[Historic evolution of psychiatric care paradigms]. / La evolución histórica de los paradigmas de atención en psiquiatría.

The rehabilitation of severely mentally-ill patients and their return to the community are related to historical progress. Their potential of achieving these goals is higher or lower depending on the presence of more or less stigma attached to their condition. Watts and Bennett have divided psychiatric rehabilitation into three phases: Phase 1: Very little was done because there was not much to be done. Patients were rejected and received mistreatment. Phase 2: Their vulnerability was admitted and protection was given to the disabled; services were provided by charity and voluntary religious institutions; there was no clear distinction between illness and poverty. Phase 3: Modern psychiatric rehabilitation began after the two World Wars in the 20th century, with attempts to modify and to oppose disability with the development of other skills. Psychiatric rehabilitation programs help these patients to resume life in the community and prevent their social isolation. By ensuring continuity of their treatment, rehabilitation programs reduce relapses and hospitalizations, thereby contributing to preserve family life and social inclusion. This reduces treatment costs to both families and communities, while promoting patients' reinsertion and recovery in the community according to their individual needs.

[A new star in the sky of psychiatry: The European College of Neuropsychopharmacology]. / Una nueva estrella en el firmamento de la psiquiatría: el Colegio Europeo de Neuropsicofarmacología.

A commentary about the activities of the ECNP, whose congresses have become a new destination for many professionals interested in clinic and high level research in psychiatry and brain is made. The author presents the goals of the ECNP, the meeting activities in general, and, in particular, the press conferences that took place during the congresses. The 26th Congress (Barcelona, Spain, October, 2013) and the 27th Congress (Berlin, Germany, October, 2014) are reviewed. The high scientific level of both congresses is highlighted.

[Alternatives to chronic hospitalization in mental health]. / Alternativas a la hospitalización crónica.

It is not possible to work on alternatives to chronic institutionalization without taking into account a reform of the mental health care system. A great deal of experience has been accumulated and a lot of unsolved problems have arisen since the beginning of the deinstitutionalization in USA and Europe in the 60s. The aim was the closing of psychiatric hospitals, and so the accent was put on the physical place of treatment instead on the quality of the treatment or on the actual needs of the people involved. A review of the experiences is made and some clues are given to avoid the major problems and errors that have presented. Political decisions, experienced professionals, a stable and sufficient budget, modification of some laws, the creation of community institutions that fulfill the patient's needs before moving them, postgraduate training in rehabilitation, flexibility and creativity with empirical and scientific grounds are needed for a successful reform of the mental health care system.

[Foster Home for children with mild and moderate behavioral problems]. / Hogar infantil de tratamiento para niños con trastornos de conducta leves a moderados.

A methodology for working with children and adolescents with disruptive behavior is presented. This program has been in use since 1998 in a boarding home for boys in Buenos Aires. A common issue in this sample is the presence of non-functional families with high levels of violence between their members.

Hogar infantil de tratamiento para niños con trastornos de conducta leves a moderados / Foster home for children with mild and moderate behavioral problems

Se presenta el modo de trabajo llevado a cabo desde hace diez años en un hogar para niños (varones) con trastornos de conducta leves a moderados que presentan diferentes trastornos mentales graves. Un denominador común es la presencia de familias disfuncionales, ausentes o expulsivas, en las que se registran altos niveles de violencia ejercida sobre estos niños. Se describe someramente el abordaje utilizado y se ilustra con una viñeta clínica.

A methodology for working with children and adolescents with disruptive behavior is presented. This program has been in use since 1998 in a boarding home for boys in Buenos Aires. A common issue in this sample is the presence of non-functional families with high levels of violence between their members.

Hogar infantil de tratamiento para niños con trastornos de conducta leves a moderados / Foster home for children with mild and moderate behavioral problems

Se presenta el modo de trabajo llevado a cabo desde hace diez años en un hogar para niños (varones) con trastornos de conducta leves a moderados que presentan diferentes trastornos mentales graves. Un denominador común es la presencia de familias disfuncionales, ausentes o expulsivas, en las que se registran altos niveles de violencia ejercida sobre estos niños. Se describe someramente el abordaje utilizado y se ilustra con una viñeta clínica.(AU)

A methodology for working with children and adolescents with disruptive behavior is presented. This program has been in use since 1998 in a boarding home for boys in Buenos Aires. A common issue in this sample is the presence of non-functional families with high levels of violence between their members.(AU)

[Behavioural and psychological signs in dementia. Clinical features. Pharmacological and non-pharmacological treatment strategies]. / Trastornos psicóticos y de conducta en las demencias: clínica y estrategias terapéuticas farmacológicas y no farmacológicas.

In first term, we define the current concepts in regard to psychosis (delirium and hallucinations) and abnormal behaviours (aggression, depression and mood changes such as mania, apathy, anxiety, agitation and desinhibition) in dementia. We also review the most used drugs in order to control these symptoms (typical and atypical antipsychotics, anti-epileptic drugs, benzodiazepines, SSRI, memantine and AcheI). As well, we take in consideration pharmacokinetic and pharmacodynamic characteristics, relationship to aging and interactions of these medications. Finally, we briefly describe the management of non-pharmacological of the most common behavioural symptoms: disruptive conducts such as exaggerated responses to minimal stimuli, catastrophic reaction, violence, anger and hostility, wandering and sundowning. As well, we discuss how to manage sleep disturbances, sexual aggression, incontinence and dressing apraxia. Management of these conditions involves, in first term, a comprehensive understanding of the whole situation and identification of underlying possible causes will make possible to evaluate results. This approach will lead to a more rationale proposal of psychotherapeutic and behavioural techniques, and milieu modifications. Finaly, we consider safety patient's in the community as well as the risk of abuse originated in a non-healthy patient-caregiver relationship.

[Nosography of dementia]. / Nosografía de las demencias.

Dementia diagnostic criteria presently in use are referred. The authors underline the importance of an early diagnosis for prognosis and treatment. Diagnostic criteria from international groups and their harmonization to Argentine culture proposed by the CAED (Argentine Consortium for the Study of Dementias) are reviewed.

[Sexual behavior in patients with schizophrenia: a review of the literature and survey in patients attending a rehabilitation program]. / Sexualidad y esquizofrenia: breve revisión del tema y resultados de una encuesta a pacientes en rehabilitación.

UNLABELLED: Sexual functioning of patients with a severe psychotic illness such as schizophrenia has received little attention from clinicians. Sexual dysfunctions are an important contributing factor to a poor quality of life in this population and important factor in non-adherence to pharmacological treatment. A high percentage of individuals with schizophrenia reported to have no sexual intercourse or showed evidence of sexual dysfunction (28%; to 40%; in females and 40%; to 60%; in males), which has different etiology, like the illness itself (12%; to 15%;), aging (35%; to 41%;), or side effects from the psychiatric medication (26%; to 36%;). We alert about this problems and show the preliminary results of a survey in an adult chronic population (ranging between 27 to 57 years of age, with an equal sex distribution, attending in a psychiatric rehabilitation program in a half-way house. RESULTS: a 36%; of the patients reported to have sexual difficulties, the 50%; of the sample has had sexual intercourse with some regularity, only the 32%; of the sample reported to have sex in the last month, and less than a 5%; of this population reported to have a regular partner, among others suggestions of sexual dysfunction.