Psychological well-being in patients undergoing stem cell transplantation

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.

Cómo utilizar los sueños en el psicoanálisis con psicóticos / Como utilizar os sonhos na psicanálise com psicóticos / Using dreams in psychoanalysis with psychotic patients / Utilisation des rêves en psychanalyse avec les psychotiques

Resumen Este artículo apunta a ofrecer soluciones prácticas a los atolladeros más comunes que suelen presentarse al momento de utilizar los sueños en el psicoanálisis con psicóticos, como la indiferenciación entre sueño, realidad y delirio, la dificultad de algunos psicóticos para asociar y el avance de las pesadillas. Se toma posición a favor de la posibilidad de utilizar los sueños en la clínica de las psicosis y se describen los modos en que estos pueden colaborar en la dirección de la cura: poniendo en discurso experiencias inefables, permitiendo la historización y sustituyendo la asociación libre por el encadenamiento entre sueños. Se concluye que la vía onírica puede constituir un remedio eficaz contra el retorno en lo real y que es preferible interrogar los sueños con preguntas no muy amplias, orientadas a vincularlos con la vida del soñante y su posición subjetiva.

Resumo Este artigo tem como objetivo apontar soluções práticas aos impasses mais comuns que costumam aparecer quando se aborda os sonhos na psicanálise com psicóticos, como a indiferenciação entre sonho, realidade e delírio, a dificuldade de alguns psicóticos com a associação livre e o avanço dos pesadelos. Toma-se posição a favor da possibilidade de utilizar os sonhos na clínica das psicoses e se descrevem os modos em que estes podem colaborar com o tratamento, colocando em discurso experiências inefáveis, permitindo a historização e substituindo a associação livre pelo encadeamento dos sonhos. Conclui-se que a vida onírica pode constituir um remédio eficaz contra o retorno no real e que é preferível interrogar os sonhos com perguntas não muito amplas, orientadas a vinculá-los com a vida do sonhante e com a sua posição subjetiva.

Abstract This paper offers some practical solutions to the most usual predicaments that usually arises when exploring dreams in psychoanalysis with psychotic patients, such as the non-distinction between dream, reality and delirium, the difficulty with free association and the invasion of nightmares. It advocates for using dreams in psychosis clinic and describes how dreams can contribute to treatment, by turning ineffable experiences into discourse, allowing historization and replacing association with dream chaining. Dream life can be an effective remedy against the return to the real, being preferable to interrogate dreams with precise questions aimed to link them to the dreamer's life and their subjective position.

Résumé Cet article propose quelques solutions pratiques aux problèmes les plus courants qui se posent lors de l'exploration des rêves en psychanalyse avec les psychotiques, tels que la non-distinction entre rêve, réalité et délire, la difficulté de l'association libre et l'invasion des cauchemars. On plaide pour l'utilisation des rêves dans la clinique des psychoses et décrit comment ceux-ci peuvent contribuer au traitement, en mettant en discours les expériences ineffables, permettant l'historisation et remplaçant l'association par l'enchaînement des rêves. La vie onirique peut être un remède efficace contre le retour au réel, étant préférable d'interroger les rêves avec des questions plus précises visant à les relier à la vie du rêveur et à sa position subjective.

Do conceito de personalidade na tese de doutorado de Jacques Lacan / On the concept of personality in Jacques Lacan's doctoral dissertation

RESUMO: O conceito de personalidade, central na tese de doutorado de Jacques Lacan, intitulada Da psicose paranóica em suas relações com a personalidade, parece figurar nesta obra, contudo, sem a devida clareza que sua nuclearidade exige. A complexa arquitetura deste conceito inclui sua subdivisão em três definições que, por suas vezes, aparecem em três diferentes níveis de manifestação. Neste trabalho, demonstraremos que é somente por meio de uma análise sistemática desta tríade tripla que o conceito de personalidade na Tese lacaniana pode ser plenamente elucidado.

Abstract: The concept of personality, which is very important in Jacques Lacan's doctoral dissertation, does not seem to be clear as it should. Its complex architecture includes its division in three definitions that appear in three different levels of manifestation. In this work, we shall demonstrate that only by a systematical analysis of this triple triad the concept of personality in Lacan's Thesis can be completely elucidated.

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".

