RETRACT ARTICLE: SOCIAL COGNITION INTERVENTIONS FOR ADOLESCENTS WITH AUTISM SPECTRUM DISORDER. A SYSTEMATIC REVIEW.

With the commitment to maintain the highest levels of quality, the editorial committee has decided to retract the article.

Mesopic pupillary reflex in patients treated with fluoxetine.

INTRODUCTION: currently the treatment of mental illness by antidepressants is very frequent. Selective serotonin reuptake inhibitors are the most prescribed antidepressants worldwide and have been associated with alterations in accommodation or pupil. The objective of this study is to evaluate the effects of fluoxetine on the pupillary reflex and the accommodation in young population. METHODOLOGY: The study group included seven patients diagnosed with depression and treated with fluoxetine; 22 subjects were included as a control group. The pupillary reflexes and the accommodative state were evaluated using the Power Refractor II pupilometer. Five phases of 3 seconds each were measured. In phase 2 there was a glare with a white light. RESULTS: For the pupil diameter, maximum and minimum values were obtained in the group of patients treated with fluoxetine than in the control in all the measurement phases. For the control group, a maximum pupillary contraction is observed in the glare phase, however, in the study group it is observed in the phase after glare. As for the accommodation, there are no significant differences between the two groups. CONCLUSIONS: In patients treated with fluoxetine there are pupillary alterations like a bigger pupillary diameters and slower pupillary contraction. The lack of conclusive results in terms of accommodation does not mean that there are no changes related to it, whose detection requires future studies with different methodologies and with a larger sample size.

La Salud Mental post COVID / No disponible

No disponible

Reflejo pupilar mesópico en pacientes tratados con fluoxetina / Mesopic pupillary reflex in patients treated with fluoxetine

INTRODUCCIÓN: Actualmente el tratamiento de enfermedades mentales mediante antidepresivos es muy frecuente. Los inhibidores selectivos de la recaptación de serotonina son los antidepresivos más prescritos a nivel mundial y han sido asociados con alteraciones en la acomodación o la pupila. El objetivo de este estudio es evaluar los efectos de la fluoxetina sobre el reflejo pupilar y la acomodación en población joven. METODOLOGÍA: El grupo de estudio contó con siete pacientes diagnosticados de depresión y tratados con fluoxetina; como grupo control se incluyeron 22 sujetos. Se evaluaron los reflejos pupilares y el estado acomodativo mediante el pupilómetro Power Refractor II. Se midieron 5 fases de 3 segundos cada una. En la fase 2 se produjo un deslumbramiento con una luz blanca. RESULTADOS: Para el diámetro pupilar se han obtenido valores máximos y mínimos mayores en el grupo de pacientes tratados con fluoxetina que en el control en todas las fases de medida. Para el grupo control se observa una contracción pupilar máxima en la fase de deslumbramiento, sin embargo, en el grupo de estudio se observa en la fase tras el deslumbramiento. En cuanto a la acomodación no se obtuvieron diferencias significativas entre ambos grupos. CONCLUSIONES: En pacientes tratados con fluoxetina existen alteraciones pupilares observándose diámetros pupilares mayores y menor velocidad de contracción pupilar. La falta de resultados concluyentes en cuanto a la acomodación no significa que no existan cambios relacionados con esta, cuya detección requerirá de futuros estudios utilizando diferentes metodologías y con un tamaño muestral mayor

INTRODUCTION: currently the treatment of mental illness by antidepressants is very frequent. Selective serotonin re-uptake inhibitors are the most prescribed antidepressants worldwide and have been associated with alterations in accommodation or pupil. The objective of this study is to evaluate the effects of fluoxetine on the pupillary reflex and the accommodation in young population. METHODOLOGY: The study group included seven patients diagnosed with depression and treated with fluoxetine; 22 subjects were included as a control group. The pupillary reflexes and the accommodative state were evaluated using the Power Refractor II pupilometer. Five phases of 3 seconds each were measured. In phase 2 there was a glare with a white light. RESULTS: For the pupil diameter, maximum and minimum values were obtained in the group of patients treated with fluoxetine than in the control in all the measurement phases. For the control group, a maximum pupillary contraction is observed in the glare phase, however, in the study group it is observed in the phase after glare. As for the accommodation, there are no significant differences between the two groups. CONCLUSIONS: In patients treated with fluoxetine there are pupillary alterations like a bigger pupillary diameters and slower pupillary contraction. The lack of conclusive results in terms of accommodation does not mean that there are no changes related to it, whose detection requires future studies with different methodologies and with a larger sample size

Los fenómenos de posesión: a propósito de un caso / Possession Phenomena: a Case Report

No disponible

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.

