Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce.

OBJECTIVES: The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. METHODS: Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. RESULTS: Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. CONCLUSIONS: Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.

Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce.

OBJECTIVES: The therapeutic use of nutrient-based 'nutraceuticals' and plant-based 'phytoceuticals' for the treatment of mental disorders is common; however, despite recent research progress, there have not been any updated global clinical guidelines since 2015. To address this, the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Disorders (CANMAT) convened an international taskforce involving 31 leading academics and clinicians from 15 countries, between 2019 and 2021. These guidelines are aimed at providing a definitive evidence-informed approach to assist clinicians in making decisions around the use of such agents for major psychiatric disorders. We also provide detail on safety and tolerability, and clinical advice regarding prescription (e.g. indications, dosage), in addition to consideration for use in specialised populations. METHODS: The methodology was based on the WFSBP guidelines development process. Evidence was assessed based on the WFSBP grading of evidence (and was modified to focus on Grade A level evidence - meta-analysis or two or more RCTs - due to the breadth of data available across all nutraceuticals and phytoceuticals across major psychiatric disorders). The taskforce assessed both the 'level of evidence' (LoE) (i.e. meta-analyses or RCTs) and the assessment of the direction of the evidence, to determine whether the intervention was 'Recommended' (+++), 'Provisionally Recommended' (++), 'Weakly Recommended' (+), 'Not Currently Recommended' (+/-), or 'Not Recommended' (-) for a particular condition. Due to the number of clinical trials now available in the field, we firstly examined the data from our two meta-reviews of meta-analyses (nutraceuticals conducted in 2019, and phytoceuticals in 2020). We then performed a search of additional relevant RCTs and reported on both these data as the primary drivers supporting our clinical recommendations. Lower levels of evidence, including isolated RCTs, open label studies, case studies, preclinical research, and interventions with only traditional or anecdotal use, were not assessed. RESULTS: Amongst nutraceuticals with Grade A evidence, positive directionality and varying levels of support (recommended, provisionally recommended, or weakly recommended) was found for adjunctive omega-3 fatty acids (+++), vitamin D (+), adjunctive probiotics (++), adjunctive zinc (++), methylfolate (+), and adjunctive s-adenosyl methionine (SAMe) (+) in the treatment of unipolar depression. Monotherapy omega-3 (+/-), folic acid (-), vitamin C (-), tryptophan (+/-), creatine (+/-), inositol (-), magnesium (-), and n-acetyl cysteine (NAC) (+/-) and SAMe (+/-) were not supported for this use. In bipolar disorder, omega-3 had weak support for bipolar depression (+), while NAC was not currently recommended (+/-). NAC was weakly recommended (+) in the treatment of OCD-related disorders; however, no other nutraceutical had sufficient evidence in any anxiety-related disorder. Vitamin D (+), NAC (++), methylfolate (++) were recommended to varying degrees in the treatment of the negative symptoms in schizophrenia, while omega-3 fatty acids were not, although evidence suggests a role for prevention of transition to psychosis in high-risk youth, with potential pre-existing fatty acid deficiency. Micronutrients (+) and vitamin D (+) were weakly supported in the treatment of ADHD, while omega-3 (+/-) and omega-9 fatty acids (-), acetyl L carnitine (-), and zinc (+/-) were not supported. Phytoceuticals with supporting Grade A evidence and positive directionality included St John's wort (+++), saffron (++), curcumin (++), and lavender (+) in the treatment of unipolar depression, while rhodiola use was not supported for use in mood disorders. Ashwagandha (++), galphimia (+), and lavender (++) were modestly supported in the treatment of anxiety disorders, while kava (-) and chamomile (+/-) were not recommended for generalised anxiety disorder. Ginkgo was weakly supported in the adjunctive treatment of negative symptoms of schizophrenia (+), but not supported in the treatment of ADHD (+/-). With respect to safety and tolerability, all interventions were deemed to have varying acceptable levels of safety and tolerability for low-risk over-the-counter use in most circumstances. Quality and standardisation of phytoceuticals was also raised by the taskforce as a key limiting issue for firmer confidence in these agents. Finally, the taskforce noted that such use of nutraceuticals or phytoceuticals be primarily recommended (where supportive evidence exists) adjunctively within a standard medical/health professional care model, especially in cases of more severe mental illness. Some meta-analyses reviewed contained data from heterogenous studies involving poor methodology. Isolated RCTs and other data such as open label or case series were not included, and it is recognised that an absence of data does not imply lack of efficacy. CONCLUSIONS: Based on the current data and clinician input, a range of nutraceuticals and phytoceuticals were given either a supportive recommendation or a provisional recommendation across a range of various psychiatric disorders. However several had only a weak endorsement for potential use; for a few it was not possible to reach a clear recommendation direction, largely due to mixed study findings; while some other agents showed no obvious therapeutic benefit and were clearly not recommended for use. It is the intention of these guidelines to inform psychiatric/medical, and health professional practice globally.

