Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Haloperidol/administración & dosificación , Lorazepam/administración & dosificación , Olanzapina/administración & dosificación , Pandemias , Neumonía Viral , Trastornos Psicóticos , Adulto , Antipsicóticos/administración & dosificación , COVID-19 , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Infecciones por Coronavirus/terapia , Deluciones/diagnóstico , Humanos , Tratamiento Involuntario , Masculino , Pandemias/prevención & control , Conducta Paranoide/diagnóstico , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Neumonía Viral/psicología , Neumonía Viral/terapia , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/tratamiento farmacológico , Trastornos Psicóticos/etiología , SARS-CoV-2 , Aislamiento Social/psicología , Resultado del TratamientoRESUMEN
Adult-onset Still's disease (AOSD) is an uncommon inflammatory condition characterised by a triad of fevers, arthralgias and a salmon-coloured rash. It is also strongly associated with high ferritin levels, whose role in its pathogenesis is not entirely clear. Central nervous system (CNS) manifestations are exceedingly rare in this disease, accounting for only a handful of reported cases. Herein, we describe a case of a 63-year-old woman who developed new-onset psychiatric symptoms in the months preceding her diagnosis. 2 months after her diagnosis, she experienced an exacerbation of psychiatric symptoms followed by new-onset seizures in conjunction with an acute lung infection. In addition, we discuss two other previously reported cases of AOSD patients with psychiatric symptoms as their initial presentation.
Asunto(s)
Agresión , Manía/inmunología , Conducta Paranoide/inmunología , Convulsiones/inmunología , Enfermedad de Still del Adulto/diagnóstico , Anticonvulsivantes/administración & dosificación , Artralgia/inmunología , Diagnóstico Diferencial , Electroencefalografía , Femenino , Fiebre/inmunología , Glucocorticoides/uso terapéutico , Humanos , Levetiracetam/administración & dosificación , Lorazepam/administración & dosificación , Manía/diagnóstico , Manía/tratamiento farmacológico , Metotrexato/uso terapéutico , Persona de Mediana Edad , Conducta Paranoide/diagnóstico , Conducta Paranoide/tratamiento farmacológico , Convulsiones/tratamiento farmacológico , Enfermedad de Still del Adulto/complicaciones , Enfermedad de Still del Adulto/tratamiento farmacológico , Enfermedad de Still del Adulto/inmunología , Resultado del TratamientoRESUMEN
This study aimed to characterize the association between paranoid ideation without psychosis (PIP) and suicide attempts in a general population. A total of 12,532 adults were randomly selected as the study sample through one-person-per-household method. Subjects completed a face-to-face interview. Among 12,532 subjects, 471 (3.76%) met criteria for the PIP group. The PIP group was younger with more divorced/widowed/separated and lower income than the non-PIP group. The PIP group showed more than fivefold higher lifetime suicide attempt (LSA) rates and ninefold multiple attempt rates than the non-PIP group. Among PIP symptoms, "spouse was being unfaithful" showed the strongest association with LSA (adjusted odds ratio [AOR], 4.49; 95% confidence interval, 2.95-6.85). Major depressive disorder (MDD) in combination with PIP was associated with a higher risk of LSA (AOR, 15.39; 95% confidence interval, 9.63-24.59) compared with subjects without MDD or PIP. In conclusion, PIP, especially "doubting spouse," was significantly associated with LSA. PIP in combination with comorbid MDD showed higher risk of LSA than subjects without PIP or MDD.
