Nuevas Adaptaciones Para la Aplicación del Mindfulness a la Psicosis / New Adaptations in the Application of Mindfulness to Psychosis Spectrum Disorders

El uso clínico del mindfulness adaptado a la psicosis ha sido rechazado por algunos profesionales de la Salud Mental debido a prejuicios y falta de información. Sin embargo, la evidencia actual ha demostrado que las Intervenciones Basadas en Mindfulness (MBI) son seguras y tienen numerosos beneficios en los trastornos del espectro psicótico. Las MBI son adaptables a diferentes contextos y situaciones clínicas, incluido el deterioro cognitivo, y aunque no constituye su objetivo principal, pueden facilitar la reducción de la sintomatología negativa en la psicosis. Las MBI permiten a las personas con psicosis enfrentar las experiencias alucinatorias desde una perspectiva diferente, fomentando la flexibilidad, la regulación emocional y la aceptación. Es importante adaptar las intervenciones a las características de la psicosis, así como distinguir entre los diferentes tipos de prácticas, para aplicarlas de manera diferencial según la sintomatología específica y las características de la persona.(AU)

The clinical use of psychosis-adapted mindfulness has been rejected by some mental health professionals due to biases and lack of information. However, current evidence has demonstrated the safety and numerous benefits of mindfulness-based interventions (MBIs) in psychotic spectrum disorders. MBIs are adaptable to diverse clinical contexts and situations, including cognitive impairment, and although it is not their primary objective, they can facilitate the reduction of negative symptomatology in psychosis. MBIs enable individuals with psychosis toapproach hallucinatory experiences from an alternative perspective, fostering flexibility, emotional regulation, and acceptance. It is crucial to tailor interventions to the characteristics of the psychosis, as well as to differentiate between the various types of practices, in order to apply them differentially depending on the specific symptoms and characteristics of the individual.(AU)

Parálisis de sueño durante la siesta como síntoma inicial de narcolepsia / Sleep paralysis during naptime as initial symptom of narcolepsy

Introducción: La narcolepsia es una enfermedad de etiología desconocida, de prevalencia muy baja (el 0,02-0,16% en adultos, aunque debe ser mayor, dado el infradiagnóstico), caracterizada por la presencia de somnolencia diurna excesiva, alucinaciones hipnagógicas y/o hipnopómpicas, parálisis de sueño y/o cataplejía (si está presente, se habla de narcolepsia de tipo 1 y, si no, de narcolepsia de tipo 2), cuya media de retraso diagnóstico se sitúa entre los 10 y los 15 años. Caso clínico: Varón de 16 años que consulta tras visitar a distintos especialistas por presentar parálisis de sueño durante las siestas, que le producen miedo y ocasional caída de objetos de las manos (diagnosticadas como posibles mioclonías). En la anamnesis nos sorprendió la presencia de parálisis de sueño inmediatamente tras el inicio de las siestas y, en la anamnesis dirigida, esos movimientos bruscos provocados por emociones eran compatibles con cataplejías, por lo que realizamos un estudio polisomnográfico nocturno y un test de latencias múltiples del sueño. Con la evolución aparecieron alucinaciones hipnopómpicas y sueño fragmentado nocturno, así como ocasional somnolencia diurna (se completó así la tétrada sintomatológica típica de la narcolepsia con cataplejía de tipo 1). Conclusión: Es importante el conocimiento de esta enfermedad, plantearla como diagnóstico diferencial en pacientes con episodios de somnolencia incoercible, realizar la derivación a consultas especializadas en trastornos de sueño y una buena anamnesis dirigida, e indicar las pruebas complementarias necesarias para el diagnóstico de esta enfermedad infradiagnosticada para su correcto manejo, tan determinante para la mejora de la calidad de vida de estos pacientes.(AU)

