Cytotoxicity evaluation of haloperidol, clozapine and a new molecule with antipsychotic potential, PT-31, in NIH-3T3 cells

Abstract Schizophrenia is an illness that affects 26 million people worldwide. However, conventional antipsychotics present side effects and toxicity, highlighting the need for new antipsychotics. We aimed to evaluate the cytotoxicity of haloperidol (HAL), clozapine (CLO), and a new molecule with antipsychotic potential, PT-31, in NIH-3T3 cells. The neutral red uptake assay and the MTT assay were performed to evaluate cell viability and mitochondrial activity, morphological changes were assessed, and intracellular reactive oxygen species (ROS) detection was performed. HAL and CLO (0.1 µM) showed a decrease in cell viability in the neutral red uptake assay and in the MTT assay. In addition, cell detachment, content decrease, rounding and cell death were also observed at 0.1 µM for both antipsychotics. An increase in ROS was observed for HAL (0.001, 0.01 and 1 µM) and CLO (0.01 and 1 µM). PT-31 did not alter cell viability in any of the assays, although it increased ROS at 0.01 and 1 µM. HAL and CLO present cytotoxicity at 0.1 µM, possibly through apoptosis and necrosis. In contrast, PT-31 does not present cytotoxicity to NIH-3T3 cells. Further studies must be performed for a better understanding of these mechanisms and the potential risk of conventional antipsychotics

Meningioma parasagital y hematoma subdural crónico, una asociación inusual / Parasagittal meningioma and chronic subdural hematoma, unusual association

RESUMEN En muchas ocasiones, los pacientes con tumores cerebrales tienen una variedad de síntomas psiquiátricos inespecíficos. Algunos de estos pueden constituir la primera o única manifestación del tumor, sin la presencia de ningún síntoma o signo neurológico. El diagnóstico ha de basarse en la anamnesis completa y en la exploración neurológica; la neuroimagen confirmará el diagnóstico clínico. Con el presente trabajo se describió la asociación inusual de hematoma subdural crónico y meningioma parasagital en un caso presentado. Se trató de un paciente de 68 años con antecedentes de esquizofrenia. Acudió a consulta con una hemiparesia izquierda. Se le realizó una tomografía axial computarizada de cráneo y arrojó un hematoma subdural crónico y un meningioma parasagital derecho. Se le aplicó tratamiento quirúrgico en dos tiempos operatorios. Su evolución posquirúrgica transcurrió sin complicaciones (AU).

ABSTRACT In many cases, patients with brain tumors have a variety of nonspecific psychiatric symptoms. Some of them can be the first or the only manifestation of the tumor, without presenting any neurological signs or symptoms. The diagnosis must be based on the complete anamnesis and on the neurological examination. The neuroimaging will confirm the clinical diagnosis. The unusual association of a chronic subdural hematoma and a parasagittal meningioma was described in a case presented in the current work. It dealt with a patient, aged 68 years with antecedents of schizophrenia. He assisted the consultation with left hemiparesis. A skull computed tomography showed a chronic subdural hematoma and a right parasagittal meningioma. He underwent a two-steps surgery. His post-surgery evolution ran without complications (AU).

Princípios fenomenológicos da compreensão da esquizofrenia fundamentados em Vigotski / Phenomenological principles of the understanding of schizophrenia based on Vygotsky / Principios fenomenológicos de la comprensión de la esquizofrenia fundamentados en Vygotski

A tradição filosófica iniciada por Edmund Husserl, a fenomenologia, e a teoria histórico-cultural, desenvolvida por Vigotski, rompem com a ideia da consciência cartesiana, como algo fechado. Ambas as concepções propiciam uma rica perspectiva de estudo das psicopatologias. Nesse sentido, o objetivo do presente artigo é contrastar as descrições provenientes da fenomenologia com as tentativas de explicação desse fenômeno desenvolvidos por Vigotski. Uma das posições mais aceitas entre os fenomenológos contemporâneos compreende essa patologia como um distúrbio do self, decorrente de alterações da estrutura da temporalidade, da corporalidade e das relações sociais. Para Vigotski, a esquizofrenia decorre da desintegração da formação conceitual da consciência, ocasionando o prejuízo na percepção da realidade, dos outros e de si mesmo. Por fim, apontaremos alguns nexos possíveis por meio do contraste das duas abordagens sobre estados patogênicos típicos da esquizofrenia

