Propuesta de un modelo de respuesta de los delirios esquizofrénicos a los antipsicóticos / Proposal of a model of schizophrenic delusions’ response to antipsychotics

Pese al gran avance experimentado por la psicofarmacología, hay preguntas obvias en la práctica cotidiana que no suelen centrar la atención de los investigadores. Se propone un modelo que explique la respuesta variable que se observa en los delirios esquizofrénicos al tratamiento antipsicótico. Se trata de un modelo compuesto por dos polos. En uno de ellos rige el paradigma de la inhibición de la respuesta de evitación condicionada, que remite al efecto ataráxico o neuroléptico de estos fármacos. El otro polo se basa en una aplicación de la fenomenología de Husserl a la psicopatología, que permite la organización de diferentes fenómenos característicos de la esquizofrenia. Las ganancias en este ámbito se ponen en relación con la hipersaliencia dopaminérgica característica del brote esquizofrénico. Por último, se reconocen las limitaciones del modelo propuesto, que no dejan de ser las mismas que las de la psiquiatría, obligada a moverse entre la neurociencia y la persona, ámbitos de conocimiento mutuamente irreductibles (AU)

Despite recent advances in psychopharmacology, some obvious questions regarding the day-to-day practice do not use to draw attention of researchers. Our model tries to explain the variable response of schizophrenic delusions to antipsychotic drugs. It is a model composed of two poles. In one of them the principle of conditioned avoidance response applies, which refers to the ataraxic or neuroleptic effect of antipsychotic drugs. At the other end of the model Husserl’s phenomenology is applied to psychopathology in order to organize diverse and distinctive phenomena of schizophrenia. Results of this research are then related to the dopaminergic aberrant salience occurring in the schizophrenic outbreak. Finally, constraints of this work are pointed out, which are the same for the very foundations of psychiatry, a medical specialty compelled to move between fields of knowledge mutually irreducible such as neuroscience and human experience (AU)

Impact of a social and employment crisis on the demand for mental health care (Footwear Crisis, Elche 2004).

INTRODUCTION: Between December 1999 and December 2004 the footwear manufacturing industry in Elche suffered a 24% fall in employment. In this context, it was decided to conduct study to detect possible changes in the demand for mental health care. MATERIAL AND METHODS: The first-time consultations between December 2001 and June 2002 were compared with those seen between October 2004 and April 2005. Differences were looked for in the percentage of referrals for work-related stress factors. The role of these work-related stress factors in the changes detected in the sociodemographic profile of the patients was also evaluated. RESULTS AND CONCLUSIONS: Changes were detected in the sociodemographic profile (gender and education level), employment status and reason for consultation. First consultations increased in the following groups: males, with a higher education level, unemployed, on sick leave or pensioners, and also those with employment problems as the main reason for consultation or a worsening of other health conditions.