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Acta sci., Health sci ; 44: e56546, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367534


The aim of the study is to determine the psychological well-being of patients who underwent stem cell transplantation. This cross-sectional study was conducted with 100 patients. Data were collected face-to-face using an introductory information form and the Brief Symptom Inventory.When the results of the patients were examined, the interpersonal sensitivity of the sub-dimensions of the scale was found to be 5.0 ± 4.06, depression 7.60 ± 5.37, and anxiety disorder 7.90 ± 5.34. There was a significant difference between the diagnosistime of the patients and all sub-factors of the scale, except phobic anxiety. It was found that the psychological state of the patients was directly related to the time of first diagnosis. As a result, the importance of following the psychological processof the patients during the treatment process was revealed when planning nursing care.

Humans , Male , Female , Adult , Middle Aged , Aged , Patients/psychology , Stem Cell Transplantation/nursing , Emotional Adjustment/ethics , Nursing Care/ethics , Anxiety Disorders/diagnosis , Anxiety Disorders/nursing , Anxiety Disorders/rehabilitation , Paranoid Disorders/diagnosis , Paranoid Disorders/nursing , Paranoid Disorders/therapy , Psychotic Disorders/diagnosis , Psychotic Disorders/nursing , Psychotic Disorders/therapy , Somatoform Disorders/diagnosis , Somatoform Disorders/nursing , Somatoform Disorders/therapy , Bone Marrow , Demography/statistics & numerical data , Cross-Sectional Studies , Depression/diagnosis , Depression/nursing , Hostility , Neoplasms/diagnosis , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/nursing , Obsessive-Compulsive Disorder/therapy
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 43(3): 324-336, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1249184


Objective: Acceptance and commitment therapy (ACT) is a third-wave psychological intervention that has attracted considerable clinical and research attention. A previous meta-analysis of ACT trials in psychosis reported a large effect size of ACT against overall psychotic symptomatology. However, there were critical methodological issues in the review that justify replication. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) testing ACT vs. any comparator condition in a sample of adults with psychosis. The outcome of interest was overall psychotic symptomatology. Results: The search identified seven published and eight unpublished trials (of which we were able to obtain data from one). Data on symptomatology were extracted from six trials that involved 274 participants. The summary effect size (Hedge's G) for overall symptomatology was small and not significant (-0.21, 95%CI -0.60-0.18). Trials were generally rated as having a high risk of bias. Safety reporting was inadequate across included trials. Conclusions: Our observed effect size contrasted with that reported in a previous meta-analysis; differences were likely explained by errors in data extraction. The findings of this review suggest that there is currently inadequate evidence to conclude that ACT is a safe and effective treatment against psychotic symptomatology. Systematic review registration: CRD42018097200

Humans , Adult , Psychotic Disorders/therapy , Acceptance and Commitment Therapy , Treatment Outcome
Rev. chil. neuro-psiquiatr ; 58(4): 425-430, dic. 2020.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388363


Resumen El síndrome de Cotard, descrito en la historia por presentar diferentes tipos de delirios siendo el principal el nihilista o de negación, ha sido reportado en diversos trastornos neuropsiquiátricos; sin embargo, existe poca literatura que lo refiera en el contexto de retraso mental, por lo que el objetivo del trabajo es examinar las características del Síndrome de Cotard a propósito de un reporte de caso. Presentamos a un paciente de 19 años que cumple con los criterios para Retraso mental y Síndrome de Cortad. Se revisó la literatura, hallando sucinta data en que se presente cuadros similares. Sería muy recomendable continuar evaluando con mayor profundidad la asociación entre retraso mental y síndrome de Cotard e investigar la respuesta al tratamiento, dado que no existen protocolos en nuestra región.

Cotard syndrome, described in the history for presenting different types of delusions being the principal as the nihilistic delusion or delusion of negation, was reported on neuropsychiatric disorders. However, there is little literature that refers to it in the context of mental retardation. The aim of this report case is to explore the characteristics of Cotard syndrome. We present a 19 year-old boy who complete criteria for intellectual disability and Cotard syndorme. The literature was reviewed, finding succinct data associated to cases like this. We recommend to evaluate deeply the association between intellectual disability and Cotard syndrome and to research the treatment, given that there are no protocols in our region.