Sobre la llamada revolución psicofarmacológica: el descubrimiento de la clorpromazina y la gestión de la locura / On the so-called psychopharmacological revolution: the discovery of chlorpromazine and the management of madness

Resumen El artículo analiza la fragilidad y los problemas existentes en la tesis que afirma la existencia de una verdadera revolución en el campo de la psiquiatría biológica, que se habría operado entre 1952 y 1954, con el descubrimiento de la clorpromazina. Para eso se analizan los discursos y las estrategias que posibilitaron el descubrimiento de esta droga que servirá de modelo para la producción de nuevos psicofármacos. Se intenta entender, también, qué es lo que se considera como "eficacia terapéutica" de la droga.

Abstract This article analyzes the shortcomings and problems of the thesis that a true revolution took place in the field of biological psychiatry between 1952 and 1954 thanks to the discovery of chlorpromazine. To do so, it analyzes the discourses and strategies that led to the discovery of this drug, which became a model for the production of new psychopharmaceuticals. It seeks to understand, also, what is meant by "therapeutic efficacy" with regard to this drug.

The scientific path of Jakub Frostig in the light of his correspondence with the leading representatives of world psychiatry - from psychoanalysis and phenomenological approach to biological psychiatry. Part 2. Towards biological psychiatry. / Droga naukowa Jakuba Frostiga w swietle jego korespondencji z czolowymi przedstawicielami psychiatrii swiatowej ­ od psychoanalizy i podejscia fenomenologicznego do psychiatrii biologicznej. Czesc 2. W strone psychiatrii biologicznej.

In the second part of the article devoted to Jakub Frostig (1896-1959), his research from the 1930s on insulin coma treatment is presented in a broader context. Frostig began his research in the psychiatric hospital Zofiówka in Otwock and continued after his emigration to the United States. Thanks to new sources, we managed to determine the reasons underlying Frostig's departure from Poland. At the end of the 1930s, the issue of emigration became a necessity for him, saving his life and his family. Frostig was well aware of the political atmosphere at the time and the threats that followed. The inability to make a scientific career in Poland was the first impulse to look for a job abroad. After taking over the post of director of Zofiówka in 1933, this factor ceased to be decisive. The feeling of danger born on the wave of European anti-Semitism, especially in Germany, after Hitler came to power, came to the fore. Efforts to obtain awork permit in Switzerland and Australia proved unsuccessful. Eventually, just before the outbreak of World War II, Frostig managed to emigrate to the USA, where he concentrated on popularizing the treatment of psychiatric disorders with insulin comas in the local psychiatric environment. He did not accomplish a scientific career in the USA as he intended. His life story came full circle, and just as in the first years of his professional career in Lviv, he was forced to switch to a private practice. Despite the difficulties mentioned above, Frostig played a significant role in Polish psychiatry and greatly contributed to its development.

[Diseases of the schizophrenia spectrum disorder in old age : Diagnostic and therapeutic challenges]. / Erkrankungen des schizophrenen Formenkreises im Alter : Diagnostische und therapeutische Herausforderungen.

BACKGROUND: The number of people with diseases of the schizophrenia spectrum in old age will increase significantly in the coming years. In the literature the topics of schizophrenia and delusional disorders in older and old people are inadequately represented. AIM: This article gives an overview of the most important diagnostic and differential diagnostic characteristics. Another important aspect is the pharmacological and non-pharmacological treatment options in old age. MATERIAL AND METHODS: The S3 guidelines of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) from 2006, the guidelines of the World Federation of Societies of Biological Psychiatry (WFSBP) from 2012, 2013, 2015 and the consensus statement of the Austrian Association for Neuro-Psychopharmacology and Biological Psychiatry (ÖGPB) from 2016 formed the basic literature for this review. In addition, a targeted search in the databases PubMed, PubPsych and Cochrane Library as well as in German Journals, such as DerNervenarzt, Neuropsychiatrie, Psychiatrische Praxis and Zeitschrift für Gerontologie und Geriatrie concerning the keywords schizophrenia, delusional disorder, diagnostics, therapy and older people was carried out. RESULTS: Besides aspects on epidemiology, clinical manifestation, diagnostics, differential diagnostics and course of the illness, pharmacological and non-pharmacological treatment options are presented. CONCLUSION/DISCUSSION: In clinical practice a clear diagnostic assignment is often a challenge in older and very old people with psychotic symptoms, The necessary pharmacological treatment is available but is limited by tolerability, comorbidities and polypharmacy. Non-pharmacological treatment options have hardly been investigated.