The philosophical tradition initiated by Edmund Husserl, phenomenology, and the historical-cultural theory, developed by Vygotsky, break with the idea of consciousness as something closed. Both conceptions provide a rich perspective on the study of psychopathology. In this sense, the aim of the present article is to contrast the descriptions coming from phenomenology with the attempts of explanation of this phenomenon developed by Vygotsky. One of the most accepted positions among contemporary phenomenologists understands this pathology as a disturbance of the self, causing changes in temporality, corporality and social relations. For Vygotsky, schizophrenia stems from the disintegration of the conceptual formation of consciousness. As a result of this, there is a loss in the perception of reality, of others and of oneself. Finally, we will point out some possible links through the contrast of the two approaches to pathogenic states typical of schizophrenia

La tradición filosófica iniciada por Edmund Husserl, la fenomenología y la teoría histórico-cultural, desarrollada por Vygotsky, rompen con la idea de la conciencia cartesiana como algo cerrado. Ambas concepciones propician una rica perspectiva de estudio de las psicopatologías. En ese sentido, el objetivo del presente artículo es contrastar las descripciones provenientes de la fenomenología con los intentos de explicación de ese fenómeno desarrollados por Vigotsky. Una de las posiciones más aceptadas entre los fenomenólogos contemporáneos comprende esa patología como un desorden del self, resultante de alteraciones de la estructura de la temporalidad, de la corporalidad y de las relaciones sociales. Para Vigotski, la esquizofrenia deriva de la desintegración de la formación conceptual de la conciencia, ocasionando el perjuicio en la percepción de la realidad, de los demás y de sí mismo. Por último, apuntaremos algunos nexos posibles por medio del contraste de los dos enfoques sobre estados patógenos típicos de la esquizofrenia

Sistemas de neurotransmisión, alteraciones neuroanatómicas y muerte celular en la esquizofrenia: actualización y perspectivas / Neurotransmitter systems, neuroanatomical pathology and cell death in schizophrenia: update and perspectives

La esquizofrenia incluye una alteración del juicio de realidad que se caracteriza por la presentación de ideas delirantes que pueden ir acompañadas de alucinaciones de alguna modalidad sensorial. Estos síntomas se presentan en la esquizofrenia, pero también pueden resultar de una amplia variedad de trastornos neurológicos y psiquiátricos. Asimismo, puede ser inducida químicamente. A pesar de que la presentación de psicosis es clínicamente similar, se desconoce si involucra mecanismos neurobiológicos distintos para cada situación. Los pacientes que sufren esquizofrenia no sólo exhiben diversas alteraciones neuroanatómicas sino, además, alteraciones en la neurotransmisión de diferentes sistemas. Actualmente, las teorías más aceptadas proponen una sobreactivación del sistema dopaminérgico y una hipofunción del sistema glutamatérgico. Adicionalmente, otros sistemas involucrados en la fisiopatología de la esquizofrenia son la vía del óxido nítrico, así como los sistemas GABAérgico, glicinérgico y serotonérgico. Más aún, dichos sistemas interactúan entre sí modulando el desarrollo del sistema nervioso y la supervivencia de las células. Las alteraciones descritas en este artículo podrían formar una misma secuencia de eventos. La investigación en este campo habrá de enfocarse en dilucidar esa cadena para acercarse aún más a sus extremos inicial, que le da origen, y final, que tiene implicaciones terapéuticas.

Schizophrenia is a thought disorder characterized by delusional thinking which may be accompanied by hallucinations involving any sensory modality. Schizophrenia may be associated with several neurologic and psychiatric disorders. Also, it may be induced by drugs. In spite of the similarity in psychoses symptomatology, it is unknown if it involves the same underlying neurobiologic mechanisms in those cases. Schizophrenic patients exhibit not only neuroanatomical alterations, but also, distortion of several neurotransmitter systems. Nowadays, the main theories in this regard involve dopaminergic hyperfunction and glutamatergic hypofunction. Additionally, other systems involved in the schizophrenia pathophysiology are the nitric oxide pathway as well as GABAergic, glycinergic and serotonergic systems. Furthermore, those systems interact with each other to modulate nervous system development and cell survival. The alterations described in this paper may be part of a single cascade of events. Research in this field should focus on the elucidation of this chain to find its limits, the initial stage that originates it, and the final stage that has therapeutic implications.

