Childhood adversity and adolescent acting-out behaviors: the mediating role of mentalizing difficulties and epistemic vigilance.

Childhood adversity is a well-established risk factor for adolescent acting-out behaviors such as self-harm, bingeing, substance abuse, and aggressive behavior. From a mentalizing perspective, acting-out behaviors are understood as resulting from a combination of impairments in mentalizing and epistemic vigilance that are a consequence of childhood adversity. Yet, few studies have investigated these assumptions. The current study investigated the potential mediating role of mentalizing impairments and epistemic vigilance in the relationship between childhood adversity and acting-out behaviors in adolescents, oversampled for risk status for psychopathology (N = 451, mean age = 15.40 years). Structural equation modeling showed a strong, direct relationship between childhood adversity and acting-out behaviors, confirming the importance of traumatic childhood experiences for adolescent acting-out behaviors. This relationship was partially mediated by both mentalizing difficulties and epistemic vigilance, explaining about 40% of the total variance. These results support the importance of focusing on strengthening mentalizing abilities and lowering epistemic hypervigilance in psychotherapeutic work with adolescents who have experienced childhood trauma.

Impacto psicológico de la hiperhidrosis primaria / Psychological impact of primary hyperhidrosis / Impacto psicológico da hiperidrose primária

La hiperhidrosis primaria es una patología frecuente que representa un motivo de consulta dermatológica común, se caracterizada por una sudoración excesiva en regiones axilares, plantares, palmares o craneofaciales que aparece generalmente en la pubertad o en la adolescencia, sus portadores con frecuencia desarrollan discapacidad psicológica como síntomas de depresión, ansiedad y auto aislamiento social. Objetivo. Identificar el impacto la hiperhidrosis primaria produce en la calidad de vida de los pacientes, mediante el análisis de la efectividad de tratamientos disponibles para la mejora de síntomas generados antes su padecimiento. Metodología. En la revisión sistemática se recopiló información científica en Pubmed, Scopus y Taylor & Francis, la información obtenida fue de artículos originales y metaanálisis comprendido entre enero de 2011 a diciembre de 2022, la ecuación de búsqueda "hiperhidrosis", "psicología", "salud mental" y "calidad de vida. Resultados. Se obtuvo 127 fuentes entre PubMed, Scopus, Taylor & Francis, se revisó y eliminó los duplicados y los artículos carentes de información de interés, seleccionando 41 artículos, y posteriormente se aplicó a los artículos restantes los criterios de inclusión y exclusión, obteniéndose finalmente 8 artículos para el análisis. Conclusión. El principal impacto psicológico de la hiperhidrosis primaria es la ansiedad y la depresión, las cuales se pueden evidenciar con mayor prevalencia en pacientes de sexo femenino y la repercusión principal en la vida diaria es el aislamiento social, donde el apoyo de sus familiares juega un papel importante en las recuperaciones del paciente, además se desconoce la causa directa de la enfermedad, siendo su causa multifactorial.

Primary hyperhidrosis is a common pathology that represents a common reason for dermatologic consultation, characterized by excessive sweating in axillary, plantar, palmar or craniofacial regions that usually appears at puberty or adolescence, its carriers often develop psychological disability such as symptoms of depression, anxiety and social self-isolation. Objective. To identify the impact of primary hyperhidrosis on the quality of life of patients, by analyzing the effectiveness of available treatments for the improvement of symptoms generated before the condition. Methodology. In the systematic review, scientific information was collected in Pubmed, Scopus and Taylor & Francis, the information obtained was from original articles and meta-analysis from January 2011 to December 2022, the search equation "hyperhidrosis", "psychology", "mental health" and "quality of life". Results. We obtained 127 sources among PubMed, Scopus, Taylor & Francis, reviewed and eliminated duplicates and articles lacking information of interest, selecting 41 articles, and then applied the inclusion and exclusion criteria to the remaining articles, finally obtaining 8 articles for analysis. Conclusion. The main psychological impact of primary hyperhidrosis is anxiety and depression, which are more prevalent in female patients, and the main repercussion in daily life is social isolation, where the support of family members plays an important role in the patient's recovery, and the direct cause of the disease is unknown, being its cause multifactorial.