Ressonâncias político-clínicas do ideal de inclusão nos centros de atenção psicossocial / Resonancias políticas y clínicas del ideal de inclusión en el centros de atención psicosocial / Political and clinical resonances of the ideal of inclusion in the centers of psychosocial care

RESUMO Buscamos, neste ensaio, analisar as ressonâncias políticas e clínicas da presença de um ideal de inclusão do louco no tratamento oferecido pelos Centros de Atenção Psicossocial (CAPS). Para tanto, num primeiro momento, fizemos um breve percurso pelo movimento da reforma psiquiátrica brasileira levando em consideração a sua principal influência, qual seja: a psiquiatria democrática italiana. Assim, partimos do pensamento paradigmático de Franco Basaglia, visando, com isso, esclarecer como se constitui o que denominamos de ideal de inclusão no CAPS. Posteriormente, pelo esforço teórico que perpassou a psicanálise e a política, analisamos, detidamente, as consequências político-clínicas de se tomar a inclusão social como horizonte final de um tratamento destinado, predominantemente, à psicose. Aqui, os conceitos de ideologia, ideal do eu e mal-estar foram de suma importância. Por fim, procuramos indicar algumas questões importantes para uma clínica possível no CAPS, que seja atinente à política e que alie a atenção dada ao sujeito e a busca por transformação social.

RESUMEN Buscamos, en este ensayo, analizar las resonancias políticas y clínicas de la presencia de un ideal de inclusión del loco en el tratamiento ofrecido por los Centros de Atención Psicosocial (Centros de Atención Psicosocial - CAPS). Para ello, en un primer momento, se hiso un breve recorrido por el movimiento de la Reforma Psiquiátrica brasileña llevando en consideración su principal influencia: la Psiquiatría Democrática italiana. Así, partimos del pensamiento paradigmático de Franco Basaglia, buscando, con ello, aclarar cómo se constituye lo que llamamos ideal de inclusión en el CAPS. Posteriormente, por intermedio de un esfuerzo teórico que atravesó el psicoanálisis y la política, analizamos detenidamente las consecuencias políticas y clínicas de tomar la inclusión social como horizonte final de un tratamiento destinado, predominantemente, a la psicosis. Aquí, los conceptos de ideología, ideal del yo y el malestar, fueron de suma importancia. Por último, buscamos indicar algunas cuestiones importantes para una clínica posible en el CAPS, que sea atinente a la política y que alíe la atención dada al sujeto y la búsqueda por transformación social.

ABSTRACT. In this essay, we sought to analyze the political and clinical resonances of the presence of an ideal of inclusion of the insane in the treatment offered by Psychosocial Care Centers (Centros de Atenção Psicossocial - CAPS). To do so, in the first moment, we made a brief analysis of the Brazilian Psychiatric Reform movement taking into consideration its main influence, namely: the Italian Democratic Psychiatry. Thus, we started from the paradigmatic thinking of Franco Basaglia, in order to clarify how such an ideal is constituted. Subsequently, through a theoretical effort that went through psychoanalysis and politics, we have analyzed in detail the political and clinical consequences of taking social inclusion as the final horizon of a treatment predominantly for psychosis. Here, the concepts of ideology, ego ideal and discontent were of paramount importance. Finally, we tried to indicate some important issues for a possible clinic at CAPS, which is related to politics and that combines the attention given to the subject and the search for social transformation.

El uso de "virado" como estrategia de reducción de daños entre los usuarios de crack del estado de Pernambuco, Brasil / The use of "virado" as a harm reduction strategy among crack users in the State of Pernambuco, Brazil

RESUMEN El objetivo del estudio es discutir uno de los usos del crack denominado "virado", como estrategia de reducción de daños entre las personas que usan crack en Pernambuco, Brasil. Se realizó una investigación cualitativa y transversal. Desde marzo hasta agosto de 2016, se realizaron entrevistas semiestructuradas sobre la cultura del uso de crack a 39 personas que usan esta substancia. El límite de participantes se estableció por el criterio de saturación. Los datos se analizaron con la técnica de análisis de contenido. Las personas que participaron relataron que el virado es una manera distinta de utilizar el crack y, al comparar su efecto con el uso fumado o inhalado, mencionaron que el virado produce menos impacto en las relaciones interpersonales y en la libido, además de reducir el uso compulsivo de crack, cuestiones que se podrían considerar como estrategias de reducción de daños. Un aspecto negativo es que comparten los canutos para aspirar el virado, lo cual es una situación de riesgo para la transmisión de enfermedades infecciosas. Conocer la cultura del uso del crack en distintas formas y situaciones es imprescindible para la planificación y desarrollo de acciones de atención a la salud.

