Vertex (Buenos Aires, Argentina)最新文献

Contemporary neuroscience is nourished by the contribution of the localizationist hypothesis of phrenology (circa 1800). However, the consideration of the brain as an organ of the mind in the West has its roots in times as old as the times of Hippocrates and Herophilus. This idea resurfaces in the modern medical tradition in the figures of Thomas Sydenham, Thomas Willis, Herman Boerhaave and William Cullen, just to name the most notable, who considered the cerebral origin of behavior and madness. The specific hypothesis of phrenology is based on the premise that the brain is made up of a series of suborgans responsible for different psychological faculties or innate human qualities (such as amativity and benevolence) that as they were more present in that individual produced a protrusion in the skull that allowed a scientific analysis of these characteristics through palpation. Spurzheim was publicly ridiculed at a meeting when he was asked to analyse the skull of the famous physicist Pierre Laplace and having given him instead that of amentally deficient man was denied. The aim of this paper is to analyze the epistemological edges of phrenology, and more specifically its characterization as a science or pseudoscience, according to the important traditions of the twentieth century: falsificationism (in its classical and sophisticated versions) and consensualism.

The accumulated body of knowledge in the field of schizophrenia is vast yet often complex, fragmented, and, in some cases, inconsistent with certain practices that have been inadvertently perpetuated in psychiatric training over recent decades. In response to this gap, the Argentine Association of Biological Psychiatry (AAPB) initiated the development of the First Argentine Consensus on the Management of Schizophrenia, prepared by a multidisciplinary panel of national experts in the field.This article presents the first section of the consensus, which outlines the working methodology employed and reviews the current definition of schizophrenia, incorporating diagnostic criteria from both the DSM-5 and ICD-11. It also addresses the major unmet clinical needs in schizophrenia, summarizes recent neurobiological findings, and examines the environmental and psychosocial factors implicated in the onset and course of the disorder. Finally, the section emphasizes the importance of prevention and early intervention, highlighting the need for updated, evidence-based, andcontextually adapted practices within the Argentine mental health system.

Introduction: Prolonged hospitalizations are a challenge for health systems. This paper discusses prolonged hospitalizations in general hospitals, considering the significance of hospitalization in these services within the framework of psychiatric reform processes. The first aspect of the discussion is to clarify the operational definition of prolongedhospitalizations.

Methods: A document review was conducted, including scientific articles and technical documents. The analysis examined the terms used to refer to prolonged hospitalizations and sought to identify whether a specific time frame was specified in such definitions.

Results: The results were organized into two categories of definitions: one focused on the temporal dimension and the other on the dimension of care organization.

Conclusion: The paper proposes using the term "delayed discharge" and establishing a duration of 30 days to account for excess hospitalization days.

This analysis critically examines the Zero Suicide initiative, exploring its foundations, limitations, and challenges in suicide prediction and prevention. It discusses the complexities of suicidal behavior, including the prevalence of fatal first attempts and the impulsive nature of many suicidal acts. The study evaluates the limitations of current risk assessment tools and presents the recommendations of the NICE guidelines, which advocate for an approach focused on individual needs rather than risk stratification. It concludes by proposing a paradigm shift towards a more realistic and holistic risk management in suicide prevention.

Objectives: Analyze reports and reports of nocturnal polysomnography with oximetry and correlate respiratory disorders with other variables related to sleep, in a long-lived population.

Materials and methods: A retrospective, cross-sectional study was carried out, based on the analysis of reports and reports of nocturnal polysomnography with oximetry, performed on outpatients aged 80 or older, referred for diagnosis of various sleep disorders.

Results: N= 245. The average age was 83 years (80-94). We divided the data according to sex into male (n=123), female (n=122) and according to age from 80 to 84 years (n=176) and 85 or more years of age (n=69). Moderate obstructive sleep apneas were greater in men (p=0.04) and oxygen desaturation was greater in women (p=0.00) who also had greater sleep onset latency

Conclusions: The analysis of presby-sleep in the elderly population showed statistically significant data, when differentiating by age, given that the oldest people had the longest REM phase onset latency and the lowest percentage of deep slow sleep. When differentiated by gender, women took longer to fall asleep. The most prevalent diagnoses were obstructive sleep apnea followed by periodic leg movements. The rate of severe respiratory events was correlated with prolonged REM onset latency and a lower percentage of both superficial and deep sleep. Showingthe objective changes that occur in sleep in the elderly can help consider improving the diagnostic and/or therapeutic approach to sleep disorders in the elderly population.

Reseña de la obra: Unshrunk. Cómo la industria de la salud mental tomó el control de mi vida, y mi lucha por recuperarla, por Laura Delano. Penguin Random House, 2025.

