Las perplejidades éticas del Rey Ludwig II de Baviera: locura, extravagancia y profesión médica / The ethical perplexities of king Ludwig II of Bavaria: madness, extravagance and medical profession / As perplexidades éticas do Rei Ludwig II da Baviera: loucura, extravagancia e profissão médica

1. Bernhard von Gudden diagnosticó el trastorno del Rey Ludwig II de Baviera como "paranoia" (locura), aunque Ludwig nunca fue personalmente evaluado por este experto psiquiatra, diagnóstico que usó el gobierno bávaro para justificar la remoción de Ludwig del poder. 2. Su conducta progresivamente anormal; sus proyectos múltiples de construcción, por los cuales incurrió en fuertes deudas; su convicción de descender directamente de los Borbones gracias al "bautismo"; su desenfrenada vida homosexual, todo constituyó la base para el diagnóstico psiquiátrico. 3. De acuerdo con los criterios actuales de la psiquiatría, Ludwig mostró rasgos de un trastorno de personalidad esquizotípico, unido a un sindrome orbitofrontal, y un modo de existencia extravagante. 4. Bernhard von Gudden fundamentó su diagnóstico y peritaje psiquiátricos siguiendo los principios éticos de beneficencia y primum non nocere, "ayudar, al menos no dañar".

Abstract: Bernhard von Guden diagnosed the Bavarian King Ludwig II with "paranoia" (madness), although Ludwig was not personally evaluated by this expert psychiatrist, a diagnosis that the Bavarian government used to justify removing Ludwig from power. 2. His increasingly abnormal behavior, his multiply building projects, for which he incurred much debt, his conviction that he descended from the Bourbons through "baptism", his unbridled homosexual life, together formed the basis for the psychiatrist´s diagnosis. 3. According to modern criteria of psychiatry Ludwig displayed traits for schizotypal personality disorder together with an orbitofrontal syndrome, and an extravagance way of existence. 4.Bernhard von Gudden based his psychiatric diagnosis and expertise following the ethical principles of beneficence and primum non nocere, "to help, at least not to harm"

Resumo: 1. Bernhard von Gudden diagnosticou o transtorno do Rei Ludwig II da Baviera como "paranoia" (loucura), ainda que Ludwig nunca tenha sido pessoalmente avaliado por este especialista psiquiatra, diagnóstico que o governo bávaro usou para justificar a remoção de Ludwig do poder. 2. Sua conduta progressivamente anormal; seus projetos múltiplos de construção, pelos quais incorreu em fortes dívidas; sua convicção de descender diretamente dos Bourbons graças ao "batismo"; sua desenfreada vida homossexual, tudo constituiu a base para o diagnóstico psiquiátrico. 3. De acordo com os critérios atuais da psiquiatria, Ludwig mostrou traços de um transtorno de personalidade esquizotípico, unido a uma síndrome órbito-frontal e um modo de existência extravagante. 4. Bernhard von Gudden fundamentou seu diagnóstico e perícia psiquiátrica seguindo os princípios éticos de beneficência e primum non nocere, "ajudar, ao menos não prejudicar".

A dimensional measure of schizotypy: cross-cultural adaptation and validation of the Oxford-Liverpool Inventory of Feelings and Experiences short version for Brazilian Portuguese (O-LIFE-S)

Abstract Introduction The Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) is a widely-used scale, and the first to include a dimensional approach to understanding schizotypy. Objective To adapt the short version of the O-LIFE (O-LIFE-S) into Brazilian Portuguese. Method a) Two independent bilingual professionals translated the original instrument into Brazilian Portuguese; b) a third bilingual professional summarized the two translations; c) a fourth bilingual expert translated the Portuguese version back into English; d) this back-translation was adjusted by a committee of psychology experts; e) a pilot study was conducted with 10 participants from the general population. Results O-LIFE-S was considered ready to be used in a formal validation study in Brazil. Conclusion The scale appears to cover the dimensional approach to schizotypy. However, a future validation study needs to be conducted to determine the internal consistency and reliability of the Brazilian Portuguese version of the O-LIFE-S .

