Intervenciones Psicosociales en el Trastorno Bipolar

Introducción. En los últimos años han sido propuestas múltiples intervenciones psicosociales para el tratamiento del trastorno bipolar. Una revisión crítica de los modelos validados empíricamente resultaría de utilidad. Método. Se realizó una revisión bibliográfica de artículos publicados en Medline/PubMed durante los años 2000- 2010 que respondieran al cruce de trastorno bipolar con las siguientes palabras claves: “psychosocial intervention”, “psychoeducational intervention” y “psychotherapy”. Resultados. Cuentan con validez empírica intervenciones provenientes de los modelos cognitivo-conductual, psicoeducativo, cuidado sistemático, interpersonal y familiar. Todas ellas dan cuenta de mejoras significativas en la adhesión a las indicaciones terapéuticas y un incremento en la funcionalidad Conclusiones. Si bien se utilizan diversas intervenciones psicosociales validadas para el abordaje del trastorno bipolar, su nivel de eficacia debería precisarse en base a variables más específicas como ser las formas clínicas, tipo de comorbilidad, fases o duración de la enfermedad. Estas delimitaciones permitirían seleccionar la intervención más adecuada según las características del paciente.Introduction. Multiple psychosocial interventions for bipolar disorder have been proposed in recent years. Therefore, we consider that a critical review of empirically validated models would be useful. Methods. A review of the literature was conducted in Medline/PubMed for articles published during 2000-2010 that respond to the combination of “bipolar disorder” with the following key words: “psychosocial intervention,” “psychoeducational intervention” and “psychotherapy.” Results. Cognitive-behavioral, psychoeducational, systematic care models, interpersonal and family therapy interventions were found to be empirically validated. All of them reported significant improvements in therapeutic adherence and in the patients’ functionality. Conclusions. Although there are currently several validated psychosocial interventions for treating bipolar disorder, their efficacy needs to be specified in relation to more precise variables such as clinical type, comorbid disorders, stages or duration of the disease. Taking into account these clinical features would enable a proper selection of the most adequate intervention according to the patient’s specific characteristicsFil: Lolich, Maria. Universidad de Palermo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Vázquez, Gustavo H.. Universidad de Palermo; ArgentinaFil: Álvarez, Lina M.. Universidad Pontificia Bolivariana; ColombiaFil: Tamayo, Jorge M.. Universidad Ces.; Colombi

Psychological symptoms, mental fatigue and behavioural adherence after 72 continuous days of strict lockdown during the COVID-19 pandemic in Argentina

Background An early and prolonged lockdown was adopted in Argentina during the first wave of COVID-19. Early reports evidenced elevated psychological symptoms. Aims To explore if the prolonged lockdown was associated with elevated anxiety and depressive symptoms; if mental fatigue was associated with lockdown adherence (a phenomenon called ‘behavioural fatigue’); and if financial concerns were associated with lockdown adherence and emotional symptoms. Method The survey included standardised questionnaires to assess depressive (PHQ-9) and anxious (GAD-7) symptoms, mental fatigue, risk perception, lockdown adherence, financial concerns, daily stress, loneliness, intolerance to uncertainty, negative repetitive thinking and cognitive problems. LASSO regression analyses were carried out to predict depression, anxiety and lockdown adherence Results The survey reached 3617 adults (85.2% female) from all provinces of Argentina after 72 days of lockdown. Data were collected between 21 May 2020 and 4 June 2020. In that period, Argentina had an Oxford stringency index of 85/100. Of those surveyed, 45.6% and 27% met the cut-offs for depression and anxiety, respectively. Mental fatigue, cognitive failures and financial concerns were correlated with psychological symptoms, but not with adherence to lockdown. In regression models, mental fatigue, cognitive failures and loneliness were the most important variables to predict depression, intolerance to uncertainty and lockdown difficulty were the most important for anxiety, and perceived threat was the most important for predicting lockdown adherence. Conclusions During the extended lockdown, psychological symptoms increased, being enhanced by mental fatigue, cognitive difficulties and financial concerns. We found no evidence of behavioural fatigue. Thus, feeling mentally fatigued is not the same as being behaviourally fatigued.Fil: Torrente, Fernando Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Yoris Magnago, Adrián Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Low, Daniel Mark. Harvard Medical School; Estados Unidos. Massachusetts Institute of Technology; Estados UnidosFil: Lopez, Pablo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Bekinschtein, Pedro Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Vázquez, Gustavo H.. Queen's University Medical School; CanadáFil: Manes, Facundo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Cetkovich Bakmas, Marcelo Gustavo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentin

Multisite international collaborative clinical trials in mania.