Psiquiatria Biológica e Psicofarmacologia: a formação de uma rede tecnocientífica / Biological Psychiatry and Psychopharmacology: a techno-scientific network in debate

Resumo A Psiquiatria Biológica emerge nos anos de 1980, nos Estados Unidos, com a publicação do DSM-III (Diagnostic and Statistical Manual of Mental Disorders). Este manual tem a proposta de ser a-teórico e apresentar descrições objetivas dos, então, chamados "distúrbios mentais" a partir de um critério classificatório que não inclui discussões acerca da etiologia destes "distúrbios". Isto implica que, apesar da denominação biológica conferida a esta vertente psiquiátrica, não houve nenhuma descoberta acerca da etiologia biológica destes distúrbios que justificasse sua denominação e seu estrondoso sucesso mundial. Neste artigo, pretendemos analisar as modificações ocorridas na psiquiatria norte-americana a partir da introdução do DSM-III, dos primeiros medicamentos psicotrópicos e o subsequente papel desempenhado pela indústria farmacêutica neste processo. Desse modo, o que está em análise neste artigo é que, ao se apropriar dos medicamentos psicotrópicos como primeira opção terapêutica, a Psiquiatria Biológica cria uma aliança com a indústria farmacêutica que a insere numa rede tecnocientífica que dificulta saber os limites entre Psiquiatria Biológica, Psicofarmacologia e Indústria farmacêutica.

Abstract Biological Psychiatry emerged in the 1980s in the United States with the publication of DSM-III (Diagnostic and Statistical Manual of Mental Disorders). This manual intends to be a-theoretical and to provide objective descriptions of "mental disorders" by using diagnostic criteria that do not include discussions about the aetiology of these "disorders". Hence and despite the "biological" label conferred to this branch of psychiatry, there is no explicit concern to ascertain the possible biological origins of "mental disorders" in DSM-III. In this paper we intend to examine the modifications in North American Psychiatry following the introduction of the first psychotropic medications and the subsequent role played by the pharmaceutical industry in this process. Thus, what is under analysis in our article is that, by appropriating psychotropic drugs as the first therapeutic option, Biological Psychiatry creates an alliance with the pharmaceutical industry that inserts it into a technoscientific network that makes it difficult to know the limits between Biological Psychiatry, Psychopharmacology and the Pharmaceutical industry.

Nutritional psychiatry: the present state of the evidence.

Mental illness, including depression, anxiety and bipolar disorder, accounts for a significant proportion of global disability and poses a substantial social, economic and heath burden. Treatment is presently dominated by pharmacotherapy, such as antidepressants, and psychotherapy, such as cognitive behavioural therapy; however, such treatments avert less than half of the disease burden, suggesting that additional strategies are needed to prevent and treat mental disorders. There are now consistent mechanistic, observational and interventional data to suggest diet quality may be a modifiable risk factor for mental illness. This review provides an overview of the nutritional psychiatry field. It includes a discussion of the neurobiological mechanisms likely modulated by diet, the use of dietary and nutraceutical interventions in mental disorders, and recommendations for further research. Potential biological pathways related to mental disorders include inflammation, oxidative stress, the gut microbiome, epigenetic modifications and neuroplasticity. Consistent epidemiological evidence, particularly for depression, suggests an association between measures of diet quality and mental health, across multiple populations and age groups; these do not appear to be explained by other demographic, lifestyle factors or reverse causality. Our recently published intervention trial provides preliminary clinical evidence that dietary interventions in clinically diagnosed populations are feasible and can provide significant clinical benefit. Furthermore, nutraceuticals including n-3 fatty acids, folate, S-adenosylmethionine, N-acetyl cysteine and probiotics, among others, are promising avenues for future research. Continued research is now required to investigate the efficacy of intervention studies in large cohorts and within clinically relevant populations, particularly in patients with schizophrenia, bipolar and anxiety disorders.

