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2.
Vertex rev. argent. psiquiatr ; 25(113): 68-72, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176950

RESUMEN

UNLABELLED: The fact that posttraumatic stress disorder is a very important construct in public health and opinion, especially in the United States of America, has veiled it dubious specificity and problematic universality. HYPOTHESIS: the abandon of Freudian theory since 1980 was correlative of a permanent revision of criteria to define "traumatic" in DSM versions, as well as of revaluation of ancient theory of dissociation. METHOD: most meaningful changes introduced in PTSD criteria are critically reviewed from DSM-IV to DSM-5. "Traumatic", symptoms and dissociative estates, and a new preschool children subtype are revised. CONCLUSION: "Traumatic" yet being an artificial criterion is steel needed in order to keep the construct as a whole. Dissociative estates occupy an important place for the American authors and have turned more visible in DSM-5 than in previous DSM. New chapter "Trauma and stressor disorders" and new descriptions about PTSD support an enlarged clinical view of "traumatic". Inconsistencies found between reviews considered for PTSD in DSM-5 show that different work groups contribute to the construction of the disorder with fragmentary and divorced parts from one another.


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos por Estrés Postraumático/clasificación , Trastornos por Estrés Postraumático/diagnóstico , Humanos
3.
Vertex rev. argent. psiquiatr ; 25(113): 63-7, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176951

RESUMEN

DSM-5 moved OCD out from under the Anxiety Disorder section, into a new category: Obsessive Compulsive and Related Disorders and added two new specifiers. Specifically a modification of one specifier (insight) and the addition of a new tic specifier. DSM-5 redefined obsessions and recognizes the importance of avoidance and thought stopping beyond compulsions as other strategies to deal with obsessions. OCD related disorders include: Trichotillomania, Hoarding Disorder, Skin Picking Disorder, and Body Dysmorphic Disorder.


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastorno Obsesivo Compulsivo/clasificación , Trastorno Obsesivo Compulsivo/diagnóstico , Humanos
4.
Vertex rev. argent. psiquiatr ; 25(113): 58-62, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176952

RESUMEN

The fifth edition of Diagnostic and Statistical Manual, the DSM-5 appeared officially in May 2013 during the development of the 166th Annual Meetingof the American Psychiatric Association (APA) in San Francisco. The drafting process was long and complex; much of the debate became public so that the expectations were great. And it must be said that the new edition did not disappoint, as many changes were made in relation to their predecessors. In Chapter of Anxiety Disorders, which is reviewed in this article, the changes were significant. Obsessive-compulsive disorder and Stress-related disorders were excluded and new clinical pictures, such as separation anxiety disorder and selective mutism, were included. And took place was the long awaited split between panic disorder and agoraphobia, now two separate disorders.


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de Ansiedad/clasificación , Trastornos de Ansiedad/diagnóstico , Humanos
5.
Vertex rev. argent. psiquiatr ; 25(113): 51-7, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176953

RESUMEN

Although bipolar disorder is highly disabling, data from different regions of the world agree on the finding that there is a prolonged diagnostic delay in affected people. Among the main factors that could explain this phenomenon are contemporary conceptualizations of bipolar disorder and diagnostic criteria of the DSM-IV. Moreover, in recent years it has been cautioned about the risk of overdiagnosis of this disorder. In this context, the new edition of the DSM is presented. The modifications included in the DSM-5 regarding the diagnosis of bipolar disorder are described in this paper. Likewise, the practical implications of these changes are discussed.


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastorno Bipolar/clasificación , Trastorno Bipolar/diagnóstico , Humanos
6.
Vertex rev. argent. psiquiatr ; 25(113): 43-50, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176954

RESUMEN

After firmly established the "kraepelinean dichotomy" (dementia praecox - manic-depressive insanity), classical psychiatry began to describe a group of psychotic disorders which did not fit in any of these main diagnoses. Many of these clinical pictures where incorporated to the DSM and underwent several changes throughout the successive editions of the American manual. This article aims to make a historical and conceptual overview of this group of non-schizophrenic psychotic disorders accompanying schizophrenia in the "Schizophrenia spectrum and other psychotic disorders" chapter of DSM-5.