Relationship between religiosity domains and traits from borderline and schizotypal personality disorders in a Brazilian community sample

Abstract Introduction Research suggests that religiosity domains are associated with mental health constructs. Some studies have focused on the relationship between religiosity and personality disorders. Objective To investigate the relationship between religiosity domains and pathological traits of the borderline (BPD) and schizotypal (SZPD) personality disorders. Methods Participants were 751 adults from the general population who answered the Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB-E), the Attachment to God Inventory (AGI), and factors of the Dimensional Clinical Personality Inventory 2 (IDCP-2). Pearson's correlation and regression analysis were conducted with pathological traits as independent variables and religiosity domains as dependent variables. Results Correlation and regression analyses indicated slightly higher associations between religiosity domain and BPD traits in comparison to SZPD traits. BPD traits showed higher associations with the hope immanent, forgiveness and hope transcendent domains, while SZPD presented higher associations with connectedness. The SZPD-related paranormality factor presented the highest correlation observed in the study and was the best SZPD predictor of religiosity domains. The BPD-related hopelessness factor was the predictor with significant contribution to most regression models. BPD traits presented slightly higher average association with religiosity domains, whereas spiritual-related domains (e.g., connectedness) tended to show higher associations with SZPD traits. Conclusions Our findings help explain the relationship between specific pathological traits and religiosity domains.

Conducta homicida en el trastorno esquizotípico. Presentación de un caso / Homicidal behavior in schizotypical disorder. A case presentation

Introducción: El trastorno esquizotípico se manifiesta desde edades tempranas como un patrón general de déficit social e interpersonal, comportamiento excéntrico, capacidad reducida para las relaciones personales y distorsiones cognoscitivas, incomprensibles psicológicamente. Objetivo: Fundamentar la responsabilidad médico-legal de un caso de trastorno esquizotípico que cometió homicidio. Presentación de caso: Individuo de 22 años, soltero, sin hijos, técnico medio, sin historia de trastornos mentales que es peritado por psiquiatría forense debido a que agredió a su abuelo materno con un arma blanca, y causó la muerte. Se le realizó examen psiquiátrico, se aplicó la Escala de Valoración de Impulsividad, se realizó electroencefalograma y valoración psicológica, que incluyó la aplicación de las pruebas proyectivas Bender, Machover y Rorschach. El diagnóstico propuesto por el equipo evaluador fue trastorno esquizotípico, sin enajenación mental. Conclusiones: El trastorno esquizotípico no es un diagnóstico frecuente en Psiquiatría. Cuando se involucra en conductas delictivas, estas ocurren en solitario y suelen estar relacionadas con agresiones hacia otras personas. Es determinante de semi-imputatibilidad o imputabilidad y no se recomienda su permanencia en régimen penitenciario(AU)

Introduction: Schizotypical disorder appears at very early ages as a general pattern of social and interpersonal deficit; eccentric behavior; reduced capacity to maintain personal relations; and cognitive distortions, which are psychologically inexplicable. Objective: To establish the medico-legal implications in a case of schizotypical personality disorder that committed homicide. Case presentation: A 22 years old individual, single, without children, technician, without history of mental disorders who is studied by Forensic Psychiatry because he attacked his maternal grandfather with a knife, which caused his death. Psychiatric examination was done; the Impulsiveness Scale was applied; and an enlectroencephalogram (EEG) and a psychological evaluation were carried out, which included Bender, Machover, and Rorschach tests. The evaluating staff made the diagnosis of Schizotypical disorder, without mental derangement. Conclusions: Schizotypical disorder is not a frequent diagnosis in Psychiatry. When it is involved in criminal behaviors, they occur in isolation and they are usually related to attacks to other persons. It is a determinant condition of semi-imputability or imputability. Prison system is not recommended(AU)