Asunto(s)
Ansiedad/psicología , Depresión/psicología , Conducta Paranoide/psicología , Trastornos Psicóticos , Ideación Suicida , Intento de Suicidio/psicología , Adolescente , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducta Paranoide/diagnóstico , Conducta Paranoide/epidemiología , Vigilancia de la Población/métodos , República de Corea/epidemiología , Factores de Riesgo , Adulto JovenRESUMEN
Identifying data-driven subtypes of major depressive disorder (MDD) is an important topic of psychiatric research. Currently, MDD subtypes are based on clinically defined depression symptom patterns. Although a few data-driven attempts have been made to identify more homogenous subgroups within MDD, other studies have not focused on using human genetic data for MDD subtyping. Here we used a computational strategy to identify MDD subtypes based on single-nucleotide polymorphism genotyping data from MDD cases and controls using Hamming distance and cluster analysis. We examined a cohort of Mexican-American participants from Los Angeles, including MDD patients (n=203) and healthy controls (n=196). The results in cluster trees indicate that a significant latent subtype exists in the Mexican-American MDD group. The individuals in this hidden subtype have increased common genetic substrates related to major depression and they also have more anxiety and less middle insomnia, depersonalization and derealisation, and paranoid symptoms. Advances in this line of research to validate this strategy in other patient groups of different ethnicities will have the potential to eventually be translated to clinical practice, with the tantalising possibility that in the future it may be possible to refine MDD diagnosis based on genetic data.
Asunto(s)
Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/genética , Exoma/genética , Americanos Mexicanos/genética , Adulto , Anciano , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/etnología , Trastornos de Ansiedad/genética , Análisis por Conglomerados , Despersonalización/diagnóstico , Despersonalización/etnología , Despersonalización/genética , Trastorno Depresivo Mayor/clasificación , Femenino , Genotipo , Humanos , Los Angeles/etnología , Masculino , Persona de Mediana Edad , Conducta Paranoide/diagnóstico , Conducta Paranoide/etnología , Conducta Paranoide/genética , Polimorfismo de Nucleótido Simple/genética , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/etnología , Trastornos del Inicio y del Mantenimiento del Sueño/genética , Adulto JovenRESUMEN
Although delusions represent one of the core symptoms of psychotic disorders, it is remarkable that few studies have investigated distinct delusional themes. We analyzed data from a large sample of first-episode psychosis patients (n=245) to understand relations between delusion types and demographic and clinical correlates. First, we conducted a principal component analysis (PCA) of the 12 delusion items within the Scale for the Assessment of Positive Symptoms (SAPS). Then, using the domains derived via PCA, we tested a priori hypotheses and answered exploratory research questions related to delusional content. PCA revealed five distinct components: Delusions of Influence, Grandiose/Religious Delusions, Paranoid Delusions, Negative Affect Delusions (jealousy, and sin or guilt), and Somatic Delusions. The most prevalent type of delusion was Paranoid Delusions, and such delusions were more common at older ages at onset of psychosis. The level of Delusions of Influence was correlated with the severity of hallucinations and negative symptoms. We ascertained a general relationship between different childhood adversities and delusional themes, and a specific relationship between Somatic Delusions and childhood neglect. Moreover, we found higher scores on Delusions of Influence and Negative Affect Delusions among cannabis and stimulant users. Our results support considering delusions as varied experiences with varying prevalences and correlates.
