Sobre la llamada revolución psicofarmacológica: el descubrimiento de la clorpromazina y la gestión de la locura / On the so-called psychopharmacological revolution: the discovery of chlorpromazine and the management of madness

Resumen El artículo analiza la fragilidad y los problemas existentes en la tesis que afirma la existencia de una verdadera revolución en el campo de la psiquiatría biológica, que se habría operado entre 1952 y 1954, con el descubrimiento de la clorpromazina. Para eso se analizan los discursos y las estrategias que posibilitaron el descubrimiento de esta droga que servirá de modelo para la producción de nuevos psicofármacos. Se intenta entender, también, qué es lo que se considera como "eficacia terapéutica" de la droga.

Abstract This article analyzes the shortcomings and problems of the thesis that a true revolution took place in the field of biological psychiatry between 1952 and 1954 thanks to the discovery of chlorpromazine. To do so, it analyzes the discourses and strategies that led to the discovery of this drug, which became a model for the production of new psychopharmaceuticals. It seeks to understand, also, what is meant by "therapeutic efficacy" with regard to this drug.

Endoplasmic Reticulum Stress: Implications for Neuropsychiatric Disorders / 전남의대학술지

The Endoplasmic reticulum (ER), an indispensable sub-cellular component of the eukaryotic cell carries out essential functions, is critical to the survival of the organism. The chaperone proteins and the folding enzymes which are multi-domain ER effectors carry out 3-dimensional conformation of nascent polypeptides and check misfolded protein aggregation, easing the exit of functional proteins from the ER. Diverse conditions, for instance redox imbalance, alterations in ionic calcium levels, and inflammatory signaling can perturb the functioning of the ER, leading to a build-up of unfolded or misfolded proteins in the lumen. This results in ER stress, and aiming to reinstate protein homeostasis, a well conserved reaction called the unfolded protein response (UPR) is elicited. Equally, in protracted cellular stress or inadequate compensatory reaction, UPR pathway leads to cell loss. Dysfunctional ER mechanisms are responsible for neuronal degeneration in numerous human diseases, for instance Alzheimer's, Parkinson's and Huntington's diseases. In addition, mounting proof indicates that ER stress is incriminated in psychiatric diseases like major depressive disorder, bipolar disorder, and schizophrenia. Accumulating evidence suggests that pharmacological agents regulating the working of ER may have a role in diminishing advancing neuronal dysfunction in neuropsychiatric disorders. Here, new findings are examined which link the foremost mechanisms connecting ER stress and cell homeostasis. Furthermore, a supposed new pathogenic model of major neuropsychiatry disorders is provided, with ER stress proposed as the pivotal step in disease development.

Psiquiatria Biológica e Psicofarmacologia: a formação de uma rede tecnocientífica / Biological Psychiatry and Psychopharmacology: a techno-scientific network in debate

Resumo A Psiquiatria Biológica emerge nos anos de 1980, nos Estados Unidos, com a publicação do DSM-III (Diagnostic and Statistical Manual of Mental Disorders). Este manual tem a proposta de ser a-teórico e apresentar descrições objetivas dos, então, chamados "distúrbios mentais" a partir de um critério classificatório que não inclui discussões acerca da etiologia destes "distúrbios". Isto implica que, apesar da denominação biológica conferida a esta vertente psiquiátrica, não houve nenhuma descoberta acerca da etiologia biológica destes distúrbios que justificasse sua denominação e seu estrondoso sucesso mundial. Neste artigo, pretendemos analisar as modificações ocorridas na psiquiatria norte-americana a partir da introdução do DSM-III, dos primeiros medicamentos psicotrópicos e o subsequente papel desempenhado pela indústria farmacêutica neste processo. Desse modo, o que está em análise neste artigo é que, ao se apropriar dos medicamentos psicotrópicos como primeira opção terapêutica, a Psiquiatria Biológica cria uma aliança com a indústria farmacêutica que a insere numa rede tecnocientífica que dificulta saber os limites entre Psiquiatria Biológica, Psicofarmacologia e Indústria farmacêutica.