Efecto del programa neuroeducativo HERVAT en el potencial evocado P300 en niños con trastorno por déficit de atención / Effect of the HERVAT neuroeducational program on evoked potential P300 in children with attention deficit disorder

Introducción. El trastorno por déficit de atención (TDA) ha sido estudiado desde muchos puntos de vista, sin embargo, todavía se desconocen los mecanismos neurobiológicos subyacentes al mismo. Los potenciales evocados y entre ellos el componente P300 pueden servir para investigar los procesos de las funciones cognitivas y atencionales deficitarios en los niños con TDA. Metodología. En este estudio analizamos la eficacia del programa del neuroeducativo HERVAT (acrónimo de Hidratación, Equilibrio, Respiración. Visión, Audición, Tacto) en el potencial evocado P300 en un grupo de niños, entre 7 y 11 años con TDA. Resultados. Los resultados indican que al final del estudio los niños con TDA que han hecho el programa HERVAT han mejorado la latencia del P300 y han reorganizado la actividad cerebral hacia áreas frontales mientras que el grupo control mantiene la misma latencia del P300 y las mismas áreas corticales posteriores durante la tarea de discriminación de estímulos multisensoriales. Conclusiones. Como conclusión podríamos decir que el programa neuroeducativo HERVAT manifiesta su eficacia en el acortamiento de la latencia del potencial evocado P300, responsable del procesamiento cerebral de la información, así como en la reorganización de la actividad cerebral desde áreas posteriores cerebrales hacia áreas corticales frontales, responsables de los procesos atencionales de las funciones ejecutivas

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 (Hidratacion [hydration], Equilibrio [balance], Respiracion [breathing], Vision [vision], Audicion [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

Pharmacogenetic testing for the guidance of psychiatric treatment: a multicenter retrospective analysis.

OBJECTIVE: We investigated the association between clinical outcome and the recommendations of a pharmacogenetic test (Neuropharmagen) in patients with a variety of psychiatric conditions whose previous treatment regimen had failed. METHODS: This retrospective, naturalistic, multicenter study included adult psychiatric patients (depression, psychosis, anxiety, bipolar, etc.) who had been seen at 3 private clinics. All patients had received pharmacogenetic testing (Neuropharmagen) and were classified depending on whether or not their post-test treatment regimen followed the test recommendations. Clinical severity was assessed with the Clinical Global Impression of Severity (CGI-S) at baseline (pre-test) and 3-month follow-up, and adverse events were recorded. RESULTS: 182 patients were available for analysis. After multivariate adjustment, patients whose treatment followed the test recommendations had odds of improvement about 4 times greater than patients whose treatment did not follow the recommendations (adjusted OR=3.86, 95%CI 1.36-10.95; p=0.011). Importantly, psychiatric diagnosis did not significantly affect the odds of improvement. Also, in the subpopulation with baseline CGI-S score >3 (N=170), the rate of stabilization at follow-up (defined as CGI-S≤3) was significantly higher in patients whose treatment followed the pharmacogenetic recommendations (p=0.033). There was no apparent difference in the incidence of adverse events (6 patients in each group). CONCLUSIONS: Non-drug naïve patients whose treatment followed the recommendations of pharmacogenetic testing were more likely to improve their condition than patients whose treatment did not. These results are consistent with previous clinical research on depressed patients, and this study also suggests that this benefit can be extended to psychiatric conditions other than depression.