Psychiatry, bio-epistemes and the making of adolescence in southern Brazil / Psiquiatria, bioepistemes e a formação da adolescência no sul do Brasil

Abstract Drawing on an ethnographic study in southern Brazil, this paper explores how therapists’ attempts to “resist bioreductionist” pharmaceutical use both succeed and crumble. Using a comparative framing, I show that pharmaceuticalization can become an anesthetizing “lid” that interacts with young people’s polarizing micro-politics and is an outgrowth of multi-generational medico-political family histories. This lid, however, is not air-tight and exceptionalities are born out of these very same histories. I argue that both pharmaceuticalization and exceptions to it emerge not through “resistance” to biopsychiatric logics but from the transformative possibilities that the patterned co-production of social, political, and psychiatric life affords.

Resumo Baseado em um estudo etnográfico no sul do Brasil, este artigo explora tentativas frustradas e bem-sucedidas de terapeutas em uma “resistência biorreducionista” a medicamentos. Comparativamente, busco mostrar que a farmaceuticalização pode se tornar uma “rolha” entorpecedora que interage com a micropolítica polarizante dos jovens, e é fruto de histórias familiares médico-políticas em várias gerações. Contudo, essa rolha não está bem vedada, dando margem a exceções nessas histórias. Acredito que a farmaceuticalização e as exceções não surjam da “resistência” à lógica biopsiquiátrica, mas sim de possibilidades transformativas na coprodução padronizada da vida social, política e psiquiátrica.

A determinação biológica dos transtornos mentais: uma discussão a partir de teses neurocientíficas recentes / La determinación biológica de los trastornos mentales: una discusión a partir de tesis neurocientíficas recientes / Biological determination of mental disorders: a discussion based on recent hypotheses from neuroscience

Resumo: A compreensão dos processos de formação dos transtornos mentais vem se mostrando desafiadora desde a fundação do campo psiquiátrico. O desenvolvimento das neurociências proporcionou novo fôlego à expectativa de encontrar estritamente no funcionamento biológico a explicação para o surgimento dos transtornos mentais. No entanto, tal objetivo não vem sendo alcançado com a esperada facilidade, de modo que novas hipóteses começam a se destacar nas pesquisas neurocientíficas. Neste artigo, identificamos as noções de epigenética, neurodesenvolvimento e plasticidade como os principais indicativos de um novo modo de compreender a biologia dos fenômenos mentais. A complexidade genética, o papel formativo do ambiente e as variações que caracterizam a vulnerabilidade implicam importantes modificações nas principais teses sobre a determinação biológica dos transtornos mentais, sugerindo uma reconfiguração dos limites entre o "social" e o "biológico" nas pesquisas em neurociências.

Resumen: La comprensión de los procesos de formación de los trastornos mentales ha representado un desafio desde que nació el campo de la psiquiatria. El desarrollo de las neurociencias proporcionó un nuevo aliento a la expectativa de encontrar, estrictamente en el funcionamiento biológico, la explicación para el surgimiento de los trastornos mentales. No obstante, tal objetivo no se alcanza con la esperada facilidad, de modo que nuevas hipótesis comienzan a destacarse en las investigaciones neurocientíficas. En este artículo, identificamos las nociones de epigenética, neurodesarrollo y plasticidad como los principales indicativos de un nuevo modo de comprender la biología de los fenómenos mentales. La complejidad genética, el papel formativo del ambiente y las variaciones que caracterizan la vulnerabilidad implican importantes modificaciones en las principales tesis sobre la determinación biológica de los trastornos mentales, sugiriendo una reconfiguración de los límites entre lo "social" y lo "biológico" en las investigaciones en neurociencias.

Abstract: Understanding the processes involved in the development of mental disorders has proven challenging ever since psychiatry was founded as a field. Neuroscience has provided new expectations that an explanation will be found for the development of mental disorders based on biological functioning alone. However, such a goal has not been that easy to achieve, and new hypotheses have begun to appear in neuroscience research. In this article we identify epigenetics, neurodevelopment, and plasticity as the principal avenues for a new understanding of the biology of mental phenomena. Genetic complexity, the environment's formative role, and variations in vulnerability involve important changes in the principal hypotheses on biological determination of mental disorders, suggesting a reconfiguration of the limits between the "social" and the "biological" in neuroscience research.

