Neurology and Psychiatry

Humans were formed when their brains changed. They gained technical skills and lost communication skills. The result was violence far in excess of all other creatures and damage has been inflicted on everything from our planet to ourselves. At last, mass communication by technology may compensate for inherent inadequacy if we learn to manage ourselves. When Did It All Go Wrong? It has always been wrong. There were other hominids, Denisovans, Neandertals and so on and we did a bit of breeding with them and then killed them. Why live happily with others when you can kill them? We always kill. We kill each other, animals, plants and our planet. It's what we do. We are humans. We are very successful.

BACKGROUND: Mental disorder can increase the likelihood of taking violent acts of some individuals, but only a small percentage of violence in societies could be attributed to patients with mental health problems. For the past several years numerous studies related to forensic psychiatry has confirmed a close causal relationship between violent offenders and psychiatric comorbidity. Several studies have provided strong evidence that antisocial personality disorders (APD) represent a significant clinical risk for violence. AIM: This study aims to show the relationship between antisocial personality disorder and antisocial personality traits with the other mental disorders and the manifestation of violence between the forensic populations of patients. METHODS: The survey was conducted at the Psychiatric Hospitals and the Mental Health Centre. The research was carried out between two groups: one group of perpetrators of violence (PV) and a control group divided into two subgroups, a co...

The dominance of albino rats in non-human research in experimental psychology was often accompanied by an assumption that they embodied unchanging fundamentals that could generalize to a wide range of vertebrates.  I describe the comparative context surrounding the original choice of the white rat as a standard animal in the thinking of the two individuals most responsible for establishment of the rat: Adolf Meyer and Henry H. Donaldson.  I argue that their original rationale for the choice of white rats as a mammalian research standard reflected careful attention to species differences.  Finally, I suggest that as a result of the engineering ideal in physiology and psychology, this reasoning was transformed into an assumption that one animal could stand for all vertebrates.

ABSTRACT IN ROMANIAN
Această prezentare își propune o sinteză practică a aspectelor esențiale de diagnostic,  tratament și prevenție a celor mai frecvente afecțiuni mentale. Se pune accentul in mod deosebit pe terapiile non-farmacologice/non-medicamentoase ale bolilor psihice si pe componenta preventivă a tratamentelor în aceste afecțiuni.
#DONATIONS. Anyone can donate for dr. Dragoi’s independent research and original music at: https://www.paypal.com/donate/?hosted_button_id=AQYGGDVDR7KH2
*
ABSTRACT IN ENGLISH
This presentation aims at a practical synthesis/review of the essential elements of diagnosis, treatment and prevention of the most common mental disorders. Particular emphasis is placed on non-pharmacological / non-drug therapies of psychiatric diseases and the preventive component of treatments in these disorders.
Authors:
Dr. Maria Roman, medic primar psihiatru, șef de secție femei cronic, Spitalul Municipal Sighetu Marmației; Competențe: psihoterapie integrativă și sistemică, hipnoză Ericksoniană, sexologie (www.facebook.com/PSIHOCONFORT/)
Coautor (documentare tehnoredactare parțiale): Dr. Andrei-Lucian Drăgoi, medic specialist pediatru (www.dragoii.com)
#DONATIONS. Anyone can donate for dr. Dragoi’s independent research and original music at: https://www.paypal.com/donate/?hosted_button_id=AQYGGDVDR7KH2

Aim

As the population ages, the problem of dementia increases and affects a growing number of people. People with mental illness are known to be stigmatised and this has been the subject of numerous studies. There have been contradictory studies assessing the stigma attached to dementia, and the majority focus on stigma at a social level and the public perception of people with dementia. There have been a number of projects that included a study group of people with dementia. However, to date, this topic has not been discussed in Poland. Hence, the aim of this paper is to carry out a literature review addressing this issue.

Perspective

The problem of stigma attached to dementia is particularly significant as it affects not only the subject, but also their family, friends and health professionals. As people with dementia develop cognitive impairment and lose their independence, stigmatisation leads to their social isolation, despite their need for care. Stigma has emotional, behavioural and social implications, including diminished self-esteem, a feeling of anxiety and the development of a sense of shame and a fear of the judgement of others. Family members also deal with the stigma, which manifests itself as embarrassment and anxiety and causes their circle of friends and acquaintances to decrease. Current studies show that professionals can also play a negative role in the process of labelling and stigmatisation of patients.

Conclusion

Stigma is a serious and common problem in dementia. It seems necessary to target this issue in research and social discourse.

Special issue of "Culture Unbound". Through an introduction and six original articles, the issue investigates a variety of cultural and scientific discourses and practices that in different ways are related to neuroscience and the brain.

The special issue was edited by guest editors Peter Bengtsen and Kristofer Hansson.

