Um capítulo esquecido na história da psicologia? sexualidades desviantes, psicopatologia e normalidade / A forgotten chapter in the history of psychology? deviant sexualities, psychopathology, and normality / ¿Un capítulo olvidado en la historia de la psicología? sexualidades desviadas, psicopatología y normalidad

Este artigo tem como objetivo produzir uma análise histórica sobre as intersecções entre Psicologia e sexualidade desviantes da norma no Brasil, de fins do século XIX a meados da década de 1980. Esta temporalidade foi escolhida por abarcar o surgimento das pesquisas científicas sobre sexualidade e desvios sexuais, a consolidação dos estudos psicológicos sobre a temática e o processo mais recente de despatologização da homossexualidade. Em termos teóricos e metodológicos, foram adotados os pressupostos da História Social da Psicologia e da historiografia das homossexualidades no Brasil. Desse modo, buscou-se compreender como as ideias, concepções e práticas psicológicas foram mudando ao longo do tempo, em conexão com as transformações socioculturais e políticas que ocorreram durante o século XX. Para isto, foram utilizadas fontes primárias e secundárias de pesquisa com vistas à produção de interpretações sobre as conexões entre as ideias, os atores e os eventos narrados. Argumenta-se, ao longo do artigo, que as ideias e práticas psicológicas estão intrinsecamente conectadas aos contextos socioculturais e políticos de seu tempo, sendo os movimentos dinâmicos e os conflitos presentes nesses contextos fatores determinantes para a sua constituição.(AU)

This article aims to produce a historical analysis of the intersections between Psychology and sexualities that deviate from the norm in Brazil, from the late 19th century to the mid-1980s. This period was chosen because it encompasses the emergence of scientific research on sexuality and sexual deviations, the consolidation of psychological studies on the subject and the most recent process of de-pathologization of homosexuality. Theoretically and methodologically, the assumptions of the Social History of Psychology and the historiography of homosexualities in Brazil were adopted. Therefore, we sought to understand how psychological ideas, conceptions and practices have changed over time, in connection with the sociocultural and political transformations that occurred throughout the 20th century. For this, primary and secondary sources of research were used to produce interpretations about the connections between the ideas, the actors and the narrated events. It is argued, throughout the article, that the psychological ideas and practices are intrinsically connected to the sociocultural and political contexts of their time, being the dynamic movements and conflicts present in these contexts determining factors for their constitution.(AU)

Este artículo tiene como objetivo realizar un análisis histórico de las intersecciones entre la Psicología y las sexualidades desviadas de la norma en Brasil desde finales del siglo XIX hasta mediados de la década de 1980. Esta temporalidad fue elegida por abarcar el surgimiento de las investigaciones científicas sobre sexualidad y desvíos sexuales, la consolidación de los estudios psicológicos sobre el tema y el más reciente proceso de despatologización de la homosexualidad. En el marco teórico y metodológico, se adoptaron los presupuestos de la Historia Social de la Psicología y de la historiografía de las homosexualidades en Brasil. De esta manera, se pretende comprender cómo las ideas, concepciones y prácticas psicológicas han cambiado a lo largo del tiempo, en conexión con las transformaciones socioculturales y políticas ocurridas durante el siglo XX. Para ello, se utilizaron las fuentes de investigación primarias y secundarias con miras a generar interpretaciones sobre las conexiones entre las ideas, los actores y los eventos narrados. Se argumenta, a lo largo de este artículo, que las ideas y las prácticas psicológicas están intrínsecamente conectadas a los contextos socioculturales y políticos de su tiempo, y los movimientos dinámicos y los conflictos presentes en estos contextos fueron los factores determinantes para su constitución.(AU)

The prevalence of impulsive compulsive behaviors in patients treated with apomorphine infusion: a retrospective analysis / Prevalência de comportamentos impulsivo-compulsivos em pacientes tratados com infusão de apomorfina: análise retrospectiva