A análise do comportamento no contexto do estudo evolucionista do comportamento social e da cultura / Behavior analysis in the context of the evolutionary study of social behavior and culture / El análisis de la conducta en el contexto del estudio evolucionista de la conducta social y cultura

A Análise do Comportamento pode ser entendida como uma perspectiva voltada para o estudo evolucionista do comportamento social e da cultura. A caracterização do comportamento social nessa área e pesquisas recentes sobre metacontingências e macrocontingências são contribuições nesse sentido. Outras perspectivas evolucionistas mais próximas da Biologia também têm produzido diversas teorias e resultados sobre o tema, mas sem dialogar com a Análise do Comportamento, que, por sua vez, pouco debate as contribuições dessas outras perspectivas. Este trabalho destaca possíveis convergências e complementaridades entre a Análise do Comportamento e estudos sobre aprendizagem social em animais não-humanos, construção de nicho e evolução cultural, visando estimular o diálogo entre pesquisadores de diferentes perspectivas evolucionistas que estudam comportamento social e cultura.

Behavior Analysis may be regarded as a perspective that tackles the evolutionary study of social behavior and culture. Social behavior's characterization in this field and recent researches on metacontingencies and macrocontingencies are contributions in this direction. Other evolutionary perspectives, closest to Biology, have also produced theories and evidences on this theme, but without dialogue with Behavior Analysis, which, by its turn, discusses little this other perspectives' contributions. This paper highlights possible convergences and complementarities between Behavior Analysis and studies on social learning in nonhuman animals, niche construction, and cultural evolution, aiming to enhance dialogues among researchers from different evolutionary perspectives studying social behavior and culture.

El Análisis de la Conducta puede ser vista desde una perspectiva enfocada al estudio evolucionista de la conducta social y cultura. La caracterización de la conducta social en esa área y estudios recientes sobre metacontingencias y macrocontingencias son algunas de sus contribuciones. Otras perspectivas evolucionistas aproximadas a la Biología también han producido diversas teorías y resultados sobre el tema, pero sin interactuar con el Análisis de la Conducta, que al mismo tiempo, poco debata las contribuciones de esas otras perspectivas. Este trabajo destaca posibles convergencias e complementaciones entre el Análisis de la Conducta y los estudios sobre aprendizaje social en animales no humanos, construcción de nicho y evolución cultural, con el objetivo de estimular el dialogo entre investigadores de diferentes perspectivas evolucionistas que estudian la conducta social y la cultura.

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia. Part 3: Update 2015 Management of special circumstances: Depression, Suicidality, substance use disorders and pregnancy and lactation.

These updated guidelines are based on the first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in the years 2005 and 2006. For this 2015 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations which are clinically and scientifically relevant. They are intended to be used by all physicians diagnosing and treating patients with schizophrenia. Based on the first version of these guidelines a systematic review, as well as a data extraction from national guidelines have been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and subsequently categorised into six levels of evidence (A-F) and five levels of recommendation (1-5). This third part of the updated guidelines covers the management of the following specific treatment circumstances: comorbid depression, suicidality, various comorbid substance use disorders (legal and illegal drugs), and pregnancy and lactation. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication and other pharmacological treatment options) of patients with schizophrenia.

Considerações sobre os movimentos de medicalização da vida / Considerations on life's medicalization movements / Consideraciones sobre los movimientos de medicalización de la vida

A ideia de que problemas cotidianos são diagnosticáveis e tratáveis pela medicina é antiga e ao mesmo tempo comum na atualidade, na qual habituou-se entender e explicar a vida psíquica e as condutas éticas pelo conhecimento da materialidade corporal. Este artigo realiza uma análise sobre a relação entre o saber biomédico e pedagógico na construção da concepção de infância normal/anormal. Nas duas últimas décadas, o investimento em pesquisas que investigam o funcionamento cerebral tem ampliado significativamente o conhecimento científico das interações entre o físico e o psicológico e sustenta fortemente a cultura somática. Nesse processo, diagnósticos psiquiátricos se tornaram dispositivos importantes na explicação e intervenção dos processos de escolarização considerados problemáticos. No percurso teórico investigado, destaca-se como a combinação entre as ciências biomédicas e a educação marcou e tem marcado as práticas de intervenção sobre os problemas enfrentados pelas crianças ao ingressarem na escola.

