Pub Date : 2023-04-01DOI: 10.1016/j.rcpeng.2021.07.004
Daniel R. Martínez
Introduction
The publication of Hecker's article on hebephrenia in 1871 was a fundamental milestone for clinical psychiatry. Despite the initial recognition, many voices were raised against this diagnostic category and its limits were attenuated throughout the 20th century until its disappearance at the beginning of this century (along with the other subtypes of schizophrenia) in the DSM and ICD.
Discussion
However, given the consistency of the clinical picture, there is the possibility of other criteria emerging that would lead its systematic study to continue or recommence. In this sense, the concepts of deficit schizophrenia, hebephrenia as a replacement for schizophrenia as a whole, and Leonhard's hebephrenias as systematic schizophrenias stand out. This article discusses the main diagnostic conflicts of the category of hebephrenia over time, with emphasis on the problems of recent decades.
Conclusions
The concept of hebephrenia has begun to be revalued in recent years, and the concepts of deficit schizophrenia, of hebephrenia as a major category, and of systematic hebephrenias allow further investigation of this foundational picture of clinical psychiatry.
{"title":"One hundred and fifty years of hebephrenia. A review","authors":"Daniel R. Martínez","doi":"10.1016/j.rcpeng.2021.07.004","DOIUrl":"10.1016/j.rcpeng.2021.07.004","url":null,"abstract":"<div><h3>Introduction</h3><p><span>The publication of Hecker's article on hebephrenia in 1871 was a fundamental milestone for </span>clinical psychiatry. Despite the initial recognition, many voices were raised against this diagnostic category and its limits were attenuated throughout the 20th century until its disappearance at the beginning of this century (along with the other subtypes of schizophrenia) in the DSM and ICD.</p></div><div><h3>Discussion</h3><p>However, given the consistency of the clinical picture, there is the possibility of other criteria emerging that would lead its systematic study to continue or recommence. In this sense, the concepts of deficit schizophrenia, hebephrenia as a replacement for schizophrenia as a whole, and Leonhard's hebephrenias as systematic schizophrenias stand out. This article discusses the main diagnostic conflicts of the category of hebephrenia over time, with emphasis on the problems of recent decades.</p></div><div><h3>Conclusions</h3><p>The concept of hebephrenia has begun to be revalued in recent years, and the concepts of deficit schizophrenia, of hebephrenia as a major category, and of systematic hebephrenias allow further investigation of this foundational picture of clinical psychiatry.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 139-145"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9884035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1016/j.rcpeng.2021.04.004
Diego Fernando Alarcón Ariza , Laura Cristina Zambrano Jerez , Carlos Enrique Ramírez Rivero , Jorge Andrés Niño García , Adriana Catalina Ruiz Quecan , Gonzalo Andrés Domínguez Alvarado
Introduction
Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental disorder. This case is the first case of burn injuries reported in the context of this disorder.
Case
We describe a young couple, with a similar pattern of burns caused by contact with a griddle. The injuries are the result of the aggression caused by a relative of one of them, who presented psychotic symptoms, related to the previously undiagnosed spectrum of schizophrenia.
Conclusions
The impact of this condition encompasses social, physical and psychological components, requiring multidisciplinary management and a high index of diagnostic suspicion.
{"title":"Burns in the context of a shared psychotic disorder in a Colombian referral centre: A case report","authors":"Diego Fernando Alarcón Ariza , Laura Cristina Zambrano Jerez , Carlos Enrique Ramírez Rivero , Jorge Andrés Niño García , Adriana Catalina Ruiz Quecan , Gonzalo Andrés Domínguez Alvarado","doi":"10.1016/j.rcpeng.2021.04.004","DOIUrl":"10.1016/j.rcpeng.2021.04.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental disorder. This case is the first case of burn injuries reported in the context of this disorder.</p></div><div><h3>Case</h3><p>We describe a young couple, with a similar pattern of burns caused by contact with a griddle. The injuries are the result of the aggression caused by a relative of one of them, who presented psychotic symptoms, related to the previously undiagnosed spectrum of schizophrenia.</p></div><div><h3>Conclusions</h3><p>The impact of this condition encompasses social, physical and psychological components, requiring multidisciplinary management and a high index of diagnostic suspicion.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 156-160"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1016/j.rcpeng.2021.01.003
Paula Robledo-Rengifo , Juan David Palacio-Ortiz , Jenny García-Valencia , Cristian Vargas-Upegui
Introduction
Bipolar disorder (BD) has been associated with a decrease in white matter integrity. Diffusion tensor imaging (DTI) studies have enabled these changes to be elucidated with higher quality. Due to BD’s high heritability, some studies have been conducted in relatives of BD patients looking at white matter integrity, and have found that structural connectivity may also be affected. This alteration has been proposed as a potential BD biomarker of vulnerability. However, there are few studies in children and adolescents.