Abstract Biological Psychiatry emerged in the 1980s in the United States with the publication of DSM-III (Diagnostic and Statistical Manual of Mental Disorders). This manual intends to be a-theoretical and to provide objective descriptions of "mental disorders" by using diagnostic criteria that do not include discussions about the aetiology of these "disorders". Hence and despite the "biological" label conferred to this branch of psychiatry, there is no explicit concern to ascertain the possible biological origins of "mental disorders" in DSM-III. In this paper we intend to examine the modifications in North American Psychiatry following the introduction of the first psychotropic medications and the subsequent role played by the pharmaceutical industry in this process. Thus, what is under analysis in our article is that, by appropriating psychotropic drugs as the first therapeutic option, Biological Psychiatry creates an alliance with the pharmaceutical industry that inserts it into a technoscientific network that makes it difficult to know the limits between Biological Psychiatry, Psychopharmacology and the Pharmaceutical industry.

Frontal Lobe Dysfunction in a Depressed Patient Who Survived a Suicide Attempt by Jumping from the Bridge on the Han River

Suicide attempts at the Han river are rapidly increasing, which are 4.11 times from 2005 to 2015, whereas the rate of completed suicide in South Korea increased 1.07 times during the same period. However, few studies have been conducted on the issue because many suicide attempters were seriously injured after a fall in the Han river. We present a case of a patient with major depressive disorder (MDD) who attempted suicide and minimally injured after jumping from the bridge at the Han river. We could assess his psychological and neurocognitive functions before and immediately after his attempt. From this case, we can identify that higher cognitive aspect of executive dysfunction, especially in the frontal domain of selective attention and inhibition, may be associated with his suicide attempt. In conclusion, we suggest psychiatric treatments for cognitive impulsiveness and safety barriers at the bridge to prevent suicide attempts of patients with MDD.

Development of a Diverse Learning Experience for Diverse Psychiatry Resident Needs: A Four-Year Biological Psychiatry Curriculum Incorporating Principles of Neurobiology, Psychopharmacology, and Evidence-Based Practice

OBJECTIVE: A clinically relevant approach to patient care grounded in neurobiological constructs and evidence based practice which emphasizes a relevant psychopharmacology is needed to optimally train psychiatry residents. METHODS: We implemented a biological psychiatry course that now incorporates neurobiology, psychopharmacology, and evidence-based practice in conjunction with a Research Domain Criteria (RDoC) perspective. A survey launched prior to course implementation and following each class session, served as the outcome metric of residents' attitudes toward the new curriculum and followed a baseline attitudinal survey designed to evaluate the program. RESULTS: Greater than 90% of the psychiatry residents at Duke University who took the attitudinal survey agreed or strongly agreed with needing a course that helped them develop an understanding of neurobiology, psychopharmacology, and evidence-based practice concepts. Most residents also indicated a less than adequate understanding of the neurobiology and psychopharmacology of psychiatric disorders prior to sessions. CONCLUSION: Our biological psychiatry curriculum was associated with enthusiasm among residents regarding the incorporation of neurobiology, psychopharmacology, and evidence-based practice into course topics and discussions. A biological psychiatry curriculum with integrated neurobiology and psychopharmacology built on an evidence base approach is possible, well-received, and needed in training of future psychiatrists.

Psychiatry, bio-epistemes and the making of adolescence in southern Brazil / Psiquiatria, bioepistemes e a formação da adolescência no sul do Brasil

Abstract Drawing on an ethnographic study in southern Brazil, this paper explores how therapists’ attempts to “resist bioreductionist” pharmaceutical use both succeed and crumble. Using a comparative framing, I show that pharmaceuticalization can become an anesthetizing “lid” that interacts with young people’s polarizing micro-politics and is an outgrowth of multi-generational medico-political family histories. This lid, however, is not air-tight and exceptionalities are born out of these very same histories. I argue that both pharmaceuticalization and exceptions to it emerge not through “resistance” to biopsychiatric logics but from the transformative possibilities that the patterned co-production of social, political, and psychiatric life affords.