Introduction: Narcolepsy is a disease of unknown etiology, with a very low prevalence (0.02-0.16% in adults, although it must be higher, given the underdiagnosis), characterized by the presence of excessive daytime sleepiness, hypnagogic and/or hypnopompic hallucinations, sleep paralysis and/or cataplexy (if present, we speak of type 1 narcolepsy and, if not, type 2 narcolepsy), whose average diagnostic delay is between 10 and 15 years. Case report: A 16-year-old male who consulted after visiting different specialists for presenting sleep paralysis during naps, which cause him fear and occasional objects falling from his hands (diagnosed as possible myoclonus). In the anamnesis we were surprised by the presence of sleep paralysis immediately after the start of the naps and, in the directed anamnesis, these sudden movements caused by emotions were compatible with cataplexies, so we performed a nocturnal polysomnographic study and a multiple sleep latency test. With evolution came hypnopompic hallucinations and fragmented nocturnal sleep, as well as occasional daytime sleepiness (thus completing the typical symptomatic tetrad of type 1 narcolepsy with cataplexy). Conclusion: Knowledge of this disease is important, considering it as a differential diagnosis in patients with episodes of intractable sleepiness, send these patients to expert doctors in sleep disorders and doing a good anamnesis, performing the necessary complementary tests for the diagnosis of this underdiagnosed disease for its correct management, which is decisive for improving the quality of life of these patients.(AU)

Psychosis in adults with autism spectrum disorder and attention deficit hyperactivity disorder at acute psychiatric wards

Background and objectives Psychotic symptoms, such as delusions and hallucinations, in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) have been increasingly reported in recent literature. In the present study, the prevalence and duration of psychotic symptoms, comorbid psychotic disorders, and clinical characteristics of adults with ASD and ADHD were retrospectively examined via a chart review. Methods The participants were 98 adults (mean age, 28.5 years; 72 men) who were admitted to the psychiatric emergency wards of Showa University Karasuyama Hospital, and who were diagnosed with ASD and/or ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. Results Among 69 individuals with ASD, 21 (30.4%) experienced psychotic symptoms, and among 29 individuals with ADHD, 5 (17.2%) exhibited psychosis. While all psychotic symptoms were classified as transient and none had comorbidity with schizophrenia and other psychotic disorders in adults with ADHD, 38.1% of psychosis was classified as prolonged and 10.3% had comorbidity with schizophrenia and other psychotic disorders in adults with ASD. Conclusion The results showed that a significant proportion of adults with ASD and ADHD experience psychosis during their course of illness, and provide evidence for the existence of a shared etiology between neurodevelopmental and psychotic disorders. (AU)

Alucinaciones como efecto adverso del topiramato / Hallucinations as an adverse effect of topiramate

El topiramato es un fármaco antiepiléptico que bloquea los canales de sodio voltaje-dependientes y potencia la actividad gabaérgica. Entre sus posibles efectos adversos se han descrito algunos muy infrecuentes como las alucinaciones visuales o auditivas. Presentamos un caso de una niña de 7 años con antecedentes de migraña sin aura sin otros antecedentes personales ni familiares de interés que, tras 15 días de tratamiento preventivo con topiramato, desarrolló alucinaciones, cambios de humor bruscos, negativismo e ideas de muerte. Dada la clínica no explicable por otra circunstancia o fármaco se retiró el topiramato con desaparición completa de los síntomas a los 20 días, sin reaparición de estos. Las alucinaciones son un efecto adverso muy inusual del topiramato. El mecanismo fisiopatológico podría estar relacionado con su efecto sobre la actividad GABA. Existen muy pocos casos de este efecto adverso descritos. En pacientes pediátricos solo se han descrito dos casos, siendo este el primer caso descrito en el contexto de tratamiento profiláctico de la migraña (AU)