Objective
To conduct a review of the literature on changes in white matter integrity determined by DTI in high-risk children and adolescents.
Results
Brain structural connectivity in the paediatric population is described in studies using DTI. Changes in the myelination process from its evolution within normal neurodevelopment to the findings in fractional anisotropy (FA) in BD patients and their high-risk relatives are also described.
Conclusions
Studies show that both BD patients and their at-risk relatives present a decrease in FA in specific brain regions. Studies in children and adolescents with a high risk of BD, indicate a reduced FA in axonal tracts involved in emotional and cognitive functions. Decreased FA can be considered as a vulnerability biomarker for BD.
{"title":"Is structural connectivity different in child and adolescent relatives of patients with bipolar disorder? A narrative review according to studies with DTI","authors":"Paula Robledo-Rengifo , Juan David Palacio-Ortiz , Jenny García-Valencia , Cristian Vargas-Upegui","doi":"10.1016/j.rcpeng.2021.01.003","DOIUrl":"10.1016/j.rcpeng.2021.01.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Bipolar disorder<span><span> (BD) has been associated with a decrease in white matter integrity. Diffusion tensor imaging (DTI) studies have enabled these changes to be elucidated with higher quality. Due to BD’s high </span>heritability, some studies have been conducted in relatives of BD patients looking at white matter integrity, and have found that structural connectivity may also be affected. This alteration has been proposed as a potential BD biomarker of vulnerability. However, there are few studies in children and adolescents.</span></p></div><div><h3>Objective</h3><p>To conduct a review of the literature on changes in white matter integrity determined by DTI in high-risk children and adolescents.</p></div><div><h3>Results</h3><p><span>Brain structural connectivity in the paediatric population is described in studies using DTI. Changes in the </span>myelination<span><span> process from its evolution within normal neurodevelopment to the findings in </span>fractional anisotropy (FA) in BD patients and their high-risk relatives are also described.</span></p></div><div><h3>Conclusions</h3><p>Studies show that both BD patients and their at-risk relatives present a decrease in FA in specific brain regions. Studies in children and adolescents with a high risk of BD, indicate a reduced FA in axonal tracts involved in emotional and cognitive functions. Decreased FA can be considered as a vulnerability biomarker for BD.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 146-155"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9878600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1016/j.rcpeng.2021.04.007
Sebastián León-Giraldo , Germán Casas , Juan Sebastián Cuervo-Sánchez , Tatiana García , Catalina González-Uribe , Rodrigo Moreno-Serra , Oscar Bernal
Background and objectives
Colombia is one of the countries with the highest levels of internal displacement resulting from armed conflict. This population has greater chances of experiencing a mental health disorder, especially in territories historically affected by armed conflict. Our objective was to compare the levels of possible mental health disorder in people experiencing internal displacement in Meta, Colombia, a department historically affected by armed conflict, compared to the internally displaced population in the National Mental Health Survey of 2015.
Methods
Analysis of data collected in the National Mental Health Survey (ENSM) of 2015, study with representative data at national level and the Conflict, Peace and Health survey (CONPAS) of 2014, representative study of the degree of impact of the conflict on the municipality, conducted in the department of Meta, Colombia. To measure possible mental health disorder, the Self-Report Questionnaire-25 (SRQ-25) was used. Internal displacement is self-reported by people surveyed in both studies. An exploratory analysis is used to measure possible mental health disorders in the displaced population in the ENSM 2015 and CONPAS 2014.
