas cl&#237;nicas de la poblaci&#243;n estudiada se recogen en la <a class="elsevierStyleCrossRef" href="#t0020">tabla 4</a><span class="elsevierStyleBold">&#46;</span></p><elsevierMultimedia ident="t0020"></elsevierMultimedia><p id="p0215" class="elsevierStylePara elsevierViewall">La gran mayor&#237;a de pacientes ingresados involuntariamente pertenecen al grupo de trastornos psic&#243;ticos &#40;51&#44;6&#37;&#41; o afectivos &#40;30&#44;2&#37;&#41;&#44; constituyendo el resto de pacientes pertenecientes a otros grupos diagn&#243;sticos una notable minor&#237;a&#46;</p><p id="p0220" class="elsevierStylePara elsevierViewall">La media de duraci&#243;n del ingreso involuntario es de 22 d&#237;as&#44; siendo el grupo de pacientes cuya estancia va de 15-30 d&#237;as el m&#225;s prevalente &#40;43&#44;7&#37;&#41;&#46; Al analizar el n&#250;mero de ingresos previos&#44; encontramos una media de 3 ingresos previos al que es objeto de nuestro estudio&#46; Contando la mayor&#237;a de pacientes con &#60; 3 ingresos &#40;52&#44;9&#37;&#41;&#46;</p><p id="p0225" class="elsevierStylePara elsevierViewall">Haciendo referencia al tratamiento&#44; aproximadamente en el 50&#37; de los pacientes se refiere un abandono del mismo previo al ingreso&#46; Si a esta cifra a&#241;adimos aquellos pacientes que no ten&#237;an un tratamiento pautado&#44; vemos que el 70&#37; de la muestra se encontraba exenta de cualquier tipo de medicaci&#243;n frente al 30&#37; que s&#237; la tomaba&#44; seg&#250;n informaci&#243;n recogida en anamnesis de pacientes o contacto con familiares&#46;</p><p id="p0230" class="elsevierStylePara elsevierViewall">El 48&#44;4&#37; de los pacientes presentaron agitaci&#243;n manifiesta al ingreso&#44; a diferencia del 51&#44;6&#37; que no&#46; Y m&#225;s de la mitad de los pacientes&#44; concretamente un 64&#37; no precis&#243; contenci&#243;n mec&#225;nica en el momento del ingreso&#44; siendo de un 36&#37; el grupo que s&#237; lo hizo&#46;</p><p id="p0235" class="elsevierStylePara elsevierViewall">Solo el 11&#44;3&#37; de los pacientes presentaban ideaci&#243;n autol&#237;tica&#44; frente al 88&#44;7&#37; que no la presentaban&#46; Y en el 86&#37; de los casos no fue necesaria la intervenci&#243;n de fuerzas del orden p&#250;blico para llevar a cabo el ingreso&#44; solo el 14&#37; de los pacientes requirieron esta medida&#46;</p></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0085">Discusi&#243;n</span><p id="p0240" class="elsevierStylePara elsevierViewall">A continuaci&#243;n&#44; se procede al an&#225;lisis de los hallazgos&#58;</p><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0090">Sexo y edad</span><p id="p0245" class="elsevierStylePara elsevierViewall">Se ha evidenciado que entre los factores implicados en el internamiento involuntario destaca el sexo masculino<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0035"><span class="elsevierStyleSup">7&#8211;11</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0075"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0080"><span class="elsevierStyleSup">16</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0095"><span class="elsevierStyleSup">19</span></a>&#46; La edad media en nuestro estudio fue de 43 a&#241;os&#44; encontr&#225;ndose este dato dentro del rango de edad reflejado en la literatura revisada<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0105"><span class="elsevierStyleSup">21</span></a>&#46;</p></span><span id="s0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0095">Estado civil y descendencia</span><p id="p0250" class="elsevierStylePara elsevierViewall">La gran mayor&#237;a de los pacientes pertenec&#237;an al grupo de los solteros y no ten&#237;an hijos<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0070"><span class="elsevierStyleSup">14&#8211;17</span></a>&#46; Este hallazgo pondr&#237;a de manifiesto dificultades en el &#225;mbito relacional y un d&#233;bil sistema de apoyo<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0105"><span class="elsevierStyleSup">21</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0110"><span class="elsevierStyleSup">22</span></a>&#46;</p></span><span id="s0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0100">Situaci&#243;n laboral</span><p id="p0255" class="elsevierStylePara elsevierViewall">El 90&#37; de los pacientes se encontraban en situaci&#243;n de desempleo en el momento del ingreso<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0035"><span class="elsevierStyleSup">7&#8211;10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0085"><span class="elsevierStyleSup">17</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0110"><span class="elsevierStyleSup">22</span></a>&#46; Este resultado sugiere que un trastorno mental severo&#44; no adecuadamente tratado&#44; constituye un importante antecedente de discapacidad o jubilaci&#243;n temprana<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a>&#46; Tambi&#233;n pone de manifiesto la discriminaci&#243;n de la que son v&#237;ctima muchos de ellos&#44; neg&#225;ndoles la oportunidad de desempe&#241;ar un oficio en la sociedad<a class="elsevierStyleCrossRef" href="#bb0105"><span class="elsevierStyleSup">21</span></a>&#46;</p></span><span id="s0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0105">Diagn&#243;stico</span><p id="p0260" class="elsevierStylePara elsevierViewall">El diagn&#243;stico principal fue esquizofrenia y otros trastornos psic&#243;ticos&#46; Este hecho sigue la misma l&#237;nea de investigaci&#243;n que otros art&#237;culos<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0035"><span