A hiperidrose primária é uma patologia comum que representa um motivo frequente de consulta dermatológica, caracterizada por sudorese excessiva nas regiões axilar, plantar, palmar ou craniofacial, que geralmente aparece na puberdade ou na adolescência, e seus portadores frequentemente desenvolvem deficiência psicológica, como sintomas de depressão, ansiedade e autoisolamento social. Objetivo. Identificar o impacto da hiperidrose primária na qualidade de vida dos pacientes, analisando a eficácia dos tratamentos disponíveis para a melhora dos sintomas gerados antes da doença. Metodologia. Na revisão sistemática, foram coletadas informações científicas no Pubmed, Scopus e Taylor & Francis, as informações obtidas foram de artigos originais e meta-análises entre janeiro de 2011 e dezembro de 2022, a equação de busca "hyperhidrosis", "psychology", "mental health" e "quality of life". Resultados. Obtivemos 127 fontes do PubMed, Scopus, Taylor & Francis, revisamos e eliminamos duplicatas e artigos sem informações de interesse, selecionando 41 artigos e, em seguida, aplicamos os critérios de inclusão e exclusão aos artigos restantes, obtendo finalmente 8 artigos para análise. Conclusão. O principal impacto psicológico da hiperidrose primária é a ansiedade e a depressão, que são mais prevalentes em pacientes do sexo feminino, e a principal repercussão na vida diária é o isolamento social, em que o apoio dos familiares desempenha um papel importante na recuperação do paciente. Além disso, a causa direta da doença é desconhecida, pois é multifatorial.

Longitudinal relationship between depression and antisocial behaviors in Korean adolescents.

Background: It is well known that depression and delinquency in adolescents are highly correlated, but longitudinal studies on the causal relationship between them are not active in East Asia compared to in Western culture. In addition, even the results of research on causal models and sex differences are inconsistent. Objectives: This study examines the longitudinal reciprocal effects between depression and delinquent behavior in Korean adolescents based on sex differences. Methods: We conducted multiple-group analysis by using an autoregressive cross-lagged model (ACLM). Longitudinal data from 2,075 individuals (2011-2013) were used for analysis. The longitudinal data are from the Korean Children and Youth Panel Survey (KCYPS), and data were used beginning with students at 14 years old (in the second grade of middle school) and tracked them until they were 16 (in the first grade of high school). Results: Boys' delinquent behaviors at 15 years (the third grade of middle school) affected their depression at 16 years (the first grade of high school). In contrast, girls' depression at 15 years (the third grade of middle school) influenced their delinquent behaviors at 16 years (the first grade of high school). Discussion: The findings support the failure model (FM) among adolescent boys and the acting-out model (ACM) among girls. The results imply that strategies to effectively prevent and treat delinquency and depression in adolescents must consider sex effects.

The Pandemic, the Protests, the Chaos: A Destabilizing Effect on the Analyst : Analyst Involvement in Protests During the Pandemic and Its Effect on a Treatment.

In May 2020, within the cultural and emotionally regressive chaos of the pandemic, the analyst witnessed a violent Black Lives Matter protest. Myriad unprocessed feelings subsequently impacted her handling the treatment of a patient who abruptly left a session to attend a protest herself. The analyst describes her own personal experience and the cascade of events that affected the treatment. She suggests that analysts can be armed with the awareness that enactments are more likely to happen when the analyst, as well the patient, are under extreme duress as is the case in the time of Covid. She describes some of the forces that were specific to this case and her own personal embroilment. She then broadens the discussion to other analysts' reports of overwhelming pandemic experiences and the corresponding effect on the work. She also elucidates the importance of the frame for therapeutic work.

[Management of patients with addictions in units for difficult patients]. / Prise en charge de patients présentant des addictions en unité pour malades difficiles.

The links between mental pathologies and violent acts, which can go as far as homicide, are a major concern for many mental health professionals. Addictive co-morbidities, which are increasingly frequent, are an additional risk factor for some of these patients to commit dangerous acts. Psychiatric and psychological care for pathological perpetrators of such violence can be provided under certain conditions in units for difficult patients, with addiction treatment if necessary.

