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Obra completa. Del psicoanálisis a la psicología social. 全集。从精神分析到社会心理学。
Pub Date : 2024-04-10
Juan Carlos Stagnaro

Reseña de la obra completa de Enrique Pichon-Rivière. Del psicoanálisis a la psicología social, 1967-1977. Establecimiento, Introducción y Notas: Fernando Fabris, con la colaboración de Joaquín Pichon-Rivière. Paidós, 2023.

恩里克-皮雄-里维埃尔全集》评论。从精神分析到社会心理学,1967-1977 年。建立、介绍和注释:费尔南多-法布里斯(Fernando Fabris),华金-皮雄-里维埃尔(Joaquín Pichon-Rivière)合作。Paidós, 2023.
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引用次数: 0
Índice. Índice.
Pub Date : 2024-04-10
Comité de Redacción
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引用次数: 0
Evaluative research of a mental health urgences protocol for the primary care level 对一级护理中的精神健康紧急情况协议进行评估研究。
Pub Date : 2024-04-10 DOI: 10.53680/vertex.v35i163.523
Julia Martin, Julieta L De Battista, Nicolás A Maugeri, Maximiliano Azcona

Introducción: Materiales y métodos: Resultados:

Introduction: This research stems from certain obstacles in the implementation of the National Mental Health Law, especially at the primary care level and regarding emergency management, with or without certain and imminent risk. The scarcity of mental health intervention protocols and the perception that they could limit the clinical understandingof each critical situation are challenges identified in practice. However, protocols can be valuable organizational tools in complex circumstances. The literature emphasizes the need to accompany their implementation with training to prevent exclusively bureaucratic and dehumanized approaches.

Materials and methods: The purpose of this work was to address this gap, by developing an emergency mental health action protocol and training for first-level healthcare personnel in a territory of the metropolitan area of Buenos Aires. The research aimed to evaluate its effectiveness. Qualitative and quantitative methods were used to characterize interventions before the protocol's implementation, comparing them with those after training and protocol application.

Results: It was found that this device facilitated more appropriate responses in critical contexts and improved knowledge about resolution strategies that can be implemented within the framework of the National Mental Health Law. Additionally, it strengthened protective factors for the mental health of healthcare workers, such as the possibility to access to a strategy that aids in task organization, and teamwork.

导言:这项研究的出发点是《国家心理健康法》在实施过程中遇到的一些障碍,尤其是在一级护理和紧急状况管理方面,无论是否存在确定和迫在眉睫的风险。心理健康干预规程的缺乏,以及认为这些规程可能会限制对每种危急情况的单独解读,都是在实践中发现的挑战。然而,在复杂的情况下,协议可以成为有价值的组织工具。文献强调,在实施协议的同时,还需要进行培训,以避免完全官僚化和非人性化的方法。材料与方法:为了弥补这一不足,我们开展了这项研究,制定了精神健康紧急情况下的行动规程,并对布宜诺斯艾利斯大都会地区的一级医疗机构的医务人员进行了相应的培训。研究的目的是评估其有效性。研究采用了定性和定量相结合的方法,对协议实施前的干预措施进行描述,并与培训和协议实施后的干预措施进行比较。结果:研究发现,协议的实施有利于在危急情况下做出更适当的反应,并提高了对解决策略的认识,这些策略可以在《国家心理健康法》的框架内实施,同时也加强了对医务工作者心理健康的保护因素,如在组织任务和团队合作时采取合作策略。
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引用次数: 0
Psychopharmacological treatment of schizophrenia in child and adolescent population: state of the art 儿科和青少年精神分裂症的精神药物治疗:最新进展。
Pub Date : 2024-04-10 DOI: 10.53680/vertex.v35i163.527
María Florencia Iveli

Schizophrenia is a chronic and severe pathology that is characterized by the presence of delusions, hallucinations, negative symptoms, disorganization of thought and behavior. Although its prevalence in children under 13 years of age is very low, it increases substantially during the adolescence. When it develops before 18 years of age, it is called early-onset schizophrenia and represents 12-33 % of all individuals with this disorder. Drugs such as haloperidol, risperidone, paliperidone, aripiprazole, olanzapine, quetiapine, brexpiprazole, and lurasidone are Food and Drug Administration approved for the treatment of schizophrenia in adolescents. However, except for haloperidol, all pharmacological indications for this disorder in children under 13 years are off label. Although this practice it is not forbidden carries an additional risk. In the following article we will review the evidence of antipsychotics used for the treatment of schizophrenia in the pediatric population with the aim of synthesizing information with clinical applicability.