class="elsevierStyleSup">7&#8211;11</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0070"><span class="elsevierStyleSup">14&#8211;16</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0095"><span class="elsevierStyleSup">19</span></a>&#44; siendo este tipo de trastornos los que m&#225;s se beneficiar&#237;an de un tratamiento agudo al presentar manifestaciones cl&#237;nicas m&#225;s severas<a class="elsevierStyleCrossRef" href="#bb0075"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a>&#46;</p></span><span id="s0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0110">Ingresos previos</span><p id="p0265" class="elsevierStylePara elsevierViewall">Este constituye un predictor de la futura necesidad de reingreso del paciente<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0070"><span class="elsevierStyleSup">14&#8211;18</span></a>&#46; En nuestra poblaci&#243;n la mayor parte de los pacientes hab&#237;an sido objeto de un ingreso previo&#44; lo cual&#44; nos lleva a pensar que los ingresos involuntarios se est&#225;n ejerciendo sobre pacientes con tendencia a ingresar y&#44; por lo tanto&#44; probablemente con una psicopatolog&#237;a m&#225;s grave&#46;</p><p id="p0270" class="elsevierStylePara elsevierViewall">Sin embargo&#44; en lo que a duraci&#243;n del ingreso se refiere&#44; este estudio establece una media de 22 d&#237;as&#44; de las m&#225;s elevadas en comparaci&#243;n con la literatura revisada&#46; Esto podr&#237;a justificar como&#44; en determinados pa&#237;ses&#44; una vez el paciente no presenta criterio de peligrosidad es dado de alta&#44; antes de la resoluci&#243;n de los s&#237;ntomas<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a>&#46; Por tanto&#44; sugiere que la hospitalizaci&#243;n de corta duraci&#243;n puede no ser tiempo suficiente para la estabilizaci&#243;n del paciente&#46;</p></span><span id="s0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0115">Adherencia al tratamiento</span><p id="p0275" class="elsevierStylePara elsevierViewall">Posiblemente nos encontremos ante el factor de riesgo que m&#225;s estrechamente se asocia al ingreso involuntario&#46; En m&#225;s del 70&#37; de los pacientes del estudio se evidenci&#243; un abandono del tratamiento previo o no se encontraban recibiendo ning&#250;n tipo de medicaci&#243;n&#46; En muchos estudios&#44; al igual que en el propio&#44; las cifras de falta de adherencia son extremadamente altas<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0040"><span class="elsevierStyleSup">8&#8211;11</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0070"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0085"><span class="elsevierStyleSup">17</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0095"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="p0280" class="elsevierStylePara elsevierViewall">Una adecuada administraci&#243;n del tratamiento debe ser la prioridad para conseguir alcanzar un menor n&#250;mero de admisiones involuntarias cada a&#241;o<a class="elsevierStyleCrossRef" href="#bb0115"><span class="elsevierStyleSup">23</span></a>&#46; Para lograr esto&#44; es imprescindible una visi&#243;n y comprensi&#243;n global por parte del paciente <span class="elsevierStyleItalic">&#171;insight&#187;</span> y su entorno acerca de la enfermedad<a class="elsevierStyleCrossRef" href="#bb0120"><span class="elsevierStyleSup">24</span></a>&#46; Adem&#225;s&#44; cabe destacar que las formulaciones <span class="elsevierStyleItalic">depot</span> de los f&#225;rmacos antipsic&#243;ticos han demostrado una menor tasa de ingresos hospitalarios en previos estudios&#44; de una manera bastante contundente&#44; con lo cual es tambi&#233;n una medida a tener en cuenta<a class="elsevierStyleCrossRef" href="#bb0125"><span class="elsevierStyleSup">25</span></a>&#46;</p></span><span id="s0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0120">Consumo de drogas</span><p id="p0285" class="elsevierStylePara elsevierViewall">El consumo de sustancias se ha relacionado con modificaciones conductuales que podr&#237;an actuar como desencadenantes de un ingreso involuntario<a class="elsevierStyleCrossRef" href="#bb0085"><span class="elsevierStyleSup">17</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0130"><span class="elsevierStyleSup">26</span></a>&#46; En nuestra muestra&#44; m&#225;s del 50&#37; de los pacientes se han clasificado como &#171;no consumidores&#187;&#46; Esto podr&#237;a deberse a la obtenci&#243;n de este dato a partir de historias cl&#237;nicas&#46; Adem&#225;s&#44; un mismo paciente puede aparecer varias veces en los datos si se produce un reingreso involuntario durante el periodo de estudio&#59; es por ello que relacionamos esta baja prevalencia en el consumo con que los pacientes&#44; desde ingresos previos&#44; hayan recibido desintoxicaci&#243;n&#47;deshabituaci&#243;n&#44; lo cual hace que no conste un consumo activo en el momento del ingreso actual&#46;</p></span><span id="s0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0125">Agitaci&#243;n manifiesta&#44; necesidad de contenci&#243;n e intervenci&#243;n policial</span><p id="p0290" class="elsevierStylePara elsevierViewall">Estos 3 factores est&#225;n &#237;ntimamente relacionados entre s&#237;&#46; Un comportamiento agresivo suele requerir frecuentemente la intervenci&#243;n de cuerpos de seguridad durante el proceso de internamiento<a class="elsevierStyleCrossRef" href="#bb0105"><span class="elsevierStyleSup">21</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0130"><span