Topiramate is an antiepileptic drug which blocks voltage-gated sodium channels and enhances GABAergic activity. We report the case of a 7-year-old girl with a medical history of migraine without aura who, after fifteen days of preventive treatment with topiramate developed visual and tactile hallucinations. She also presented sudden mood swings, negativism and even death ideation. She had no other personal or family medical or psychiatric history. Due to the symptomatology, Topiramate was stopped, with a complete disappearance of symptoms twenty days after its suspension, and without the recurrence of them.Hallucinations are a very unusual side effect of Topiramate. There are very few cases of this adverse effect described in the literature. In pediatric patients, there were only two cases, this being the first case described in the context of prophylactic treatment of migraine. (AU)

Alucinaciones secundarias a tratamiento en paciente con Parkinson / Hallucinations after treatment in a patient with Parkinson’s

La enfermedad de Parkinson (EP) se puede considerar como la segunda enfermedad neurodegenerativa en cuanto a prevalencia se refiere. La EP es una enfermedad de carácter crónico que evoluciona en fases consecutivas, con un diagnóstico inicial insidioso y de manejo complejo para el médico de Atención Primaria. En este artículo presentamos un caso de una interacción medicamentosa poco estudiada entre fármacos antidepresivos y antiparkinsonianos. La paciente acudió a revisión de neurología y, en un ajuste de medicación realizado por el compañero de neurología, se añadió rasalagina a su tratamiento habitual (levodopa/carbidopa) y ello creó a la paciente un cuadro de alucinaciones. Tras un estudio pormenorizado del caso, se llegó a la conclusión de que la rasalagina debía ser retirada y el cuadro neurológico de alucinaciones remitió.

Parkinson's Disease (PD) can be deemed the second neurodegenerative disease in terms of prevalence. PD is a chronic disease that evolves in consecutive phases, with an insidious initial diagnosis and complex management for the primary care physician. In this paper we report a case of a poorly studied drug interaction between antidepressant and antiparkinsonian drugs. The patient went to a neurology review where, in a medication adjustment made by a neurology colleague, Rasalagin was added to her usual treatment (levodopa/carbidopa), which created hallucinations in the patient. After a minor case study, the conclusion was drawn that rasalagin should be withdrawn and the neurological picture of hallucinations remitted.(AU)

Twice daily low frequency rTMS for treatment-resistant auditory hallucinations

Background: Repetitive transcranial magnetic stimulation (rTMS) has emerged as a therapeutic solution in patients with treatment-resistant auditory verbal hallucinations. However, the optimal stimulation parameters remain unclear, especially for patients with clozapine-resistant symptoms. Method: In an open label retrospective study, we investigated whether parameters of stimulation that were useful in patients with major depressive disorder would help schizophrenia patients with treatment-resistant auditory verbal hallucinations. Fourteen participants, including 9 under clozapine, received 30 sessions of 1 Hz rTMS over 3 weeks (360 pulses per sessions delivered with 60 s ‘on’ and 30 s ‘off’ at 110% of the resting motor threshold, 2 sessions per day). Stimulations were applied over the left temporoparietal junction (T3-P3 according to 10/20 system). Results: After rTMS, a significant decrease of auditory verbal hallucinations was observed (−38.7% ± 31.8, p = 0.003) on the Auditory Hallucination Rating Scale. The beneficial effects were also significant in the 9 patients who were also receiving clozapine (−34.9% ± 28.4, p = 0.01). Conclusions: Low frequency rTMS, 30 sessions over 3 weeks, appears to be a suitable approach to decrease treatment-resistant auditory verbal hallucinations, including in patients with clozapine-resistant symptoms. Results from the current retrospective study in the clinical settings need to be confirmed by large-scale randomized sham-controlled trials. (AU)

Different measures for auditory hallucinations in populations with psychosis. The Validation of the Spanish versions of the Auditory Vocal Hallucination Rating Scale (AVHRS) and the Positive and Useful Voices Inquiry (PUVI) / Diferentes medidas para las alucinaciones auditivas en poblaciones con psicosis. Validación de las versiones españolas de la Escala de Valoración de Alucinaciones Auditivas Vocales (AVHRS) y de la Encuesta sobre Voces Positivas y Útiles (PUVI)