Results
1089 adults were surveyed in CONPAS 2014 and 10,870 adults were surveyed in the ENSM 2015. 42.9% (468) and 8.7% (943) of people reported being internally displaced in CONPAS 2014 and ENSM 2015, respectively. In both studies, internally displaced populations have greater chances of experiencing any mental health disorder compared to non-displaced populations. For CONPAS 2014, 21.8% (95%CI, 18.1−25.8) of this population had a possible mental health disorder (SRQ+) compared to 14.0% (95%CI, 11.8−16.3) in the ENSM 2015. Compared with the ENSM 2015, at the regional level (CONPAS 2014), displaced people had a greater chance of presenting depression by 12.4% (95%CI, 9.5−15.7) compared to 5.7% (95%CI, 4.3−7.4) in the ENSM 2015, anxiety in 21.4% (95%CI, 17.7−25.3) compared to 16.5% (95%CI, 14.2−19.1) in the ENSM 2015, and psychosomatic disorders in 52.4% (95%CI, 47.5−56.7) in CONPAS 2014 compared to 42.2% (95%CI, 39.0−45.4) in the ENSM 2015. At the national level (ENSM 2015), displaced people had greater possibilities of presenting, compared to the regional level, suicidal ideation in 11.9% (95%CI, 9.3–14.1) compared to 7.3% (95%CI, 5.0−10.0) in CONPAS 2014 and bipolar disorder in 56.5% (95%CI, 53.2−59.7) compared to 39.3% (95%CI, 34.8−43.9) in CONPAS 2014.
Conclusions
The greater possibilities of displaced populations at the regional level of experiencing a mental health disorder, compared to this same population at the national level, may represent and indicate greater needs in mental health care services in territories affected by conflict. Therefore, and given the need to facilitate access to health services in mental health for populations especially affecte
{"title":"Mental health disorders in population displaced by conflict in Colombia: Comparative analysis against the National Mental Health Survey 2015","authors":"Sebastián León-Giraldo , Germán Casas , Juan Sebastián Cuervo-Sánchez , Tatiana García , Catalina González-Uribe , Rodrigo Moreno-Serra , Oscar Bernal","doi":"10.1016/j.rcpeng.2021.04.007","DOIUrl":"10.1016/j.rcpeng.2021.04.007","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Colombia is one of the countries with the highest levels of internal displacement resulting from armed conflict. This population has greater chances of experiencing a mental health disorder, especially in territories historically affected by armed conflict. Our objective was to compare the levels of possible mental health disorder in people experiencing internal displacement in Meta, Colombia, a department historically affected by armed conflict, compared to the internally displaced population in the National Mental Health Survey of 2015.</p></div><div><h3>Methods</h3><p>Analysis of data collected in the National Mental Health Survey (ENSM) of 2015, study with representative data at national level and the Conflict, Peace and Health survey (CONPAS) of 2014, representative study of the degree of impact of the conflict on the municipality, conducted in the department of Meta, Colombia. To measure possible mental health disorder, the Self-Report Questionnaire-25 (SRQ-25) was used. Internal displacement is self-reported by people surveyed in both studies. An exploratory analysis is used to measure possible mental health disorders in the displaced population in the ENSM 2015 and CONPAS 2014.</p></div><div><h3>Results</h3><p><span>1089 adults were surveyed in CONPAS 2014 and 10,870 adults were surveyed in the ENSM 2015. 42.9% (468) and 8.7% (943) of people reported being internally displaced in CONPAS 2014 and ENSM 2015, respectively. In both studies, internally displaced populations have greater chances of experiencing any mental health disorder compared to non-displaced populations. For CONPAS 2014, 21.8% (95%CI, 18.1−25.8) of this population had a possible mental health disorder (SRQ+) compared to 14.0% (95%CI, 11.8−16.3) in the ENSM 2015. Compared with the ENSM 2015, at the regional level (CONPAS 2014), displaced people had a greater chance of presenting depression by 12.4% (95%CI, 9.5−15.7) compared to 5.7% (95%CI, 4.3−7.4) in the ENSM 2015, anxiety in 21.4% (95%CI, 17.7−25.3) compared to 16.5% (95%CI, 14.2−19.1) in the ENSM 2015, and psychosomatic disorders in 52.4% (95%CI, 47.5−56.7) in CONPAS 2014 compared to 42.2% (95%CI, 39.0−45.4) in the ENSM 2015. At the national level (ENSM 2015), displaced people had greater possibilities of presenting, compared to the regional level, suicidal ideation in 11.9% (95%CI, 9.3–14.1) compared to 7.3% (95%CI, 5.0−10.0) in CONPAS 2014 and </span>bipolar disorder in 56.5% (95%CI, 53.2−59.7) compared to 39.3% (95%CI, 34.8−43.9) in CONPAS 2014.</p></div><div><h3>Conclusions</h3><p>The greater possibilities of displaced populations at the regional level of experiencing a mental health disorder, compared to this same population at the national level, may represent and indicate greater needs in mental health care services in territories affected by conflict. Therefore, and given the need to facilitate access to health services in mental health for populations especially affecte","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 121-129"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1016/j.rcpeng.2021.07.003
Yéssica P. López-Echeverri, Kelly J. Cardona-Londoño, Jhonny F. Garcia-Aguirre, Mary Orrego-Cardozo
Introduction
Serotonin is highly implicated in the regulation of emotional state and the execution of cognitive tasks, so much so that the serotonin transporter genes (5-HTT, SLC6A4) and the serotonin receptor genes (HTR1A, HTR1B, HTR2A) have become the perfect candidates when studying the effects that these genes and their polymorphic variations have on depression characteristics.