class="elsevierStyleSup">26</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bb0140"><span class="elsevierStyleSup">28&#8211;30</span></a>&#46;</p><p id="p0295" class="elsevierStylePara elsevierViewall">Sin embargo&#44; en nuestra muestra&#44; a pesar de presentar la mitad de los pacientes un estado notable de agitaci&#243;n a su llegada&#44; la necesidad de contenci&#243;n con medidas mec&#225;nicas fue mucho menor&#44; y m&#225;s a&#250;n la necesidad de intervenci&#243;n de fuerzas del orden p&#250;blico&#44; solo en el 13&#37; de los casos&#46; Resultado muy favorecedor de la gesti&#243;n llevada a cabo en este hospital en comparaci&#243;n con la literatura existente&#44; donde existe un significativo n&#250;mero de casos en los que la presencia policial es requerida<a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a>&#46;</p></span><span id="s0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0130">Comportamiento autol&#237;tico</span><p id="p0300" class="elsevierStylePara elsevierViewall">Pr&#225;cticamente el 90&#37; de pacientes no present&#243; comportamiento autol&#237;tico manifiesto en el momento del ingreso&#46; En algunos estudios la ideaci&#243;n suicida se asocia a ingresos voluntarios m&#225;s que a involuntarios<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a>&#46; Esto puede sugerir que el comportamiento autol&#237;tico no es un factor predictor de la necesidad de ingreso involuntario del paciente psiqui&#225;trico&#46;</p></span></span><span id="s0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0135">Conclusi&#243;n</span><p id="p0305" class="elsevierStylePara elsevierViewall">El perfil del paciente subsidiario de ingreso involuntario en nuestro servicio es el de un var&#243;n&#44; en la cuarta d&#233;cada de la vida&#44; soltero&#44; sin hijos ni empleo&#44; con un diagn&#243;stico de trastorno psic&#243;tico o afectivo mayor que muy probablemente ha abandonado el tratamiento&#46;</p><p id="p0310" class="elsevierStylePara elsevierViewall">De cara a la pr&#225;ctica cl&#237;nica se recomienda hacer un especial seguimiento a los pacientes que cumplan el perfil anteriormente descrito con el objetivo de minimizar la involuntariedad&#46;</p><span id="s0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0140">Limitaciones</span><p id="p0315" class="elsevierStylePara elsevierViewall">La principal limitaci&#243;n del estudio viene determinada por su dise&#241;o&#46; El uso de la restringida informaci&#243;n de las historias cl&#237;nicas y la calidad de las mismas&#44; dificult&#243; la obtenci&#243;n de algunas variables como el &#171;consumo de drogas&#187; o &#171;necesidad de contenci&#243;n mec&#225;nica&#187;&#44; as&#237; como del &#171;tiempo en el que se han producido los ingresos previos&#187;&#59; de los diagn&#243;sticos CIE incluidos&#44; solo se tom&#243; el principal&#44; obviando la comorbilidad&#46;</p><p id="p0320" class="elsevierStylePara elsevierViewall">Al no ser posible en este estudio la comparaci&#243;n entre grupos&#44; se trata &#250;nicamente de un estudio epidemiol&#243;gico&#44; por lo que&#44; no podemos concretar por el momento&#44; si las variables estudiadas son predictivas de involuntariedad o no&#46; La discusi&#243;n desarrollada est&#225; orientada a proponer medidas que mejorar&#237;an estas variables&#44; pero es posible que est&#233;n asociadas a cualquier tipo de internamiento en una unidad de hospitalizaci&#243;n de psiquiatr&#237;a&#44; no espec&#237;ficamente a aquellos de car&#225;cter involuntario&#46; Por ello&#44; ser&#237;a interesante determinar qu&#233; factores se asocian con la involuntariedad&#44; para poder explicar la causa de afectaci&#243;n de la capacidad para consentir o mejorar la adecuaci&#243;n del tipo de internamiento en cada caso concreto&#46;</p></span></span></span>"
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        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Introducci&#243;n</span><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">los ingresos involuntarios por raz&#243;n de trastorno ps&#237;quico se producen con relativa asiduidad en las unidades de internamiento hospitalarias de nuestro pa&#237;s&#46; Este trabajo someter&#225; a estudio las caracter&#237;sticas socio-demogr&#225;ficas y cl&#237;nicas que se encuentran en relaci&#243;n con este tipo de pacientes&#44; para disponer de m&#225;s informaci&#243;n&#44; tanto cl&#237;nica como legal&#44; con la que trabajar y desempe&#241;ar una mejor funci&#243;n&#44; administraci&#243;n de recursos y desarrollo de habilidades necesarias ante estas situaciones&#46;</p></span> <span id="as0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Material y m&#233;todos</span><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">estudio observacional descriptivo retrospectivo&#44; en el cual se analizar&#225;n diferentes variables&#44; seleccionadas previamente&#44; presentes en la poblaci&#243;n de pacientes psiqui&#225;tricos ingresados involuntariamente en el Hospital Doctor Negr&#237;n en un per&#237;odo de tiempo de 2 a&#241;os&#44; 2019 y 2020&#44; determinando as&#237; el grado de prevalencia de cada una de ellas&#46;</p></span> <span id="as0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Resultados</span><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">entre las variables m&#225;s asociadas al ingreso involuntario se encuentran&#58; ser var&#243;n&#44; en la cuarta d&#233;cada de la vida&#44; soltero&#44; sin hijos ni empleo y con un diagn&#243;stico de trastorno psic&#243;tico o afectivo mayor que