Carlos Castilla del Pino: resistir, explorar, comunicar / Carlos Castilla del Pino: Resisting, Exploring, Communicating

A partir de una experiencia en común, se intenta resaltar alguna característica personal descollante de Carlos Castilla del Pino que le permitió resistir la atonía socio-cul-tural y profesional del franquismo y desarrollar, a pesar de todo, una vida profesional y teó-rica relevante. Tuvo que resistir esa atonía y amordazamiento de la larga noche de piedra y argamasa del franquismo en una ciudad de provincias duramente represaliada durante la guerra y posguerra civil española, dominada por tanto durante decenios por el fascismo institucional e ideológico. A pesar de ello, Carlos Castilla logró desarrollar una obra teórica (en especial en psicopatología, antropología e ideología) sumamente avanzada, coherente y arriesgada, para cuya compresión propongo un marco pragmático. El lema republicano, resistir es vencer, podría ser un buen resumen de su vida profesional y teórica, aunque es más dudoso que tal afirmación pueda tener el mismo valor para su vida personal. (AU)

Based on a common experience, we try to highlight some outstanding perso-nal characteristic of Carlos Castilla del Pino that allowed him to resist the socio-cultural and professional lethargy of Francoism and develop, despite everything, a relevant pro-fessional and theoretical life. To do so, he had to resist that lethargy and gagging of the long night of stone and mortar of Francoism and, on top of that, in a provincial city hars-hly retaliated during and after the Spanish civil war; therefore dominated for decades by institutional and ideological fascism. Despite this, Castilla del Pino managed to develop a highly advanced, coherent and risky theoretical work, especially in psychopathology, anthropology and ideology, for whose understanding I propose a pragmatic framework. The Republican motto, “to resist is to win”, could be a good summary of his professional and theoretical life, although it is more doubtful that such statement can have the same value for his personal life. (AU)

[Prevention of mental health disorders in primary care: Pregnancy in adolescence]. / Prevención de los trastornos de la salud mental. Embarazo en la adolescencia.

Adolescent pregnancy is generally an unwanted pregnancy, a situation that involves significant biological, psychological and social overloads, with repercussions on the health of the mother and the child. But the psychosocially important fact is that an unwanted pregnancy in its entirety gives rise to the birth of an ambivalently wanted child, a high-risk child. Those born in Spain in 2020 to women under 20 years of age were 8,305, which corresponds to 1.97% of all births. This review presents measures and recommendations for the protection and prevention of the mental health of the mother and child when pregnancy takes place in adolescence.

¿Cómo mejorar la perspectiva integrativa de los médicos clínicos? (II): dos muestras descriptivas de grupos de reflexión "tipo Balint" / How to improve the integrative approach in clinicians (II): two descriptive samples of "Balint-type" reflection groups

Los grupos Balint significaron una importante aportación para la formación y la formación continuada del personal sanitario, y, a mi entender, del personal de todos los servicios asistenciales. En ese sentido, las ideologías, políticas y economías “neoliberales” en el ámbito asistencial proponen otro modelo de asistencia y de “formación” (¿o deformación?) de los médicos y del personal asistencial. Su progresivo avance es una de las explicaciones fundamentales para el declive en el uso de procedimientos de formación integral, formación continuada y formación para la reparatividad. En el trabajo anterior se realizó una breve descripción de la difusión y extensión de los grupos “tipo Balint” tanto a nivel nacional como internacional, así como de sus cambios técnicos. Mi perspectiva actual es que los “grupos de reflexión”, como sistemas de formación y contención del personal comunitario, siguen siendo una técnica o sistema que podría proporcionar importantes ayudas en la asistencia sanitaria y comunitaria clínica. Para contribuir a su conocimiento lo más directo posible, se incluyen dos muestras descriptivas: una transcripción completa de una sesión y un listado de los temas y aproximaciones realizadas en diversas sesiones de uno de dichos grupos

