[III Colloquium of Bonneval: Ey and Lacan discuss the reality of mental illness]. / III Coloquio de Bonneval: Ey y Lacan discuten sobre la realidad de la enfermedad mental.

This paper analyzes the contributions emerging from the discussions of the III Colloquium of Bonneval, France, on "The problem of the psychogenesis of neuroses and psychoses" carried out in 1946, and especially the debate between H. Ey and J. Lacan. These contributions gravitated on the conception that psychiatrists have about the reality of mental illness. After presenting the different meanings of the term psychogenesis and the antecedents on the notions of the normal and the pathological in the work of G. Cangilhem, the positions of H. Ey and J. Lacan are analyzed in detail.

Valor humano del enfermo mental / Human value of the mentally ill

En este artículo se sostiene que la no estigmatización y la defensa de los derechos personales de los enfermos mentales dependen esencialmente de que se reconozca que su trastorno psíquico constituye un déficit en su humanidad. Con ese objetivo se consideran trespuntos. En el primero se analiza qué es lo que se ®asiste¼ psicológicamente en el ®área de saludmental¼ y qué segmento de esa ®asistencia¼ esestigmatizado; en el segundo se analiza cómo y por qué se ha pasado del modelo médico de la patología mental a la construcción social que afirma que la enfermedad mental es un mito (Th. Szasz, M. Foucault), entendiendo que esa afirmación debe ser cuestionada; en el tercero se afirma que el reconocimiento de que el déficit de autonomía personal de los diferentes tipos psicopatológicos está determinado por un proceso mórbido es lo que fundamenta el valor humano del enfermo mental.

This article argues that the non-stigmatization and defense of the personal rights of the mentally ill depend essentially on the recognition that their psychic disorder constitutes a deficit in their humanity. To this end, three points are considered. In the first, what is analyzed is analyzed psychologically in the "health area" and which segment of that "assistance" is stigmatized; in the second one, it is analyzed how and why the medical model of mental pathology has been passed to the social construction that affirms that mental illness is a myth (Th.Szasz, M. Foucault), understanding that this affirmation must be questioned; in the third it is affirmed that the recognition that the deficit of personal autonomy of the different psychopathological types is determined by a morbid process is what bases the human value of the mentally ill.

El término «locuras discordantes¼ de Ph. Chaslin y el concepto de «escisión esquizofrénica¼ de E. Bleuler / Ph. Chaslin's term \"discordant follies\" and E. Bleuler's concep of \"schizofphrenic splitting\"

En este artículo se consideran tres puntos. En primer lugar, se esquematiza el libro sobre semiología mental de Phillipe Chaslin basada en el análisis de los signos de los casos clínicos concretos y de los «tipos clínicos¼, entre los cuales describe las «locuras discordantes¼. En segundo lugar,se analiza el concepto de «escisión¼ (Spaltung) esquizofrénica de Eugen Bleuler como uno de sus «síntomas fundamentales¼ mediante el cual se describió el orden psíquico infraestructural, cuya naturaleza exige un método semiológico específico. Finalmente, se analiza la afirmación hecha por Bleuler de que podía haber utilizado el término «discordancia¼ para su concepto de «escisión esquizofrénica¼ y lo que esto significa.

The "mental feature" in mental illness: difficulties that this reality poses for diagnosis and classification.

Four points are considered in this article. In the first place, it is argued that the "settings" of psychiatric care express the need to respond to the degree of decrease in personal freedom of the patient. Then, the issue of how "the mental feature" of the mental pathology has been recognized and categorized since the 18th century is examined, pointing out the difficulties involved in considering the mental nature of the subject of psychiatry. In the third place, the issue of how current systems of diagnosis and classification are posed regarding this reality is briefly looked at. Finally, the characteristics of a working hypothesis that allows organizing consistent clinical facts providing a heuristic perspective are analyzed.

The "mental feature" in mental illness: difficulties that this reality poses for diagnosis and classification / O "mental" na doença mental: dificuldades que sua realidade impõe em relação a diagnóstico e classificação

Four points are considered in this article. In the first place, it is argued that the "settings" of psychiatric care express the need to respond to the degree of decrease in personal freedom of the patient. Then, the issue of how "the mental feature" of the mental pathology has been recognized and categorized since the 18th century is examined, pointing out the difficulties involved in considering the mental nature of the subject of psychiatry. In the third place, the issue of how current systems of diagnosis and classification are posed regarding this reality is briefly looked at. Finally, the characteristics of a working hypothesis that allows organizing consistent clinical facts providing a heuristic perspective are analyzed

Neste artigo, quatro pontos são considerados. Em primeiro lugar, argumenta-se que os "espaços" da atenção psiquiátrica expressam a necessidade de responder ao grau de diminuição da liberdade pessoal do paciente. Em seguida, são discutidas as formas como o "mental" da doença mental tem sido reconhecido e categorizado a partir do século 18, apontando para dificuldades envolvidas ao se considerar o caráter mental do objeto da psiquiatria. Em terceiro lugar, são discutidas brevemente as formas como os sistemas atuais de diagnóstico e classificação se posicionam sobre essa realidade. Finalmente, as características de uma hipótese de trabalho que permita organizar de modo coerente os fatos clínicos e que proporcione uma perspectiva que seja heurística são analisadas

[The evolution of psychiatry in Uruguay]. / Breve síntesis de la evolución de la psiquiatría en el Uruguay.

