Artículos (Psiquiatría)

URI permanente para esta colecciónhttps://hdl.handle.net/11441/11080

Examinar

Mostrando 1 - 20 de 119

10Kin1day: A Bottom-Up Neuroimaging Initiative
(Frontiers Research Foundation, 2019-05-09) Heuvel, Martijn P. van den; Scholtens, Lianne H.; Burgh, Hannelore K. van der; Agosta, Federica; Alloza, Clara; Arango, Celso; Crespo Facorro, Benedicto; De Lange, Siemon C.; Universidad de Sevilla. Departamento de Psiquiatría
We organized 10Kin1day, a pop-up scientific event with the goal to bring together neuroimaging groups from around the world to jointly analyze 10,000+ existing MRI connectivity datasets during a 3-day workshop. In this report, we describe the motivation and principles of 10Kin1day, together with a public release of 8,000+ MRI connectome maps of the human brain.
1q21.1 distal copy number variants are associated with cerebral and cognitive alterations in humans
(Springer Nature, 2021) Sønderby, Ida E.; van der Meer, Dennis; Moreau, Clara; Kaufmann, Tobias; Walters, G. Bragi; Ellegaard, Maria; Crespo Facorro, Benedicto; Ophoff, Roel A.; Universidad de Sevilla. Departamento de Psiquiatría; Universidad de Sevilla. CTS1086: Psiquiatría Traslacional
Low-frequency 1q21.1 distal deletion and duplication copy number variant (CNV) carriers are predisposed to multiple neurodevelopmental disorders, including schizophrenia, autism and intellectual disability. Human carriers display a high prevalence of micro- and macrocephaly in deletion and duplication carriers, respectively. The underlying brain structural diversity remains largely unknown. We systematically called CNVs in 38 cohorts from the large-scale ENIGMA CNV collaboration and the UK Biobank and identified 28 1q21.1 distal deletion and 22 duplication carriers and 37,088 non-carriers (48% male) derived from 15 distinct magnetic resonance imaging scanner sites. With standardized methods, we compared subcortical and cortical brain measures (all) and cognitive performance (UK Biobank only) between carrier groups also testing for mediation of brain structure on cognition. We identified positive dosage effects of copy number on intracranial volume (ICV) and total cortical surface area, with the largest effects in frontal and cingulate cortices, and negative dosage effects on caudate and hippocampal volumes. The carriers displayed distinct cognitive deficit profiles in cognitive tasks from the UK Biobank with intermediate decreases in duplication carriers and somewhat larger in deletion carriers—the latter potentially mediated by ICV or cortical surface area. These results shed light on pathobiological mechanisms of neurodevelopmental disorders, by demonstrating gene dose effect on specific brain structures and effect on cognitive function
A Guideline and Checklist for Initiating and Managing Clozapine Treatment in Patients with Treatment-Resistant Schizophrenia
(Springer, 2022-06-27) Correll, C. U.; Agid, Ofer; Crespo Facorro, Benedicto; de Bartolomeis, Andrea; Fagiolini, Andrea; Seppälä, Niko; Howes, Oliver D.; Universidad de Sevilla. Departamento de Psiquiatría
Treatment-resistant schizophrenia (TRS) will affect about one in three patients with schizophrenia. Clozapine is the only treatment approved for TRS, and patients should be treated as soon as possible to improve their chances of achieving remission. Despite its effectiveness, concern over side effects, monitoring requirements, and inexperience with prescribing often result in long delays that can expose patients to unnecessary risks and compromise their chances of achieving favorable long-term outcomes. We critically reviewed the literature on clozapine use in TRS, focusing on guidelines, systematic reviews, and algorithms to identify strategies for improving clozapine safety and tolerability. Based on this, we have provided an overview of strategies to support early initiation of clozapine in patients with TRS based on the latest evidence and our clinical experience, and have summarized the key elements in a practical, evidence-based checklist for identifying and managing patients with TRS, with the aim of increasing confidence in prescribing and monitoring clozapine therapy.