Multi-regional collaborative clinical trials include those conducted across heterogeneous areas of the world under common protocols. Such trials appear to be driven primarily to provide data required for regulatory approval or licensing of new drug products in a relatively rapid and presumably efficient and cost-effective manner. Commonly, they include underserved populations and areas where costs of trials are lower than in most developed countries. In addition, such studies can potentially make innovative treatments widely and rapidly available in vast, international markets. Other potential benefits to collaborating sites may include diffusion of knowledge and improvement of research skills, as well as improvement of treatment and a broader salutary impact on health services and perhaps on employment opportunities and economic growth (Demol +6; Weihrauch, 1997; Glickman et al. 2009; Gopal et al. 2005; Greco +6; Diniz, 2008; ICH Guideline, 2002; Smulevich et al. 2005; U.S. FDA, 1998). Successful conduct of international trials requires compliance with varying local and international laws, regulations and ethical requirements, and confronting a range of systems of review of ethical aspects of subject recruitment, compensation, consenting procedures, research protocols, and provision of aftercare – all which can add complexity. In addition, there is variance among regions, countries and cultures in levels of education, and in the nature of information, financial inducements, clinical care and aftercare provided to research subjects. Complexities arise also from culture-dependent conceptualizations of mental disorders, criteria for diagnosis, and efforts at validating, interpreting and scoring of symptom ratings designed to characterize changes during treatment, and methods for detecting adverse events. In the continuing quest to define core or universal features of psychiatric disorders, it is crucial to consider the anthropological and cultural context in which they develop and are modified (Karno +6; Jenkins, 1993; Lopez-Ibor, 2003;

Visual Learning in Multiple-Object Tracking

Tracking moving objects in space is important for the maintenance of spatiotemporal continuity in everyday visual tasks. In the laboratory, this ability is tested using the Multiple Object Tracking (MOT) task, where participants track a subset of moving objects with attention over an extended period of time. The ability to track multiple objects with attention is severely limited. Recent research has shown that this ability may improve with extensive practice (e.g., from action videogame playing). However, whether tracking also improves in a short training session with repeated trajectories has rarely been investigated. In this study we examine the role of visual learning in multiple-object tracking and characterize how varieties of attention interact with visual learning.Participants first conducted attentive tracking on trials with repeated motion trajectories for a short session. In a transfer phase we used the same motion trajectories but changed the role of tracking targets and nontargets. We found that compared with novel trials, tracking was enhanced only when the target subset was the same as that used during training. Learning did not transfer when the previously trained targets and nontargets switched roles or mixed up. However, learning was not specific to the trained temporal order as it transferred to trials where the motion was played backwards.These findings suggest that a demanding task of tracking multiple objects can benefit from learning of repeated motion trajectories. Such learning potentially facilitates tracking in natural vision, although learning is largely confined to the trajectories of attended objects. Furthermore, we showed that learning in attentive tracking relies on relational coding of all target trajectories. Surprisingly, learning was not specific to the trained temporal context, probably because observers have learned motion paths of each trajectory independently of the exact temporal order

Detección de síntomas depresivos durante el postparto inmediato y el seguimiento a largo plazo: estabilidad temporal y factores asociados

