<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-5173</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Medicina Geral e Familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Med Geral Fam]]></abbrev-journal-title>
<issn>2182-5173</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Medicina Geral e Familiar]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-51732023000400327</article-id>
<article-id pub-id-type="doi">10.32385/rpmgf.v39i4.13698</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[A importância da continuidade de cuidados na patologia psiquiátrica: um relato de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[The importance of continuity of care in psychiatric pathology: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Canha]]></surname>
<given-names><![CDATA[Filipa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pitta]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Conde]]></surname>
<given-names><![CDATA[Margarida Esteves Nunes Gil]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário de Lisboa Central  ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,ACeS Lisboa Central USF Jardins da Encarnação ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,ACeS Lisboa Central USF Jardins da Encarnação ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidade de Lisboa Faculdade de Medicina Instituto de Medicina Preventiva e Saúde Pública]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,ARSLVT Comissão de Ética para a Saúde Secção de Investigação]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>07</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>07</month>
<year>2023</year>
</pub-date>
<volume>39</volume>
<numero>4</numero>
<fpage>327</fpage>
<lpage>331</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-51732023000400327&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-51732023000400327&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-51732023000400327&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Os cuidados de saúde primários (CSP) são responsáveis pela resposta a situações de diagnóstico e tratamento de patologias do foro psiquiátrico bem como a referenciação de determinados casos para nível hospitalar. A Lei da Saúde Mental (Lei n.º 36/98) determina os princípios da política de saúde mental e regulamenta o internamento compulsivo de pessoas com doença mental, sendo da responsabilidade do médico de família a identificação dessas situações e a ativação do Mandado de Condução ao Serviço de Urgência.  Descrição do caso:  O caso refere-se a uma utente do sexo feminino, de 50 anos de idade, com antecedentes psiquiátricos de tentativa de suicídio e seguida em consulta de psiquiatria. Em consulta programada de psiquiatria a utente refere quadro de ansiedade e agitação noturna, tendo sido realizado ajuste terapêutico com reavaliação posterior. Por manter queixas é novamente realizada alteração do plano terapêutico. Posteriormente recorre aos CSP em consulta do dia com a médica de família, onde refere incumprimento terapêutico bem como agravamento sintomático associado a irritabilidade e alucinações auditivas na forma de voz única com instruções para realizar atos de auto e hetero-agressividade; fora encaminhada e avaliada no serviço de urgência, com novo ajuste terapêutico e indicação para antecipação de consulta de psiquiatria para reavaliação do quadro. Em consulta subsequente com a médica de família apura-se ideação suicida, auto e hetero-agressividade associadas a pseudo-alucinações acústico-verbais, tendo sido proposta nova ida a SU, que a utente recusou. Pelo contexto, a médica de família aciona o Mandado de Condução que a utente compreende e aceita. Durante o internamento foi realizado novo plano terapêutico, observando-se remissão da ideação auto e hetero-agressiva e das pseudo-alucinações auditivas, bem como eutimização do humor e redução da anedonia e cognições de cariz depressivo.  Comentário:  Este caso clínico representa a gestão partilhada de utentes com patologia psiquiátrica entre os CSP e a psiquiatria e ainda a importância da vigilância da resposta terapêutica, reforçando a necessidade de aperfeiçoamento na articulação entre os diversos níveis de cuidados com o objetivo de garantir partilha de informação mais eficaz e a melhor prestação de cuidados aos utentes de foro psiquiátrico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Primary health care (PHC) workers are responsible for diagnosing and treating psychiatric disorders, as well as referring some instances to secondary care. The Mental Health Law (Law no. 36/98) sets out the principles for mental health policy and regulates the involuntary hospitalization of people with mental illness. It is the responsibility of the family physician to identify such situations and activate the &#8220;emergency assessment warrant&#8221;.  Case description:  The case concerns a 50-year-old female patient with a history of attempted suicide and followed up in psychiatry. In a scheduled psychiatry appointment, the patient reported anxiety and night-time agitation, and therapeutic adjustment was made with subsequent reevaluation. Due to persistent symptoms, the therapeutic plan was adjusted again. Later, she sought care from her family physician reporting noncompliance with treatment and worsening symptoms of irritability and auditory hallucinations in the form of a single voice with instructions for self- and hetero-aggressive acts. The patient was referred to the emergency department, evaluated, and received a new therapeutic adjustment and a recommendation for an earlier psychiatry appointment for reassessment. In a subsequent appointment with the family physician, it was identified suicidal ideation, self- and hetero-aggression, and acoustic-verbal pseudo hallucinations, and a new visit to the emergency department was proposed, which the patient refused. Given the context, the family physician activated the &#8220;Mandado de Condução à Urgência&#8221; which the patient understood and accepted. During hospitalization, a new therapeutic plan was implemented, resulting in remission of self and hetero-aggressive ideation and auditory pseudo hallucinations, as well as improvement in mood and reduction of anhedonia and depressive cognitions.  Comments:  This clinical case represents shared management of patients with psychiatric illness between PHC and psychiatry, as well as the importance of monitoring therapeutic response, reinforcing the need for improved coordination among various levels of care to ensure more effective information sharing and better care for patients with psychiatric disorders.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Transtornos psicóticos]]></kwd>
<kwd lng="pt"><![CDATA[Depressão]]></kwd>
<kwd lng="pt"><![CDATA[Decisões judiciais]]></kwd>
<kwd lng="pt"><![CDATA[Relato de caso]]></kwd>
<kwd lng="en"><![CDATA[Psychotic disorders]]></kwd>
<kwd lng="en"><![CDATA[Depression]]></kwd>
<kwd lng="en"><![CDATA[Judicial decisions]]></kwd>
<kwd lng="en"><![CDATA[Case report]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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