Las perplejidades éticas del Rey Ludwig II de Baviera: locura, extravagancia y profesión médica / The ethical perplexities of king Ludwig II of Bavaria: madness, extravagance and medical profession / As perplexidades éticas do Rei Ludwig II da Baviera: loucura, extravagancia e profissão médica

1. Bernhard von Gudden diagnosticó el trastorno del Rey Ludwig II de Baviera como "paranoia" (locura), aunque Ludwig nunca fue personalmente evaluado por este experto psiquiatra, diagnóstico que usó el gobierno bávaro para justificar la remoción de Ludwig del poder. 2. Su conducta progresivamente anormal; sus proyectos múltiples de construcción, por los cuales incurrió en fuertes deudas; su convicción de descender directamente de los Borbones gracias al "bautismo"; su desenfrenada vida homosexual, todo constituyó la base para el diagnóstico psiquiátrico. 3. De acuerdo con los criterios actuales de la psiquiatría, Ludwig mostró rasgos de un trastorno de personalidad esquizotípico, unido a un sindrome orbitofrontal, y un modo de existencia extravagante. 4. Bernhard von Gudden fundamentó su diagnóstico y peritaje psiquiátricos siguiendo los principios éticos de beneficencia y primum non nocere, "ayudar, al menos no dañar".

Abstract: Bernhard von Guden diagnosed the Bavarian King Ludwig II with "paranoia" (madness), although Ludwig was not personally evaluated by this expert psychiatrist, a diagnosis that the Bavarian government used to justify removing Ludwig from power. 2. His increasingly abnormal behavior, his multiply building projects, for which he incurred much debt, his conviction that he descended from the Bourbons through "baptism", his unbridled homosexual life, together formed the basis for the psychiatrist´s diagnosis. 3. According to modern criteria of psychiatry Ludwig displayed traits for schizotypal personality disorder together with an orbitofrontal syndrome, and an extravagance way of existence. 4.Bernhard von Gudden based his psychiatric diagnosis and expertise following the ethical principles of beneficence and primum non nocere, "to help, at least not to harm"

Resumo: 1. Bernhard von Gudden diagnosticou o transtorno do Rei Ludwig II da Baviera como "paranoia" (loucura), ainda que Ludwig nunca tenha sido pessoalmente avaliado por este especialista psiquiatra, diagnóstico que o governo bávaro usou para justificar a remoção de Ludwig do poder. 2. Sua conduta progressivamente anormal; seus projetos múltiplos de construção, pelos quais incorreu em fortes dívidas; sua convicção de descender diretamente dos Bourbons graças ao "batismo"; sua desenfreada vida homossexual, tudo constituiu a base para o diagnóstico psiquiátrico. 3. De acordo com os critérios atuais da psiquiatria, Ludwig mostrou traços de um transtorno de personalidade esquizotípico, unido a uma síndrome órbito-frontal e um modo de existência extravagante. 4. Bernhard von Gudden fundamentou seu diagnóstico e perícia psiquiátrica seguindo os princípios éticos de beneficência e primum non nocere, "ajudar, ao menos não prejudicar".

Mediating role of childhood abuse for the relationship between schizotypal traits and obsessive-compulsive disorder

Abstract Background The mediating role of childhood trauma in the relationship between schizotypal symptoms and obsessive-compulsive disorder (OCD) was not sufficiently investigated to date. Objectives In the present study, our major goal was to analyse the mediator role of childhood abuse (emotional, physical, and sexual), and neglect (emotional and physical) on the link between schizotypal symptoms and OCD, after controlling for duration of OCD, the mean number of comorbid Axis I disorders, and current anxiety. Methods One hundred fifteen patients (aged 18-65 years) who had primary diagnosis of OCD and Yale-Brown Obsessive-Compulsive Scale score ≥16 were assessed using the short form of Childhood Trauma Questionnaire questionnaire (CTQ-SF), Schizotypal Personality Questionnaire (SPQ), and Beck Anxiety Inventory (BAI). Results The all types of schizotypal symptoms were significantly correlated with the scores of childhood abuse and neglect, and BAI. The childhood abuse as a mediator significantly predicted the total YBOCS scores (p = 0.02) after when BAI scores were controlled. However, childhood neglect was not multivariately related to current OCD severity, and did not mediate the relationship between schizotypal traits and total YBOCS scores. Discussion We suggested that childhood trauma mediated the schizotypal traits in relationship with current OCD severity independent from anxiety severity.