Resumo Baseado em um estudo etnográfico no sul do Brasil, este artigo explora tentativas frustradas e bem-sucedidas de terapeutas em uma “resistência biorreducionista” a medicamentos. Comparativamente, busco mostrar que a farmaceuticalização pode se tornar uma “rolha” entorpecedora que interage com a micropolítica polarizante dos jovens, e é fruto de histórias familiares médico-políticas em várias gerações. Contudo, essa rolha não está bem vedada, dando margem a exceções nessas histórias. Acredito que a farmaceuticalização e as exceções não surjam da “resistência” à lógica biopsiquiátrica, mas sim de possibilidades transformativas na coprodução padronizada da vida social, política e psiquiátrica.

Research on Psychiatric Treatment by Psychiatrists of Chosun-Governor Hospital and Keijo Imperial University Hospital in Korea during Japanese Colonial Rule / 신경정신의학

This review describes the types of psychiatric treatment studied during the Japanese colonial period of 1910–1945 in Korea, known at the time as Chosun. Twenty-nine research papers and abstracts on psychiatric treatment were reviewed, which were published in the Shinkeigaku-zassi (Neurologia), the Seishin-shinkei-gaku zassi (Psychiatria Et Neurologia Japonica) and the Journal of Chosun Medical Association, by faculty members of the department of neuropsychiatry, Chosun-Governor Hospital and Keijo (Seoul) Imperial University School of Medicine. The major research area was biological psychiatry and biological treatment, as Japanese pioneers in psychiatry at that time had introduced German psychiatry into Japan. Professor Kubo published the most papers, followed by Dr. Hattori, Dr. Hikari, and Professor Suits. In Chosun-Governor Hospital, research on prolonged sleep therapy was an active field. In the Imperial University Hospital, malarial fever therapy, sulphur-induced fever therapy, and insulin shock treatment were the most frequent research topics. Some were tried for the first time in the Japanese Empire, which reflected the pioneering position of the university. These achievements are attributed to Professor Kubo. Six papers on psychotherapy were published. Among them, two papers were on persuasion therapy, three papers were case reports of psychoanalytic therapy, and one paper on Freud. However, this psychoanalytic therapy research seemed to be limited trials conducted following literal guidance, and no further development was noted. Generally, research was characterized by simple design, small numbers of subjects, lack of objective evaluation method, lack of statistical treatment, and especially lack of ethical consideration comparing with today's standard.

A determinação biológica dos transtornos mentais: uma discussão a partir de teses neurocientíficas recentes / La determinación biológica de los trastornos mentales: una discusión a partir de tesis neurocientíficas recientes / Biological determination of mental disorders: a discussion based on recent hypotheses from neuroscience

Resumo: A compreensão dos processos de formação dos transtornos mentais vem se mostrando desafiadora desde a fundação do campo psiquiátrico. O desenvolvimento das neurociências proporcionou novo fôlego à expectativa de encontrar estritamente no funcionamento biológico a explicação para o surgimento dos transtornos mentais. No entanto, tal objetivo não vem sendo alcançado com a esperada facilidade, de modo que novas hipóteses começam a se destacar nas pesquisas neurocientíficas. Neste artigo, identificamos as noções de epigenética, neurodesenvolvimento e plasticidade como os principais indicativos de um novo modo de compreender a biologia dos fenômenos mentais. A complexidade genética, o papel formativo do ambiente e as variações que caracterizam a vulnerabilidade implicam importantes modificações nas principais teses sobre a determinação biológica dos transtornos mentais, sugerindo uma reconfiguração dos limites entre o "social" e o "biológico" nas pesquisas em neurociências.

Resumen: La comprensión de los procesos de formación de los trastornos mentales ha representado un desafio desde que nació el campo de la psiquiatria. El desarrollo de las neurociencias proporcionó un nuevo aliento a la expectativa de encontrar, estrictamente en el funcionamiento biológico, la explicación para el surgimiento de los trastornos mentales. No obstante, tal objetivo no se alcanza con la esperada facilidad, de modo que nuevas hipótesis comienzan a destacarse en las investigaciones neurocientíficas. En este artículo, identificamos las nociones de epigenética, neurodesarrollo y plasticidad como los principales indicativos de un nuevo modo de comprender la biología de los fenómenos mentales. La complejidad genética, el papel formativo del ambiente y las variaciones que caracterizan la vulnerabilidad implican importantes modificaciones en las principales tesis sobre la determinación biológica de los trastornos mentales, sugiriendo una reconfiguración de los límites entre lo "social" y lo "biológico" en las investigaciones en neurociencias.