Humans , Male , Adult , Psychotic Disorders/complications , Psychotic Disorders/therapy , Delirium/complications , Delirium/therapy , Intellectual Disability/complications , Intellectual Disability/therapy , Syndrome , Hypochondriasis
Estilos clín ; 24(1): 111-120, Jan.-Apr. 2019.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1039840


O desejo de analista é uma questão fundamental à psicanálise e preciosa àqueles que se iniciam em sua prática. Este trabalho se debruça sobre o desejo de analista a fim de encontrar uma direção de tratamento para uma criança psicótica. Diante do imperativo ético de o analista se abster de seu desejo próprio frente ao analisante, haveria uma especificidade do desejo de analista na clínica com crianças e, particularmente, com crianças autistas e psicóticas?

El deseo de analista es una cuestión fundamental al psicoanálisis y valiosa para aquellos que se inician en su práctica. Este trabajo examina el deseo de analista con el objetivo de encontrar una forma de tratamiento a un niño psicótico. Ante el imperativo ético del analista abstenerse de su propio deseo frente al analizante, ¿habría una especificidad del deseo de analista en la clínica con niños, más específicamente con niños autistas y psicóticos?

The desire of the analyst is a fundamental issue to psychoanalysis and precious to those who are in the beginning of their practice. This paper explores this desire with the intent to find a direction of treatment for a psychotic child. Before the analyst ethical imperative to abstain their own desire vis-a-vis with the analysand, would there be certain specificity on the desire of the analyst in a clinic with children, particularly with autistic and psychotic children?

Humans , Child, Preschool , Psychoanalysis , Psychotic Disorders/therapy , Autistic Disorder/therapy
Ciênc. Saúde Colet. (Impr.) ; 24(1): 229-246, ene. 2019. tab
Article in Portuguese | LILACS | ID: biblio-974818


Resumo O Método Diálogo Aberto foi desenvolvido na Finlândia para atender crises psíquicas graves utilizando diálogo e inclusão da rede social. Este artigo pretende, através de uma revisão da literatura sobre o Método do Diálogo Aberto, identificar seus princípios e contribuições para processos de desisntitucionalização. Método: As bases utilizadas neste artigo de revisão foram: PubMed (365), PsycInfo (134) e Lilacs (nehuma publicação encontrada), além de 2 livros, incluídos por referência cruzada. Foram selecionadas 34 publicações que atendiam ao objetivo proposto. A busca foi realizada em outubro de 2015. Os descritores selecionados foram: open dialogue, crisis, first episode psycosis, schizophrenia, terapy family, need adapted approach. Resultados: Foram encontrados 3 artigos de revisão, 5 estudos teóricos, 21 estudos qualitativos e 5 estudos quantitativos. Destes, 2 foram escritos em italiano, 1 em francês e 31 em inglês. Com relação ao país de origem dos autores temos: Noruega, Estados Unidos, Finlândia, Austrália, Reino Unido, Bélgica, Canadá e Polônia. As produções foram agrupadas para análise em: Concepções e princípios do Diálogo Aberto; Contribuições do diálogo Aberto; Desafios para implementação do Diálogo Aberto em outros países, realidades e contextos.

Abstract The Open Dialogue Method was developed in Finland in order to deal with severe psychotic crises using dialogue and social network inclusion. By means of a review of the literature on the Open Dialogue Method, this article sought to identify the principles and contributions for deinstitutionalization. Method: The PubMed (365), PsycInfo (134), Lilacs (no articles found) databases and 2 books were consulted. Thirty-four publications that fulfilled the requirements of this review were selected. The search was conducted in October 2015. The key words used were: open dialogue, crisis, first psychotic episode, schizophrenia, family therapy, need-adapted approach. Results: There were 3 reviews, 5 theoretical studies, 21 qualitative studies and 5 quantitative studies. Two of them were written in Italian, one in French and thirty-one in English. The authors were from Norway, the United States, Finland, Australia, the United Kingdom, Belgium, Canada and Poland. The publications were grouped for purposes of analysis into the following categories: Open Dialogue concepts and principles; Open Dialogue contributions; Challenges for Open Dialogue implementation in other countries, realities and contexts.