Objective
A review of research reports that have studied the effects of variations in the serotonin transporter and receptor genes on different clinical features of depression.
Methods
A search of the Scopus, Web of Science and PubMed databases was conducted using the keywords ("depression" AND "polymorphism").
Conclusions
According to the review of 54 articles, the short allele of the 5-HTTLPR polymorphism was found to be the most reported risk factor related to the development of depression and its severity. Variations in the genes studied (SLC6A4, HTR1A, HTR2A) can generate morphological alterations of brain structures.
引言血清素与情绪状态的调节和认知任务的执行密切相关，因此血清素转运蛋白基因（5-HTT、SLC6A4）和血清素受体基因（HTR1A、HTR1B、HTR2A）已成为研究这些基因及其多态性变异对抑郁症特征影响的完美候选者。目的综述研究血清素转运蛋白和受体基因变异对抑郁症不同临床特征的影响的研究报告。方法检索Scopus、Web of Science和PubMed数据库，关键词为“抑郁症”和“多态性”。所研究的基因（SLC6A4、HTR1A、HTR2A）的变异可以引起大脑结构的形态学改变。
{"title":"Effects of serotonin transporter and receptor polymorphisms on depression","authors":"Yéssica P. López-Echeverri, Kelly J. Cardona-Londoño, Jhonny F. Garcia-Aguirre, Mary Orrego-Cardozo","doi":"10.1016/j.rcpeng.2021.07.003","DOIUrl":"10.1016/j.rcpeng.2021.07.003","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Serotonin is highly implicated in the regulation of emotional state and the execution of cognitive tasks, so much so that the serotonin transporter genes </span><em>(5-HTT, SLC6A4)</em><span> and the serotonin receptor genes </span><em>(HTR1A, HTR1B, HTR2A)</em> have become the perfect candidates when studying the effects that these genes and their polymorphic variations have on depression characteristics.</p></div><div><h3>Objective</h3><p>A review of research reports that have studied the effects of variations in the serotonin transporter and receptor genes on different clinical features of depression.</p></div><div><h3>Methods</h3><p>A search of the Scopus, Web of Science and PubMed databases was conducted using the keywords (\"depression\" AND \"polymorphism\").</p></div><div><h3>Conclusions</h3><p>According to the review of 54 articles, the short allele of the <em>5-HTTLPR</em> polymorphism was found to be the most reported risk factor related to the development of depression and its severity. Variations in the genes studied <em>(SLC6A4, HTR1A, HTR2A)</em> can generate morphological alterations of brain structures.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 130-138"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9884039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1016/j.rcpeng.2021.02.008
Carla Aparecida Arena Ventura , Bruna Sordi Carrara , Iracema Da Silva Frazão , Samira Janis Eugênio , Stefany Guimarães de Ávila Domingos , Paulo Sergio Ferreira
This research described the perspective of illicit drug users regarding illicit drug use prevention initiatives. The study used a convergent parallel mixed methods design, combining quantitative and qualitative methods. In the quantitative component of the study, 111 subjects from a psychosocial care centre (CAPS-AD). The qualitative data were collected through semi-structured interviews with 11 subjects who were selected from among the participants and who declared themselves to be personally affected as being or having been illicit drugs users. From the perspective of drug users, the results pointed out different prevention initiatives and the institutions that should be responsible for them. For preventive actions to be successful, they must be intersectoral and involve government, community and families.