ABSTRACT Background: Impulsive compulsive behaviors (ICBs) can affect a significant number of Parkinson's disease (PD) patients. Objective: We have studied brain samples from a brain bank of PD patients who received apomorphine via continuous infusion in life to assess the prevalence and outcome of ICBs. Methods: A search on the Queen Square Brain Bank (QSBB) database for cases donated from 2005 to 2016 with a pathological diagnosis of idiopathic PD was conducted. Notes of all donors who used apomorphine via continuous infusion for at least three months were reviewed. Clinical and demographic data were collected, as well as detailed information on treatment, prevalence and outcomes of ICBs. Results: 193 PD cases, 124 males and 69 females, with an average age at disease onset of 60.2 years and average disease duration of 17.2 years were reviewed. Dementia occurred in nearly half of the sample, depression in one quarter, and dyskinesias in a little over 40%. The prevalence of ICBs was 14.5%. Twenty-four individuals used apomorphine infusion for more than three months. Patients on apomorphine had younger age at disease onset, longer disease duration, and higher prevalence of dyskinesias. The prevalence of de novo ICB cases among patients on apomorphine was 8.3%. Apomorphine infusion was used for an average of 63.1 months on an average maximum dose of 79.5 mg per day. Ten patients remained on apomorphine until death. Conclusions: Apomorphine can be used as an alternative treatment for patients with previous ICBs as it has low risk of triggering recurrence of ICBs.

RESUMO Antecedentes: Comportamentos impulsivo-compulsivos (CICs) podem acometer uma parcela significativa de indivíduos com doença de Parkinson (DP). Objetivo: Nós estudamos amostras de tecido cerebral de uma população de pacientes com DP de um banco de cérebros que receberam apomorfina por infusão contínua em vida, com a finalidade de avaliar a prevalência e o desfecho dos CICs. Métodos: Uma pesquisa no banco de dados do Banco de Cérebros de Queen Square foi conduzida à procura de doações recebidas entre 2005 e 2016 com diagnóstico anatomopatológico de DP idiopática. Os prontuários de todos os doadores que usaram apomorfina por infusão contínua por um período mínimo de três meses foram revisados. Dados clínicos e demográficos foram coletados, assim como informações detalhadas sobre o tratamento, prevalência e desfecho dos CICs. Resultados: 193 casos de DP, 124 do sexo masculino e 69 do sexo feminino, com idade média de início da doença de 60,2 anos e tempo médio de duração da doença de 17,2 anos, foram revisados. Aproximadamente metade dos casos apresentaram demência, um quarto depressão, e um pouco mais de 40% discinesias. A prevalência de CICs foi 14,5%. Vinte e quatro indivíduos usaram infusão de apomorfina por mais de três meses. Os pacientes que usaram apomorfina apresentaram DP mais cedo, maior duração da doença, e uma maior prevalência de discinesias. A prevalência de novos casos de CICs entre pacientes usando apomorfina foi de 8,3%. Infusão de apomorfina foi usada em média por 63,1 meses a um dose máxima média de 79,5 mg por dia. Dez pacientes permaneceram usando apomorfina até o óbito. Conclusões: Apomorfina pode ser usada como opção de tratamento alternativo para pacientes que apresentarem CICs no passado considerando seu baixo risco de causar recorrência de CICs.

Assessment of therapeutic strategies for management of impulse control disorder in Parkinson's disease / Evaluación de las estrategias terapéuticas en trastornos del control de impulsos en enfermedad de Parkinson

ABSTRACT Background: Impulse control disorders (ICD) occur frequently in individuals with Parkinson's disease. So far, prevention is the best treatment. Several strategies for its treatment have been suggested, but their frequency of use and benefit have scarcely been explored. Objective: To investigate which strategy is the most commonly used in a real-life setting and its rate of response. Methods: A longitudinal study was conducted. At the baseline evaluation, data on current treatment and ICD status according to QUIP-RS were collected. The treatment strategies were categorized as "no-change", dopamine agonist (DA) dose lowering, DA removal, DA switch or add-on therapy. At the six-month follow-up visit, the same tools were applied. Results: A total of 132 individuals (58.3% men) were included; 18.2% had at least one ICD at baseline. The therapeutic strategy most used in the ICD group was no-change (37.5%), followed by DA removal (16.7%), DA switch (12.5%) and DA lowering (8.3%). Unexpectedly, in 20.8% of the ICD subjects the DA dose was increased. Overall, nearly 80% of the subjects showed remission of their ICD at follow-up. Conclusions: Regardless of the therapy used, most of the subjects presented remission of their ICD at follow-up Further research with a longer follow-up in a larger sample, with assessment of decision-making processes, is required in order to better understand the efficacy of strategies for ICD treatment.

