RESUMEN
At the end of the 19th century, several authors became interested in the physical and psychological symptoms resulting from traumatic life events. Oppenheim presented 42 detailed clinical observations. He suggested the term "traumatic neurosis." Charcot, who was interested in male hysteria, published over 20 cases of traumatic hysteria between 1878 and 1893. The symptoms were considered to have a dynamic or functional origin. The role of horror and terror during the trauma was emphasized. However, Charcot opposed the idea of traumatic neuroses as specific syndromes as he considered them to be only an etiological form of hystero-neurasthenia. In The Tuesday Lessons (Les Leçons du Mardi), he presents several observations. They are surprising when compared with the current criteria for posttraumatic stress disorder (PTSD). Although he had rejected this new entity, a hundred years before the appearance of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, Charcot described most of the symptoms mentioned for a diagnosis of PTSD such as intrusion (reliving the trauma, nightmares, and severe emotional distress), avoidance, negative changes in thinking and mood (negative thoughts, lack of interest, etc.), arousal, and reactivity (trouble sleeping, trouble concentrating, being easily startled or frightened, irritability, etc.).
Asunto(s)
Histeria/fisiopatología , Neurastenia/fisiopatología , Trauma Psicológico/fisiopatología , Trastornos por Estrés Postraumático/fisiopatología , Historia del Siglo XIX , Humanos , Histeria/etiología , Histeria/historia , Neurastenia/etiología , Neurastenia/historia , Trauma Psicológico/complicaciones , Trastornos por Estrés Postraumático/etiologíaRESUMEN
The word hysteria originated in the Corpus Hippocraticum (c420â¯BCE) as a natural explanation for a variety of diseases in women linked in the Greco-Roman mind to an animate or inanimate womb, but which in the last five centuries has evolved to describe an elusive disorder of brain⯱â¯mind in men and women, currently referred to by neurologists as "functional neurological disorder". The Babylonians, Assyrians and Egyptians had no knowledge of brain or psychological function. Babylonian and Assyrian descriptions of disease and behaviour include only rare examples suggestive of modern hysteria. An earlier suggestion that the Greek concept of hysteria was transmitted from Egypt is not supported by recent evidence. The Greco-Roman civilisations had some knowledge of neuroanatomy, but little of nervous system function, conceived in terms of humors. The examples cited here suggestive of modern hysteria are relatively infrequent and fragmentary. The most plausible are attempts to separate the "sacred disease" from other causes of loss of consciousness. The great achievement of Greco-Roman medicine was in introducing natural causation, including causation linked to the womb, rather than gods or evil spirits. Nevertheless medicine, magic and religion have remained intertwined to varying degrees in all cultures up to the present time, despite the growth of modern scientific medicine. The study of hysteria in ancient civilisations adds interesting insight into the evolution of thinking about brain, psyche, mind and self. Babylonian and Egyptian medical and behavioural descriptions are based on observation. Greek and Roman accounts include some subjective aspects, probably linked to early attempts to understand identity, the psyche, intellectual and emotional functions. The great philosophical debate whether the latter resided in the head/brain (Plato) or the heart (Aristotle) has only been settled in the last few centuries, during which hysteria also became linked to brain⯱â¯mind. Our more recent increasing knowledge of brain function has also been accompanied by increasing interest in subjective feelings, thoughts, the inner life and subconscious mechanisms, suggesting we may have become more self-aware than in earlier civilisations, which in turn may perhaps influence the clinical presentation of hysteria. The study of hysteria may be one of the keys to a greater understanding of the relationship between brain and mind.
