Disforia de genero: realidad asistencial en psiquiatria del niño y el adolescente

espanolIntroduccion: La demanda de atencion sanitaria a ninos y adolescentes con disforia de genero (DG) es un hecho reciente en Espana que plantea necesidades aun poco estudiadas. Por una parte, conocemos mal su incidencia en la poblacion, por otra, el consenso entre especialistas es bajo y, aunque hay varias guias de practica clinica, no hay acuerdo sobre ciertos aspectos del diagnostico y tratamiento. Finalmente, el marco legislativo cambia segun las Comunidades Autonomas, e incluso dentro de la misma comunidad hay diferencias asistenciales entre areas de salud. Objetivos: Definir la realidad de la demanda asistencial, las peculiaridades personales y el punto de vista de las familias sobre la atencion. Metodologia: Estudio retrospectivo descriptivo mediante revision de historias clinicas de los casos atendidos en el Equipo de Salud Mental Infanto Juvenil (ESMIJ) de Burgos hasta diciembre de 2017. Ademas se solicito a las familias que cumplimentasen un cuestionario de satisfaccion, opiniones y propuestas de mejora. Resultados: Se atendieron 12 pacientes entre 2011 y 2017. Las intervenciones se centraron en el acompanamiento de los menores, asesoramiento familiar y psicoterapia de apoyo. Las valoraciones familiares muestran una satisfaccion elevada con la atencion y sugieren problemas de coordinacion entre servicios e instituciones. Conclusiones: Aunque el acompanamiento y asesoramiento en el ESMIJ parecen satisfacer EnglishIntroduction: Health care for children and adolescents with gender dysphoria (DG) is a recent development in Spain, which poses needs that have not been well studied. On one hand, we know little about its incidence in the population. On the other, the degree of consensus among specialists is low and, despite having several clinical practice guidelines, there is no agreement on aspects of diagnosis and treatment. Finally, the legislative framework changes according to the autonomous communities, and even within the same community, the healthcare situation is different in each health area. Objectives: To define the reality of the demand for care, the personal features and the families point of view of healthcare. Methodology: A retrospective descriptive study is carried out by reviewing clinical histories of the cases treated until December 2017 in the Child and Youth Mental Health Unit (ESMIJ) of Burgos. In addition, families were asked to fill in a satisfaction questionnaire to gather their opinions and suggestions for improvement. Results: 12 patients were treated between 2011 and 2017. The interventions focused on the accompaniment of minors, family counseling and supportive psychotherapy. Family assessments show a high level of satisfaction with care and suggest coordination problems between services and institutions. Conclusions: While the accompaniment and advice in the ESMIJ seem to meet the expectations of the families, it is necessary to move forward to a more coordinated and integral attention model.