Humans , Psychotic Disorders/therapy , Crisis Intervention/methods , Family Therapy/methods , Psychotic Disorders/physiopathology , Social Support , Severity of Illness Index , Mental Health , Acute Disease , Finland
Psiquiatr. salud ment ; 35(3/4): 257-261, jul.-dic. 2018.
Article in Spanish | LILACS | ID: biblio-1005051


Paciente de 47 años, casada, con 3 hijos. Antecedentes de patología psiquiátrica en madre y hermano. Sin antecedentes psiquiátricos previos. Ingresa hace 4 años al Servicio. Con síntomas polimorfos, varios diagnósticos desde el ingreso, pero con respuesta al tratamiento y con periodos de estabilidad psicopatológica demás de un año. Conocida en varios dispositivos del servicio. Diagnósticos: Trastorno Delirante, Obs. Trastorno Afectivo Bipolar, Trastorno Esquizoafectivo

Patient 47 years old, married, with 3 children. History of psychiatric pathology in mother and brother. No previous psychiatric history. Enter the Service 4 years ago. With polymorphic symptoms, several diagnoses from admission, but with response to treatment and with periods of psychopathological stability over a year. Known in several service devices. Diagnoses: Delusional Disorder, Obs. Bipolar Affective Disorder, Schizoaffective Disorder

Humans , Female , Middle Aged , Psychotic Disorders/diagnosis , Schizophrenia, Paranoid/diagnosis , Bipolar Disorder/diagnosis , Psychotherapy , Psychotic Disorders/therapy , Schizophrenia, Paranoid/therapy , Signs and Symptoms , Syndrome , Antipsychotic Agents/therapeutic use , Bipolar Disorder/therapy , Occupational Therapy
Rev. polis psique ; 8(1): 191-211, jan.-abr. 2018.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1043288


A abordagem Open Dialogue foi desenvolvida na Finlândia na década de 1980, como um conjunto de práticas e princípios que modificou o modelo de atenção aos problemas de saúde mental da região. Através da proposta de reuniões familiares envolvendo a rede social das pessoas em crise em uma perspectiva dialógica, a abordagem Open Dialogue reduziu o número de internações em hospitais psiquiátricos e o tempo não tratado da doença; incorporou o uso seletivo de neurolépticos e promoveu taxas de recuperação de 84% das pessoas tratadas. O objetivo deste artigo é apresentar uma revisão narrativa da literatura sobre a abordagem Open Dialogue trazendo a história de seu desenvolvimento, os sete princípios que orientam suas práticas e estudos de efetividade. Por fim, convidamos o leitor ao debate de estratégias de cuidado aos primeiros episódios psicóticos, contando que a abordagem Open Dialogue possa oferecer pistas para a Atenção Psicossocial brasileira. (AU)

The Open Dialogue approach was developed in Finland in the 1980's as a set of practices and principles that changed the model of mental health care delivery in the Western Lapland region. Through family meetings conducted in accordance with a dialogical perspective involving the person in crisis and their social network, the Open Dialogue approach reduced the number of hospitalisations in psychiatric hospitals, diminished the duration of untreated illness, incorporated the selective use of neuroleptics and promoted recovery in 84% of persons treated. This paper presents a literature review of the Open Dialogue approach outlining its history and development, as well as the seven principles that guide clinical practice and effectiveness studies. Finally, we invite the reader to participate in the debate regarding care strategies for first episode psychosis, given to understand that the Open Dialogue approach may provide new paths for Brazilian Psychosocial Care. (AU)

El enfoque Open Dialogue fue desarrollado en Finlandia en la década de 1980 como un conjunto de prácticas y principios que modificó el modelo de atención a los problemas de salud mental de la región. A través de la propuesta de reuniones familiares incluyendo a la red social de las personas en crisis desde una perspectiva dialógica, el enfoque Open Dialogue redujo el número de internaciones en hospitales psiquiátricos y el tiempo no tratado de la enfermedad; incorporó el uso selectivo de neurolépticos y promovió tasas de recuperación de 84% de las personas tratadas. El objetivo de este artículo es presentar una revisión narrativa de la literatura sobre el enfoque Open Dialogue trayendo la historia de su desarrollo, los siete principios que orientan sus prácticas y estudios de efectividad. Por último, invitamos al lector al debate de estrategias de cuidado a los primeros episodios psicóticos, contando que el abordaje Open Dialogue pueda ofrecer pistas para la Atención Psicosocial brasileña. (AU)

Psychotic Disorders/therapy , Therapeutics/methods , Mental Health , Family , Communication , Social Networking
Rev. neuropsiquiatr ; 80(4): 265-272, 2017. tab
Article in Spanish | LILACS, MTYCI | ID: biblio-1007458