The idea that everyday problems are diagnosable and treatable by medicine is ancient as well as common today, when we are used to understanding and explaining the psyche and ethical conduct by knowing the materiality of the body. In the last two decades, investment in research investigating brain functioning has significantly expanded scientific knowledge of physiological and psychological interactions, which strongly support somatic culture. Thus, psychiatric diagnoses have become important tools in the explanation and intervention of schooling procedures considered "problematic". The combination of biomedical sciences and education has had an impact on intervention practices regarding the problems faced by children when they enter school. We are going to take a diachronic look at the relationship between biomedical knowledge and pedagogy that created the concept of normal/abnormal childhood.

La idea de que problemas cotidianos son diagnosticables y tratables por la medicina é antigua y al mismo tiempo común en la actualidad, donde se habituó a entender y explicar la vida psíquica y de las conductas éticas por el conocimiento de la materialidad corporal. Este artículo realiza un análisis sobre la relación entre el saber biomédico y pedagógico en la construcción de la concepción de infancia normal/anormal. En las dos últimas décadas, el patrocinio de investigaciones que se interesan por el funcionamiento cerebral, ha ampliado significativamente el conocimiento científico de las interacciones entre lo físico y lo psicológico y sustenta fuertemente la cultura somática. En este proceso, diagnósticos psiquiátricos se convirtieron en dispositivos importantes para la explicación e intervención de los procesos de escolarización considerados problemáticos. En el recorrido teórico investigado, se destaca como la combinación entre las ciencias biomédicas y la educación ha marcado las prácticas de intervención sobre los problemas enfrentados por los niños al ingresar a las instituciones educativas.

[Maurycy Urstein: forgotten Polish contributor to German psychiatry]. / Maurycy Urstein: zapomniany polski wspóltwórca niemieckiej psychiatrii.

Polish psychiatrist Maurycy Urstein (1872-1940) is nowadays almost forgotten. He is not mentioned in the history of Polish psychiatry which only partially may be explained by the fact that his most essential works were published in German language. His scientific oeuvre contains dozens of publications, including four monographs on catatonia. Urstein was an ardent advocate of the autointoxication theory of psychiatric disorders, fierce opponent of psychoanalysis and enthusiast of the use of biological methods of treatment in psychiatry. Both some eccentric views and specific personality probably equally contributed to his almost complete isolation among psychiatrists in the interwar Poland.

La Revista de Neuro-Psiquiatría y los primeros tratamientos biológicos en la psiquiatría mundial / The Revista de Neuro-Psiquiatría and the first biological treatments in world psychiatry

A lo largo de las primeras décadas de su existencia, la Revista de Neuro-Psiquiatría fue testigo y fuente efectiva de difusión de los trascendentales avances en la terapéutica psiquiátrica que se dieron entre los años de 1930 a 1960, particularmente en el campo de los tratamientos biológicos. Estos avances condujeron a que la psiquiatría, aun cuando no sin tropiezos u obstáculos, fuera considerada, con toda justicia, como una especialidad médica.

During the first decades of its existence, the Revista de Neuro-Psiquiatría became both a witness and an effective source of dissemination of the significant advances in psychiatric treatment that occurred between the 1930s and 1960s, particularly in the area of biological treatments. These advances led psychiatry, even though not without obstacles or setbacks, to being considered, in all fairness, as a medical specialty.

Una visiíon personal de la psiquiatría actual, con ánfasis en el papel de la Psiquiatría Biológica / A personal view of psychiatry today, with emphasis on the role of Biological Psychiatry

A punto de partida de un examen A punto de partida de un examen panorámico de la psiquiatría contemporánea, se pasa revista a diversos periodos de la historia de nuestra disciplina con énfasis en su contribución epistemológica a lo largo de los últimos tres siglos. Se presta particular atención a recientes debates nosológicos, al rol del diagnóstico y clasificaciones para luego centrarse en el crucialmente dominante papel de la psiquiatría biológica en el momento actual. Los avancesde la bioquímica y fisiología cerebral y de la genética y resultados de investigaciones neurocientíficas y de neuro-imágenes abren la puerta a explicaciones causales, implicaciones terapéuticas y preventivas representadas por proyectos internacionales, uno de cuyos objetivos fundamentales es la identificación de marcadores biológicosde enfermedades mentales. Se postula, como ejemplo de estos avances, la hipótesis de que la psicoterapia misma tiene repercusiones notables en la fisiología y la genética cerebrales

