RESUMO
Like high life expectancy also emancipation for questions of life quality and sexuality in old age is increasing. Estimations and possibilities for psychotherapy in old age would be painted out and discussed.
Assuntos
Envelhecimento/psicologia , Amor , Psicoterapia , Sexualidade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , MasculinoRESUMO
Schizophrenia is a major psychiatric disease, which affects the centre of the personality, with severe problems of perception, cognition as well as affective and social behaviour. In cerebrospinal fluid of drug-free schizophrenic patients, a significant decrease in the level of total glutathione (GSH) by 27% (P<0.05) was observed as compared to controls, in keeping with the reported reduced level of its metabolite gamma-glutamylglutamine. With a new non-invasive proton magnetic resonance spectroscopy methodology, GSH level in medial prefrontal cortex of schizophrenic patients was found to be 52% (P = 0.0012) lower than in controls. GSH plays a fundamental role in protecting cells from damage by reactive oxygen species generated among others by the metabolism of dopamine. A deficit in GSH would lead to degenerative processes in the surrounding of dopaminergic terminals resulting in loss of connectivity. GSH also potentiates the N-methyl-D-aspartate (NMDA) receptor response to glutamate, an effect presumably reduced by a GSH deficit, leading to a situation similar to the application of phencyclidine (PCP). Thus, a GSH hypothesis might integrate many established biological aspects of schizophrenia.
Assuntos
Glutationa/líquido cefalorraquidiano , Glutationa/deficiência , Córtex Pré-Frontal/metabolismo , Esquizofrenia/líquido cefalorraquidiano , Esquizofrenia/fisiopatologia , Adolescente , Adulto , Cromatografia Líquida de Alta Pressão , Dopamina/metabolismo , Humanos , Espectroscopia de Ressonância Magnética , Masculino , Espectrometria de Massas , Degeneração Neural/metabolismo , Degeneração Neural/patologia , Degeneração Neural/fisiopatologia , Córtex Pré-Frontal/patologia , Córtex Pré-Frontal/fisiopatologia , Terminações Pré-Sinápticas/metabolismo , Terminações Pré-Sinápticas/patologia , Espécies Reativas de Oxigênio/metabolismo , Esquizofrenia/patologiaRESUMO
Anxiety is a normal and ubiquitous emotion with adaptive value, in that is acts as a warning system alerting a person of impending danger. This system can be considered maladaptive, however, when anxiety becomes unjustifiably excessive and, thus, morbid. Both forms of anxiety, situational anxiety and pathological anxiety are common in the elderly. Also anxiety disorders in elderly persons are among the most frequently encountered psychiatric conditions. In this paper I begin with the epidemiology of anxiety in the elderly, discuss the clinical characteristics of late life anxiety with special attention to difficulties in the differential diagnostic evaluation and describe treatment strategies for managing elderly patients with anxiety disorders. In conclusion I try to discuss the question: "Anxiety in the elderly--Condition sine qua non?"
