Otto Kernberg states three types of personality organizations, also named psychological functiona... more Otto Kernberg states three types of personality organizations, also named psychological functional levels. They reflect the patient's predominant psychological characteristics: identity integration grade, defense mechanisms, and reality test. In mental disorders, the predominant defensive style influences significantly in the severity and evolution of the suffering.
Although pharmacotherapy is the essential treatment for bipolar I disorder depression, a signific... more Although pharmacotherapy is the essential treatment for bipolar I disorder depression, a significant percentage of patients continue experiencing emotional episodes. Cognitive behavioral therapy (CBT), interpersonal psychotherapy and social rhythm and focused family therapy, as well as psychoeducation, share the emphasis on the empowerment of the patient so she/he becomes an active participant in treatment, becomes aware of the nature of the disorder who suffers, and learns to recognize early symptoms of depressive episodes in order to prevent its recurrence. The addition of the CBT aims to alleviate depressive symptoms, restore the psychosocial functioning and prevent the appearance of new affective episodes. Objectives This paper aimed to demonstrate the importance and usefulness of the CBT as an adjuvant of the pharmacological management of depression in bipolar disorder type I in those areas which cannot be resolved by pharmacological treatment (residual symptoms, adherence and compliance with treatment, awareness and understanding of bipolar disorder, identification of prodromal symptoms and developing coping skills). Method Controlled clinical trials about the usefulness of CBT as an adjunctive treatment of patient with depression due to bipolar disorder type I are reviewed. Results CBT increases adherence to drug therapy, decreases the frequency of relapses, diminishes residual symptoms, the need for hospitalization, and the duration time of depressive episodes; it also improves psychosocial functioning. However, these effects diminish over time and its results are lower in patients with more affective episodes and greater comorbidity. Conclusions There is evidence of the utility of the CBT as a useful tool to improve the evolution of the condition in depressed patients due to bipolar I disorder and of the need to extend the time of this and other psychosocial interventions, since this disorder is a condition that lasts a lifetime and causes significant impact on psychosocial functioning of the person.
Otto Kernberg states three types of personality organizations, also named psychological functiona... more Otto Kernberg states three types of personality organizations, also named psychological functional levels. They reflect the patient's predominant psychological characteristics: identity integration grade, defense mechanisms, and reality test. In mental disorders, the predominant defensive style influences significantly in the severity and evolution of the suffering.
Parkinson's disease is a progressive and degenerative disease due to the loss of the substantia n... more Parkinson's disease is a progressive and degenerative disease due to the loss of the substantia nigra dopaminergic neurons in the mesencephalon. Its manifestations are: tremor at rest, rigidity and slowing of movements, and alterations in posture and gait. The early onset of dementia or the presence of hallucinations, not related to the dopaminergic treatment, are associated with the presence of dementia with Lewy bodies (DLB) or Alzheimer's disease. The scales used to assess the stage and severity of Parkinson's disease are: the scale of Stages of Hoehn and Yahr, and the Unified Parkinson's Disease Rating Scale. Although there is not a drug that stops the progression of Parkinson's disease, the current treatment for this illness consist in: a) dopamine replacement through the use of its precursor, levodopa, b) administering substances, like ropinirole, pramipexole, and bromocriptine, that increase dopamine activity to stimulate their receptors, and c) inhibiting the enzymes that destroy dopamine as the catechol-O-methyltransferase with entacapone, and monoamine oxidase type B (MAO B) with selegiline and rasagiline. Surgical treatment of Parkinson's disease consists of ablative procedures and deep brain stimulation. This review describes their indications, administration and side effects.
... Patients answered the Defense Style Questionnaire (DSQ) with 88 items (16). ... Defenses and ... more ... Patients answered the Defense Style Questionnaire (DSQ) with 88 items (16). ... Defenses and response to pharmacological treatment The most frequent defense used , by those who had a response to ... There are no studies dem-onstrating that defenses change throughout life. ...
