La Salud Mental post COVID / No disponible

No disponible

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

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.

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

No disponible

Psicosis inducidas por estados excepcionales de conciencia / No disponible

No disponible

¿Qué necesitan aprender los psiquiatras? Conocimientos, habilidades y actitudes / What do psychiatrists need to learn? knowledge, skills and attitudes

En todas las culturas y a lo largo de la historia la religión ha desempeñado un papel destacado, de lo que se deduce que realiza una función adaptativa, invocada en todas las sociedades para satisfacer una o varias necesidades universales humanas. Por tanto, y desde el punto de vista psicológico el rasgo más destacado de la religión es su universalidad. La religión y la espiritualidad son importantes para la vida de muchas personas, le dan un sentido a sus vidas, en este sentido y no en otro, se puede considerar que la religión y la espiritualidad son parte de la calidad de vida. La organización mundial de la salud (OMS) reconoce que los valores espirituales o la espiritualidad es un componente de la calidad de vida. Muy a menudo el fenómeno religioso ha sido considerado muy superficialmente por los psiquiatras. Por eso no es de extrañar que pocas publicaciones existen que ayuden a los psiquiatras a explorar la religiosidad de los pacientes. Muchos estudios científicos que demuestran que la religión en particular o la espiritualidad en general (definida como experiencia individual y personal y que no incluye los ritos y rituales de una determinada religión) se asocia con un mayor bienestar y disminuye los síntomas depresivos pudiendo relacionarse con estilos de vida (mejorar las estrategias de afrontamiento ante situaciones adversas) y proporcionan una de las mayores y más poderosas redes sociales. A lo largo de su formación como especialistas los psiquiatras son entrenados en la entrevista clínica y en la exploración del estado mental, son conscientes de los aspectos que deben abordar durante la entrevista: el motivo de consulta, los criterios diagnósticos, la historia familiar y social..., pero incluso aunque sabemos que la espiritualidad es a veces muy importante para el paciente, psiquiatras consideramos que es más difícil preguntar a los pacientes sobre sus creencias religiosas que sobre aspectos relacionados con la sexualidad. En este trabajo se revisan una serie de cuestionarios que pueden ser utilizados y ayudar a los psiquiatras a explorar la religiosidad, la espiritualidad y si la religión o no juega un papel en las estrategias de afrontamiento del paciente. Los aspectos religiosos y espirituales de nuestros pacientes deben ser explorados, es necesario que tengamos en cuenta que son valores en ocasiones importantes y que junto con otros deben pasar a formar parte de lo que hoy se denomina medicina basada en el paciente. Por lo tanto los psiquiatras deben de aprender el papel que la religiosidad y la espiritualidad juegan en la aparición y manifestaciones de la enfermedad y en el proceso de afrontar la enfermedad, el sufrimiento y la discapacidad y en la resiliencia en general (AU)

In every culture and through history, religion has always being important, it is considered to play an adaptative role, that may help different societies to satisfied one or some human universal necessities. Therefore, according to psychological point of view, the more common aspect of religion in universality. Religion and spirituality are very important for some people, it helps them to find life sense, in this aspect and not in other, we can clonclude that religion and spirituality are part of the quality of life. The World Health Organization (WHO) support that spiritual values or spirituality are an important component in quality of life. Very often religious experience has not been taken into consideration by psychiatrist. It is not surprising that there are very few research studies and publications that help psychiatrist to explore religiosity in their patients. Many data suggest that religion in particular, or sipirituality in general (considered as an intimate and personal experience that not include rituals of any religion) is associated with increased sense of well-being, decreased depressive symptoms and is related with lifestyle behaviors’ (enhance positive coping strategies against stressful life events) and provide larger and stronger social networks. Psychiatrists are trained in interviewing and they are aware of the domains that should be assessed: history of the present illness, diagnostic criteria, family history , formal mental status, social history, ... but even though we know spirituality is sometimes essential for patients, psychiatrist in general find more difficult and intimate to talk about one's religions or spiritual life than one's sexual experience. In this paper we review questionaires that measure religiosity, spiritual well-being, religious coping strategies and beliefs and could help psychiatrist in taking spiritual history. Spiritual matters and religion should become part of clinical psychiatric assessment, we have to take into consideration cultural beliefs, values that are important for patients and therefore spiritual concerns should be considered as a part of the patient-center medicine. Therefore psychiatrists need to take into consideration the role of religion and spirituality in the diagnosis, symptoms, dyshabilities and resilience (AU)