The Schizotypal Personality Questionnaire-Brief lacks measurement invariance across three countries.

The Schizotypal Personality Questionnaire-Brief (SPQ-B) is a commonly-used tool for measuring schizotypal personality traits and due to its wide application, its cross-cultural validity is of interest. Previous studies suggest that the SPQ-B either has a three- or four-factor structure, but the majority of studies have been conducted in Western contexts and little is known about the psychometric properties of the scale in other populations. In this study factorial invariance testing across three cultural contexts-Australia, China and Chile was conducted. In total, 729 young adults (Mean age = 23.99 years, SD = 9.87 years) participated. Invariance testing did not support the four-factor model across three countries. Confirmatory Factor Analyses revealed that neither the four- nor three-factor model had strong fit in any of the settings. However, in comparison with other competing models, the four-factor model showed the best for the Australian sample, while the three-factor model was the most reasonable for both Chinese and Chilean samples. The reliability of the SPQ-B scores, estimated with Omega, ranged from 0.86 to 0.91. These findings suggest that the SPQ-B factors are not consistent across different cultural groups. We suggest that these differences could be attributed to potential confounding cultural and translation issues.

How to tell a happy from an unhappy schizotype: personality factors and mental health outcomes in individuals with psychotic experiences

Objective: It is unclear why some individuals reporting psychotic experiences have balanced lives while others go on to develop mental health problems. The objective of this study was to test if the personality traits of harm avoidance, self-directedness, and self-transcendence can be used as criteria to differentiate healthy from unhealthy schizotypal individuals. Methods: We interviewed 115 participants who reported a high frequency of psychotic experiences. The instruments used were the Temperament and Character Inventory (140), Structured Clinical Interview for DSM-IV, and the Oxford-Liverpool Inventory of Feelings and Experiences. Results: Harm avoidance predicted cognitive disorganization (β = 0.319; t = 2.94), while novelty seeking predicted bipolar disorder (β = 0.136, Exp [β] = 1.146) and impulsive non-conformity (β = 0.322; t = 3.55). Self-directedness predicted an overall decrease in schizotypy, most of all in cognitive disorganization (β = -0.356; t = -2.95) and in impulsive non-conformity (β = -0.313; t = -2.83). Finally, self-transcendence predicted unusual experiences (β = 0.256; t = 2.32). Conclusion: Personality features are important criteria to distinguish between pathology and mental health in individuals presenting high levels of anomalous experiences (AEs). While self-directedness is a protective factor, both harm avoidance and novelty seeking were predictors of negative mental health outcomes. We suggest that the impact of AEs on mental health is moderated by personality factors.

The Biological Rhythms Interview of Assessment in Neuropsychiatry in patients with bipolar disorder: correlation with affective temperaments and schizotypy

Objective: To assess the relationship of biological rhythms, evaluated by the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), with affective temperaments and schizotypy. Methods: The BRIAN assessment, along with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A) and the Oxford-Liverpool Inventory for Feelings and Experiences (O-LIFE), was administered to 54 patients with remitted bipolar disorder (BD) and 54 healthy control (HC) subjects. Results: The TEMPS-A cyclothymic temperament correlated positively and the hyperthymic temperament correlated negatively with BRIAN scores in both the BD and HC groups, although the correlation was stronger in BD subjects. Depressive temperament was associated with BRIAN scores in BD but not in HC; conversely, the irritable temperament was associated with BRIAN scores in HC, but not in BD. Several positive correlations between BRIAN scores and the schizotypal dimensions of the O-LIFE were observed in both BD and HC subjects, especially with cognitive disorganization and less so with unusual experiences and impulsive nonconformity. A correlation with introversion/anhedonia was found only in BD subjects. Conclusion: Cyclothymic and depressive temperaments predispose to disturbances of biological rhythms in BD, while a hyperthymic temperament can be protective. Similar predispositions were also found for all schizotypal dimensions, mostly for cognitive disorganization.

The correlates of obsessive-compulsive, schizotypal, and borderline personality disorders in obsessive-compulsive disorder.