Balint groups represented an important contribution to the training and continuous education of health personnel, and, in my opinion, of the personnel of all healthcare services. In this sense, "neoliberal" ideologies, policies and economies in the health care field propose another model of doctors and health care personnel attention and "training" (or rather deformation?). Its progressive advance is one of the fundamental explanations for the decline in the use of comprehensive training procedures, continuous training, and training for reparativity. In the previous work, a brief description of the diffusion and extension of "Balint type" groups, both nationally and internationally, as well as of their technical changes, was made. My current perspective is that "reflection groups", as training and contention systems for community personnel, continue to be a technique or tool that could provide important aid in clinical health and community care. Here, to contribute to its knowledge as directly as possible, two descriptive samples are included: a complete transcription of a session and a list of the topics and approximations made in different sessions of one of these groups

¿Cómo mejorar la perspectiva integrativa de los médicos clínicos?: una revisión acerca de los grupos Balint y los grupos de reflexión (I) / How to improve the integrative approach in clinicians: a review of Balint and reflection groups

Los grupos Balint, tardíamente reconocidos por las especialidades médicas en nuestro país, significaron una importante aportación para la formación y la formación continuada del personal sanitario y, a mi entender, del personal de todos los servicios asistenciales. Pero son solo una aportación para un modelo asistencial: el modelo basado en la asistencia pública, la solidaridad, el comunitarismo y la atención integral. En ese sentido, las ideologías, políticas y economías neoliberales en el ámbito asistencial proponen otro modelo de asistencia y de formación (¿o deformación?) de los médicos y del personal asistencial. Su progresivo avance es una de las explicaciones fundamentales del declive en el uso de procedimientos de formación integral, formación continuada y formación para la reparatividad. Precisamente, esos eran los objetivos básicos de los grupos Balint y de los grupos de reflexión, los que los llevaron a ocupar un lugar relevante durante los años ochenta y noventa del siglo XX en la formación de los especialistas de medicina de familia y comunitaria en numerosos países del "primer y segundo mundos". En este trabajo se realiza una breve descripción de la difusión y extensión de los grupos "tipo Balint" tanto a nivel nacional como internacional. Apoyándome en otros trabajos anteriores sobre el tema, se apuntan algunas de sus variantes y aplicaciones. Mi perspectiva actual es que los grupos de reflexión, como sistemas de formación y contención del personal comunitario, siguen siendo una técnica o sistema que podría ayudar de forma importante a lograr esos objetivos. Sin embargo, están siendo progresivamente arrinconados en los sistemas de formación occidentales con el silencio cómplice de numerosos administradores y docentes sanitarios, psicoanalistas incluidos

Balint groups, belatedly recognized by medical specialties in our country, meant an important contribution to the training and continuing education of health personnel, and, in my opinion, of personnel across all healthcare services. However, they are only a part of a welfare model: the model based on public assistance, solidarity, communitarianism, and comprehensive care. In this regard, neoliberal ideologies, policies and economies in care settings propose another model of assistance and "formation" (or deformation?) of doctors and health care personnel. Its progressive advance is one of the fundamental explanations for the decline in the use of comprehensive training procedures, ongoing training, and training for reparation. Precisely, these were the basic objectives of Balint and reflection groups, which led them to play a relevant part in the training of family and community medicine specialists in many first and second world countries during the eighties and nineties of the twentieth century. In this paper a brief description of the diffusion and extension of Balint-type groups is made, both nationally and internationally. Drawing on other previous works on the subject, some of their variants and applications are pointed out. My current perspective is that reflection groups, as systems of containment and training of care and community personnel, continue to be a technique or system that could provide important support for these objectives. However, they are being progressively cornered in Western training systems with the complicit silence of many health administrators and teachers, including psychoanalysts

¿Trastorno límite de personalidad, trastorno por inestabilidad emocional o trastorno por desequilibrio emocional?: una actualización para la Atención Primaria de Salud / Is it a borderline personality disorder, an emotional instability disorder or an emotional imbalance disorder? An update for Primary Health Care / Trastorn límit de la personalitat, trastorn per inestabilitat emocional o trastorn per desequilibri emocional?