Background Personality disorders are a multi-theoretical construct that encompasses predictable a... more Background Personality disorders are a multi-theoretical construct that encompasses predictable and quantifiable behavioral, cognitive, and affective characteristics in individuals. Previous studies underscore the existence of a relationship between personality disorders and defense mechanisms, these being coping styles that arise unconsciously in the face of adversity and that have adaptive purposes. There is evidence that alludes to a connection between pathological personality, defense mechanisms, and their relationship with negative mental health outcomes, such as depressive and anxious symptoms. The objective of this study was to study, psychometrically measure, and associate personality disorders, defense mechanisms, and depressive and anxious symptoms. Methodology A cross-sectional study was conducted on 81 participants with major depressive disorder, generalized anxiety disorder, and panic disorder who received treatment at a tertiary care institution between July 2021 and February 2022. Psychometric instruments were employed to evaluate the study variables, such as the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Personality Diagnostic Questionnaire-Version 4 (PDQ-4) Plus, and the 40-item Defensive Styles Questionnaire (DSQ-40). Results Depressive and anxious symptoms were related to the scores obtained in the Defensive Styles Questionnaire and the Personality Disorders Questionnaire. Some defense mechanisms were positive predictors of the score between these scales. Conclusions There is a relationship between personality traits and defense mechanisms that could influence the development and severity of depressive and anxious psychopathology in this population.
Reporte y análisis clínico de un caso de hipocondriasis de acuerdo al diagnóstico multiaxial (DSM... more Reporte y análisis clínico de un caso de hipocondriasis de acuerdo al diagnóstico multiaxial (DSM-IV-TR).
La tianeptina es un agente antidepresivo que aumenta la recaptura de la serotonina en los seres h... more La tianeptina es un agente antidepresivo que aumenta la recaptura de la serotonina en los seres humanos y en los animales. La eficacia y la seguridad de la tianeptina se han comparado con las de la imipramina y el placebo en un estudio de grupos paralelos, doble ciego, randomizado, y multicentrico. Luego de una semana con placebo, 186 pacientes que presentaban depresion mayor o trastornos depresivos bipolares segun el DSM-III-R, con un puntaje total en la escala de MADRS de por lo menos 25, fueron tratados durante 6 semanas con tianeptina, imipramina o placebo. La eficacia fue evaluada por medio de las escalas MADRS, CGI, HARS, HSCL, y VAS. La tianeptina y la imipramina resultaron ser mas eficaces que el placebo al comparar los puntajes finales de la MADRS en los pacientes tratados por lo menos durante 14 dias (n=171), en los puntajes de la MADRS de los pacientes tratados durante 42 dias (n=129), y en la escala CGI (reactivo 1) de todos los pacientes (n=186). En la poblacion total hubo mas respondedores a la MADRS con tianeptina que con placebo. Los resultados prueban la eficacia de la tianeptina (37.5 mg diarios) en el tratamiento de la depresion mayor y de los trastornos depresivos bipolares, en comparacion con el placebo. La eficacia entre la tianeptina y la imipramina (150 mg diarios) no fue diferente. La tolerancia a la tianeptina no difirio de la tolerancia del placebo.
SUMMARY Depression is a frequent mental disorder in the general population. Approximately 3.7% of... more SUMMARY Depression is a frequent mental disorder in the general population. Approximately 3.7% of the population will suffer a major depressive episode throughout life. Pharmacological treatment with selective serotonin receptor inhibitors (SSRIs) is useful to treat this condition and other mental disorders. Citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline, which constitute this group, are characterized by having an easy way
El proposito de este estudio fue determinar las caracteristicas de la muestra necesaria para desa... more El proposito de este estudio fue determinar las caracteristicas de la muestra necesaria para desarrollar el proceso de estandarizacion de la Figura compleja de Rey-Osterrieth. La prueba de copia y de memoria inmediata se le aplico a 937 sujetos de 4 a 15 anos de edad. Los datos se analizaron utilizando un analisis de varianza factorial y la prueba de diferencia minima significativa (DMS).