ABSTRACT The aim of the study is to discuss the use of crack in the form of "virado" as a harm reduction strategy in Pernambuco, Brazil. This is a cross-sectional study with a qualitative approach in which semi-structured interviews were conducted regarding aspects related to the culture of crack use with 39 crack users between March and August 2016. Participants were recruited using saturation criteria and data were analyzed through content analysis. Respondents discussed the use of "virado" and compared its effects in relation to crack, addressing improvement in interpersonal relationships, libido, and non-compulsive drug use, which can all be understood as harm reduction strategies. On the other hand, equipment sharing for the use of "virado" was identified as a high-risk practice with regards to the transmission of infectious diseases. Knowing about the culture of crack use in different contexts is essential in order to plan and develop health care actions.

Uma reflexão sobre a transferência dos psicóticos na teoria freudiana / Une réflexion sur le transfert chez les psychotiques dans la théorie freudienne / A consideration about transference with psychotics in Freudian theory

O artigo tem como objetivo identificar por que, de acordo com Freud, a transferência de pacientes psicóticos é inadequada para a clínica analítica. Descobrimos que essa afirmativa tem relação com o mecanismo de defesa empregado pelo psicótico que, diante de uma frustração, ao invés de recalcar, rechaça uma representação da consciência, e retorna a libido dessa representação de volta ao próprio ego, em pontos de fixação autoeróticos ou narcísicos. Depositada no Eu, a libido que se direciona para o mundo externo se tornou escassa, diminuindo a capacidade transferencial com o analista. Na esquizofrenia, Freud percebeu uma transferência insuficiente; na paranoia, de manejo impossível. Por conta disso, Freud não recomenda a psicanálise para tratar psicóticos, porque a análise se encerra precocemente, ou não apresenta ganhos terapêuticos. Não obstante, o autor deixa um grande alicerce teórico sobre as psicoses, e delega à posterioridade a responsabilidade de elaborar uma forma de tratamento

Cet article a le but d' identifier la raison pour laquelle, selon Freud, le transfert des patients psychotiques est inapproprié pour la clinique analytique. Nous découvrons que cette affirmation est liée au mécanisme de défense employé par le psychotique qui, face à la frustration, au lieu de la réprimer, il rejette une représentation de la conscience et renvoie la libido de cette représentation au moi, aux points d'attachement auto-érotiques ou narcissiques. Déposée sur le Je, la libido dirigée vers le monde extérieur se raréfie, diminuant la capacité de transférer avec l'analyste. Dansla schizophrénie, Freud a remarqué un transfert insuffisant; dans la paranoïa, sa gestion est impossible. Par conséquent, Freud ne recommande pas la psychanalyse pour traiter les psychotiques, parce que l'analyse se termine trop tôt ou sans gains thérapeutiques. Cependant, l'auteur laisse une grande base théorique sur la psychose et il donne aux successeurs la responsabilité de développer une forme de traitement

The article aims to identify why, according to Freud, the transfer in psychotic patients is inappropriate for the analytical clinic. We found that this affirmation is related to the defense mechanism employed by the psychotic who, in the face of frustration, instead of repressing, rejects a representation in consciousness, and returns the libido of that representation back to the ego itself, in autoerotic or narcissistic fixation points. Deposited in the Self, the libido that is directed to the external world becomes scarce, decreasing the transference capacity with the analyst. In schizophrenia, Freud noticed an insufficient transfer; in paranoia, it is impossible to manage. Thus, Freud does not recommend psychoanalysis to treat psychotics, because the analysis ends early, or there are no therapeutic gains. Nevertheless, the author leaves a great theoretical foundation on psychoses, and delegates to his successors the responsibility of elaborating a form of treatment

Discrepancies of Implicit and Explicit Self-Esteem as Predictors of Attributional Bias and Paranoia