El trastorno límite de personalidad es uno de los trastornos más debatidos de la psiquiatría y la psicopatología contemporáneas. Además, es un problema que en atención primaria manifiesta una prevalencia y una frecuentación mayor y más grave que otros muchos tipos de problemas, tanto orgánicos como emocionales. Sin embargo, es uno de los cuadros de la psicopatología actual que resulta más urgente replantearse, al menos desde las perspectivas teóricas, etiopatogénicas y terapéuticas

The borderline personality disorder is one of the most debated disorders in contemporary psychiatry and psychopathology. In addition, in primary care, it represents a more severe problem, with higher and more frequent prevalence compared to other types of problems, both organic and emotional. However, it is one of the icons of the current psychopathology that is most urgent to reconsider, at least from the theoretical, etiopathogenic and therapeutic perspectives

El trastorn límit de la personalitat és un dels trastorns més debatuts de la psiquiatria i la psicopatologia contem-porànies. A més, és un problema que a l'atenció primária manifesta una prevalença i una freqüentació més gran i més greu que molts altres tipus de problemes, tant orgánics com emocionals. No obstant, és un dels quadres de la psicopatologia actual que resulta més urgent replantejar-se, almenys des de les perspectives teóriques, etiopatogéniques i terapéutiques

Una revisión sobre los factores de riesgo en la infancia para la esquizofrenia y los trastornos mentales graves del adulto / Review of risks factors in childhood for schizophrenia and severe mental disorders in adulthood

OBJETIVO: A través de la revisión bibliográfica sobre los factores de riesgo psicosociales en salud mental se pretende demostrar la existencia de una asociación entre la acumulación de factores estresantes en la infancia y el incremento del riesgo de aparición de un trastorno mental en la vida adulta. DISEÑO: Búsqueda bibliográfica, realizada hasta diciembre del 2011, en las bases de datos electrónicas de Medline y de las universidades Autónoma y central de Barcelona. Las palabras clave utilizadas fueron: infancia, prenatal, vulnerabilidad, riesgo, abusos, negligencia, trastorno mental en la infancia, esquizofrenia, prevención. Selección de estudios: Los incluidos fueron aquellos que cumplían las siguientes condiciones: a) estudios prospectivos sobre acontecimientos vitales adversos en la gestación, parto o infancia; b) estudios que incluyan grupo control; c) estudios con información estadística el riesgo de aparición de trastornos mentales, y d) estudios de tamaño de la muestra superior a 30 sujetos. RESULTADOS: Existe una amplia variedad de factores de riesgo fáciles de identificar en la infancia y que pueden ayudar a prevenir la aparición de un trastorno mental grave. Se pueden agrupar en: a) embarazo, parto y puerperio; b) alteración de los vínculos con las figuras paternas; c) los 2 primeros años de vida, y d) dificultades en los aprendizajes y en las relaciones en la escuela. CONCLUSIONES: Existen acontecimientos vitales que pueden ser considerados de riesgo para la salud mental de un niño. Se ha demostrado que la acumulación de estas circunstancias genera una trayectoria de vida alterada que hace más vulnerables a las personas ante la posibilidad de presentar un trastorno mental (AU)

AIM: To provide scientific evidence, using a literature review on psychosocial risk factors in mental health, that a high exposure to psychosocial stress situations in childhood increases the risk of mental disorders in adult hood,. DESIGN: A literature review up to December 2011 in the electronic databases from Medline, Universitat de Barcelona, and the Universitat Autonoma de Barcelona. The keywords used were: childhood, prenatal, vulnerability, risk, abuse, neglect, child mental disorder, schizophrenia, and prevention. Inclusion criteria for the studies reviewed: 1) designed to investigate childhood risk factors; 2) Comparative studies with persons without risk factors; 3) Studies with sufficient statistical significance; 4) Studies with ''n'' participants equal to o more than30 persons. RESULTS: There are a group of easily identifiable mental health risk factors in childhood that can help in the prevention of mental disorders in the adulthood. They can be grouped into four categories: A) Pregnancy, birth and perinatal problems; B) Poor interpersonal relations with parents; C) Adverse life events in the first two years of life; D) Cognitive deficits in primary school, and social isolation during school years. CONCLUSIONS: There are life events that may increase the possibilities of suffering some kind of Psychopathology. It is necessary to consider those events as Risk Factors for Mental Health. The accumulation of these Risk Factors increases vulnerability to Mental Disorders

[Review of risks factors in childhood for schizophrenia and severe mental disorders in adulthood]. / Una revisión sobre los factores de riesgo en la infancia para la esquizofrenia y los trastornos mentales graves del adulto.