Resumen Antecedentes: Los trastornos del control de impulsos (TCI) son frecuentes en personas con enfermedad de Parkinson. A la fecha, la prevención es el mejor tratamiento. Existen varias estrategias sugeridas para su tratamiento, pero su frecuencia de uso y beneficio ha sido escasamente explorada. Objetivo: Investigar qué estrategia es la más utilizada en un entorno de la vida real y su tasa de respuesta. Métodos: Se realizó un estudio longitudinal. En la evaluación inicial, se recopiló el tratamiento actual y el estado del TCI de acuerdo con el QUIP-RS. La estrategia de tratamiento se clasificó como "sin cambios", reducción de la dosis de agonista de la dopamina (AD), eliminación de AD, cambio de AD o terapia complementaria. En la visita de seguimiento a los 6 meses, se aplicaron las mismas herramientas. Resultados: Se incluyeron un total de 132 (58.3% hombres) personas. El 18.2% tenía al menos un TCI al inicio del estudio. La estrategia terapéutica más utilizada en el grupo de TCI fue sin cambios (37.5%), seguida de eliminación de DA (16.7%), cambio de AD (12.5%) y reducción de DA (8.3%). En el 20.8% de los sujetos con TCI se aumentó la dosis de AD. Casi el 80% de los sujetos tuvieron una remisión del TCI al seguimiento. Conclusiones: Independientemente de la terapia utilizada, la mayoría de los sujetos tuvieron una remisión del TCI. Se requiere más investigación con un seguimiento y una muestra mayor para evaluar l proceso de toma de decisiones para comprender mejor la eficacia de las estrategias.

Predictors of gaming disorder in children and adolescents: a school-based study

Objective: To determine whether psychiatric and gaming pattern variables are associated with gaming disorder in a school-based sample. Methods: We analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders, a community sample aged 10 to 18, using questionnaires on gaming use patterns. We applied the Gaming Addiction Scale to diagnose gaming disorder and the Development and Well-Being Behavior Assessment for other diagnoses. Results: Out of 407 subjects, 83 (20.4%) fulfilled the criteria for gaming disorder. More role-playing game players were diagnosed with gaming disorder that any other genre. Gaming disorder rates increased proportionally to the number of genres played. Playing online, being diagnosed with a mental disorder, and more hours of non-stop gaming were associated with higher rates of gaming disorder. When all variables (including age and gender) were considered in a logistic regression model, the number of genres played, the number of non-stop hours, the proportion of online games, and having a diagnosed mental disorder emerged as significant predictors of gaming disorder. Conclusion: Each variable seems to add further risk of gaming disorder among children and adolescents. Monitoring the length of gaming sessions, the number and type of genres played, time spent gaming online, and behavior changes may help parents or guardians identify unhealthy patterns of gaming behavior.

Momentos de "des-existir" e espaços vazios de "des-existência" / Moments of "de-existing" and empty spaces of "de-existence" / Momentos de "des-existir" y espacios vacíos de "des-existencia"

A utilização do conceito des-existir, usado por mim neste e em outros trabalhos, resulta de uma necessidade de nomear e delimitar situações em geral transitórias limitadas à esfera psíquica. Diferencia-se do conceito de matar, verbo ativo que implica na ação de um sujeito, seja em termos físicos ou metafóricos. Assim como diferencia-se também do conceito de morrer, ligado a algo mais definitivo em termos naturais ou figurados. Des-existir refere-se a uma situação momentânea, temporária e às vezes prolongada, em que o sujeito entra em processo de falência como sujeito psíquico por desinvestimento. Pode ser des-existido em diferentes graus de apagamento em um espectro que se estende entre a situação ativa de sujeito e a condição passiva de objeto da pulsão de morte (AU)

I employ the idea of de-existing, in this and other papers, as a result from an urge to name and delimit usually transient situations limited to the psychic sphere. It differs from the idea of killing, active verb that implies the action of a subject, in physical or metaphorical terms. As well as it also differs from the idea of dying, connected to something more definitive in natural or figurative terms. De-existing refers to a momentary, temporary situation, sometimes long-lasting, in which, due to disinvestment, the subject goes into a process of failure as psychic subject. It may be de-existed in different levels of effacement in a spectrum that extends between the active situation as subject and the passive condition of object of the death drive (AU)