muy probablemente ha abandonado el tratamiento&#46;</p></span> <span id="as0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Discusi&#243;n</span><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">ser&#237;a conveniente hacer un especial seguimiento a los pacientes que cumplan el perfil anteriormente descrito con el objetivo de minimizar la involuntariedad&#46; Es necesario el desarrollo de programas educacionales&#44; de seguimiento y adherencia al alcance de la poblaci&#243;n de pacientes psiqui&#225;tricos para as&#237; poder minimizar la necesidad de ingresos involuntarios en nuestro medio&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "as0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "as0010"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "as0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "as0020"
            "titulo" => "Discusi&#243;n"
          ]
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="as0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0035">Introduction</span><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">Involuntary admissions due to mental disorders occur with relative regularity in hospital admission units in our country&#46; This work will study the socio-demographic and clinical characteristics found in relation to this type of patients&#44; in order to have more information&#44; both clinical and legal&#44; with which to work and perform a better function&#44; administration of resources and development of necessary skills in these situations&#46;</p></span> <span id="as0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0040">Material and methods</span><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall">Retrospective descriptive observational study&#44; in which different variables will be analyzed&#44; previously selected&#44; present in the population of psychiatric patients involuntarily admitted to the Doctor Negr&#237;n Hospital in a period of 2 years&#44; 2019 and 2020&#44; thus determining&#44; the degree of prevalence of each of them&#46;</p></span> <span id="as0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0045">Results</span><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall">Among the variables most associated with involuntary admission are&#44; being a man&#44; in the fourth decade of life&#44; single&#44; without children&#44; or employment&#44; with a diagnosis of major psychotic or affective disorder who has most likely abandoned treatment&#46;</p></span> <span id="as0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0050">Discussion</span><p id="sp0065" class="elsevierStyleSimplePara elsevierViewall">It would be advisable to carry out a special follow-up of patients who meet the profile described above in order to minimize involuntary occurrence&#46; It is necessary to develop educational&#44; follow-up and adherence programs within the reach of the population of psychiatric patients in order to minimize the need for involuntary admissions in our environment&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "as0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "as0030"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "as0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "as0040"
            "titulo" => "Discussion"
          ]
        ]
      ]
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">344&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Empleado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3334845.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas socio-demogr&#225;ficas de los pacientes ingresados involuntariamente &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>380&#41;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "t0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "al0010"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cannabis &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Alcohol &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coca&#237;na &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Policonsumo &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hombres</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;273</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Mujeres</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab3334844.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Proporci&#243;n sexo-consumo de drogas en los pacientes ingresados involuntariamente</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "t0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "al0015"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Afectivos&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Psic&#243;ticos&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Esquizoafectivos&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Neur&#243;ticos&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sustancias&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Org&#225;nicos&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">TCA&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Personalidad&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hombres&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;606&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;548&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">90&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">88&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Policonsumo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Si&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;623&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">71&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;137&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;383&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3334843.