A journey across perversions history – from Middle Age to DSM

2016 ◽  
Vol 33 (S1) ◽  
pp. S588-S588
Author(s):  
A. Amaral ◽  
I. Ferraz ◽  
M. Mota
Keyword(s):  
Middle Age ◽  
Sexual Interest ◽  
Cultural Dimensions ◽  
Sexual Practices ◽  
Sexual Deviance ◽  
Diagnostic And Statistical Manual ◽  
Family Pedigree ◽  
Pubmed Database ◽  
Paraphilic Disorders ◽  
Competing Interest

IntroductionPsychiatry's viewpoint of sexual deviance has waved between the normal and the pathological. “Normal” is not determined by nature but by the values of a specific society.AimsTo review the main landmarks in paraphilias history and the importance of social and cultural dimensions to it.MethodsPubMed database was searched using the keywords perversion, sexual deviance, paraphilia, culture and society.ResultsThroughout Middle Age and Renaissance any sexual act that differed from the natural/divine law was considered a vice. Unnatural vices (masturbation, sodomy, bestiality) were the most severely punished, as they could not result in conception. In 1886, Krafft-Ebing stated perversions were functional diseases of the sexual instinct caused by “hereditary taintedness” in the family pedigree and worsened by excessive masturbation. Proper perversions were sadism, masochism, antipathic sexuality (homosexuality, transvestism, transsexuality) and fetishism. Later, Havelock Ellis and Hirschfeld claimed sexual interest in the population followed a statistical norm, opposed the idea that masturbation led to diseases and demanded the decriminalization of homosexuality. Freud believed the “perverse disposition” to be universal in the childhood giving rise to healthy and pathological adult behaviors. In 1950's, Albert Kinsey surprised America when he proved many supposedly deviant sexual practices were quite common. The first Diagnostic and Statistical Manual (1952) was mainly psychoanalytic. Later, by 1973, homosexuality was removed from classifications. Recently, DSM-5 distinguishes between paraphilias and paraphilic disorders.ConclusionA progress in the paraphilic instincts’ acceptance has occurred. We hypothesize, in the future, paraphilias will follow homosexuality out of the diseases’ classifications.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Self-mutilations – an addictive behavior?

2017 ◽  
Vol 41 (S1) ◽  
pp. S457-S457
Author(s):  
R. Velasco Rodrigues ◽  
J. Mesquita Reis ◽  
L. Queiroga
Keyword(s):  
Additive Model ◽  
Addictive Behavior ◽  
Therapeutic Interventions ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Self Mutilation ◽  
Pubmed Database ◽  
Dsm Iv ◽  
Direct Aggression ◽  
Competing Interest

IntroductionSelf-mutilations are defined as an intentional behaviour that involves direct aggression to the person's body, without aware suicide intention. The Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) included self-mutilation as part of the diagnostic criteria for the other specified disruptive, impulse-control, and conduct disorder or borderline personality disorder. Later, the DSM-5 suggests that this behavior constitutes a separate diagnostic entity. Despite the growing concern regarding the increased incidence of self-mutilation among adolescents, there is still no consensus on the pathogenesis of this behavior. Recent studies have suggested that, in some cases, non-suicidal self-injurious behavior may be understood as an addictive behavior. Based on this hypothesis, several researchers have conducted genetic, neurobiological and clinical studies, to verify the existence of common pathways between these two nosological entities.ObjectivesThe aim of this study is to conduct a literature review of studies that propose an additive model for self-injurious behavior, discussing its implications in the diagnostic and therapeutic interventions.MethodologyArticles indexed in the Pubmed database were analyzed as well as book and studies published in scientific journals.ConclusionA better understanding of the pathogenesis of self-mutilation is crucial to our diagnostic and therapeutic interventions. Unfortunately, studies done on this topic in the past were inconclusive. Further clarification, through new studies, is needed in order for us to help adolescents with this behavior in a more effective way.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Aripiprazole once-monthly efficacy in patients with schizophrenia. Review

2016 ◽  
Vol 33 (S1) ◽  
pp. S582-S582
Author(s):  
M.F. Molina López ◽  
M.C. Cancino Botello ◽  
A. Peña Serrano ◽  
M.D.L.A. Canseco Navarro
Keyword(s):  
Quality Of Life ◽  
Negative Symptoms ◽  
Partial Agonist ◽  
Emotional Interaction ◽  
Medication Delivery ◽  
Pubmed Database ◽  
Competing Interest ◽  
Long Acting