Abstract: Understanding the processes involved in the development of mental disorders has proven challenging ever since psychiatry was founded as a field. Neuroscience has provided new expectations that an explanation will be found for the development of mental disorders based on biological functioning alone. However, such a goal has not been that easy to achieve, and new hypotheses have begun to appear in neuroscience research. In this article we identify epigenetics, neurodevelopment, and plasticity as the principal avenues for a new understanding of the biology of mental phenomena. Genetic complexity, the environment's formative role, and variations in vulnerability involve important changes in the principal hypotheses on biological determination of mental disorders, suggesting a reconfiguration of the limits between the "social" and the "biological" in neuroscience research.

A análise do comportamento no contexto do estudo evolucionista do comportamento social e da cultura / Behavior analysis in the context of the evolutionary study of social behavior and culture / El análisis de la conducta en el contexto del estudio evolucionista de la conducta social y cultura

A Análise do Comportamento pode ser entendida como uma perspectiva voltada para o estudo evolucionista do comportamento social e da cultura. A caracterização do comportamento social nessa área e pesquisas recentes sobre metacontingências e macrocontingências são contribuições nesse sentido. Outras perspectivas evolucionistas mais próximas da Biologia também têm produzido diversas teorias e resultados sobre o tema, mas sem dialogar com a Análise do Comportamento, que, por sua vez, pouco debate as contribuições dessas outras perspectivas. Este trabalho destaca possíveis convergências e complementaridades entre a Análise do Comportamento e estudos sobre aprendizagem social em animais não-humanos, construção de nicho e evolução cultural, visando estimular o diálogo entre pesquisadores de diferentes perspectivas evolucionistas que estudam comportamento social e cultura.

Behavior Analysis may be regarded as a perspective that tackles the evolutionary study of social behavior and culture. Social behavior's characterization in this field and recent researches on metacontingencies and macrocontingencies are contributions in this direction. Other evolutionary perspectives, closest to Biology, have also produced theories and evidences on this theme, but without dialogue with Behavior Analysis, which, by its turn, discusses little this other perspectives' contributions. This paper highlights possible convergences and complementarities between Behavior Analysis and studies on social learning in nonhuman animals, niche construction, and cultural evolution, aiming to enhance dialogues among researchers from different evolutionary perspectives studying social behavior and culture.

El Análisis de la Conducta puede ser vista desde una perspectiva enfocada al estudio evolucionista de la conducta social y cultura. La caracterización de la conducta social en esa área y estudios recientes sobre metacontingencias y macrocontingencias son algunas de sus contribuciones. Otras perspectivas evolucionistas aproximadas a la Biología también han producido diversas teorías y resultados sobre el tema, pero sin interactuar con el Análisis de la Conducta, que al mismo tiempo, poco debata las contribuciones de esas otras perspectivas. Este trabajo destaca posibles convergencias e complementaciones entre el Análisis de la Conducta y los estudios sobre aprendizaje social en animales no humanos, construcción de nicho y evolución cultural, con el objetivo de estimular el dialogo entre investigadores de diferentes perspectivas evolucionistas que estudian la conducta social y la cultura.

Research by Psychiatrists of Chosun Chongdokbu Hospital and Keijo Imperial University in Korea during Japanese Colonial Rule / 신경정신의학