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de la muestra de acuerdo al tipo de trastorno que origin&#243; el ingreso</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "t0020"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "al0020"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">T&#58; Trastorno&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frecuencia absoluta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frecuencia relativa &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">T&#46; Afectivos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">T&#46; Psic&#243;ticos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">T&#46; Org&#225;nicos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">TCA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60; 1 semana&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;2&#44;9&#41;&#8239;&#8239;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tratamiento previo al ingreso</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Abandono&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">182&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No abandono&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">111&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Agitaci&#243;n manifiesta</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">196&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Necesidad de contenci&#243;n mec&#225;nica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">137&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">243&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Necesidad de intervenci&#243;n policial</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">328&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Ideaci&#243;n suicida recogida en anamnesis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">337&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas de los pacientes ingresados involuntariamente &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>380&#41;</p>"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and social factors associated with increased risk for involuntary psychiatric hospitalisation&#58; a systematic review&#44; meta-analysis&#44; and narrative synthesis"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Walker"
                            1 => "E&#46; Mackay"
                            2 => "P&#46; Barnett"
                            3 => "L&#46; Sheridan Rains"
                            4 => "M&#46; Leverton"
                            5 => "C&#46; Dalton-Locke"
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Psychiatry"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of mental disorders in Europe&#58; results from the European Study of the Epidemiology of Mental Disorders &#40;ESEMeD&#41; project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Alonso"
                            1 => "M&#46;C&#46; Angermeyer"
                            2 => "S&#46; Bernert"
                            3 => "R&#46; Bruffaerts"
                            4 => "T&#46;S&#46; Brugha"
                            5 => "H&#46; Bryson"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Psychiatr Scand Suppl"
                        "fecha" => "2004"
                        "volumen" => "420"
                        "paginaInicial" => "21"
                        "paginaFinal" => "27"
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              "identificador" => "bb0015"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Internamiento no voluntario del paciente psiqui&#225;trico&#58; normas legales y aspectos cr&#237;ticos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Ib&#225;&#241;ez Bern&#225;ldez"
                            1 => "Blanco M&#46; Casado"
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                    0 => array:2 [
                      "doi" => "10.1016/j.semerg.2017.05.004"
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                        "tituloSerie" => "Medicina de Familia SEMERGEN"
                        "fecha" => "2018"
                        "volumen" => "44"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics associated with involuntary versus voluntary legal status at admission and discharge among psychiatric inpatients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Craw"
                            1 => "M&#46;T&#46; Compton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Soc Psychiat Epidemiol"
                        "fecha" => "2006"
                        "volumen" => "41"
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              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency of involuntary admissions and its associations with demographic and clinical characteristics in China"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Gou"
                            1 => "J&#46;-S&#46; Zhou"
                            2 => "Y&#46;-T&#46; Xiang"
                            3 => "X&#46;-M&#46; Zhu"
                            4 => "C&#46;U&#46; Correll"
                            5 => "G&#46;S&#46; Ungvari"
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Información del artículo
ISSN: 03774732
Idioma original: Español
DOI:10.1016/j.reml.2023.04.001
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