Entre lo pseudoneurótico y lo limítrofe / Among the pseudo-neurotic and the borderline

El término Pseudoneurótico recogería el problema de la interface fenomenológica entre psicosis y neurosis. Acuñan este término para tratar de especificar un cuadro psicopatológico caracterizado por exhibir manifestaciones clínicas pan-neuróticas, pan-sexuales y pan-ansiosas, enmascarando síntomas de una real esquizofrenia. Los fenómenos psicóticos serían sutiles y breves y en ocasiones se sufriría de episodios psicóticos intensos diurnos o nocturnos tales como pesadillas que se continúan con alucinaciones. La esquizofrenia Pseudoneurótica, junto con los conceptos de demencia precoz atenuada, esquizofrenia latente, esquizofrenia ambulatoria, estructura de personalidad pre esquizofrénica y esquizofrenia límite, se reclutaron en la noción de personalidad límite.

The term Pseudoneurotic would pick up the problem of the phenomenological interface between psychosis and neurosis. This term was coined trying to specify a psychopathological disorder characterized by exhibiting pan-neurotic, pan-sexual and pan-anxious clinical manifestations, masking symptoms of a real schizophrenia. Pseudoneurotic schizophrenia, together with the concepts of attenuated early dementia, latent schizophrenia, ambulatory schizophrenia, preschizophrenic personality structure and borderline schizophrenia, were recruited into the notion of borderline personality.

Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study / Tendência na prescrição de clozapina em um hospital psiquiátrico: estudo observacional de 5 anos

Abstract Introduction Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS). Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. Objective To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. Methods In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico) and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10) diagnoses during the study period were considered to be possible confounders. Results A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (β coefficient = 15.82; 95% confidence interval 10.88-20.75). Conclusion Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.

Resumo Introdução Clozapina é um medicamento reconhecidamente eficaz para alguns pacientes com esquizofrenia refratária ao tratamento. Apesar dos seus potenciais benefícios e de sua indicação clínica para aproximadamente 30% dos pacientes, a frequência de prescrição de clozapina é baixa. Objetivos Avaliar a tendência na prescrição de clozapina durante um período de 5 anos em um hospital psiquiátrico. Métodos Neste estudo observacional, dados coletados prospectivamente pelo Serviço de Arquivo Médico e Estatístico e pela Divisão de Farmácia (DF) do Instituto de Psiquiatria de Santa Catarina foram analisados por pesquisadores cegos para a coleta de dados. O número de comprimidos de clozapina 100 mg dispensados pela DF às enfermarias foi considerado a variável dependente e a medida de prescrição de clozapina. Número de leitos de internação ocupados e número de pacientes admitidos com diagnósticos F20-F29 (CID-10) durante o período de estudo foram considerados possíveis confundidores. Resultados Após análise com modelo de regressão linear múltipla, tempo em meses foi independentemente associado com aumento do número de comprimidos de clozapina 100 mg dispensados pela DF (coeficiente β = 15,82; intervalo de confiança de 95% 10,88-20,75). Conclusão Houve um aumento na prescrição de clozapina durante o período de 5 anos estudado, uma tendência oposta à relatada em vários outros países.

How to tell a happy from an unhappy schizotype: personality factors and mental health outcomes in individuals with psychotic experiences

