El delirio en la esquizofrenia como objeto de estudio interdisciplinario en la filosofía de la mente

Delusions are a transdiagnostic phenomenon with higher prevalence in schizophrenia. Historically, delusions have been regarded as the hallmark of psychosis. Over the last 20 years, delusions have attracted the attention of philosophers, psychiatrists, and cognitive sciences due to the ways in which they challenge some of the most fundamental claims about the nature of the human mind. However, despite its clinical relevance for the diagnosis of a number of conditions, the study of delusions still leads to a number of conceptual and empirical disagreements. This article clarifies some of the most fundamental problems raised by the observation of delusions in schizophrenia from an interdisciplinary point of view. Our analysis is meant to inform experimental approaches to the phenomenon, and, in turn, advance its treatment. In this sense, conceptual progress in this field is fundamental to map different paths for empirical and clinical research. This, due to the fact that any theory aiming at explaining delusions in schizophrenia should offer some kind of answer to the problems that we clarify in this paperEl delirio es un fenómeno transdiagnóstico más frecuente en la esquizofrenia. Históricamente, el delirio se ha considerado la marca de la psicosis. Dada las formas en que desafía algunas de las premisas más fundamentales acerca de la naturaleza de la mente humana, durante los últimos 20 años el delirio ha atraído la atención de filósofos, psiquiatras e investigadores en ciencias cognitivas. Sin embargo, a pesar de su relevancia clínica en el diagnóstico de una serie de condiciones, el estudio del delirio aún produce diversas discusiones conceptuales y empíricas. Este artículo intenta clarificar algunos de los problemas más fundamentales que surgen del estudio interdisciplinario del delirio en el contexto de la esquizofrenia. Es importante señalar que la resolución de tales discusiones no constituye un simple ejercicio retórico, sino que permitiría, en el mejor de los casos, sentar las bases para el avance en la investigación clínica y experimental conceptualmente bien informada y, por ende, permitiría importantes avances en su tratamiento. En este sentido, el avance conceptual en el área será importante para definir la carta de navegación de la investigación empírica en el tema. Esto, porque cada teoría que intenta contar una historia explicativa completa y contextualizada del fenómeno de los delirios en la esquizofrenia debería ofrecer respuestas a los problemas que identificamos en este trabajo

El delirio en la esquizofrenia como objeto de estudio interdisciplinario en la filosofía de la mente*

El delirio es un fenómeno transdiagnóstico más frecuente en la esquizofrenia. Históricamente, el delirio se ha considerado la marca de la psicosis. Dada las formas en que desafía algunas de las premisas más fundamentales acerca de la naturaleza de la mente humana, durante los últimos 20 años el delirio ha atraído la atención de filósofos, psiquiatras e investigadores en ciencias cognitivas. Sin embargo, a pesar de su relevancia clínica en el diagnóstico de una serie de condiciones, el estudio del delirio aún produce diversas discusiones conceptuales y empíricas. Este artículo intenta clarificar algunos de los problemas más fundamentales que surgen del estudio interdisciplinario del delirio en el contexto de la esquizofrenia. Es importante señalar que la resolución de tales discusiones no constituye un simple ejercicio retórico, sino que permitiría, en el mejor de los casos, sentar las bases para el avance en la investigación clínica y experimental conceptualmente bien informada y, por ende, permitiría importantes avances en su tratamiento. En este sentido, el avance conceptual en el área será importante para definir la carta de navegación de la investigación empírica en el tema. Esto, porque cada teoría que intenta contar una historia explicativa completa y contextualizada del fenómeno de los delirios en la esquizofrenia debería ofrecer respuestas a los problemas que identificamos en este trabajo.//Delusions are a transdiagnostic phenomenon with higher prevalence in schizophrenia. Historically, delusions have been regarded as the hallmark of psychosis. Over the last 20 years, delusions have attracted the attention of philosophers, psychiatrists, and cognitive sciences due to the ways in which they challenge some of the most fundamental claims about the nature of the human mind. However, despite its clinical relevance for the diagnosis of a number of conditions, the study of delusions still leads to a number of conceptual and empirical disagreements. This article clarifies some of the most fundamental problems raised by the observation of delusions in schizophrenia from an interdisciplinary point of view. Our analysis is meant to inform experimental approaches to the phenomenon, and, in turn, advance its treatment. In this sense, conceptual progress in this field is fundamental to map different paths for empirical and clinical research. This, due to the fact that any theory aiming at explaining delusions in schizophrenia should offer some kind of answer to the problems that we clarify in this paper