AIM: To provide scientific evidence, using a literature review on psychosocial risk factors in mental health, that a high exposure to psychosocial stress situations in childhood increases the risk of mental disorders in adulthood,. DESIGN: A literature review up to December 2011 in the electronic databases from Medline, Universitat de Barcelona, and the Universitat Autonoma de Barcelona. The keywords used were: childhood, prenatal, vulnerability, risk, abuse, neglect, child mental disorder, schizophrenia, and prevention. Inclusion criteria for the studies reviewed: 1) designed to investigate childhood risk factors; 2) Comparative studies with persons without risk factors; 3) Studies with sufficient statistical significance; 4) Studies with "n" participants equal to o more than 30 persons. RESULTS: There are a group of easily identifiable mental health risk factors in childhood that can help in the prevention of mental disorders in the adulthood. They can be grouped into four categories: A) Pregnancy, birth and perinatal problems; B) Poor interpersonal relations with parents; C) Adverse life events in the first two years of life; D) Cognitive deficits in primary school, and social isolation during school years. CONCLUSIONS: There are life events that may increase the possibilities of suffering some kind of Psychopathology. It is necessary to consider those events as Risk Factors for Mental Health. The accumulation of these Risk Factors increases vulnerability to Mental Disorders.

Attachment style predicts 6-month improvement in psychoticism in persons with at-risk mental states for psychosis.

AIM: Insecure attachment may influence vulnerability to and outcome of psychotic symptomatology. The present study examined whether attachment style predicted symptoms and functioning of at-risk mental state (ARMS) patients after 6 months of psychosocial intervention, over and above the effects of initial clinical severity and premorbid social adjustment (PSA). METHODS: Symptoms and functioning were assessed at baseline and 6 months later in 31 ARMS patients (mean age = 15.7). No patient received antipsychotic medication, but all engaged in intense psychosocial needs-adapted treatment. Clinicians (unaware of the aims of the study) rated attachment, PSA, symptoms, and functioning. RESULTS: Attachment was not related to baseline clinical severity. However, improvement in psychoticism was predicted by attachment (in particular by secure, preoccupied and dismissing) beyond the effects of baseline clinical severity and PSA. Secure attachment also predicted improvements in disorganization and functioning. Poor PSA predicted less improvement in disorganization and negative symptoms but did not impact psychoticism. CONCLUSIONS: The three attachment prototypes that predicted improvement in psychoticism (secure, preoccupied and dismissing) share the existence of at least one positive psychological model (either about self or about others). It may be that the psychosocial intervention helped ARMS patients to disconfirm negative models and/or reinforce positive ones. Patients' attachment styles were not related to baseline clinical severity but impacted improvement of positive symptoms. These findings appear consistent with evidence that impaired self-esteem and dysfunctional self and others schemas constitute risk factors for reality distortion.

Crianza de los hijos y actividad laboral: ¿Cómo aproximarnos hacia la necesaria conciliación? (y II) / Parenting and work: How to approach a necessary reconciliation?

