Pub Date : 2023-10-10DOI: 10.53680/vertex.v34i161.488
Marcelo Cetkovich-Bakmas, Andrea Abadi, Sebastián Camino, Gerardo García Bonetto, Luis Herbst, Eliana Marengo, Fernando Torrente, Tomás Maresca, Julián Bustin, Carlos Morra, Ricardo Corral, Daniel Sotelo, Sergio Strejilevich, Julián Pessio, Juan José Vilapriño, Manuel Vilapriño, Gustavo Vázquez, Alejo Corrales
This document constitutes the third and last part of the Third Argentine Consensus on the Management of Bipolar Disorders carried out by the Argentine Association of Biological Psychiatry (AAPB). Continuing with the initial objective, this section of the Consensus on the Management of Bipolar Disorders is focused on the management of bipolar disorders in special populations. This section constitutes a comprehensive review and expert consideration of the scientific evidence on: a) the management of bipolar disorders in treatment-resistant patients; b) the management of bipolar disorder in childhood and adolescence; c) the management of bipolar disorders in women during their perinatal period and, d) the management of bipolar disorders in older adults.
{"title":"Third Argentine Consensus statement on management Bipolar Disorders. Section3: Bipolar Disorder in the context of special situations","authors":"Marcelo Cetkovich-Bakmas, Andrea Abadi, Sebastián Camino, Gerardo García Bonetto, Luis Herbst, Eliana Marengo, Fernando Torrente, Tomás Maresca, Julián Bustin, Carlos Morra, Ricardo Corral, Daniel Sotelo, Sergio Strejilevich, Julián Pessio, Juan José Vilapriño, Manuel Vilapriño, Gustavo Vázquez, Alejo Corrales","doi":"10.53680/vertex.v34i161.488","DOIUrl":"10.53680/vertex.v34i161.488","url":null,"abstract":"<p><p>This document constitutes the third and last part of the Third Argentine Consensus on the Management of Bipolar Disorders carried out by the Argentine Association of Biological Psychiatry (AAPB). Continuing with the initial objective, this section of the Consensus on the Management of Bipolar Disorders is focused on the management of bipolar disorders in special populations. This section constitutes a comprehensive review and expert consideration of the scientific evidence on: a) the management of bipolar disorders in treatment-resistant patients; b) the management of bipolar disorder in childhood and adolescence; c) the management of bipolar disorders in women during their perinatal period and, d) the management of bipolar disorders in older adults.</p>","PeriodicalId":75297,"journal":{"name":"Vertex (Buenos Aires, Argentina)","volume":"34 161, jul.-sept.","pages":"87-110"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223033","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 : 2023-07-10DOI: 10.53680/vertex.v34i160.460
Edith Labos, Claudia Verónica Bavec, Diana Cristalli, Florencia Deschle, Cristian Isaac, Guido Dorman, Juan Ollari, Valeria Rubiño, María Julieta Russo
The spectrum of neurodegenerative diseases that primarily affect cognition and behaviorspreads from asymptomatic preclinical disease to very mild cognitive impairment to frank dementia. Alzheimer's disease (AD) is the most common cause of a decline in cognitive ability. Also, it is a devastating condition that affects patients and their entirefamilies of caregivers, exacting tremendous financial hardships. Diagnosis may be complicated by other forms of dementia that have symptoms and pathologies similar to AD. Knowing the key features and pathology of each type of dementia can help in the accurate diagnosis of patients, so they will receive the treatment and support services appropriate for their condition and maintain the highest possible functioning in daily life and quality of life. Differentiate, based on clinical criteria, neuropathology, and biomarkers, AD and its atypical variants from other common dementias including Dementia with Lewy Bodies, Vascular Cognitive Impairment, Frontotemporal Degeneration, and less frequent cognitive disorders. The importance of getting an accurate and early diagnosis of dementiais now increasingly significant to make important decisions about treatment, support, and care. Nonpharmacological as well as pharmacological interventions should be initiated once the diagnosis is obtained. Biochemical markers to identify Alzheimer's disease play a central role in the new diagnostic criteria for the disease and in the recent biological definition of AD. This review article presents up-to-date data regarding the recent diagnostic criteria of Alzheimer´s disease and related disorders, emphasizing its usefulness in routine clinical practice.