Introductionlong acting injectable formulations of antipsychotics are a valuable option for patients with schizophrenia, offering continuous medication delivery and stable dosage levels. Aripiprazole once-monthly is the first dopamine partial agonist available in long acting formulation approved in Europe for Schizophrenia with excellent results so far.Aimsto conduct a current review of articles related to the use and efficacy of Aripiprazole once monthly in patients with Schizophrenia.Methodssystematic review of the literature in English using the following keywords: “aripiprazole once-monthly”, “aripiprazole long acting formulation”, “schizophrenia”. PubMed database.ResultsAripiprazole once-monthly (AOM) formulation efficacy has been proven in many studies. The importance of maintaining an oral overlap during 14 days is highlighted in all studies that have been reviewed in order to reach therapeutic level; therefore, it can be used in patients with acute decompensations. Recent studies comparing AOM versus Paliperidone Palmitate once monthly (PP) have shown that patients with AOM had greater clinical improvement and, even though both drugs were well tolerated, when Quality of Life Style Scale was analyzed an important improvement in empathy, sense of purpose, emotional interaction and curiosity in the AOM group was observed.Conclusionslong acting injectable antipsychotics increase long-term adherence treatment and reduce risk of relapse. Because of its unique mechanism of action, Aripiprazole once-monthly improves positive and negative symptoms, giving the patient an opportunity to have a better quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Sex, human rights and AIDS: an analysis of new technologies for HIV prevention in the Brazilian context

2015 ◽  
Vol 18 (suppl 1) ◽  
pp. 89-103 ◽  
Author(s):  
Dulce Ferraz ◽  
Vera Paiva
Keyword(s):  
Human Rights ◽  
Hiv Prevention ◽  
New Technologies ◽  
Process Development ◽  
Technical Information ◽  
Implementation Process ◽  
Social Constructionist ◽  
Sexual Practices ◽  
Risk Compensation ◽  
Pubmed Database

ABSTRACTWorldwide, HIV prevention is challenged to change because clinical trials show the protective effect of technologies such as circumcision, preexposure prophylaxis, and the suppression of viral load through antiretroviral treatment. In the face of demands for their implementation on population levels, the fear of stimulating risk compensation processes and of increasing riskier sexual practices has retarded their integration into prevention programs. In this article, following a narrative review of the literature on risk compensation using the PubMed database, we offer a critical reflection on the theme using a constructionist approach of social psychology integrated to the theoretical framework of vulnerability and human rights. The use of biomedical technologies for prevention does not consistently induce its users to the increase of riskier practices, and variations on the specificity of each method need to be carefully considered. Alternatives to the theories of sociocognitive studies, such as social constructionist approaches developed in the social sciences and humanities fields, indicate more comprehensive interpretations, valuing the notions of agency and rights. The critical analysis suggests priority actions to be taken in the implementation process: development of comprehensive programs, monitoring and fostering dialog on sexuality, and technical information. We highlight the need to implement a human rights-based approach and to prioritize dialog, stressing how complementary these technologies can be to meet different population needs. We conclude by stressing the need to prioritize sociopolitical changes to restore participation, dialog about sexuality, and emphasis on human rights such as core elements of the Brazilian AIDS policy.

scholarly journals Biological markers as predictors of postoperative neurocognitive disorders

2021 ◽  
Vol 20 (2) ◽  
pp. 95-100
Author(s):  
О. М. Basenko ◽  
А. А. Astakhov ◽  
А. I. Sinitzky ◽  
D G. Voroshin
Keyword(s):  
Mental Disorders ◽  
Biological Markers ◽  
Laboratory Diagnosis ◽  
Neurocognitive Disorders ◽  
Cognitive Status ◽  
Surgical Trauma ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Pubmed Database ◽  
Biochemical Laboratory

Introduction. The literature review presents new definitions of the concepts of postoperative cognitive dysfunctions, taking into account the new nomenclature according to DSM-5 (Diagnostic and Statistical Manual of mental disorders, fifth edition — Diagnostic and statistical manual of mental disorders, 5th edition) and time of their manifestations, depending on the age of the surgical intervention performed. The main discussed tactical aspects of the anesthesiologist's management of patients at risk of cognitive impairment in the postoperative period are outlined. The main biological markers, predictors of the development of cognitive postoperative disorders, are emphasized.Aim of the study: to highlight the main discussed tactical points of anesthesiologist's management of patients, to outline more promising aspects of biochemical laboratory diagnosis of postoperative neurocognitive disorders.Materials and methods. The data were analyzed and systematized based on scientific publications in the general PubMed database for the period 2016-2020.Results and discussion. New research advances in the search for biological targets, markers and predictors of postoperative neurocognitive disorders at the molecular level are presented, allowing a more precise impact on the pathogenetic mechanisms of neuronal inflammation and assessment of the potential damage to the cognitive status of the patient. The paper outlines more promising aspects of biochemical laboratory diagnosis using markers of innate immunity response to surgical trauma and the resulting systemic inflammation. Conclusion. Problems requiring further study to find pathogenetic therapy for postoperative neurocognitive disorders have been identified.