Las alteraciones en la memoria se han investigado con benzodiazepinas de todas clases, solas o en... more Las alteraciones en la memoria se han investigado con benzodiazepinas de todas clases, solas o en combinacion con otros compuestos, administradas en forma aguda y cronica y por diversas vias, pero utilizando metodos e instrumentos variables, lo que impide comparar los estudios y establecer conclusiones utiles. Los objetivos de este estudio fueron observar que efecto produce el lorazepam en la memoria inmediata administrado en forma aguda y por via oral a dosis terapeuticas, y si este se relaciona con el nivel de sedacion producido. Se utilizo el lorazepam por tener una vida media corta y alcanzar niveles sanguineos maximos a las dos horas. El instrumento utilizado para medir la funcion mnesica fue la Escala Clinica de Memoria de Wechsler. Se estudiaron 14 voluntarios sanos, masculinos, con edades entre 25 y 30 anos, sin antecedentes de uso de psicofarmacos. Los resultados permiten establecer las seguientes conclusiones: 1) La Prueba de Memoria de Wechsler es un instrumento util para la evaluacion de las alteraciones mnsica producidas por psicofarmacos. 2) El lorazepam produce alteraciones, principalmente en la memoria inmediata a las 2 hrs de administrarlo, lo que coincide con su comportamiento farmacocinetico. 3) El tipo de memoria mas afectada es la visual. 4) No parece existir relacion entre el grado de sedacion y las alteraciones de memoria. Hasta el momento no se tienen los conocimientos necesarios para explicar, desde el punto de vista neuroquimico, el efecto amnesico de las benzodiazepinas. Se ha propuesto que pudiera ser secundario a modificaciones de los sistemas colinergico o vasopresinergico centrales
Los resúmenes en inglés y español, así como los cuadros de este artículo aparecieron en la primer... more Los resúmenes en inglés y español, así como los cuadros de este artículo aparecieron en la primera parte, volumen 27, número 5, octubre de 2004.
Otto Kernberg states three types of personality organizations, also named psychological functiona... more Otto Kernberg states three types of personality organizations, also named psychological functional levels. They reflect the patient's predominant psychological characteristics: identity integration grade, defense mechanisms, and reality test. In mental disorders, the predominant defensive style influences significantly in the severity and evolution of the suffering.
Although pharmacotherapy is the essential treatment for bipolar I disorder depression, a signific... more Although pharmacotherapy is the essential treatment for bipolar I disorder depression, a significant percentage of patients continue experiencing emotional episodes. Cognitive behavioral therapy (CBT), interpersonal psychotherapy and social rhythm and focused family therapy, as well as psychoeducation, share the emphasis on the empowerment of the patient so she/he becomes an active participant in treatment, becomes aware of the nature of the disorder who suffers, and learns to recognize early symptoms of depressive episodes in order to prevent its recurrence. The addition of the CBT aims to alleviate depressive symptoms, restore the psychosocial functioning and prevent the appearance of new affective episodes. Objectives This paper aimed to demonstrate the importance and usefulness of the CBT as an adjuvant of the pharmacological management of depression in bipolar disorder type I in those areas which cannot be resolved by pharmacological treatment (residual symptoms, adherence and compliance with treatment, awareness and understanding of bipolar disorder, identification of prodromal symptoms and developing coping skills). Method Controlled clinical trials about the usefulness of CBT as an adjunctive treatment of patient with depression due to bipolar disorder type I are reviewed. Results CBT increases adherence to drug therapy, decreases the frequency of relapses, diminishes residual symptoms, the need for hospitalization, and the duration time of depressive episodes; it also improves psychosocial functioning. However, these effects diminish over time and its results are lower in patients with more affective episodes and greater comorbidity. Conclusions There is evidence of the utility of the CBT as a useful tool to improve the evolution of the condition in depressed patients due to bipolar I disorder and of the need to extend the time of this and other psychosocial interventions, since this disorder is a condition that lasts a lifetime and causes significant impact on psychosocial functioning of the person.
