Countertransferential manifestations and psychopharmacological management in the first care of elderly people in a geriatric psychiatry outpatient

Authors

DOI:

https://doi.org/10.15448/2357-9641.2024.1.45784

Keywords:

countertransference, elderly., outpatient care

Abstract

Aims: the present study aimed to assess countertransference manifestations and their implications on psychopharmacological management during the first care of elderly patients at a psychiatry outpatient clinic in a tertiary hospital.


Methods: elderly patients were cared for by doctors completing their specialization in psychiatry, with face-to-face supervision from the service’s psychiatric and psychoanalysis preceptors. After the consultation, the participating doctors completed the Countertransference
Assessment Scale (EACT). The results were subsequently correlated with examiner and patient data, as well as the medication adjustments made during the first consultation.


Results: a clinically significant association was found between psychopharmacological conduct and sociodemographic data of patients and evaluators when associated with countertransference manifestations, represented by the scores of approach (R²=51.8%), distancing (R²=55.3%), and indifference (R²=53.30%). Countertransferential approach scores were positively associated with the suspension of psychotropic drugs (p=0.001), and negatively with hypnotics interruption (p=0.020), hypnotics dosage reduction (p=0.000), switching between hypnotics (p=0.015) and anticonvulsants initiation (p=0.002). Countertransference withdrawal scores were positively associated with the same variables: hypnotics interruption (p=0.011), hypnotics dosage reduction (p=0.000), switching between hypnotics (p=0.000) and anticonvulsants initiation (p=0.006), whereas the number of medication adjustments (p=0.026) was negatively associated. Countertransference indifference scores were also negatively associated with the number of medication adjustments (p=0.047).


Conclusion: therefore, we highlight the importance of understanding countertransference manifestations as a tool within clinical practice, contributing to the overall quality of patient care.

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Author Biographies

Guilherme Noschang Vieira Bacchi, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Graduated in Medicine from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil. Postgraduate degree in Hospital Medical Practice – Psychiatry from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil.

Larissa Belon Albuquerque, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Graduated in Medicine from the Universidade do Oeste Paulista (Unoeste), in Presidente Prudente, SP, Brazil. Postgraduate in Hospital Medical Practice – Psychiatry from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil.

Marina Mosele Guidi, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Graduated in Medicine from the Pontifícia Universidade Católica do Paraná (PUCPR), in Curitiba, PR, Brazil.
Postgraduate in the Psychiatry Residency of the São Lucas Hospital (HSL), in Porto Alegre, RS, Brazil.

Mateus Vizentini Mendes, Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil

Graduated in Medicine from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil. Postgraduate in Hospital Medical Practice – Psychiatry from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil.

Pedro Marques da Rosa, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Graduated in Medicine from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil. Postgraduate degree in Hospital Medical Practice – Psychiatry from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil.

Edgar Chagas Diefenthaeler, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Master in Medicine and Health Sciences from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil. Preceptor and Supervisor of Psychiatry at Hospital São Lucas (HSL), in Porto Alegre, RS, Brazil.

Vanessa Sgnaolin, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

PhD in Biomedical Gerontology from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil. Professor at the School of Health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil.

Alfredo Cataldo Neto, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

PhD in Medicine and Health Sciences from the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil. Professor at the School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), in Porto Alegre, RS, Brazil.

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Published

2024-09-30

How to Cite

Rorig de Azevedo, A., Noschang Vieira Bacchi, G., Belon Albuquerque, L., Mosele Guidi, M., Vizentini Mendes, M., Marques da Rosa, P., … Cataldo Neto, A. (2024). Countertransferential manifestations and psychopharmacological management in the first care of elderly people in a geriatric psychiatry outpatient. PAJAR - Pan American Journal of Aging Research, 12(1), e45784. https://doi.org/10.15448/2357-9641.2024.1.45784

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Vol. 12 No. 1 (2024): Single Volume - Continuous flow

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