Clustering properties of intermediate and high-mass Young Stellar Objects

We have selected 337 intermediate and high-mass YSOs ($1.5$ to $20$ M$_{\odot}$) well-characterised with spectroscopy. By means of the clustering algorithm HDBSCAN, we study their clustering and association properties in the Gaia DR3 catalogue as a function of stellar mass. We find that the lower mass YSOs ($1.5-4$ M$_{\odot}$) have clustering rates of $55-60\%$ in Gaia astrometric space, a percentage similar to the one found in the T Tauri regime. However, intermediate-mass YSOs in the range $4-10$ M$_{\odot}$ show a decreasing clustering rate with stellar mass, down to $27\%$. We find tentative evidence suggesting that massive YSOs ($>10$ M$_{\odot}$) often appear $-$yet not always$-$ clustered. We put forward the idea that most massive YSOs form via a mechanism that demands many low-mass stars around them. However, intermediate-mass YSOs form in a classical core-collapse T Tauri way, yet they do not appear often in the clusters around massive YSOs. We also find that intermediate and high-mass YSOs become less clustered with decreasing disk emission and accretion rate. This points towards an evolution with time. For those sources that appear clustered, no major correlation is found between their stellar properties and the cluster sizes, number of cluster members, cluster densities, or distance to cluster centres. In doing this analysis, we report the identification of 55 new clusters. We present tabulated all the derived cluster parameters for the considered intermediate and high-mass YSOs.Comment: Accepted for publication in The Astronomical Journal on August 18th, 2023. Table 1 and the new clusters can be provided upon reques

Validación de una versión en español abreviada de la batería EMOTICOM (VEA-EMOTICOM) (Validation of a Spanish short version of the EMOTICOM battery (VEA-EMTICOM))

Introduction: Most scales used in the assessment of psychiatric disorders focus on the clinical status of the patient. However, it is important to quantitatively measure specific dimensions, such as cognitive, affective or social functioning, and to record their evolution in the clinical or research setting. The EMOTICOM battery includes four domains of affective cognition; processing of emotions; motivation; impulsivity; and social cognition. Here we present psychometric data from an abbreviated Spanish version (VEA-EMOTICOM). Methodology: The sample included two hundred healthy volunteers (31.68 years ± 8.38; 111 men). Forty-two subjects were re-evaluated, to determine test-retest reliability. The VEA-EMOTICOM comprises 9 tasks programmed on a laptop computer to be completed in one hour. The battery was administered in a random sequence and rest periods were allowed. Results: Small floor effects were observed for 3 outcomes and moderate for 1 outcome, as well as small ceiling effects for 3 outcomes and moderate for 1 outcome. Two tasks showed excellent test-retest reliability; four showed good reliability; seven showed moderate reliability; and two showed poor test-retest reliability. The results of most of the tasks were not correlated with age or gender. An underlying four-factor structure could not be confirmed. Conclusions: The VEA-EMOTICOM seems to be a practical and adequate battery to evaluate affective cognition in Spanish-speaking populatio

Catatonia: A narrative review of its historical development, diagnosis, pathophysiology, and therapeutics