Eighty-three of 114 original articles and abstracts of research published by neuropsychiatrists of Chosun Chongdokbu Hospital (the Japanese colonial government hospital in Korea) and Keijo (Seoul) Imperial University Hospital during the Japanese colonial period (1910-1945) in journals including Shinkeigaku-zassi (Neurologia), Seishin-shinkei-gaku zassi (Psychiatria Et Neurologia Japonica), and The Journal of Chosun (Korea) Medical Association were reviewed. Most articles were on clinical research based on descriptive and biological psychiatry while only 4 articles were on dynamic psychiatry, probably because Japanese pioneers in psychiatry had introduced German psychiatry into Japan during the 1880s. The first paper was written by Dr. Shim Ho-sub. Professor Kubo of Keijo (Seoul) Imperial University published most articles, followed by Dr. Hikari, Dr. Hattori, and Dr. Sugihara. There were more articles on symptomatic psychosis and morphine addiction, followed by general paralysis, schizophrenia, neurological diseases, narcolepsy, epilepsy, and neurasthenia. The meaningful articles even for today were comparative studies between Japanese and Koreans and articles on opioid use disorder in Korea. Authors reported a markedly lower rate of psychotic inpatients in the population of Koreans compared with Japanese. Japanese researchers argued that, because of simpleness in social life in Korea and less violence or excitement in symptoms, Korean mental patients could be cared for by family or members of the community, or be treated by shamanism rather than bringing them to a public mental hospital, and poverty also prohibited hospital care. Finding of higher ratio of schizophrenia to manic-depressive psychosis among Koreans than Japanese was discussed in relation to delayed cultural development of Korea compared to Japan. In addition, traditional customs prohibiting marriage between relatives in Korea was related to low prevalence of manic-depressive psychosis, local endemic malaria was related to low prevalence of general paresis, and poor general hygiene was related to high prevalence of epilepsy. Unclear (undifferentiated) form of psychotic symptoms including hallucination and delusion was reported in more Koreans than Japanese. Also Korean patients showed a more atypical form in diagnosis. Authors added that they had found no culture-specific mental illness in Korea. However, no Korean psychiatrists were included as author in such comparative studies. Comparative studies on constitution between Koreans and Japanese mental patients and prisoners were also unique. However, no Korean psychiatrists participated in such comparative studies. In studies on morphine addiction in Koreans, Japanese researchers argued that such studies were necessary to prevent introduction of morphine-related criminal phenomena to Japan. Meanwhile, Dr. Kubo had left a notion on adaptation problems of Japanese living in the foreign country, Korea. Nevertheless he reported nothing about psychosocial aspects of mental illness in relation to political, cultural, and economic difficulties Koreans were experiencing under the colonial rule of Japan. These general trends of studies based on German biological and descriptive psychiatry and policies of colonial government to isolate "dangerous" mental patients in hospital appeared to reflect colonial or ethnopsychiatry of those days. These policy and research trends seem to have worsened stigma attached to mental disorders. Japanese tradition of psychiatric research was discontinued by return home of Japanese scholars with the end of WWII and colonial rule.

Considerações sobre os movimentos de medicalização da vida / Considerations on life's medicalization movements / Consideraciones sobre los movimientos de medicalización de la vida

A ideia de que problemas cotidianos são diagnosticáveis e tratáveis pela medicina é antiga e ao mesmo tempo comum na atualidade, na qual habituou-se entender e explicar a vida psíquica e as condutas éticas pelo conhecimento da materialidade corporal. Este artigo realiza uma análise sobre a relação entre o saber biomédico e pedagógico na construção da concepção de infância normal/anormal. Nas duas últimas décadas, o investimento em pesquisas que investigam o funcionamento cerebral tem ampliado significativamente o conhecimento científico das interações entre o físico e o psicológico e sustenta fortemente a cultura somática. Nesse processo, diagnósticos psiquiátricos se tornaram dispositivos importantes na explicação e intervenção dos processos de escolarização considerados problemáticos. No percurso teórico investigado, destaca-se como a combinação entre as ciências biomédicas e a educação marcou e tem marcado as práticas de intervenção sobre os problemas enfrentados pelas crianças ao ingressarem na escola.

The idea that everyday problems are diagnosable and treatable by medicine is ancient as well as common today, when we are used to understanding and explaining the psyche and ethical conduct by knowing the materiality of the body. In the last two decades, investment in research investigating brain functioning has significantly expanded scientific knowledge of physiological and psychological interactions, which strongly support somatic culture. Thus, psychiatric diagnoses have become important tools in the explanation and intervention of schooling procedures considered "problematic". The combination of biomedical sciences and education has had an impact on intervention practices regarding the problems faced by children when they enter school. We are going to take a diachronic look at the relationship between biomedical knowledge and pedagogy that created the concept of normal/abnormal childhood.