{"title":"Diagnostic criteria in dementing illness. What's new?","authors":"Edith Labos, Claudia Verónica Bavec, Diana Cristalli, Florencia Deschle, Cristian Isaac, Guido Dorman, Juan Ollari, Valeria Rubiño, María Julieta Russo","doi":"10.53680/vertex.v34i160.460","DOIUrl":"https://doi.org/10.53680/vertex.v34i160.460","url":null,"abstract":"<p><p>The spectrum of neurodegenerative diseases that primarily affect cognition and behaviorspreads from asymptomatic preclinical disease to very mild cognitive impairment to frank dementia. Alzheimer's disease (AD) is the most common cause of a decline in cognitive ability. Also, it is a devastating condition that affects patients and their entirefamilies of caregivers, exacting tremendous financial hardships. Diagnosis may be complicated by other forms of dementia that have symptoms and pathologies similar to AD. Knowing the key features and pathology of each type of dementia can help in the accurate diagnosis of patients, so they will receive the treatment and support services appropriate for their condition and maintain the highest possible functioning in daily life and quality of life. Differentiate, based on clinical criteria, neuropathology, and biomarkers, AD and its atypical variants from other common dementias including Dementia with Lewy Bodies, Vascular Cognitive Impairment, Frontotemporal Degeneration, and less frequent cognitive\u0000disorders. The importance of getting an accurate and early diagnosis of dementiais now increasingly significant to make important decisions about treatment, support, and care. Nonpharmacological as well as pharmacological interventions should be initiated once the diagnosis is obtained. Biochemical markers to identify Alzheimer's disease play a central role in the new diagnostic criteria for the disease and in the recent biological definition of AD. This review article presents up-to-date data regarding the recent diagnostic criteria of Alzheimer´s disease and related disorders, emphasizing\u0000its usefulness in routine clinical practice.</p>","PeriodicalId":75297,"journal":{"name":"Vertex (Buenos Aires, Argentina)","volume":"34 160, abr.-jun.","pages":"54-78"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997420","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 : 2023-07-10DOI: 10.53680/vertex.v34i160.461
Nahuel Enrique Baca
We are currently witnessing a renaissance of psychedelic science in clinical research. In Argentina, the challenges related to its study and the development of new treatments in the field of Psychiatry are subject to the adoption of certain regulatory policies. The evolution of the knowledge about the effects, mechanisms of action and therapeutic potential of serotonergic psychedelics warrants a change in the regulatory framework for their use in clinical research. In a world that demands rapid flexibility and adaptation, we should avoid waiting for advances from developed countries. It is evident that psychopharmacological progress in the last thirty years have not been up to the expectations of the so-called "decade of the brain". Aware of these limitations, in this paper we carry out a historical and ethnopharmacological review of the classic psychedelics, from the 50's to the present -without ignoring their ancestral uses-, in order to highlight the political and cultural controversies that these molecules have raised in the field of Psychiatry. We hope to promote in the local environment an approach devoid of stigmas and that considers the therapeutic potential of these substances, with the ultimate goal of providing relief to severe mental illnesses that to this day continue to remain unanswered.