"Call Me by Your Name": The Wrong Action: From Ferenczi to Enactment as a Process.

It is always hard for psychoanalysis to connect free associations and action. With Freud, action could be interpreted only when it referred to the transference; otherwise, action was a resistance to the possibility of free association. Unlike Freud, Ferenczi recognized the importance of the analyst's acting-out as the patient's unconscious request for experiences of trauma to be mobilized. By presenting a clinical case, the author offers the analyst's error as the mobilization of a traumatic block. The error activates a "Process of enactment," whereas if the error is not considered positively, it is simply a mistake, or the loss of a creative opportunity.

[Units for difficult patients in the mental health care system]. / Les unités pour malades difficiles dans le dispositif de soins en santé mentale.

The links between mental pathologies and violent acts, which can go as far as homicide, are a major concern for many mental health professionals. Psychiatric and psychological care of pathological perpetrators of such violence can be carried out under certain conditions in units for difficult patients.

Addiction Psychotherapy: Going Beyond Self-Medication.

Scientific and clinical work concerning the etiology of substance use and addiction has come a long way in the past decades. Current theories highlight the notion that addiction is rooted in deficits in neurobiological and psychological reward mechanisms, but also as a coping-oriented effort to contend with, or "self-medicate," negative emotional experiences. As such, contemporary approaches in the dynamic psychotherapy of addiction highlight the compensatory nature of addiction, encouraging clinicians to detect the mental suffering underlying addiction and promote alternative coping behaviors. In this perspective article, the authors advocate for an integrative approach toward understanding and addressing addiction in psychotherapy, acknowledging its biological, psychological and social aspects. We propose that in addition to the regulatory process of self-medication, in which negative emotions are being suppressed, compulsive substance use may also reflect a substitutive function, in which negative emotions are being 'acted-out' through the use of drugs or alcohol. We suggest an integrative clinical approach which addresses these psychological aspects in a sequential manner and discuss consequent benefits for clinicians and patients working with and through addiction.

[Units for difficult patients]. / Les unités pour malades difficiles.

The ten French units for difficult patients are secure psychiatric services which receive people suffering from mental pathologies who could have committed or have committed dangerous acts. Among the mental health structures presented in this dossier, the units for difficult patients are those which admit prisoners with psychological disorders and problems of dangerousness for the longest period of time. As fully-fledged care facilities, they offer intensive and multi-professional care.

[Psychiatric intensive care units]. / Les unités de soins intensifs psychiatriques.

The intensive psychiatric care units are intermediate health structures between the sector psychiatric services and the units for difficult patients. Prisoners can be treated there under article D. 398 of the Code of Criminal Procedure.

Encenação do decálogo da saúde mental positiva: relato de experiência num internamento de psiquiatria de agudos / Acting out of the positive mental health decalogue: an experience report in an acute psychiatric hospitalization / Escenario de lo decalogo de salud mental positiva: informe de experiencia en una hospitalización de psiquiatría aguda

Resumo Contexto: A prevalência de perturbações psiquiátricas justifica um maior investimento na promoção da Saúde Mental, ainda que conscientes de que esta prioridade se mantém um desafio nas políticas de saúde. A promoção do bem-estar da pessoa com perturbação mental com recurso a intervenções psicoterapêuticas, implementadas pelo enfermeiro especialista em Saúde Mental, constituiu-se um desafio nesta experiência. Objetivo(s): Descrever um relato de experiência decorrente de um programa de Saúde Mental Positiva desenvolvido num serviço de internamento de agudos. Métodos: Trata-se de um programa que se concretiza na encenação do Decálogo de Saúde Mental Positiva da autoria de Lluch-Canut (2011). Utilizou-se uma metodologia participativa envolvendo os utentes com doença mental (n=24), destacando-se a Depressão Major, a Esquizofrenia e a Doença Bipolar. Participaram, ainda, enfermeiros especialistas em Saúde Mental e Psiquiatria e estudantes de Enfermagem desde a conceção do guião, planeamento, preparação do cenário e dramatização. Resultados: Os resultados da avaliação deste programa revelaram i) elevada adesão dos utentes internados; ii) que o programa constituiu uma experiência significativa para os utentes; iii) que o programa foi um contributo para o alcance de fatores promotores de Saúde Mental Positiva, integrantes do Modelo Multifatorial apresentado por Lluch-Canut (1999): satisfação pessoal; atitude pro-social; autocontrolo; autonomia; resolução de problemas e auto-atualização e habilidades de relacionamento interpessoais. Conclusões: A encenação, com a participação ativa dos utentes internados e profissionais de saúde, foi eficaz na expressão de emoções positivas, nos envolvidos, pelo que se sugere um maior investimento neste tipo de intervenções em pessoas com doença mental.