La idea de que problemas cotidianos son diagnosticables y tratables por la medicina é antigua y al mismo tiempo común en la actualidad, donde se habituó a entender y explicar la vida psíquica y de las conductas éticas por el conocimiento de la materialidad corporal. Este artículo realiza un análisis sobre la relación entre el saber biomédico y pedagógico en la construcción de la concepción de infancia normal/anormal. En las dos últimas décadas, el patrocinio de investigaciones que se interesan por el funcionamiento cerebral, ha ampliado significativamente el conocimiento científico de las interacciones entre lo físico y lo psicológico y sustenta fuertemente la cultura somática. En este proceso, diagnósticos psiquiátricos se convirtieron en dispositivos importantes para la explicación e intervención de los procesos de escolarización considerados problemáticos. En el recorrido teórico investigado, se destaca como la combinación entre las ciencias biomédicas y la educación ha marcado las prácticas de intervención sobre los problemas enfrentados por los niños al ingresar a las instituciones educativas.

La Revista de Neuro-Psiquiatría y los primeros tratamientos biológicos en la psiquiatría mundial / The Revista de Neuro-Psiquiatría and the first biological treatments in world psychiatry

A lo largo de las primeras décadas de su existencia, la Revista de Neuro-Psiquiatría fue testigo y fuente efectiva de difusión de los trascendentales avances en la terapéutica psiquiátrica que se dieron entre los años de 1930 a 1960, particularmente en el campo de los tratamientos biológicos. Estos avances condujeron a que la psiquiatría, aun cuando no sin tropiezos u obstáculos, fuera considerada, con toda justicia, como una especialidad médica.

During the first decades of its existence, the Revista de Neuro-Psiquiatría became both a witness and an effective source of dissemination of the significant advances in psychiatric treatment that occurred between the 1930s and 1960s, particularly in the area of biological treatments. These advances led psychiatry, even though not without obstacles or setbacks, to being considered, in all fairness, as a medical specialty.

Una visiíon personal de la psiquiatría actual, con ánfasis en el papel de la Psiquiatría Biológica / A personal view of psychiatry today, with emphasis on the role of Biological Psychiatry

A punto de partida de un examen A punto de partida de un examen panorámico de la psiquiatría contemporánea, se pasa revista a diversos periodos de la historia de nuestra disciplina con énfasis en su contribución epistemológica a lo largo de los últimos tres siglos. Se presta particular atención a recientes debates nosológicos, al rol del diagnóstico y clasificaciones para luego centrarse en el crucialmente dominante papel de la psiquiatría biológica en el momento actual. Los avancesde la bioquímica y fisiología cerebral y de la genética y resultados de investigaciones neurocientíficas y de neuro-imágenes abren la puerta a explicaciones causales, implicaciones terapéuticas y preventivas representadas por proyectos internacionales, uno de cuyos objetivos fundamentales es la identificación de marcadores biológicosde enfermedades mentales. Se postula, como ejemplo de estos avances, la hipótesis de que la psicoterapia misma tiene repercusiones notables en la fisiología y la genética cerebrales

After a panoramic review of contemporary psychiatry, several periods of its history are examined with emphasis on their epistemological contributions throughout the last three centuries. Particular attention is paid to recent nosological debates, to the role of diagnosis and classifications to, finally, center on the nowadays crucially dominant role of biological psychiatry at the present time. Advances in brain biochemistry and physiology, genetics and the results of neuroscientific and neuro-imaging investigations open the door to causal explanations, therapeutic and preventive implications represented by international projects, one of whose fundamental objectives is the identification of biological markers of mental disorders. As an example of these advances, the hypothesis of notable repercussions of psychotherapy on brain physiology and genetics is presented.

Trends in Scientific Literature on Atypical Antipsychotics in South Korea: A Bibliometric Study