La ayahuasca es una bebida alucinógena, producto de la decocción de las plantas Banisteriopsis caapi y Psychotria viridis y que cuenta con N,N-dimetiltriptamina y ß-carbolinas, como sus compuestos principales. Aunque produce alteraciones somáticas, cognitivas y subjetivas agudas, a menudo intensas, casi no se han reportado efectos adversos luego de un cuadro de intoxicación con este agente. En este artículo se presenta el caso de un varón de 40 años, procedente de la Amazonía peruana, que siguió un curso psicótico tras una sesión ritual de consumo; el episodio psicótico se resolvió favorablemente con tratamiento específico. Aun cuando infrecuentes, estos episodios pueden llegar a ser muy severos y asociarse a conductas violentas. Los usuarios con antecedentes de psicosis, manía o abuso de sustancias psicoactivas parecen estar en mayor riesgo. La literatura en relación al riesgo de reacciones adversas (incluidas conductas psicóticas) debidas al uso de ayahuasca, es escasa y poco concluyente por lo que casos similares al descrito deben evaluarse cuidadosamente y difundirse de manera apropiada. (AU)

Humans , Psychotic Disorders/therapy , Banisteriopsis/drug effects , Peru , Plants, Medicinal , Medicine, Traditional
EMHJ-Eastern Mediterranean Health Journal. 2017; 23 (4): 314-320
in French | IMEMR | ID: emr-186911


Sectorisation was introduced in Tunisia in 1999. The objective of this study was to examine the difficulties and resistance to the sectorisation of psychiatric care in the state of Nabeul. A transversal study was conducted over a period of 5 months from 1 November 2014 to 31 March 2015 on 96 patients resident in the state of Nabeul and treated at Razi hospital. Patients were aged between 18 and 69 years old [ sex ratio equal to one], 55.2% were single and 46% had a low socio-economic level [n=44]. Chronic psychotic disorder was diagnosed in 64.3%, depression in 12.3%, bipolar disorder in 18.8% and mental retardation in 3% of cases. Most of them refused to continue psychiatric treatment in the second or the first line of care. Resistance to sectorisation was associated with a low socioeconomic level [P = 0.039], availability of a companion [P = 0.04], celibacy [P = 0.04], gender [P = 0.05] and negatively correlated to psychotic disorder diagnosis. It was concluded that the environment plays an important role in the choice of the place of care. Subjects treated for mental illness were found to have greater trust in the structures that treated the acute episode of their illness, and paradoxically felt less stigmatized in Razi hospital

Humans , Female , Male , Adolescent , Young Adult , Adult , Middle Aged , Aged , Psychotic Disorders/therapy , Psychiatry , Psychotic Disorders/diagnosis , Mental Disorders/therapy , Depression/diagnosis
Article in English | LILACS | ID: biblio-829163


OBJECTIVE: Cognitive Behavioral Therapy (CBT) has been recommended by several international guidelines as the gold-standard treatment to address the needs of patients with schizophrenia. This review provides an overview on recent advances regarding CBT for schizophrenia. METHODS: An electronic search was performed on PubMed/MEDLINE, Web of Science and Cochrane Database, using the key-words: "schizophrenia", "psychosis", "cognitive-behavioral therapy", "CBT" and "psychotherapy". RESULTS: Numerous systematic reviews support the immediate and long-term efficacy of Cognitive Behavioral Therapy to reduce positive and negative symptoms in patients with schizophrenia. In the last decade, CBT for schizophrenia has been applied to clinical high-risk subjects and delivered using innovative approaches (low intensity, web-based and self-guided). Brain regions and networks which support high-level cognitive functions have been associated with CBT responsiveness. There is preliminary evidence indicating that CBT induces a prefrontal dependent increase in the top-down modulation of social threat activation. CONCLUSION: In the last decade, CBT for schizophrenia has explored new treatment outcomes, targeted acute and pre-clinical populations and provided alternative methods to reach more patients and reduce intervention costs. The patients' neurocognitive profile seems to play a critical role in treatment response and combining CBT with cognitive remediation may allow to enhance therapeutic effects. Although CBT for schizophrenia is widely established as a gold-standard practice, future studies using innovative CBT protocols, exploring brain-related predictors and treatment outcomes may allow this intervention to be more effective, personalized and to reach a wider number of patients.

