Sensory properties of obsessive thoughts in OCD and the relationship to psychopathology.

For decades hallucinations and perception-laden thoughts were considered specific indicators of schizophrenia. This assumption has been revised over the years. Novel studies indicate that a subgroup of patients with obsessive-compulsive disorder (OCD), borderline disorder or depression display hallucinations and "loud"/perceptual thoughts. The present study examined the frequency of sensory-laden obsessive thoughts and their relationship with the severity of obsessive-compulsive, paranoid and depressive symptoms in a sample of 137 OCD patients who were recruited via the Internet. Participants were asked to fill out the Sensory Properties of Obsessions Questionnaire (SPOQ), the Obsessive-Compulsive Inventory-Revised (OCI-R), the Paranoia Checklist and the Patient Health Questionnaire (PHQ9). In line with a prior study, a total of 72% displayed perceptual intrusions (i.e. vivid obsessions). Correlations emerged between perceptual thoughts and obsessive-compulsive, paranoid and depressive symptoms. Results further strengthen the assumption of a continuum ranging from "silent" thoughts to vivid intrusions and hallucinations.

Síntomas psicóticos en la enfermedad de Sturge-Weber / Psychotic symptoms in Sturge-Weber syndrome

El síndrome de Sturge-Weber (SSW) es una anomalía congénita de origen desconocido caracterizada por angioma cutáneo, glaucoma congénito, calcificaciones intracraneales, crisis epilépticas, retraso intelectual y hemiparesia contralateral. Desde el punto de vista psiquiátrico el SSW se asocia típicamente a cuadros afectivos, trastornos adaptativos y alteraciones conductuales. Los síntomas psicóticos son poco frecuentes y suelen caracterizarse por la presencia de delirios de contenido paranoide. El presente artículo hace una pequeña revisión sobre las características clínicas y los criterios diagnósticos clásicos de este síndrome y presenta un caso clínico de una mujer de 48 años aquejada del SSW que muestra episodios psicóticos con delirios y alucinaciones auditivas y visuales que precisaron ingreso hospitalario. La paciente tenía una conciencia parcial de enfermedad y mejoró con el uso de un antipsicótico vía parenteral (palmitato de paliperidona). El presente caso tiene importancia clínica y puede servir para que otros profesionales sepan cómo diagnosticar y tratar dicho síndrome (AU)

Sturge-Weber syndrome (SWS) congenital anomaly of unknown origin, and is characterised by cutaneous angioma, congenital glaucoma, intracranial calcifications, epileptic seizures, intellectual retardation, and contralateral hemiparesis. From a psychiatric point of view, SWS is typically associated with affective symptoms, adaptive disorders, and behavioural changes. Psychotic symptoms are uncommon and are usually characterised by the presence of a paranoid-type delirium. This article presents a short review of the clinical characteristics and classic diagnostic criteria of this syndrome, as well as presenting a case of a 48 year-old women suffering from SWS who had psychotic episodes with delirium and auditory and visual hallucinations that required hospital admission. The patient was partially aware of the disease, and improved with the use of parenteral antipsychotics (paliperidone palmitate). The case presented is of clinical importance and may enable other professionals to know how to diagnose and treat this syndrome (AU)

Social threat perception and the evolution of paranoia.

Rapid and efficient judgments about the significance of social threat are important for species survival and may recruit specialized neurocognitive systems, consistent with biological models of threat processing. We review cognitive, psychophysiological, neuropsychological, and neuroimaging evidence in support of specialized neural networks subserving the processing of facial displays of threat. Cognitive research suggests that faces depicting anger are detected quickly when presented amongst other facial expressions, on the basis of distinguishing facial features. Psychophysiological investigations using visual scanpath techniques provide evidence for increased foveal attention to facial features of threat-related expressions (anger, fear), which may facilitate rapid detection and subsequent appraisal of the significance of threat (such as the direction of impending threat). Neuropsychological and neuroimaging studies implicate a primary role for the amygdale and pre-frontal cortices in interpreting signs of danger from facial expressions and other social stimuli. Subtle disturbances in these neurocognitive systems underlying efficient threat detection (manifesting in attentional biases and aberrant neural activity) may result in abnormally heightened perception of social threat, as seen in clinical levels of social anxiety and/or persecutory delusions in schizophrenia. Clinical states of paranoia may therefore reflect normal variation (i.e. biases) in the adaptive mechanisms which have evolved, in the Darwinian sense, to facilitate efficient threat detection in humans. As such, clinical levels of paranoia may represent the inevitable cost of efficient threat perception--or 'justified' suspicion--that is necessary for survival of the human species.

Psicosis paranoide recurrente: primera manifestación de feocromocitoma / Relapsing paranoid psychosis as the first manifestation of phaeochromocytoma

Aunque de vez en cuando se ven manifestaciones psiquiátricas en los pacientes con feocromocitoma, éstas se limitan normalmente a estados de ansiedad. Otras manifestaciones menos frecuentes son la depresión y los síntomas psicóticos. En este artículo describimos a un paciente que presentó una psicosis paranoide como única manifestación de un feocromocitoma mucho antes de que éste fuera diagnosticado de dicha enfermedad. El trastorno delirante, que se trató con fármacos antipsicóticos durante dos años, desapareció tras la resección del tumor. Se podría especular que las catecolaminas podrían tener relación con el estado psicótico de este paciente y nos planteamos hasta que punto el feocromocitoma podría ser un "ejemplo natural" para explicar la fisiopatología catecolaminérgica involucrada en algunos trastornos psicóticos (AU)

Aportaciones de la obra filosófica de Jean-Paul Sartre a la psiquiatría actual (parte II) / Jean-Paul Sartres's philosophical work contributions to the current psychiatry (partII)

En esta segunda parte, se han aplicado las directrices sartreanas a la clínica psiquiátrica; en concreto a los cuadros paranoides psicóticos y, más tarde, a las "actitudes paranoides" de los neuróticos. En ambos casos, hemos obtenido resultados que definen bastante bien los dos procesos, pero también se ha logrado aportar nuevos datos en relación a una clara diferenciación entre neurosis y psicosis. Lo aquí hallado nos resulta muy importante por dos razones: a) porque frecuentemente se asiste a atribuciones de aspectos psicológicos diversos que son claramente neuróticos a los paranoicos (psicóticos), como es el caso de: inferioridad, inseguridad, indecisión, falta de autoestima, etc.; y b) que una diferenciación clara puede influir decisivamente sobre nuestras actuaciones, definiendo mejor qué podemos hacer en cada caso (AU)

[Psychopathologic conditions from the standpoint of the functional specialization of the cerebral hemispheres]. / Issledovanie psikhopatologicheskikh sostoianii s tochki zreniia funktsional'noi spetsializatsii polusharii golovnogo mozga.

A comprehensive examination of the nature of psychopathological syndromes and the functional involvement of the structures of the right or left hemispheres (assessed by the degree of spatial synchronization of the biopotentials) revealed a relationship between the features of the syndrome formation and the predominant utilization of the mechanisms of perception and procession of information common to the left (in syndromes determined by interpretative formations) or the right (in hallucinational syndromes) hemisphere. The predominant involvement of the systems of one or another hemisphere may determine some characteristics of the clinical picture of mental diseases detected in transcultural studies.