Effect of the HERVAT neuroeducational program on evoked potential P300 in children with attention deficit disorder.

INTRODUCTION: Attention deficit disorder (ADD) has been investigated from various perspectives. However, the neurobiological mechanisms underlying this condition remain unknown. Evoked potentials, including P300, can be used to investigate the processes underlying deficient attentional and cognitive functions in children with ADD. METHODS: In this study, we analyze the effect of a neuroeducational program, HERVAT (Hidratación [hydration], Equilibrio [balance], Respiración [breathing], Visión [vision], Audición [hearing], Tacto [touch]), on evoked potential P300 in a group of children aged 7-11 years with ADD. RESULTS: At the end of the study, the latency of P300 improved and brain activity was reorganized toward frontal areas in children with ADD who undertook the HERVAT program. In the control group, on the other hand, the latency of P300 and the posterior cortical areas remained unchanged during tests to discriminate between multisensory stimuli. CONCLUSIONS: In conclusion, the neuroeducational program HERVAT effectively shortened the latency of evoked potential P300, which is responsible for information processing in the brain, and reorganized brain activity from posterior areas toward frontal cortical areas, which are responsible for the attentional processes involved in executive function.

Romanticism and schizophrenia. First part: The recency hypothesis and the core Gestalt of the disease.

Descriptions of irrational, incomprehensible, or unconstrained behavior such as is common nowadays in patients suffering from severe mental disorders can be found in the Bible, in Mesopotamian scripts, in classical Greek and Roman literature, and in the writings of many non-Western cultures. However, the presence of full-blown features of schizophrenia as seen today in psychiatric settings is controversial. Typical symptoms, the expected onset, duration and outcome, the impact of the disease on psychic functioning and the associated disability of the disease are mostly absent in those texts. Torrey (1980) and Hare (1988) have claimed that the disease did not exist before the year 1800 (this is known as the recency hypothesis). This would be the consequence of biological factors such as viruses, genetic or dietary factors or environmental contaminants associated to civilization. Others have put the emphasis on industrialization and its repercussions on social conditions such as family structure and migration. After analyzing the many manifestations of insanity in literary characters, in medical texts and in key historical figures, the arguments presented in this paper tend to support the recency hypothesis. A review of the core characteristics of schizophrenia and its impact on selfhood, intersubjetivity and ipseity, topics relatively neglected in recent psychiatric literature, opens the doors to consider in a second part the relationship between the features of Romanticism, starting by the "discovery of intimacy", and its articulation with the disturbance of ipseity and selfhood characteristic of the disease.

Romanticism and schizophrenia. Second part: The intimacy hypothesis.

In the first part of this article we have analyzed the evidence supporting the recency hypothesis of schizophrenia and also what we can call the intimate nature of the disease. In this part we highlight the role of certain cultural aspects that have been ignored up to now, aspects that are associated with deep changes in the Weltanschauung and systems of beliefs on human nature brought up by the late Modernism, specifically by Romanticism. The description of the main characteristics of Romanticism, starting with the “discovery of intimacy”, leads to the conclusion that the characteristic alteration of subjectivity and ipseity of the disease appears to be a vulnerability factor when somebody has to face the new challenges raise Romanticism. The consideration of Hölderlin’s literary achievements and the deep psychological drama prevailing in them, makes explicit how the late modern human being finds in Romanticism the source of creativity and personal development but also the threat of his or her own destruction. Finally we link our hypothesis with recent genetic perspectives that consider sets of diseases associated to the same gene or genes (diseasome). In any case the process of associating the traits of Late Modernism and Romanticism with the core features of schizophrenia allows to consider the amalgamation of insanity with society, both at a general level an in what concerns individual patients, paving the way for novel therapeutic strategies.

Perception, experience and body identity.

Physician has to know the patient in the disease and not only the disease in the patient, from the dual perspective of the body as object and the body as subject. This also affects the patient who has to cope with the reality of having a body that bursts into the subject's consciousness as a vital threat, as source of discomfort and inability and being a body (Marcel). The human body in its dual aspect has been and is a great unknown, if not a great outrage in spite of the fact that we are our body and our body is each of us. We sometimes do not feel as we are and thus a confrontation arises, sometimes more normal, others more morbid. This forces the physician to face complex ethics considerations and the scientist to accept a personal identity disorder. Dualism considers that there are two substances in us, one that distinguishes us from other beings and from the rest of the individuals of the human species, the soul, the psychic life, mind or consciousness, and another more insubstancial one, the body. The aim of the first substance is to dominate the body, to survive it after death when it is, already a corpse is meant to become putrefied, is buried, incinerated or thrown to the depth of the sea. This dualism aims to explain the origin of the evil and the attitude to defeat it and it does so efficiently. This anthropology has very ancient roots (the Upvanishads, in the orphic texts, in Plato), it is the core of Gnostic thought and the foundation of the modern science since Descartes. Some monist perspectives are a masked dualism or a mereologic fallacy, according to which, the brain is conscious, when that what is conscious is the subject, although the subject, with the brain could not be conscious. Therefore, a new perspective is proposed, chiasmatic or janicular monism, that considers the adaptive value of focusing on the reality from two perspectives, as physical universe and the world of interpersonal relationships. In the agnosias and in the phantom limb there is a confrontation between the body object and the body subject that has made it possible to investigate how the perception of the own body is and how the brain generates the schema and the body image. The study of the body experience, from the phenomenology and the anthropological psychiatry perspective, has made it possible to go greater in-depth into the knowledge of the alterations of the experience of the own body in different mental diseases, especially in those in which a confrontation between the body and the personal identity arises makes it necessary to consider the process of individual identification and a category of personal identity disorders that would include body dysmorphic disorder, erythrophobia, anorexia nervosa, body integrity identity as well as the gender-type disorders (transsexualism, nonfetishistic transvestism, gender identity disorder during childhood). Key words: Dualism, Monism, Agnosia, Phantom limb, Cenesthesia, Body schema, Body image, Body experience, Personal identity disorders, Body dysmorphic disorder, Anorexia nervosa, Personal integrity identity disorder.

The evolving concept of Treatment- Resistant Schizophrenia.

Schizophrenia is a chronic disease of body and mind that affects 1% of the population. The existence of the person with schizophrenia should be understood, at least, from two perspectives: one considering the integration of the individual into the social community, another understanding that there is a patient with a medical problem treatable with medications and psychotherapies. There is a large group of patients with 'treatment-resistant schizophrenia," that is, cases in which a minimum degree of remission with conventional treatments is not obtained. These cases have pointed to the fact that even today we still lack an integrative treatment model obtained through the assembling of specific interventions with verifiable effectiveness. The concept of treatment-resistant schizophrenia should have evolved in accordance with the advancing of the currently available knowledge and therapeutic resources. Why hasn't this happened? This article reviews the history of the concept of "resistance" to account for such failure and proposes a methodological approach to overcome this stagnation.

Hypothalamic-pituitary-adrenal axis response in borderline personality disorder without post-traumatic features.

Hypothalamic-pituitary-adrenal (HPA) axis sensitivity was investigated in 32 non-medicated patients with borderline personality disorder without comorbid post-traumatic syndromes and in 18 normal individuals using a modified dexamethasone suppression test (0.25 mg). Enhanced cortisol suppression was found in the patients v. controls (P<0.05) and the percentage of participant's with non-suppression was smaller in the patient (34%) than in the control group (89%) (P<0.01). Baseline cortisol levels in the patients were also lower than in the controls (P<0.05). The 0.25 mg dexamethasone suppression test reveals increased feedback inhibition of the HPA in borderline personality disorder.