Asunto(s)
Deluciones/diagnóstico , Deluciones/psicología , Demografía/métodos , Análisis de Componente Principal , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Adolescente , Adulto , Deluciones/epidemiología , Femenino , Alucinaciones/diagnóstico , Alucinaciones/epidemiología , Alucinaciones/psicología , Humanos , Masculino , Conducta Paranoide/diagnóstico , Conducta Paranoide/psicología , Trastornos Psicóticos/epidemiología , Adulto JovenRESUMEN
BACKGROUND: The aim of this study was to adapt and obtain validity evidence of the Spanish Green Paranoid Thought Scales (S-GPTS). METHOD: 191 Spanish people responded to S-GPTS, Peters Delusions Inventory (PDI), and measures of psychopathology. RESULTS: Principal Component Analyses on the polychoric correlation matrix identified two factors accounting for 71.0% of the cumulative variance. Cronbach alphas for S-GPTS total and its subscales were above .90 in clinical and non-clinical group. The value of the area under the receiver operating characteristic curve was higher for the S-GPTS (.898), than for the PDI (.859). The best S-GPTS threshold to discriminate between cases and non-cases was 92 (sensitivity, 97.35%; specificity, 65%). S-GPTS scores positively correlated with PDI and measures of anxiety and depression. CONCLUSION: The S-GPTS has adequate psychometric properties to provide valid measures of delusional ideation in a Spanish population
ANTECEDENTES: el objetivo del presente estudio fue adaptar y obtener evidencias de validez de la versión española de las escalas de pensamiento paranoide de Green (S-GPTS). MÉTODO: 191 participantes españoles respondieron al S-GPTS, al Inventario de Delirios de Peters (PDI) y a medidas de psicopatología.RESULTADOS: el Análisis de Componentes Principales a partir de la matriz de correlaciones policóricas identificó dos factores que explicaban el 71% de la varianza acumulada. El coeficiente α de Cronbach para el S-GPTS y sus subescalas fue superior a .90 en ambos grupos. El valor del área bajo la curva ROC fue más alto para el S-GPTS (.898) que para el PDI (.859). El punto de corte que mejor discriminaba entre el grupo clínico y el no clínico fue 92 (97,35% de sensibilidad, 65% de especificidad). Las puntuaciones del S-GPTS correlacionaron positivamente con el PDI y con medidas de ansiedad y depresión. CONCLUSIONES: el S-GPTS posee propiedades psicométricas adecuadas para proporcionar una medida válida de la ideación delirante en población española
Asunto(s)
Humanos , Masculino , Femenino , Conducta Paranoide/complicaciones , Conducta Paranoide/diagnóstico , Conducta Paranoide/psicología , Psicopatología/educación , Psicopatología/ética , Conducta Paranoide/clasificación , Conducta Paranoide/prevención & control , Psicopatología/historia , Psicopatología , España/etnologíaRESUMEN
BACKGROUND: Research suggested that negative affective-laden sounds act as environmental stressors that elicit negative affect (Bradley and Lang, 2000a). AIMS: We tried to test for the role of an interaction between predisposition to hallucinatory experiences and exposure to negative affective laden sounds for the presence of paranoid ideation. METHOD: We used an experimental design that followed the vulnerability × stress model. We defined three groups from a sample of students: paranoia group vs. social anxiety group vs. control group. Their psychological characteristics were measured through self-reports of paranoia, anxiety, predisposition to hallucinations and depressive symptoms at Time 1 (before the experiment). Participants had to listen to either negative affective laden sounds (e.g. screaming) or positive affective laden sounds (e.g. sound of ocean waves). Their paranoid ideation and positive vs. negative emotional reactions to sounds were measured through self-reports at Time 2 (after the experiment). RESULTS: Data showed that the paranoia group presented more serious psychological vulnerabilities than the social anxiety group. A MANCOVA also showed that the independent variables ("group" and "experimental sound conditions") had statistically significant main effects on general paranoia ideation at Time 2. Furthermore, there was a significant three-way interaction between group x predisposition to hallucinatory experiences × experimental condition of sounds for the presence of general paranoid ideation at Time 2. Limitations included the small sample size and the effects of parasite variables, e.g. noise. CONCLUSIONS: Individuals' predisposition for hallucinatory experiences increases the probability of possessing paranoid ideation. This tendency is a characteristic of paranoid non-clinical individuals.