El uso del concepto des-existir, que utilizo en este y otros trabajos, resulta de una necesidad de nombrar y delimitar en general situaciones transitorias limitadas a la esfera psíquica. Se diferencia del concepto de matar, verbo activo que implica la acción de un sujeto, ya sea en términos físicos o metafóricos. Además, también se diferencia del concepto de morir, ligado a algo más definitivo en términos naturales o figurativos. El des-existir se refiere a una situación momentánea, temporal y en ocasiones prolongada en la que el sujeto entra en proceso de desplome como sujeto psíquico debido a la desinversión. Puede ser des-existido en diferentes grados de desvanecimiento en un espectro que se extiende entre la situación activa del sujeto y la condición pasiva de objeto de la pulsión de muerte (AU)

Differentiating irritable mood and disruptive behavior in adults

Abstract Introduction Irritability has both mood and behavioral manifestations. These frequently co-occur, and it is unclear to what extent they are dissociable domains. We used confirmatory factor analysis and external validators to investigate the independence of mood and behavioral components of irritability. Methods The sample comprised 246 patients (mean age 45 years; 63% female) from four outpatient programs (depression, anxiety, bipolar, and schizophrenia) at a tertiary hospital. A clinical instrument rated by trained clinicians was specifically designed to capture irritable mood and disruptive behavior dimensionally, as well as current categorical diagnoses i.e., intermittent explosive disorder (IED); oppositional defiant disorder (ODD); and an adaptation to diagnose disruptive mood dysregulation disorder (DMDD) in adults. Confirmatory factor analysis (CFA) was used to test the best fitting irritability models and regression analyses were used to investigate associations with external validators. Results Irritable mood and disruptive behavior were both frequent, but diagnoses of disruptive syndromes were rare (IED, 8%; ODD, 2%; DMDD, 2%). A correlated model with two dimensions, and a bifactor model with one general dimension and two specific dimensions (mood and behavior) both had good fit indices. The correlated model had root mean square error of approximation (RMSEA) = 0.077, with 90% confidence interval (90%CI) = 0.071-0.083; comparative fit index (CFI) = 0.99; and Tucker-Lewis index (TLI) = 0.99, while the bifactor model had RMSEA = 0.041; CFI = 0.99; and TLI = 0.99 respectively). In the bifactor model, external validity for differentiation of the mood and behavioral components of irritability was also supported by associations between irritable mood and impairment and clinical measures of depression and mania, which were not associated with disruptive behavior. Conclusions Psychometric and external validity data suggest both overlapping and specific features of the mood vs. disruptive behavior dimensions of irritability.

Aggression directed towards others vs. aggression directed towards the self: clinical differences between intermittent explosive disorder and nonsuicidal self-injury

Objective: To investigate the clinical differences between intermittent explosive disorder (IED) (disorder of aggression primarily directed towards others) and nonsuicidal self-injury (NSSI) (disorder of aggression predominantly directed towards the self) in order to better understand the different clinical subtypes of aggression. Methods: We used treatment-seeking samples to compare demographic and clinical correlates between 82 participants with IED and 55 participants with NSSI. Results: The IED group was older, more likely to be male, in a relationship, and employed than the NSSI group. With respect to clinical variables, the NSSI group had more severe depressive symptoms and more social adjustment difficulties. Regarding psychiatric co-morbidities, the IED group had higher rates of generalized anxiety disorder. On the other hand, the NSSI group had higher rates of major depressive disorder, agoraphobia, substance use disorder, and bulimia nervosa. Conclusions: Individuals with NSSI may benefit from better management of psychiatric comorbidities, specifically depressive symptoms and social adjustment difficulties. Conversely, the treatment of individuals with IED may be improved by targeting comorbid generalized anxiety disorder. Our results provide important insight for the development of tailored interventions for specific subtypes of aggression.

Cognitive-behavioral group therapy for intermittent explosive disorder: description and preliminary analysis

Objectives: To evaluate the efficacy of a group therapy based on cognitive-behavioral techniques customized for intermittent explosive disorder (IED). The current report presents the preliminary results of a clinical trial comparing pre- and post-intervention scores in different anger dimensions. Methods: The studied sample consisted of 84 treatment-seeking subjects. The mean (standard deviation) age was 43.0 (11.9) years, and 78% were male. The therapeutic group program consisted of 15 weekly sessions plus three maintenance sessions. The sessions lasted approximately 90 minutes each. Results: No differences were found in demographic profile and pre-treatment status between subjects who completed treatment (n=59) and dropouts (n=25). Comparison of State-Trait Anger Expression Scale (STAXI) scores pre- and post-treatment showed statistically significant changes in all anger scales and subscales of the questionnaire. Conclusion: This preliminary report is a significant addition to currently scarce clinical data. Our findings provide further evidence that structured cognitive-behavioral group therapy, with a focus on anger management and cognitive coping, may be a promising approach to the treatment of IED.