Introduction: Subjective cognitive complaints (SCC) refer to the perception of cognitive alterations in individuals withnormal performance on neuropsychological tests. SCC are associated with an increased risk of cognitive decline, dementia, and neuropsychiatric symptoms, such as anxiety and depression. The COVID-19 pandemic has worsened global mental health, elevating rates of anxiety and depression. This study aims to report the prevalence of neuropsychiatric symptoms in individuals with SCC, particularly anxiety and depression, and to compare these symptoms between the pre-pandemic and pandemic periods.

Methods: A cross-sectional study was conducted on 136 neuropsychological reports of adults with SCC evaluated between June 2018 and December 2022. Depressive symptoms were assessed using the Beck Depression Inventory-II or the Geriatric Depression Scale-15, while anxious symptoms were assessed with the Beck Anxiety Inventory. For cases with an informant, the Neuropsychiatric Inventory was employed.

Results: Among participants, 52.2% presented with anxiety symptoms and 30.9% with depressive symptoms, based on self-administered questionnaires. Anxiety symptoms were significantly more prevalent and severe during the pandemic compared to the pre-pandemic period. In the 59 cases evaluated with the Neuropsychiatric Inventory, depressive symptoms were the most frequent, followed by irritability and anxiety.

Conclusions: Anxiety and depressive symptoms are common in individuals with SCC, with a marked increase in anxiety during the pandemic. These findings underscore the importance of comprehensively evaluating neuropsychiatric symptoms in this population to mitigate their present and future impact.

Introduction: Neurocognitive Disorders (NCD), also called Dementia, includes those disorders in which the main clinicaldeficit is failure in one or more cognitive functions and which are acquired. Early Onset Dementia (EOD) is defined as major NCD that begins before age 65, with diverse etiological causes and a significant impact on health costs and family quality of life. Neuropsychiatric symptoms, such as depression and anxiety, may be non-neurodegenerative causes of cognitive impairment and complaints. This study focuses on describing the performance in the Neurocognitive Assessment (NCA) and the presence of depression, anxiety, and other neuropsychiatric symptoms in young people who consult for cognitive complaints in a neurology service.

Materials and methods: Descriptive, retrospective study based on Cognitive Tests reports from young patients (≤64 years) who consulted for cognitive complaints between June 2018 and December 2022. Patients with a history of neurodevelopmental disorders were excluded. We classified patients into categories based on their cognitive performance and impairment in activities of daily living. Additionally, demographic data, neurological and psychiatric history were collected, and scales were used to assess neuropsychiatric symptoms.

Results: Of the 214 Cognitive Tests reports, 54.21% were normal, while the remaining showed cognitive impairment. No statistically significant differences were found in the presence of depression or anxiety between the groups with normal and pathological NCD. However, 84% of cases presented neuropsychiatric symptoms accordingto family reports, with depression and anxiety being the most reported.

Conclusions: Normal cognitive performance was obtained in more than half of the sample and some degree of cognitive impairment in the rest. A high frequency of neuropsychiatric symptoms was detected. The importance of a complete NCA and the detection of neuropsychiatric symptoms for early intervention in young patients is highlight.

This document corresponds to the third and final part of the First Argentine Consensus on the management of attention deficit hyperactivity disorder in adults, focused on summarizing the current evidence on therapeutic approaches to this pathology in adult patients. Following the methodology described in the first and second parts of the Consensus, the panel of experts conducted an exhaustive review of the literature and, as a result of a subsequent debate on the available information, the final part of this document was prepared, covering the comprehensive treatment of adults with this disorder. During the debate and discussion stage, it was decided to structure this final section of the consensus with some points that we believe will be of great use to the interdisciplinary team responsible for managing adult ADHD patients. In this section of the document, you will find general recommendations for pharmacological treatment and the management of adverse effects, comorbidity treatment, non-pharmacological interventions (NPI), as well asthe impact of untreated ADHD.

Introduction: This study investigates the implementation of psychopharmacological treatments for anxiety in incarceratedwomen during the Preventive and Mandatory Social Isolation (PMSI) in the COVID-19 pandemic, in thePenal Unit No. IV of the city of Santa Fe, from January to June 2020.

Objective: The objective of this research is to characterize the profile of psychopharmacological use and to evaluate if there were variations during the PMSI compared to the pre-pandemic period and analyze through a documentary review of clinical histories from a quantitative perspective based on existing data on the prescription of psychotropic drugs.

Method: A descriptive and comparative approach is proposed to describe the profile of anxiety symptoms in incarcerated women in the city of Santa Fe during the mentioned period. The potential impact of the PMSI on the mental health of detained women justifies the research.

Results: The results reveal an increase in the number of treatments during the PMSI, with 29% of detained women presenting anxiety symptoms that required psychopharmacological treatment. Reactive anxiety was the mainreason for prescription, both before and during the PMSI. In addition, a significant variation in the use of psychotropic drugs was observed, where sedative-profile antipsychotics were used in combination for treatment.

Conclusion: These findings support the hypothesis that there is a relationship between the PMSI, the presence of anxiety symptoms, and the increase in the implementation of psychopharmacological treatments in detained women during the COVID-19 pandemic in Santa Fe, Argentina.