[Intracranial sinus thrombosis secondary to the consumption of inhaled speed]. / Trombosis de seno venoso intracraneal secundaria al consumo de speed inhalado.

INTRODUCTION: Speed is a psychostimulant of the Central Nervous System that can cause behavioral alterations, euphoria, psychosis and diverse organic medical pictures. CLINICAL CASE: The case of a 19 year old male patient, who consumes amphetamines, who had behavioral alterations and heteroaggressiveness, circumstances that required psychiatric admission is presented. After performing brain imaging tests, intracranial venous sinus thrombosis was found, which has not, up to the present date, developed significant symptoms. CONCLUSIONS: The aim of the above-mentioned report is to know the mechanism of action of the speed and to relate it consumption to the appearance of intracranial sinus thrombosis. To do so, a search was conducted in the PubMed database using the following terms: amphetamines and intracranial sinus thrombosis; street drugs and cerebrovascular disease; and adverse effects of the drugs.

Trombosis de seno venoso intracraneal secundaria al consumo de speed inhalado / Intracranial sinus thrombosis secondary to the consumption of inhaled speed

Introducción. El speed es un psicoestimulante del SNC que puede provocar alteraciones conductuales, euforia, psicosis y diversos cuadros a nivel orgánico. Caso clínico. Paciente de 19 años, consumidora de anfetaminas, que presentó alteraciones conductuales y heteroagresividad, circunstancias que requirieron ingreso psiquiátrico, en el cual tras la realización de pruebas de imagen cerebral se encontró una trombosis del seno venoso intracraneal que no había desarrollado sintomatología significativa hasta el momento. Conclusiones. El objetivo de dicha comunicación es conocer el mecanismo de acción del speed y relacionar su consumo con la aparición de trombosis del seno venoso. Para ello se ha realizado una búsqueda en la base de datos Pub-Med con los siguientes términos: amphetamines y thrombosissinus intracranial; street drugs y cerebrovascular disease;y adverse effects de las drogas (AU)

Introduction. Speed is a psychostimulant of the Central Nervous System that can cause behavioral alterations, euphoria, psychosis and diverse organic medical pictures. Clinical case. The case of a 19 year old male patient, who consumes amphetamines, who had behavioral alterations and hetero aggressiveness, circumstances that required psychiatric admission is presented. After performing brain imaging tests, intracranial venous sinus thrombosis was found, which has not, up to the present date, developed significant symptoms. Conclusions. The aim of the above-mentioned report is to know the mechanism of action of the speed and to relate it consumption to the appearance of intracranial sinus thrombosis. To do so, a search was conducted in the PubMed database using the following terms: amphetamines and intracranial sinus thrombosis; street drugs and cerebrovascular disease; and adverse effects of the drugs (AU)

Personality profiles of the morbidly obese after vertical banded gastroplasty.

BACKGROUND: The authors attempted to determine if mental status could predict personality profiles, 18 months after surgery in morbidly obese patients. METHODS: Personality characteristics of 100 morbidly obese patients (85 female, 15 male) were analyzed after bariatric surgery (vertical banded gastroplasty). Patients were given the Millon Clinical Multiaxial Inventory-II (MCMI-II). Data were compared with a Spanish clinical population to validate the test in our country. RESULTS: Significant differences were found in Schizoid scale (P<0.0001), Paranoid scale (P<0.001), Histrionic scale (P<0.0001), Compulsive scale (P<0.0001), and Delusional disorder scale (P<0.0001) between the two groups. When psychiatric comorbidity appeared, there were higher values on these scales. CONCLUSIONS: Morbidly obese patients undergoing bariatric surgery show traits and personality disturbances, and the mental state impairs the personality structure.

History of anorexia nervosa in bulimic patients: its influence on body composition.