Asunto(s)
Afecto , Percepción Auditiva , Alucinaciones/diagnóstico , Alucinaciones/psicología , Conducta Paranoide/diagnóstico , Conducta Paranoide/psicología , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/psicología , Adolescente , Nivel de Alerta , Depresión/diagnóstico , Depresión/psicología , Femenino , Humanos , Masculino , Inventario de Personalidad/estadística & datos numéricos , Psicometría/estadística & datos numéricos , Reproducibilidad de los Resultados , Factores de Riesgo , Estrés Psicológico , Estudiantes/psicología , Adulto JovenRESUMEN
En 1915, Kraepelin describe el «delirio paranoide de los sordos y duros de oído» como un cuadro de reacción paranoide que se produce en situaciones de deprivación sensorial, y que asienta sobre una base disposicional o caracterial en sujetos con rasgos de inseguridad. En 1924, el psiquiatra español Sanchís Banús, profundizando en la nosología kraepeliniana, describe una nueva entidad similar que aparece en los ciegos. Se trata de 2 pacientes con ceguera adquirida que, bajo presiones ambientales, desarrollaron ideas delirantes de persecución (uno) y celotípicas (otro), con intentos suicidas en ambos casos y sin antecedentes psicopatológicos previos. El síndrome de Sanchís-Banús (SSB) se incorporará, a partir de aquí, como una entidad nosológica con personalidad propia en los tratados alemanes clásicos (p.ej., Bumke) y en los textos españoles fenomenológicos de referencia (Alonso-Fernández; Barcia, Ruiz-Ogara y López-Ibor Aliño; Barcia). No obstante, resulta llamativa la muy escasa bibliografía existente sobre el SSB en las bases de datos de raíz anglosajona, de forma similar a lo que sucede con el original «delirio paranoide de los sordos» de Kraepelin. Se presenta un caso de «delirio paranoide de los ciegos» o SSB, muy similar en su presentación a los pacientes originales descritos por el psiquiatra español, revisándose la ubicación nosológica del SSB y sus características clínicas y evolutivo-pronósticas a la luz de la bibliografía actual (AU)
In 1915, the «paranoid delusion of the deaf» was described by Kraepelin as a paranoid reaction which appeared in sensory impairment situations. This clinical presentation was based, following Kraepelin, on both the characterial disposition of the person and insecurity personality traits. In 1924, the Spanish psychiatrist Sanchís-Banús, looking further into Kraepelinian nosology, described a similar clinical presentation of paranoid reaction in blind people. Sanchís-Banús focused on two patients who became blind and who, due to environmental stress developed paranoid and jealousy delusional ideas. The patients did not have psychiatric backgrounds, and suicidal attempts were made in both cases. The so-called «Sanchís-Banús syndrome» (SBS) was mentioned in later classical German texts of Psychiatry (e.g., Bumke), and also in phenomenological Spanish books of that period (e.g., Alonso-Fernández; Barcia, Ruiz-Ogara & López-Ibor; Barcia). However, we must emphasize that there are references either SBS or the Kraepelinian «delusion of the deaf» in English language databases. We present a case-report of «paranoid delusion of the blind» (SBS), quite similar in its clinical characteristics to those of the original patients of Sanchís-Banús. The nosological, clinical, and prognostic features of SBS are discussed in light of the current literature (AU)
Asunto(s)
Humanos , Masculino , Femenino , Psiquiatría Biológica/historia , Psiquiatría Biológica/métodos , Psiquiatría Biológica/tendencias , Psiquiatría/historia , Conducta Paranoide/diagnóstico , Trastorno de Personalidad Paranoide/complicaciones , Trastorno de Personalidad Paranoide/diagnóstico , Ceguera/complicaciones , Trastornos Sordoceguera/complicaciones , Personas con Daño Visual/psicología , Trastornos Sordoceguera/psicologíaRESUMEN
OBJECTIVES: Multiple complex developmental disorder (MCDD) is a little-known disorder characterized by disturbances in the regulation of emotions, social interactions and thought disorders. Neither the classification system of ICD-10 nor the DSM-IV lists MCDD as an independent disorder. METHODS: The study presents an overview on diagnostic criteria, current research and illustration by a case report of a 17-year-old adolescent. RESULTS: MCDD, autistic disorders and schizophrenic disorders partially overlap. A clear classification or differentiation is currently not clearly possible. CONCLUSIONS: Many open questions remain, and further research is needed.