{"title":"21st Century Psychedelic Science","authors":"Nahuel Enrique Baca","doi":"10.53680/vertex.v34i160.461","DOIUrl":"https://doi.org/10.53680/vertex.v34i160.461","url":null,"abstract":"<p><p>We are currently witnessing a renaissance of psychedelic science in clinical research. In Argentina, the challenges related to its study and the development of new treatments in the field of Psychiatry are subject to the adoption of certain regulatory policies. The evolution of the knowledge about the effects, mechanisms of action and therapeutic potential of serotonergic psychedelics warrants a change in the regulatory framework for their use in clinical research. In a world that demands rapid flexibility and adaptation, we should avoid waiting for advances from developed countries. It is evident\u0000that psychopharmacological progress in the last thirty years have not been up to the expectations of the so-called \"decade of the brain\". Aware of these limitations, in this paper we carry out a historical and ethnopharmacological review of the classic psychedelics, from the 50's to the present -without ignoring their ancestral uses-, in order to highlight the political and cultural controversies that these molecules have raised in the field of Psychiatry. We hope to promote in the local environment an approach devoid of stigmas and that considers the therapeutic potential of these substances,\u0000with the ultimate goal of providing relief to severe mental illnesses that to this day continue to remain unanswered.</p>","PeriodicalId":75297,"journal":{"name":"Vertex (Buenos Aires, Argentina)","volume":"34 160, abr.-jun.","pages":"79-86"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050691","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}
Book Review: El peligro de estar cuerda, by Rosa Montero
书评:理智的危险,罗莎·蒙特罗著
{"title":"The Danger of Being Sane","authors":"Nicole M Moreno","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Book Review: El peligro de estar cuerda, by Rosa Montero</p>","PeriodicalId":75297,"journal":{"name":"Vertex (Buenos Aires, Argentina)","volume":"34 160, abr.-jun.","pages":"138-139"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050695","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 : 2023-07-10DOI: 10.53680/vertex.v34i160.463
Tamara Chernoff, Bruno Kliger, Dante Hernán Venturini
Traditional psychedelics, such as LSD, psilocybin, or DMT, are psychoactive compounds that exert their effects mainly through agonism over serotonergic receptors. In appropriate doses and contexts, they produce profound changes in the subjective experience, configuring altered states of consciousness that, upon reaching a critical point, involve the appearance of phenomena of mystical, transcendental, or ego dissolution experiences. These events are associated with diverse therapeutic effects in several mental conditions. Psychedelics are safe substances, with minimal risk of serious or long-lasting adverse effects and without addictive potential. Current evidence comes from systematic reviews and meta-analyses based on phase II clinical studies, with small groups of subjects, strict exclusion criteria, and difficulties in applying the double-blind methodology. Worldwide there is a growing number of clinical trials, which seek to promote the approval of psychedelic-assisted therapies as therapeutic tools in the coming years. In this bibliographic review, we will address the phenomenological characteristics of the psychedelic experience, its potential therapeutic uses, and the mechanisms that underlie them.
{"title":"Psychedelic Experiences: Phenomenology, Therapeutic Potentials and Explanatory Models","authors":"Tamara Chernoff, Bruno Kliger, Dante Hernán Venturini","doi":"10.53680/vertex.v34i160.463","DOIUrl":"https://doi.org/10.53680/vertex.v34i160.463","url":null,"abstract":"<p><p>Traditional psychedelics, such as LSD, psilocybin, or DMT, are psychoactive compounds that exert their effects mainly through agonism over serotonergic receptors. In appropriate doses and contexts, they produce profound changes in the subjective experience, configuring altered states of consciousness that, upon reaching a critical point, involve the appearance of phenomena of mystical, transcendental, or ego dissolution experiences. These events are associated with diverse therapeutic effects in several mental conditions. Psychedelics are safe substances, with minimal risk of serious or long-lasting adverse effects and without addictive potential. Current evidence comes from systematic reviews and meta-analyses based on phase II clinical studies, with small groups of subjects, strict exclusion criteria, and difficulties in applying the double-blind methodology. Worldwide there is a growing number of clinical trials, which seek to promote the approval of psychedelic-assisted therapies as therapeutic tools in the coming years. In this bibliographic review, we will address the phenomenological characteristics of the psychedelic experience, its potential therapeutic uses, and the\u0000mechanisms that underlie them.</p>","PeriodicalId":75297,"journal":{"name":"Vertex (Buenos Aires, Argentina)","volume":"34 160, abr.-jun.","pages":"100-112"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997419","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 : 2023-07-10DOI: 10.53680/vertex.v34i160.465
Mariela Verzero
This article arises from the work carried out in 2020 and 2021 as an interdisciplinary psychosocial team in a high complexity hospital in the town of Cañuelas, province of Buenos Aires, Argentina, during the COVID-19 pandemic, assisting people and their families in intensive care rooms. The proposal of this work aims to give a resignification to the practices of comprehensive health care for people, applying a gender and rights perspective to hospital practice. From this experience, the postulate of empathy as the central axis of care arises.