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos Psicóticos/clasificación , Trastornos Psicóticos/diagnóstico , Humanos
7.
Vertex rev. argent. psiquiatr ; 25(113): 36-42, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176955

RESUMEN

The system of classification of psychiatric disorders has evolved during the last half-century. This article briefly reviews the modifications of the structure of the chapter "Schizophrenia spectrum and other psychotic disorders" in DSM-5; then analyzes in detail the changes that were specifically made for schizophrenia. Among them, the fundamentals are: a) the elimination of the special treatment of bizarre delusions and hallucinations of Schneiderian "first rank", b) the clarification of the definition of negative symptoms, and c) the addition of the requirement that at least one of the two required characteristic symptoms should be disorganized speech, hallucinations or delusions. It also discusses the elimination of subtypes of schizophrenia and the addition of psychopathological dimensions, and the consequences of the lack of validated biomarkers that could facilitate the diagnosis.


Asunto(s)
Esquizofrenia/clasificación , Esquizofrenia/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Humanos
8.
Vertex rev. argent. psiquiatr ; 25(113): 33-5, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176956

RESUMEN

The change from "mental retardation" to "intellectual disability" (ID) in the new version of the DSM-5 aims not only to eliminate stigmatization but also to modify diagnostic criteria. The IQ is no longer preeminent for defining ID or its severity, relying instead on broader clinical criteria and neuropsychological evaluation. More relevance is given to the evaluation of the individual’s performance on daily life. This perspective addresses the concerns raised since the 1990’s by organizations representing professionals and patients and their families. To better understand these changes we reviewed the definitions and criteria of previous DSM editions. The adoption of the alternative denomination of the "intellectual developmental disorder" is compatible with the ICD-11 to be released in 2015. This guideline was based on the recommendation of the working group for the classification of the intellectual disabilities.


Asunto(s)
Discapacidad Intelectual , Discapacidad Intelectual/diagnóstico , Humanos , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Terminología como Asunto
9.
Vertex rev. argent. psiquiatr ; 25(113): 27-32, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176957

RESUMEN

The Research Domain Criteria (RDoC) is an initiative of the National Institute of Mental Health of the United States of America, which based on research purposes consists of a new way of classifying mental disorders. His raison d’Ûtre is based on the conclusion that the knowledge progress of neurosciences does not seem to confirm the validity of the conventional psychiatric diagnoses. Furthermore, researching based on such diagnoses would weaken the progress in Psychiatry. Besides these scientific reasons, the Research Domain Criteria project is born within a political framework, giving raise to economic tensions. The objective of this paper is to discuss the first issue without avoiding the second one.


Asunto(s)
Trastornos Mentales/clasificación , Trastornos Mentales/diagnóstico , Estados Unidos , Humanos , Manual Diagnóstico y Estadístico de los Trastornos Mentales , National Institute of Mental Health (U.S.) , Investigación Biomédica , Política , Psiquiatría/normas
10.
Vertex rev. argent. psiquiatr ; 25(113): 18-26, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176958

RESUMEN

One of the main problems of current psychiatry is that its diagnostic classification systems are not precise and reliable, they do not help to identify with certainty a specific type of mental disorder and they frequently overlap two or more diagnoses. This may conduce to over diagnosis and overtreatment, which is the main criticism of the DSM system. The American Psychiatric Association (APA) launched recently the DSM-5, the fifth edition of its diagnostic manual, which provides diagnostic criteria for thousands of psychiatrist, psychologist and researchers and who will be using it in the next coming years. DSM-5, like the preceding editions, placed disorders in discrete categories such as bipolar disorder or schizophrenia. The problem is that scientists have been unable to find yet a genetic or neurobiological evidence to support the theory of mental disorders as separate categories. Several authors wanted the latest DSM to move away from the category model towards a new "dimensional approach", where disorders can be measured and mental illnesses overlapping can be reduced. Recent findings supports this new dimensional strategy, suggesting that the disorders are a product of shared risk factors that lead to abnormalities in specific drives, which can be measured and used to place persons on one of several spectra. In some parts the DSM-5 entered changes aiming to achieve a greater objectivity. The door for new changes in each category, dimension or criteria has been opened, favoring an evidence-based development of the future versions. DSM-5 is presented as a "living document" that can be updated easily. However, the category model still remains for many disorders. The future research in psychiatric diagnostic systems requires more genetic-molecular and neurophysiological evidence and more objective multinational field trials, in order to confirm the existence of the new diagnostic entities, spectrums or dimensions. This approach may provide us reliable information about the pathogenesis, psychopathology, adequate taxonomy and treatment of mental disorders.