A meta-analysis of deep brain structural shape and asymmetry abnormalities in 2,833 individuals with schizophrenia compared with 3,929 healthy volunteers via the ENIGMA Consortium
(WILEY, 2022) Gutman, Boris A.; Van Erp, Theo G.M; Tordesillas-Gutiérrez, Diana; Crespo Facorro, Benedicto; Setién Suero, Esther; Wang, Lei; Universidad de Sevilla. Departamento de Psiquiatría
Schizophrenia is associated with widespread alterations in subcortical brain structure.While analytic methods have enabled more detailed morphometric characterization,findings are often equivocal. In this meta-analysis, we employed the harmonizedENIGMA shape analysis protocols to collaboratively investigate subcortical brainstructure shape differences between individuals with schizophrenia and healthy con-trol participants. The study analyzed data from 2,833 individuals with schizophreniaand 3,929 healthy control participants contributed by 21 worldwide research groupsparticipating in the ENIGMA Schizophrenia Working Group. Harmonized shape analy-sis protocols were applied to each site's data independently for bilateral hippocam-pus, amygdala, caudate, accumbens, putamen, pallidum, and thalamus obtained fromT1-weighted structural MRI scans. Mass univariate meta-analyses revealed more-concave-than-convex shape differences in the hippocampus, amygdala, accumbens,and thalamus in individuals with schizophrenia compared with control participants,more-convex-than-concave shape differences in the putamen and pallidum, and bothconcave and convex shape differences in the caudate. Patterns of exaggerated asym-metry were observed across the hippocampus, amygdala, and thalamus in individualswith schizophrenia compared to control participants, while diminished asymmetryencompassed ventral striatum and ventral and dorsal thalamus. Our analyses also rev-ealed that higher chlorpromazine dose equivalents and increased positive symptomlevels were associated with patterns of contiguous convex shape differences acrossmultiple subcortical structures. Findings from our shape meta-analysis suggest thatcommon neurobiological mechanisms may contribute to gray matter reduction acrossmultiple subcortical regions, thus enhancing our understanding of the nature of net-work disorganization in schizophrenia.
A polygenic resilience score moderates the genetic risk for schizophrenia
(Springer Nature, 2021) Hess, Jonathan L.; Tylee, Daniel S.; Mattheisen, Manuel; D. Børglum, Anders; D. Als, Thomas; Grove, Jakob; Crespo Facorro, Benedicto; Universidad de Sevilla. Departamento de Psiquiatría
Based on the discovery by the Resilience Project (Chen R. et al. Nat Biotechnol 34:531–538, 2016) of rare variants that confer resistance to Mendelian disease, and protective alleles for some complex diseases, we posited the existence of genetic variants that promote resilience to highly heritable polygenic disorders1,0 such as schizophrenia. Resilience has been traditionally viewed as a psychological construct, although our use of the term resilience refers to a different construct that directly relates to the Resilience Project, namely: heritable variation that promotes resistance to disease by reducing the penetrance of risk loci, wherein resilience and risk loci operate orthogonal to one another. In this study, we established a procedure to identify unaffected individuals with relatively high polygenic risk for schizophrenia, and contrasted them with risk-matched schizophrenia cases to generate the first known “polygenic resilience score” that represents the additive contributions to SZ resistance by variants that are distinct from risk loci. The resilience score was derived from data compiled by the Psychiatric Genomics Consortium, and replicated in three independent samples. This work establishes a generalizable framework for finding resilience variants for any complex, heritable disorder.
Alberto Ramos Santana (coord.): La Constitución de 1812. Clave del liberalismo en Andalucía
(Universidad de Cadiz, 2014) Núñez García, Víctor Manuel; Universidad de Sevilla. Departamento de Psiquiatría
América Latina y el nacionalismo español. Alfonso XIII ante el movimiento hispanoamericanista (1902-1929)
(Instituto de Investigaciones Dr. José María Luis Mora, 2019) Núñez García, Víctor Manuel; Calero Delgado, María Luisa; Universidad de Sevilla. Departamento de Psiquiatría
Dentro del imaginario nacionalista español desarrollado a finales del siglo XIX y las primeras décadas del XX Latinoamérica y el incipiente movimiento hispanoamericanista va ganando un peso específico significativo, hasta desplegarse como un elemento fundamental tanto de consolidación interior como de proyección exterior. Para la corona y para las elites españolas las políticas de la memoria y la reactualización del pasado se convirtieron en vectores esenciales a la hora de generar sinergias positivas para concitar adhesiones y lealtades al proyecto nacionalizador. El objetivo del artículo se centra en el papel del monarca, Alfonso XIII, dentro del movimiento hispanista desarrollado a ambas márgenes del Atlántico durante su reinado. Para ello se analizarán las visitas reales de Alfonso XIII a territorios de la actual Andalucía, sus conexiones con el movimiento hispanoamericanista y sus hipotéticas proyecciones hacia la consolidación del imaginario nacionalista español a través de una mirada renovada hacia América.
