La demencia del rey Fernando VI y el año sin rey / The dementia of King Ferdinand VI and the year with no king

Introducción. Fernando VI fue rey de España entre 1746 y 1759. Su último año de reinado se conoce como el año sin rey. Durante ese año, el monarca sufrió un rápido empeoramiento de sus condiciones mentales. La enfermedad generalmente ha sido atribuida a una condición psiquiátrica primaria, generalmente por un trastorno bipolar. Desarrollo. Se realiza un estudio de investigación en los archivos documentales españoles y bibliotecas en busca de información clínica sobre la enfermedad de Fernando VI. Se realiza una evaluación y discusión clínica de la enfermedad del rey sobre la base de la información obtenida. Conclusiones. El inicio del empeoramiento clínico del último año de Fernando VI empezó tras la muerte de su amada esposa. Los síntomas iniciales descritos pueden ser similares a los de un episodio depresivo mayor, sin embargo, el monarca sufrió un empeoramiento rápidamente progresivo con alteraciones de la personalidad, conductuales, encamamiento, pérdida de control de esfínteres y crisis epilépticas. Los últimos meses de su vida estuvo en un estado de postración con un estado cognitivo compatible con una demencia grave. Por todo ello, aunque es posible que Fernando VI pudiera padecer previamente algún tipo de trastorno psiquiátrico, la enfermedad que le llevó a su muerte precoz sería compatible con lo que hoy conocemos como una demencia rápidamente progresiva (AU)

Introduction. Ferdinand VI was king of Spain from 1746 until 1759. His last year of reign is known as the year without a king. Over this year the king suffered a rapidly progressive deterioration of his mental health status. The clinical condition has been always attributed to a pure psychiatric disorder, generally a bipolar disorder. Development. We review the sources of information in the Spanish archives and libraries, in order to find clinical information about the illness suffered by the king. We made a clinical evaluation and discussion about the disease of the king according to the information that has been obtained and the different diseases that could have caused the illness. Conclusions. Last year clinical deterioration of Ferdinand VI started with the death of his lovely wife. At first, the symptoms were similar to the symptoms of a mayor depressive disorder. Although the king had a rapidly progressive deterioration with severe changes in behavior and conduct, long stay in bed, loss of sphincters control and seizures. During the last months of his life, the king fell into a state of prostration with a marked cognitive impairment. Although it is possible that Ferdinand VI could have had a previous psychiatric disorder, there is enough information to think about a rapidly progressive dementia as the main cause of his clinical worsening and dead (AU)

Hydrotherapy in state mental hospitals in the mid-twentieth century.

This research describes nurses' experiences in administering "the water cure," hot or cold wet sheet packs, and continuous tub baths in state mental hospitals during the early twentieth century. Student and graduate nurses were required to demonstrate competence in hydrotherapy treatments used to calm agitated or manic patients in the era before neuroleptics. The nurses interviewed for this study indicated that, although labor intensive, hydrotherapy worked, at least temporarily. Although no longer used in state hospitals, hydrotherapy is regaining popularity with the general public and may serve as an adjunct to pharmacological treatments to calm hospitalized patients in the future.

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This paper traces the history of 'akathisia' and related syndromes, and examines the important studies that have helped shape our current understanding of the concept. Even though the term has come to be used synonymously with drug-induced akathisia, its origin was in the pre-neuroleptic era, and it is still often used to describe syndromes not related to medication. The literature clearly distinguishes restless legs syndrome (RLS) from akathisia. The complexity of the akathisia syndrome has increasingly become manifest, and a number of sub-types have been described. Recent attempts have been made to operationalize its diagnostic criteria and understand its pathophysiology. Akathisia due to non-neuroleptic drugs, in particular the serotonin-specific reuptake inhibitors (SSRIs), has also received much attention. The development of newer psychopharmacotherapeutic drugs, with different side-effects profiles, has made this focus pertinent and timely.