Asunto(s)
Histeria/historia , Encéfalo/fisiopatología , Femenino , Historia Antigua , Humanos , Histeria/fisiopatología , MasculinoRESUMEN
Chromosomal abnormalities involving 2q32q33 deletions are very rare and present with a specific phenotype. This case report describes a 37-year-old female patient with 2q32q33 microdeletion syndrome presenting with the characteristic features, but with the addition of secondary cognitive decline. Molecular karyotyping was performed on the patient and her parents. It revealed an 8.6 megabase deletion with the proximal breakpoint in the chromosome band 2q32.2 and the distal breakpoint in 2q33.1. The deletion encompassed 22 known genes, including theGLS,MYO1B,TMEFF2,PGAP1andSATB2genes. The observed deletion was confirmed using a paralogue ratio test. This case report provides further evidence that theSATB2gene, together withGLS,MYO1B,TMEFF2and possiblyPGAP1,is a crucial gene in 2q32q33 microdeletion syndrome. TheSATB2gene seems to be crucial for the behavioural problems noted in our case, but deletion of theGLS,MYO1BandTMEFF2genes presumably contributed to the more complex behavioural characteristics observed. Our patient is also, to our knowledge, the only patient with 2q32q33 microdeletion syndrome with secondary cognitive decline.
Asunto(s)
Anomalías Múltiples/genética , Agresión/psicología , Disfunción Cognitiva/genética , Histeria/fisiopatología , Discapacidad Intelectual/genética , Conducta Autodestructiva/fisiopatología , Anomalías Múltiples/diagnóstico , Anomalías Múltiples/fisiopatología , Adulto , Puntos de Rotura del Cromosoma , Deleción Cromosómica , Cromosomas Humanos Par 2/genética , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/fisiopatología , Femenino , Glutaminasa/deficiencia , Glutaminasa/genética , Humanos , Histeria/psicología , Discapacidad Intelectual/diagnóstico , Discapacidad Intelectual/fisiopatología , Cariotipificación , Proteínas de Unión a la Región de Fijación a la Matriz/deficiencia , Proteínas de Unión a la Región de Fijación a la Matriz/genética , Proteínas de la Membrana/deficiencia , Proteínas de la Membrana/genética , Miosina Tipo I/deficiencia , Miosina Tipo I/genética , Proteínas de Neoplasias/deficiencia , Proteínas de Neoplasias/genética , Fenotipo , Monoéster Fosfórico Hidrolasas/deficiencia , Monoéster Fosfórico Hidrolasas/genética , Conducta Autodestructiva/psicología , Factores de Transcripción/deficiencia , Factores de Transcripción/genéticaRESUMEN
Na concepção antroposófica, a histeria só pode ser compreendida quando comparada sob o ponto de vista fenomenológico ao seu oposto, a neurastenia. Quando o equilíbrio entre os sistemas orgânicos estiver ausente ou deficitário, irão resultar causas constitucionais para doenças na organização vital. Rudolf Steiner as chama de histeria e neurastenia, num sentido muito mais amplo que a terminologia médica.No caso da histeria, as forças do mundo exterior não podem ser digeridas e suficientemente transformadas. O polo superior está fraco demais para transformar completamente as forças exteriores. Já na neurastenia, o polo superior está excessivamente envolvido com a atividade consciente da organização anímica e do eu. Em ambos os casos, a base da terapia está relacionada ao sistema rítmico. A síndrome pré-menstrual pode ser entendida como um distúrbio histérico, onde processos metabólicos "mal digeridos" repercutem sobre o polo neurossensorial e sobre todo o comportamento do indivíduo. A histeria significa a invasão da consciência e do campo anímico de sensibilidade por conteúdos inconscientes, volitivos, metabólicos. Entre os sintomas da histeria, estão distúrbios menstruais acompanhados de dores, humor instável, perturbações digestivas, sintomas sexuais, emotividade exagerada e avidez desejosa. Bryophyllum calycinum (família Crassulaceae), é uma planta suculenta, com uma relação peculiar com o elemento aquoso. Propaga-se principalmente por brotação foliar, e não por sementes. Regenera-se com facilidade incomum. Steiner propôs uma indicação totalmente nova para esta planta: o tratamento da histeria. Não a histeria no sentido psiquiátrico, mas antroposófico, em contraposição à neurastenia. Coube também a Steiner a indicação do cultivo do Bryophyllum com prata dinamizada, pelo processo denominado vegetabilização. A prata (Argentum) possui a faculdade de ligar a organização vital ao corpo físico. O Bryophyllum Argento cultum possibilita melhor controle das forças vitais no âmbito do sistema metabólico.(AU)