OBJECTIVE: To analyze the body composition of a group of patients fulfilling DSM-IV criteria for bulimia nervosa (BN), comparing the patients who had a history of DSM-IV anorexia nervosa (AN) with those without such a history to determine (1) whether both groups differed in terms of body composition and (2) whether the differences between groups could be the consequence of the past condition. METHODS: The sample consisted of 104 patients, 43 with prior AN (BN-AN group) and 61 without a history of AN (BN-nonAN). The patients were assessed using anthropometric and bioelectrical methods: height and weight, body circumferences, abdominal diameter, skinfold thickness, and body impedance analysis. In a later phase and to test the influence of current low weight on the results, two experimental groups were created: the first group was composed of the patients from the BN-AN group who had a normal body mass index (BMI range in this group, 20.1-23.4 kg/m2; n = 23); the second group consisted of 23 patients from the BN-nonAN group in the same BMI range. In both phases unpaired sample t tests were performed for statistical analysis. RESULTS: More than 40% of the bulimic patients with a history of AN had a BMI less than 20. They had a lower percentage of body fat, lower muscle mass, and higher percentage of extracellular water. Nevertheless, most of these differences disappeared in the second phase of the analysis, when only the patients within a normal weight range were compared. DISCUSSION: According to these results, a significant number of bulimic patients with a history of AN tend to retain some clinical traits of the past condition and could be viewed as remaining in a "subclinical anorexic status": they are thinner and seem to have less difficulties in maintaining low weight than patients without a history of AN. Nevertheless, in patients who have reached a normal weight after AN, all these differences disappear. This fact raises some important questions related to the boundaries between AN and BN, the shifting from one to another, or when AN patients really recover.

Diferencias psicológicas en pacientes con obesidad mórbida tras cirugía gástrica / Psychological differences in morbidly obese patients after bariatric surgery

Analizar el estado psicológico de los pacientes con obesidad mórbida que son sometidos a tratamiento quirúrgico para perder peso. Analizamos la pérdida de peso en 100 pacientes con obesidad mórbida (85 mujeres y 15 hombres) tras ser sometidos a cirugía bariátrica (gastroplastia vertical bandeada). Relacionamos el porcentaje de pérdida de peso, calidad de vida, conducta alimentaria, psicopatología y rasgos de personalidad en todos los pacientes según el tiempo trancurrido. Los pacientes que llevan menos de un año intervenidos pierden menos peso, tienen más insatisfación corporal y manifiestan sus rasgos de personalidad. Tras 2 años de la intervención quirúrgica, la pérdida de peso es importante, tienen peor calidad de vida, estado psicológico y conducta alimentaria. El tratamiento quirúrgico es una opción correcta en la pérdida de peso de los pacientes con obesidad mórbida. El mayor malestar psicológico tras dos años de cirugía apunta a la necesidad de protocolizar este tipo de intervención incluyendo sistemáticamente a facultativos de la salud mental en el manejo de estos enfermos antes y después de la cirugía (AU)

Psicopatología en pacientes con obesidad mórbida poscirugía gástrica / Psychopathology in patients with morbid obesity after gastric surgery

Se sabe que la obesidad mórbida es una enfermedad compleja que puede deberse a factores biológicos, psicológicos o sociales, además de estar influida por determinados factores metabólicos y de comportamiento. Se analizó la psicopatología de un grupo compuesto por 100 pacientes (85 mujeres, 15 hombres) con obesidad mórbida, que habían recibido tratamiento quirúrgico de restricción gástrica (gastroplastia vertical bandeada) para perder peso. Cada paciente completó la Symptom Check List- 90-R (SCL-90-R) 18 meses después de la cirugía; 40 (40(por ciento) cumplieron criterios CIE-10 de patología psiquiátrica. Se determinaron los diagnósticos psiquiátricos más frecuentes: trastornos afectivos, de ansiedad, alimentarios (trastorno por atracón, anorexia nerviosa, bulimia nerviosa) y dependencia de alcohol. Se precisó la conflictiva de pareja en el 50(por ciento) de las pacientes con patología psiquiátrica. El estudio de regresión logística ha mostrado relación entre la existencia de patología psiquiátrica y las escalas de depresión, ansiedad, hostilidad e índice de severidad general de la SCL-90-R. No se halló relación entre la edad de inicio y la psicopatología detectada. Se comprobó que los pacientes con enfermedad mórbida presentan una importante tasa de patología psiquiátrica y elevados niveles de malestar psicológico y dicho estado se relaciona con el índice de severidad general de la SCL-90R(AU)

Psicopatología en pacientes con obesidad mórbida poscirugía gástrica / Psychopathology in patients with morbid obesity after gastric surgery