About the possible relationship between the scoundrel and the psychopath / Sobre o possível parentesco entre o canalha e o psicopata

Busca-se demonstrar como a posição canalha, tal como foi concebida por Lacan e Jacques Alain Miller, pode ser uma chave de leitura para o fenômeno representado pela psicopatia. Ao aproximarmos o canalha do psicopata, é-nos possível extrair norteamentos teóricos e, principalmente, clínicos, uma vez que toca diretamente na advertência lacaniana de que devemos negar a psicanálise aos canalhas, bem como os motivos que o levaram a tal conclusão.

We aim to demonstrate how the scoundrel position, such as it was conceived by Lacan and Jacques Alain Miller, can be a key of comprehension to the psychopathic phenomenon. As we approximate the scoundrel to the psychopath, it is possible to extract theoretical guidance and mainly clinical, once it touches directly in the lacanian direction of denying the psychoanalysis to the scoundrel and also the reasons that led him to that conclusion.

Impulse control and related disorders in Parkinson's disease / Transtorno de controle de impulso e condições relacionadas na doença de Parkinson

ABSTRACT Neuropsychiatric disorders are common among patients with Parkinson's disease and may appear in any stage of the disease. However, these disorders often go undiagnosed and receive insufficient treatment. Observations in recent years have revealed that dopamine replacement therapy may lead to the development or worsening of conditions, such as gambling disorder, compulsive sexual behavior, compulsive buying and binge eating, in addition to punding and dopamine dysregulation syndrome. The pathophysiology of these disorders seems to be related to abnormal dopaminergic stimulation of the basal regions of the basal ganglia, especially via nigro-mesolimbic pathways. The aim of the present study was to perform a literature review on impulsivity, impulse control disorders and related conditions among patients with Parkinson's disease, with emphasis on their epidemiology, clinical characteristics and treatment.

RESUMO Alterações neuropsiquiátricas são comuns na doença de Parkinson e estão presentes em todas as fases da enfermidade. No entanto, frequentemente não são reconhecidas e recebem tratamento insuficiente. Ao longo dos últimos anos, observou-se que a terapia de reposição dopaminérgica pode levar ao desenvolvimento ou piora de condições como transtorno do jogo, compulsão por sexo, compras, e comida, além da síndrome de desregulação dopaminérgica e punding. Sua fisiopatologia parece estar relacionada à estimulação dopaminérgica anormal das regiões basais dos núcleos da base, sobretudo pelas vias nigro-mesolímbicas. O presente artigo tem como objetivo fazer uma revisão da literatura a respeito de impulsividade, transtornos do controle de impulso e condições relacionadas na doença de Parkinson, com foco na epidemiologia, características clínicas e tratamento.

Religiosity is a moderator of the relationship between impulsivity and internalizing symptoms

Abstract Background There is growing interest in the role of religion in psychiatric disorders. Impulsivity is a psychological trait associated with acting without thinking, with a decision process favoring short-term outcomes without further consideration of its consequences, and is a risk factor for the development of mental disorders. Objective In this study, the objective was to analyze the role of religiosity as a possible moderator between the association of impulsivity and internalizing psychiatric symptoms. Methods The hypothesis was assessed in a cross-sectional study enrolling 366 adults evaluated using the abbreviated version of the Barratt Impulsiveness Scale-11, the Self Reporting Questionnaire-20, and the Duke Religion Index. Results Internalizing symptoms were significantly influenced by an interaction between religiosity and impulsivity. Religiosity acted as a protective factor against internalizing symptoms only for participants with high impulsivity. Discussion The results suggest a moderation role of religiosity in the association of impulsivity with internalizing symptoms.