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Psiquiatría/normas , Trastornos Mentales/clasificación , Trastornos Mentales/diagnóstico , Humanos
12.
Vertex rev. argent. psiquiatr ; 25(113): 5-9, 2014 Jan-Feb.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176960

RESUMEN

Consultations in our hospital center are problematic, mainly due to the poor living situation which patients come from (the suburbs of Buenos Aires). The housing situation, the environment and the economic or political conditions of these patients frame "the social" emergency that sets the context and the impact in the different psychopathological symptoms that they present. These conditions should also be reviewed from our theoretical assessment together with the clinical approach that our assistance practice studies. From a perception viewpoint we observe that "self-perception is far from any ideals. The perception of their environment is threatening and has no future". We constantly note the loss of the value of words and speech, when we hear our patients, wo have turned language into just an abject joy, as in the word of the addict. These issues must be studied from a theoretical point of view to be applied clinically. Such analysis reveals that our practice takes place in a context of failure. However, we cannot move backwards in "potential treatment" as Lacan states in the ethics as regards psychosis.


Asunto(s)
Psiquiatría/normas , Trastornos Mentales , Factores Socioeconómicos , Humanos
13.
Vertex rev. argent. psiquiatr ; 25(114): 85-91, 2014 Mar-Apr.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176962

RESUMEN

The aim of the study was to analyze the impact of treatment with vitamin D in the progression of Alzheimer’s disease. We performed a retrospective study including patients with mild stage of Alzheimer’s disease with more than four years of follow-up. The presence of cardiovascular risk factors, osteoporosis, treatment with memantine, acetylcholinesterase inhibitors drugs and vitamin D were analyzed as independent variables. Time of progression to moderate and severe Alzheimer’s disease was analyzed as dependent variable. The analysis was done using multivariate linear regression model, Kaplan Meier analysis, Chi-square and T test. Two hundred and two patients met the inclusion criteria. 11


of the patients (n = 23) remained in the mild stage of the disease, 54


(n = 110) developed the moderate form in a mean time of 3 ± 1.4 years while 35


(n = 69) developed the severe form in a mean time of 4.6 ± 1.4 years. Time of progression to severe stage of Alzheimer’s disease was slower in patients under treatment with vitamin D compared with those without treatment (5.4 ± 0.4 years vs. 4.4 ± 0.16 years respectively, p=0.003). Treatment with vitamin D may be an independent protecting factor in the progression of Alzheimer’s disease.


Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico , Estudios Retrospectivos , Femenino , Humanos , Anciano , Masculino , Persona de Mediana Edad , Progresión de la Enfermedad , Índice de Severidad de la Enfermedad
15.
Vertex rev. argent. psiquiatr ; 25(114): 144-8, 2014 Mar-Apr.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176964

RESUMEN

Social networking is a virtual space in which people relate and build their identity, share information, publish content and intervene on the content posted by others. We will describe an experiment carried out in the psychiatry service of Italian Hospital in Buenos Aires, in which we use Whatsapp Social Network applied to the development of clinical work and teaching task. From these new ways of relating between professional, emerge a new way to work, participate in groups or try to evaluate various options for dealing with a patient. We analyze the usefulness of this virtual platform as a working tool.


Asunto(s)
Medios de Comunicación Sociales , Psiquiatría/educación , Humanos
16.
Vertex rev. argent. psiquiatr ; 25(114): 131-43, 2014 Mar-Apr.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176965

RESUMEN

The common denominator is the interactive intersubjectivity in the biological, psychological, social, and cultural contexts. Contemporary subjective distress is rooted in these last two areas. It is important to consider that social and cultural factors are relevant in the process of subjectivity, that is, the way desire and fantasy are arranged. Therefore, the modifications in subjectivity generate new spatialities and temporalities. Space and time are not simply physical containers of human action but represent, at once, the container and contents of social practices. The fact that subjects are present at birth as both actors and carriers of institutions constitutes the foundation of these institutions in relation to subjectivity. The relational frames in which the subject is immersed are never a single element, but they express joint successive institutional and social spheres. The challenge is to think current demand differently, not only in the way it should be addressed, but mainly by the different characteristics of how subjectivity and the nature of social representations are expressed. Nowadays a clinical procedure that only takes into account the social factor is not enough - a clinical procedure for a social and interactive subject is required. The objective is to build a historicized subjectivity to enable taking action on the present. New social realities affect our clinical practice and form a new social and cultural context that forces us to reflect on these changes and think about the necessary adjustments in our practice and knowledge.