精神分裂症是一种以妄想、幻觉、阴性症状、思维和行为紊乱为特征的慢性严重疾病。虽然精神分裂症在 13 岁以下儿童中的发病率很低,但在青春期发病率会大幅上升。在 18 岁之前发病的精神分裂症被称为早发型精神分裂症,占精神分裂症患者总数的 12-33%。美国食品和药物管理局(FDA)批准用于治疗青少年精神分裂症的药物有氟哌啶醇(haloperidol)、利培酮(risperidone)、帕利哌酮(paliperidone)、阿立哌唑(aripiprazole)、奥氮平(olanzapine)、喹硫平(quetiapine)、布来哌唑(brexpiprazole)和鲁拉西酮(lurasidone)。然而,除氟哌啶醇外,所有治疗 13 岁以下儿童精神分裂症的药物适应症都是 "标签外 "的。虽然这种做法并未被禁止,但却存在额外的风险。下文将对使用抗精神病药物治疗儿童和青少年精神分裂症的现有证据进行回顾,旨在总结具有临床适用性的信息。
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引用次数: 0
Mental health and social vulnerability. The case of women living on the street at Buenos Aires, Argentine 心理健康与社会脆弱性:阿根廷布宜诺斯艾利斯街头妇女的案例。
Pub Date : 2024-04-10 DOI: 10.53680/vertex.v35i163.524
Andrés Rousseaux

Introduction: The purpose of this research is to investigate the possible relationship between homelessness and mentalpathology in a population of women housed in a Social Inclusion Center of the Autonomous City of Buenos Aires, Argentina. There could be a clinical bias that characterizes homelessness as a consequence of a mental illness.

Methods: A group of women between 18 and 65 years of age, socially assisted in the Social Inclusion Center for women alone or with minor children “Azucena Villaflor” of the City of Buenos Aires, who in turn consult or have consulted in the past about their mental health before or after being homeless. An observational, descriptive and cross-sectional quantitative study was carried out, collecting primary data through semi-structured interviews, complementing the research with a qualitative approach using the narrative method through in-depth interviews.

Conclusion: There is no unicausal relationship between having a mental illness and being homeless. The job search, a form of re-entry into the productive system, is extremely difficult, due to the market itself, not due to the psychological state of the users. However, the fruitless search generates situations of frustration that, given the context of vulnerability in which they find themselves, can lead to mental health consultations.

简介本研究的目的是调查阿根廷布宜诺斯艾利斯自治市社会包容中心的妇女群体中,街头处境与精神疾病之间可能存在的关系。这可能存在一种临床偏见,即认为街头处境是精神疾病的后果。研究方法:对布宜诺斯艾利斯市 "Azucena Villaflor "单身妇女或有未成年子女妇女社会包容中心的一组 18 至 65 岁的妇女进行了为期 10 个月(2022 年 1 月至 2022 年 10 月)的研究。研究采用定量、观察、描述和横截面研究方法,通过半结构化访谈收集原始数据,并通过深度访谈采用叙事方法对研究进行定性补充。结论:患有精神疾病与流落街头之间并不存在因果关系;作为重新进入生产系统的一种方式,寻找工作极其困难,这是因为市场本身的原因,而不是因为使用者的精神状态。然而,求职不成功会产生挫折感,鉴于他们所处的脆弱环境,这种挫折感会导致心理健康咨询。
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引用次数: 0
Suicide risk in adults with autism spectrum disorder: prevalence, assessment, and possible therapeutic interventions 自闭症谱系障碍成人的自杀风险:发病率、评估和可能的治疗干预。
Pub Date : 2024-04-10 DOI: 10.53680/vertex.v35i163.526
Francisco Musich, Celeste Berardo, Agustina Aragón-Daud

Introduction: Suicide risk in autism spectrum disorder (ASD) has emerged as a long-neglected issue. This revision aims to explore the prevalence, methods of assessment, and available treatments for suicide risk in this population.

Methods: A narrative review was carried out on three aspects related to the risk of suicide in the adult population with ASD: prevalence, evaluation and available evidence-based interventions. The bibliographic search was carried out using the Pubmed, Scielo, Dialnet and Psychinfo search engines, limited to articles published from 2010 onwards. In order to identify relevant literature, various combinations of keywords were used, such as “suicide risk,” “autism spectrum disorder,” and “suicide in autism,” in both Spanish and English.