Introduction: An updated summary of the most used instruments assessing auditory hallucinations in population with psychosis, allows us to underline the scarceness and need of Spanish versions of important instruments. The aim of the study is to examine the psychometric characteristics of two different and complementary instruments for assessing auditory hallucinations, the Spanish version of the Auditory Vocal Hallucination Scale (AVHRS) and the Spanish version of the Positive and Useful Voices Inquiry (PUVI). Materials and methods: A sample of 68 patients from four different centres, with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder presenting with auditory hallucinations were included. Apart from the AVHRS and the PUVI, the Psychotic Symptom Rating Scales-Auditory Hallucinations subscale (PSYRATS-AH) and the Positive and Negative Syndrome Scale (PANSS) were also administered to all patients, plus an acceptability questionnaire. Results: The Spanish version of the AVHRS showed a good internal consistency, a moderate to high inter-rater reliability, a medium to moderate test–retest reliability, and a good convergent and discriminant validity. The Spanish version of the PUVI showed a good internal consistency and a heterogeneous, but in general moderate, test–retest reliability. Conclusions: The Spanish versions of the AVHRS and the PUVI have good psychometric properties and are well accepted among patients. (AU)

Introducción: Un resumen actualizado de los instrumentos más utilizados en la evaluación de las alucinaciones auditivas en poblaciones con psicosis, nos permite subrayar la escasez y necesidad de versiones españolas de importantes instrumentos. El objetivo del estudio es examinar las características psicométricas de dos instrumentos para la evaluación de las alucinaciones auditivas diferentes y complementarios, la versión española de la Escala de Valoración de Alucinaciones Auditivas Vocales (AVHRS) y la versión española de la Encuesta sobre Voces Positivas y Útiles (PUVI). Material y métodos: Se incluyó una muestra de 68 pacientes de cuatro centros diferentes, con diagnóstico de esquizofrenia o trastorno esquizoafectivo según el DSM-IV, que presentaban alucinaciones auditivas. Además de la AVHRS y de la PUVI, se administraron también a todos los pacientes la subescala de Alucinaciones Auditivas de la Escalas de Evaluación de Síntomas Psicóticos (PSYRATS-AH) y la Escala de Evaluación de Síndrome Positivo y Negativo (PANSS), además de un cuestionario de aceptabilidad. Resultados: La versión española de la AVHRS mostró una buena consistencia interna, una fiabilidad inter-jueces de moderada a alta, una fiabilidad re-test de media a moderada, y una buena validez convergente y discriminante. La versión española de la PUVI mostró una buena consistencia interna y una fiabilidad test-retest heterogénea pero, en general, moderada. Conclusiones: Las versiones españolas de la AVHRS y la PUVI tienes buenas propiedades psicométricas y son bien aceptadas entre los pacientes. (AU)

Transient improvement in visual hallucinations with 'eye closing' technique

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Sospechas de ideación suicida y alucinaciones atribuibles a hidroxicloroquina en el tratamiento de la enfermedad por Coronavirus-19 / Suspicion of suicides and hallucinations possibly due to hydroxychloroquine for the treatment of Coronavirus Disease 2019