Se sabe que la obesidad mórbida es una enfermedad compleja que puede deberse a factores biológicos, psicológicos o sociales, además de estar influida por determinados factores metabólicos y de comportamiento. Se analizó la psicopatología de un grupo compuesto por 100 pacientes (85 mujeres, 15 hombres) con obesidad mórbida, que habían recibido tratamiento quirúrgico de restricción gástrica (gastroplastia vertical bandeada) para perder peso. Cada paciente completó la Symptom Check List- 90-R (SCL-90-R) 18 meses después de la cirugía; 40 (40(por ciento) cumplieron criterios CIE-10 de patología psiquiátrica. Se determinaron los diagnósticos psiquiátricos más frecuentes: trastornos afectivos, de ansiedad, alimentarios (trastorno por atracón, anorexia nerviosa, bulimia nerviosa) y dependencia de alcohol. Se precisó la conflictiva de pareja en el 50(por ciento) de las pacientes con patología psiquiátrica. El estudio de regresión logística ha mostrado relación entre la existencia de patología psiquiátrica y las escalas de depresión, ansiedad, hostilidad e índice de severidad general de la SCL-90-R. No se halló relación entre la edad de inicio y la psicopatología detectada. Se comprobó que los pacientes con enfermedad mórbida presentan una importante tasa de patología psiquiátrica y elevados niveles de malestar psicológico y dicho estado se relaciona con el índice de severidad general de la SCL-90R(AU)

It is known that morbid obesity is a complex disease that may be caused by biological, psychological or social factors and that certain metabolic and compartmental factors influence on it. The psychopathology of a group made up of 100 patients (85 women, 15 men) with morbid obesity that had undergone surgical treatment of gastric restriction (vertical banding gastroplasty) to lose weight was analyzed. Each patient completed the Symptom Check List-90-R (SCL-90-R). 18 months after surgery, 40 of them (40 percent) fulfilled the ICD-10 criteria of psychiatric pathology. The most frequent psychiatric diagnoses were determined: affective disturbance, anxiety disorder and food disorder (disturbance due to gluttony, nervous anorexia and nervous bulimia) and alcohol dependence. The conflict of the couple was observed in 50 percent of the patients with psychiatric pathology. The logistic regression study has shown a relationship between the existance of psychiatric pathology and the scales of depression, anxiety, hostility and index of general severity of the SCL-90-R. No relation was found between the age at onset and the detected psychopathology. It was proved that the patients with morbid disease present an important rate of psychiatric pathology and high levels of psychological malaise and such state is related to the index of general severity of the SCL-90-R(AU)

Gastric surgery and restraint from food as triggering factors of eating disorders in morbid obesity.

UNLABELLED: Obese patients may share some clinical features with anorexia nervosa patients because they risk developing an eating disorder when they diet. Methods and Results Some common etiological, psychological, and social factors have been proposed for both disorders. We present two cases of patients suffering from morbid obesity who, after weight loss, presented an intense fear of regaining weight and developed anorexic-like symptoms. In the first case, the symptoms appeared after gastric reduction surgery. In the second case, a strict diet was the triggering factor. DISCUSSION: This paper stresses the need for psychiatric evaluation of all patients with morbid obesity who seek treatment in clinical settings, in order to identify the factors that may lead to psychiatric complications.

Psychopathological status and interpersonal functioning following weight loss in morbidly obese patients undergoing bariatric surgery.

BACKGROUND: We questioned whether differences in psychopathological status and interpersonal relations exist in a group of morbidly obese patients 18 months after bariatric surgery, as related to extent of weight loss. METHODS: The study group consisted of 100 morbidly obese patients (85 female, 15 male) who had undergone surgical treatment (vertical banded gastroplasty) for weight reduction. Each patient completed the Lancashire Quality of Life Profile European version, the Eating Disorder Inventory, the Symptom Check List-90-Revised, and the Millon Clinical Multiaxial Inventory-II. The sample was divided into 2 groups according to the percentage of excess weight loss 18 months after surgery: a greater weight loss group (weight loss > 30%) and a lesser weight loss group (weight loss < 30%). RESULTS: Significant differences were found between the 2 groups in percentage of weight loss (P < 0.0001), negative self-esteem (P < 0.001), drive for thinness (P < 0.001), body dissatisfaction (P < 0.001), global EDI (P < 0.002), anxiety (P < 0.003), GSI (P < 0.002), avoidant (P < 0.001), borderline (P < 0.0001), and passive-aggressive (P < 0.002). CONCLUSION: Greater weight loss strongly correlates with improved quality of life, less disturbed eating behavior, and lower psychopathology. These results justify the clinical use of surgical procedures and demonstrate that weight loss has powerful psychological and psychosocial implications.