Asunto(s)
Factores Sociológicos , Procesos Mentales , Psiquiatría , Trastornos Mentales , Humanos
17.
Vertex rev. argent. psiquiatr ; 25(114): 122-30, 2014 Mar-Apr.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176966

RESUMEN

This paper presents only some of the most important contributions in the development of cultural psychiatry in Latin America. The continental efforts to understand the role that culture plays in the manifestation and treatment of mental disorders have been fruitful. The authors included are: Fernando Pagés of Argentina; Mario G. Hollweg of Bolivia; Rubim Alvaro de Pinho and Adalberto Barreto of Brazil; Carlos A. Leon and Carlos A. Uribe of Colombia; Antonio José A. Bustamante and Santa Cruz de Cuba, Carlos Leon Andrade of Ecuador, Guatemala Cristina Chavez; Sergio Villasenor J. Bayardo of Mexico; Carlos A. Seguin, Hermilio Valdizán and Javier Mariátegui in Peru; Y. Bespaldi of Consens of Uruguay; Rojas and Carlos Malpica and Jacqueline Briceño Clarac of Venezuela.


Asunto(s)
Etnopsicología , América Latina , Humanos
18.
Vertex rev. argent. psiquiatr ; 25(114): 113-21, 2014 Mar-Apr.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176967

RESUMEN

This article explores the notion of "wandering" through the use of some phenomena enrolled at the dawn of modernity such as the Rousseau dromomanie’s philosopher and writer, the origin of the first mad traveler (Albert Dadas), epidemics of mad travelers Europe and romantic tourism (with renewed acquires significance in the "beat generation" of the twentieth century). These historical facts are "mounting" as play contemporary manifestations such as loss, disorientation, to lose one’s way, and wandering without reducing them only to clinical psychosis. Readings of classic psychiatrists such as Régis, Foville, Sérieux and Capgras, Tissié, go hand in hand with the current readings of the philosopher Ian Hacking and critics of pop culture as S. Reynolds and D. Diederichsen, illustrating how the travel’s phenomenon can make different subjective configurations depending on historical times. In conclusion it is noted that not only psychosis exposes the wandering soul of suffering but there are also subject positions (as will be exemplified in a clinical case) and go no further nesting wandering into human existence.


Asunto(s)
Trastornos Psicóticos , Viaje/psicología , Humanos
19.
Vertex rev. argent. psiquiatr ; 25(114): 105-12, 2014 Mar-Apr.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176968

RESUMEN

Cultural Psychiatry deals with the description, definition, evaluation and management of psychiatric conditions as a clinical reflection of cultural factors within an integral context, and as an explanatory, interpretative, nosological, therapeutic and preventive attribute in professional practice. This article attempts to analyze that link in the context of the dominant classification in our era, the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA), with emphasis on the development of its latest version, DSM-5. The cultural content of the International Classification of Diseases (ICD) of the World Health Organization (WHO) can be the subject of further analysis, even when it can be said that, in general, it seemingly has less reach than the American classification. The author’s participation, work and reflections about the DSM-5 Committee, created by the APA at the beginning of this century, constitute the basis of the presentation and discussion of concrete achievements, more or less idealized hopes, and more or less realistic expectations with a view to the future. Conclusions will also try to cover implications of DSM-5 cultural components in the field of Latin American and spanish-speaking psychiatry.


Asunto(s)
Etnopsicología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos Mentales/diagnóstico , Humanos
20.
Vertex rev. argent. psiquiatr ; 25(114): 102-4, 2014 Mar-Apr.
Artículo en Español | LILACS, BINACIS | ID: biblio-1176969

Asunto(s)
Cultura , Psiquiatría , Humanos
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