Objetivo: Detectar y notificar casos de suicidios o intentos de suicidios y alucinaciones en pacientes tratados con hidroxicloroquina para la enfermedad por Coronavirus 2019.Material y método: Estudio descriptivo retrospectivo de todos los pacientes tratados con hidroxicloroquina en los 40 días previos al suceso y que cumplían: suicidio consumado, psicosis aguda con intento de suicidio y comportamiento psicótico y agresividad con daño a terceros. Se excluyeron pacientes con situación previa de depresión, intento o plan organizado de suicidio, abuso de alcohol, falta de pensamiento racional o carencia de apoyo social. Para establecer el grado de asociación entre la sospecha de reacción adversa e hidroxicloroquina, se utilizó el algoritmo Karch y Lasagna modificado.Resultados: Se detectaron cinco casos graves de trastornos neuropsiquiátricos posiblemente relacionados con hidroxicloroquina: suicidio consumado (tres), crisis de psicosis aguda con intento de suicidio (uno) y comportamiento psicótico y agresividad con daño a terceros (uno); los dos últimos se recuperaron tras la retirada del medicamento. Todos eran varones, con edades comprendidas entre los 26-85 años. Las reacciones adversas de tipo psiquiátrico aparecieron entre los 2-5 días tras el inicio. Ninguno tenía antecedentes psiquiátricos previos, y todos se encontraban tranquilos, colaboradores y sin síntomas depresivos durante la hospitalización.Conclusión: La evidencia en otras patologías sugiere un aumento potencial de síntomas como ansiedad, ideación suicida y alucinaciones que pueden provocar agresiones o suicidio con la exposición a hidroxicloroquina, por lo que sería necesario generar evidencia del uso de hidroxicloroquina en esta situación actual de pandemia por la COVID-19 y en condiciones diferentes a las autorizadas. (AU)

Objective: This paper aims to detect and report suicide cases or suicide attempts and hallucinations during the emergency use of hydroxychloroquine for the treatment of Coronavirus Disease 2019.Methods: It was a retrospective descriptive study in which patients treated with hydroxychloroquine 40 days before the event were included: completed suicide, acute psychosis with suicide attempt and psychotic behavior and aggressiveness with harm to third parties. Patients with a previous situation of depression, attempted or organized suicide plan, alcohol abuse and lack of rational thought or social support were excluded. To establish the degree of association between suspected adverse drug reaction and hydroxychloroquine, the modified version of the algorithm proposed by Karch and Lasagna was used.Results: There were five case reports neuropsychiatric adverse events associated with the use of hydroxychloroquine: completed suicide (three); acute psychosis crisis with suicide attempt (one) and psychotic behavior and aggressiveness with harm to third parties (one), which recovered after withdrawal of hydroxychloroquine. All of them were male, with age ranged between 26-85 years. Psychiatric-type adverse reactions appeared between 2-5 days after initiating therapy. None had a prior psychiatric history, and all were calm, cooperative, and without depressive symptoms during hospitalization.Conclusion: Evidence in other pathologies suggests a potential increase in symptoms such as anxiety, suicidal ideation and hallucinations that can cause aggression or suicide with exposure to hydroxychloroquine, so others studies are needed in this current situation of pandemic by COVID-19 and unapproved use of hydroxychloroquine. (AU)

Apomorfina: un poderoso aliado en la enfermedad de Parkinson / Apomorphine: a powerful ally in Parkinson’s disease

Introducción: La apomorfina, agonista dopaminérgico D1 y D2, es el fármaco más antiguo con efectividad en el tratamiento de la enfermedad de Parkinson (EP) y el único de potencia análoga a la levodopa. Su utilidad, tanto en la administración intermitente como en la perfusión continua en el control de las fluctuaciones motoras, está demostrada tanto en estudios abiertos como controlados. Objetivo: Analizar el papel de la apomorfina en las distintas manifestaciones y momentos evolutivos de la EP mediante una revisión narrativa de la literatura científica (1951-2020). Desarrollo: Más allá del aumento de la duración del on, la reducción del off, la mejoría de la distonía en off y la calidad de vida en pacientes con EP avanzada, existe evidencia de la efectividad de la apomorfina en áreas menos conocidas de la EP, como síntomas no motores, menor riesgo de inducir trastornos de control de impulsos, potencial para atenuar las alucinaciones visuales, mejora de la clínica neuropsiquiátrica asociada a la EP, ayuda a un mejor control de las discinesias o influencia en los síntomas axiales. Sin embargo, el momento óptimo de su instauración sigue siendo objeto de debate, y existen varios factores que históricamente han limitado el uso de este valioso fármaco. Conclusiones: La apomorfina es un fármaco con propiedades únicas dentro del abanico de posibilidades para tratar la EP, con potenciales aplicaciones más allá del control de las fluctuaciones motoras. Conocerlas para indicarlas a los pacientes que más puedan beneficiarse de ellos, así como valorar adecuadamente el estadio de la EP en que iniciar la apomorfina, puede ser clave para mejorar el control clínico de esta compleja patología.(AU)