Abstract Background: The prevalence of psychiatric disorders justifies an investment in the promotion of Mental Health, although aware that this priority remains a challenge in health policies. The promotion of the well-being of the person with mental disorders, recurring to psychotherapeutic interventions, implemented by the specialist nurse in Mental Health, was also a challenge in this experience. Aim: To describe an experience report resulting from a Positive Mental Health Program developed in an acute hospitalization service. Methods: The experience made use of the Decalogue of Positive Mental Health by Lluch-Canut (2011). A participatory methodology involving people with mental illness (n=24) was used, highlighting Major Depression, Schizophrenia and Bipolar Disorder. Also participating were nurses specialized in Mental Health and Psychiatry and Nursing students from the conception of the script, planning, scenario preparation and dramatization. Results: The results of the evaluation of this program revealed i) high support of hospitalized users; (ii) that the program was a significant experience for users; iii) the intervention program contributed to achieving promoting factors of Positive Mental Health, integrated on the multifactorial model presented by Lluch-Canut (1999) such as: personal satisfaction; pro-social attitude; self-control; autonomy; problem-solving and self-updating; and interpersonal skills. Conclusions: The dramatization, with the active participation of hospitalized users and health professionals, was effective in expressing positive emotions of all people involved, suggesting a greater investment in this type of intervention in people with mental illness.

Resumen Contexto: La prevalencia de los trastornos psiquiátricos, justifica una mayor inversión en la promoción de la Salud Mental, aún sabiendo que esta prioridad se mantiene como un desafío en las políticas de salud. En este sentido, la promoción del bienestar de la persona con trastorno mental con el uso de intervenciones psicosociales, implementado por la enfermera especialista en Salud Mental, también fue un desafío en esta experiencia. Objetivo(s): Describa un informe de experiencia resultante de un Programa de Salud Mental Positiva con actividades desarrolladas en un servicio de hospitalización de internación aguda. Metodología: Se trata de una experiencia en la que dio lugar a la realización de la puesta en escena del Decálogo de Salud Mental Positiva por Lluch-Canut (2011). Se utilizó una metodología participativa en la que participaron usuarios hospitalizados con enfermedad mental (n=24), de los cuales hemos resaltamos de la Depresión Mayor, Esquizofrenia y Trastorno Bipolar. La implementación del programa de intervención contó con la participación de enfermeros especializados en Salud Mental y Psiquiatría y estudiantes de Enfermería desde el diseño del guión, planificación, preparación de escenarios y dramatización. Resultados: Los resultados de la evaluación de este programa revelaron i) un alto adhesión de los usuarios hospitalizados; (ii) que el programa fue una experiencia muy significativa para los usuarios; iii) que el programa de intervención fue una contribución al logro de factores que promueven la Salud Mental Positiva, miembros del Modelo Multifactorial presentado por Lluch-Canut (1999), a saber: satisfacción personal; actitud pro-social; autocontrol; autonomía; resolución de problemas y autoactualización y habilidades de relación interpersonal. Conclusiones: La puesta en escena, con la participación de usuarios hospitalizados y profesionales de la salud, fue eficaz para expresar emociones positivas de todas las personas involucradas, sugiriendo una mayor inversión en este tipo de intervenciones en personas con enfermedades mentales.

