La locura mixedematosa. El delirio que cura con levotiroxina / Myxoedema madness. The delusion that is cured with levothyroxine

Objetivo: El objetivo de este artículo es analizar, a través de un caso clínico, los trastornos psicóticos relacionados con el hipotiroidismo. Caso clínico: Se presenta el caso clínico de una mujer de 51años ingresada en el hospital por un trastorno psicótico agudo, con delirios paranoides y conducta alucinatoria. La evaluación revela un estado hipotiroideo severo y la paciente es tratada con terapia hormonal y antipsicóticos, consiguiéndose la remisión clínica completa. Resultados: La aparición de trastornos mentales, especialmente trastornos del estado de ánimo, durante las enfermedades de la tiroides se conoce desde hace un siglo, mientras que los trastornos psicóticos asociados con disfunción tiroidea rara vez se describen. Conclusiones: Este caso pone de relevancia el papel del equilibrio hormonal de la tiroides en el inicio de las manifestaciones psicóticas y enfatiza la necesidad de valorar la funcionalidad de esta glándula endocrina en el contexto del diagnóstico etiológico de la psicosis

Objective: The aim of this article is to analyse, using a clinical case, the psychotic disorders related to hypothyroidism. Case report: The case is presented of a 51-year-old woman who was admitted to the hospital with an acute psychotic disorder, as well as paranoid delusions and hallucinatory behaviour. The evaluation revealed a severe hypothyroid state, for which the patient was treated with hormone therapy and antipsychotics, resulting in full clinical remission. Results: The occurrence of mental disorders, especially mood disorders, during thyroid diseases have been known for a century, while psychotic disorders associated with thyroid diseases are rarely described. Conclusions: This case highlights the role of thyroid hormone balance in the onset of psychotic manifestations, and emphasises the need to assess the functionality of this endocrine gland in the context of the aetiological diagnosis of psychosis

La evolución del concepto de Esquizofrenia Resistente al Tratamiento / The evolving concept of treatment-resistant schizophrenia

La esquizofrenia es una enfermedad crónica del cuerpo y de la mente que afecta al 1% de la población. La existencia de la persona con esquizofrenia debe ser entendida, por lo menos, con dos perspectivas: una, la que contempla su integración en la comunidad social; otra, la que entiende que hay un paciente con un problema de salud tratable con medicinas y con psicoterapias. Hay un grupo numeroso de pacientes con presentaciones ‘resistentes’ de la esquizofrenia, es decir: casos en los que no se obtiene un grado mínimo de remisión con los tratamientos convencionales. Estos casos dejan en evidencia el hecho de que todavía hoy carecemos de un modelo de tratamiento integrador que esté armado a partir de intervenciones específicas cuya eficacia sea verificable. El concepto de ‘esquizofrenia resistente’ debería haber evolucionado a la par que los conocimientos y los recursos terapéuticos que hoy tenemos. ¿Por qué no ha ocurrido? Este artículo revisa la historia del concepto de ‘resistencia’ para dar cuenta de tal fracaso y proponer perspectivas metodológicas que nos saquen del estancamiento (AU)

Schizophrenia is a chronic disease of body and mind that affects 1% of the population. The existence of the person with schizophrenia should be understood, at least, with two perspectives: one considering the integration of the individual into the social community, another which includes the understanding that there is a patient with a medical problem treatable with medications and psychotherapies. There is a large group of patients with ‘treatment-resistant schizophrenia,” that is, cases in which a minimum degree of remission with conventional treatments is not obtained. These cases have pointed to the fact that even today we still lack an integrative treatment model obtained through the assembling of specific interventions with verifiable effectiveness. The concept of treatment-resistant schizophrenia should have evolved in accordance with the advancing of the currently available knowledge and therapeutic resources. Why hasn’t this happened? This article reviews the history of the concept of “resistance” to account for such failure and proposes a methodological approach to overcome this stagnation (AU)

The evolving concept of Treatment- Resistant Schizophrenia.

Schizophrenia is a chronic disease of body and mind that affects 1% of the population. The existence of the person with schizophrenia should be understood, at least, from two perspectives: one considering the integration of the individual into the social community, another understanding that there is a patient with a medical problem treatable with medications and psychotherapies. There is a large group of patients with 'treatment-resistant schizophrenia," that is, cases in which a minimum degree of remission with conventional treatments is not obtained. These cases have pointed to the fact that even today we still lack an integrative treatment model obtained through the assembling of specific interventions with verifiable effectiveness. The concept of treatment-resistant schizophrenia should have evolved in accordance with the advancing of the currently available knowledge and therapeutic resources. Why hasn't this happened? This article reviews the history of the concept of "resistance" to account for such failure and proposes a methodological approach to overcome this stagnation.

El recién nacido de bajo peso / The premature infant

En un doble trabajo prospectivo y retrospectivo se analizan características etiológicas y clínicas de los niños nacidos con un peso menor a los 2500 g. De dicho análisis surge un grupo de conclusiones, en su mayor parte concordantes con los trabajos previos de otros autores, que resumen la importancia de los distintos factores etiológicos, parámetros clínicos y acontecer evolutivo de este importante grupo de pacientes.