Amparo Gómez Rodríguez y Antonio Francisco Canales Serrano, (eds.), Estudios políticos de la ciencia. Políticas y desarrollo científico en el siglo XX. Madrid, Plaza y Valdés Ed., 2013. 283 pp.[Reseña]
(2015) Núñez García, Víctor Manuel; ; ; Universidad de Sevilla. Departamento de Psiquiatría
Análisis de los resultados en una encuesta de prevalencia sobre el consumo de bebidas alcohólicas en la provincia de Sevilla
(Aran Ediciones, 1988) Gili-Miner, Miguel; Giner-Ubago, J.; Lacalle Remigio, Juan Ramón; Franco Fernández, María Dolores; Perea-Milla, E.; Sariego Morillo, A.; Fernández Palacín, Ana; Millán Sáez, C.; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de Psiquiatría
Se analizan los resultados de una encuesta sobre el consumo de bebidas alcohólicas en una muestra representativa de la provincia de Sevilla ( 1.536 personas). Se estudia la proporción de bebedores y abstemios, la frecuencia de consumo, las cantidades de alcohol consumidas en gramos por semana, las circunstancias de consumo (la compañía, el lugar y el tipo de bebida), las diferencias urbano-rurales y la distribución de la frecuencia y la cantidad de alcohol consumido según el status socioeconómico medio en ingresos mensuales en pesetas.
Andaluces en la Corte de Isabel II. Influencias y poder político en la Nación Liberal
(Schedes, 2018) Núñez García, Víctor Manuel; Universidad de Sevilla. Departamento de Psiquiatría
La Corona y la Corte se manifiestan a mediados del s. XIX como espacios de poder informal con amplias vinculaciones e influencias sobre los poderes formales (ejecutivos, ámbito parlamentario, diplomático…). El presente artículo plantea aportar elementos de análisis para abordar esta problemática historiográfica, desde los actores históricos que actuaron y bascularon entre los difusos límites de la política formal e informal isabelina. En este caso se analizan las influencias cortesanas y su trasunto en la política nacional de actores históricos naturales de los actuales territorios de Andalucía.
Animal-assisted interventions: Review of current status and future challenges
(Asociación de Análisis del Comportamiento (AAC), 2014) López-Cepero Borrego, Javier; Rodríguez Franco, Luis; Perea-Mediavilla, María de los Ángeles; Blanco Piñero, Nuria; Tejada Roldán, Arcadio; Blanco Picabia, Ildefonso; Universidad de Sevilla. Departamento de Personalidad, Evaluación y Tratamiento Psicológicos; Universidad de Sevilla. Departamento de Psiquiatría
Previous bibliographic reviews have highlighted that Animal-Assisted Interventions (AAIs), though promising, may have some weaknesses in their empirical basis that must be addressed. Present study reviewed 228 references gathered through PyscINFO database, all of which included the terms animal and assisted within the key concepts field, providing several indicators of productivity (such as publications per year, the relative presence of different types of texts, the country and the language of publication, the author?s productivity and type of reference, and the main sources of information such as journals and research teams) and content (relative presence of different assisted interventions, methodology, areas of interest, and contents addressed by the most prolific authors) in the field. The number of texts on AAI published per year has increased only slightly in the last decade, and such texts have been published in mainly U.S. English-language sources. Animal assisted therapy appeared as the most researched intervention, although inconsistencies in the use of terms and definitions were found. Empirical studies represented most of the classified texts, although their prominence among the most prolific authors was low. It was detected that AAIs have an increasing empirical base, although the gap between research and dissemination keeps open. More research efforts will be necessary to cover the deficiencies identified in the field.