Adolescencias en pandemia: acerca de las conductas de riesgo y la construcción del "cuidado de sí" / Adolescències en pandèmia: sobre les conductes de risc i la construcció de la "cura d’un mateix" / Adolescences in a pandemic: about risk behaviours and the construction of "self care"

Las adolescencias plantean hoy renovados desafíos. En nuestros días, los clásicos duelos adolescentes cobran sentidos que interpelan, tanto por las situaciones de riesgo actual y sus modos de darse, como por las circunstancias deuna época signada por la inmediatez, las tecnologías y la pandemia de la COVID-19. El autor propone en esteartículo un análisis de la construcción del “cuidado de sí” como un modo del “cuidado del otro”, articulando laconstitución del sujeto desde las dimensiones del prójimo y del semejante, en tanto formas del Nebenmensch freudiano, con categorías foucaultianas, para desarrollar sus ideas.(AU)

Adolescence poses newchallenges today. In our times, the classic adolescent mourning takes on new meanings that challenge us, bothbecause of the current risk situations and the ways in which they occur, and because of the circumstances of anera marked by immediacy, technologies, and the pandemic of COVID-19. In this article, the author proposes ananalysis of the construction of "self-care" as a way of "caring for the other", articulating the constitution of thesubject from the dimensions of the other and the similar, as forms of the Freudian Nebenmensch, with "Foucaul-dian" categories, in order to develop his ideas.(AU)

Les adoles-cències plantegen avui renovats desafiaments. En els nostres dies, els clàssics duels adolescents cobren sentitsque interpel·len, tant per les situacions de risc actual i les maneres com es donen, com per les circumstànciesd'una època signada per la immediatesa, les tecnologies i la pandèmia de la COVID-19. L'autor proposa enaquest article una anàlisi de la construcció de la “cura d’un mateix” com una manera de la "cura de l'altre", arti-culant la constitució del subjecte des de les dimensions de l’altre i del semblant, a la manera del Nebenmenschfreudià, amb categories foucaultianes, per desenvolupar les seves idees.(AU)

Functions of the Treatment Contract in TFP.

The use of a verbal or written contract has been employed in many different modalities of treatment as a means of establishing the expectations and parameters of treatment. Traditionally, the contract is seen as serving a somewhat utilitarian purpose: setting up the practical conditions of treatment and providing a containing frame for the patient. Contracts, however, can extend to establishing agreed-upon goals of treatment, anticipating obstacles that may arise in the treatment and clarifying how they will be dealt with should they arise, and clearly defining the roles of the patient and therapist in a way that aids the exploratory process once the treatment has begun. Importantly, the mutually agreed-upon contract serves as a useful roadmap to keep the treatment focused and on track. In this article we will emphasize how the treatment contract can facilitate in-depth understanding of the patient's internal world, particularly when challenges to the contract are enacted by the patient. We will begin by briefly summarizing the functions of the contract and then focus on the key role of the treatment contract in furthering the exploratory process of the patient's dynamics as expressed in the transference/countertransference matrix.

Enactment: A necessary conceptual review.

Enactment as a psychoanalytic concept was coined by Jacobs in 1986. Since then, it has developed within the psychoanalytic community as a concept. Originally, enactment described an aspect of countertransference expressed through subtle actions within the analytic process, as distinct from noisier performances that fall within the spectrum of "acting out". Nowadays, the concept of enactment poses some difficulties that should not be ignored. As a theoretical concept, enactment has a complex epistemological position, and as a clinical concept it sheds light on contemporary psychoanalytic practices. This paper explores the results from an empirical and conceptual research work, focusing on the history, translations and usages of the term "enactment", and its comparison with related terms. It will also consider the epistemological perspective regarding the current status of enactment as a scientific concept and its relationship with the psychoanalytic theoretical field.

[Acting out in the four psychic structures]. / Les rouages du passage à l'acte dans les quatre structures psychiques.

To try to understand acting out, it depends of conciliation between the reality of the act and the psychic life. For that, it is necessary to listen the word of the criminal authors. What transgression represents for them? Based on clinical experience in a correctional center, this article takes a closer look about prisoner, incarcerated after having committed criminal acts. This clinical material could help to raise a new perspective around modern psychopathology. What is the act's difference between neurosis, perversion, borderline and psychosis? Our research will try to differentiate the psychic issues.