Mundi-o: considerações sobre um caso de psicose / Mundi-o: Considerations on a case of psychosis

Este artigo apresenta o caso de Raimundo, ressaltando sua grande produção escrita e construção delirante, segundo a qual retraça a evolução urológica do reino animal. Esta partiria das esponjas, seres assexuados, e alcançaria ele mesmo, Raimundo, elemento único de uma espécie superior, que seria detentor de ambos os genitais, masculino e feminino. O trabalho destaca um conjunto de discussões que o relato do caso suscita. Entre elas salienta-se o interesse na questão da denegação, do corpo e da sexuação no tratamento das psicoses.

Mundi-o: Considerations on a case of psychosis. This article presents Raimundo's case, highlighting his wide written production and his delusional construction involving the urologic evolution of the animal kingdom. That would start from the sponges, asexual beings, to reach Raimundo himself as the single element of a superior species that holds both genitals, male and female. The text also highlights a set of discussions that are raised as a consequence of the report. Among these discussions, the interest on the subjects of denial, of the body and sexuation in the treatment of psychosis are emphasized.

Systematization of Nursing Care in undergraduate training: the perspective of Complex Thinking / Sistematização da Assistência de Enfermagem na graduação: um olhar sob o Pensamento Complexo / Sistematización de la Asistencia de Enfermería en la graduación: una mirada utilizando el Pensamiento Complejo

AIM: to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility METHOD: longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. RESULTS: The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). CONCLUSION: the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context. .

OBJETIVO: analisar as percepções dos acadêmicos de um curso de graduação em enfermagem sobre sua formação em Sistematização da Assistência de Enfermagem. MÉTODO: estudo qualitativo compreensivo, realizado com 32 acadêmicos das quatro séries do curso de enfermagem de uma universidade pública brasileira estadual, que tem a Sistematização da Assistência de Enfermagem como tema transversal. A coleta de dados foi realizada por meio de grupo focal, com questões orientadoras que abordaram a aprendizagem do tema. Os grupos focais foram gravados, filmados, transcritos na íntegra e submetidos a um processo de análise de conteúdo, segundo Bardin. O referencial teórico empregado foi o Pensamento Complexo, proposto por Edgar Morin. RESULTADOS: foram elaboradas três categorias que agruparam as atividades de ensino e aprendizagem, os sentimentos vivenciados e a visão do estudante sobre sua formação em Sistematização da Assistência de Enfermagem. CONCLUSÃO: constatou-se que a temática está presente em todas as séries, porém, de maneira fragmentada e que, o desenvolvimento do processo e da consulta de enfermagem na prática foram as atividades que marcaram o aprendizado da Sistematização da Assistência de Enfermagem dos acadêmicos. .

OBJETIVO: analizar las percepciones de los estudiantes de un curso de graduación en enfermería sobre su formación en la Sistematización de la Asistencia de Enfermería. MÉTODO: estudio cualitativo comprensivo, realizado con 32 estudiantes de las cuatro series del curso de enfermería de una universidad pública brasileña estatal, que tiene la Sistematización de la Asistencia de Enfermería como tema transversal. La recolección de datos fue realizada por medio de grupo focal, con preguntas orientadoras que abordaron el aprendizaje del tema. Los grupos focales fueron grabados, filmados, transcritos en su totalidad y sometidos a un proceso de análisis de contenido, según Bardin. El referencial teórico empleado fue el Pensamiento Complejo, propuesto por Edgar Morin. RESULTADOS: fueron elaboradas tres categorías que agruparon las actividades de enseñanza y aprendizaje, los sentimientos experimentados y la visión del estudiante sobre su formación en la Sistematización de la Asistencia de Enfermería. CONCLUSIÓN: se constató que la temática está presente en todas las series, sin embargo, de manera fragmentada y que, el desarrollo del proceso y de la consulta de enfermería en la práctica, fueron las actividades más importantes en el aprendizaje de la Sistematización de la Asistencia de Enfermería por los estudiantes. .

5-Hydroxytryptamine (serotonin) 2A receptor gene polymorphism is associated with schizophrenia.