Conclusions: The main findings suggest a high prevalence of suicide risk, highlighting the need of developing standardized protocols to assess such risk in the autistic population. Moreover, Dialectical Behavioral Therapy has shown promise as a therapeutic option to decrease suicidality, but further research is needed to establish its effectiveness and standardization as a treatment.

导言:长期以来,自闭症谱系障碍(ASD)中的自杀风险一直是一个未得到充分考虑的问题。本综述旨在探讨成人自闭症患者自杀风险的发生率、评估和治疗方法。研究方法:我们就成人自闭症患者自杀风险的三个相关方面进行了叙述性综述:患病率、评估和现有的循证干预措施。文献检索通过 Pubmed、Scielo、Dialnet 和 Psychinfo 等搜索引擎进行,仅限于 2010 年以后发表的文章。为了确定相关文献,我们使用了各种关键词组合,如 "自杀风险"、"自闭症谱系障碍 "和 "自闭症自杀",包括西班牙语和英语。结论:主要研究结果表明,自闭症患者的自杀风险较高,因此有必要制定标准化的评估方案。此外,"辩证行为疗法 "已被确定为减少自闭症患者自杀倾向的一种有前途的治疗方法,但仍需进一步研究以确定其疗效并将其作为一种标准化的治疗方法。
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引用次数: 0
History of writing as a tool for the practice of psychiatry and mental health 作为精神病学和心理健康实践工具的写作史。
Pub Date : 2024-04-10 DOI: 10.53680/vertex.v35i163.528
Ramiro Pérez Martín

Writing as we know it today is a relatively new development in the cultural history of humanity. More current still is the massiveness of the literacy of the population. Since the origins of psychiatry, writing has been an inherent part of it in the medical literature, but it has also been a tool applied in practice in various formats, both for diagnostic and therapeutic purposes. However, compared to the classic communication tools, such as speech, and in child psychiatry, also play and drawing, writing seems to have been relegated. In this bibliographical research, that would not have precedents of its kind, a historical overview of the subject was carried out from the emergence of psychiatry as a specialty to the present day; where events such as the World Wars, the evolution of the concept of disability or the COVID-19 pandemic seem to have played a key role in delimiting variables that characterize at least three historical periods and presuming a fourth in full gestation. The technological support with which it is written and the use and format given to writing were the main variables of the different periods. Being a time of very high demand in Mental Health, challenging in its accessibility and the massive use of writing from information technologies, this research would represent a significant contribution to the development of writing as a tool for the practice of psychiatry and mental health.

今天我们所熟知的文字是人类文化史上一个相对较新的发展。更具有现实意义的是大众扫盲。自精神病学起源以来,文字一直是医学文献中精神病学的固有组成部分,同时也是以诊断和治疗为目的,以各种形式应用于实践的工具。然而,与传统的交流工具(如语言)以及儿童精神病学中的游戏和绘画相比,书写似乎一直处于次要地位。在这项史无前例的书目研究中,我们对这一主题进行了历史回顾,从精神病学作为一门专科出现至今,世界大战、残疾概念的演变或 COVID-19 大流行等事件似乎在划分变量方面发挥了关键作用,这些变量至少是三个历史时期的特征,并推测第四个历史时期正在酝酿之中。书写所使用的技术媒介以及书写的用途和形式是不同时期的主要变量。目前是精神卫生需求量非常大的时期,在其可获取性和基于信息技术的写作的大量使用方面具有挑战性,因此,这项研究将为把写作作为精神病学和精神卫生实践的一种工具的发展做出重大贡献。
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引用次数: 0
Carta de lectores. 读者来信
Pub Date : 2024-04-10
Julia Martin
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引用次数: 0
Acting out as criminal impulse. History, Definitions, Forensic aspects 关于通过犯罪行为。历史、定义、法医学方面。
Pub Date : 2024-04-10 DOI: 10.53680/vertex.v35i163.529
Antonio Avalos, María José Riquelme

The present article aims to conduct a comprehensive review of the existing scientific literature on this human behavioral modality, impulsive and transient, which escapes the conscious control of the subject, from a psychopathological and forensic approach. To achieve this, historical points about the different nuances of the topic will be made, supplying a panoramic and critical overview of it. It can be said that these are implicit memories about past traumatic situations that, because of a present reenactment of the unpleasant event through a dissociative mechanism, generate in the individual an impulsive aggressive reaction, over which the person has no control or awareness. This type of behavior opens the debate, within the framework of Forensic Psychology and Psychiatry, about the defendants' ability, under these circumstances, to understand the criminality of the act and direct their actions, posing a controversial challenge to the criteria of different courts. Similarly, it is necessary to understand these behaviors, develop more proper prevention strategies, propose new therapeutic approaches to psychological trauma, and intervene in these criminal behaviors that endanger society's safety and well-being.