Percepción, vivencia e identidad corporales / Perception, experience and body identity

El médico ha de conocer al enfermo en la enfermedad y no sólo a la enfermedad en el enfermo, desde la doble perspectiva del cuerpo como objeto y el cuerpo como sujeto. Esto también afecta al enfermo que ha de enfrentarse a la realidad de tener un cuerpo que irrumpe en su conciencia como amenaza vital, como fuente de malestar y discapacidad y el ser un cuerpo. (Marcel). El cuerpo humano en su doble vertiente ha sido y es un gran desconocido, cuando no un gran ultrajado a pesar del hecho somos nuestro cuerpo y nuestro cuerpo es cada uno de nosotros. A veces no nos sentimos como somos y surgen así confrontaciones, unas veces más normales, otras más morbosas, que obligan al clínico a consideraciones éticas complejas y al científico a aceptar una patología de la identidad personal. El dualismo considera que hay en nosotros dos sustancias una que nos distingue de los demás seres y del resto de los individuos de la especie humana, el alma, vida psíquica, mente o conciencia, y otra más insustancial, el cuerpo. La primera está destinada a dominar a éste, a sobrevivirle tras la muerte cuando éste, ya cadáver destinado a la putrefacción, es sepultado, incinerado o arrojado a la profundidad del mar. Este dualismo pretende, explicar el origen del mal y la actitud para derrotarlo, y lo hace con eficacia. Esta antropología tiene raíces muy antiguas (los Upvanisvads, en los textos órficos, en Platón), es el núcleo del pensamiento gnóstico y la base de la ciencia moderna desde Descartes. Algunas perspectivas monistas son un dualismo enmascarado o una falacia mereológica, según la cual, el cerebro es consciente, cuando el que es consciente es el sujeto, aunque sin su cerebro no podría serlo, y por eso se propone una nueva perspectiva, monismo quiasmótico o janicular que considera el valor adaptativo de enfocar la realidad desde dos perspectivas, como universo físico y mundo de relaciones interpersonales. En las agnosias y en el miembro fantasma existe una confrontación entre el cuerpo objeto y el cuerpo sujeto que ha permitido investigar cómo es la percepción del propio cuerpo y cómo genera el cerebro el esquema y la imagen corporal. El estudio de la vivencia corporal desde la perspectiva de la fenomenología y de la psiquiatría antropológica permite profundizar en el conocimiento de alteraciones de la experiencia del propio cuerpo en diferentes enfermedades mentales, en especial en aquellas en las que se presenta una confrontación entre cuerpo e identidad personal obliga a considerar el proceso de la identificación individual y una categoría de trastornos de la identidad personal en la que se incluirían el trastorno dismórfico corporal, la eritrofobia, la anorexia nerviosa, el trastorno de identidad de integridad corporal y los de naturaleza sexual (transexualismo, transvestis mono fetichista, trastorno de identidad sexual en la infancia) (AU)

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

La evolución del concepto de Esquizofrenia Resistente al Tratamiento / The evolving concept of treatment-resistant schizophrenia

La esquizofrenia es una enfermedad crónica del cuerpo y de la mente que afecta al 1% de la población. La existencia de la persona con esquizofrenia debe ser entendida, por lo menos, con dos perspectivas: una, la que contempla su integración en la comunidad social; otra, la que entiende que hay un paciente con un problema de salud tratable con medicinas y con psicoterapias. Hay un grupo numeroso de pacientes con presentaciones ‘resistentes’ de la esquizofrenia, es decir: casos en los que no se obtiene un grado mínimo de remisión con los tratamientos convencionales. Estos casos dejan en evidencia el hecho de que todavía hoy carecemos de un modelo de tratamiento integrador que esté armado a partir de intervenciones específicas cuya eficacia sea verificable. El concepto de ‘esquizofrenia resistente’ debería haber evolucionado a la par que los conocimientos y los recursos terapéuticos que hoy tenemos. ¿Por qué no ha ocurrido? Este artículo revisa la historia del concepto de ‘resistencia’ para dar cuenta de tal fracaso y proponer perspectivas metodológicas que nos saquen del estancamiento (AU)

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

The evolving concept of Treatment- Resistant Schizophrenia.

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

Perception, experience and body identity.

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

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

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