Enfermedad de Parkinson y espectro obsesivo-compulsivo / Parkinson´s disease and obsessive-compulsive spectrum

Introducción. La descripción de la asociación de síntomas obsesivos con trastornos neurológicos ha sentado las bases de los modelos neuroanatómicos del trastorno obsesivo-compulsivo y ha involucrado a los ganglios basales y lóbulos frontales en su etiopatogenia. En la última década se han comunicado frecuentemente en pacientes con enfermedad de Parkinson fenómenos obsesivo-compulsivos –ya sean rasgos o síntomas– y trastornos del control de impulsos –en el otro extremo del espectro–. Se ha postulado que esta asociación constituiría una prueba más del hipotético papel de los ganglios de la base en los circuitos implicados en la aparición de los fenómenos característicos de los trastornos del espectro obsesivo-compulsivo. Objetivos. Se realiza una revisión en Medline con las expresiones ‘obsessive compulsive Parkinson’ e ‘impulse control Parkinson’, con la finalidad de comprobar las evidencias existentes sobre dichas asociaciones. Desarrollo. Parecen existir suficientes datos como para no considerar casual la aparición de novo de trastornos del control de impulsos en enfermos parkinsonianos. Esto se ha relacionado sobre todo con el tratamiento con agonistas dopaminérgicos. Mayor desacuerdo existe sobre la presentación de síntomas obsesivo-compulsivos en la enfermedad de Parkinson, al encontrarse estudios con resultados dispares y con importantes diferencias metodológicas, incluso en la definición del fenómeno obsesivo. Conclusiones. Actualmente son necesarios más estudios que profundicen en esta cuestión y que sean lo más rigurosos posible, por los avances que podría suponer para el conocimiento de la neurobiología de estas entidades (AU)

Introduction. The description of obsessive symptoms associated with neurological diseases are in the basis of the neuroanatomical models of obsessive-compulsive disorder, with participation of basal ganglia and frontal lobes in its ethiopathogenesis. In the last years, the growth of obsessive-compulsive phenomena –including personality features or symptoms– and impulse control disorders –at the other extreme of the spectrum– in patients with Parkinson’s disease were frequently reported. It was proposed that this association could be other proof of the role of basal ganglia in the characteristic features of the obsessive-compulsive spectrum disorders. Aims. A review in Medline was conduced using the expressions ‘obsessive compulsive Parkinson’ and ‘impulse control Parkinson’. The purpose of this review was to compile the current evidence about these associations. Development. There are sufficient data to support that the growth of impulse control disorders in parkinsonian patients are not produced by chance. It was mainly related with the dopaminergic agonist treatments. More controversial is the growth of obsessive-compulsive symptoms in Parkinson’s disease. The studies found have shown contradictory results and important methodological disparities that included even the definition of obsessive phenomenon. Conclusions. Further and more rigorous studies about these topics are needed, because they could produce and important advance in the knowledge of the neurobiology of these entities (AU)

[Parkinson's disease and obsessive-compulsive spectrum]. / Enfermedad de Parkinson y espectro obsesivo-compulsivo.

INTRODUCTION: The description of obsessive symptoms associated with neurological diseases are in the basis of the neuroanatomical models of obsessive-compulsive disorder, with participation of basal ganglia and frontal lobes in its ethiopathogenesis. In the last years, the growth of obsessive-compulsive phenomena -- including personality features or symptoms -- and impulse control disorders -- at the other extreme of the spectrum -- in patients with Parkinson's disease were frequently reported. It was proposed that this association could be other proof of the role of basal ganglia in the characteristic features of the obsessive-compulsive spectrum disorders. AIMS: A review in Medline was conduced using the expressions 'obsessive compulsive Parkinson' and 'impulse control Parkinson'. The purpose of this review was to compile the current evidence about these associations. DEVELOPMENT: There are sufficient data to support that the growth of impulse control disorders in parkinsonian patients are not produced by chance. It was mainly related with the dopaminergic agonist treatments. More controversial is the growth of obsessive-compulsive symptoms in Parkinson's disease. The studies found have shown contradictory results and important methodological disparities that included even the definition of obsessive phenomenon. CONCLUSIONS: Further and more rigorous studies about these topics are needed, because they could produce and important advance in the knowledge of the neurobiology of these entities.

Psicosis psicogénica / Psychogenic psychosis

En 1916 Wimmer describió las psicosis psicogénicas como psicosis secundarias a traumas mentales. Actualmente, las psicosis psicogénicas se incluyen en los trastornos psicóticos agudos y transitorios (F23) de la CIE-10 y en los trastornos psicóticos breves (298.8) del DSM-IV-TR. Presentamos un caso de psicosis psicogénica en una mujer de 39 años y se analiza desde el modelo predisposición- trauma

In 1916, Wimmer described psychogenic psychosis as psychosis secondary to mental trauma. Psychogenic psychoses are currently included in acute and transient psychotic disorders (F23) in the ICD-10 and in the brief psychotic disorders (298,8) in the DSM-IV-TR. We present a case report of psychogenic psychosis in a 39 year-old female and analyze it with the predispositiontrauma mental model