Background & objectives: Schizophrenia, the debilitating neuropsychiatric disorder, is known to be heritable, involving complex genetic mechanisms. Several chromosomal regions associated with schizophrenia have been identified during the past; putative gene (s) in question, to be called the global signature for the pathophysiology of the disease, however, seems to evade us. The results obtained from the several population-wise association-non association studies have been diverse. we therefore, undertook the present study on Tamil speaking population in south India to examine the association between the single nucleotide polymorphisms (SNPs) at the serotonin receptor gene (5HT2A) and the occurrence of the disease. Methods: Blood samples collected from 266 cases and 272 controls were subjected to genotyping (PCR amplification of candidate SNPs, RFLP and sequencing). The data on the SNPs were subjected to statistical analysis for assessing the gene frequencies in both the cases and the controls. Results: The study revealed significant association between the genotypic frequencies of the serotonin receptor polymorphism and schizophrenia. SNP analysis revealed that the frequencies of GG (30%, rs6311) and CC genotypes (32%, rs6313), were higher in patients (P<0.05) than in controls. The study also showed presence of G and C alleles in patients. significant levels of linkage disequilibrium (LD) were found to exist between the genotype frequencies of rs6311 and rs6313. Interpretation & conclusions: This study indicated an association between the SNPs (rs6311 and rs6313) of the serotonin receptor 5HT2A and schizophrenia. HapMap analysis revealed that in its genotype distribution, the Tamil speaking population was different from several other populations across the world, signifying the importance of such ethnicity-based studies to improve our understanding of this complex disease.

How semantic deficits in schizotypy help understand language and thought disorders in schizophrenia: a systematic and integrative review / Como déficits semânticos na esquizotipia auxiliam a compreender transtornos da linguagem e do pensamento na esquizofrenia: uma revisão sistemática e integrativa

Introduction: Disorders of thought are psychopathological phenomena commonly present in schizophrenia and seem to result from deficits of semantic processing. Schizotypal personality traits consist of tendencies to think and behave that are qualitatively similar to schizophrenia, with greater vulnerability to such disorder. This study reviewed the literature about semantic processing deficits in samples of individuals with schizotypal traits and discussed the impact of current knowledge upon the comprehension of schizophrenic thought disorders. Studies about the cognitive performance of healthy individuals with schizotypal traits help understand the semantic deficits underlying psychotic thought disorders with the advantage of avoiding confounding factors usually found in samples of individuals with schizophrenia, such as the use of antipsychotics and hospitalizations. Methods: A search for articles published in Portuguese or English within the last 10 years on the databases MEDLINE, Web of Science, PsycInfo, LILACS and Biological Abstracts was conducted, using the keywords semantic processing, schizotypy and schizotypal personality disorder. Results: The search retrieved 44 manuscripts, out of which 11 were firstly chosen. Seven manuscripts were additionally included after reading these papers. Conclusion: The great majority of the included studies showed that schizotypal subjects might exhibit semantic processing deficits. They help clarify about the interfaces between cognitive, neurophysiological and neurochemical mechanisms underlying not only thought disorders, but also healthy human mind's creativity (AU)

Introdução: Transtornos do pensamento são fenômenos psicopatológicos comumente presentes na esquizofrenia e parecem resultar de déficits do processamento semântico. Traços esquizotípicos de personalidade consistem de tendências de pensamento e comportamento qualitativamente semelhantes às observadas na esquizofrenia, além de uma maior vulnerabilidade para esse transtorno. O presente trabalho teve como objetivo revisar a literatura sobre déficits de processamento semântico em amostras de indivíduos com traços esquizotípicos, discutindo o impacto desse conjunto de conhecimentos sobre a compreensão dos transtornos de pensamento na esquizofrenia. Estudos sobre o desempenho cognitivo de indivíduos saudáveis que apresentam traços esquizotípicos são úteis na elucidação dos déficits semânticos subjacentes aos transtornos psicóticos do pensamento, com a vantagem adicional de evitar fatores confundidores normalmente presentes em amostras clínicas de indivíduos esquizofrênicos, tais como uso de antipsicóticos e hospitalizações. Métodos: Foi realizada uma busca por artigos publicados em português ou inglês nos últimos 10 anos nas bases de dados MEDLINE, Web of Science, PsycINFO, LILACS e Biological Abstracts, utilizando-se as palavras-chave semantic processing, schizotypy e schizotypal personality disorder. Resultados: A pesquisa resultou em 44 manuscritos, dos quais 11 foram inicialmente selecionados. A partir da leitura desses artigos, outros sete foram adicionalmente incluídos. Conclusão: A grande maioria dos estudos incluídos mostrou que indivíduos esquizotípicos podem apresentar déficits de processamento semântico, auxiliando a compreender as interfaces cognitiva, neurofisiológica e neuroquímica subjacentes não só aos distúrbios pensamento, mas também à criatividade na mente humana saudável (AU)