From the anthroposophic conception, hysteria can only be understood if compared under phenomenological point of view to its opposite, neurasthenia. The imbalance of the organic systems generates the constitutional bases to disorders of the vital organization. Rudolf Steiner called them hysteria and neurasthenia, in a much wider sense than defined by medical terminology. In case of hysteria, the forces coming from external world cannot be sufficiently metabolized and transformed. The superior pole is too weak to transform completely external forces. While in neurasthenia, the superior pole is excessively involved with the conscious activity of the soul and I-organization. In both cases, the base of therapy is focused on rhythmic system. Premenstrual syndrome may be understood as a hysterical disorder, where metabolic processes poorly "metabolized" resound over nerve-senses pole and over the whole behavior of the individual. Hysteria means the invasion of the consciousness and the soul field of sensibility by unconscious, volitional, metabolic contents. Among the symptoms of hysteria are menstrual disorders accompanied by pain, instable humor, digestive disorders, sexual symptoms, exaggerated emotiveness and anxious desire. Bryophyllum calycinum (Crassulaceae) is a succulent plant with a peculiar relationship with aqueous element. It propagates itself mainly by leaves sprouting, not by seeds. It regenerates itself in an unusually easy way. Steiner proposed a totally new indication to this plant: treatment for hysteria. Not hysteria in psychiatric meaning, but in anthroposophic one, as opposite of neurasthenia. Steiner had also given the indication for Bryophyllum cultivation with potentized silver, through the process called vegetabilization. Silver (Argentum) is capable of binding the vital organization to the physical body. Bryophyllum Argento cultum enables better control of vital forces in the sphere of metabolic system.(AU)
Asunto(s)
Humanos , Histeria/tratamiento farmacológico , Kalanchoe/fisiología , Medicina Antroposófica , Histeria/fisiopatología , Síndrome Premenstrual/tratamiento farmacológicoRESUMEN
BACKGROUND: In the late 19th century, a man with a psychogenic movement disorder was evaluated by many of the Philadelphia neurologists associated with Silas Weir Mitchell. In 1885, prior to the development of movie cameras or projectors, the patient was photographed by pioneering photographer Eadweard Muybridge, in collaboration with neurologist Francis Dercum, using arrays of sequentially triggered single-image cameras. The photographic sequences are among the first motion picture sequences of patients with neurologic disorders. METHODS: Examination of extant primary source documents concerning this patient, including published writings and photographic sequences by Muybridge and Dercum, the original clinical descriptions, Mitchell's documentation of the patient's later clinical course, and results of the autopsy. RESULTS: Mitchell and his colleagues concluded that this was a "case of undoubted hysteria" in a man. Support for this contention includes the following: protracted course, spanning decades with temporary remissions; inconsistent character of the movement and features incongruous with typical "organic" tremors; complex, bizarre movements that are difficult to classify; increase in movements with attention; alteration in frequency of the movements with movement of the opposite arm; ability to trigger or temporarily stop the movements with unusual or nonphysiologic interventions; involvement of the opposite arm in a synchronous abnormal movement later in the course; remission with hypnotic suggestion; absence of other neurologic signs; and normal brain autopsy. CONCLUSION: The clinical history, serial examinations, photographic documentation, and autopsy results support Mitchell's contention that this was a case of male hysteria, or, in modern terminology, a psychogenic movement disorder.