Objective: It is unclear why some individuals reporting psychotic experiences have balanced lives while others go on to develop mental health problems. The objective of this study was to test if the personality traits of harm avoidance, self-directedness, and self-transcendence can be used as criteria to differentiate healthy from unhealthy schizotypal individuals. Methods: We interviewed 115 participants who reported a high frequency of psychotic experiences. The instruments used were the Temperament and Character Inventory (140), Structured Clinical Interview for DSM-IV, and the Oxford-Liverpool Inventory of Feelings and Experiences. Results: Harm avoidance predicted cognitive disorganization (β = 0.319; t = 2.94), while novelty seeking predicted bipolar disorder (β = 0.136, Exp [β] = 1.146) and impulsive non-conformity (β = 0.322; t = 3.55). Self-directedness predicted an overall decrease in schizotypy, most of all in cognitive disorganization (β = -0.356; t = -2.95) and in impulsive non-conformity (β = -0.313; t = -2.83). Finally, self-transcendence predicted unusual experiences (β = 0.256; t = 2.32). Conclusion: Personality features are important criteria to distinguish between pathology and mental health in individuals presenting high levels of anomalous experiences (AEs). While self-directedness is a protective factor, both harm avoidance and novelty seeking were predictors of negative mental health outcomes. We suggest that the impact of AEs on mental health is moderated by personality factors.

Importancia diferencial de los componentes fundamentales de la esquizotipia: un metaanálisis / Differential importance of the basic components of schizotypy: A meta-analysis

Resumen La esquizotipia puede entenderse como un trastorno incluido en el espectro de la esquizofrenia o como rasgo psicométrico que comprende 3 dimensiones: cognitivo-perceptual, interpersonal y desorganización cognitiva. La primera se relaciona con creencias extrañas y experiencias perceptuales inusuales; la segunda, con anhedonia y déficit en relaciones interpersonales, y la desorganización se identifica con pensamientos, conductas y lenguaje raros. Diferentes estudios han intentado esclarecer cuál de estas dimensiones es el componente esencial del constructo. Para dar respuesta a esta cuestión se llevó a cabo un metaanálisis en el que se realizó una revisión sistemática de las principales bases de datos que comparan las dimensiones de esquizotipia asociadas con diferentes áreas temáticas: composición factorial, síntomas clínicos y marcadores de vulnerabilidad. A partir de 300 artículos encontrados, se seleccionaron 27 estudios. Los resultados indicaron que la dimensión interpersonal parece estar más relacionada con la sintomatología clínica, mientras que la dimensión cognitivo-perceptual predomina en la investigación sobre marcadores de vulnerabilidad. La desorganización cognitiva contribuye a ambas temáticas. Se concluye que las dimensiones de esquizotipia tienen una importancia diferencial en función de las áreas de funcionamiento psicológico en estudio.

Abstract Schizotypy can be understood as a disorder included in the schizophrenia spectrum or as a psychometric trait that includes three factors: cognitive-perceptual, interpersonal, and disorganized. The first relates to strange beliefs and unusual perceptual experiences; the second, with anhedonia and deficits in interpersonal relationships, and the third, disorganisation, is identified with strange thoughts, behaviors, and language. Several studies have attempted to clarify which of these dimensions is more relevant when predicting the construct. To answer this question, a meta-analysis was conducted using a systematic review of the major databases comparing schizotypy dimensions associated with different categories: structure, health, and vulnerability markers. A total of 27 studies were selected from 300 items found. The results indicate that the interpersonal dimension seems to be related to clinical symptoms, while the cognitive-perceptual dimension dominates research on vulnerability markers. Cognitive disorganization contributes to both topics. It is concluded that the dimensions of schizotypy have a differential importance in terms of the areas of psychological functioning under study.

The Biological Rhythms Interview of Assessment in Neuropsychiatry in patients with bipolar disorder: correlation with affective temperaments and schizotypy

Objective: To assess the relationship of biological rhythms, evaluated by the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), with affective temperaments and schizotypy. Methods: The BRIAN assessment, along with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A) and the Oxford-Liverpool Inventory for Feelings and Experiences (O-LIFE), was administered to 54 patients with remitted bipolar disorder (BD) and 54 healthy control (HC) subjects. Results: The TEMPS-A cyclothymic temperament correlated positively and the hyperthymic temperament correlated negatively with BRIAN scores in both the BD and HC groups, although the correlation was stronger in BD subjects. Depressive temperament was associated with BRIAN scores in BD but not in HC; conversely, the irritable temperament was associated with BRIAN scores in HC, but not in BD. Several positive correlations between BRIAN scores and the schizotypal dimensions of the O-LIFE were observed in both BD and HC subjects, especially with cognitive disorganization and less so with unusual experiences and impulsive nonconformity. A correlation with introversion/anhedonia was found only in BD subjects. Conclusion: Cyclothymic and depressive temperaments predispose to disturbances of biological rhythms in BD, while a hyperthymic temperament can be protective. Similar predispositions were also found for all schizotypal dimensions, mostly for cognitive disorganization.