本文旨在从精神病理学和法医学的角度,详尽评述现有科学文献中有关这种特殊人类行为方式的内容,这种行为方式具有冲动性和短暂性,不受主体意识的控制。为此,将对这一主题的不同细微差别提出历史性的观点,提供一个全景式的批判性视角。可以说,这些都是关于过去创伤情况的内隐记忆,通过解离机制对不愉快事件进行重新编辑,在个人中产生冲动的攻击性反应,而个人对此没有任何控制或意识。在法医心理学和精神病学的框架内,这类行为引发了关于被控犯罪的人是否有能力理解其行为的犯罪性并指导自己的行为的辩论,这对不同国家的法院提出了有争议的挑战。此外,还必须能够理解这些行为,制定更适当的预防战略,考虑对心理创伤采取新的治疗方法,并对这些危及社会安全和福祉的犯罪行为进行干预。
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引用次数: 0
Update on the use and management of lithium in neuropsychiatry 神经精神病学中锂的使用和管理的最新进展。
Pub Date : 2024-01-10 DOI: 10.53680/vertex.v34i162.504
Alejo Corrales, Marcelo Cetkovich-Bakmas, Andrea Abadi, Sebastián Camino, Gerardo García Bonetto, Andrea Márquez Lopez Mato, Eliana Marengo, Estela Abraham, Tomás Maresca, Pablo Bagnati, Amalia Dallamea, Diego Canseco, Carlos Morra, Ricardo Corral, Daniel Sotelo, Sergio Strejilevich, Julián Pessio, Juan José Vilapriño, Manuel Vilapriño, Federico Rebok, Gustavo Vázquez

Lithium is an alkaline metal, used for more than 60 years in psychiatry, and currently considered the gold standard in the treatment of bipolar disorder (BD). According to recent evidence, this active ingredient is useful for the treatment of a wide spectrum of clinical varieties of affective disorders. In addition, it is estimated that lithium reduces the risk of suicide and suicidal behavior in people with mood disorders. On the other hand, some novel studies have shown that the cation has a potential efficacy for the treatment of other neuropsychiatric processes, such as the likelihood of reducingthe risk of dementia and slowing down the development of neurodegenerative diseases. Despite the enormous evidence in favor of the use of lithium, it is known that, in Argentina, medications containing it are prescribed less than expected. In view of all this, the Asociación Argentina de Psiquiatría Biológica (Argentine Association of Biological Psychiatry) (AAPB or AABP) convened a group of experts to review the available scientific literature and prepare an updated document on the management and use of lithium in neuropsychiatry. In addition to the use of the ion in daily clinical practice, thescope of this review includes other contents that have been considered of interest for the psychiatrist, such as certain pharmacological and pharmacogenetic aspects, possible clinical predictors of response to treatment with lithium, management of ion during perinatal period, management of lithium in child and adolescent population, management of adverse effects linked to cation and interactions with drugs and other substances.

评论文章 锂是一种碱金属,在精神病学中使用已有 60 多年的历史,目前被认为是治疗躁狂症(BD)的黄金标准。根据最新证据,这种活性物质可用于治疗多种临床情感障碍。此外,人们一直认为锂能降低情绪障碍患者的自杀风险和自杀行为。另一方面,一些新的研究表明,阳离子在治疗其他神经精神过程中也有潜在的疗效,如降低痴呆症的风险和减缓神经退行性疾病的发展。尽管有大量证据支持锂的使用,但众所周知,在阿根廷,含锂的药品处方比预期的要少。有鉴于此,阿根廷生物精神病学协会(AAPB)召集了一个专家小组,对现有的科学文献进行审查,并编写了一份关于神经精神病学中锂的管理和使用的最新文件。除了在日常临床实践中使用锂离子外,本综述的范围还包括精神科医生感兴趣的其他内容,如某些药理学和药物遗传学方面、锂治疗反应的可能临床预测因素、围产期锂离子的管理、儿科锂离子的管理、阳离子相关不良反应的管理以及与药物和其他物质的相互作用。
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引用次数: 0
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Vertex (Buenos Aires, Argentina)
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