Sinaptogénesis y esquizofrenia: rol de la proteína DISC 1 / Synaptogenesis and Schizophrenia: The role of DISC 1 protein

El presente trabajo aporta información respecto del posible rol en la esquizofrenia del gen DISC 1 y la proteína que este gen codifica. Se realiza un recorrido desde el hallazgo de la translocación cromosómica que llevó a su descubrimiento, hasta la perspectiva actual, que lo conceptualiza como un modulador funcional complejo. La mencionada translocación fue originariamente identificada en una familia escocesa, y se observó que cosegregaba con esquizofrenia y otros trastornos mentales. Actualmente, se considera a DISC 1 como una proteína central dentro de una red de interacciones con otras proteínas - lo que en varios trabajos se denomina interactoma -, tales como NDEL 1, LIS 1 y PDE 4B, entre otras.

This paper provides information regarding the possible role in schizophrenia of the DISC 1 gene and the protein it encodes. It is a tour from the discovery of the chromosomal translocation that led to its discovery, up to the current perspective, which is conceptualized as a complex functional modulator. The above translocation was originally identified in a Scottish family, and it was noted that it cosegregated with schizophrenia and other mental discorders. Currently, DISC 1 is considered as a central protein within its network of protein interactions (named as interactome in several papers), such as NDEL 1, LIS 1 and PDE 4B, among others.

Esquizofrenia en niños y adolescentes / Schizophrenia in children and adolescents

La población infantil y adolescente es considerada, junto con los ancianos y embarazadas, vulnerable por representar un sistema fisiológico que dista del adulto promedio para el cual están basadas la mayoría de prácticas terapéuticas. La esquizofrenia tiene una especial importancia en este grupo ya que es considerada una enfermedad del neurodesarrollo. Para poder instaurar un tratamiento adecuado resulta capital conocer los procesos y circuitos neurobilógicos que constituyen la base de la patología. Las hipótesis mejor estudiadas son la dopaminérgica, de la cual deriva el arsenal farmacológico actual, y la hipoglutamatérgica. Esta última invita al desarrollo de nuevas moléculas con potencial antipsicótico pero que no posean blancos terapéuticos dopaminérgicos. Hasta hoy, no existe un fármaco comercializado que actúe sobre las vías glutamatérgicas para tratar la esquizofrenia pero sí existen varios ejemplos en ensayos clínicos de fases I y II. También es necesario establecer las pautas de dosificación para los grupos vulnerables las cuales derivan, en su mayoría, de las establecidas para adultos.

The population of children and adolescents is considered, along with the elderly and pregnant women, vulnerable, for representing a physiological system that is far from the average adult, for whom most therapeutic practices are based on. Schizophrenia has special relevance within this group, since it is considered a neurodevelopmental disorder. In order to establish an adquate treatment, it is key to know the processes and neurobiological circuits which form the basis of this disease. The best studied hypotheses are the dopaminergic hypothesis, from which the current pharmacological studies derive, and the hypoglutamatergic hypothesis. The latter proposes the development of new molecules with antipsychotic potential, which do not have dopaminergic therapeutic targets. Up to now, there is no marketed drug which acts on glutamatergic pathways to treat schizophrenia, although several examples can be found in phase I and II clinical trials. It is also necessary to establish dosing guidelines for vulnerable groups, most of which result from the ones established for adults.

Disability in Person with Schizophrenia: Its Correlation with Psychopathology and Socio-Demographic Profile.

Schizophrenia causes considerable functional disability. The present study was designed to assess disability in person with schizophrenia and to see its relationship with psychopathology (PANNS score), UKU side effect, duration of illness, duration of treatment, perceived social support and other socio-demographic factors . The study was done at the Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, India. For this study 100 patients with a clinical diagnosis of schizophrenia as per ICD-10 were taken. Thereafter, all patients were assessed on Positive and Negative Syndrome Scale for Schizophrenia (PANSS) for psychopathology, on Indian Disability Evaluation Assessment Schedule (IDEA) for disability, on UKU Side Effect Rating Scale for side effects of drugs and on Social Support Questionnaire (SSQ) for perceived social support. It was found that majority of the patients were having severe level of disability in global, interpersonal activity and communication & understanding area and moderate level in work and self care domains. PANSS total score had a significant (<0.035) positive correlation and SSQ total score had a significant (p<0.000) negative correlation with global disability. Age of onset, duration of illness have an effect on disability. The total score of PANSS and SSQ SERS total score emerged as the sole significant predictor of global disability. Treatment in schizophrenia should be focused on psychopathology and social support system to improve competencies in retaining an occupation, better interpersonal relationship with co-workers, and significant others.