Asunto(s)
Histeria/diagnóstico , Trastornos del Movimiento/diagnóstico , Espasmo/diagnóstico , Adulto , Autopsia , Historia del Siglo XIX , Humanos , Histeria/historia , Histeria/fisiopatología , Masculino , Trastornos del Movimiento/historia , Trastornos del Movimiento/fisiopatología , Fotograbar/historia , Fotograbar/métodos , Espasmo/historia , Espasmo/fisiopatologíaRESUMEN
Hysteria has generated the most heated debates among physicians, from antiquity to the present day. It has been long confused with neuroses and neurological pathologies such as Parkinson's disease and epilepsy, principally associated with women and sexual disorders. The clinical manifestations must first be seen in their historical context, as interpretation varies according to the time period. Recently, the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association marked a break in the consensus that previously seemed to apply to the concept of hysteria and approach to the clinical manifestations. The clinical manifestations of hysteria are numerous and multifaceted, comprising 3 main classifications: paroxysms, attacks, and acute manifestations; long-lasting functional syndromes, and visceral events. Each main classification can be subdivided into several subgroups. The first main group of paroxysms, attacks, and acute manifestations includes major hysterical attacks, such as prodrome, trance and epileptic states, minor hysterical attacks such as syncope and tetany, twilight states, paroxysmal amnesia, and cataleptic attacks. The second group includes focal hysterical symptoms, paralyses, contractures and spasms, anesthesia, and sensory disorders. Visceral manifestations can be subdivided into spasms, pain, and general and trophic disorders. The diversity of the symptoms of hysteria and its changing clinical presentation calls into question the same hysterical attacks and the same symptoms, which have had only a few differences for over 2,000 years. A new definition of hysteria should be proposed, in that it is a phenomenon that is not pathological, but physiological and expressional.
Asunto(s)
Histeria/diagnóstico , Histeria/historia , Conocimiento , Ilustración Médica/historia , Medicina en la Literatura , Historia del Siglo XVII , Historia del Siglo XIX , Historia Medieval , Humanos , Histeria/fisiopatología , Histeria/psicologíaRESUMEN
Medical humanities is the interdisciplinary field of humanities (literature, philosophy, ethics, history, and religion), social science (anthropology, cultural studies, psychology, and sociology), and the arts (literature, theater, film, and visual arts), and their application to medical education and practice. In this chapter, the concept of 'hysteria' is put into a medical humanities perspective. We review the concept of hysteria concisely. Two novels and one autobiographical story are used as material in order to study how 'hysteria' is represented in literary work. Madame Bovary (Gustave Flaubert), Hedda Gabler (Henrik Ibsen), and A Story in an Almost Classical Mode (Harold Brodkey) were searched for elements that are characteristic of hysteria. Excessive emotion, dramatics, attention-seeking behavior, physical symptoms of unknown and unidentifiable organic causes, self-centered behavior, and flirtatious behavior are the six elements used to operationalize hysteria. It was found that these elements were present in both a quantitative and qualitative manner in the literary works examined. Acknowledging some limitations and suggesting some research areas and clinical implications, we conclude that literary works are useful in analyzing concepts in medicine. Also, more generally, using literary works seems to have a positive impact on readers, healthcare providers, and researchers in the healthcare domain. Studying novels and related literary work contributes to the body of knowledge of medical humanities.
Asunto(s)
Autobiografías como Asunto , Histeria/historia , Literatura Moderna/historia , Medicina en la Literatura , Anciano , Femenino , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Histeria/fisiopatología , Histeria/psicología , Masculino , Ilustración Médica/historiaRESUMEN
Babinski, 'Chef de Clinique' of Charcot from 1885 to 1887, fully supported the ideas of his teacher on hysteria and thought that a dynamic brain cortical lesion is the cause of the disease. After Charcot's death in 1893, Babinski gradually revised his position. In a first step, he described many neurological signs in order to clearly distinguish hysterical manifestations from the organic disorders of the central nervous system. The most famous one bears his name, the Babinski sign, an inversion of the plantar cutaneous reflex, testifying to a lesion of the pyramidal tract. In a second step, he defined what remained of hysteria and proposed in 1901 to abandon the term 'hysteria' in favor of the neologism 'pithiatism', defined as a pathologic state resulting in disorders which can be very accurately reproduced by suggestion, and can disappear by persuasion. Babinski therefore retained the exclusive etiological role of suggestion and refuted, unlike Dejerine, the role of emotion. He also sought to separate pithiatism from simulation, but ambiguously he made pithiatics 'semi-malingerers'. During the Great War, with Froment, he described physiopathic disorders and separated them from pithiatic disorders and simulation. After being accepted by many French neurologists, pithiatism, the word as well as the concept, gently died out. There remained little more than a few philosophical uses (especially by Jean-Paul Sartre and Maurice Merleau-Ponty) or metaphorical ones. What remains of the work of Babinski in the field of hysteria is not so much the creation of pithiatism as the masterly description of neurological signs to formally exclude an organic lesion of the nervous system or simulation before looking like hysteria disorders.