INTRODUÇÃO: A terapia cognitivo-comportamental (TCC) tem sido recomendada em diversas guidelines internacionais como a intervenção psicoterapêutica padrão de ouro para pacientes com esquizofrenia. Esta revisão tem como objetivo fornecer uma visão global sobre os avanços recentes da TCC na esquizofrenia. MÉTODOS: Para esta revisão narrativa foi realizada uma busca eletrônica na PubMed/MEDLINE, Web of Science e Cochrane Database utilizando as palavras-chave: "schizophrenia", "psychosis", "cognitive-behavioral therapy", "CBT" e "psychotherapy". RESULTADOS: Várias revisões sistemáticas suportam a eficácia da TCC na redução a curto e longo prazo dos sintomas positivos e negativos da esquizofrenia. Na última década, a TCC tem sido aplicada a indivíduos com alto risco de psicose, sendo também exploradas abordagens inovadoras na sua utilização (curta duração, web-based, autogestão). Redes neurais responsáveis por funções cognitivas de nível superior têm sido associadas a respostas positivas após TCC para esquizofrenia. Existe ainda evidência preliminar que a TCC promove a ativação de zonas pré-frontais responsáveis pela modulação top-down face a ameaças sociais. CONCLUSÃO: Na última década, a TCC para esquizofrenia tem explorado novos desfechos, intervindo em populações agudas e pré-clínicas e utilizado métodos alternativos para alcançar mais pacientes e reduzir custos O perfil neurocognitivo dos pacientes aparenta ter um papel crítico na resposta ao tratamento, pelo que combinar a TCC com reabilitação cognitiva poderá potenciar os seus efeitos terapêuticos. Apesar da TCC ser uma prática recomendada para a esquizofrenia, estudos futuros usando protocolos inovadores e explorando preditores e desfechos relacionados com o cérebro poderão possibilitar que esta intervenção seja mais eficaz, personalizável e alcance o máximo número de pacientes possível.

Humans , Psychotic Disorders/therapy , Schizophrenia/therapy , Cognitive Behavioral Therapy , Neuronal Plasticity
Rev. psiquiatr. Urug ; 80(1): 26-32, sept. 2016. ilus
Article in Spanish | LILACS | ID: biblio-973338


La esquizofrenia es una patología que evolucionade forma crónica, proclive al deterioro, siendo este último variable de acuerdo con comorbilidades presentes y adherencia al tratamiento integral. Genera alteraciones cognitivas e influye negativamente en el desempeño de quienes la padecen, causando detrimento global de los pragmatismos. La electroconvulsoterapia es una opción terapéutica ampliamente utilizada en nuestro país para tratar sintomatología del humor y episodios psicóticos agudos, entre otros. En la actualidad se sabe que la detección e intervención precoz de un episodio psicótico agudo —el cual puede corresponder al primer episodio psicótico de esquizofrenia —mejora el pronóstico a largo plazo. El objetivo es demostrar si existe un vínculo entre la indicación de electroconvulsoterapia durante el primer episodio psicótico de esquizofrenia y la duración del intervalo libre de internación. Este es un estudio de tipo analítico, observacional, retrospectivo (cohorte histórica) que busca aumentar las evidencias en este amplio campo de investigación. Observamos que el tiempo libre de internación luego de la primera hospitalización no tuvo relación con el hecho de si recibieron electroconvulsoterapia o no; sin embargo, al realizar el análisis de potencia estadístico surge que los resultados no son concluyentes. Se destaca el importante porcentaje de patología dual en este grupo de usuarios: un 39%.

Schizophrenia is a chronic disease, prone todeterioration, the latter being variable accordingto comorbidities and treatment adherence. It generates cognitive impairment and adverselyaffects overall performance, causing deterioration of pragmatisms. Electroconvulsive therapy is awidely used therapeutic option in our countryfor acute affective and psychotic episodes. It iswell known that early detection and interventionof an acute psychotic episode —which maycorrespond to the first psychotic episode of schizophrenia— improves long-term prognosis.This study intended to show whether there is alink between early indication of electroconvulsive therapy during the first episode and timeto relapse and hospital readmission. This is ananalytical, observational, retrospective (historical cohort) study, which aims to increase theevidence in this broad research field. As a resultthere was no link between time to relapse and electro convulsive therapy in the first episode; nevertheless after a post hoc analysis resultsare not conclusive. Dual diagnosis stands outin this group and corresponds to 39%.