Las adicciones no relacionadas a sustancias (DSM-5, APA, 2013): un primer paso hacia la inclusión de las adicciones conductuales en las clasificaciones categoriales vigentes / Non-substance related addictions (DSM-5, APA 2013): A first step towards the inclusion of Behavioral Addictions in current categorical classifications

Se evalúan los cambios en la nomenclatura de las Adicciones en el DSM-5 y la inclusión de una nueva categoría dentro de las mismas, a la que denomina "Trastornos no relacionados a sustancias" y con la cual se designa a las llamadas adicciones conductuales. Dentro ella se incluye como única patología aprobada al juego patológico o ludopatía con un nuevo rótulo: "Trastorno por juego de apuestas". El inconveniente de tal etiqueta diagnóstica para su aceptación y uso por el público en general es que puede dar lugar al supuesto erróneo de que la práctica del juego genera siempre enfermedad. Por otro lado, sin embargo, el considerar al juego patológico una adicción y no un trastorno del control de impulsos ha sido un gran avance. Lamentablemente no fue incluida la "Adicción a Internet" en el nuevo rubro, pese a su enorme y creciente importancia mundial. Se describen además las características clínicas de esta última enfermedad

Changes in DSM-5 nomenclature of Addictions are evaluated and commented upon. Particular attention is paid to the inclusion of a new category named "Non-substance related Disorders" which designates the so-called behavioral addictions. The only entity accepted here is pathological gambling or ludopathy, using the new label "Gambling Addiction". The inconvenience of such label for its acceptance and use by the general public is that it may lead to the erroneous assumption that the practice o gambling can always cause the illness. On the other hand, however, considering pathological gambling as an addiction and not an impulse control disorder constitutes a great step forward. Regrettably "Internet Addiction" has not been included under the new rubric, in spite of its enormous and growing relevance across the world. The clinical characteristics of the latter are described

Trastorno explosivo intermitente: un diagnóstico controversial / Intermittent Explosive Disorder: A Controversial Diagnosis

Introducción: El trastorno explosivo intermitente (TEI) es un trastorno externalizante que se caracteriza por episodios recurrentes de agresividad. Aunque es un trastorno descrito desde hace varias décadas, y que ocasiona consecuencias personales y sociales, la producción bibliográfica sobre este tema es sorprendentemente escasa. Objetivo: Realizar una conceptualización sobre el TEI a partir de la revisión y el análisis bibliométrico de los artículos científicos disponibles. Material y métodos: Se realizó una búsqueda en las bases de datos con los términos en inglés intermittent explosive disorder, impulse control disorders [MeSH] en combinación con otros términos. Se realizó un análisis bibliométrico utilizando los datos obtenidos en el buscador GoPubMed®. Discusión: La prevalencia del TEI oscila entre el 1,4 y el 7%, con mayor frecuencia durante la adolescencia media, y con más repercusiones notorias en varones que en mujeres. El núcleo psicopatológico del TEI es la conducta agresiva impulsiva que se presenta en forma de «ataques¼ que ocurren en respuesta a un estímulo precipitante menor. Las publicaciones científicas sobre el TEI son pocas, relativamente recientes, y la mayoría de Estados Unidos (56,56%), en cabeza un solo autor. Este hecho resalta la necesidad de repetir los hallazgos descritos sobre el TEI para demostrar validez y confiabilidad de sus criterios diagnósticos. Es posible que las dudas sobre la existencia del diagnóstico estén conduciendo a que se publique tan escasamente sobre el TEI. Conclusiones: Los estudios disponibles sobre TEI permiten caracterizar un grupo de sujetos con episodios de agresividad impulsiva, pero esta descripción requiere que se repita en latitudes diferentes.

Introduction: Intermittent explosive disorder (IED) is aan externalizing externalising disorder characterized characterised by recurrent aggression episodes. Even though this disorder was described several decades ago, and it carries personal and social consequences, there is little in the medical scientific literature on this. bibliographic production about it is scanty. Objective: To perform a conceptualization conceptualisation of this disorder, through the review and bibliometric analysis of the available scientific articles. Material and methods: A search was performed in databases with the english English terms intermittent explosive disorder, impulse disorders control [MeSH], in combination with other terms. A bibliometric analysis in the GoPubMed® search engineer was also performed using all data obtained in the search. was also perfomed. Discussion: IED prevalence ranges from 1.4% to 7%, it presents more frequently during middle adolescence, and with more noticeable repercussions in men males than in womenfemales. The psychopathological core of IED is the impulsive aggressive behaviour that presents in the form of «attacks¼ that occurs in response to a lower precipitating stimulus. Scientific publications about IED are few and relatively recent, and the vast majority is provided bycomes from the United States (56.56%), and headed by a single author. This fact highlights the need to replicate the findings described about the IED in order to demonstrate the validity and reliability of its diagnostic criteria. It is possible that doubts about the existence of a diagnosis lead have led to such a scant literature about the IED. Conclusions: Available studies about IED allow have allowed characterizing a group of subjects with episodes of impulsive aggression to be characterised, but this description requires replication in different latitudes needs to be repeated in different areas.