Asunto(s)
Trastornos Generalizados del Desarrollo Infantil/diagnóstico , Trastornos Generalizados del Desarrollo Infantil/psicología , Relaciones Interpersonales , Conducta Paranoide/diagnóstico , Conducta Paranoide/psicología , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/psicología , Ajuste Social , Pensamiento , Adolescente , Terapia Conductista , Niño , Trastornos Generalizados del Desarrollo Infantil/clasificación , Trastornos Generalizados del Desarrollo Infantil/terapia , Terapia Combinada , Comorbilidad , Diagnóstico Diferencial , Humanos , Discapacidades para el Aprendizaje/clasificación , Discapacidades para el Aprendizaje/diagnóstico , Discapacidades para el Aprendizaje/psicología , Discapacidades para el Aprendizaje/terapia , Masculino , Conducta Paranoide/clasificación , Conducta Paranoide/terapia , Trastornos Fóbicos/clasificación , Trastornos Fóbicos/terapia , Trastorno de la Personalidad Esquizotípica/clasificación , Trastorno de la Personalidad Esquizotípica/diagnóstico , Trastorno de la Personalidad Esquizotípica/psicología , Trastorno de la Personalidad Esquizotípica/terapiaRESUMEN
Individuals who report psychotic-like experiences are at increased risk of future clinical psychotic disorder. They constitute a unique "high-risk" group for studying the developmental trajectory to schizophrenia and related illnesses. Previous research has used screening instruments to identify this high-risk group, but the validity of these instruments has not yet been established. We administered a screening questionnaire with 7 items designed to assess psychotic-like experiences to 334 adolescents aged 11-13 years. Detailed clinical interviews were subsequently carried out with a sample of these adolescents. We calculated sensitivity and specificity and positive predictive value (PPV) and negative predictive value (NPV) for each screening question for the specific symptom it enquired about and also in relation to any psychotic-like experience. The predictive power varied substantially between items, with the question on auditory hallucinations ("Have you ever heard voices or sounds that no one else can hear?") providing the best predictive power. For interview-verified auditory hallucinations specifically, this question had a PPV of 71.4% and an NPV of 90.4%. When assessed for its predictive power for any psychotic-like experience (including, but not limited to, auditory hallucinations), it provided a PPV of 100% and an NPV of 88.4%. Two further questions-relating to visual hallucinations and paranoid thoughts-also demonstrated good predictive power for psychotic-like experiences. Our results suggest that it may be possible to screen the general adolescent population for psychotic-like experiences with a high degree of accuracy using a short self-report questionnaire.
Asunto(s)
Entrevista Psicológica , Tamizaje Masivo/estadística & datos numéricos , Trastornos Psicóticos/diagnóstico , Adolescente , Niño , Comorbilidad , Deluciones/diagnóstico , Deluciones/psicología , Diagnóstico Precoz , Femenino , Alucinaciones/diagnóstico , Alucinaciones/psicología , Humanos , Irlanda , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Conducta Paranoide/diagnóstico , Conducta Paranoide/psicología , Psicometría/estadística & datos numéricos , Trastornos Psicóticos/psicología , Valores de Referencia , Reproducibilidad de los Resultados , Medición de Riesgo/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
This study has examined bio-socio-demographic and psychopathological factors probably associated with unhealthy eating patterns among university students and to estimate a multifactorial model following the associated factors by gender. Adjusted odds ratios were calculated to describe associations on basis of Eating Disorder Inventory (EDI) stratified by gender in a representative sample of Spanish university students (n = 2551). The high EDI scorers for both sexes presented higher prevalence of dieting, body dissatisfaction, levels of psychopathology and lower self-esteem than the low EDI scorers. The results suggest that older students and higher self-esteem scores present lower scores in the EDI. In the female population, depression, paranoid dimension, dieting and body dissatisfaction were associated with population with unhealthy eating patterns. In the male sample, dieting, body dissatisfaction and interpersonal sensibility were also associated with unhealthy eating patterns. The results corroborate that abnormal eating patterns tend to affect specific vulnerable groups. We do not know the precise mechanisms through which these risk behaviors and attitudes, such as dieting or body dissatisfaction, may facilitate the later development of an eating disorder.