Asunto(s)
Histeria/historia , Histeria/fisiopatología , Neurología/historia , Psiquiatría/historia , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Masculino , Modelos Psicológicos , Reflejo de Babinski , Escultura/historiaRESUMEN
At the end of the 19th century, neurasthenia and hysteria were considered distinct diseases. Specifically, neurasthenia was regarded as a disease of the body, whereas hysteria was regarded as a disease of the psyche. However, immediately before World War I, due to their common characteristics, both hysteria and neurasthenia were thought to be 'functional diseases'. Moreover, it was suggested that heredity and the presence in both of the predisposing condition called 'nervous weakness' were other shared factors. Nervous weakness was considered essential for the definition of neurasthenia, but it was also considered a precondition for the development of hysteria. Because of this, it is still difficult to demarcate a line between neurasthenia and hysteria; therefore, the two diseases should be considered as sharing a common borderland with each other.
Asunto(s)
Histeria/fisiopatología , Neurastenia/fisiopatología , Historia de la Medicina , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Histeria/historia , Neurastenia/historiaRESUMEN
We here review behavioral, neuroimaging and electrophysiological studies of hypnosis as a state, as well as hypnosis as a tool to modulate brain responses to painful stimulations. Studies have shown that hypnotic processes modify internal (self awareness) as well as external (environmental awareness) brain networks. Brain mechanisms underlying the modulation of pain perception under hypnotic conditions involve cortical as well as subcortical areas including anterior cingulate and prefrontal cortices, basal ganglia and thalami. Combined with local anesthesia and conscious sedation in patients undergoing surgery, hypnosis is associated with improved peri- and postoperative comfort of patients and surgeons. Finally, hypnosis can be considered as a useful analogue for simulating conversion and dissociation symptoms in healthy subjects, permitting better characterization of these challenging disorders by producing clinically similar experiences.
Asunto(s)
Encéfalo/fisiología , Hipnosis , Red Nerviosa/fisiología , Percepción del Dolor/fisiología , Humanos , Histeria/fisiopatologíaRESUMEN
Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.
Asunto(s)
Trastornos de Conversión/diagnóstico , Histeria/diagnóstico , Trastornos de Conversión/complicaciones , Trastornos de Conversión/fisiopatología , Humanos , Histeria/complicaciones , Histeria/fisiopatología , Enfermedades del Sistema Nervioso Periférico/etiología , Trastornos de la Visión/etiología , Trastornos de la Visión/fisiopatologíaRESUMEN
The main objective of this paper is to present the importance of hysteria on Babinski's oeuvre, and the conceptions of pithiatism from Babinski until the one of conversion disorder. Babinski gave a mental basis for hysteria in the place of Charcot's encephalopatic one, and several important semiotic tools to differentiate organic from hysterical manifestations based on studies from 1893-1917/8. His teachings were spread worldwide, and in Brazil they were also appreciated in the work on hysteria by Antonio Austregesilo, the first Brazilian neurology chairman. The neurobiological basis of hysteria conceived by Charcot is nowadays reappraised, and Babinski's neurosemiological contribution is everlasting. The patients believed to be hysterical, and the two outstanding neurologists, Charcot and Babinski, gave support for the development of the modern neurology.
