Las fases iniciales de la psicosis. ¿Se han olvidado de Klaus Conrad? / The early phases of psychosis. Has Klaus Conrad been forgotten?

Las primeras fases de la psicosis han sido objeto de atención psicopatológica, con especial empuje a partir de las aportaciones de Jaspers y su escuela. Tradicionalmente, se sabe que la evaluación de estas fases requiere de una exploración clínica atenta y cuidadosa. Sin embargo, a principios de este siglo una corriente de entusiasmo biomédico llevó al convencimiento de que era posible identificar a las personas en riesgo de psicosis mediante biomarcadores. De esta forma se podrían aplicar medidas preventivas para evitar su progresión. Los programas de fases iniciales o de primeros episodios se extendieron profusamente. Los promotores de estos programas hicieron tabla rasa del saber psicopatológico previo y buscaron en un espacio natural donde no encontraron nada. Las claves para entender la psicosis están en la vivencia, no en los biomarcadores. Klaus Conrad hizo aportaciones indispensables para identificar y describir los fenómenos vivenciales que aparecen en las primeras etapas de la psicosis. A pesar del tiempo transcurrido desde entonces y de los hallazgos neurocientíficos, conservan vigencia y actualidad. (AU)

The first phases of psychosis have been the object of psychopathological attention, with special emphasis from the contributions of Jaspers and his school on. It is traditionally known that the evaluation of these phases requires an attentive and careful clinical examination. However, at the beginning of this century a current of biomedical enthusiasm led to the conviction that it was possible to identify people at risk of psychosis by means of biomarkers. In this way, preventive measures could be applied in order to avoid progression. Early-stage or first-episode programs spread widely. The promoters of these programs made a clean slate of previous psychopathological knowledge and searched in a natural space in which they found nothing. The keys to understanding psychosis are in the experience, not in biomarkers. Klaus Conrad made essential contributions to identify and describe the experiential phenomena that appear in the early stages of psychosis. Despite the time that has passed and neuroscientific contributions, they remain valid and up-to-date. (AU)

Early Impact of the COVID-19 Outbreak on Sleep in a Large Spanish Sample.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) forced Spain to implement unprecedented lockdown restriction. In this context, different factors could worsen sleep quality, but the impact of the pandemic and lockdown on sleep is still mostly unknown. In this cross-sectional study, we describe self-reported sleep disturbances in people without mental health disorders from a large Spanish sample (n = 15,070). METHODS: During the early phase of the lockdown (19-26 March), an online survey was launched using a snowball sampling method and included sociodemographic and clinical data along with the Depression, Anxiety, and Stress Scale (DASS-21) and the Impact of Event Scale (IES). Two items of the IES were employed to assess sleep characteristics. Descriptive and bivariate analysis and logistic regression models were performed. RESULTS: Difficulty initiating or maintaining sleep were reported by 23.9% of the sample and was associated in the regression model with age (OR = 1.008, p = .003), female sex (OR = 1.344, p < .001), an income reduction >50% (OR = 1.248, p = .037), having one (OR = 1.208, p = .029) and two or more (OR = 1.299, p = .035) elderly dependents, drinking alcohol (OR = 1.129, p = .024), and a higher score on DASS-21 depression (OR = 1.148, p < .001), anxiety (OR = 1.218, p < .001), or stress (OR = 1.302, p < .001) subscales, whereas being able to enjoy free time (OR = 0.604, p < .001) and painting or listening to music (OR = 0.853, p = .012) were protective factors. Dreams related to COVID-19 were reported by 12.9% of the sample and were associated in the regression model with female sex (OR = 1.617, p < .001), being married (OR = 1.190, p = .015), self-employed (OR = 1.373, p = .032), or a civil servant (OR = 1.412, p = .010), having been tested for COVID-19 (OR = 1.583, p = .012), having infected family or friends (OR = 1.233, p = .001), reading news about coronavirus (OR = 1.139, p = .023), drinking alcohol (OR = 1.251, p < .001), and higher scores on DASS-21 depression (OR = 1.102, p < .001), anxiety (OR = 1.222, p < .001), or stress (OR = 1.213, p < .001) subscales, while protective factors were older age (OR = 0.983, p < .001) and being retired (OR = 0.625, p = .045). CONCLUSIONS: These findings could help clinicians and public health systems design and deliver tailored interventions, such as internet-delivered campaigns, to promote sleep quality in the general population.

Nacidos para curar... y vivir / Born to heal... and live

Se presentan argumentos para el debate acerca del impacto para la sociedad y el individuo de las técnicas de reproducción que permiten el «diseño» genético de bebes para el tratamiento de hermanos con enfermedades incurables (AU)

Presents arguments for the debate about the assisted reproductive techniques that allow babies genetic «design» for treatment of brothers or sisters with incurable diseases and their impact on society and individuals (AU)

¿Es posible un tratamiento diferente de las adicciones? / No disponible

Los tratamientos de los trastornos adictivos siguen la inercia de los criterios asistenciales de la segunda mitad del siglo XX. Aunque estos han dado una respuesta satisfactoria a ciertas personas, hay un numeroso grupo de alcohólicos y drogodependientes con repetidas experinecias terapéuticas fracasadas, expuestos en las recaídas a severos procesoso de marginación. EStos hechos junto con las modernas hipótesis sustentadas en los resultados de las investigaciones y en las relaciones observadas entre drogas y trastornos mentales, animan a revisar los objetivos y medios del tratamiento de los drogodependientes(AU)

Drug addiction has today almost the same therapeutica approach that it had in the first sixties. The therapeutic models prevailing now adays have had success in some patients, although some others have repeted failures and relapses with margination problems associated. This facts plus the moder hypothesis about the drug dependence make necessary addictives disorders treatment(AU