OBJECTIVE: We have carried out a bibliometric study on the scientific publications in relation to atypical or second-generation antipsychotic drugs (SGAs) in South Korea. METHODS: With the EMBASE and MEDLINE databases, we selected those publications made in South Korea whose title included the descriptors atypic* (atypical*) antipsychotic*, second-generation antipsychotic*, clozapine, risperidone, olanzapine, ziprasidone, quetiapine, sertindole, aripiprazole, paliperidone, amisulpride, zotepine, asenapine, iloperidone, lurasidone, perospirone and blonanserin. We applied some bibliometric indicators of paper production and dispersion with Price's law and Bradford's law, respectively. We also calculated the participation index (PI) of the different countries, and correlated the bibliometric data with some social and health data from Korea (such as total per capita expenditure on health and gross domestic expenditure on research and development). RESULTS: We collected 326 original papers published between 1993 and 2011. Our results state fulfilment of fulfilled Price's law, with scientific production on SGAs showing exponential growth (correlation coefficient r=0.8978, as against an r=0.8149 after linear adjustment). The most widely studied drugs were risperidone (91 papers), aripiprazole (77), olanzapine (53), and clozapine (43). Division into Bradford zones yielded a nucleus occupied by the Progress in Neuro-Psychopharmacology and Biological Psychiatry (36 articles). A total of 86 different journals were published, with 4 of the first 10 used journals having an impact factor being greater than 4. CONCLUSION: The publications on SGAs in South Korea have undergone exponential growth over the studied period, without evidence of reaching a saturation point.

Manifestaciones psiquiátricas en epilepsia / Psychiatric manifestations in epilepsy

La Organización Mundial de la Salud (OMS) y la Liga Internacional contra la Epilepsia (ILAE), la definen como una afección neurológica crónica, recurrente y repetitiva de fenómenos paroxíticos, ocasionados por descargas neuronales desorganizadas y excesivas. La epilepsia es la condición neurológica más seria y más común. Se estima que la prevalencia actual del trastorno es de 5-10/1000 personas; excluyendo a las convulsiones febriles, los casos de una crisis única y los casos inactivos. Sus causas pueden ser muy diversas y sus manfiestaciones muy variadas, de esta manera su sintomatología se ubica dentro de un polimorfismo acentuado. Dentro de las posibles manfiestaciones clínicas que pueden presentarse, se encuentran aquellas en las que predominan las alteraciones conductuales. El objetivo de la presente revisión es el poder dar cuenta de la presentación de los síntomas psiquiátricos en epilepsia, el impacto de estos y la importancia del manejo interdisciplinario con neurólogos. El reconocimiento de estos cuadros resulta de suma importancia en la práctica de la interconsulta, dada la implicancia de los profesionales de salud mental en el manejo sintomático de dichas manifestaciones.

The World Health Organization (WHO) and the International League Against Epilepsy (ILAE) define epilepsy as a chronic neurological affection, characterized by recurrent and repetitive paroxysmal phenomena generated by disorganized and excessive neuronal discharges. Epilepsy is the most serious and frequent neurological condition. It is estimated that its current prevalence is 5-10/1,000 people; excluding febrile seizures, single seizures and inactive cases. Because its causes and manifestations can be very varied, its symptomatology is placed with in a marked polymorphism. Among the possible clinical manifestations that may appear are those in which behavioral alterations prevail. The aim of this review is to describe the onset of psychiatric symptoms in epilepsy, their impact and the importance of interdisciplinary management of this disease with Neurologists. Identifying these clincal symptoms is of the utmost importance, given the involvement of healthcare profesionals in the symptomatic treatment of those manifestations.

Biological behavior and disease pattern of carcinoma gallbladder shown on 64-slice CT scanner: A hospital-based retrospective observational study and our experience.

Purpose: The aim of this diagnostic observational study was to assess the spread and biological behavior of gallbladder cancer using 64-slice computerized tomography (CT) scanner in this particular geographic belt (eastern Uttar Pradesh, western Bihar, and northern Madhya Pradesh provinces of North India). Indians are ethnically and culturally different from their Western counterparts among whom the incidence of this disease is comparatively low. Subjects and Methods: After systemic examination, all patients (87) were subjected to ultrasonographic examination. All cases were histopathologically proven. Confirmed cases were subjected to volumetric CT examination of abdomen and pelvis, plain, post contrast and delayed phase. Results: Majority of the cases were adenocarcinoma. There was female preponderance with majority belonging to fifth and sixth decades. Commonest presentation was diffuse, irregular, enhancing wall thickening in 49.4%. Majority had invasion of liver parenchyma (74.7%). Cholelithiasis was seen in 48.3% cases. Invasion of biliary radicals was high (13.8-18.4%). Eleven cases had invasion of portal vein and tumor thrombus, with hepatic artery invasion in one case. In two cases, both hepatic artery and portal vein invasion was seen. Portal and peripancreatic nodal metastasis was seen in 58.5%. Distant metastasis was reported. Conclusion: Few studies involving the Indian population have attempted to use multi-row detector CT to define the biological behavior of carcinoma gallbladder. The opinion whether the pathology is operable or non-operable can reasonably be given. This large-scale, single-center study gives insight about the epidemiology and biological behavior of carcinoma gallbladder.