{"title":"Prevention of Illicit Drug use from the Users’ Perspective","authors":"Carla Aparecida Arena Ventura , Bruna Sordi Carrara , Iracema Da Silva Frazão , Samira Janis Eugênio , Stefany Guimarães de Ávila Domingos , Paulo Sergio Ferreira","doi":"10.1016/j.rcpeng.2021.02.008","DOIUrl":"10.1016/j.rcpeng.2021.02.008","url":null,"abstract":"<div><p>This research described the perspective of illicit drug<span> users regarding illicit drug<span> use prevention initiatives. The study used a convergent parallel mixed methods design, combining quantitative and qualitative methods. In the quantitative component of the study, 111 subjects from a psychosocial care centre (CAPS-AD). The qualitative data were collected through semi-structured interviews with 11 subjects who were selected from among the participants and who declared themselves to be personally affected as being or having been illicit drugs users. From the perspective of drug users, the results pointed out different prevention initiatives and the institutions that should be responsible for them. For preventive actions to be successful, they must be intersectoral and involve government, community and families.</span></span></p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 93-100"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1016/j.rcpeng.2021.04.008
Francesco Monteleone , Márcia Gonçalves , Luís Fonseca , Sónia Simões , Andreia Gonçalves , Eduarda Machado , João Fonseca
Introduction
Clozapine is an atypical antipsychotic drug eligible for treatment-resistant schizophrenia. It frequently represents the best and the only choice in resistant schizophrenia. However, its use is feared by many professionals due to its possible adverse effects, such as eosinophilia.
Case report
We report a case of a young white male suffering from treatment-resistant schizophrenia who rapidly developed eosinophilia after starting clozapine.
Discussion
We present a case of a 26-year-old white man diagnosed with schizophrenia with poor clinical response to several antipsychotics owing to which clozapine was started. Psychotic symptoms improved dramatically but a progressively ascendant eosinophilia was reported during serial haematological analyses. The patient remained physically asymptomatic. An exhaustive assessment with ancillary diagnostic tests revealed no cause for eosinophilia. Thus, a diagnosis of clozapine-induced eosinophilia was made. The drug was discontinued and eosinophil count progressively returned to normal but psychotic symptoms worsened.
Conclusions
Clozapine treatment is frequently feared due to its possible side effects and complications, delaying its use in refractory schizophrenia. Also, to our knowledge, there are no specific guidelines on how to manage haematological side effects such as eosinophilia. This is problematic as, in some cases, it may lead to an unnecessary withdrawal of clozapine with a worsening of psychotic symptoms. We present a brief discussion of the recent literature on the subject.
{"title":"Clozapine-Induced Eosinophilia: a Case Report","authors":"Francesco Monteleone , Márcia Gonçalves , Luís Fonseca , Sónia Simões , Andreia Gonçalves , Eduarda Machado , João Fonseca","doi":"10.1016/j.rcpeng.2021.04.008","DOIUrl":"10.1016/j.rcpeng.2021.04.008","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Clozapine is an atypical antipsychotic </span>drug<span> eligible for treatment-resistant schizophrenia. It frequently represents the best and the only choice in resistant schizophrenia. However, its use is feared by many professionals due to its possible adverse effects, such as eosinophilia.</span></p></div><div><h3>Case report</h3><p>We report a case of a young white male suffering from treatment-resistant schizophrenia who rapidly developed eosinophilia after starting clozapine.</p></div><div><h3>Discussion</h3><p><span>We present a case of a 26-year-old white man diagnosed with schizophrenia with poor clinical response to several antipsychotics owing to which clozapine was started. Psychotic symptoms improved dramatically but a progressively ascendant eosinophilia was reported during serial haematological analyses. The patient remained physically asymptomatic. An exhaustive assessment with ancillary diagnostic tests revealed no cause for eosinophilia. Thus, a diagnosis of clozapine-induced eosinophilia was made. The drug was discontinued and </span>eosinophil count progressively returned to normal but psychotic symptoms worsened.</p></div><div><h3>Conclusions</h3><p>Clozapine treatment is frequently feared due to its possible side effects and complications, delaying its use in refractory schizophrenia. Also, to our knowledge, there are no specific guidelines on how to manage haematological side effects such as eosinophilia. This is problematic as, in some cases, it may lead to an unnecessary withdrawal of clozapine with a worsening of psychotic symptoms. We present a brief discussion of the recent literature on the subject.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 161-164"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Electroconvulsive therapy is an effective and safe procedure, which is indicated mainly in patients with both unipolar and bipolar depressive episodes, mania and schizophrenia, when they do not respond to other treatments.