Transtorno esquizotípico e homeopatia: relato de caso / Schizotypal personality disorder and homeopathy: case report

Transtornos da personalidade são um grupo de condições caracterizadas por incapacidade para se relacionar com outras pessoas e aprender da experiência. Sujeitos com transtornos da personalidade podem vir a perceber que as suas crenças e atitudes são diferentes daquelas da maioria das pessoas. Outros descobrem que a sua conduta é inusual, inesperada e mesmo ofensiva. No presente artigo é discutido o caso de um paciente de sexo masculino e 42 anos de idade com transtorno esquizotípico, tendo a alucinação típica de ser sujeito de abuso e perseguição, e posterior sensação de formigamento. Com o medicamento homeopático corretamente selecionado a autoconfiança, sintomas somáticos, estresse e preocupação, ansiedade e alucinações melhoraram, o que sugere que a homeopatia pode ser muito útil no tratamento deste tipo de transtornos da personalidade...

Personality disorders are a group of conditions characterized by an inability to get on with other people and learn from experience. People with a personality disorder may find that their beliefs and attitudes are different from those of most other people. Others may find their behavior unusual, unexpected or perhaps offensive. In this paper, we discuss a case of a 42- year-old man with schizotypal personality disorder with typical delusions of being abused and persecuted and subsequent formication. With a properly selected homoeopathic medicine the patient experienced symptom improvement in self-confidence, somatic complaints, stress and worry, anxiety, and delusions, suggesting that homoeopathy is quite useful in the treatment of such personality disorders...

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)

Validación de la escala Schizophrenia Quality Of Life Scale (SQLS) para medir la calidad de vida en pacientes con diagnóstico de esquizofrenia en Colombia / Validation of the Schizophrenia Quality Of Life Scale (SQLS) to Measure Quality of Life in Patients Diagnosed With Schizophrenia in Colombia

Objetivo: Validar la escala SQLS para medir la calidad de vida de los pacientes con diagnóstico de esquizofrenia en Colombia. Métodos: Se aplicó a 251 pacientes la escala autoaplicable SQLS. La aplicación se repitió a los 2 días a 28 pacientes y a los 30 días a 38 pacientes para evaluar la confiabilidad test-retest y la sensibilidad al cambio respectivamente; 50 pacientes cumplimentaron además la escala SF-12 para determinar la validez concurrente. Resultados: Se encontraron tres dominios para la escala SQLS en Colombia: para los tres dominios se encontraron coeficientes alfa de Cronbach > 0,7. El modelo con tres factores no mostró un ajuste adecuado. En la evaluación test-retest, se encontraron valores de correlación adecuados (> 0,86). No se encontró una diferencia significativa en las mediciones de la sensibilidad al cambio. La validez concurrente mostró valores de correlación aceptables sólo con los dominios de la SF-12, relacionados con salud y funcionamiento mental. Conclusiones: Aunque la escala SQLS muestra una estructura factorial consistente con la propuesta original, buena consistencia interna y estabilidad en el tiempo, se requiere un estudio más detallado del funcionamiento de algunos ítems que pueden no estar midiendo el constructo adecuadamente.