El hombre: objetivo de la psiquiatrí­a y sus aspectos antropológicos básicos / Human being: an objective of psychiatry and the basic anthropological aspects

La psiquiatría precisa de otros panoramas epistemológicos de observación, fuera de su esquema biomédico, para poder comprender al individuo en su totalidad. De ahí parte al encuentro de la antropología médica, que brinda el conocimiento científico sobre el hombre como sujeto sano, enfermable, enfermo, sanable y mortal, pero desde una nueva configuración: la antropsiquiatría, la cual permite ir más allá de la propia enfermedad, es decir, trascender hasta su esfera de persona y entender la verdad de una existencia humana concreta, que se evidencia en su vida física, psí­quica, moral, espiritual y cultural. Esta caracterización epistemológica y praxiológica justifica la necesidad de elaborar un modelo de formación profesional antropsiquiátrica en la especialización de psiquiatría.

Psychiatry requires some other epistemological panoramas of observation, out of its biomedical diagram, in order to comprehend the individual completely. That is why psychiatry meets medical anthropology, which provides the scientific knowledge about the human being as a healthy, sick, and mortal subject who may get ill or cured starting from a new configuration: anthropsychiatry. It allows going beyond the disease, that is to say, transcending up to its sphere of person and understanding the truth of a concrete human existence, which is shown in the physical, psychical, moral, spiritual, and cultural life. This epistemological and praxiological characterization justifies the need to develop an anthropsychiatric professional training model for psychiatry specialization.

O imáginario do trabalho em saúde mental: elementos para discussão / The mental health work imaginary: elements for discussion

Este artigo tem como objetivo identificar os elementos imaginários que recobrem o exercício do trabalho em saúde mental em um Centro de Atenção Psicossocial (CAPS), examinando também de que maneira esse imaginário traz impactos para a relação do profissional com seu trabalho. Com o intuito de atingir esse objetivo, utilizou-se do referencial teórico da psicossociologia francesa contemporânea e o discurso de profissionais da área, a partir dos quais emergiram representações sobre o exercício do trabalho e suas vivências organizacionais. Tal investigação extraiu seu material empírico de uma pesquisa de campo realizada no ano de 2007, em um CAPS do município do Rio de Janeiro, Brasil. Nesta análise, o imaginário do trabalho em saúde mental surge ancorado em um ideal de mudança positivado, pautado principalmente na reforma psiquiátrica, processo apropriado subjetivamente por meio da formulação de três grandes núcleos de representações: regime/local de assistência, relação assistencial e relação sociedade/loucura. Detectou-se igualmente no imaginário uma imagem de fragilidade/incerteza, sobre os resultados do trabalho e a condução dos casos, que derivou em uma relação com o trabalho marcada pelo rebaixamento de expectativas. Na coexistência e na alquimia que mistura esses elementos no cotidiano da organização, surge uma inesperada composição que busca assegurar a própria continuidade do trabalho.

This article aims to identify the imaginary elements that recover the exercise of the work in mental health in a Centro de Atenção Psicossocial (CAPS), examining also how this imaginary brings impacts to the relation between the professional and his work. To fulfill this objective, it was used the theoretical basis of the French school of psychosociology and the professionals' speech of the area, from which surfaced representations of the exercise of the work and their organizational experiences. This investigation extracted its empirical material from a field research carried out in 2007 within a CAPS of Rio de Janeiro, Brazil. In this analysis, the imaginary of the work in mental health appears anchored in an ideal of change made positive, ruled principally in the psychiatric reform, process appropriated subjectively through the formulation of three great nucleuses of representations: type/place of assistance, assistencial relation and society/madness relation. An image of fragility/uncertainty was equally detected in the imaginary of the results of the work and conducti on of the cases, which causes a relation with the work marked by the reduction of expectations. In the coexistence and in the alchemy that mix these elements, appears an unexpected composition that tries to secure the continuity of the work.