Psychosis and concurrent impulse control disorder in Parkinson's disease: A review based on a case report / Psicose e transtorno de impulsividade concomitantes na Doença de Parkinson: revisão baseada em um relato de caso

ABSTRACT Psychosis, impulse control disorders (e.g., pathological gambling and hypersexuality) and repetitive behaviors such as punding are known psychiatric complications of Parkinson's disease (PD). Impulsive, compulsive and repetitive behaviors are strongly associated with dopamine-replacement therapy. We present the case of a 58-year-old man with PD and a myriad of psychiatric symptoms. Concurrent psychosis, punding and pathological gambling developed more than six years after the introduction of pramipexole and ceased shortly after the addition of quetiapine and discontinuation of pramipexole. This report emphasizes the importance of monitoring for a wide array of psychiatric symptoms in patients on dopamine replacement therapy.

RESUMO Psicose, transtornos do impulso (como jogo patológico e hipersexualidade) e comportamentos repetitivos como punding são complicações psiquiátricas conhecidas da doença de Parkinson. Comportamentos repetitivos, impulsivos e compulsivos são fortemente associados a terapia de reposição dopaminérgica. Nós apresentamos o caso de um homem de 58 anos com doença de Parkinson de início precoce e múltiplos sintomas psiquiátricos. Psicose, punding e jogo patológico surgiram mais de seis anos após a introdução de pramipexol e cessaram pouco após sua descontinuação e introdução de quetiapina. Nosso relato enfatiza a importância do monitoramento para uma ampla gama de sintomas psiquiatricos em pacientes com doença de parkinson em uso de terapia de reposição dopaminérgica.

Infarto agudo do miocárdio em jogador patológico / Acute myocardial infarction in pathological player

O jogo patológico caracteriza-se pela maneira desajustada do indivíduoproceder diante de jogos de azar, de forma recorrente,excessiva, e com repercussões negativas na vida pessoal, familiare profissional. Jogadores patológicos são rotineiramente submetidosà grande carga de estresse, devido a problemas financeirose familiares, e, frequentemente, possuem múltiplos fatores derisco tradicionais para doença aterosclerótica coronariana. Adependência do jogo patológico altera o estado subjetivo do indivíduo,interagindo com a atividade cerebral, pela estimulaçãoda atividade nervosa. O jogo, em muitos aspectos, pode mimetizaros efeitos do abuso de drogas estimulantes, cursando comliberação catecolaminérgica contínua. Considerando as diversasalterações psíquicas e autonômicas associadas ao jogo patológico,existe a possibilidade de essa patologia apresentar associaçãocom a instabilidade do ateroma e consequente infarto agudodo miocárdio. Neste relato de caso, descrevemos uma pacienteportadora de múltiplos fatores de risco cardiovascular, que sofreuum infarto agudo do miocárdio durante atividade de jogoe aposta, evidência que contribui com a hipótese em potencialde que alterações autonômicas associadas ao jogo patológico podemter algum papel na instabilização do ateroma.(AU)

Pathological gambling is characterized by the dysfunctional,recurrent and excessive way the individual handles gambling,which leads to adverse consequences for the gambler?s personal,professional and family lives. Pathological gamblers are regularlyunder a lot of stress due to financial and family problems, andthey often have multiple traditional risk factors for coronaryatherosclerotic disease. Pathological gambling addiction alters theindividual?s subjective state of mind, interacting with the brainactivity by stimulating the nervous system. The gambling in manyways may mimic the effects of stimulant drugs, evolving withcontinuous catecholaminergic response. Considering the severalpsychic and autonomic changes associated with pathologicalgambling, this disorder could be related to atheroma instabilityand consequent acute myocardial infarction. This paper describeda patient with multiple cardiovascular risk factors, who has sufferedan acute myocardial infarction during gambling activity, that wasan evidence which contributes to the potential hypothesis thatautonomic changes associated with pathological gambling mayhave some role in the atheroma destabilizatio.(AU)