Male , Female , Humans , Adolescent , Young Adult , Electroconvulsive Therapy/adverse effects , Schizophrenia/therapy , Psychotic Disorders/therapy , Hospitalization/statistics & numerical data , Retrospective Studies , Prognosis , Treatment Outcome
Brasília; CONITEC; jun. 2016. ilus.
Monography in Portuguese | LILACS, BRISA | ID: biblio-837306


Contexto: Ao se delinear a revisão do Protocolo Clínico e Diretrizes Terapêuticas (PCDT) da doença de Parkinson (DP), observou-se a necessidade de garantir também o acesso ao tratamento com o antipsicótico clozapina, hoje disponível no SUS para o tratamento de esquizofrenia e transtorno esquizoafetivo. A clozapina é um antipsicótico atípico, assim denominado por não possuir quase nenhum efeito extrapiramidal, possibilitando o tratamento da psicose na DP, sem reduzir a função motora destes pacientes. No Brasil, possui registro e comercialização aprovados pela Anvisa para, dentre outras indicações, a psicose na DP[1] Pergunta: A clozapina é eficaz e segura no tratamento da psicose associada à doença de Parkinson? Evidências científicas: A maioria dos estudos selecionados tem graves problemas metodológicos, incluindo um pequeno número de participantes, avaliação contra medicamentos não considerados padrão-ouro ou comprovadamente ineficazes, como o caso da olanzapina, e delineamento aberto. A melhor evidência atualmente disponível sobre eficácia e segurança deste medicamento no tratamento de sintomas psicóticos associados à DP é baseada em dois estudos clínicos randomizados contra placebo, com tempo de seguimento relativamente curto. Todavia, poderia dar suporte à recomendação o fato de que essa situação clínica é um fator que influencia negativamente no desfecho da doença de base, com aumento da dependência, das hospitalizações em casas de saúde e da mortalidade, e ainda que não há alternativas com maior evidência de benefício e segurança. Decisão: Incorporar a clozapina para o tratamento de psicose relacionada à doença de Parkinson, conforme Protocolo Clínico do Ministério da Saude, no âmbito do Sistema Único de Saúde ­ SUS, dada pela Portaria SCTIE-MS nº 22 publicada no Diário Oficial da União (D.O.U.) nº 106, de 06 de junho de 2016.

Humans , Clozapine/therapeutic use , Parkinson Disease/complications , Parkinson Disease/therapy , Psychotic Disorders/therapy , Brazil , Cost-Benefit Analysis , Technology Assessment, Biomedical , Unified Health System
Agora (Rio J.) ; 18(2): 273-288, jul.-dez. 2015.
Article in Portuguese | LILACS | ID: lil-762064


O artigo apresenta considerações sobre a intervenção terapêutica de indivíduos refugiados no Brasil junto ao Alto Comissariado das Nações Unidas para Refugiados. Frente a situações de reassentamento solidário dos refugiados de diferentes culturas, observamos que a especificidade do trauma do exílio convoca o sujeito a exprimir no corpo o conflito decorrente de sua situação de deslocamento. O trabalho analítico entra em jogo quando outra linguagem é necessária para fazer falar o sofrimento destes indivíduos. Nossa hipótese de investigação reside em compreender como as manifestações somáticas apresentadas por tais sujeitos estão imbricadas no sintoma de desenraizamento identitário do exílio.

Psychic work of exile: the body of the resistant transition. The following paper presents considerations on therapeutic interventions with refugees in Brazil through the United Nations High Commissioner for Refugees. In face of situations of solidarity resettlement of refugees from different cultures, we have observed that the specificity of exile trauma requests one to express in the body the conflicts originating from a displacement situation. The analytical work begins when the use of a different language is necessary to have those individuals express their suffering. Our main hypothesis relines on analyzing how the somatic manifestations presented by those individuals are attached to the identity destabilization symptoms of exile.