En la segunda parte de este trabajo, me centraré en los argumentos psicológicos, biológicos, psicopedagógicos y éticos del tema. Una coyuntura facilitadora para estas reflexiones viene propiciada por la actual convergencia de los resultados de los estudios sobre el desarrollo precoz de los bebés y los niños desde los puntos de vista psicológico, psicoanalítico, neurológico, biológico y psicosocial (AU)

In the second part of this work, we will focus the arguments on psychological, biological, psycho-pedagogical and ethical issues. A joint facilitator for these reflections is provided by the current convergence of the results of studies on the early development of babies and children form the psychological point of view, psychoanalytic, neurological, biological and psychosocial (AU)

Crianza de los hijos y actividad laboral: ¿cómo aproximamos hacia la necesaria conciliación? (I Parte) / Parenting and work; how to approach a necessary reconciliation? Psychosocial reflections (Part 1)

Muchas de las intervenciones que desde las instituciones públicas se han realizado en las últimas décadas sobre de la conciliación entre vida familiar y vida social, han tenido poco en cuenta los datos psicológicos disponibles, al menos los precedentes de la psicología del desarrollo. Frecuentemente, esas intervenciones han estado orientadas por presupuestos ideológicos, no verificables ni contrastables, cuando no corporativos, a menudo poco coincidentes con los nuevos descubrimientos científicos. En la primera parte de este trabajo se proponen una serie de argumentos sociales y psicosociales a favor y en contra de la escolarización temprana, así como algunas de las propuestas y prácticas internacionales en este ámbito (AU)

Many of the interventions made by public institutions in recent decades concerning the balancing of family and social life have paid scant attention to the psychological data available, at least form the field of developmental psychology. When data has been considered, it has often been so only partially. Interventions have frequently been guided by ideological beliefs, not verifiable or testable, if not corporate, and poorly matched with new scientific discoveries. The first part of this paper presents a series of social and psychological arguments for and against early schooling. Several international proposals and practices in this ambit are reviewed (AU)

Mourning and psychosis: a psychoanalytic perspective.

The author attempts to develop some of the basic models and concepts relating to mourning processes in psychotic patients on the assumption that situations of loss and mourning are key moments for psychoanalysis, psychotherapy, and therapeutic approaches in general. Secondly, he reminds us that 'mourning processes in psychotics' are not always 'psychotic mourning processes', that is to say, that they do not necessarily occur within, or give rise to, a psychotic clinical picture. These ideas are illustrated by a number of sessions and vignettes concerning two psychotic patients in psychotherapeutic and psychoanalytic treatment. In theoretical terms, it seems vitally important in this context to combine a relationship-based approach within a framework of special psychoanalytic psychopathology with an updated view of processes of mourning and affective loss. A fundamental requirement at clinical level is to determine the role to be played by psychoanalytically based treatments in combined, integrated or global therapies when working with psychotic patients. For this purpose, the paper ends by outlining a set of principles and objectives for such treatments.

At-risk mental state (ARMS) detection in a community service center for early attention to psychosis in Barcelona.

AIM: To describe the strategy and some results in at-risk mental state (ARMS) patient detection as well as some of the ARMS clinical and socio-demographical characteristics. The subjects were selected among the patients visited by an Early Care Equipment for patients at high risk of psychoses, in Barcelona (Spain) during its first year in operation. METHODS: Descriptive study of the community-team relations, selection criteria and intervention procedure. Description of patient's socio-demographic and symptomatic characteristics according to the different instruments used in detection and diagnoses, taking account of four principal origins of referrals: mental health services, primary care services, education services and social services. RESULTS: Twenty of 55 referred people fulfilled the at-risk mental state criteria, showing an incidence of 2.4 cases per 10,000 inhabitants. They were mainly adolescent males referred from health, education and social services. Overall, negative symptoms were predominant symptoms and the more frequent specific symptoms were decrease of motivation and poor work and school performance, decreased ability to maintain or initiate social relationships, depressed mood and withdrawal. CONCLUSIONS: It is possible to detect and to provide early treatment to patients with prodromal symptoms if the whole matrix of the community--including the social services--contributes to the process. The utilization of a screening instrument and a two-phase strategy--the second carried out by the specialized team--seems to be an appropriate approach for early psychosis and ARMS detection.