Abstract Objective: To validate the SQLS scale in Colombian patients diagnosed with schizophrenia. Method: The self-report scale was applied to 251 patients. Measures of test-retest reliability, internal consistency and correlation inter-scales with the SF-12 were made by applying the scale 2 days later in 28 patients, and 30 days later in 38; 50 patients filled-out the SF-12 scale to determine the concurrent validity. Results: Three domains were found with all of them having Cronbach's alphas >0.7. The three factors model did not show adequate fit indexes.Test-retest evaluation showed satisfactory correlation values (>0.86). Sensitivity to change did not shown significant differences between the repeated measures. As regards concurrent validity, acceptable correlation values were found only in SF-12 domains related to mental health and functioning. Conclusions: The SQLS has a factorial structure consistent with previous reports, adequate internal consistency and temporal stability. However, a more detailed examination of some of these items is required, considering that the measurement of the construct does not appear to be adequate.

Esquizofrenia e criatividade artística / Schizophrenia and artistic creativity

Este artigo constitui um estudo teórico sobre a esquizofrenia e a criatividade artística. O estudo foi baseado no levantamento da produção científica nas bases de dados Web of Science, PsycINFO e Medline, dos últimos dez anos, utilizando as palavras-chave Schizophrenia e Creativity. A maioria dos estudos aponta que o mais provável é que a vulnerabilidade para a esquizofrenia manifeste diferentes vantagens criativas por causa de suas possíveis características perceptuais, cognitivas e de personalidade. Contudo a ideia de que distúrbios do espectro da esquizofrenia possam desencadear a criatividade artística não é defensável. (AU)

This article constitutes itself as a theoretical study about schizophrenia and artistic creativity. The study was based on a survey of the scientific production in the databases Web of Science, PsycINFO and Medline for the last ten years, using the key words Schizophrenia and Creativity. The majority of the studies points out that the most probable fact is that the vulnerability for schizophrenia manifests several creative advantages because of its possible perceptual, cognitive and personality characteristics. However, the idea of a spectrum of schizophrenia to trigger artistic creativity is not defensible. (AU)

Personality disorders and coping strategies in female sex-workers

The aim of the present study was to assess the rate of personality disorders and coping strategies in female sex-workers. In this observational cross-sectional study 30 female sex-workers who were selected using convenience sampling, completed the Structured Clinical Interview DSM-IV axis H disorders [SCID-II] and Billings Coping Style Questionnaire. Data were analyzed using descriptive statistics. The findings showed a prevalence of 90% for personality disorders, with passive-aggressive personality disorder having the highest prevalence of 53.3%. Also, schizotypal personality disorder was not present in subjects. Among coping strategies, emotion-focused coping [56.7%] and somatization-focused coping [23.3%] were the most prevalent. Considering the high prevalence of personality disorder among female sex-workers and their high use of emotion-focused coping in confronting life events, training this group with coping and problem solving skills is recommended

Causal model in emotional intelligence, schizotypy and psychopathology

To assess the relationship of emotional intelligence, schizotypy and psychopathology. In this descriptive-analytical study 150 normal high school students [94 girls and 56 boys] aged 14 to 17 years [15.5 +/- 0.67] in the educational year 1387-1388 in Shahr-e-Rey, completed schizotypal trait questionnaire [STA], Modified Schutte [Emotional Intelligence] El Scale [MSEIS], and three subtests of Symptom Checklist-90-Revised [SCL-90-R], namely, psychoticism, hostility, and paranoid ideation. Data analysis was done by SPSS 11.5 and LISREL 8.54 using independent t-test U, Mann-Whitney test, and path analysis. Path analysis revealed a causal relationship between El and psycho-pathology [t=-4.03, p<0.05]; as well as a causal relationship between emotion appraisal and magical thinking [r=-2.25, p<0.05], paranoid ideation [t=2.03, p<0.05] and schizotypy [t=-3.39, p<0.05]. An accurate assessment of the relationship between factors revealed that emotion appraisal has a causal effect on schizotypy and psychopathology. Emotion appraisal is the perception and evaluation of the emotional situation in oneself as well as others. In fact, individuals with positive emotion appraisal and evaluation are at lower risk of developing signs of schizotypy and psychopathology

