ABSTRACT
The last several years have witnessed the accumulation of evidence suggesting that the Kraepelinian binary system of classification of the psychoses does not capture their true nature, as Kraepelin himself had cautioned in his late years. The long-awaited new edition of the APAs Diagnostic and Statistical Manual will in all probability incorporate symptom dimensions and suppress schizophrenia subtypes. However, the initial Kraepelinian conceptualization of the psychoses is maintained, along with the diagnostic category that epitomizes its obsolescence: schizoaffective disorder. We hereby make a brief critical appraisal of this fact, pointing out how the current classification system might be an obstacle to much-needed advances in this knowledge field.
Subject(s)
Diagnostic and Statistical Manual of Mental Disorders , Psychotic Disorders/diagnosis , HumansSubject(s)
Humans , Middle Aged , Acute Disease , Depression/complications , Depression/physiopathology , Heart Rate/physiology , Heart Diseases , PrognosisABSTRACT
El presente estudio revisa las interacciones entre enfermedad cardiovascular y depresión. En pacientes con enfermedad cardiovascular conocida, la depresión empeora el pronóstico, siendo esto especialmente evidente en sobrevivientes de infarto de miocardio. Los individuos que desarrollan depresión parecen asimismo tener un riesgo aumentado de desarrollo ulterior de enfermedad cardiovascular. Se ofrece una hipótesis que vincula ambos cuadros y se revisan estrategias de manejo de la depresión en pacientes cardiológicos
Subject(s)
Humans , Cardiovascular Diseases/psychology , Depression/complications , Depression/etiology , Depression/drug therapy , Antidepressive Agents/therapeutic use , Myocardial Infarction/mortality , Risk FactorsABSTRACT
In 57 patients with psicovegetative disorders and abnormal MMPI, abnormality in MMPI scales indicating hypochondriasis, hysteria, gender deviant, paranoia, psychastenia, schizophrenia, hypomania or introversion was accompanied by increased plasma catecholamine levels and/or responses to hypoglycemia or by an increased cardiovascular reactivity. A high depression scale was associated with lower plasma catecholamine levels. Blunted plasma growth hormone responses to hypoglycemia were found in abnormal hypomania scale, and augmented responses of plasma cortisol in abnormal hysteria or schizophrenia scales. Paranoia and hypomania traits correlated with absence of morning-evening differences in blood cortisol levels. Electrodermal responses compatible with increased sympathetic activity correlated with high hysteria, gender, paranoia, schizophrenia or hypomania MMPI scales. This study indicates that most psychopathological traits in MMPI are accompanied by humoral and/or electrophysiological signs of abnormality of the autonomic nervous system