Catatonia was initially a clinical presentation of certain types of schizophrenia, but basic and epidemiological evidence has demonstrated its association with multiple somatic and psychiatric conditions. We describe and discuss current clinical, etiological, pathophysiological, and therapeutic concepts regarding catatonia. We conducted a broad narrative review of articles published in MEDLINE/PubMed. The diagnosis is clinical and can be supported by additional tests, but there are psychometric instruments with different clinical focus. The most validated subtypes are inhibited and excited catatonia. It is mostly associated with somatic, neurological, affective, psychotic, and autistic spectrum disorders. Genetic factors related to oligodendrocytes have been studied in its pathophysiology. Some findings point to an imbalance in neurotransmission and density of GABA and dopamine receptors, consistent with their function in motor pathways and therapeutic response with benzodiazepines. Likewise, glutamatergic activity has been analyzed from the pathophysiological model of autoimmune encephalitis. The cortico-cortical and cortico-subcortical pathways would have a central role, including structures such as the orbitofrontal and temporal cortex, basal nuclei, and brainstem, involved in decision-making, emotion regulation, storage, planning, and motor processing. The main therapeutic lines are benzodiazepines and electroconvulsive therapy. Other interventions studied are zolpidem, antipsychotics, mood stabilizers, glutamatergic modulators, and transcranial magnetic stimulation. New neurobiological findings challenge nosological and therapeutic precepts, renewing the cycle in the conceptualization of catatonia. We highlight the affective component of the psychomotor syndrome and the role of interventions aimed at its modulation

The phenomenology of auditory verbal hallucinations in schizophrenia and the challenge from pseudohallucinations

In trying to make sense of the extensive phenomenological variation of first-personal reports on auditory verbal hallucinations, the concept of pseudohallucination is originally introduced to designate any hallucinatory-like phenomena not exhibiting some of the paradigmatic features of “genuine” hallucinations. After its introduction, Karl Jaspers locates the notion of pseudohallucinations into the auditory domain, appealing to a distinction between hallucinatory voices heard within the subjective inner space (pseudohallucination) and voices heard in the outer external space (real hallucinations) with differences in their sensory richness. Jaspers' characterization of the term has been the target of a number of phenomenological, conceptual and empirically-based criticisms. From this latter point of view, it has been claimed that the concept cannot capture distinct phenomena at the neurobiological level. Over the last years, the notion of pseudohallucination seems to be falling into disuse as no major diagnostic system seems to refer to it. In this paper, we propose that even if the concept of pseudohallucination is not helpful to differentiate distinct phenomena at the neurobiological level, the inner/outer distinction highlighted by Jaspers' characterization of the term still remains an open explanatory challenge for dominant theories about the neurocognitive origin of auditory verbal hallucinations. We call this, “the challenge from pseudohallucinations”. After exploring this issue in detail, we propose some phenomenological, conceptual, and empirical paths for future research that might help to build up a more contextualized and dynamic view of auditory verbal hallucinatory phenomena

The phenomenology of auditory verbal hallucinations in schizophrenia and the challenge from pseudohallucinations

In trying to make sense of the extensive phenomenological variation of first-personal reports on auditory verbal hallucinations, the concept of pseudohallucination is originally introduced to designate any hallucinatory-like phenomena not exhibiting some of the paradigmatic features of “genuine” hallucinations. After its introduction, Karl Jaspers locates the notion of pseudohallucinations into the auditory domain, appealing to a distinction between hallucinatory voices heard within the subjective inner space (pseudohallucination) and voices heard in the outer external space (real hallucinations) with differences in their sensory richness. Jaspers' characterization of the term has been the target of a number of phenomenological, conceptual and empirically-based criticisms. From this latter point of view, it has been claimed that the concept cannot capture distinct phenomena at the neurobiological level. Over the last years, the notion of pseudohallucination seems to be falling into disuse as no major diagnostic system seems to refer to it. In this paper, we propose that even if the concept of pseudohallucination is not helpful to differentiate distinct phenomena at the neurobiological level, the inner/outer distinction highlighted by Jaspers' characterization of the term still remains an open explanatory challenge for dominant theories about the neurocognitive origin of auditory verbal hallucinations. We call this, “the challenge from pseudohallucinations”. After exploring this issue in detail, we propose some phenomenological, conceptual, and empirical paths for future research that might help to build up a more contextualized and dynamic view of auditory verbal hallucinatory phenomena

Rendimiento Neuropsicológico en hermanos de personas enfermas de Esquizofrenia.

