2,034 research outputs found

    Hypochondriasis : a clinical and nosological study.

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    The Posterity of Hiding: A Psychoanalytic Reading of The Diary of Anne Frank

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    Focusing on Anne Frank’s diary, this essay brings to the foreground a reading that has continually been blue pencilled, unwrapping the way Anne’s localised position as a Jew in hiding is connected with her psychic process of exploring her desires as well as her voice as a woman. As this analysis reveals, Anne’s relationships in the Annex and her psychic development are in fact symbolically linked to her being chained in hiding, away from the social realm. Peeping at the world through a key hole from her marginal standpoint, she experiences a different process of growing into womanhood, whereby she reclaims the legitimacy of her voice and challenges basic conceptions of gender and sexuality

    Glutamatergic hypothesis of schizophrenia

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    Schizophrenia is a devastating psychiatric disorder whose pathophysiology has not been fully clarified yet. Although dopamine dysfunction in schizophrenia is unequivocal, there are many evidences suggesting the involvement of the glutamatergic system. This paper briefly describes some basic knowledge regarding the functioning of the glutamatergic receptors with emphasis on the N-methyl-D-aspartate (NMDA) receptors. Presents evidence for glutamatergic dysfunction in schizophrenia, more specifically NMDA receptor hypofunction. Finaly the paper discusses the interaction between the dopaminergic and the glutamatergic systems; in special how hyperdopaminergic state found in schizophrenia can be associated to glutamatergic dysfunctions.A esquizofrenia Ă© um transtorno psiquiĂĄtrico devastador cuja fisiopatologia ainda estĂĄ para ser esclarecida. Apesar de uma disfunção dopaminĂ©rgica estar bem estabelecida na esquizofrenia, hĂĄ uma sĂ©rie de evidĂȘncias sugerindo o envolvimento do sistema glutamatĂ©rgico na fisiopatologia do transtorno. Este artigo faz uma breve revisĂŁo de alguns aspectos bĂĄsicos do funcionamento dos receptores glutamatĂ©rgicos com ĂȘnfase nos receptores N-metil-D-aspartato (NMDA). Apresenta evidĂȘncias cientĂ­ficas sugerindo uma disfunção do sistema glutamatĂ©rgico na esquizofrenia (hipofunção de receptores NMDA). E discute as interaçÔes entre os sistemas dopaminĂ©rgico e glutamatĂ©rgico; mais especificamente como os estados hiperdopaminĂ©rgicos encontrados na esquizofrenia podem estar associados a uma alteração glutamatĂ©rgica.Universidade Federal de SĂŁo Paulo (UNIFESP) Departamento de PsiquiatriaKing's College London Institute of Psychiatry Section of Neurochemical ImagingUNIFESP, Depto. de PsiquiatriaSciEL

    Characteristics of drug users who do or do not have care of their children

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    Aims - To compare the relative frequency of eight indicators of problem drug use and potentially adverse social circumstances in drug using parents and non-parents and to explore whether a profile based on these characteristics differs according to whether or not dependent children live with their drug-using parent. Design – The study utilises a 5-year national UK treatment monitoring system dataset. Sample – 61,425 users with, and 105,473 without dependent children accessing drug treatment services in England and Wales between January 1996 and December 2000. Measurements – Information about parenthood and children’s residence was routinely collected. Drug use and social circumstance indicators were daily heroin use, daily alcohol use, regular stimulant use, sharing of injecting equipment, living with another user, living alone, unstable accommodation, and criminal justice referral. Findings – There were clear differences between drug using parents according to where children live. Parents with children at home and non-parents showed fewer of the indicators than parents with children in care or elsewhere. Sixty-five percent of parents with none of the indicators lived with their children, compared to only 28% of those with three indicators and 9% of those with six or more indicators. Parents with children in care or living elsewhere showed the highest prevalence for each individual indicator. Conclusions – Drug using parents demonstrate a range of potentially unfavourable drug use behaviours and social circumstances but those whose children live with them use drugs less frequently and live in more favourable conditions than those whose children live elsewhere. Protective factors may operate in family situations while severe drug use and adverse social circumstances may result in a breakdown of family structures

    TREC-Rio trial: a randomised controlled trial for rapid tranquillisation for agitated patients in emergency psychiatric rooms [ISRCTN44153243]