OBJECTIVE: The current study aimed to examine the association of implicit self-esteem, explicit self-esteem and their interaction with paranoia and attributional bias. The relationship of the size and the direction of the discrepancy between implicit and explicit self-esteem with paranoia and attributional bias was examined. METHODS: A total of 128 female college students participated. We administered the Implicit Association Test to assess implicit self-esteem, and the Rosenberg Self-Esteem Scale to measure explicit self-esteem. Paranoia Scale was used, and the attributional bias was assessed using the Ambiguous Intentions Hostility Questionnaire. RESULTS: Results showed that explicit but not implicit self-esteem was negatively associated with paranoia, blame bias and hostility perception bias in ambiguous situations. The interaction of implicit and explicit self-esteem was associated with hostility perception in ambiguous situations. As for the discrepancy, the size of the discrepancy between implicit and explicit self-esteem was positively associated with hostility perception in ambiguous situations. Moreover, the direction of the discrepancy was specifically relevant: damaged self-esteem (high implicit and low explicit self-esteem) was associated with increased levels of paranoia, blame bias and hostility perception in ambiguous situations. CONCLUSION: These findings provide new insights into the role of the implicit and explicit self-esteem in attributional bias and paranoia and point to damaged self-esteem as a possible vulnerability marker for illogical attribution of blaming others and perceiving hostility in social situations.

Síndrome de Capgras: una revision de la literatura / Capgras syndrome: a review of the literature

Los síndromes de falsa identificación delirante (DMS, por su sigla en inglés) son trastornos neuropsiquiátricos poco frecuentes que se caracterizan por tener ideas delirantes respecto a la propia identidad y la de otras personas, animales o lugares conocidos por el paciente. Los principales DMS son el Síndrome de Capgras (SC), el de Fregoli, el de doble subjetivo y el de intermetamorfosis. Se presentan en contexto tanto de enfermedades psiquiátricas como en cuadros orgánicos. Distintos modelos han tratado de encontrar una explicación a los DMS, con aportes tanto desde la psicología como de las neurociencias. Entre las causas están enfermedades neurodegenerativas, cuadros psiquiátricos, alteraciones estructurales, efecto de drogas, y alteraciones metabólicas. El manejo depende de la patología de base y las características clínicas específicas. Esta revisión se centra específicamente en el SC, ya que dentro de los DMS, es el más frecuente y estudiado

Delusional misidentification syndromes (DMS) are rare neuropsychiatric disorders that are characterized by having delirious ideas regarding one's and other people, animals or places identity known by the patient. The main DMS are the Capgras syndrome, the Fregoli syndrome, the subjective double syndrome and the intermetamorphosis syndrome. They appear in context of both psychiatric illnesses and organic disorders. Different models have tried to find an explanation to the DMS, with contributions from both psychology and neurosciences. Among the causes are neurodegenerative diseases, psychiatric symptoms, structural alterations, drug effects, and metabolic alterations. Management depends on the underlying pathology and the specific clinical characteristics. This review focuses specifically on the SC, since within the DMS, it is the most frequent and studied.

Comparative Study on Personality Assessment Inventory and MMPI-2 Profiles of Groups with High and Low Depression and Suicide Ideation in Psychiatry Patients and Discriminant Variables of Depression and Suicide Ideation / 신경정신의학

OBJECTIVES: The purpose of this study was to compare psychological test profiles of psychiatric outpatients with high and low depression/suicide ideation and to identify predictor variables for depression/suicide ideation. METHODS: Component scores of the Personality Assessment Inventory (PAI) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were compared using t-tests. Discriminant analysis was conducted for predictor variables of depression/suicide ideation. RESULTS: Regarding PAI profiles, somatic complaints (SOM), anxiety (ANX), anxiety-related disorder (ARD), depression (DEP), paranoia (PAR), borderline features (BOR), antisocial features (ANT), mania (MAN) drug problems (DRG) scores were significantly elevated in high depression and high suicide ideation groups. Concerning MMPI-2 profiles, the scores of hypochondriasis (Hs), depression (D), hysteria (Hy), psychopathic deviate (Pd), paranoia (Pa), psychasthenia (Pt), schizophrenia (Sc), social introversion (Si) were significantly elevated in these same groups. The PAI and MMPI-2 profile shapes were remarkably similar between high depression and high suicide ideation groups. Therefore, in terms of psychological profile, depression and suicidal ideation seemed to reflect the same construct. However, in discriminant analysis, significant predictors for depression were found to be Pt and D Sc from MMPI-2, while those for suicide ideation were found to be Pa and Sc, suggest subtle differences. CONCLUSION: The superficial characteristics of depression and suicide ideation groups reflected by the psychological test profiles seemed similar, but the determining factors may differ. Thus, the psychological interventions for these two groups may have to follow different routes considering these subtle differences.