Between anguish and act: challenges for the management of subjective urgency in the psychoanalytic clinic / Entre angústia e ato: desafios para o manejo da urgência subjetiva na clínica psicanalítica

RESUMO: A partir de questões suscitadas pela clínica da recepção em um ambulatório público de saúde mental, investigamos o manejo clínico da urgência subjetiva. Tendo em vista a recorrência do sofrimento psíquico relacionado à angústia e a manifestações ligadas ao ato, revisamos o lugar da angústia em psicanálise e sua relação com o acting out e a passagem ao ato. Verificamos como o psicanalista pode acolher a urgência subjetiva, permitindo que este momento de crise dê lugar ao trabalho psíquico e possibilite uma subjetivação do sofrimento.

Abstract: From issues raised by the reception clinic in a public mental health clinic, we investigated the clinical management of subjective urgency. In view of the recurrence of psychic suffering related to the anguish and manifestations associated with the act, we review the place of anguish in psychoanalysis and its relation to the acting out and the passage to the act. We verify how the psychoanalyst can take on the subjective urgency, allowing this moment of crisis to give way to psychic work and enable a subjectivation of suffering.

Do delírio paranoico de reivindicação: crimes de gozo e em nome do ideal / Paranoid querulant delirium: crimes of jouissance and in the name of the ideal / Crimes de jouissance et au nom de lidéal chez les paranoïaques revendicateurs / Del delirio de reivindicación paranoico : crímenes de goce y en nombre del ideal

O perigo potencial dos paranoicos reivindicadores é um dado clínico que se impôs na psiquiatria. A lógica subjetiva inerente à passagem ao ato se distingue, entretanto, da de outros homicídios ou tentativas de assassinato cometidas por sujeitos psicóticos que tentam, ao fazê-lo, tratar o gozo do qual são objeto. Tal lógica explica-se a partir das especificidades do delírio paranoico de reivindicação que o ensino lacaniano permite compreender. Esse delírio edifica-se sobre a base de um prejuízo de gozo que persegue o sujeito. Os crimes que daí resultam são motivados por uma vontade de gozo e cometidos em nome de um ideal de justiça em torno do qual o sujeito organiza sua existência.

The danger of querulant paranoids is a clinical notion present in the psychiatric field. The underlying subjective logic of their outbursts can be distinguished from those of murders or murder attempts perpetrated by psychotic subjects who, in doing so, attempt to treat the jouissance they are the object of. The specificities of the paranoid querulant delirium explain such logic and Lacan's teaching allow for its comprehension. This delirium is built upon a jouissance prejudice that persecutes the subject. The deriving crimes are motivated by a wish for jouissance and perpetrated in the name of a justice ideal around which the subject organizes his existence.

La dangerosité des paranoïaques revendicateurs est une donnée clinique qui s'est imposée en psychiatrie. La logique subjective sous-tendant leurs passages à l'acte se distingue cependant de celle des autres meurtres ou tentatives commis par des sujets psychotiques qui tentent, ce faisant, de traiter la jouissance dont ils sont l'objet. Elle s'explique à partir des spécificités du délire paranoïaque de revendication que l'enseignement lacanien permet de comprendre. Ce délire s'édifie sur fond de préjudice de jouissance qui persécute le sujet. Les crimes qui en dérivent sont motivés par une volonté de jouissance et commis au nom d'un idéal de justice sur lequel le sujet règle son existence.

La peligrosidad de las paranoias de reivindicación es una noción clínica presente en el campo de la psiquiatría. La lógica subjetiva detrás de sus brotes se diferencia de los homicidios o de los intentos cometidos por sujetos psicóticos que, al hacerlo, intentan tratar el goce del que son objeto. Las especificidades del delirio de reivindicación paranoico explican tal lógica y las enseñanzas de Lacan permiten su comprensión. Se construye este delirio sobre un prejuicio del goce que persigue al sujeto. Los crímenes derivados son motivados por una voluntad de goce y perpetrados en nombre de un ideal de justicia alrededor del cual el sujeto organiza su existencia..