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    Agitated or violent patients constitute 10% of all emergency psychiatric treatment. Management guidelines, the preferred treatment of clinicians and clinical practice all differ. Systematic reviews show that all relevant studies are small and none are likely to have adequate power to show true differences between treatments. Worldwide, current treatment is not based on evidence from randomised trials. In Brazil, the combination haloperidol-promethazine is frequently used, but no studies involving this mix exist. TREC-Rio (Tranquilização Råpida-Ensaio Clínico [Translation: Rapid Tranquillisation-Clinical Trial]) will compare midazolam with haloperidol-promethazine mix for treatment of agitated patients in emergency psychiatric rooms of Rio de Janeiro, Brazil. TREC-Rio is a randomised, controlled, pragmatic and open study. Primary measure of outcome is tranquillisation at 20 minutes but effects on other measures of morbidity will also be assessed. TREC-Rio will involve the collaboration of as many health care professionals based in four psychiatric emergency rooms of Rio as possible. Because the design of this trial does not substantially complicate clinical management, and in several aspects simplifies it, the study can be large, and treatments used in everyday practice can be evaluated

    Inhibition of microglial activation with minocycline at the intrathecal level attenuates sympathoexcitatory and proarrhythmogenic changes in rats with chronic temporal lobe epilepsy

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    The incidence of sudden unexpected death in epilepsy (SUDEP) is highest in people with chronic and drug resistant epilepsy. Chronic spontaneous recurrent seizures cause cardiorespiratory autonomic dysfunctions. Pituitary adenylate cyclase-activating polypeptide (PACAP) is neuroprotective, whereas microglia produce both pro- and anti- inflammatory effects in the CNS. During acute seizures in rats, PACAP and microglia produce sympathoprotective effect at the intermediolateral cell column (IML), whereas their action on the presympathetic rostral ventrolateral medulla (RVLM) neurons mediates proarrhythmogenic changes. We evaluated the effect of PACAP and microglia at the IML on sympathetic nerve activity (SNA), cardiovascular reflex responses, and electrocardiographic changes in the post-status epilepticus (SE) model of acquired epilepsy, and control rats. Chronic spontaneous seizures in rats produced tachycardia with profound proarrhythmogenic effects (prolongation of QT interval). Antagonism of microglia, but not PACAP, significantly reduced the SNA and the corrected QT interval in post-SE rats. PACAP and microglia antagonists did not change baroreflex and peripheral or central chemoreflex responses with varied effect on somatosympathetic responses in post-SE and control rats. We did not notice changes in microglial morphology or changes in a number of M2 phenotype in epileptic nor control rats in the vicinity of RVLM neurons. Our findings establish that microglial activation, and not PACAP, at the IML accounts for higher SNA and proarrhythmogenic changes during chronic epilepsy in rats. This is the first experimental evidence to support a neurotoxic effect of microglia during chronic epilepsy, in contrast to their neuroprotective action during acute seizures

    Range and extinction dynamics of the steppe bison in Siberia : A pattern-oriented modelling approach

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    Aim To determine the ecological processes and drivers of range collapse, population decline and eventual extinction of the steppe bison in Eurasia. Location Siberia. Time period Pleistocene and Holocene. Major taxa studied Steppe bison (Bison priscus). Methods We configured 110,000 spatially explicit population models (SEPMs) of climate-human-steppe bison interactions in Siberia, which we ran at generational time steps from 50,000 years before present. We used pattern-oriented modelling (POM) and fossil-based inferences of distribution and demographic change of steppe bison to identify which SEPMs adequately simulated important interactions between ecological processes and biological threats. These "best models" were then used to disentangle the mechanisms that were integral in the population decline and later extinction of the steppe bison in its last stronghold in Eurasia. Results Our continuous reconstructions of the range and extinction dynamics of steppe bison were able to reconcile inferences of spatio-temporal occurrence and the timing and location of extinction in Siberia based on hundreds of radiocarbon-dated steppe bison fossils. We showed that simulating the ecological pathway to extinction for steppe bison in Siberia in the early Holocene required very specific ecological niche constraints, demographic processes and a constrained synergy of climate and human hunting dynamics during the Pleistocene-Holocene transition. Main conclusions Ecological processes and drivers that caused ancient population declines of species can be reconstructed at high spatio-temporal resolutions using SEPMs and POM. Using this approach, we found that climatic change and hunting by humans are likely to have interacted with key ecological processes to cause the extinction of the steppe bison in its last refuge in Eurasia.Peer reviewe

    Substance use disorders among inhalant users: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

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    To assess the prevalence, correlates, and age of onset of DSM-IV substance use disorders (SUDs) among adult inhalant users