A review of transcranial magnetic stimulation for treating negative symptoms of schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S554-S555
Author(s):  
J. Oliveira ◽  
G. Sobreira ◽  
C.A. Moreira ◽  
M.A. Aleixo ◽  
S. Brissos
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Negative Symptoms ◽  
Current Evidence ◽  
Positive Effects ◽  
Prefrontal Function ◽  
Prefrontal Dysfunction ◽  
Pubmed Database ◽  
Dorsolateral Prefrontal ◽  
Competing Interest

IntroductionThe finding of prefrontal dysfunction in schizophrenia patients with negative symptoms (NS) has raised interest in using transcranial magnetic stimulation (TMS), which can modulate prefrontal function and dopamine release, as potential treatment for NS.ObjectiveTo briefly review current literature concerning the use of TMS as treatment for NS.AimsTo assess whether current evidence supports the use of TMS for NS.MethodsNarrative review of articles found through a PubMed database search using the keywords “transcranial magnetic stimulation”, “schizophrenia”, and “negative symptoms” between 1998 and 2015.ResultsUp to date, reviews of randomized sham-controlled studies found positive effects of TMS in NS. However, they exposed several methodological difficulties. More recent studies, reviewed in this poster, tried to overcome these, using results from multiple centers, larger samples and blinding. Various TMS techniques were studied, differing in frequency, motor threshold (MT), stimulus location, and treatment duration. Overall, TMS continues to show promising results in reducing NS; particularly rTMS 10 Hz, for at least 15 sessions on the left dorsolateral prefrontal cortex (DLPFC) at a 110% MT.ConclusionsTMS may be a useful treatment for NS for patients not responding to pharmacological treatment alone. Studies remain difficult to compare due to different measures of outcome (PANSS and SANS being the most commonly used) and techniques. Furthermore, possible modulators of response include duration of illness, cognitive symptoms amelioration, medication and their dose, and different NS may respond differently to TMS. More studies are needed to better understand the utility of TMS in NS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Auditory Hallucinations In A Deaf Patient? – A Clinical Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S527-S527
Author(s):  
M.A. Aleixo ◽  
C.A. Moreira ◽  
G. Sobreira ◽  
J. Oliveira ◽  
L. Carvalhão Gil
Keyword(s):  
Psychotic Disorders ◽  
Outpatient Setting ◽  
Auditory Hallucinations ◽  
Current Evidence ◽  
Psychotic Symptoms ◽  
Clinical Report ◽  
Pubmed Database ◽  
Paradoxical Finding ◽  
Competing Interest ◽  
Prelingually Deaf

IntroductionAccording to some studies, deaf psychiatric inpatients have prevalence rates of psychotic disorders ranging from 20 to 54%. There are descriptions of the paradoxical finding that prelingually deaf patients with psychosis may hear voices.ObjectivesTo present a case report and conduct a database review in order to understand if deaf patients with psychosis can have auditory hallucinations.AimsThe authors’ aim is to describe a case, highlight the clinical and scientific relevance of auditory hallucinations in deaf patients and the difficulties and limitations of this process.MethodsA Pubmed database search using as keywords “auditory hallucinations”, “deaf” and “deafness” and retrieved papers were selected according to their relevance.ResultsThe authors report a case of a 47-year-old female patient apparently suffering from congenital deafness. The patient had no previous psychiatric history until 4 months prior to her admission at our institution, when she started having psychotic symptoms. The patient was admitted into a Neurology ward but because no neurological sign was found psychiatric liaison consultation was requested. Four months later, she had the same symptoms, describing a voice that said to “shut up” and was admitted to a psychiatric hospital. After medication, the symptoms relapsed and now she is followed in an outpatient setting.The presence and nature of auditory hallucinations in deaf patients is not fully elucidated and there are methodological problems in the investigation of this subject.ConclusionsCurrent evidence is still inconclusive and the fact that prelingually deaf patient hear voices needs further research.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Acceptance and commitment therapy and anxiety disorders: Clinical case

2017 ◽  
Vol 41 (S1) ◽  
pp. S410-S410
Author(s):  
R. Guijarro ◽  
M. Cerviño ◽  
P. Castrillo
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Single Case ◽  
Human Condition ◽  
Diagnostic And Statistical Manual ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Flexible Working ◽  
Before And After ◽  
Competing Interest