After a panoramic review of contemporary psychiatry, several periods of its history are examined with emphasis on their epistemological contributions throughout the last three centuries. Particular attention is paid to recent nosological debates, to the role of diagnosis and classifications to, finally, center on the nowadays crucially dominant role of biological psychiatry at the present time. Advances in brain biochemistry and physiology, genetics and the results of neuroscientific and neuro-imaging investigations open the door to causal explanations, therapeutic and preventive implications represented by international projects, one of whose fundamental objectives is the identification of biological markers of mental disorders. As an example of these advances, the hypothesis of notable repercussions of psychotherapy on brain physiology and genetics is presented.

Manifestaciones psiquiátricas en epilepsia / Psychiatric manifestations in epilepsy

La Organización Mundial de la Salud (OMS) y la Liga Internacional contra la Epilepsia (ILAE), la definen como una afección neurológica crónica, recurrente y repetitiva de fenómenos paroxíticos, ocasionados por descargas neuronales desorganizadas y excesivas. La epilepsia es la condición neurológica más seria y más común. Se estima que la prevalencia actual del trastorno es de 5-10/1000 personas; excluyendo a las convulsiones febriles, los casos de una crisis única y los casos inactivos. Sus causas pueden ser muy diversas y sus manfiestaciones muy variadas, de esta manera su sintomatología se ubica dentro de un polimorfismo acentuado. Dentro de las posibles manfiestaciones clínicas que pueden presentarse, se encuentran aquellas en las que predominan las alteraciones conductuales. El objetivo de la presente revisión es el poder dar cuenta de la presentación de los síntomas psiquiátricos en epilepsia, el impacto de estos y la importancia del manejo interdisciplinario con neurólogos. El reconocimiento de estos cuadros resulta de suma importancia en la práctica de la interconsulta, dada la implicancia de los profesionales de salud mental en el manejo sintomático de dichas manifestaciones.

The World Health Organization (WHO) and the International League Against Epilepsy (ILAE) define epilepsy as a chronic neurological affection, characterized by recurrent and repetitive paroxysmal phenomena generated by disorganized and excessive neuronal discharges. Epilepsy is the most serious and frequent neurological condition. It is estimated that its current prevalence is 5-10/1,000 people; excluding febrile seizures, single seizures and inactive cases. Because its causes and manifestations can be very varied, its symptomatology is placed with in a marked polymorphism. Among the possible clinical manifestations that may appear are those in which behavioral alterations prevail. The aim of this review is to describe the onset of psychiatric symptoms in epilepsy, their impact and the importance of interdisciplinary management of this disease with Neurologists. Identifying these clincal symptoms is of the utmost importance, given the involvement of healthcare profesionals in the symptomatic treatment of those manifestations.

El hombre: objetivo de la psiquiatrí­a y sus aspectos antropológicos básicos / Human being: an objective of psychiatry and the basic anthropological aspects

La psiquiatría precisa de otros panoramas epistemológicos de observación, fuera de su esquema biomédico, para poder comprender al individuo en su totalidad. De ahí parte al encuentro de la antropología médica, que brinda el conocimiento científico sobre el hombre como sujeto sano, enfermable, enfermo, sanable y mortal, pero desde una nueva configuración: la antropsiquiatría, la cual permite ir más allá de la propia enfermedad, es decir, trascender hasta su esfera de persona y entender la verdad de una existencia humana concreta, que se evidencia en su vida física, psí­quica, moral, espiritual y cultural. Esta caracterización epistemológica y praxiológica justifica la necesidad de elaborar un modelo de formación profesional antropsiquiátrica en la especialización de psiquiatría.

Psychiatry requires some other epistemological panoramas of observation, out of its biomedical diagram, in order to comprehend the individual completely. That is why psychiatry meets medical anthropology, which provides the scientific knowledge about the human being as a healthy, sick, and mortal subject who may get ill or cured starting from a new configuration: anthropsychiatry. It allows going beyond the disease, that is to say, transcending up to its sphere of person and understanding the truth of a concrete human existence, which is shown in the physical, psychical, moral, spiritual, and cultural life. This epistemological and praxiological characterization justifies the need to develop an anthropsychiatric professional training model for psychiatry specialization.