Romanticismo y Esquizofrenia. Segunda Parte: La hipótesis de la Intimidad / Romanticism and Schizophrenia. Second part: The Intimacy hypothesis

En la primera parte de este artículo hemos analizado la evidencia en que se basa la hipótesis de la recencia de la esquizofrenia y también lo que podemos llamar la naturaleza íntima de la enfermedad. En esta parte subrayamos el papel de ciertos aspectos culturales que han sido ignorados hasta ahora, aspectos que se asocian con los profundos cambios en la Weltanschauung y en los sistemas de creencias sobre la naturaleza humana que trajo consigo la modernidad tardía y concretamente el romanticismo. La descripción de las características principales del romanticismo, empezando por "el descubrimiento de la intimidad", nos lleva a la conclusión de que la alteración de la ipseidad y de la subjetividad característica de la enfermedad parece ser un factor de vulnerabilidad cuando la persona ha de afrontar los nuevos retos que plantea el romanticismo. La consideración de los logros literarios de Hölderlin y del drama psicológico profundo presente en su obra, pone de manifiesto como, en el contexto del final de la edad moderna tardía, el ser humano encuentra en el romanticismo no sólo una fuente de creatividad y desarrollo personal, sino también la amenaza de su propia destrucción. Por último, ponemos nuestra hipótesis en relación con hipótesis genéticas recientes que identifican conjuntos de enfermedades asociadas con el mismo gen o genes (diseasoma). En todo caso, el proceso de asociación de los rasgos del romanticismo con las principales características de la esquizofrenia nos permite considerar la posibilidad de una especie de amalgama entre locura y civilización, tanto a nivel general como en los pacientes individuales, que allana el camino para nuevos enfoques terapéuticos

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

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.

Romanticismo y Esquizofrenia. Primera parte: La Hipótesis de la recencia y el núcleo fundamental de la enfermedad / Romanticism and schizophrenia. First part: The recency hypothesis and the core Gestalt of the disease

Podemos encontrar en la Biblia, en tablillas de Mesopotamia, en la literatura clásica griega y romana y en los escritos de muchas culturas no occidentales, descripciones de comportamientos irracionales, incomprensibles o fuera de control, tal y como es frecuente en nuestros días en pacientes con trastornos mentales graves. Sin embargo, la presencia en tiempos antiguos del cuadro completo de la esquizofrenia que vemos hoy en día en nuestros servicios psiquiátricos es cuestionable. De hecho, los síntomas típicos, su inicio, sus características, su duración y su estado final no aparecen con nitidez. El impacto de la enfermedad sobre el funcionamiento psíquico y la discapacidad asociada a la enfermedad están en su mayoría ausentes en esos textos. Torrey (1980) y Hare (1988) afirman que la enfermedad no existía antes del año1800 (esto se conoce como hipótesis de recencia). En su opinión, esto sería consecuencia de factores biológicos, como virus, predisposición genética, factores dietéticos o contaminantes ambientales asociados a otras consecuencias de la civilización. Otros han puesto más énfasis en la industrialización y sus consecuencias sobre determinadas condiciones sociales, tales como la estructura familiar y la migración. Después de analizar las múltiples facetas de la locura en personajes literarios, en textos de medicina y en diversas figuras históricas, los argumentos que presentamos tienden a apoyar de la hipótesis de recencia. Una revisión de las características nucleares de la esquizofrenia, de su impacto en la vivencia del yo individual, en la intersubjetividad y en la ipseidad, temas que están relativamente descuidados en la literatura psiquiátrica reciente, nos abren las puertas para considerar en una segunda parte la relación entre las características del romanticismo, empezando por "el descubrimiento de la intimidad", y su articulación con la alteración de la ipseidad y de la subjetividad característica de la enfermedad

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 year1800 (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. 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.

Deep brain stimulation for obsessive-compulsive disorder: is the side relevant?

BACKGROUND: Deep brain stimulation for obsessive-compulsive disorder (OCD) has targeted several subcortical nuclei, including the subthalamic nucleus (STN) and the nucleus accumbens. While the most appropriate target is still being looked for, little attention has been given to the side of the stimulated hemisphere in relationship to outcome. METHODS: We report 2 patients diagnosed with OCD, one having symmetry obsessions and the other one with sexual-religious obsessive thoughts. They were implanted bilaterally with deep electrodes located at both STN and nuclei accumbens. The effectiveness of the stimulation was tested for every possible paired combination of electrodes guided by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score reduction. RESULTS: In both cases, the combination of electrodes which best relieved the OCD symptoms was both the left STN and left accumbens. In case 1, the preoperative Y-BOCS score was 33, and 1 month after stimulation it was 16. In case 2, the Y-BOCS scores were 33 and 3, respectively, with the patient being free of obsessions. CONCLUSION: Some reports suggest that lesion stimulation or stimulation of only the right side relieves OCD symptoms. However, anatomical and functional studies are not conclusive as to which side is most affected in OCD. Possibly, each OCD patient has an individualized optimal side to stimulate.