Effect of three-step acupuncture combined with small dosage antipsychotic in treating incipient schizophrenia / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the clinical efficacy and safety of three-step acupuncture (TSA) combined with small dosage antipsychotic in treating incipient schizophrenia (IS).</p><p><b>METHODS</b>Sixty IS patients were randomly assigned to the test group and the control group equally. Patients in the test group received the combined therapy of TSA and antipsychotic, while patients in the control group were treated by full-dose antipsychotic, all for 8 weeks. The clinical efficacy was assessed by the positive and negative syndrome scale (PANSS), and the adverse reaction was evaluated by treatment emergent symptom scale (TESS).</p><p><b>RESULTS</b>The clinical efficacy in the two groups showed insignificant difference at the end of the 8-week treatment (P > 0.05), but the total scores of PANSS evaluated at the end of the 2nd and 4th week in the test group (74.26 +/- 9.54, 56.33 +/- 10.12) were significantly higher than those in the control group (85.56 +/- 9.73, 70.57 +/- 9.62), respectively (P < 0.05), furthermore, TESS analysis showed that the incidence of adverse reactions in nervous system and autonomic nervous system in the test group were also lesser than in the control group (P < 0.05).</p><p><b>CONCLUSION</b>The combined therapy of TSA and small dose antipsychotic shows an efficacy equivalent to that of full-dose antipsychotic, but with shorter initiation time and less side effects.</p>

Esquizotipia, habilidades "Teoria da Mente" e vulnerabilidade à psicose: uma revisão sistemática

CONTEXTO: A capacidade de inferir estados mentais de terceiros (também chamada habilidade "Teoria da Mente" ou "ToM") desenvolveu-se em decorrência de uma pressão evolutiva exercida por sociedades progressivamente mais complexas e parece estar comprometida na esquizofrenia e em portadores de transtorno esquizotípico de personalidade. Tal comprometimento poderia explicar o aparecimento de sintomas psicóticos nestes indivíduos. OBJETIVO: Revisar criticamente a literatura sobre alterações ToM em indivíduos esquizotípicos ou portadores de sintomas psicóticos subsindrômicos. MÉTODOS: Realizou-se uma busca na base MedLine por trabalhos publicados em inglês e português, entre 1990 e 2008, utilizando a frase "Schizotypal Personality Disorder [MeSH] AND "Theory of Mind" OR "Mentalising". RESULTADOS: Foram selecionados 15 artigos, os quais utilizaram diversos desenhos experimentais e instrumentos para avaliação de traços esquizotípicos, propensão à psicose e habilidades ToM. CONCLUSÕES: Os trabalhos revisados visaram estabelecer relações entre vulnerabilidade à psicose e alterações ToM. Alguns artigos também abordaram o caráter traço ou estado dependente das alterações ToM. A maioria dos trabalhos selecionados sugeriu que indivíduos com escores altos para esquizotipia e familiares de esquizofrênicos apresentam problemas no processamento ToM (este teria, portanto, um caráter traço-dependente). Tais dados devem ser interpretados cuidadosamente em virtude de problemas metodológicos observados na maioria dos estudos.

BACKGROUND: The ability of inferring mental states of others (also named "Theory of Mind" or "ToM" abilitiy) has been developed due an evolution pressure exerted by progressively more complex societies and it might be impaired in schizophrenia and in schizotypal individuals. Such impairment might explain the occurrence of psychotic symptoms in these individuals. OBJECTIVE: To review critically the literature on possible alterations of ToM processing in individuals with schizotypy or subsyndromal psychotic symptoms. METHODS: We performed a search on MedLine database for articles published in English or Portuguese between 1990 and 2008, using the phrase "Schizotypal Personality Disorder [MeSH] AND "Theory of Mind" OR "Mentalising". RESULTS: Fifteen manuscripts have been selected, which used diverse experimental designs and instruments to evaluate schizotypal traits, vulnerability to psychosis and ToM abilities. DISCUSSION: The reviewed articles aimed to establish relationships between vulnerability to psychosis and alterations in ToM processing. Some articles also approached the trait or state dependence character of ToM impairments. The great majority of the selected manuscripts suggested that individuals who scored high in schizotypy scales, as well as schizophrenic relatives, do show problems in ToM processing (which suggests a trait dependence character). However, these results should be interpreted carefully due to methodological problems seen in the majority of the studies.

