Scielo RSS http://scielo.isciii.es/rss.php?pid=0213-616320090001&lang=en vol. 23 num. 1 lang. en http://scielo.isciii.es/img/en/fbpelogp.gif http://scielo.isciii.es http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632009000100001&lng=en&nrm=iso&tlng=en Background and objectives: Various clinical aspects of Major Depressive Disorder (MDD) are related to the neuropsychological impairments characteristic of this illness. The aim of this study was to determine the relation between certain clinical variables of MDD - in particular the presence of comorbid anxiety disorders - and the neuropsychological performance of patients with MDD selected for a clinical trial. Methods: Using cluster analyses, we generated two groups of patients: one group with Major Depressive Disorder and a Comorbid Anxiety Disorder (MDDAD), and the other with Pure Major Depressive Disorder (PMDD). Both groups were assessed clinically and neuropsychologically before and after 24 weeks of pharmacological treatment. Neuropsychological performance prior to treatment was comparable in the two groups. Results: After treatment, both groups showed cognitive improvement in attention tasks, memory, and executive functions Conclusions: The PMDD group obtained greater neurocognitive benefits from the antidepressive treatment than the MDDAD group. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632009000100002&lng=en&nrm=iso&tlng=en Background and objectives: Deep venous thrombosis and pulmonary embolism are serious, possibly life-threatening events which are often ignored in psychiatric settings. This article investigates which psychiatric patients are at increased risk of developing a venous thromboembolism. To our knowledge we are the first to perform a literature review of clinical studies relating venous thrombosis and pulmonary embolism to psychotropic drugs and mental disorders. Methods: A Medline search for English studies using the appropriate search terms was performed. In addition, cross references of the relevant articles` literature references were considered. We withheld 12 observational studies, 29 case-reports and one review-article. Results: We found evidence that low potency antipsychotic drugs like chlorpromazine and thioridazine, and clozapine for treatment of resistant schizophrenia have an increased risk of venous thromboembolism. There is no evidence that antidepressants, benzodiazepines or mood stabilizers have a similar effect. Also psychiatric conditions like physical restraint, catatonia and neuroleptic malignant syndrome are related to a higher incidence of deep venous thrombosis. Conclusions: Limitations of the studies and hypotheses about underlying biological mechanisms are reviewed. The rationale for prophylactic measures is discussed and recommendations to prevent deep venous thrombosis and pulmonary embolism are given. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632009000100003&lng=en&nrm=iso&tlng=en Background and Objectives: A recent report highlighted the importance of considering a chromosomal abnormality in the differential diagnosis of adult clinical psychiatry. This case report illustrates the importance of considering Fragile X syndrome, an X-linked genetic disorder associated with psychiatric morbidities. Methods: A 45 years old woman was referred to the clinical genetics department by her psychiatrist for investigation of her gross obesity, hyperphagia, learning difficulties and affective disorder. Results: Cytogenetic analysis revealed a 47,XXX karyotype. Molecular testing identified an expansion of approximately 580 repeats in the FRAXA gene carried on two of her three copies of the X chromosome. Clinical evaluation revealed features consistent with the Prader-Willi like phenotype of Fragile X syndrome. Conclusions: It is important to consider molecular and cytogenetic testing in patients with dysmorphic features, complex neuro-behavioural profile and/or psychotic disorders in order to establish a causative diagnosis, provide adequate counselling and initiate cascade screening where applicable. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632009000100004&lng=en&nrm=iso&tlng=en Objective: Self-perception is a complex, dynamic system and sexual self-perception is only one of the items in that complex system. Our goal was to establish whether the differences in sexual self-perception between schizophrenic patients and healthy individuals exist, and to establish possible differences in sexual self-perception between acute and chronic schizophrenic patients. Method: Bezinovic’s test for sexual self-perception was used because it assesses multiple aspects of sexual self-perception and provides thorough insight of that part of self. Results: Results revealed that schizophrenic patients, compared to healthy individuals, scored significantly higher on the aspects of negative emotionality and sexual incompetence and significantly lower on the aspect of sexual satisfaction. No statistically significant differences were established between acute and chronic schizophrenic patients. Conclusions: It can be concluded that the conscious part of libido organization in schizophrenic patients exhibits proper consciousness of own sexuality, normal readiness for sexual activity, normal sexual adventurism, significantly higher negative emotionality and sexual incompetence and significantly lower sexual satisfaction. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632009000100005&lng=en&nrm=iso&tlng=en Serotonin syndrome is a potentially severe acute adverse reaction to a serotonin agonist. It is characterized by cognitive and behavioral changes, autonomic dysfunction and neuromuscular abnormalities. The growing use of SSRIs is related to the frequency of the syndrome. The aim of our presentation was to describe a unique case of severe hyperserotoninergic state caused by a single dose of fluvoxamine and an analgesic drug. Physicians who prescribe SSRIs should be aware that the patient is not a medical specialist and needs detailed information on any new drug he has been prescribed. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632009000100006&lng=en&nrm=iso&tlng=en Background: The pain, which is involved in Cluster Headache (CH), is excruciating and is probably one of the most painful conditions known to humans. In the early 70es it was found out that lithium could be used in treating this rare condition. Ekbom produced his first report of using lithium successfully to treat five cases of CH and this was followed later by other studies, which showed the effectiveness of lithium in this condition. Objective: In this article we reviewed the evidence for using lithium in CH. We discuss some issues including the duration, the dosage of lithium required and the short and long-term side effects, which are likely to occur. We also included the mechanism of action of lithium in treating this condition. Methodology: We searched the Medline database from 1950 to date. We included all studies done in English, which were related to the use of lithium in cluster headache. We excluded all studies which were not in English and which included other types of headache. Results and conclusions: We concluded that lithium is effective in both chronic and episodic forms of cluster Headache.