Objective
To describe the demographic, social and clinical properties of a group of patients treated with electroconvulsive therapy (ECT) with anaesthetic and muscular relaxant at the Universidad de La Sabana Clinic for a period of 8 years.
Methods
The databases and records of the procedures were reviewed from 1 January 2009 to 31 December 2017. An analysis was performed with descriptive statistics.
Results
In this period, 1322 procedures were performed on 143 patients (54.5% women) with an associated diagnosis of major depression in 57%. The number of treatments per person was 9.2 and complications occurred in 3.8%, without any of them requiring invasive management.
Conclusions
Electroconvulsive therapy is performed safely in patients and with different parameters in terms of age, gender and diagnosis, in comparison to other countries in Latin America and the world. It is important to join efforts in research that allow a more complete overview of the characteristics of its application in the country.
{"title":"Clinical experience of electroconvulsive therapy with anaesthetic and muscle relaxant at the Clínica Universidad de La Sabana: 2009–2017","authors":"Ángela Rocío Acero González , Yahira Rossini Guzmán Sabogal , Hollman Salamanca Dimas , Verónica Páez Avendaño , Erika Pineda Carrascal , Juliana Izquierdo Polanco , Alejandra Ayala Escudero","doi":"10.1016/j.rcpeng.2021.01.004","DOIUrl":"10.1016/j.rcpeng.2021.01.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Electroconvulsive therapy<span> is an effective and safe procedure, which is indicated mainly in patients<span> with both unipolar and bipolar depressive episodes, mania and schizophrenia, when they do not respond to other treatments.</span></span></p></div><div><h3>Objective</h3><p>To describe the demographic, social and clinical properties of a group of patients treated with electroconvulsive therapy (ECT) with anaesthetic and muscular relaxant at the Universidad de La Sabana Clinic for a period of 8 years.</p></div><div><h3>Methods</h3><p>The databases and records of the procedures were reviewed from 1 January 2009 to 31 December 2017. An analysis was performed with descriptive statistics.</p></div><div><h3>Results</h3><p>In this period, 1322 procedures were performed on 143 patients (54.5% women) with an associated diagnosis of major depression in 57%. The number of treatments per person was 9.2 and complications occurred in 3.8%, without any of them requiring invasive management.</p></div><div><h3>Conclusions</h3><p>Electroconvulsive therapy is performed safely in patients and with different parameters in terms of age, gender and diagnosis, in comparison to other countries in Latin America and the world. It is important to join efforts in research that allow a more complete overview of the characteristics of its application in the country.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 101-106"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antipsychotics are drugs that can produce transient elevations of hepatic enzymes. Clozapine is an atypical antipsychotic used in treatment-resistant schizophrenia and there is evidence that it can produce elevations of hepatic transaminases, expression of liver damage in a hepatocellular pattern.
Methods
Case report and non-systematic review of the relevant literature.
Case presentation
A 39-year-old woman with a diagnosis of paranoid schizophrenia attended the emergency department of a general hospital for nausea, vomiting and jaundice that appeared after the initiation of clozapine. There was no clinical improvement during hospitalisation, and death occurred after 44 days.
Literature review
Clozapine can increase the liver enzyme levels transiently and asymptomatically; however, there are clinical criteria that recommend the withdrawal of the antipsychotic.
Conclusions
This is the third case reported in the literature of a fatal outcome of clozapine-induced hepatotoxicity.