Algunos autores han planteado dudas metodológicas respecto a las evaluaciones neuropsicológicas en familiares de personas con esquizofrenia. Nuestro objetivo es comparar el funcionamiento cognitivo en hermanos discordantes para la enfermedad y sujetos controles de similares características demográficas. Metodología: muestra compuesta por tres grupos de 20 individuos (pacientes, hermanos, controles), de 15 a 30 años de edad, sin comorbilidades. Los sujetos completaron la siguiente batería: Test de Stroop, Toulouse, COWAT, Letternumber, California Verbal Learning, WAIS y escala SOPS. Resultados: No hay diferencias de coeficiente intelectual intergrupos, ni de género en los rendimientos evaluados. Los hermanos obtienen puntajes inferiores a los controles en los test de Toulouse, dígitos y letras y CVLT 1 y 2, sin diferencias en los test de Stroop y COWAT. Además los síntomas negativos, se asociaron con un menor desempeño. Conclusiones: los hermanos de personas con esquizofrenia presentaron un rendimiento menor al grupo control, y semejante a los pacientes, en las pruebas de concentración, atención, memoria de trabajo y fluidez verbal. Este trabajo contribuye a identificar las áreas más sensibles al deterioro cognitivo en los hermanos de personas enfermas de esquizofrenia.Some authors have raised methodological concerns regarding neuropsychological assessments in relatives of people with schizophrenia. Our goal is to compare cognitive function in siblings discordant for the disease and control subjects with similar demographic characteristics. Methodology: three groups of 20 individuals each (patients, siblings, controls), 15 to 30 years of age, no comorbidities. All subjects completed the following battery: Stroop Test, Toulouse, COWAT, Letter-number, California Verbal Learning, WAIS and SOPS. Results: there were no differences in IQ between groups. Scores in the tests did not vary with gender. Siblings scored lower than controls, in the Toulouse test, digits and letters and CVLT 1 and 2, there were no differences in the Stroop Test, and COWAT. Negative symptoms were associated with lower scores. Conclusions: siblings of people with schizophrenia scored lower than the control group and similarly to patients in tests of concentration, attention, working memory and verbal fluency. This work helps to identify the areas most sensitive to cognitive impairment in the siblings of people suffering from schizophrenia

Clustering Properties of Intermediate and High-mass Young Stellar Objects

We have selected 337 intermediate- and high-mass young stellar objects (YSOs; 1.5–20 M _⊙ ) well-characterized with spectroscopy. By means of the clustering algorithm HDBSCAN, we study their clustering and association properties in the Gaia DR3 catalog as a function of stellar mass. We find that the lower-mass YSOs (1.5–4 M _⊙ ) have clustering rates of 55%–60% in Gaia astrometric space, a percentage similar to that found in the T Tauri regime. However, intermediate-mass YSOs in the range 4–10 M _⊙ show a decreasing clustering rate with stellar mass, down to 27%. We find tentative evidence suggesting that massive YSOs (>10 M _⊙ ) often (yet not always) appear clustered. We put forward the idea that most massive YSOs form via a mechanism that demands many low-mass stars around them. However, intermediate-mass YSOs form in a classical core-collapse T Tauri way, yet they do not appear often in the clusters around massive YSOs. We also find that intermediate- and high-mass YSOs become less clustered with decreasing disk emission and accretion rate. This points toward an evolution with time. For those sources that appear clustered, no major correlation is found between their stellar properties and the cluster sizes, number of cluster members, cluster densities, or distance to cluster centers. In doing this analysis, we report the identification of 55 new clusters. We tabulated all of the derived cluster parameters for the considered intermediate- and high-mass YSOs