Boundary of Anxiety Disorders: Obsessive-Compulsive Disorder and Schizophrenia / 신경정신의학

Although obsessive-compulsive disorder (OCD) is recognized as a major psychiatric illness, few studies have investigated obsessive-compulsive symptoms in patients with schizophrenia. Recent increases in dual diagnosis due to changes to the DSMIV diagnostic criteria, findings of obsessive-compulsive symptoms (OCS) after administration of atypical antipsychotics, increased reports of co-occurrence of schizophrenia and OCD have increased the interest in OCS in schizophrenia. The incidence of OCS in patients with schizophrenia is reported to be 3-59%; however, the rate of progression to schizophrenia from OCD is not higher than in the general population. Level of insight, which differentiates obsessions from delusions, can be confounded by the specifier 'with poor insight' in OCD. OCD with schizotypal personality disorder or poor insight differs from pure OCD in that it responds poorly to treatment, has a poor prognosis, leads to deficits in cognitive functioning similar to those observed in schizophrenia, and responds well to low-dose antipsychotics. In the past, it was believed that OCS could prevent or delay the deteriorative course of schizophrenia. However, recent studies have shown that co-occurrence of OCD and schizophrenia increases the severity of symptoms, delays the treatment response, and reduces socio-occupational functions. Schizophrenia and OCD share the same pathophysiology in that both diseases have defects in the fronto-basal functional circuitry of the brain. The use of serotonin and dopamine has been addressed in schizophrenia due to the use of atypical antipsychotics in patients with schizophrenia. The finding of drug-induced OCS suggested that the two diseases share a similar pathogenesis involving neurotransmitters. Further studies are needed to make an exact diagnosis between the two diseases and to determine the common pathophysiology between OCD and schizophrenia.

Squalor syndrome

Squalor syndrome is a rare psychiatric syndrome. We report this syndrome in a 46 year old female care worker who suffered from obesity, hypothyroidism, diabetes mellitus, major depression, obsessive compulsive disorder and schizotypal personality disorder. Her house was very much neglected and filthy. Various aetiological hypotheses for squalor syndrome are reviewed briefly in the context of this case

The Study on Classification Method of Obsessive-Compulsive Disorder with Schizotypal Trait using Frontal Lobe Function Test / 대한의료정보학회지

OBJECTIVE: The identifying schizotypal trait in obsessive-compulsive disorder (OCD) patients is important to predict clinical course, since those patients are hardly overcome through conventional intervention methods. This paper presents the trial of classification method of obsessive-compulsive disorder with schizotypal trait using Frontal Lobe Function Test (FLFT). METHODS: 110 OCD patients are divided into two groups:27 pure OCD patients, and 83 non-pure OCD patients. After training artificial neural network (ANN) using frontal-lobe function test data of train data (schizophrenia, pure OCD, and normal group), we classify test data (non-pure OCD patients) into one of the three groups. RESULTS: Among the total 83 test data (non-pure OCD patients), 44 patients were classified as schizophrenia, 32 patients as normal, and 7 patients as pure OCD. With respect to the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) data of those classified patients, ordering score in compulsion was significantly different between three groups. Moreover, cluster A socre (Schizoid, Schizotypal) of Personality Diagnostic Questionnaire (PDQ) data showed significant difference between them. CONCLUSION: The results presented that those OCD patients who are classified as schizophrenia using generated model with machine learning technique is tend to have compulsive symptom of arrangement and schizotypal personality disorder.