Management of health personnel' psychological safety, in emergency situations by COVID-19 in the hospitable or isolation context / Gestión de seguridad psicológica del personal sanitario en situaciones de emergencia por COVID-19 en el contexto hospitalario o de aislamiento / Gerenciamento de segurança psicológica do pessoal de saúde em situações de emergência pelo COVID-19 no contexto hospitalar ou de isolamento

Background: The COVID-19 pandemic has tested health systems in almost all countries around the world, the devastating results of the spread of the disease have indicated that psychological safety of health workers is an indispensable condition for them to provide care for the sick; however, existing protocols do not take into account this aspect. Objective: Systematizing actions for the management of psychological safety of health personnel in emergency conditions by COVID-19 pandemic in the hospitable or isolation context.Methods: Systematic bibliographic review, based on protocols for the care of patients with COVID-19, PAHO technical documents- Coronavirus disease and scientific articles published in national and international sources, in Spanish and English, in the period December 2019 April 2020, indexed in the databases: Sage Journal, Oxford University Press, Elsevier and Science. The PRISMA method was used in the search strategy, combining keywords and Boolean operators. Content analysis was performed on the results.Conclusion: A system of actions for organizing the work of health professionals, will allows seeing them not only as someone just treating the disease, but as vulnerable persons in need of being object of managing their safety.

Introducción La pandemia de la COVID-19 ha puesto a prueba los sistemas de salud en casi todos los países del mundo, los resultados de la propagación de la enfermedad han indicado que la seguridad psicológica del personal sanitario es condición indispensable para brindar cuidados a los enfermos, sin embargo, los documentos vigentes no tienen en cuenta de forma explícita ese aspecto. Objetivo Sintetizar acciones para la gestión de la seguridad psicológica del personal sanitario en condiciones de emergencia por pandemia de la COVID-19 en el contexto hospitalario o de aislamiento.Métodos Revisión bibliográfica sistemática, basada en los protocolos de atención a pacientes con COVID-19, documentos técnicos de la OPS- Enfermedad por el coronavirus y de artículos científicos publicados en fuentes nacionales e internacionales, en español e inglés, en el período diciembre 2019 abril 2020 , indexadas en las bases de datos: Sage Journal, Oxford University Press, Elsevier y Science. En la estrategia de búsqueda se utilizará el método PRISMA, combinando palabras clave y operadores boléanos. A los resultados se realizaron análisis de contenidos. Conclusiones Un sistema de acciones para organizar el trabajo de profesionales de la salud afectados no solo como tratantes de la enfermedad, sino como personas vulnerables y necesitadas de ser objeto de la gestión de su seguridad para su salud mental.

Introdução. A pandemia do COVID-19 pôs à prova os sistemas de saúde em quase todos os países do mundo; os resultados da disseminação da doença indicaram que a segurança psicológica do pessoal de saúde é uma condição essencial para a prestação de cuidados aos doentes, no entanto, os documentos atuais não levam explicitamente esse aspecto em consideração. Objetivo. Sintetizar ações para o gerenciamento da segurança psicológica do pessoal de saúde em situações de emergência devido à pandemia do COVID-19 no contexto hospitalar ou de isolamento. Métodos Revisão bibliográfica sistemática, com base em protocolos de atendimento ao paciente com COVID-19, documentos técnicos da OPAS - Doença por coronavírus e artigos científicos publicados em fontes nacionais e internacionais, em espanhol e inglês, no período de dezembro de 2019 a abril de 2020 , indexado nos bancos de dados: Sage Journal, Oxford University Press, Elsevier e Science. O método PRISMA foi utilizado na estratégia de busca, combinando palavras-chave e operadores boleanos. A análise de conteúdo foi realizada nos resultados. Conclusões Um sistema de ações para organizar o trabalho dos profissionais de saúde permitirá que eles sejam vistos não apenas como traficantes da doença, mas como pessoas vulneráveis ​​que precisam estar sujeitas ao gerenciamento de sua segurança para a saúde mental.

Psychological Intervention in the Oocyte Pick-up Room and Recovery Room in Assisted Reproduction: new listening accounts.