Antipsychotic Treatment Effectiveness in First Episode of Psychosis: PAFIP 3-Year Follow-Up Randomized Clinical Trials Comparing Haloperidol, Olanzapine, Risperidone, Aripiprazole, Quetiapine, and Ziprasidone
(Oxford University Press, 2020) Gómez-Revuelta, Marcos; Pelayo-Terán, José María; Juncal-Ruiz, María; Vázquez-Bourgon, Javier; Suárez-Pinilla, Paula; Romero-Jiménez, Rodrigo; Crespo Facorro, Benedicto; Universidad de Sevilla. Departamento de Psiquiatría; AstraZeneca; Bristol-Myers Squibb; Fundacion Marques de Valdecilla; Gerencia Regional de Salud de Castilla y Leon; Johnson Johnson; Pfizer; Plan Nacional de Drogas Research; SENY Fundacio
Background: Different effectiveness profiles among antipsychotics may be a key point to optimize treatment in patients suffering a first episode of psychosis to impact on long-term outcome. The aim of this study is to compare the clinical effectiveness of olanzapine, risperidone, haloperidol, aripiprazole, ziprasidone, and quetiapine in the treatment of first episode of psychosis at 3-year follow-up. Method: From February 2001 to January 2011, 2 phases of a prospective, randomized, open-label study were undertaken. A total of 376 first-episode drug-naïve patients were randomly assigned to olanzapine (n = 55), risperidone (n = 63), haloperidol (n = 56), aripiprazole (n = 78), ziprasidone (n = 62), or quetiapine (n = 62) and followed up for 3 years. The primary effectiveness measure was all cause of treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted in the analysis for clinical efficacy. Results: The overall dropout rate at 3 years reached 20.75%. Treatment discontinuation rates were significantly different among treatment groups (olanzapine = 69.09, risperidone = 71.43, aripiprazole = 73.08%, ziprasidone = 79.03%, haloperidol = 89.28%, and quetiapine = 95.53%) (χ2 = 79.86; P = .000). Statistically significant differences in terms of lack of efficacy, adherence, and tolerability were observed among treatment groups along the 3-year follow-up, determining significant differences in time to all-cause discontinuation (log-rank = 92.240; P = .000). Significant differences between treatments were found in the categories of sleepiness/sedation, increased sleep duration, akinesia, weight gain, ejaculatory dysfunction, extrapyramidal-symptoms, and amenorrhea. Conclusions: Olanzapine, risperidone, and aripiprazole presented advantages for the first-line treatment of first episode of psychosis in terms of effectiveness. Identifying different discontinuation patterns may contribute to optimize treatment selection after first episode of psychosis.ClinicalTrials.gov Identifier: NCT02526030 https://clinicaltrials.gov/show/NCT02526030.
Aportaciones de la semiótica a la medicina
(Instituto Technologico de Estudios Superiores de Monterrey. Campus Estado de México, 2016) García Arroyo, José Manuel; Universidad de Sevilla. Departamento de Psiquiatría
Para aplicar la semiótica a la medicina hay que entender la enfermedad como un proceso que excede las manifestaciones biológicas, pues se inserta en un medio social. En principio, la enfermedad es inasimilable por los procesos semióticos, dado que pertenece a lo “real” del cuerpo; ahora bien, los personajes que intervienen en el acto médico pueden transformarla en un “signo”. Esto puede hacerse de distinta forma: a) el paciente realiza una apropiación desde el “significado”, interviniendo las creencias y los mitos populares y b) el médico efectúa el mismo trabajo desde el “significante”, convirtiendo el saber médico en un verdadero sistema con una sintaxis propia. Con ello, hemos encontrado un conjunto de regularidades, lo que coincide con los propósitos de la semiótica contemporánea.
Aproximación al "esquema L" de Lacan y sus implicaciones en la clínica (parte I)
(2011) García Arroyo, José Manuel; Domínguez López, María Luisa; Universidad de Sevilla. Departamento de Psiquiatría
Aproximación al "esquema L" de Lacan y sus implicaciones en la clínica (parte I)
(Asociación Española de Neuropsiquiatría, 2011) García Arroyo, José Manuel; Domínguez López, M.L.; Universidad de Sevilla. Departamento de Psiquiatría
A lo largo de la obra de Lacan es común encontrar diferentes diagramas que pueden entenderse como intentos de formalizar ciertos aspectos de la teoría psicoanalítica; estos últimos deben quedar claros, al menos desde el punto de vista teórico, para poder actuar correctamente en el trabajo analítico. En esta ocasión, vamos a centrarnos en uno de ellos: el “esquema L”, cuya presentación se produce en uno de sus seminarios orales, dedicado a la posición del “yo” en la teoría de Freud y que captó la atención de facultativos y especialistas de aquella época. En él su autor trabaja, de un modo ciertamente original, el funcionamiento de las relaciones intersubjetivas en sus conexiones con el lenguaje. En la primera parte del trabajo, vamos a estudiar los componentes del “esquema L” y las dos relaciones fundamentales que se establecen entre ellos y que forman los ejes “imaginario” y “simbólico”. Lacan los considera en oposición pues se interfieren mutuamente, de modo tal que el mensaje inconsciente queda interrumpido o cortocircuitado constantemente por la relación imaginaria, formada por el “yo” y su semejante, el “otro”.