Introduction: Apomorphine, a D1-D2 dopamine agonist, is the oldest drug with proven efficacy in the treatment of Parkinson’s disease (PD), and the only with similar symptomatic power to levodopa. Its usefulness in the control of motor fluctuations, both as intermittent injections and in continuous subcutaneous infusion, has been demonstrated in open label and placebo controlled trials. Aim: To analyse the role of apomorphine in the varied clinical symptoms and different clinical stages of PD through a narrative review of scientific literature (1951-2020). Development: Beyond on-time increase, off-time decrease, off dystonia and quality of life improvement in advanced PD, there is evidence to support a role of apomorphine in less known clinical areas of PD, such as non motor symptoms, a lower risk of impulse control disorders, potential to ameliorate visual hallucinations, improve neuropsychiatric symptoms and dyskinesia and even axial features. Nevertheless, the optimal timing of apomorphine treatment remains controversial, and its implementation of this valuable drug in clinical practice has been historically hindered by several factors. Conclusions: Apomorphine is a unique drug in the PD treatment scenario, with a number of potential applications beyond motor fluctuations control. Acknowledging these properties, selecting the patient most likely to benefit from it and finding the right timing may be key in the symptomatic control of this complex disease.(AU)

Narcolepsia y psicosis, a propósito de un caso / Narcolepsy and psychosis, a case report

La narcolepsia es trastorno neurológico infrecuente, incluido dentro del catálogo de enfermedades raras. Pese a la existencia de criterios diagnósticos precisos, se encuentra infradiagnosticada. Se caracteriza por una excesiva somnolencia diurna asociada a cataplejías, y en algunos casos puede aparecer alucinaciones hipnagógicas e hipnopómpicas, alucinaciones auditivas y/o ideación delirante. La presencia de síntomas psicóticos dificulta enormemente el diagnóstico diferencial (narcolepsia, esquizofrenia o la concomitancia de ambas). Además, el manejo terapéutico puede resultar complejo, ya que el tratamiento de una patología puede empeorar la otra. El siguiente caso clínico corresponde a una paciente con esta infrecuente comorbilidad entre ambos trastornos, en el que quedan patentes las importantes dificultades tanto en el diagnóstico diferencial como en el manejo terapéutico, una vez alcanzado el diagnóstico de certeza

Narcolepsy is an infrequent neurological disorder, included in the catalog of rare diseases. Despite the existence of precise diagnostic criteria, this entity remains underdiagnosed. It is characterized by excessive daytime sleepiness associated with cataplexy; in some cases, hypnagogic or hypnopompic hallucinations, auditory hallucinations, and/or delusional ideation may appear. The occurrence of psychotic symptoms makes differential diagnosis extremely difficult (narcolepsy, schizophrenia, or both). Furthermore, therapeutic management may be complex, since the treatment of one of the disorders may worsen the other. Here we describe the case of a patient with this rare comorbidity, which illustrates the major difficulties associated to both differential diagnosis and therapeutic management once a definitive diagnosis has been reached

Trastorno psicótico de novo inducido por levetiracetam: ¿existe un perfil de paciente epiléptico neuroestructural y/o biológicamente más vulnerable a desarrollarlo? / Levetiracetam-induced de novo psychosis: Is there a type of patient with epilepsy who is neurostructural and/or biologically more vulnerable to developing it?