Inclusão da loucura no pensar: um diálogo possível entre Lacan e a fenomenologia husserliana / L'inclusion de la folie dans la pensée: un dialogue possible de Lacan avec la phénoménologie de Husserl / Inclusión de la locura en el pensar: un posible diálogo entre Lacan y la fenomenología husserliana / Inclusion of madness into thinking: the possible dialogue between Lacan and Husserlian phenomenology

Por que pensar a loucura teria algum sentido na filosofia? A tese de Jacques Lacan de 1932 nos dá uma dica. Pois o autor se volta a um caso de paranoia e esboça algumas críticas à fenomenologia husserliana. A aposta desse texto é tentar mostrar que a reflexão sobre o que é dito enquanto anormal pode abrir um espaço para repensar a fenomenologia husserliana

Pourquoi penser que la folie peut être intéressant à la philosophie? La thèse de Jacques Lacan de 1932 nous donne des pistes, parce que Lacan travaille dans un cas de paranoïa et essaye quelques critiques sur la phénoménologie husserlienne. Ce texte veux montrer que ce qu'est dit anormal peux ouvrir un espace à repenser la phénoménologie husserlienne

¿Por qué pensar la locura tendría algún sentido en la filosofía? La tesis de Jacques Lacan, del año 1932, nos ofrece una indicación. Ya que el autor se vuelca en un caso de paranoia y esboza algunas críticas a la fenomenología husserliana. La apuesta de este texto consiste en tratar de mostrar que la reflexión acerca de lo que se entiende como anormal puede abrir un espacio para repensar la fenomenología husserliana

Why think madness would have some sense in philosophy? Jacques Lacan's thesis from 1932 gives us a hint. This is because Lacan turns to a case of paranoia and outlines some criticism of Husserl's phenomenology. The objective of this paper is to show that the reflection of what is said as abnormal could open room to rethink Husserl's phenomenology

A evolução dos conceitos sobre as psicoses paranoides tardias (psicoses funcionais do espectro esquizofrênico) / Medical Education. The evolution of concepts about late paranoid psychoses

As psicoses paranoides tardias, psicoses de espectro da esquizofrenia, constituem grupo complexo e heterogêneo de psicoses, assim considerado desde sua primeira descrição por Kraepelin, no início do século 20. Desde então, inúmeras descrições e conceitos surgiram e foram, posteriormente, excluídas, em função de sua visão parcial dessa candente questão psicogeriátrica. O conceito de parafrenia tardia, descrito por Kraepelin, em 1903, foi recuperado, em 1953, por Roth, mantendo muitas de suas características originais, entretanto, também se mostrou insuficiente para a caracterização desse grupo de transtornos psíquicos. As tentativas de obtenção de classificações psiquiátricas, realizadas na contemporaneidade pela Organização Mundial de Saúde ou Associação Americana de Psiquiatria, têm se voltado para os conceitos originais de Kraepelin e Bleuler, especialmente de Kraepelin, mas suas descrições ainda deixam lacunas importantes para que as psicoses funcionais do espectro esquizofrênico sejam diagnosticadas com segurança. Em 1999 surgiu m consenso internacional para o diagnóstico desse grupo de entidades que preenche com mais rigor os critérios para maior índice de acertos quanto ao seu diagnóstico. Esta revisão objetiva apresentar as características que permitem com mais praticidade estabelecer os critérios para o diagnóstico das psicoses paranoides tardias. (AU)

Late-life paranoid psychoses, schizophrenia spectrum psychoses, constitute a complex and heterogeneous group of psychoses, so considered since its first description by Kraepelin, in the early 20th century. Since then, numerous descriptions and concepts have emerged and were subsequently droppedd, in function of his partial view of this burning psychogeriatric question. The concept of late-paraphrenia, described by Kraepelin in 1903, was recovered in 1953 by Roth, maintaining many of its original characteristics, however, it was also insufficient for the characterization of this group of psychic disorders. Attempts to obtain psychiatric ratings, carried out contemporaneously by the World Health Organization or American Psychiatric Association, have turned to the original concepts of Kraepelin and Bleuler, especially of Kraepelin, but their descriptions still leave important gaps for functional psychoses of the schizophrenic spectrum are safely diagnosed. In 1999, an international consensus emerged for the diagnosis of this group of entities that more accurately meets the criteria for a better index of correct diagnosis. This review aims to present the characteristics that allow us to more easily establish the criteria for the diagnosis of late paranoid psychosis. (AU)