{"title":"Empathy as the axis of care. Rethinking Comprehensive Health Care Policies and Practices with a Gender Perspective","authors":"Mariela Verzero","doi":"10.53680/vertex.v34i160.465","DOIUrl":"https://doi.org/10.53680/vertex.v34i160.465","url":null,"abstract":"<p><p>This article arises from the work carried out in 2020 and 2021 as an interdisciplinary psychosocial team in a high complexity hospital in the town of Cañuelas, province of Buenos Aires, Argentina, during the COVID-19 pandemic, assisting people and their families in intensive care rooms. The proposal of this work aims to give a resignification to the practices of comprehensive health care for people, applying a gender and rights perspective to hospital practice. From this experience, the postulate of empathy as the central axis of care arises.</p>","PeriodicalId":75297,"journal":{"name":"Vertex (Buenos Aires, Argentina)","volume":"34 160, abr.-jun.","pages":"123-128"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997421","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 : 2023-07-10DOI: 10.53680/vertex.v34i160.458
Mauro Damián Martini, Felipe Aníbal Gregalio, Fernando Javier Vázquez, María Lourdes Posadas, María Florencia Grande Ratti, Javier Alberto Pollán
Objective: To estimate the prevalence of Antidepressant use in patients with a history of venous thromboembolism (VTE). Describe the patient's characteristics and which drugs are the most prescribed.
Methods: A cross-sectional study involving a consecutive sample of patients included in the Registro de Enfermedad Tromboembólica (RIET) from the Hospital Italiano de Buenos Aires in a period between 01/01/2014 to 01/09/2018. All patients presented symptomatic VTE and confirmed diagnosis. Drugs considered included in this study were: Selective Serotonin Reuptake Inhibitors (SSRI), Dopamine and Norepinephrine Reuptake Inhibitors (NDRI), Serotonin and Norepinephrine Reuptake Inhibitors (SNRI) and Tricyclic antidepressants (TCA).
Results: From a total of 2373 patients with VTE, 472 were active users of antidepressants, showing a prevalence of antidepressant use of 19.9% (CI 95%). The most frequently prescribed drugs by drug classification were: SSRI 83.9%, TCA 20.5%, ISRN 14.6%, and NDRI 2.5%. Patients presented a median age of 76 years, predominantly women (71.4%), with several comorbidities: 52.24% arterial hypertension, 37.29% overweight, and 34.75% history of smoking. Concerning relevant history, we observed: 29.03% active oncologic disease, 26.27% major surgery before the VTE, and 21.61% previous VTE.
Conclusion: The prevalence of antidepressant use in patients with VTE is 19.9%, superior by far to that of the general population. Depression is a major cause of morbidity worldwide, and its prevalence is increasing over the years.
{"title":"Prevalence of the use of antidepressants in patients with venous thromboembolism","authors":"Mauro Damián Martini, Felipe Aníbal Gregalio, Fernando Javier Vázquez, María Lourdes Posadas, María Florencia Grande Ratti, Javier Alberto Pollán","doi":"10.53680/vertex.v34i160.458","DOIUrl":"https://doi.org/10.53680/vertex.v34i160.458","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of Antidepressant use in patients with a history of venous thromboembolism (VTE). Describe the patient's characteristics and which drugs are the most prescribed.</p><p><strong>Methods: </strong>A cross-sectional study involving a consecutive sample of patients included in the Registro de Enfermedad Tromboembólica (RIET) from the Hospital Italiano de Buenos Aires in a period between 01/01/2014 to 01/09/2018. All patients presented symptomatic VTE and confirmed diagnosis. Drugs considered included in this study were: Selective Serotonin Reuptake Inhibitors (SSRI), Dopamine and Norepinephrine Reuptake Inhibitors (NDRI), Serotonin and Norepinephrine Reuptake Inhibitors (SNRI) and Tricyclic antidepressants (TCA).</p><p><strong>Results: </strong>From a total of 2373 patients with VTE, 472 were active users of antidepressants, showing a prevalence of antidepressant use of 19.9% (CI 95%). The most frequently prescribed drugs by drug classification were: SSRI 83.9%, TCA 20.5%, ISRN 14.6%, and NDRI 2.5%. Patients presented a median age of 76 years, predominantly women (71.4%), with several comorbidities: 52.24% arterial hypertension, 37.29% overweight, and 34.75% history of smoking. Concerning relevant history, we observed: 29.03% active oncologic disease, 26.27% major surgery before the VTE, and 21.61% previous VTE.</p><p><strong>Conclusion: </strong>The prevalence of antidepressant use in patients with VTE is 19.9%, superior by far to that of the general population. Depression is a major cause of morbidity worldwide, and its prevalence is increasing over the years.</p>","PeriodicalId":75297,"journal":{"name":"Vertex (Buenos Aires, Argentina)","volume":"34 160, abr.-jun.","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997423","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}