Precisiones sobre algunas informaciones históricas en la "Crónica de Alfonso III"

La "Crónica de Alfonso III" contiene en su primera parte un conjunto de informaciones sobre el Reino visigodo de Toledo, cuyo tema podría llamarse 'la maldad de la estirpe de Witiza'. Estas noticias han influido siempre en nuestra imagen de los últimos decenios del reino godo. En este artículo se investigan algunas de ellas: el envenenamiento de Wamba, la sucesión al trono y la legislación de Ervigio, el repudio de la reina Cixilo y la noticia de que Witiza era hijo de Cixilo. Resulta muy probable que ninguna de ellas se ajuste a la realidad histórica. Se trata, sin embargo, según se pretende hacer plausible en este artículo, de elementos de una verdadera polémica contra el rey Ervigio, su supuesto nieto, el rey Witiza, y contra los hijos de aquel, especialmente el presunto obispo Oppa acusado de colaborar con los sarracenos.The Chronicle of Alfonso III contains in its first section some historical news about the Kingdom of Toledo that could be summarized as "the wickedness of the family of Witiza". This information has ever since determined our perception of the final decades of the Visigothic kingdom. Some of this information is examined more precisely in this paper: the poisoning of King Wamba, the succession and legislation by King Ervig, the repudiation of Egicas's spouse Cixilo and the mention that King Witiza was a son of Cixilo. As this paper renders plausible, it is highly uncertain that each of these reports should reflect historical facts. It does seem, however, that all of these elements constitute a comprehensive polemic against King Ervig, his alleged grandson King Witiza and his sons, especially the so-called bishop Oppa accused of collaborating with the Saracens

Comorbidity patterns in adolescents and young adults with suicide attempts

The role of comorbidity as a risk for suicide attempts is investigated in a random sample of 3021 young adults aged 14–24 years. The M-CIDI, a fully standardized and modified version of the Composite International Diagnostic Interview, was used for the assessment of various DSM-IV lifetime and 12-month diagnoses as well as suicidal ideation and suicide attempts. Of all suicide attempters, 91% had at least one mental disorder, 79% were comorbid or multimorbid respectively and 45% had four or more diagnoses (only 5% in the total sample reached such high levels of comorbidity). Suicide attempters with more than three diagnoses were 18 times more likely (OR = 18.4) to attempt suicide than subjects with no diagnosis. Regarding specific diagnoses, multivariate comorbidity analyses indicated the highest risk for suicide attempt in those suffering from anxiety disorder (OR = 4.3), particularly posttraumatic stress disorder followed by substance disorder (OR = 2.2) and depressive disorder (OR = 2.1). Comorbidity, especially when anxiety disorders are involved, increases the risk for suicide attempts considerably more than any other individual DSM-IV diagnoses

Inter-rater agreement of comorbid DSM-IV personality disorders in substance abusers

<p>Abstract</p> <p>Background</p> <p>Little is known about the inter-rater agreement of personality disorders in clinical settings.</p> <p>Methods</p> <p>Clinicians rated 75 patients with substance use disorders on the DSM-IV criteria of personality disorders in random order, and on rating scales representing the severity of each.</p> <p>Results</p> <p>Convergent validity agreement was moderate (range for r = 0.55, 0.67) for cluster B disorders rated with DSM-IV criteria, and discriminant validity was moderate for eight of the ten personality disorders. Convergent validity of the rating scales was only moderate for antisocial and narcissistic personality disorder.</p> <p>Discussion</p> <p>Dimensional ratings may be used in research studies and clinical practice with some caution, and may be collected as one of several sources of information to describe the personality of a patient.</p

Reliability and cultural applicability of the Greek version of the International Personality Disorders Examination.

BACKGROUND: The International Personality Disorders Examination (IPDE) constitutes the proposal of the WHO for the reliable diagnosis of personality disorders (PD). The IPDE assesses pathological personality and is compatible both with DSM-IV and ICD-10 diagnosis. However it is important to test the reliability and cultural applicability of different IPDE translations. METHODS: Thirty-one patients (12 male and 19 female) aged 35.25 ± 11.08 years, took part in the study. Three examiners applied the interview (23 interviews of two and 8 interviews of 3 examiners, that is 47 pairs of interviews and 70 single interviews). The phi coefficient was used to test categorical diagnosis agreement and the Pearson Product Moment correlation coefficient to test agreement concerning the number of criteria met. RESULTS: Translation and back-translation did not reveal specific problems. Results suggested that reliability of the Greek translation is good. However, socio-cultural factors (family coherence, work environment etc) could affect the application of some of the IPDE items in Greece. The diagnosis of any PD was highly reliable with phi >0.92. However, diagnosis of non-specfic PD was not reliable at all (phi close to 0) suggesting that this is a true residual category. Dianosis of specific PDs were highly reliable with the exception of schizoid PD. Diagnosis of antisocial and Borderline PDs were perfectly reliable with phi equal to 1.00. CONCLUSIONS: The Greek translation of the IPDE is a reliable instrument for the assessment of personality disorder but cultural variation may limit its applicability in international comparisons

Suicide risk in schizophrenia: learning from the past to change the future

Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5–13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide risk among schizophenia patients