Freire, Dercirier. Paranóia e Crime: do Direito à Psicanálise / Freire, Dercirier. Paranóia and Crime

Sem dúvida, querer pensar o crime a partir de dois campos de saber, o Direito e a Psicanálise, não é uma tarefa fácil, já que o que está em jogo é o conceito de loucura, o qual, por sua vez, implica a questão crucial no que diz respeito à responsabilidade ou não de um ato. A teoria jurídica se apoia na psiquiatria, na medida em que o destino de quem praticou o ato criminoso depende de um laudo dado por um psiquiatra forense. Imputável se for diagnosticado como "doente mental". Ou Culpado se for considerado considerado são. A prisão ou o hospital psiquiátrico é o destino. Aqui entra em cena não só a contribuição do livro de Dercirier, mas também sua proposta: por que o Direito não leva em conta o que a psicanálise tem a dizer sobre a loucura? Essa é a pergunta não escrita, mas implícita nas entrelinhas. Para a psicanálise não há a dicotomia normal/ anormal e sim estruturas. Há estruturas: psicose, perversão e neurose. E mais: para a psicanálise todo indivíduo é responsável por seus atos.Ou seja: ao contrário do Direito, em toda ação praticada pelo homem, independente de sua estrutura clínica, há implicação subjetiva. Mas do ponto de vista do direito, a loucura isenta o autor do seu ato, amordaçando sua fala e o enclausurando, na maioria das vezes, até a morte, em um manicômio judiciário.

Metodología y construcción del caso Schreber: una prefacio olvidado / Methodology and structure of schreber´ s case: a forgotten preface

Analizar psicoanalíticamente la escritura de los paranoicos sigue siendo hoy día un campo de activos y controversiales debates, y todos ellos se originan en el análisis del libro Memorias de un neurópata de D. P. Schreber. La construcción del historial freudiano que versa sobre Schreber se ha realizado casi exclusivamente a partir de la lectura de este libro, siendo éste un procedimiento metodológico no del todo esclarecido hasta la fecha, especialmente en lo atinente a la fundamentación epistemológica de dicha interpretación. Estos interrogantes fueron los impulsores de la tesis doctoral denominada "Escritura y paranoia. El aporte metodológico de la fenomenología hermenéutica a un texto de Freud: Puntualizaciones psicoanalíticas sobre un caso de paranoia descrito autobiográficamente", cuyo objetivo principal es establecer los principios epistémico-metodológicos de construcción del historial. En este paper se presentarán a discusión algunos resultados preliminares concernientes a los procedimientos actuales de interpretación del historial de Freud que no han abordado exhaustivamente el hecho de que el mismo autor pensó las "Formulaciones sobre los dos principios del acaecer psíquico" como Prefacio del historial.

The psychoanalytic analyze of writing in paranoia remains nowadays as a field of controversial and active debates, and all of them were originated in Schreber´ s book "Memoires of my nervous illness". The structure of the Freudian clinical report upon Schreber has been constructed exclusively by the reading of this book, and this methodological procedure has not been completely clarified up to now from an epistemological point of view of this interpretation. This questions where the propels of the doctoral thesis named "Writing and paranoia. The methodological contribution of hermeneutic phenomenology to Freud´s text: Psychoanalytic remarks about a case of paranoia autobiographically described", which main objective was to establish the methodological and epistemic principles of this clinical report. In this paper we will present to discussion some preliminary results concerning the actual interpreting procedures of Freud´ s clinical report that had not highlighted the fact that the author himself thought the "Formulations of the two principles of mental functioning" as a Preface of this clinical report.

Una lectura del caso Schreber / A reading of Schreber case

ara esbozar el problema de la psicosis en psicoanálisis, es importante conocer el análisis que Freud realiza sobre la paranoia en referencia al caso Schreber (Puntualizaciones psicoanalíticas sobre un caso de paranoia -Dementia paranoides- descrito autobiográficamente). De este modo, la paranoia se constituye como un elemento de especial relevancia para interrogar el estatuto de la psicosis, puesto que esquizofrenia o melancolía (en su vertiente psicótica) son tratadas en un segundo plano al ser construidos los fundamentos en el campo psicoanalítico por Freud y Lacan. Por lo tanto, se busca hacer un recorrido teórico del historial clínico de Schreber, presentado por Freud en el año de 1911 y del cual se pueden extraer las primeras teorizaciones del ámbito psicoanalítico en cuanto a la psicosis se refiere.