OBJECTIVE: This study seeks to identify the role and possible participation of a psychologist/psychoanalyst inside an Oocyte Pick-up Room and Recovery Room (OPR-RR) in an Assisted Reproduction clinic and its implications on patients and team. METHODS: Prospective study of psychological support during the procedures from September 2014 to December 2018. Most visits took place during oocyte retrievals, for either IVF/ICSI or gamete freezing. RESULTS: Of the 2,343 cases, the psychologist was present in 965 of them (41%), during oocyte retrievals, with available professionals in 59% of the times (722 cases). The embryo transfers (1,011) had psychological assistance in 20% of the time (218 cases). The intrauterine insemination cases were excluded for not happening in a surgical environment. The recovery room was identified as one of the spaces for welcoming and listening to anxieties, desires, projects, worries, fears, frustrations, joys and expectations for those who come to the clinic seeking the desire to gestate. The patients' talks, collected in observations transcribed from what was heard, with dates and types of procedures, were discussed with either the team or the assistant physician. The team stands positively in the presence of a psychologist/psychoanalyst, who brings new perceptions and the development of the whole art of listening, for all involved. CONCLUSION: The presence of a psychologist/psychoanalyst in the Oocyte Pick-up Room and the Recovery Room in an Assisted Reproduction clinic means an opportunity to listen to patients' emotions, providing well-being to patients and echoing in the teamwork relationships.

Adolescência, atos e o risco de suicídio / Adolescence, acts and risk of suicide / Adolescence, actes et le risque de suicide / Adolescencia, actos y el riesgo de suicidio

Resumo Este artigo discute o problema do risco do suicídio na adolescência, utilizando a série Os 13 porquês como recurso metodológico para decantar o que está em jogo na relação entre a adolescência, os atos e o risco de suicídio. Para compreender mais profundamente o tema, as autoras realizam uma leitura da adolescência a partir do referencial teórico da psicanálise de Freud e Lacan, ressaltando a tendência ao agir da adolescência e os comportamentos de risco característicos dessa etapa da vida. O texto traça, ainda, uma distinção entre acting out e passagem ao ato, e propõe uma discussão sobre o manejo clínico do analista que escuta uma ideação suicida de um adolescente.

Abstract This article discusses suicide among adolescents, using the television series 13 reasons why as methodological strategy to further analyze what is at stake in the relations between adolescence, acts and the risk of suicide. To accomplish a thorough comprehension of the matter, we reflect on adolescence based on Freudian and Lacanian theoretical elaborations, emphasizing their tendency to act out and the risky behaviors that characterize this stage of life. The text also makes a distinction between acting out and Lacan's concept of passage to the act and discusses how the analyst should clinically respond to adolescents who express any sort of suicidal ideas.

Résumé Cet article aborde la problématique du risque de suicide à l'adolescence, en utilisant la série Les 13 pourquoi comme ressource méthodologique pour décanter les enjeux de la relation entre l'adolescence, les actes et le risque de suicide. Afin de mieux comprendre le thème, les auteurs comprennent l'adolescence à partir du cadre théorique de la psychanalyse de Freud et Lacan, en soulignant la tendance à l'acte de l'adolescence et les comportements à risque caractéristiques de cette étape de la vie. Le texte fait également la distinction entre acting out et passage à l'acte et propose une discussion sur la gestion clinique de l'analyste qui écoute les idées suicidaires d'un adolescent.

Resumen Este artículo discute el problema del riesgo de suicidio en la adolescencia, utilizando la serie Por trece razones como recurso metodológico para dar a conocer qué está en juego en la relación entre la adolescencia, los actos y el riesgo de suicidio. Para una comprensión más profunda del tema, las autoras realizan una lectura de la adolescencia a partir del marco teórico del psicoanálisis de Freud y Lacan, resaltando la tendencia al actuar de la adolescencia y los comportamientos de riesgo característicos de esa etapa de la vida. El texto traza, además, una distinción entre acting out y pasaje al acto y propone discutir sobre el manejo clínico del analista que escucha una ideación suicida de un adolescente.