Uruguay, a country in South America situated between Brazil and Argentina, has a population of 3 million, a literacy rate of 97%, and health coverage of 87% . Treatment of patients with mental disturbances has existed throughout its history. From colonial times and in the Spanish religious tradition, treatment of mental alienation had recourse to the "madhouse" of the Charity Hospital in Montevideo (1788). Half a century after independence the National Lunatic Asylum was built (1880), and the field of psychiatry began to develop, centred on the asylum-hospital. Within a French medical heritage, institutions such as the Chair of Psychiatry (1907) and the Society of Psychiatry (1923) were created; their academic activities permanently invigorated the growth of this branch of medicine. Since the late 1960's, with the contribution of both European thought and the North American influence, psychiatry has begun a progressive transformation, with positive gains (extension of psychiatry to the whole country, more pragmatic treatments with community involvement, academic links with non-public institutions, integration between models, etc.), but also with negative aspects (an increasing risk of abandoning the discipline of psychopathology and of trivialising diagnosis and therapy).

[The hallucination: a perception deficit]. / La alucinación: déficit de percepción.

To be able to understand the reality of perception as much as the reality of hallucinations, it is necessary to start from notions that, placing in doubt those of "common sense", make possible: a) recognize the psychic structure essentially different from the imaginary phenomena of hallucination (Henri Ey talks about "heteronomy"), and b) understand that heteronomy express the desorganization of the perceptive act. Thereby, it is showed that the hallucination is a "false perception" and not a way of "further perception", as it is deduced from the series of DSM. Because of that Ey says that hallucination is essentially "factic" in the double sense of the term, of being a clinical fact as well as being characterized as an irruption of irreality.

La alucinación: déficit de percepción / The Hallucination: a perception deficit

Para poder comprender tanto la realidad de la percepción como la de la alucinación es necesario partir de conceptos que, poniendo en cuestión los "de sentido común", hagan posible: a) reconocer la estructura psíquica esencialmente diferente de los fenómenos imaginarios alucinatorios (Henri Ey habla de: "heteronomía"), y b) comprender que esa heteronomía expresa la desorganización del acto perceptivo. Así se evidencia que la alucinación es una "falsa percepción" y no una forma de "más percepción" como se entiende en la serie de los DSM. Por eso Ey dice que la alucinación es esencialmente "fáctica" en el doble sentido de la palabra, de ser un hecho clínico y de caracterizarse por ser una irrupción de irrealidad.(AU)

To be able to understand the reality of perception as much as the reality of hallucinations, it is necessary to start from notions that, placing in doubt those of "common sense", make possible: a) recognize the psychic structure essentially different from the imaginary phenomena of hallucination (Henri Ey talks about "heteronomy"), and b) understand that heteronomy express the desorganization of the perceptive act. Thereby, it is showed that the hallucination is a "false perception" and not a way of "further perception", as it is deduced from the series of DSM.(AU)

La alucinación: déficit de percepción / The Hallucination: a perception deficit

Para poder comprender tanto la realidad de la percepción como la de la alucinación es necesario partir de conceptos que, poniendo en cuestión los "de sentido común", hagan posible: a) reconocer la estructura psíquica esencialmente diferente de los fenómenos imaginarios alucinatorios (Henri Ey habla de: "heteronomía"), y b) comprender que esa heteronomía expresa la desorganización del acto perceptivo. Así se evidencia que la alucinación es una "falsa percepción" y no una forma de "más percepción" como se entiende en la serie de los DSM. Por eso Ey dice que la alucinación es esencialmente "fáctica" en el doble sentido de la palabra, de ser un hecho clínico y de caracterizarse por ser una irrupción de irrealidad.

To be able to understand the reality of perception as much as the reality of hallucinations, it is necessary to start from notions that, placing in doubt those of "common sense", make possible: a) recognize the psychic structure essentially different from the imaginary phenomena of hallucination (Henri Ey talks about "heteronomy"), and b) understand that heteronomy express the desorganization of the perceptive act. Thereby, it is showed that the hallucination is a "false perception" and not a way of "further perception", as it is deduced from the series of DSM.