Effects of the Family Resilience Enhancement Program for Families of Patients with Chronic Schizophrenia

PURPOSE: The purpose of this study was to evaluate the effects of the Family Resilience Enhancement Program (FREP) on family hardiness, family sense of coherence, family problem solving communication, family crisis oriented personal evaluation, and adaptation in families of patients with chronic schizophrenia. METHODS: The study design was a nonequivalent control group prepost test design. Study participants were 17 families in the experimental group and 17 in the control group. Ten sessions of FREP were provided over 5 weeks. The data were analyzed using SPSS 15.0. RESULTS: There were statistically significant differences in family hardiness, family sense of coherence, family problem-solving communication, family crisis-oriented personal evaluation, social resources, and family adaptation between the experimental group and the control group. CONCLUSION: FREP based on the family resilience model developed in this study, shows the effect of leading the families to positive family adaptation.

Development of a Coping Scale for Families of Patients with Schizophrenia

PURPOSE: The purpose of this study was to develop and evaluate a coping scale for families of patients with schizophrenia(CSFPS). METHODS: Item construction was derived from literature reviews and interviews with family members and psychiatric nurses. Content validity was tested by experts. Each item was scored on a four-point Likert scale. The preliminary questionnaire was administered to 188 family members of patients with schizophrenia. The data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's alpha. RESULTS: From the factor analysis, 32 items in five factors were derived. The factors were named active coping strategies, avoidance coping strategies, hospital treatment-oriented coping strategies, emotional coping strategies, and suppressive coping strategies for problematic behaviors. The five factors explained 49.7% of the total variance, Cronbach's alpha of the total items was .83 and the factors ranged from .66 to .86. CONCLUSION: The results of this study suggest that CSFPS is a reliable and valid instrument to measure coping in families of patients with schizophrenia.

Alteración de la memoria de trabajo en la esquizofrenia / The Alteration of Working Memory in Schizophrenia

La memoria de trabajo o working memory es un constructo teórico que se refiere a las estructuras y procesos usados para el almacenamiento temporal (memoria a corto plazo) y la manipulación de la información, con una naturaleza activa, creadora o transformadora de la memoria. El rol de la corteza prefrontal en la memoria de trabajo es fundamental adaptativas en base a la información on line. Permite mantener activada una cantidad limitada de información necesaria para guiar la conducta. El sujeto necesita disponer de una representación mental tanto del objetivo como de la información relevante, no sólo acerca actual sino también en relación a la situación futura. La esquizofrenia es una enfermedad que presenta alteraciones que clínicamente abarcan las dimensiones de síntomas positivos, negativos y cognitivos. Los síntomas cognitivos presentan alteraciones en las funciones ejecutivas, atención, memoria declarativa verbal y espacial y la memoria de trabajo. La patofisiología de la esquizofrenia se puede entender como un complejo entramado entre factores genéticos y ambientales que generan alteraciones del neurodesarrollo y neurodegenerativos. Las hipótesis de la enfermedad conducen a una disregulación de los circuitos dopaminérgicos, glutamatérgicos, gabaérgicos, serotonérgico y colinérgicos, involucrando a las áreas corticales, hipocampo, ganglios de la base y tronco del encéfalo, en la fisiopatología de la enfermedad. La neurobiología de la enfermedad permite un acercamiento a la comprensión de esta patología y evaluar de manera racional, posibles abordajes psicofarmacológicos y psicosociales...

