[Clinical dilemmas derived from the need to certify rape for voluntary pregnancy interruption]. / Dilemas clínicos en la constitución de la tercera causal de la interrupción voluntaria del embarazo.

Since 2017, women in Chile are allowed to interrupt voluntarily a pregnancy on three grounds: 1) When a woman's life is at risk due to the pregnancy, 2) When there are fetal anomalies incompatible with life, or 3) When pregnancy is result of rape. Women who qualify for any of these three pregnancy interruption requirements are entitled to a psychosocial accompaniment program to promote an integrative approach. In this article we will discuss the role of the psychosocial team in cases of rape resulting pregnancy. Specifically, the clinical and ethical dilemmas posed by the need to certify the rape in a general hospital such as difficulties in assessment of the story's plausibility, clinician's dual role and the limits to confidentiality, are discussed.

Dilemas clínicos en la constitución de la tercera causal de la interrupción voluntaria del embarazo / Clinical dilemmas derived from the need to certify rape for voluntary pregnancy interruption

Since 2017, women in Chile are allowed to interrupt voluntarily a pregnancy on three grounds: 1) When a woman's life is at risk due to the pregnancy, 2) When there are fetal anomalies incompatible with life, or 3) When pregnancy is result of rape. Women who qualify for any of these three pregnancy interruption requirements are entitled to a psychosocial accompaniment program to promote an integrative approach. In this article we will discuss the role of the psychosocial team in cases of rape resulting pregnancy. Specifically, the clinical and ethical dilemmas posed by the need to certify the rape in a general hospital such as difficulties in assessment of the story's plausibility, clinician's dual role and the limits to confidentiality, are discussed.

EEG Classification During Scene Free-Viewing for Schizophrenia Detection.

Currently, the diagnosis of schizophrenia is made solely based on interviews and behavioral observations by a trained psychiatrist. Technologies such as electroencephalography (EEG) are used for differential diagnosis and not to support the psychiatrist's positive diagnosis. Here, we show the potential of EEG recordings as biomarkers of the schizophrenia syndrome. We recorded EEG while schizophrenia patients freely viewed natural scenes, and we analyzed the average EEG activity locked to the image onset. We found significant differences between patients and healthy controls in occipital areas approximately 500 ms after image onset. These differences were used to train a classifier to discriminate the schizophrenia patients from the controls. The best classifier had 81% sensitivity for the detection of patients and specificity of 59% for the detection of controls, with an overall accuracy of 71%. These results indicate that EEG signals from a free-viewing paradigm discriminate patients from healthy controls and have the potential to become a tool for the psychiatrist to support the positive diagnosis of schizophrenia.

[Psychiatric sick leave]. / Licencia médica psiquiátrica: revisión de los efectos positivos y negativos del reposo.

There is no consensus amongst physicians, social security representatives and researchers about optimum sick leaves. This is an indication that should maximize positive outcomes and minimize potential side effects, both for the patient and society. The use of sick leaves during the last decade rose steadily, particularly in the psychiatric field. The most important causes of this increase are: changes in public policies, overuse of psychiatric diagnosis to cover up unmet social needs, and modifications to labour structure. It is analysed the impact that this situation has implied for physician patient relationship as well as for health budget. Even though sick leave diminishes presentism associated to a psychiatric disorder, published evidence about the effect of prolonged sick leave shows that damage overruns potential benefits: augmented morbidity and mortality, workplace phobia, economic loss, among others.

Licencia médica psiquiátrica: revisión de los efectos positivos y negativos del reposo / Psychiatric sick leave

There is no consensus amongst physicians, social security representatives and researchers about optimum sick leaves. This is an indication that should maximize positive outcomes and minimize potential side effects, both for the patient and society. The use of sick leaves during the last decade rose steadily, particularly in the psychiatric field. The most important causes of this increase are: changes in public policies, overuse of psychiatric diagnosis to cover up unmet social needs, and modifications to labour structure. It is analysed the impact that this situation has implied for physician patient relationship as well as for health budget. Even though sick leave diminishes presentism associated to a psychiatric disorder, published evidence about the effect of prolonged sick leave shows that damage overruns potential benefits: augmented morbidity and mortality, workplace phobia, economic loss, among others.

Small Saccades and Image Complexity during Free Viewing of Natural Images in Schizophrenia.

In schizophrenia, patients display dysfunctions during the execution of simple visual tasks such as antisaccade or smooth pursuit. In more ecological scenarios, such as free viewing of natural images, patients appear to make fewer and longer visual fixations and display shorter scanpaths. It is not clear whether these measurements reflect alterations in their proficiency to perform basic eye movements, such as saccades and fixations, or are related to high-level mechanisms, such as exploration or attention. We utilized free exploration of natural images of different complexities as a model of an ecological context where normally operative mechanisms of visual control can be accurately measured. We quantified visual exploration as Euclidean distance, scanpaths, saccades, and visual fixation, using the standard SR-Research eye tracker algorithm (SR). We then compared this result with a computation that includes microsaccades (EM). We evaluated eight schizophrenia patients and corresponding healthy controls (HC). Next, we tested whether the decrement in the number of saccades and fixations, as well as their increment in duration reported previously in schizophrenia patients, resulted from the increasing occurrence of undetected microsaccades. We found that when utilizing the standard SR algorithm, patients displayed shorter scanpaths as well as fewer and shorter saccades and fixations. When we employed the EM algorithm, the differences in these parameters between patients and HC were no longer significant. On the other hand, we found that image complexity plays an important role in exploratory behaviors, demonstrating that this factor explains most of differences between eye-movement behaviors in schizophrenia patients. These results help elucidate the mechanisms of visual motor control that are affected in schizophrenia and contribute to the finding of adequate markers for diagnosis and treatment for this condition.