{"title":"Hepatoxicity induced by clozapine: Case report and brief review","authors":"Joshep Revilla-Zúñiga , Joise Cornejo-Del Carpio , Lizardo Cruzado","doi":"10.1016/j.rcpeng.2021.04.005","DOIUrl":"10.1016/j.rcpeng.2021.04.005","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Antipsychotics are </span>drugs<span><span> that can produce transient elevations of hepatic enzymes<span>. Clozapine is an atypical antipsychotic used in treatment-resistant schizophrenia and there is evidence that it can produce elevations of hepatic </span></span>transaminases, expression of liver damage in a hepatocellular pattern.</span></p></div><div><h3>Methods</h3><p>Case report and non-systematic review of the relevant literature.</p></div><div><h3>Case presentation</h3><p><span>A 39-year-old woman with a diagnosis of paranoid schizophrenia attended the </span>emergency department of a general hospital for nausea, vomiting and jaundice that appeared after the initiation of clozapine. There was no clinical improvement during hospitalisation, and death occurred after 44 days.</p></div><div><h3>Literature review</h3><p>Clozapine can increase the liver enzyme levels transiently and asymptomatically; however, there are clinical criteria that recommend the withdrawal of the antipsychotic.</p></div><div><h3>Conclusions</h3><p>This is the third case reported in the literature of a fatal outcome of clozapine-induced hepatotoxicity.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 165-170"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1016/j.rcpeng.2021.04.006
Jennifer Vilchez-Cornejo , Luccio Romani , Saraí Chávez-Bustamante , César Copaja-Corzo , Juan C. Sánchez-Vicente , Ronald David Viera-Morón , Benggi Ocampo-Portocarrero
Objective
To determine the factors associated with impostor syndrome in medical students from six regions of Peru.
Material and methods
A multicentre, cross-sectional study was conduced on students from first to the sixth year in six Peruvian regions. Sociodemographic, academic, and psychological characteristics were included through the Depression, Anxiety, and Stress Scale-21, the Rosenberg Self-Esteem Scale and the Clance Imposter Phenomenon Scale. Generalised linear models were performed using crude and adjusted estimated prevalence ratios.
Results
Of 2,231 medical students, 54.3% were female and 30.6% had the impostor phenomenon. An association was found between the PI and those who suffered from depression (aPR = 1.51; 95%CI, 1.27–1.79), anxiety (aPR = 2.25; 95%CI, 1.75–2.90), stress (aPR = 1.37; 95%CI, 1.19–1.57), and being female (aPR = 1.12; 95%CI, 1.01–1.26).
Conclusions
Three out of 10 medical students suffer from PI; having some level of depression, anxiety, stress, being a woman, and/or attending the fourth academic year were predisposing factors for their development.
{"title":"Imposter syndrome and its associated factors in medical students in six Peruvian faculties","authors":"Jennifer Vilchez-Cornejo , Luccio Romani , Saraí Chávez-Bustamante , César Copaja-Corzo , Juan C. Sánchez-Vicente , Ronald David Viera-Morón , Benggi Ocampo-Portocarrero","doi":"10.1016/j.rcpeng.2021.04.006","DOIUrl":"10.1016/j.rcpeng.2021.04.006","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the factors associated with impostor syndrome in medical students from six regions of Peru.</p></div><div><h3>Material and methods</h3><p>A multicentre, cross-sectional study was conduced on students from first to the sixth year in six Peruvian regions. Sociodemographic, academic, and psychological characteristics were included through the Depression, Anxiety, and Stress Scale-21, the Rosenberg Self-Esteem Scale and the Clance Imposter Phenomenon Scale. Generalised linear models were performed using crude and adjusted estimated prevalence ratios.</p></div><div><h3>Results</h3><p>Of 2,231 medical students, 54.3% were female and 30.6% had the impostor phenomenon. An association was found between the PI and those who suffered from depression (aPR<!--> <!-->=<!--> <!-->1.51; 95%CI, 1.27–1.79), anxiety (aPR<!--> <!-->=<!--> <!-->2.25; 95%CI, 1.75–2.90), stress (aPR<!--> <!-->=<!--> <!-->1.37; 95%CI, 1.19–1.57), and being female (aPR<!--> <!-->=<!--> <!-->1.12; 95%CI, 1.01–1.26).</p></div><div><h3>Conclusions</h3><p>Three out of 10 medical students suffer from PI; having some level of depression, anxiety, stress, being a woman, and/or attending the fourth academic year were predisposing factors for their development.</p></div>","PeriodicalId":74702,"journal":{"name":"Revista Colombiana de psiquiatria (English ed.)","volume":"52 2","pages":"Pages 113-120"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9884038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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