To outline the problem of psychosis in psychoanalysis, it is important to know Freud's analysis of paranoia in reference to the Schreber case (psychoanalytic notes on a case of paranoia -Dementia paranoides- described autobiographically). In this way, paranoia is constituted as an element of special relevance to interrogate the status of psychosis, since schizophrenia or melancholy (in its psychotic aspect) are treated in the background when the foundations are constructed in the psychoanalytic field by Freud. and Lacan. Therefore, we seek to make a theoretical overview of Schreber's clinical history, presented by Freud in the year 1911 and from which the first theorizations of the psychoanalytic field can be extracted as far as psychosis is concerned.

Comparison of MMPI Profile Patterns between Patients with Epileptic Seizures and Psychogenic Non-Epileptic Seizures

BACKGROUND: Psychogenic non epileptic seizures (PNES) are characterized by repeated seizures that are typically caused by stress and psychologic problems such as anxiety and depression. This contrasts with epileptic seizures (ES), which are transient and caused by irregular excitement of nerve cells. PNES can be found in patients with ES, but due to their differing etiologies, it is important to determine the psychologic characteristics that differentiate PNES from ES. METHODS: This study identified psychopathologic and personality traits in 137 patients with PNES (n=7, 49.3% female) or ES (n=0, 35.7% female) using MMPI. The diagnosis was based on a medical history of seizures and the clinical examination in patients who visited the epilepsy clinic. Statistical analyses for comparing MMPI differences between the two groups were conducted using the t-test, chi-square test, and analysis of covariance. RESULTS: We analyzed the frequency of individuals who exhibited a T score of ≥5 on the MMPI, and the results indicated that there were significantly more patients in the PNES group than in the ES group who had elevated scores on the hypochondriasis (Hs) scale and hysteria (Hy) scale. The mean scores of Hs, Hy, paranoia scale and schizophrenia scale were significantly higher in the PNES group than in the ES group. CONCLUSIONS: These results suggest that patients with PNES have greater psychologic problems than ES patients. Differences in MMPI profile patterns between patients with PNES and ES may be helpful in tailoring appropriate therapeutic interventions for the two groups.

Da paranoia do conhecimento à psicose: uma travessia teórica no texto de lacan / The paranoia of knowledge to psychosis: a theoretical crossing in the text lacan

Analisamos aqui as bases teóricas que fundamentaram a tese lacaniana do conhecimento paranoico. Ela surgiu como uma torção da tese de doutorado de Lacan de 1932, na qual ele propõe a paranoia como fenômeno de conhecimento; nos trabalhos subsequentes, acaba por estender ao conhecimento humano em geral a pré-condição paranoica. Verificamos que a "paranoia" passa a designar a estrutura mais universal do eu, permitindo a Lacan atribuir a pré-condição paranoica ao conhecimento humano, e, como psicose, uma estrutura clínica. Através de uma análise do esquema ótico, propusemos uma forma de interpretar como conciliáveis as duas noções citadas acima.

From the paranoia of knowledge to psychosis: a theoretical crossing in the text of Lacan. In this work we analyze the theoretical bases that underlied the Lacanian thesis of paranoiac knowledge. It appeared as a twist of Lacan's doctorate thesis in 1932, where he considers paranoia as a knowledge phenomenon; in his subsequent works he extends the paranoiac precondition to the human knowledge in general. We note that "paranoia" is to designate the most universal structure of the self, allowing Lacan to attribute the paranoiac precondition to the human knowledge, and as psychosis, a clinical structure. Through an analysis of the optic project, we considered one way of interpreting how to conciliate the two concepts mentioned above.

The Relationship between Cognitive Decline and Psychopathology in Patients with Schizophrenia and Bipolar Disorder