Castração química em casos de pedofilia: considerações bioéticas / Castración química en los casos de pedofilia: consideraciones bioéticas / Chemical castration in cases of pedophilia: bioethics considerations

A pedofilia é classificada como doença psiquiátrica e sua prática acaba por atingir e ofender diretamente crianças e pré-adolescentes, sendo um fato social de extrema relevância. O presente trabalho tem como objetivo analisar a eticidade da castração química como mecanismo de controle da pedofilia, problematizando sua eventual tríplice natureza: pena, tratamento médico e experimento científico. Trata-se de um estudo de revisão bibliográfica, mediante o levantamento de literatura especializada sobre bioética, castração química, pedofilia, tratamento médico e ética em pesquisa. Conclui-se que as três acepções não se excluem: a castração química como pena, tratamento médico e experimento científico representa arquétipos que se encontram intrinsecamente ligados, apesar de cada um possuir conotações éticas próprias. Este estudo teve o mérito de ampliar a compreensão do tratamento hormonal para pedófilos, diante da escassez de bibliografia no contexto brasileiro...

La pedofilia es clasificada como una enfermedad psiquiátrica y su práctica termina por afectar y ofender directamente a los niños y preadolescentes, al ser un hecho social de extremada relevancia. Este estudio tiene como objetivo analizar la ética de la castración química como un mecanismo de control de la pedofilia, discutiendo su posible triple naturaleza: pena, tratamiento médico y experimento científico. Se trata de una revisión bibliográfica a través de la encuesta de literatura especializada sobre bioética, castración química pedofilia, tratamiento médico y ética en la investigación. Se concluye que los tres significados no son mutuamente excluyentes: la castración química como pena, tratamiento médico y experimento científico, en realidad, son arquetipos que están intrínsecamente vinculados, aunque cada uno tiene sus propias connotaciones éticas. El presente estudio tuvo el mérito de ampliar la comprensión del tratamiento hormonal para los pedófilos, frente a la escasez de bibliografía en el contexto brasileño...

Pedophilia is classified as a psychiatric disease and its practice ends up directly reaching and offending children and pre-teenagers, being an extreme relevant social issue. This paper aims to analyze the ethics of chemical castration as a tool to avoid pedophilia, problematizing its triple nature: punishment, medical treatment and scientific experiment. It is a bibliographic review, through analyzes of specialized literature on bioethics, chemical castration, pedophilia, medical treatment and ethics in research. It is concluded that the three meanings do not exclude themselves: chemical castration as punishment, medical treatment and scientific experiment are, actually, archetypes which are intrinsically linked, despite each one has their own ethics connotations. This paper had the merit of expanding the hormonal treatment for pedophiles, given the lack of bibliography in the Brazilian context...

Confiabilidad y validez de la escala de impulsividad de Barratt (BIS-11) en adolescentes / Reliability and validity of Barratt impulsiveness scale (BIS-11) in adolescents

Introducción: La Escala de Impulsividad de Barratt (BIS) es uno de los instrumentos más frecuentemente usados para evaluar la impulsividad. Este artículo describe la confiabilidad y validez de la BIS-11 en adolescentes chilenos. Sujetos y Métodos: El estudio se efectuó en estudiantes de enseñanza media (n = 763). La confiabilidad se evaluó con análisis de consistencia interna y homogeneidad de los ítems. Para la validez se empleó coeficiente de correlación de Pearson y prueba t de student para muestras independientes. Resultados: La escala obtuvo un coeficiente alfa de Cronbach de 0,77 y su puntaje total correlacionó significativamente con impulsividad según DSM IV, impulsividad según reporte del profesor, intento de suicidio y consumo de alcohol. Conclusiones: La BIS-11 es una medida de impulsividad con adecuada confiabilidad y validez en esta población.

Background: The Barratt Impulsivity Scale (BIS) is one of the most commonly used scales for the assessment of impulsiveness. This report describes the reliability and validity of the BIS-11. Subjects and Methods: The study was conducted in high school students (n = 763). The reliability was evaluated with analysis of internal consistency and homogeneity of the items. For the validity Pearson coefficient of correlation and the student t-test for independent sample were used. Results: The scale obtained a Cronbach alpha coefficient of 0,77, and the total scores of the scale correlated significantly with impulsivity according to DSMIV, impulsivity according to the teacher, suicide attempt and alcohol consumption. Conclusions: The BIS-11 is a valid and reliable measure of impulsivity in this population.