Asunto(s)
Imagen Corporal , Dieta Reductora/psicología , Conducta Alimentaria , Conductas Relacionadas con la Salud , Estudiantes/psicología , Adolescente , Anorexia Nerviosa/diagnóstico , Anorexia Nerviosa/psicología , Ansiedad/diagnóstico , Ansiedad/psicología , Índice de Masa Corporal , Bulimia Nerviosa/diagnóstico , Bulimia Nerviosa/psicología , Depresión/diagnóstico , Depresión/psicología , Ejercicio Físico/psicología , Femenino , Humanos , Relaciones Interpersonales , Masculino , Conducta Paranoide/diagnóstico , Conducta Paranoide/psicología , Inventario de Personalidad/estadística & datos numéricos , Psicometría , Psicopatología , Factores de Riesgo , Autoimagen , Factores Sexuales , España , Adulto JovenRESUMEN
INTRODUCTION: Thought suppression may play a role in the formation and/or maintenance of persecutory delusions, although this possibility has not yet been empirically studied. We investigated thought suppression levels in relation to the presence of persecutory delusion-like beliefs (PDLBs), and hypothesised that only when levels of anxiety or negative affect were high would thought suppression predict levels of PDLBs. METHOD: Thought suppression, anxiety, negative affect, social desirability, and persecutory ideation were assessed in a nonclinical sample (N=183) using online questionnaires. RESULTS: When gender, anxiety, and negative affect were controlled, the interaction between thought suppression and anxiety predicted levels of PDLBs. Further analysis of this interaction showed that thought suppression was positively associated with PDLBs only when anxiety was high. Neither thought suppression by itself, nor the two-way interaction between negative affect and thought suppression, nor the three-way interaction between negative affect, anxiety, and thought suppression, were predictors of PDLB levels. CONCLUSION: The results are consistent with a proposed interaction between thought suppression and anxiety in the development of PDLBs. Possible causal mechanisms underlying this relation are considered further, future research in the area proposed, and potential clinical implications examined.
Asunto(s)
Cultura , Deluciones/psicología , Conducta Paranoide/psicología , Represión Psicológica , Pensamiento , Adolescente , Adulto , Ansiedad/diagnóstico , Ansiedad/psicología , Deluciones/diagnóstico , Depresión/diagnóstico , Depresión/psicología , Femenino , Humanos , Internet , Masculino , Conducta Paranoide/diagnóstico , Inventario de Personalidad/estadística & datos numéricos , Psicometría , Factores Sexuales , Deseabilidad Social , Estudiantes/psicología , Encuestas y CuestionariosRESUMEN
La enfermedad de Huntington (EH) es una afección hereditaria que produce disfunción del núcleo estriado y sus conexiones, caracterizándose clínicamente por la triada de demencia de patrón subcortical sin afasia, movimientos anormales (coreicos) y síntomas psiquiátricos no cognitivos. Estos últimos presentan una prevalencia del 35-70% de los casos, siendo habitual su insuficiente exploración por parte de los clínicos. Asimismo, la bibliografía suele también concentrarse en los movimientos anormales, encontrándose escasamente reflejados los síntomas psiquiátricos no cognitivos: clínica ansiosa o depresiva, obsesivo-compulsiva, maniaca o delirante-alucinatoria (esquizofrenia-like). Los síntomas específicamente psiquiátricos son difíciles de diferenciar de los correspondientes trastornos psiquiátricos idiopáticos, y pueden, ocasionalmente, preceder al deterioro cognitivo y los movimientos anormales. Presentamos un caso de EH con clínica esquizofrenia-like, discutiendo acerca de la importancia de la historia clínica y la anamnesis como pilar fundamental del diagnóstico, que se completa con el estudio genético (número de repeticiones del triplete de bases inestable CAG en el brazo corto del cromosoma 4, que suele correlacionar con el pronóstico). El paciente fue tratado con 20 mg/día de olanzapina, con buena respuesta de los síntomas psiquiátricos y mejoría parcial de los movimientos anormales