Working memory is a theoretical construct that refers to the structures and processes used for the temporary storage (short-term memory) and the manipulation of informations, with an active, creative or transformative nature of memory. The role of the prefrontal cortex in working memory is essential to establish a space of ordering, plannign, and sequencing. Filtered as irrelevant and build adaptive responses based on the on-line information. Keeps activated a limited amount of information needed to guide the behavior. The subject needs to have a mental representation both the objective and relevant information not only about the current state but also in relation to the future situation. Schizophrenia is a disease that presents disorders that clinically encompass the dimensions of positive, negative and cognitive symptoms present alterations in executive functions, attention and declarative memory spatial and verbal working memory. The pathophysiology of schizophrenia can be understoood as a complex network between genetic and environmetal factores that generate neurodegenerative and neurodevelopmental alterations. The hypothesis of the disease leading to a dysregulation of the circuits dopaminergic, glutamatergics, serotonergic and GABAergic, involving the cortical areas, hippocampus, basal ganglia and brainstem in the pathphysiology of the disease. The Neurobiology of disease allows an approach to the understanding of this desease and evaluate in a rational way, possible approaches psychopharmacologic and psychosocial...

Considerações psicanalíticas sobre o delírio de influência / Psychoanalytical considerations on the delusion of influence / Consideraciones psicoanaliticas sobre el delirio de la influencia en el psicoanálisis

O artigo busca desenvolver reflexões sobre a questão do delírio de influência na esquizofrenia a partir de casos clássicos da história da psicanálise - apresentados sobretudo por Victor Tausk, assim como por S. Freud e Margaret Mahler - colocando em evidência a relação da máquina ao corpo do psicótico, tentando assim tecer considerações a partir da teoria lacaniana para realizar uma leitura atualizada destes casos: uma vez que a compensação imaginária não opera mais para esses sujeitos, tem-se então psicóticos sobre influência, seja por máquinas, seja por um semelhante - consequência direta sobre o corpo e seus orgãos da foraclusão da significação fálica.

The article seeks to develop some reflections on the question of the delirium of influence in schizophrenia cases from the history of classical psychoanalysis presented by Victor Tausk, S. Freud and Margaret Mahler - bringing to the light the relationship of the machine to the body of psychotic, trying to develop some considerations from the lacanian theory to perform an updated reading of these cases, since the compensation does not any more operate for these subjects, we have an psychotic under influence either by machines or by a similar - direct consequence on the body and its organs of forclusion of phallic signification.

El artículo tiene por objeto desarrollar las reflexiones sobre la cuestión del delirio de la influencia en los casos de esquizofrenia de la historia del psicoanálisis clásico, en especial presentado por Victor Tausk, y S. Freud y Margaret Mahler - sacando a la luz la relación de la máquina para el cuerpo de psicóticos, tratando de desarrollar algunas consideraciones de la teoría lacaniana para realizar une lectura actualizada de estos casos, ya que la compensación no opera más de imaginar en estos sujetos, hemos para psicóticos sobre la influencia, ya sea por máquinas o por une similar - consecuencia directa sobre el cuerpo y sus órganos de ejecución de une forclusion de la significación fálica.

Comorbilidad, trastorno psiquiátrico y consumo de sustancias psicoactivas (patología dual) / Comorbility, psichiatric disorder and psychoactive substance consumption (dual pathology)

La patología dual es una problemática en la que se observa la coexistencia de un trastorno psiquiátrico y el consumo de sustancias psicoactivas, simultáneamente. Es de difícil diagnóstico y tratamiento. Se observa en los estados depresivos, los trastornos de ansiedad, la esquizofrenia, el trastorno bipolar y los trastornos de conducta. El abordaje debe ser integral e incluir tratamiento psicofarmacológico, psicoterapéutico cognitivo-conductual, psicoterapia grupal y orientación a la familia, asimismo, lograr un compromiso del paciente, los familiares y los amigos en el cumplimiento estricto del tratamiento. El tratamiento puede realizarse en forma ambulatoria, en hospital de día, con internación breve para la desintoxicación o en comunidades terapéuticas, la elección dependerá del tipo de patología psiquiátrica y del nivel bajo, medio o alto de consumo de sustancias concomitante.

Dual pathology is a problem in which a psychiatric disorder and the consumption of psychoactive substances coexist at the same time. It is difficult to diagnose and to treat. This pathology is observed in depressive states, anxiety disorders, shizophrenia, bipolar disorder and behavior disorders. Its approach should be integral and include psychopharmacological, psychotherapeutic, cognitive-behavioral treatment, group psychotherapy and family guidance, and it should achieve commitment on the part of the patient, relatives and friends, in the strict compliance of such treatment. Treatment can be performed externally, at a day hospital, through brief hospitalization for desintoxication or in therapeutic communities, the choice will depend on the type of psychiatric pathology and on the low, medium or high concomitant level of consumption of substances.