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Síndrome del oído musical / Musical ear syndrome

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Alucinaciones tras ingerir una infusión de una planta anticolinérgica con confirmación toxicológica / Hallucinations and toxicologic findings after ingestion of an infusion made from an anticholinergic plant

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"Escrúpulos religiosos extremos" y delirio místico - religioso: entre la devoción cristiana y la psicopatología en Colombia, 1920-1960 / "Extreme religious scruples" or mystical delirium - religious: between christian devotion and psychopathology in Colombia, 1920-1960

OBJETIVO: comprender la semiología del delirio místico-religioso y la incidencia del contenido sociocultural en la configuración de los síntomas en la psicopatología moderna en Colombia, 1920-1960. METODOLOGÍA: investigación histórico-hermenéutica, mediante análisis de una serie de historias clínicas del antiguo Manicomio Departamental de Antioquia y del Asilo Psiquiátrico San Isidro del Valle del Cauca. RESULTADOS: entre las psicopatologías más recurrentes en las que se manifestaron los delirios se encuentra el grupo de las manías, principalmente la intermitente, psicosis maniaco-depresiva y melancolía; seguido por la esquizofrenia paranoide, y también fue frecuente en la psicosis puerperal o posparto; asimismo, se presentó en la parálisis general progresiva (neurosífilis) y en el síndrome cerebral agudo o estado de confusión agudo, nosografía moderna dada al delirio. Según las historias clínicas, la exaltación de ideas religiosas confluye en un delirio polimorfo. Los síntomas más recurrentes fueron las alucinaciones visuales y auditivas, logorrea o locuacidad, insomnio, negativismo alimentario acompañado de miedo a ser envenenado, excitación psicomotora o hiperquinética, accesos de furia controlados con camisa de fuerza y otros medios de contención, intento de suicidio y tendencia a la fuga de la casa, por lo tanto, se consideraba de peligrosidad para sí mismos y para los demás

OBJECTIVE: To understand the semiotics of mystical-religious delirium and the incidence of sociocultural content in the configuration of symptoms in modern psychiatry in Colombia, 1920-1960. METHODOLOGY: hermeneutic historical, research by analysis of a series of case histories of the old Madhouse Department of Antioquia and the Psychiatric Asylum San Isidro del Valle del Cauca. RESULTS: Among the most frequent psychopathologies in which delusions demonstrated is the group of hobbies, mainly intermittent, manic depression and melancholy; followed by paranoid schizophrenia, and was also common in puerperal or postpartum psychosis; He also appeared in general paresis (neurosyphilis) and acute brain syndrome or acute confusional state, delirium given modern nosography. According to medical records, the exaltation of religious ideas comes together in a polymorph delirium. The most frequent symptoms were visual and auditory hallucinations, logorrea or talkativeness, insomnia, accompanied food negativism fear of being poisoned, psychomotor or hyperkinetic excitement, fits of rage controlled straitjacket and other means of containment, attempted suicide and trend the escape of the house, therefore it was considered dangerous to themselves and others

Correlation between the severity level of the symptom and the distress of patient halucination

OBJECTIVE: This study aimed to identify the severity level of the symptom and the distress of patients with hallucination at Prof. Ildrem Asylum in Medan. METHODS: The study used descriptive method. The sample were 99 respondents, taken by using consecutive sampling technique. The data were gathered by using questionnaires on demographic data, severity level of symptom, and distress. The result of univariate analysis showed that 67 respondents (67.7%) had low level symptom hallucination and 70 respondents (70.7%) had heavy distress. The result of bivariate analysis, using Chi-Square statistic test, showed that p-value=0.175. CONCLUSION: No difference of the distress level proportion among patients who are having a severity of heavy hallucination symptom. Recommandations: Nurses are expected to be able to help patients using constructive coping in controlling the hallucination in order to decrease the symptoms and its effects on patients and other people

