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Augmentation treatment with amisulpride in schizophrenic patients partially responsive to olanzapine. (Enlace)


1 de junio de 2011

"The association of antipsychotics is a widespread therapeutic resource in clinical practice. The purpose of the present work was to evaluate the efficacy and safety of amisulpride augmentation in patients responding at least partially to olanzapine. In this observational 3-months open-label investigation, we evaluated the effectiveness of the addition of amisulpride to 49 subjects, after having scored at least 25 on the brief psychiatric rating scale (BPRS) following olanzapine monotherapy for 6 weeks. Patients were assessed at baseline, 1 and 3 months using the BPRS, the clinical global impression severity of illness (CGI-S) scale and the Udvalg for Kliniske Undersogelser side effect rating scale (UKU).
In subjects who were at least partially responsive to monotherapy with olanzapine, coadjuvant treatment with amisulpride achieved a statistically significant improvement in mental status over a 3 month period as measured by the BPRS, CGI and UKU scales. The response rate (>20% reduction in BPRS score) was 75.51%.
Amisulpride augmentation, in a group of patients partially or non-responsive to olanzapine, may lead to an improvement in schizophrenic symptoms. However, these results are subject to several limitations making it difficult to derive firm clinical recommendations, and underscoring the need for future research into the value of these therapeutic alternatives in poor responders."

Borderline personality disorder: a review and reformulation from evolutionary theory. (Enlace)

Medical Hipotheses

1 de septiembre de 2009

"A number of authors have provided a useful evolutionary perspective on personality disorders, arguing that personality traits can be conceptualized in terms of evolutionary strategies. If we consider personality traits not as illnesses but as stable evolutionary strategies, the characteristic features of borderline personality disorder may respond to a behavioral pattern which, although deviating from the norm, would be in the service of survival of the species. Early environments involving factors such as childhood physical/sexual abuse may prove useful for explanation of personality traits based on gene-environment interaction, potentially providing a model for understanding borderline personality traits. We also review the question of whether personality traits exist in animals to also provide a translational perspective. We propose that certain traits in borderline personality disorder may derive from evolved mechanisms which in the short-term serve to help respond to adversity, but which when activated in an ongoing way prove maladaptive."

Psychiatry and political-institutional abuse from the historical perspective: the ethical lessons of the Nuremberg Trial on their 60th anniversary. (Enlace)

Prog Neuropsychopharmacol Biol Psychiatry. 2007 May 9;31(4):791-806. Epub 2006 Dec 15. Review.

1 de mayo de 2007

"Sixty years ago at the Nuremberg Trials, 23 Nazi leaders were tried as war criminals, in what was known as "The Doctors' Trial". This trial exposed a perverse system of the criminal use of medicine in the fields of public health and human research. These practices, in which racial hygiene constituted one of the fundamental principles and euthanasia programmes were the most obvious consequence, violated the majority of known bioethical principles. Psychiatry played a central role in these programmes, and the mentally ill were the principal victims. The aim of the present work is to review, from the historical perspective, the antecedents of the shameful euthanasia programmes for the mentally ill, the procedures involved in their implementation and the use of mentally ill people as research material. The Nuremberg Code, a direct consequence of the Doctors' Trial, is considered to be the first international code of ethics for research with human beings, and represented an attempt to prevent any repeat of the tragedy that occurred under Nazism. Nevertheless, the last 60 years have seen continued government-endorsed psychiatric abuse and illegitimate use of psychoactive drugs in countries such as the Soviet Union or China, and even in some with a long democratic tradition, such as the United States. the improper use of psychiatry on behalf of governments is seen to be occurring in numerous parts of the globe: religious repression in China, enforced hospitalization in Russia, administration of psychoactive drugs in immigrant detention centres in Australia, and the application of the death penalty by lethal injection and psychiatric participation in coercive interrogation at military prisons, in relation to the USA. The Declaration of Madrid in 1996 constituted the most recent attempt to eradicate, from the ethical point of view, these horrendous practices. Various strategies can be used to combat such abuses, is uncertain how effective they are in preventing them."


eduPsykhé, 2009, Vol. 8, No. 2, 101-126

1 de marzo de 2009

"La presencia en un sujeto de un trastorno de personalidad puede suponer que éste tenga una forma de ser cuando menos "peculiar" y que en ocasiones estas características sean determinantes o influyan en la comisión de un delito. Dentro del
amplio grupo de los trastornos de personalidad concurren diferentes características con mayor o menor influencia en la imputabilidad del sujeto, es decir, en sus capacidades cognoscitiva y volitiva. En nuestra jurisprudencia, encontramos un
tratamiento de los trastornos de personalidad muy variado, desde sentencias en las que no se considera que exista un trastorno
mental y que por lo tanto el sujeto es plenamente imputable, hasta otras, las menos, en las que se le aplica una eximente
completa declarándolo inimputable.

The presence in a subject of a personality disorder can be assumed that it has a way of being "peculiar" and sometimes
these features are not decisive or influence in the commission of a crime. In the group of personality disorders there are several features with greater or lesser influence on the attribution of the subject, cognitive and volitional capacities. In our case, we found that treatment of personality disorders varied from judgments in which there is not considered a mental disorder and therefore the subject is fully attributable to other, less, where it be a complete
exemption applies declaring karina. In this article, me analyse various personality disorders, their influence on the attribution of the person and the judicial treatment."

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