Asunto(s)
Trastornos de Conversión/historia , Histeria/historia , Brasil , Trastornos de Conversión/fisiopatología , Historia del Siglo XIX , Historia del Siglo XX , Histeria/fisiopatología , Ilustración Médica , Neurología/historiaRESUMEN
The main objective of this paper is to present the importance of hysteria on Babinski's oeuvre, and the conceptions of pithiatism from Babinski until the one of conversion disorder. Babinski gave a mental basis for hysteria in the place of Charcot's encephalopatic one, and several important semiotic tools to differentiate organic from hysterical manifestations based on studies from 1893-1917/8. His teachings were spread worldwide, and in Brazil they were also appreciated in the work on hysteria by Antonio Austregesilo, the first Brazilian neurology chairman. The neurobiological basis of hysteria conceived by Charcot is nowadays reappraised, and Babinski's neurosemiological contribution is everlasting. The patients believed to be hysterical, and the two outstanding neurologists, Charcot and Babinski, gave support for the development of the modern neurology.
O objetivo principal deste trabalho é apresentar a importância da histeria na obra de Babinski e a concepção de pitiatismo de Babinski até a de transtorno de conversão. Babinski deu uma base mental para histeria no lugar da encefalopática de Charcot, e várias ferramentas semiológicas importantes para diferenciar manifestações orgânicas de histéricas, com base em estudos de 1893-1917/8. Seus ensinamentos foram disseminados em todo o mundo, e no Brasil eles também foram apreciados no trabalho sobre a histeria por Antonio Austregésilo, o primeiro catedrático da neurologia brasileira. A base neurobiológica da histeria concebida por Charcot é reavaliada hoje em dia, e a contribuição neurosemiológica de Babinski é perene. Os pacientes considerados histéricos e os dois grandes neurologistas, Charcot e Babinski, deram suporte para o desenvolvimento da neurologia moderna.
Asunto(s)
Historia del Siglo XIX , Historia del Siglo XX , Trastornos de Conversión/historia , Histeria/historia , Brasil , Trastornos de Conversión/fisiopatología , Histeria/fisiopatología , Ilustración Médica , Neurología/historiaRESUMEN
En el momento presente la clasificación psicopatológica destaca por su gran complejidad y confusión, que da lugar a incontables debates. Realizamos una indagación en este terreno partiendo del concepto de "histeria" por tratarse de un diagnóstico proteico y esquivo, que en cierta medida se solapa con el más de moda, pero no menos confuso, "trastorno límite", y con otros trastornos, como la psicosis, lo que hace de él un caso paradigmático dentro de la discusión diagnóstica en general y psicoanalítica en particular. Su presentación multiforme posiblemente ha llevado, en tiempos de positivismo dominante, a su desprestigio y práctica eliminación de los sistemas de clasificación oficiales. Sin embargo, cuando hablamos de "diagnóstico" al referirnos a la personalidad no debemos entenderlo tanto en el sentido de agrupación de signos y síntomas sino como la valoración y descripción de esas pautas complejas de comportamiento cuyo nivel privilegiado de análisis es el de la relación interpersonal, relación que cuando se constituye como área principal de desadaptación permite hablar de "Trastornos de la personalidad". Concluimos que, a pesar de su complejidad, la personalidad histriónica (PH) es un patrón relacional que conserva una presencia muy importante en la clínica psicoterapéutica, en salud mental y en otros ámbitos de la salud, y que precisamente su adecuada valoración y diferenciación de otros patrones relacionales permitirá afinar los sistemas clasificatorios futuros (AU)