Humans , Adult , Depression/psychology , Wounds and Injuries/psychology , Psychotic Disorders/therapy
Arq. neuropsiquiatr ; 73(10): 856-860, Oct. 2015. tab
Article in English | LILACS | ID: lil-761532


Purpose To analyze the effectiveness of electroconvulsive therapy for the management of depression and/or psychosis refractory to drug therapy in patients with Parkinson disease.Methods A retrospective study was carried out including patients treated with electroconvulsive therapy during the period between 2002 and 2013. A review of the literature was performed.Results A total of 27 patients were included. In regards to the neuropsychiatric diagnosis, 14 patients had major depression, 12 patients had both psychosis and depression, and only one patient had isolated psychosis. The mean number of electroconvulsive therapy sessions was 12 ± 2.8. After electroconvulsive therapy, all patients showed a statistically significant improvement in the Brief Psychiatric Rating scale (reduction of 52% points) and Hamilton Depression Rating Scale (reduction of 50% points) independent of the presence of psychosis, depression or both.Conclusion Electroconvulsive therapy is effective for the treatment of refractory neuropsychiatric symptoms in Parkinson’s disease.

Propósito Analisar a eficácia da eletroconvulsoterapia para o tratamento da depressão e/ou psicoses refratária ao tratamento medicamentoso em pacientes com doença de Parkinson.Métodos Um estudo retrospectivo foi realizado com pacientes tratados com a eletroconvulsoterapia, durante o período entre 2002 e 2013. Uma revisão da literatura foi realizada.Resultados Um total de 27 pacientes foram incluídos. Em relação ao diagnóstico neuropsiquiátrico, 14 pacientes tinham depressão maior, 12 pacientes tiveram tanto psicoses e depressão, e apenas um paciente tinha isolado psicoses. O número médio de sessões de eletroconvulsoterapia foi de 12 ± 2,8. Após a eletroconvulsoterapia, todos os pacientes apresentaram uma melhora estatisticamente significativa no Brief Psychiatric Rating Scale (redução de 52% de pontos) e Hamilton Depression Rating Scale (redução de 50% de pontos), independente da presença de psicose, depressão ou ambos.Conclusão Eletroconvulsoterapia é eficaz para o tratamento de sintomas neuropsiquiátricos refractários na doença de Parkinson.

Aged , Female , Humans , Male , Middle Aged , Depressive Disorder/therapy , Electroconvulsive Therapy/methods , Parkinson Disease/therapy , Psychotic Disorders/therapy , Psychiatric Status Rating Scales , Parkinson Disease/psychology , Retrospective Studies , Treatment Outcome
Article in Spanish | LILACS | ID: biblio-1392140


La prevalencia de Esquizofrenia es muy baja en la infancia y adolescencia temprana, aumentando en la adolescencia y adultez a un 1%. Se ha estimado que la prevalencia de psicosis de 0,9 en 10.000 a los 13 años y 17,6 en 10.000 a los 18 años. Los cuadros esquizofrénicos de inicio temprano y muy temprano son una variante severa del trastorno y se asocian a un mayor deterioro funcional, curso clínico más grave y peor evolución. Todo esto determina la necesidad de implementar tratamientos multimodales tempranos y eficaces, así como estrategias preventivas en los grupos de mayor riesgo. El tratamiento farmacológico cuenta con mayores evidencias de efectividad en este cuadro y otorga notables beneficios a los pacientes, sin embargo se requiere mayor investigación a largo plazo respecto a los efectos adversos secundarios, su impacto en individuos en desarrollo y la eficacia de estos agentes. Estos avances permitirán al clínico establecer un justo balance costo/beneficio de su uso en población infantojuvenil.

The prevalence of schizophrenia is very low during childhood and early adolescence, increasing later in adolescence and adulthood to 1%. It has been established that the prevalence of psychosis is 0.9/10000 at 13 years of age and 17.6/10000 at 18 years of age. Early and very early onset schizophrenia are a severe form of this disorder, and are associated to a larger disability, more severe form of the disease and worse prognosis. These factors determine the need of implementing treatments that are multimodal, early and effective, as well as preventive strategies in high risk groups. The pharmacological treatment of schizophrenia has evidence of effectiveness and gives patients important benefits, however, more long term research is needed regarding its side effects, its impact on the developing brain and its effectiveness. These facts would help the psychiatrist to establish the value, risks and benefits of the use of drugs in children and adolescents.

Humans , Child , Adolescent , Psychotic Disorders/therapy , Schizophrenia/therapy , Psychotic Disorders/prevention & control , Psychotic Disorders/drug therapy , Schizophrenia/prevention & control , Schizophrenia/drug therapy , Antipsychotic Agents/therapeutic use