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Las alucinaciones visuales en la obra de Oliver Sacks / Visual hallucinations in the works of Oliver Sacks

Introducción: Las alucinaciones visuales constituyen una de las manifestaciones más singulares de diversas situaciones clínicas, ya sea en el ámbito de las enfermedades mentales, de las alteraciones físicas o del consumo de drogas. Sin embargo, el análisis detallado de su vivencia en relación con las causas que pueden producirlas es poco frecuente. Objetivo: Considerar la representación de las alucinaciones visuales en las publicaciones del neurólogo y escritor Oliver Sacks, con especial atención a su obra Hallucinations. Desarrollo: Las alucinaciones han llamado la atención de la cultura, la religión y el arte, lo que ha conllevado múltiples interpretaciones. El interés de Sacks por la percepción de las sensaciones le llevó a investigar los mecanismos por los que se producen las alucinaciones, debido al escaso conocimiento que se tenía sobre el tema. Las alucinaciones aparecieron ya en obras como Migraine, Awakenings o A leg to stand on. En Musicophilia abordó las alucinaciones auditivas, y en Hallucinations las consideró de forma monográfica. En esta última obra, Sacks analizó especialmente las presentes en el síndrome de Charles Bonnet, en situaciones de privación sensorial y en pacientes con epilepsia, las precipitadas por la levodopa y las causadas por drogas de abuso. Conclusiones: Hallucinations es una de las obras de Oliver Sacks con mayor contenido neurooftalmológico. La descripción de las alucinaciones de sus pacientes o las experimentadas en su propia piel y la reflexión sobre el mundo de la percepción hacen de Hallucinations una de las obras más fascinantes de Sacks

Introduction: Hallucinations are one of the most bizarre experiences in several diseases. They appear in mental diseases as well as in physical illnesses and may be the consequence of the usage of drugs of abuse. However, a detailed analysis of how patients feel under hallucinations caused by different diseases is uncommon. Aim: This article analyses how visual hallucinations are considered in the works of the neurologist and writer Oliver Sacks, with special attention to his book Hallucinations. Development: Hallucinations have been under consideration by culture, religion and arts, which has led to multiple interpretations. Sackss interest in perception of sensations led him to work on the analysis of hallucinations, given the limited knowledge on the topic. References to hallucinations appeared in several of his books like Migraine, Awakenings and A leg to stand on. In Musicophilia Sacks approached the auditory hallucinations and in Hallucinations he considered them in depth. In the latter work, Sacks analyses especially those present in Charles Bonnet syndrome, in situations of sensory deprivation, in patients with epilesy, those present during treatment with levodopa and those caused by drug of abuse. Conclusions: Hallucinations is one of Sacks’s books with greater neuroophthalmological content. The descriptions of the hallucinations of his patients or those experienced by himself, as well as the reflective analysis on the world of perception make this book one of the most fascinating works of Oliver Sacks

Altered auditory self-recognition in people with schizophrenia

Self-recognition is of great significance to our sense of self. To date, disturbances in the processing of visual self-recognition are well studied in people with schizophrenia, whereas relatively few studies have focused on the processing of self in other domains, such as auditory. An investigation of auditory self-recognition contributes to delineate changes related to self and the potential roots of the described psychopathological aspects connoting schizophrenia. By applying unimodal task and multisensory test, this study investigated auditory self-recognition in people with schizophrenia under unimodal and bimodal circumstances. Forty-six adults diagnosed with schizophrenia and thirty-two healthy controls were involved in this study. Results suggested that people with schizophrenia seemed to have significantly lower perceptual sensitivity in detecting self-voice, and also showed stricter judgment criteria in self-voice decision. Furthermore, in the presentation of stimuli that combined the stimulation of others' faces with one's own voice, people with schizophrenia mistakenly attributed the voices of others as their own. In conclusion, altered auditory self-recognition in people with schizophrenia was found

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