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The diagnosis of hypochondria has disappeared in the new classification of mental illness. About 25% of patients who were diagnosed with hypochondria now fall into the category illness anxiety disorder. This disorder constitutes a new diagnostic category in DSM5 and is included within the somatic symptom and related disorders.
We propose to carry out a bibliographic review off the new diagnostic category of illness anxiety disorder.
We present the clinical case of a 27-year-old man in the context of the Covid19 pandemic.
The illness anxiety disorder is characterized by being concerned about having or acquiring a serious illness. Somatic symptoms are not present, but if they are, they are of mild intensity. The level of concern is excessive or disproportionate if there is any disease or if there is a high risk of developing it. There is a high level of health anxiety and the individual is easily alarmed by personal health status. It is a disorder that tends to be chronic and recurrent. The exact comorbidity is still unknown. However, it is important to keep in mind that hypochondria concurs with anxiety disorders and depressive disorders. Treatment is based on the cognitive restructuring of bodily symptoms. In addition, exposure therapy and acceptance and commitment therapy are also effective. Regarding pharmacological treatment, SSRIs are useful in relation with comorbidity.
Illness anxiety disorder is characterized by significant attention to somatic concerns in medical places, making it very useful for primary care professionals.
inhaled loxapine has shown efficiency in the treatment of the mild-moderate agitation syndrome of schyzophrenia and mania patients. Its rapid response and calming effect non-sedative allow to hypothesize reasonable efficiency and tolerability in borderline personality disorder diagnosed patients.
analyze the efficiency and tolerability of inhaled loxapine as a pharmacological approach in the treatment of agitation in borderline personality disorder (BPD) clinical diagnosed patients.
Materials and method
an application was administered for every agitation episode in BPD patients treated with inhaled loxapine in the emergency room or the psychiatric ward, which included B aRS and CGI-S scales for the evaluation of each episode and its severity, before and after its use. Other secondary measures of efficiency were taken into account, such as requirement of physical restrain.
in the majority of evaluated episodes inhaled loxapine decreased notably initial B aRS and CGI-S values and no serious clinical side effects attributable to this medication were observed.
in our sample, inhaled loxapine was efficiency and well tolerated pharmacological intervention for agitation in BPD patients.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The concept of psychogenic psychosis was introduced by Wimmer in 1916 and subsequently extended by Strömgren in the mid twentieth century. It typically describes a polymorphic psychotic episode of abrupt onset and which follows a trauma or stressful life situation. The duration of the episode is usually brief and remission occurs ad integrum. In recent decades, the notion has fallen into disuse in clinical psychiatry and international classifications. This could be due to a general improvement in living conditions, with less exposure to traumatic situations.
We intend to study the characteristics of psychogenic psychosis in immigrants. We believe that the condition could be observed better in this population, given their greater vulnerability to trauma. For this purpose, we chose a sample of Romanian patients, who nevertheless have considerable cultural affinity with the Spanish population.
We collected the clinical and biographical data of four cases of psychogenic psychosis admitted to our clinic between 2012 and 2015.
Four Romanian women aged 25 to 42 were diagnosed with psychogenic psychosis in this period. Mean length of hospitalization was 5, 0 days. All patients reported familiar or occupational stress prior to the onset of symptoms. Psychotic symptoms remitted quickly with low doses of medication, despite being initially intense.
Reported cases fit remarkably well with the original description of Wimmer. The concept of psychogenic psychosis, along with similar brief psychotic entities, could be useful in describing the psychopathology derived from new social models and crises.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Depression is the most common psychiatric manifestation in patients with Parkinson's disease (PD). In addition, depressive symptoms may be considered to be a prodromal manifestation of PD. In recent years, the association between PD and depression has been the focus of neuroimaging studies using functional and structural techniques.
The aim of this study was to review the main neuroimaging studies assessing the comorbidity between depression and PD. Literature searches were conducted to find the major neuroimaging studies that consider primarily the comorbidity between depression and PD using the indices Web of Science and Lilacs.
In total, 296 papers were identified, and 18 of these studies were selected for the current review. The principal neuroimaging technique used was SPECT. The structural neuroimaging studies that have evaluated the impact of current or previous bouts of depression on the neurodegenerative process of PD are scarce and inclusive. The instruments that were used to evaluate depression differed among the studies. Several brain regions appear to be involved in depression, particularly the limbic system and the basal ganglia. In addition, the serotonergic, dopaminergic, and noradrenergic systems also appear to be associated with depressive symptoms in PD.
Several brain regions and neurotransmitter systems are involved in depression in PD; however, the variety of criteria used to evaluate depressive symptoms precludes more specific conclusions.
Atomic force microscopy (AFM) and Raman spectroscopy were used to characterize the morphology and the local mechanical properties of polypropylene-based graphene nanocomposites. Amplitude Modulated AFM was used to perform phase angle measurements to estimate the loss tangent, along with the local elastic modulus of the nanocomposite’s surface as a function of graphene content. We have observed an increasing trend in phase angle as the graphene content increased. We also identified wrinkled graphene flakes embedded in the polymer matrix. The graphene corrugation and mismatched strain between polymer and graphene sheets show a variation in the phase angle that is corroborated with Raman measurements. Mechanically exfoliated graphene on SiO2 was characterized as a baseline to understand the effect of graphene wrinkles compared to graphene surfaces on phase angle. The Raman results revealed that there are changes in the crystalline morphology of the polymer with the addition of graphene.
High resolution spectroscopic data of a large sample of galactic planetary nebulae with [WC] central stars ([WC]PNe) are analyzed to determine their kinematical behavior. Their heliocentric velocities have been determined with a precision better than a few km/s. Distances obtained from the literature are used to derive the peculiar velocities of the objects. Our preliminary results are: (a) The [WC] PNe are distributed in the galactic disk and they appear more concentrated than the normal PNe. (b) Separating the sample in Peimbert's types, we find that Type I PNe show in general low peculiar velocities (<50 km/s) except for a couple of objects apparently belonging to the galactic bulge. For the other [WC]PNe, most of them belong to the Peimbert's Type II (defined as having Vpec ≤ 60 km/s). However there is an important fraction (28%) showing Vpec larger than 60 km/s therefore they are classified as Peimbert's Type III.
Family perception of organ donation has been explored by numerous authors using statements by the people who decided whether or not to donate the organs of a relative in a situation of brain death. Within this tradition, in this work, we analyze the discourse of six families who granted permission for organ donation and three who refused. We describe the process-based interpretation of this experience and identify psychosocial variables and processes that further our understanding of the decision finally adopted. We have identified two heuristics that guide family decision when organ donation is requested: the explicit or inferred will of the deceased and family attitudes to organ donation and transplant. It is postulated that the interaction of these two factors explains a large amount of the decisions made. We also hypothesize that a marked discrepancy between these two factors increases the importance of other aspects, especially the role of the transplant coordinator and of other healthcare personnel. These results support, at a social level, the implementation of transplant promotion programs; and at a healthcare level, the combined use of techniques of crisis intervention and attitude change.
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