Subjective cognition in adults with common psychiatric classifications; a systematic review.

The aim is to assess whether instruments developed to measure subjective cognitive complaints (SCCs) and in neurology and aging can reliably be used in ADHD and other common psychiatric classifications. MEDLINE, PsycINFO, CINAHL and EMBASE+EMBASE CLASSIC were searched for relevant work on SCCs in psychiatric classifications (ADHD, autism, mood disorders, schizophrenia) in two phases: 1 identify instruments, 2 relevant studies. 35 studies with varying study quality were included. SCCs are most commonly studied in ADHD and mood disorders, but are found in all psychiatric classifications. SCCs show inconsistent and low associations to objective cognition across disorders, but higher and consistent relations are found with behavioral outcomes. SCCs are not qualitatively different for ADHD compared to other psychiatric classifications, and should thus not be seen as analogous to well validated measures of objective cognition. However, SCCs do reflect suffering, behavioral difficulties and problems experienced by across those with psychiatric problems in daily life.

Reflexiones y debates sobre el autismo / Reflections and debates on autism

El artículo plantea algunas reflexiones sobre el lugar del autismo en las diversas clasificaciones psiquiátricas y sobre ciertos posicionamientos que tratan de sacarlo de ellas por juzgarlas estigmatizadoras. Señala ciertas tendencias sociales e ideológicas que afectan a la psiquiatría y que influyen en la creación, supresión y modificaciones de sus diagnósticos, cuestionando su legitimidad para imponerlos. Describe, desde una perspectiva psicodinámica y estructural, aspectos de la psicopatología clínica y propone una comprensión integradora de la etiopatogenia del autismo y del denominado “neurodesarrollo”. Postula el valor epistemológico de una psicopatología psicodinámica para una clasificación de los funcionamientos autísticos que tenga en cuenta tanto su estructura psíquica como sus variantes clínicas, así como su utilidad para conducir a intervenciones psicoterapéuticas basadas en una comprensión que debe producirse en un marco relacional aceptado por los afectados y sus familiares. Debate sobre las características individuales y excepcionales de este tipo de tratamientos, y sobre las dificultades de poder evaluarlos conforme a las necesarias exigencias metodológicas actuales y las posibilidades de reproducirlos de manera uniforme y generalizada. (AU)

This article brings up some reflections on the place of autism in different psychiatric classifications and on some stances that intend to exclude it from them because it is considered stigmatizing. It points out some social and ideological tendencies that have an impact on psychiatry and influence in the creation, suppression, and modifications of its diagnoses, calling into question its legitimacy to impose them. It describes, from a psychodynamic and structural perspective, some aspects of clinical psychopathology and proposes an integrative understanding of the etiopathogeny of autism and the so-called “neurodevelopment”. It postulates the epistemological value of a psychodynamic psychopathology for a classification of autistic functioning that takes into consideration both its psychic structure and its clinical variants, as well as the usefulness to carry out psychotherapeutic interventions based on an understanding that must take place in a relational framework accepted by both the affected and their families. It discusses the individual and exceptional characteristics of these kinds of treatments, the difficulties to assess them according to the current methodological demands, and the possibilities to reproduce them in a uniform and generalized way. (AU)

[Negative symptoms of schizophrenia: historical aspects]. / Les symptômes négatifs de la schizophrénie: aspects historiques.

The history of negative symptoms of schizophrenia rises early days of medicine in clinical and pathophysiological differences between positive and negative and their complex joint. Forming a set of typical core of symptoms, and some feature of a syndrome belonging to a specific pathophysiological mechanism, negative symptoms of schizophrenia emerge from old descriptions of clinical pictures, related to the overall look of madness, the heart of alienation, a central sign of early dementia, gradually more precisely describing the strange nature of the autistic withdrawal and schizophrenic apragmatism. At therapeutic era, negative symptoms have taken over the positive symptoms to establish an operational criteria whose importance lies in the progressive severity of this clinical type and in their contribution to therapeutic resistance. Despite the efforts of modern typological classifications, this work rehabilitates the old concept of "unitary psychosis" by defining a common symptomatic core to multiple clinical forms of psychosis, combining deficit of emotional expression and avolition, meaning a native psychopathology and a pathophysiology possibly in a common final way, and calling the arrival of new treatment strategies.

Las diez clasificaciones de Kraepelin / The ten Kraepelin's classifications

Pocos pensadores y clínicos de la psiquiatría han marcado tanto su desarrollo y las nosografías de la especialidad como el maestro alemán Emil Kraepelin. En este artículo se presentan en forma sinóptica las diez clasificaciones que presentó a lo largo de su trabajo clínico.

Just few thinkers and clinical psychiatrists have branded the development and nosographies of the specialty as much as the German teacher Emil Kraepelin did. This article presents in a synoptic way the ten classifications he has developed during his clinical work.

Las diez clasificaciones de Kraepelin / The ten Kraepelins classifications

Pocos pensadores y clínicos de la psiquiatría han marcado tanto su desarrollo y las nosografías de la especialidad como el maestro alemán Emil Kraepelin. En este artículo se presentan en forma sinóptica las diez clasificaciones que presentó a lo largo de su trabajo clínico.(AU)

Just few thinkers and clinical psychiatrists have branded the development and nosographies of the specialty as much as the German teacher Emil Kraepelin did. This article presents in a synoptic way the ten classifications he has developed during his clinical work.(AU)

Deficiência, autismo e neurodiversidade / Disability, autism and neurodiversity

O artigo analisa o surgimento recente do movimento de neurodiversidade, situando-o no contexto dos estudos sobre a deficiência e da organização política de deficientes físicos. O movimento da neurodiversidade é organizado por autistas chamados de alto funcionamento que consideram que o autismo não é uma doença a ser tratada e se for possível curada. Trata-se antes de uma diferença humana que deve ser respeitada como outras diferenças (sexuais, raciais, entre outras). Os ativistas do movimento de neurodiversidade se opõem aos grupos de pais de filhos autistas e profissionais que buscam uma cura para a doença. No texto, são apresentados os argumentos dos grupos pró-cura e anticura, avaliando as duas posições e seu impacto na área da saúde e no desenvolvimento de políticas públicas para autistas.

This article analyzes the emergence of the neurodiversity movement in the context of studies about disabilities and the political organization of disabled people. The neurodiversity movement is organized by the so-called high functioning autists, who believe that autism is not a disease to be treated and, if possible, cured. It is instead a human difference that has to be respected just like other differences (sexual, racial, among others). The activists of the neurodiversity movement oppose the groups of parents of autistic children and professionals seeking for a cure for autism. This article presents the arguments of the pro- and anti-cure groups and analyzes both positions as well as their impact upon the field of health and the development of public policies for autists.