Aproximación al "esquema L" de Lacan y sus implicaciones en la clínica (parte II)
(2011) García Arroyo, José Manuel; Domínguez López, María Luisa
Aripiprazole and Risperidone Present Comparable Long-Term Metabolic Profiles: Data From a Pragmatic Randomized Controlled Trial in Drug-Naïve First-Episode Psychosis
(Oxford University Press, 2022-05-31) Vázquez-Bourgon, Javier; Ortiz García de la Foz, Víctor; Gómez-Revuelta, Marcos; Mayoral-van Son, Jaqueline; Juncal-Ruiz, María; Garrido-Torres, Nathalia; Crespo Facorro, Benedicto; Universidad de Sevilla. Departamento de Psiquiatría; AstraZeneca; Bristol-Myers Squibb; Instituto de Investigacion Sanitaria Valdecilla; Instituto de Salud Carlos III; Janssen Johnson Johnson; Lundbeck; Pfizer
Objective Aripiprazole and risperidone are 2 of the most used second-generation antipsychotics (SGAs) worldwide. Previous evidence shows a similar effect of these SGAs on weight and metabolic changes in the short term. However, a longer period is necessary for a better assessment of the SGA´s metabolic profile. We aimed to compare the long-term (1-year) metabolic profile of these 2 antipsychotics on a sample of drug-naïve first episode-psychosis (FEP) patients. Methods A total 188 drug-naïve patients, suffering from a first episode of non-affective psychosis (FEP), were randomly assigned to treatment with either aripiprazole or risperidone. Weight and glycemic/lipid parameters were recorded at baseline and after 1-year follow-up. Results We observed significant weight increments in both groups (9.2 kg for aripiprazole and 10.5 kg for risperidone) after 1 year of treatment. Despite this, weight and body mass index changes did not significantly differ between treatment groups (P > .05). Similarly, both treatment groups presented similar metabolic clinical impact with a comparable increase in the proportion of participants meeting criteria for metabolic disorders such as obesity or hypercholesterolemia, but not for metabolic syndrome (Δ9.2% vs Δ4.3%) or hypertriglyceridemia (Δ21.9% vs Δ8.0%), where aripiprazole showed worse outcomes than risperidone. Conclusion This study shows that aripiprazole and risperidone share a similar long-term metabolic profile. After 1 year of antipsychotic treatment, drug-naïve FEP patients in both treatment groups presented a significant increase in weight and metabolic changes, leading to a greater prevalence of metabolic disorders.
Aripiprazole as a candidate treatment of COVID-19 identified through genomic analysis
(Frontiers Media SA, 2021) Crespo Facorro, Benedicto; Ruiz Veguilla, Miguel; Vázquez-Bourgon, Javier; Sánchez-Hidalgo, Ana C.; Garrido-Torres, Nathalia; Cisneros, José Miguel; Prieto, Carlos; Sainz, Jesús; Universidad de Sevilla. Departamento de Psiquiatría; Universidad de Sevilla. Departamento de Medicina; Ministerio de Economía y Competitividad (MINECO). España; European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER)
Background: Antipsychotics modulate expression of inflammatory cytokines and inducible inflammatory enzymes. Elopiprazole (a phenylpiperazine antipsychotic drug in phase 1) has been characterized as a therapeutic drug to treat SARS-CoV-2 infection in a repurposing study. We aim to investigate the potential effects of aripiprazole (an FDA approved phenylpiperazine) on COVID-19-related immunological parameters. Methods: Differential gene expression profiles of non-COVID-19 vs. COVID-19 RNA-Seq samples (CRA002390 project in GSA database) and drug-naïve patients with non-affective psychosis at baseline and after three months of aripiprazole treatment were identified. An integrative transcriptomic analyses of aripiprazole effects on differentially expressed genes in COVID-19 patients was performed. Findings: 82 out the 377 genes (21.7%) with expression significantly altered by aripiprazole have also their expression altered in COVID-19 patients and in 93.9% of these genes their expression is reverted by aripiprazole. The number of common genes with expression altered in both analyses is significantly higher than expected (Fisher’s Exact Test, two tail; p value = 3.2e-11). 11 KEGG pathways were significantly enriched with genes with altered expression both in COVID-19 patients and aripiprazole medicated non-affective psychosis patients (p adj<0.05). The most significant pathways were associated to immune responses and mechanisms of hyperinflammation-driven pathology (i.e.,“inflammatory bowel disease (IBD)” (the most significant pathway with a p adj of 0.00021), “Th1 and Th2 cell differentiation” and “B cell receptor signaling pathway”) that have been also associated with COVID19 clinical outcome. Interpretation: This exploratory investigation may provide further support to the notion that a protective effect is exerted by aripiprazole (phenylpiperazine) by modulating the expression of genes that have shown to be altered in COVID-19 patients. Along with many ongoing studies and clinical trials, repurposing available medications could be of use in countering SARS-CoV-2 infection, but require further studies and trials. © Copyright © 2021 Crespo-Facorro, Ruiz-Veguilla, Vázquez-Bourgon, Sánchez-Hidalgo, Garrido-Torres, Cisneros, Prieto and Sainz.