Nowadays psychopathological classification is characterized by a great complexity and confusion, which produces innumerable debates. We make here an inquiry focusing on the concept of "hysteria" as starting point, for it is an elusive and protean diagnostic term, which overlaps to some extent to the more fashionable - but not less fuzzy - one of "borderline disorder", as well as to other disorders, the psychosis for instance, making it a paradigmatic case inside the general discussion in psychopathology and psychoanalysis. In these times of positivist thinking the multiform presentation of hysteria has led to its discredit and virtual elimination from the official classification systems. However, when we use the word "diagnostics" for the personality we should not take it as a mere aggregate of signs and symptoms but as the appraisal and description of those complex behavioral patterns whose privileged level of analysis is the interpersonal relationship. When the relationship is the main area of maladjustment constitutes just what is called "personality disorder". We reach the conclusion that histrionic personality is, in spite of its complexity, a relational pattern with a huge presence in the psychotherapeutic clinic, in mental health and in other domains of the health care system, and that its accurate assessment and differentiation from other patterns will improve future classification systems (AU)
Asunto(s)
Humanos , Masculino , Femenino , Psicoanálisis/métodos , Psicoanálisis/normas , Psicoanálisis/tendencias , Histeria/psicología , Trastorno de Personalidad Limítrofe/epidemiología , Trastorno de Personalidad Limítrofe/prevención & control , Trastorno de la Personalidad Esquizotípica/epidemiología , Trastorno de la Personalidad Esquizotípica/psicología , Psicoanálisis/instrumentación , Psicoanálisis/organización & administración , Histeria/clasificación , Histeria/fisiopatología , Salud Mental/normasRESUMEN
In the paper below we present the clinical case of a 48 year old female with various symptoms associated with functional visual disturbance -constricted tubular visual fields, wich lasts from 6 years; the extensive clinical and paraclinical ophthalmological investigations ruled out the presence of an organic disorder. In the present, we suspect a diagnosis of hysteria, still uncertain, wich represented over time a big challenge in psychology and ophthalmology. The mechanisms and reasons for hysteria are still not clear and it could represent a fascinating research theme. The tunnel, spiral or star-shaped visual fields are specific findings in hysteria for patients who present visual disturbance. The question of whether or not a patient with hysterical visual impairment can or cannot "see" is still unresolved.
Asunto(s)
Histeria/diagnóstico , Trastornos de la Visión/diagnóstico , Campos Visuales , Diagnóstico Diferencial , Femenino , Glaucoma de Ángulo Abierto/diagnóstico , Humanos , Histeria/complicaciones , Histeria/fisiopatología , Persona de Mediana Edad , Pronóstico , Trastornos de la Visión/etiología , Trastornos de la Visión/fisiopatología , Agudeza VisualRESUMEN
This article provides a neurobiological account of symptoms that have been called 'hysterical', 'psychogenic' or 'medically unexplained', which we will call functional motor and sensory symptoms. We use a neurobiologically informed model of hierarchical Bayesian inference in the brain to explain functional motor and sensory symptoms in terms of perception and action arising from inference based on prior beliefs and sensory information. This explanation exploits the key balance between prior beliefs and sensory evidence that is mediated by (body focused) attention, symptom expectations, physical and emotional experiences and beliefs about illness. Crucially, this furnishes an explanation at three different levels: (i) underlying neuromodulatory (synaptic) mechanisms; (ii) cognitive and experiential processes (attention and attribution of agency); and (iii) formal computations that underlie perceptual inference (representation of uncertainty or precision). Our explanation involves primary and secondary failures of inference; the primary failure is the (autonomous) emergence of a percept or belief that is held with undue certainty (precision) following top-down attentional modulation of synaptic gain. This belief can constitute a sensory percept (or its absence) or induce movement (or its absence). The secondary failure of inference is when the ensuing percept (and any somatosensory consequences) is falsely inferred to be a symptom to explain why its content was not predicted by the source of attentional modulation. This account accommodates several fundamental observations about functional motor and sensory symptoms, including: (i) their induction and maintenance by attention; (ii) their modification by expectation, prior experience and cultural beliefs and (iii) their involuntary and symptomatic nature.