Huntingtons Disease (HD) is a heritable disorder related with a striatum nuclei disfunction and also its cortical and subcortical connections. Clinically, HD appears as subcortical dementia without afasia, abnormal movements (chorea) and psychiatric, noncognitive symptoms. The prevalence of psychiatric symptomatology in HD is about 35-70%. However, these clinical features are uncompletely explored by physicians, and their bibliographic references are also scarce: anxiety, depression, maniac-depressive phenomenology and delusionalhallucinatory syndrome (schizophrenia-like). These psychiatric, noncognitive symptoms can be very similar to that corresponding to idiopatic psychiatric diseases, and may also appear at the beginning of HD, preexisting to motor symptoms and dementia. A case-report of HD with schizophrenia-like phenomenology is presented, emphasizing on the importante of anamnesis and clinical history in diagnostic procedure. We complete the diagnosis with the genetic study (number of repetitions of unstable triplet CAG in the short arm of cromosome 4), in order to confirm it and to stablish the prognosis and course of disease. Patient was treated with olanzapine 20 mg/day, showing a good response of psychiatric symptoms and partial improvement of abnormal movements
Asunto(s)
Masculino , Adulto , Humanos , Enfermedad de Huntington/diagnóstico , Enfermedad de Huntington/psicología , Trastornos del Movimiento/complicaciones , Trastornos del Movimiento/psicología , Demencia/complicaciones , Demencia/diagnóstico , Demencia/psicología , Delirio/diagnóstico , Delirio/psicología , Carbamazepina/uso terapéutico , Delirio/complicaciones , Enfermedad de Huntington/complicaciones , Trastornos del Movimiento/diagnóstico , Diagnóstico Diferencial , Delirio/fisiopatología , Conducta Paranoide/diagnóstico , Esquizofrenia Paranoide/psicología , Dibenzazepinas/uso terapéuticoRESUMEN
Borderline personality disorder is a particularly devastating, yet understudied form of psychopathology. One of the most significant gaps in existing knowledge is the lack of systematic, prospective empirical attention to the developmental precursors of borderline personality. The present investigation was an exploratory attempt to address this limitation through (a) development of a psychometrically sound self-report instrument that assesses borderline personality features in childhood, the Borderline Personality Features Scale for Children (BPFS-C); (b) examination of the stability of BPF in childhood; (c) evaluation of gender differences in BPF in childhood; and (d) evaluation of the specificity of the BPFS-C for assessing borderline personality features. These goals were achieved through the prospective study of a normative sample of 400 (54% female) fourth though sixth graders who were assessed during the Fall of Year 1, Spring of Year 1, and Fall of Year 2. The use of linear mixed modeling techniques provided evidence for the construct validity of the BPFS-C. Further, borderline personality features as assessed with the BPFS-C were found to be moderately stable over the course of the study, with girls reporting higher levels of BPF than boys. Results also demonstrated that children's scores on the BPFS-C were uniquely related to indicators of borderline personality pathology above and beyond their scores on the Children's Depression Inventory. The implications of these results for the study of the development and etiology of borderline pathology are discussed.