Objetivos: describir la frecuencia de sintomatología depresiva compatible con el diagnóstico de depresión posparto durante el período perinatal, factores asociados y estabilidad temporal. Métodos: durante los años 2006-2007 fueron entrevistadas un total de 398 mujeres puérperas asistidas en el CEMIC, dentro de los 5 días posteriores al parto, utilizando la Escala de Depresión Posnatal de Edimburgo, así como un cuestionario socio-demográfico. Fue realizado un análisis de regresión logística a fin de identificar factores asociados a un screening positivo. Durante los 6-12 meses siguientes se realizó un seguimiento con dos grupos de similares características. Resultados: la frecuencia de sintomatología depresiva en el postparto inmediato fue de 17,8% (puntaje de corte = 10). Antecedentes depresivos y complicaciones en el recién nacido resultaron significativamente asociados con un screening positivo. De las 110 pacientes entrevistadas, 24 obtuvieron resultados positivos durante el seguimiento. Conclusión: la prevalencia de riesgo de sufrir depresión posparto en las pacientes encuestadas se encuentra dentro de los parámetros que reporta la literatura internacional. En un seguimiento en el período comprendido entre los 6 meses y los 12 meses posteriores al parto, resultaron positivas 6 mujeres asintomáticas en la primera evaluación. Se postula la existencia de cuadros de depresión posparto que se manifiestan hasta un año después del nacimiento.Aims: To describe the frequency of depressive symptoms compatible with a postpartum depression diagnosis, the associated factors and the temporal stability. Methods: During 2006-2007 398 hospitalized puerperal women who attended CEMIC were interviewed 5 days after childbirth using the Edinburg Postnatal Depression Scale and a socio-demographic questionnaire. A logistic regression analysis was performed to identify associated factors with a positive screening. During the following 6-12 months a follow up was carried with two groups of similar characteristics. Results: The frequency of depressive symptoms at post partum was 17.8% (cut off = 10). Depressive history and neonatal intensive care were significantly related to a positive screening. From the 110 interviewed women, 24 were positive in the follow-up. Conclusion: The prevalence of risk for postpartum depression in the sample of patients surveyed is within the parameters reported in international literature. At the 6 month follow up, 6 previously asymptomatic women during the first screening turned on positive. It is theorize the existence of potential postpartum depression cases that can manifest up to a year after childbirth.Fil: Rozic, Pablo R.. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Schvartzman, Javier Alfonso. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Paolini, Cynthia Inés. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Gadow, Andrea. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Calvo, Diego A.. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Paesani, Fernando. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Pieczanski, Pedro. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Vázquez, Gustavo H.. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Lolich, Maria. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Krupitzki, Hugo Bernardo. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

The discovery of Stromatolites developing at 3570 m above sea level in a high-altitude volcanic lake Socompa, Argentinean Andes

We describe stromatolites forming at an altitude of 3570 m at the shore of a volcanic lake Socompa, Argentinean Andes. The water at the site of stromatolites formation is alkaline, hypersaline, rich in inorganic nutrients, very rich in arsenic, and warm (20-24°C) due to a hydrothermal input. The stromatolites do not lithify, but form broad, rounded and low-domed bioherms dominated by diatom frustules and aragonite micro-crystals agglutinated by extracellular substances. In comparison to other modern stromatolites, they harbour an atypical microbial community characterized by highly abundant representatives of Deinococcus-Thermus, Rhodobacteraceae, Desulfobacterales and Spirochaetes. Additionally, a high proportion of the sequences that could not be classified at phylum level showed less than 80% identity to the best hit in the NCBI database, suggesting the presence of novel distant lineages. The primary production in the stromatolites is generally high and likely dominated by Microcoleus sp. Through negative phototaxis, the location of these cyanobacteria in the stromatolites is controlled by UV light, which greatly influences their photosynthetic activity. Diatoms, dominated by Amphora sp., are abundant in the anoxic, sulfidic and essentially dark parts of the stromatolites. Although their origin in the stromatolites is unclear, they are possibly an important source of anaerobically degraded organic matter that induces in situ aragonite precipitation. To the best of our knowledge, this is so far the highest altitude with documented actively forming stromatolites. Their generally rich, diverse and to a large extent novel microbial community likely harbours valuable genetic and proteomic reserves, and thus deserves active protection. Furthermore, since the stromatolites flourish in an environment characterized by a multitude of extremes, including high exposure to UV radiation, they can be an excellent model system for studying microbial adaptations under conditions that, at least in part, resemble those during the early phase of life evolution on Earth.Instituto de Biotecnologia y Biologia Molecular (IBBM

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file