Otto Kernberg states three types of personality organizations, also named psychological functiona... more Otto Kernberg states three types of personality organizations, also named psychological functional levels. They reflect the patient's predominant psychological characteristics: identity integration grade, defense mechanisms, and reality test. In mental disorders, the predominant defensive style influences significantly in the severity and evolution of the suffering.
Parkinson's disease is a progressive and degenerative disease due to the loss of the substantia n... more Parkinson's disease is a progressive and degenerative disease due to the loss of the substantia nigra dopaminergic neurons in the mesencephalon. Its manifestations are: tremor at rest, rigidity and slowing of movements, and alterations in posture and gait. The early onset of dementia or the presence of hallucinations, not related to the dopaminergic treatment, are associated with the presence of dementia with Lewy bodies (DLB) or Alzheimer's disease. The scales used to assess the stage and severity of Parkinson's disease are: the scale of Stages of Hoehn and Yahr, and the Unified Parkinson's Disease Rating Scale. Although there is not a drug that stops the progression of Parkinson's disease, the current treatment for this illness consist in: a) dopamine replacement through the use of its precursor, levodopa, b) administering substances, like ropinirole, pramipexole, and bromocriptine, that increase dopamine activity to stimulate their receptors, and c) inhibiting the enzymes that destroy dopamine as the catechol-O-methyltransferase with entacapone, and monoamine oxidase type B (MAO B) with selegiline and rasagiline. Surgical treatment of Parkinson's disease consists of ablative procedures and deep brain stimulation. This review describes their indications, administration and side effects.
... Patients answered the Defense Style Questionnaire (DSQ) with 88 items (16). ... Defenses and ... more ... Patients answered the Defense Style Questionnaire (DSQ) with 88 items (16). ... Defenses and response to pharmacological treatment The most frequent defense used , by those who had a response to ... There are no studies dem-onstrating that defenses change throughout life. ...
Background Personality disorders are a multi-theoretical construct that encompasses predictable a... more Background Personality disorders are a multi-theoretical construct that encompasses predictable and quantifiable behavioral, cognitive, and affective characteristics in individuals. Previous studies underscore the existence of a relationship between personality disorders and defense mechanisms, these being coping styles that arise unconsciously in the face of adversity and that have adaptive purposes. There is evidence that alludes to a connection between pathological personality, defense mechanisms, and their relationship with negative mental health outcomes, such as depressive and anxious symptoms. The objective of this study was to study, psychometrically measure, and associate personality disorders, defense mechanisms, and depressive and anxious symptoms. Methodology A cross-sectional study was conducted on 81 participants with major depressive disorder, generalized anxiety disorder, and panic disorder who received treatment at a tertiary care institution between July 2021 and February 2022. Psychometric instruments were employed to evaluate the study variables, such as the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Personality Diagnostic Questionnaire-Version 4 (PDQ-4) Plus, and the 40-item Defensive Styles Questionnaire (DSQ-40). Results Depressive and anxious symptoms were related to the scores obtained in the Defensive Styles Questionnaire and the Personality Disorders Questionnaire. Some defense mechanisms were positive predictors of the score between these scales. Conclusions There is a relationship between personality traits and defense mechanisms that could influence the development and severity of depressive and anxious psychopathology in this population.
Reporte y análisis clínico de un caso de hipocondriasis de acuerdo al diagnóstico multiaxial (DSM... more Reporte y análisis clínico de un caso de hipocondriasis de acuerdo al diagnóstico multiaxial (DSM-IV-TR).