Asunto(s)
Teorema de Bayes , Histeria/fisiopatología , Histeria/psicología , Modelos Psicológicos , Teoría Psicológica , Encéfalo/fisiopatología , Humanos , Modelos BiológicosRESUMEN
OBJECTIVE: Excessive food intake has been linked to many factors including taste preference and the presence of psychopathology. The purpose of this study was to investigate the association between sweet and salty taste preference and psychopathology in patients with severe obesity. METHODS: A consecutive series of patients applying for bariatric surgery was recruited for the study. Taste preference was self-reported. Psychopathology was assessed using the revised version of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). 190 patients were included in the study. RESULTS: In comparison with patients who had salty taste preference, patients with sweet taste preference had significantly higher elevations on the depression (OD: 4.090, p = 0.010) and the hysteria (OD: 2.951, p = 0.026) clinical scales of the MMPI-2. CONCLUSION: The results suggest the presence of an association between taste preference and psychopathology. The findings may be of interest for clinicians who are involved in the treatment of obesity. In particular, they may wish to pay increased attention to patients with sweet taste preference or who have a strong attraction for both sweet and salty foods, in order to detect psychopathology and to adapt the treatment.
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Preferencias Alimentarias/fisiología , Obesidad Mórbida/fisiopatología , Obesidad Mórbida/psicología , Gusto , Adolescente , Adulto , Factores de Edad , Índice de Masa Corporal , Depresión/fisiopatología , Carbohidratos de la Dieta , Femenino , Humanos , Hiperfagia/fisiopatología , Hiperfagia/psicología , Histeria/fisiopatología , Masculino , Persona de Mediana Edad , Obesidad Mórbida/cirugía , Factores Sexuales , Cloruro de Sodio DietéticoRESUMEN
Mass hysteria or collective hysteria usually begins when an individual shows a hysteric manifestation in front of others in the same group who later contagiously acquire the same symptoms. The underlying pathogenesis of mass hysteria is still unknown. It has been demonstrated that the mirror neuron system (MNS) provides an important neural substrate for humans' ability to imitate and there is an inhibitive component of MNS keeping us from imitating everything we see. We proposed that the inhibitive component for MNS automatic imitation may not function well in individuals of the group that results in the outbreaks of mass hysteria. We also provide evidences from emotional contagion, gender difference and treatment in mass hysteria to support this hypothesis.
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Encéfalo/fisiopatología , Histeria/etiología , Histeria/fisiopatología , Conducta Imitativa , Modelos Neurológicos , Neuronas/fisiología , Dinámica Poblacional , Humanos , Histeria/psicología , Inhibición Neural , Trastornos Psicofisiológicos/etiología , Trastornos Psicofisiológicos/fisiopatología , Trastornos Psicofisiológicos/psicologíaRESUMEN
A partir de la presentación y estudio evolutivo de uncaso, se pretende demostrar la vigencia del trastorno deconversión en la actualidad y, de esta manera, desmitificaresta patología que, desde que tuvo su origen comoentidad nosológica en la época de Charcot, aún es objetode interés clínico y científico.Así se han recopilado los artículos actuales de mayorevidencia científica y se han revisado diversas fuentesbibliográficas que inciden en un antes y un después deeste trastorno.Finalmente se estudia el abordaje psicoterapéuticosegún el modelo cognitivo conductual y las estrategiasque, basadas en este modelo, se han adecuado al caso
According to the exposure and the evolutionarystudy of a concrete case, we are going to show how conversiondisorder is still in force. Therefore, it will becompulsory to demystify certain studies about thispathology, which is nowadays an important issue ofclinic and scientific interest since its origin as a nosologicentity in Charcots time.In the beginning, we have been making a compilationof the most interesting and newest articles in whichscientific evidence appears. Furthermore, we have beenchecking several bibliographic sources emphasizing inthe different way of treating this kind of disorder.Finally, we have aimed a psychotherapy analyse bytaking into account the cognitive and conductual pattern,as well as the suitable strategies to our case whichare based on this pattern