We assessed correlates of obsessive-compulsive (OCPD), schizotypal (SPD) and borderline (BPD) personality disorders in 110 obsessive-compulsive disorder (OCD) patients. We found OCD patients with OCPD (20.9%) to exhibit higher rates of hoarding and bipolar disorders, increased severity of hoarding and symmetry, lower prevalence of unacceptable thoughts involving sex and religion and less non-planning impulsivity. Conversely, OCD patients with SPD (13.6%) displayed more frequently bipolar disorder, increased severity of depression and OCD neutralization, greater prevalence of "low-order" behaviors (i.e., touching), lower low-planning impulsivity and greater "behavioral" compulsivity. Finally, in exploratory analyses, OCD patients with BPD (21.8%) exhibited lower education, higher rates of several comorbid psychiatric disorders, greater frequency of compulsions involving interpersonal domains (e.g. reassurance seeking), increased severity of depression, anxiety and OCD dimensions other than symmetry and hoarding, more motor and non-planning impulsivity, and greater "cognitive" compulsivity. These findings highlight the importance of assessing personality disorders in OCD samples.

How semantic deficits in schizotypy help understand language and thought disorders in schizophrenia: a systematic and integrative review / Como déficits semânticos na esquizotipia auxiliam a compreender transtornos da linguagem e do pensamento na esquizofrenia: uma revisão sistemática e integrativa

Introduction: Disorders of thought are psychopathological phenomena commonly present in schizophrenia and seem to result from deficits of semantic processing. Schizotypal personality traits consist of tendencies to think and behave that are qualitatively similar to schizophrenia, with greater vulnerability to such disorder. This study reviewed the literature about semantic processing deficits in samples of individuals with schizotypal traits and discussed the impact of current knowledge upon the comprehension of schizophrenic thought disorders. Studies about the cognitive performance of healthy individuals with schizotypal traits help understand the semantic deficits underlying psychotic thought disorders with the advantage of avoiding confounding factors usually found in samples of individuals with schizophrenia, such as the use of antipsychotics and hospitalizations. Methods: A search for articles published in Portuguese or English within the last 10 years on the databases MEDLINE, Web of Science, PsycInfo, LILACS and Biological Abstracts was conducted, using the keywords semantic processing, schizotypy and schizotypal personality disorder. Results: The search retrieved 44 manuscripts, out of which 11 were firstly chosen. Seven manuscripts were additionally included after reading these papers. Conclusion: The great majority of the included studies showed that schizotypal subjects might exhibit semantic processing deficits. They help clarify about the interfaces between cognitive, neurophysiological and neurochemical mechanisms underlying not only thought disorders, but also healthy human mind's creativity (AU)

Introdução: Transtornos do pensamento são fenômenos psicopatológicos comumente presentes na esquizofrenia e parecem resultar de déficits do processamento semântico. Traços esquizotípicos de personalidade consistem de tendências de pensamento e comportamento qualitativamente semelhantes às observadas na esquizofrenia, além de uma maior vulnerabilidade para esse transtorno. O presente trabalho teve como objetivo revisar a literatura sobre déficits de processamento semântico em amostras de indivíduos com traços esquizotípicos, discutindo o impacto desse conjunto de conhecimentos sobre a compreensão dos transtornos de pensamento na esquizofrenia. Estudos sobre o desempenho cognitivo de indivíduos saudáveis que apresentam traços esquizotípicos são úteis na elucidação dos déficits semânticos subjacentes aos transtornos psicóticos do pensamento, com a vantagem adicional de evitar fatores confundidores normalmente presentes em amostras clínicas de indivíduos esquizofrênicos, tais como uso de antipsicóticos e hospitalizações. Métodos: Foi realizada uma busca por artigos publicados em português ou inglês nos últimos 10 anos nas bases de dados MEDLINE, Web of Science, PsycINFO, LILACS e Biological Abstracts, utilizando-se as palavras-chave semantic processing, schizotypy e schizotypal personality disorder. Resultados: A pesquisa resultou em 44 manuscritos, dos quais 11 foram inicialmente selecionados. A partir da leitura desses artigos, outros sete foram adicionalmente incluídos. Conclusão: A grande maioria dos estudos incluídos mostrou que indivíduos esquizotípicos podem apresentar déficits de processamento semântico, auxiliando a compreender as interfaces cognitiva, neurofisiológica e neuroquímica subjacentes não só aos distúrbios pensamento, mas também à criatividade na mente humana saudável (AU)