Aripiprazole vs Risperidone Head-to-Head Effectiveness in First-Episode Non-Affective-Psychosis: A 3-Month Randomized, Flexible-Dose, Open-Label Clinical Trial
(Oxford University Press, 2022-07-27) Garrido Sánchez, Lucía; Gómez-Revuelta, Marcos; Ortiz García de la Foz, Víctor; Pelayo-Terán, José María; Juncal-Ruiz, María; Ruiz Veguilla, Miguel; Mayoral-van Son, Jaqueline; Ayesa-Arriola, Rosa; Vázquez-Bourgon, Javier; Crespo Facorro, Benedicto; Universidad de Sevilla. Departamento de Psiquiatría; AstraZeneca; Bristol-Myers Squibb; Fundacion Marques de Valdecilla; Instituto de Salud Carlos III; Johnson Johnson; Pfizer; Plan Nacional de Drogas Research Grant 2005; SENY Fundacio Research Grant
Background Antipsychotic choice for the acute phase of a first episode of psychosis (FEP) is of the utmost importance since it may influence long-term outcome. However, head-to-head comparisons between second-generation antipsychotics remain scarce. The aim of this study was to compare the effectiveness in the short term of aripiprazole and risperidone after FEP outbreak. Methods From February 2011 to October 2018, a prospective, randomized, open-label study was undertaken. Two hundred-sixty-six first-episode drug-naïve patients were randomly assigned to aripiprazole (n = 136) or risperidone (n = 130) and followed-up for 12 weeks. The primary effectiveness measure was all-cause treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted to assess clinical efficacy. Results The overall dropout rate at 12 weeks was small (6.39%). Effectiveness measures were similar between treatment arms as treatment discontinuation rates (χ 2 = 0,409; P = .522), and mean time to all-cause discontinuation (log rank χ 2 = −1.009; P = .316) showed no statistically significant differences. Despite no statistically significant differences between groups regarding clinical efficacy, aripiprazole required higher chlorpromazine equivalent dosage (χ 2 = 2.160; P = .032) and extended mean time (W = 8183.5; P = .008) to reach clinical response. Sex-related adverse events and rigidity were more frequent in the risperidone group, whereas sialorrhea was on the aripiprazole group. Conclusions No differences regarding effectiveness were found between aripiprazole and risperidone for the short-phase treatment of FEP. Despite the importance of efficacy during this phase, differences in side effect profiles and patient’s preferences are essential factors that may lead clinical decisions for these patients.
Aspectos subjetivos de la mujer con dismenorrea primaria
(Sociedad Chilena de Obstetricia y Ginecologia, 2017) García Arroyo, José Manuel; Universidad de Sevilla. Departamento de Psiquiatría
En el presente trabajo estudiamos la dismenorrea primaria, un cuadro bastante aparatoso para el que se han venido postulado numerosas hipótesis, predominando las de índole biológica. No obstante, una serie de autores se han referido a la intervención de factores psicológicos en el cuadro. El objetivo que nos mueve consiste en descubrir cuáles son los componentes subjetivos que favorecen la aparición y/o mantenimiento del dolor en estas mujeres, más allá de las directrices biológicas. Para lograrlo tomamos un grupo de jóvenes (entre 17 y 25 años) que, aunque consultaron por otros problemas, el dolor menstrual era un síntoma importante, y a las que se trató mediante psicoterapia. Las entrevistas realizadas con ellas, aparte de ayudarlas a mejorar, nos permitieron obtener un material verbal que era expresivo del síntoma. Este proceder nos permitió desentrañar los diferentes aspectos subjetivos propios de la alteración, entre ellos destacan: la escasa tolerancia al dolor, la respuesta emocional exagerada y, sobre todo, el rechazo referido a la maduración como mujer y a los desempeños propios de ésta. Estos últimos factores se sostienen en significados personales erróneos y sustentados en los mensajes recibidos por la paciente y aceptados como propios.

Examinar

Examinando Artículos (Psiquiatría) por Título