Psicosis y diferencias sociales: comparando la prevalencia de las psicosis en dos medios urbanos diferenciados / Psychosis and social differences: comparing psychosis prevalence between two socially differentiated urban settings

Objetivos: Contribuir a la reflexión sobre la etiología y/o los factores de riesgo para las psicosis comparando la prevalencia en población general y población de riesgo de la esquizofrenia y otras psicosis en dos barrios de Barcelona (España). Método: Nuestras aportaciones en este trabajo se apoyan sobre todo en un estudio descriptivo transversal de todos los pacientes con psicopatología detectados en la USM de Sant Martí-La Mina: un territorio geodemográfica y asistencialmente delimitado formado por 5 Áreas Básicas de Salud (103.615 habitantes. Resultados: Sobre un total de 21.536 pacientes con registro de casos abierto desde el año 1982 hasta el año 2000, se halló que 838 cumplían los criterios restrictivos para ser diagnosticados como «esquizofrénicos» (N=476) o «afectados por otras psicosis» (N=362). Sin embargo, las prevalencias de esquizofrenia y otras psicosis en el barrio sujeto a más factores de riesgo psicosociales eran alrededor de 2 veces mayores que las encontradas en el barrio colindante por el mismo equipo y en el mismo período temporal. Conclusión: Es necesario tener en cuenta el gran peso de los factores de sociales y psicosociales para poderse explicar las diferencias de prevalencia de la esquizofrenia y otras psicosis entre diferentes poblaciones (AU)

Objectives: To contribute to the discussion about aetiology and risk factors of psychosis comparing the prevalence in general population and in «age of risk population» for schizophrenias and other psychoses on two neighbourhoods of Barcelona (Spain). Method: We base our reflections in a transversal study about the results of an informatized case register of all the patients' with detected psychopathology in this geodemographic and assistencially differentiated area: 5 Basic Areas of Health (103.615 inhabitants). Results: The total «psychopathological patients» detected were 21.536. From them, 838 completed the restrictive criteria to be diagnosed as «schizophrenics» (476) or «affected by other psychoses» (362). Among the neighborhood charged with psychosocial risk factors and the other 4 adjacent basic areas of health, assisted for the same team, so much clinical as investigator, the incidence and the prevalence of the schizophrenia and other psychoses is twice as much, almost in each group diagnosis. Conclusion: It seems necessary to keep in mind the great weight of the social and psychosocial factors to explain those differences of incidence and prevalence of the schizophrenia and the psychoses in different populations (AU)

¿Uno por ciento de esquizofrenia? / No disponible

No disponible

Bases para un equipo de atención precoz a los pacientes con psicosis / Basis for an early attention team to psychotic patients

Pródromos, la duración de la fase prodrómica y los factores de riesgo en la infancia y adolescencia de los cuadros psicóticos y, en especial, del «desequilibrio psicótico postpuberal» o «esquizofrenia» (AU)

Prodromic symptoms, the duration of the prodromic phase and the risk factors in the childhood and adolescence of the psychotic disorders and, especially, of the «postpuberal psychotic disorder» or schizophrenia (AU)

Neighborhood differences in psychoses: prevalence of psychotic disorders in two socially-differentiated metropolitan areas of Barcelona.

INTRODUCTION: The prevalence of schizophrenia and other psychoses can vary between close geographic locations and can be biased by the use of epidemiological designs. With data derived from a public mental health centre with close relations to primary care teams we have compared the distribution of psychotic disorders in two neighborhoods in Barcelona with marked psycho-social differences. METHODS: Using a computerized database from Barcelona's National Health Service covering 5 basic health-care areas with a total population of 103,615 inhabitants, we have accessed case records showing any psycho-pathology between the years of 1982 and 2000. RESULTS: From the case records of 21,536 registered patients showing any psycho-pathology, and using strict diagnostic, clinical and assistance criteria, we found that there were 476 patients diagnosed as "schizophrenic" and 362 that were "affected by other psychoses." Despite being evaluated by the same mental health personal, the same research team using identical criteria and over the same period of time (thus precluding operator and selection bias) the prevalence of these disorders was twice as high in La Mina (a district with a marked accumulation of psycho-social risk-factors) as compared to the neighboring district of La Verneda. CONCLUSIONS: When assessing prevalence of psychoses, it is necessary to consider the impact of social and psycho-social factors, even in neighboring communities.