OBJECTIVE: The primary goals of the present study were to assess intellectual function in participants with schizophrenia or bipolar disorder (BD) and to investigate the relationships between cognitive decline and the severity of each type of psychopathology. METHODS: The present study included 51 patients with schizophrenia and 42 with BD who were recruited from the psychiatry outpatient clinic of Jeju University Hospital between March 2011 and March 2014. The Korean Wechsler Adult Intelligence Scale (K-WAIS) was administered to each of the 93 participants, and they were categorized into two groups based on their current intelligence quotient (IQ) and their estimated premorbid IQ: severely impaired group (SIG) and mildly impaired group (MIG). The Minnesota Multiple Personality Inventory (MMPI) and the Brief Psychiatric Rating Scale (BPRS) were used to assess psychopathology. RESULTS: The SIG schizophrenia participants exhibited significantly higher scores on the frequent (F) and schizophrenia (Sc) subscales of the MMPI, but significantly lower scores on the correction (K) and psychopathic deviate (Pd) subscales compared with the MIG schizophrenia participants. Furthermore, the BPRS scores were significantly higher in the SIG schizophrenia participants relative to the MIG schizophrenia participants. The SIG BD participants had significantly higher F, masculinity-femininity (Mf), paranoia (Pa), and Sc but significantly lower Pd scores compared with the MIG BD participants. CONCLUSION: The present findings revealed a significant discrepancy between the estimated premorbid levels of cognitive function and current cognitive function in participants with schizophrenia or BD. Moreover, this discrepancy was correlated with severity of psychopathology in both groups.

Characteristics of Emotion and Personality in Obstructive Sleep Apnea Patients with Insomnia Symptoms: Analysis of Minnesota Multiphasic Personality Inventory

OBJECTIVES: Obstructive sleep apnea-hypopnea syndrome (OSAHS) and insomnia are two of the most common sleep disorders in the general population. Because OSAHS patients with insomnia may have difficulty in adapting to the sleep breathing medical equipment, it is necessary to pay special attention to the diagnosis and treatment of comorbid insomnia. This study is to investigate the emotion and personality in OSAHS patients with insomnia complaints by using Minnesota Multiphasic Personality Inventory-2 (MMPI-2). METHODS: We reviewed the results of the standardized questionnaires assessing sleep-related variables, MMPI, and polysomnographic findings of the patients diagnosed as OSAHS. RESULTS: 145 subjects were 49.05+/-11.83 years of age. The mean Respiratory Disturbance Index was 33.57+/-19.91 and the mean score of Insomnia Severity Index (ISI) was 11.52+/-6.49. The mean scores of the Beck Depression Inventory (BDI) and MMPI-2 were within normal ranges. We divided the patients into two groups based on the scores of the ISI, OSAHS with insomnia (n=109) and OSAHS without insomnia (n=36). OSAHS patients with insomnia symptoms had significantly higher scores of hypochondriasis, hysteria, psychasthenia, schizophrenia, paranoia and psychopathic deviate scales and BDI than those without insomnia. CONCLUSIONS: Our results suggest that insomnia complaints are very common in OSAHS patients and the psychological problems are more frequently found in OSAHS patients with insomnia symptom than those without it.

A originalidade e a origem do estádio do espelho em Lacan / The originality and the origin of the mirror stage in Lacan / La originalidad y el origen del estadio del espejo de Lacan

Este artigo traz um estudo da obra inicial de Lacan, na qual se rompe com o estudo das psicoses pela psiquiatria tradicional, e nos interessa no ponto em que tal ruptura nos mostra a originalidade dos caminhos iniciais de Lacan com o esquema do estádio do espelho. Inicialmente, a teorização lacaniana desenvolve-se agregando o campo da personalidade aos estudos da psicose, definindo os fenômenos paranoicos em suas relações de compreensão. Essa perspectiva só se torna possível na medida em que Lacan opera um avanço teórico, ao fazer uma distinção entre a ordem genética e a gnosiológica no homem...

This paper presents a study of the early works of Lacan, in which he breaks with the study of psychosis by traditional psychiatry, which interests us at the point where such a rupture shows the originality of the initial paths of Lacan. Initially, the Lacanian theory is developed by adding the field of personality studies to psychosis, defining the paranoid phenomena in their understanding of relationships. This perspective becomes possible only insofar as Lacan operates a theoretical advance, in making a distinction between the genesis and gnoseological orders in men...

En este artículo se presenta un estudio de la obra lacaniana inicial, que rompe con el estudio de la psicosis por la psiquiatría tradicional, y que nos interesa en el punto donde esta ruptura muestra la originalidad de los caminhos iniciales con el esquema estadio del espejo de Lacan. Inicialmente, la teoría lacaniana se desarrolla con la agregación del campo de la personalidade en los estudios de la psicoses, definiendo así los fenómenos paranoicos en sus relaciones de entendimiento. Esta perspectiva sólo es posible en la medida que Lacan opera un avance teórico, haciendo una distinción entre la orden de la génesis y la orden gnoseológica en el hombre...