Paving the way for new research strategies in mental disorders. Second part: the light at the end of the tunnel.

Following we consider strategies to overcome the situation described in a previous article (López-Ibor JJ, López-Ibor MI. Paving the Way for New Research Strategies in Mental Disorders. First part: the recurring crisis of psychiatry. Actas Esp Psiquiat. 2013;41(1):33-43), by putting emphasis on psychopathology instead than in classification, in functions rather than in diagnostic criteria, to be aware in the progress in neuroscientific monistic perspectives and by importing the methods of the emerging connectomics. Medicine is undergoing deep changes. Networking is becoming the new paradigm and we consider that it should be the turning point of the future psychiatry, both in research and in practice.

Hacia nuevas estrategias de investigación en los trastornos mentales. Segunda parte: La luz al final del túnel / Paving the way for new research strategies in mental disorders. Second part: The light at the end of the tunnel

A continuación consideraremos las estrategias a seguir para superar la situación descrita en un artículo previo (López-Ibor JJ, López-Ibor MI. Hacia nuevas estrategias de investigación en los trastornos mentales. Primera parte: La crisis recurrente de la psiquiatría. Actas Esp Psiquiat. 2013; 41(1); 33-43.) centrándonos en la psicopatología en lugar de en la clasificación, en las funciones más que en los criterios diagnósticos, teniéndolos en cuenta en el progreso de las perspectivas monistas neurocientíficas e importando los métodos de la conectómica emergente. La medicina está sufriendo profundos cambios. La creación de redes se está convirtiendo en el nuevo paradigma y consideramos que este debería ser el punto de inflexión de la futura psiquiatría, tanto en investigación como en la práctica (AU)

Following we consider strategies to overcome the situation described in a previous article (López-Ibor JJ, López-Ibor MI. Paving the Way for New Research Strategies in Mental Disorders. First part: the recurring crisis of psychiatry. Actas Esp Psiquiat. 2013;41(1):33-43), by putting emphasis on psychopathology instead than in classification, in functions rather than in diagnostic criteria, to be aware in the progress in neuroscientific monistic perspectives and by importing the methods of the emerging connectomics. Medicine is undergoing deep changes. Networking is becoming the new paradigm and we consider that it should be the turning point of the future psychiatry, both in research and in practice (AU)

Paving the way for new research strategies in mental disorders. First part: the recurring crisis of psychiatry.

Psychiatry is going through a deep crisis, both as a scientific discipline as a medical speciality. In the present paper we consider in length what we consider to be the three aspects that could explain the situation: the recurring disappointment in classification; the persistence of dualistic perspectives in research; and third, the continuing of a localizacionism inadequate to explain normal and pathological behaviour. Psychiatry lacks a definition of mental disorder that covers all situations, there are difficulties in drawing a precise distinction between normality and psychopathology, and the majority of these “diagnostic” categories are not validated by biological criteria. Furthermore, there is still a debate on the nature of the symptoms of mental disorders, a confusion classification and diagnosis and a preoccupation with the growing inflation of diagnostic categories. Dualism is at the core of psychopathology, simply because Cartesian dualism led to the development of modern science, but the price paid includes the split-up of mental and physical phenomena and illnesses and of psychiatry and the rest of medicine. Localizationism, that is, the approach to brain function considering that particular pychological functions are carried out by particular brain areas or centers, helps to understand many clinical and psychological phenomena, but have largely fild in explaining the nature of most mental disorders. In a second part of this article we provide some strategies that could help to go beyond the present impasse.

Investigación en psiquiatría: Entre Sísifo y Pedro / Research in psychiatry: between Sisyphus and Peter

No disponible