Asunto(s)
Trastorno de Personalidad Limítrofe/diagnóstico , Agresión/psicología , Trastorno de Personalidad Limítrofe/psicología , Niño , Depresión/diagnóstico , Depresión/psicología , Emociones , Femenino , Amigos/psicología , Hostilidad , Humanos , Estudios Longitudinales , Masculino , Apego a Objetos , Conducta Paranoide/diagnóstico , Conducta Paranoide/psicología , Inventario de Personalidad/estadística & datos numéricos , Psicometría/estadística & datos numéricos , Reproducibilidad de los Resultados , Factores Sexuales , Ajuste SocialRESUMEN
En esta segunda parte, se han aplicado las directrices sartreanas a la clínica psiquiátrica; en concreto a los cuadros paranoides psicóticos y, más tarde, a las "actitudes paranoides" de los neuróticos. En ambos casos, hemos obtenido resultados que definen bastante bien los dos procesos, pero también se ha logrado aportar nuevos datos en relación a una clara diferenciación entre neurosis y psicosis. Lo aquí hallado nos resulta muy importante por dos razones: a) porque frecuentemente se asiste a atribuciones de aspectos psicológicos diversos que son claramente neuróticos a los paranoicos (psicóticos), como es el caso de: inferioridad, inseguridad, indecisión, falta de autoestima, etc.; y b) que una diferenciación clara puede influir decisivamente sobre nuestras actuaciones, definiendo mejor qué podemos hacer en cada caso (AU)
Asunto(s)
Conducta Paranoide/diagnóstico , Conducta Paranoide/fisiopatología , Conducta Paranoide/psicología , Filosofía Médica , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Fantasía , Imaginación/fisiología , Conciencia , Trastornos Neuróticos/fisiopatología , Trastornos Neuróticos/psicología , Trastornos Neuróticos/complicaciones , Trastornos Paranoides/psicología , Autoimagen , Imaginación/fisiología , Delirio/diagnóstico , Delirio/psicología , Delirio/complicaciones , Psicopatología/métodos , Psicopatología/organización & administración , Psicopatología/tendencias , Trastornos Fóbicos/psicología , Conducta Obsesiva/psicología , Histeria/complicaciones , Histeria/psicologíaRESUMEN
The aim of this fiction psychiatric article, is to take a psychiatric look to El Quijote and to determine his strange and fascinating madness. His symptoms are analyzed as those of any patient and the conclusion is that he had a pre senile paranoia. This diagnosis, that gratifies clinicians curiosity, says nothing about the charm of his unusual mental profile or the captivating fascination of his nobility and poetry
Asunto(s)
Conducta Paranoide/diagnóstico , Medicina en la Literatura , Delirio/diagnóstico , Personajes , Fantasía , Literatura Medieval , Trastornos Psicóticos/diagnósticoAsunto(s)
Deluciones/diagnóstico , Demencia/diagnóstico , Conducta Paranoide/diagnóstico , Actividades Cotidianas , Anciano , Terapia Conductista , Deluciones/psicología , Deluciones/terapia , Demencia/psicología , Demencia/terapia , Humanos , Conducta Paranoide/psicología , Conducta Paranoide/terapia , Relaciones Médico-Paciente , Prueba de Realidad , Aislamiento Social , Resultado del TratamientoRESUMEN
OBJECTIVE: Determine whether spurious SCL 90-R profiles resulting from endorsement of neurologic treatment items can be corrected and still retain ecological validity. DESIGN: The proportion of subjects' item endorsement was compared with the adult non-patient norm group. Items with discriminative power (chi 2 > 25, p < 0.001 and endorsement by at least 25% of subjects) underwent principal-components analysis with somatic treatment and psychiatric factors identified. Items in the somatic treatment factor were extracted as the corrective factor. The resultant corrected T scores were plotted against original SCL 90-R profiles. SETTING: University medical centre. PATIENTS: Thirty community dwelling adults with biopsy confirmed malignant brain tumours referred by their treating physician for evaluation prior to aggressive treatment. INTERVENTIONS: The SCL 90-R was part of a neuropsychological test battery. MAIN OUTCOME MEASURE: The SCL 90-R was selected prior to data collection because it is the second most frequently used psychosocial instrument in medical settings, yet has demonstrated attenuated validity with neurologic patients. RESULTS: Extraction of 10 somatic treatment items resulted in lower profiles on Somatization, OBSESSIVE: Compulsive, Depression, and Anxiety dimensions and the global indicators. However, clinical caseness for individuals remained greater than indicated by clinical interview. CONCLUSION: Correction for SCL 90-R neurologic treatment items resulted in reduced sensitivity and poorer ecological validity.