Factores de riesgo para padecer trastornos psicóticos: ¿es posible realizar una detección preventiva? / Psychosis risk factors: is there a chance for preventive identification?

Introducción: Revisión de los factores de riesgo para las psicosis desde la perspectiva de la literatura internacional y desde la perspectiva de la experiencia clínica e investigadora del equipo. Objetivo principal: Se presenta el diseño y las primeras pruebas de un instrumento de exploración y cribaje de señales de alarma y factores de riesgo de trastornos mentales severos, y en especial trastornos psicóticos, aplicable en los primeros años de vida por parte de los servicios de atención primaria de salud y los equipamientos de salud mental vinculados con ellos. Se trata del LISMEN(Listado de ítems de Salud Mental en edades preescolares y escolares). Metodología: 5 muestras diferentes, tanto de edad infantil como de adultos. El trabajo se centra en la muestra A del Proyecto LISMEN: Se trata de un estudio descriptivo retrospectivo de los dossieres de los pacientes que han desarrollado una psicosis (N=838) y se habían visitado previamente, ya durante la infancia, en la misma Unidad de Salud Mental (N=120). Resultados: Se utilizan los resultados de las muestras anteriormente estudiadas para encuadrar el tema y presentar los primeros resultados de la muestra A: Estos señalan una constelación de factores de riesgo que aparecen ya en las historias o dossiers clínicos de la infancia de los pacientes que van a desarrollar una psicosis postpuberal. Conclusiones: Aunque hoy poseemos un amplio acervo de conocimientos sobre factores de riesgo de la esquizofrenia y otras psicosis, eso no implicaque podamos predecir el trastorno en base a los mismos. El LISMEN es un intento en ese sentido (AU)

This paper reviews risk factors associated with psychosis from both a literatureperspective and the clinical and research practice. The development of atool for the diagnosis and screening of alarm signs and risk factors of severemental disorders is described along with preliminary tests. The tool is aimedto be administered by primary health care systems and associated mentalhealth teams during a person’s early years. The tool is called LISMEN–standing for “list of mental health items at pre-school and school ages”.The list was administered to 5 different samples including children andadults. This paper focuses on Project LISMEN sample A. It is an investigationof medical records of patients who had developed a psychosis (N = 838). Anumber of them (N = 120) had already been assisted by the same MentalHealth Unit during their childhood. Samples already assisted were used as abenchmark for sample A preliminary results. A constellation of risk factors hadalready been identified in medical records during the childhood of people whowould develop a psychosis after their adolescence.Even though there is a broad pool of knowledge on risk factors associatedwith schizophrenia and other psychoses, this does not mean that prediction ofthe disorder can be made on this base. Nevertheless, LISMEN is a contributionin this direction (AU)

El 'niño hiperactivo' como síntoma de una situación profesional y social: ¿Mito, realidad, medicalización? / The 'Hyperactive Child' as a symptom of a professional and social situation: Myth, Reality, Medicalization:?

Resumen: se introduce el tema con un breve repaso del síndrome en las clasificaciones DSM y CIE y de algunas limitaciones de las mismas. A continuación se amplía la reflexión sobre tres aspectos concretos del síndrome; el empírico, con breves referencias a la genómica y la neuroquímica cerebrales; el teórico, con insistencia en una perspectiva psicopatológica, y pragmático, revisando los tratamientos propuestos para tal síndrome. Se termina con una reflexión sobre los diversos tipos de guías o protocolos clínicos alternativos a los dominantes y a los progresivamente impuestos por la BigPharma (AU)

This paper begins with a brief of the syndrome in the DSM and ICD, and with a reminder of some of the limitations of these classifications. The author then reflects on three concrete aspects of the syndrome : an empirical one, with brief references to genomics and cerebral neurochemistry ; a theoretical one, with an insistence on a psychopathological perspective; and a pragmatic one, by revising the treatments proposed for such a syndrome. the paper finally ends with a reflection on the different types of guides or clinical protocols, and on the difficulties to develop guides or alternative clinical protocols to the dominant ones and those progressively imposed by Bigpharma (AU)