La tianeptina es un agente antidepresivo que aumenta la recaptura de la serotonina en los seres h... more La tianeptina es un agente antidepresivo que aumenta la recaptura de la serotonina en los seres humanos y en los animales. La eficacia y la seguridad de la tianeptina se han comparado con las de la imipramina y el placebo en un estudio de grupos paralelos, doble ciego, randomizado, y multicentrico. Luego de una semana con placebo, 186 pacientes que presentaban depresion mayor o trastornos depresivos bipolares segun el DSM-III-R, con un puntaje total en la escala de MADRS de por lo menos 25, fueron tratados durante 6 semanas con tianeptina, imipramina o placebo. La eficacia fue evaluada por medio de las escalas MADRS, CGI, HARS, HSCL, y VAS. La tianeptina y la imipramina resultaron ser mas eficaces que el placebo al comparar los puntajes finales de la MADRS en los pacientes tratados por lo menos durante 14 dias (n=171), en los puntajes de la MADRS de los pacientes tratados durante 42 dias (n=129), y en la escala CGI (reactivo 1) de todos los pacientes (n=186). En la poblacion total hubo mas respondedores a la MADRS con tianeptina que con placebo. Los resultados prueban la eficacia de la tianeptina (37.5 mg diarios) en el tratamiento de la depresion mayor y de los trastornos depresivos bipolares, en comparacion con el placebo. La eficacia entre la tianeptina y la imipramina (150 mg diarios) no fue diferente. La tolerancia a la tianeptina no difirio de la tolerancia del placebo.
SUMMARY Depression is a frequent mental disorder in the general population. Approximately 3.7% of... more SUMMARY Depression is a frequent mental disorder in the general population. Approximately 3.7% of the population will suffer a major depressive episode throughout life. Pharmacological treatment with selective serotonin receptor inhibitors (SSRIs) is useful to treat this condition and other mental disorders. Citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline, which constitute this group, are characterized by having an easy way
El proposito de este estudio fue determinar las caracteristicas de la muestra necesaria para desa... more El proposito de este estudio fue determinar las caracteristicas de la muestra necesaria para desarrollar el proceso de estandarizacion de la Figura compleja de Rey-Osterrieth. La prueba de copia y de memoria inmediata se le aplico a 937 sujetos de 4 a 15 anos de edad. Los datos se analizaron utilizando un analisis de varianza factorial y la prueba de diferencia minima significativa (DMS).
Las alteraciones en la memoria se han investigado con benzodiazepinas de todas clases, solas o en... more Las alteraciones en la memoria se han investigado con benzodiazepinas de todas clases, solas o en combinacion con otros compuestos, administradas en forma aguda y cronica y por diversas vias, pero utilizando metodos e instrumentos variables, lo que impide comparar los estudios y establecer conclusiones utiles. Los objetivos de este estudio fueron observar que efecto produce el lorazepam en la memoria inmediata administrado en forma aguda y por via oral a dosis terapeuticas, y si este se relaciona con el nivel de sedacion producido. Se utilizo el lorazepam por tener una vida media corta y alcanzar niveles sanguineos maximos a las dos horas. El instrumento utilizado para medir la funcion mnesica fue la Escala Clinica de Memoria de Wechsler. Se estudiaron 14 voluntarios sanos, masculinos, con edades entre 25 y 30 anos, sin antecedentes de uso de psicofarmacos. Los resultados permiten establecer las seguientes conclusiones: 1) La Prueba de Memoria de Wechsler es un instrumento util para la evaluacion de las alteraciones mnsica producidas por psicofarmacos. 2) El lorazepam produce alteraciones, principalmente en la memoria inmediata a las 2 hrs de administrarlo, lo que coincide con su comportamiento farmacocinetico. 3) El tipo de memoria mas afectada es la visual. 4) No parece existir relacion entre el grado de sedacion y las alteraciones de memoria. Hasta el momento no se tienen los conocimientos necesarios para explicar, desde el punto de vista neuroquimico, el efecto amnesico de las benzodiazepinas. Se ha propuesto que pudiera ser secundario a modificaciones de los sistemas colinergico o vasopresinergico centrales
Los resúmenes en inglés y español, así como los cuadros de este artículo aparecieron en la primer... more Los resúmenes en inglés y español, así como los cuadros de este artículo aparecieron en la primera parte, volumen 27, número 5, octubre de 2004.
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