Acceptance and commitment therapy (ACT) is a third-generation therapy that relates to human suffering as an inherent part of life in the human condition. Concerning personal values, ACT is focused on the acceptance of suffering, by doing away with the avoidance of things that cause us discomfort.The goal of the therapy is to make a person's reactions to suffering more flexible, working with the role of the symptoms rather than with the eliminating the symptoms themselves.This paper shows how the application of this therapy to a person with generalized anxiety disorder helps to reduce symptoms such as uncontrollable worrying, lack of concentration and muscular tension that these patients often suffer. The modification of symptoms has been measured by a single case study, where the symptoms are assessed by questionnaires before and after the treatment's application. Diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders’ (DSM-IV) criteria.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychiatric disorders among asthmatic patients: Literature review

2016 ◽  
Vol 33 (S1) ◽  
pp. S376-S376
Author(s):  
C.A. Moreira ◽  
A.M. Marinho ◽  
L.C. Gil ◽  
M. Bairrão ◽  
L. Queiroz
Keyword(s):  
General Population ◽  
Panic Disorder ◽  
Psychiatric Disorders ◽  
Public Health Problem ◽  
Close Correlation ◽  
Major Public Health Problem ◽  
Psychological Consequences ◽  
Asthmatic Patients ◽  
Pubmed Database ◽  
Competing Interest

IntroductionAsthma is a major public health problem and its prevalence has increased in both developed and developing countries during the last few years. Once it is a chronic illness, it has also revealed psychological consequences. Moreover, recent studies have suggested an association between asthma (especially of severe grade) and mental disorders.ObjectivesThe authors pretend to make a brief review concerning psychiatric disorders among asthmatic patients.AimsTo understand and to be able to deal with the psychiatric disorders among chronic asthmatic patients.MethodsThe review was based on scientific documentation published in PubMed database, using the following terms as keywords: “asthma”, “depression”, “anxiety” and “panic disorder”.ResultsCompared to the general population, both anxiety and mood disorders rates are at least two times those observed in asthmatic patients. Moreover, certain psychiatric disorders rates, including panic disorder (PD) and major depressive disorder, are as much as six times more prevalent among asthmatics when compared to the general population. The association between psychiatric disorders and poor asthma control and asthma-related quality of life could occur through several pathways, such as behavioural pathways; cognitive or perceptual pathways; or through the direct physiological effects of depression and anxiety on the autonomic nervous system (ANS) and immune systems which increase asthma symptomatology.Discussions/ConclusionsThere is a close correlation between anxiety, PD and depression, and a poor controlled asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Zoophilia in a Patient with Parkinson's Disease

2017 ◽  
Vol 41 (S1) ◽  
pp. S632-S632
Author(s):  
A. Fornelos ◽  
M. Roque
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Case Report ◽  
Educational Background ◽  
Muscle Rigidity ◽  
Motor Symptoms ◽  
Brain Disorder ◽  
Pubmed Database ◽  
Paraphilic Disorders ◽  
Clinical Records

IntroductionParkinson's disease (PD) is a neurodegenerative brain disorder characterized by Bradykinesia, muscle rigidity and resting tremor. Non-motor symptoms like neuropsychiatric manifestations can also cause significant morbidity. Common medications used in anti-Parkinsonian treatment such as dopaminergic agonists, may help motor symptoms but can also cause or contribute to adverse behavioral manifestations. These include dementia, depression, anxiety, insomnia, psychosis and paraphilic disorders. There are sporadic reports of zoophilia in association with dopaminergic therapy.ObjectivesReport of a clinical case of PD and zoophilia.Aimsclinicians must be aware of paraphilic disorders, namely zoophilia, in patients with dopaminergic medication.MethodSearch of the Pubmed database was conducted for articles published that had “zoophilia [All Fields] and Parkinson [All Fields]”, resulting in 3 eligible articles through October 2016. The patient's clinical records were also reviewed.Case ReportA 77-year-old man, living in a rural area and with a low educational background, with akinetic–rigid PD in an advanced stage and followed by neurology since 2003. His family physician sent him to a psychiatric assessment for hyper-sexuality with zoophilia. The psychiatrist found that these behaviors had begun a week after levodopa was increased along with the introduction of selegiline. The psychiatrist has introduced quetiapine with significant decrease of the hyper-sexuality and the end of zoophilic episodes.ConclusionDespite hyper-sexuality is found in just 2–6% of PD patients in connection with dopaminergic treatment. This case report emphasizes how crucial it is to evaluate PD patients’ sexuality as well as to explain these adverse effects to the families involved.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Depression and mild cognitive impairment – Comorbidity and/or continuum?

2016 ◽  
Vol 33 (S1) ◽  
pp. S190-S191
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Pubmed Database ◽  
Competing Interest ◽  
The Relationship

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sign in / Sign up

Export Citation Format

Share Document