Background: The study aimed to elucidate previously observed associations between morningness-eveningness and depressive symptomatology in university students. Relations between components of depressive symptomatology and morningness-eveningness were analysed.
Methods: Nine hundred and seventy-four university students completed Polish versions of the Centre for Epidemiological Studies – Depression scale (CES-D; Polish translation appended to this paper) and the Composite Scale of Morningness. Principal component analysis (PCA) was used to test the structure of depressive symptoms. Pearson and partial correlations (with age and sex controlled), along with regression analyses with morning affect (MA) and circadian preference as predictors, were used.
Results: PCA revealed three components of depressive symptoms: depressed/somatic affect, positive affect, interpersonal relations. Greater MA was related to less depressive symptoms in three components. Morning circadian preference was related to less depressive symptoms in depressed/somatic and positive affects and unrelated to interpersonal relations. Both morningness-eveningness components exhibited stronger links with depressed/somatic and positive affects than with interpersonal relations. Three CES-D components exhibited stronger links with MA than with circadian preference. In regression analyses only MA was statistically significant for positive affect and better interpersonal relations, whereas more depressed/somatic affect was predicted by lower MA and morning circadian preference (relationship reversed compared to correlations).
Limitations: Self-report assessment.
Conclusions: There are three groups of depressive symptoms in Polish university students. Associations of MA with depressed/somatic and positive affects are primarily responsible for the observed links between morningness-eveningness and depressive symptoms in university students. People with evening circadian preference whose MA is not lowered have less depressed/somatic affect.

TO READ THE PREVIEW SCROLL DOWN TO READ THE PREVIEW SCROLL DOWN

A great American psychologist summarizes one of the most difficult of subjects--the nature of dreaming--after decades of lifting matters out of the morass of Freudianism. The result nonetheless is a thin gruel that misses the main thing about dreams: their unworldly imaginative power. But he is not the only one. Who defends the psyche in modern science? Who knows what it is, where it resides, and how it controls the brain? The true theory of dreaming will emerge only by facing and answering these questions, which can be said to have baffled ancient, medieval, and modern investigators alike. At present materialism stands confused, pathetically benighted in its own shadow.

Readers are now advised that a new approach to the true theory of dreaming, as well as the first mechanistic explanation of Night Terrors in scientific history, is contained in the reviewer's illustrated essay on this page called 'The Last Day.' Both this late 2017 review and the new 2020 essay concern the same foundational ideas within idealism and can be said to blend smoothly together to produce an increasingly coherent view of the phenomenology as well as the fundamental nature of dreaming, the achievement of which depends on isolating and identifying the cosmic generator of dreams.

See also 'Sartre on Dreaming' (2022) and 'On the Materialization of Being' (2022) for deeper insights into the nature of dreaming according to idealism and in the context of the embodiment of the psyche, which reaches far deeper inwardly than the farthest galaxies are from the Solar System.

Die Plastizität des Nervensystems unterstützt das
Wiedererlangen bestimmter Fähigkeiten wie auch
die Entstehung adaptiver Phänomene, z. B. Bewegungseinschränkungen durch Muskelverkürzung,
Gelenksteifigkeit und mangelnde Bewegungstoleranz
des Nervensystems. Zusätzlich kommt es durch den
Prozess der trainingsinduzierten Plastizität zu Veränderungen der kortikalen Repräsentation des Körpers.
Richtig eingesetzt können Botulinum Toxin, redressierende Verbände und Schienen dem Patienten helfen, besser im Alltag zurecht zu kommen.

Alzheimer's disease (AD) is the most common cause of dementia in older adults and an important public health problem. The purpose of this review article is to provide a brief introduction to AD and the related concept of mild cognitive impairment (MCI). The article emphasizes clinical and neurobiological aspects of AD and MCI that medical students should be familiar with. In addition, the article describes advances in the use of biomarkers for diagnosis of AD and highlights ongoing efforts to develop novel therapies.

Resumen

Schopenhauer, pese a la reticencia de Freud en reconocer estos “prestamos inconfesables”, se anticipó a Freud en medio siglo. En Schopenhauer aparece por vez primera una filosofía explícita del inconsciente y del cuerpo. Schopenhauer procede de los “años salvajes de la filosofía”, pese a su  enemistad con el Romanticismo, en el convergen muchas de estas ideas convirtiéndolo, tal vez a su pesar, en un insospechado heredero de un legado del que se convierte en mediador –a través de Nietzsche (y Freud) a importantes corrientes de pensamiento del siglo XX.  Schopenhauer nada contra la corriente de su tiempo: no le anima el placer de la acción, sino el arte del nirvana. Este filósofo de lo irracional, diseña una filosofía de la contemplación, que invita a inhibir la acción o suprimir el deseo-  Su sueño es un mundo transformado en el espejo “desinteresado”de la música.   

Palabras Clave: voluntad, psicoanálisis, inconsciente, represión, eros, mundo.

Dr. Adolfo Vásquez Rocca

Misophonia is a condition in which a person has an acute emotional response of anger or disgust to a commonly occurring innocuous auditory or visual stimulus referred to as a trigger.  This case details the effective treatment of misophonia in a young woman that included a counterconditioning treatment called the Neural Repatterning Technique (NRT), which combines a continuous positive stimulus and a reduced intensity, intermittent trigger.  The treatment was delivered via the Misophonia Trigger Tamer smartphone app and all treatments were conducted independently by the patient.  In this patient, the trigger elicited a physical reflex of contraction of the flexor digitorum profundus, which caused her to clench her fist.  To enhance the effect of the NRT treatment, Progressive Muscle Relaxation was incorporated to increase her ability to deliberately relax the affected muscle during treatment.  During NRT treatment sessions, the patient experienced a weak physical reflex to the reduced trigger stimulus but no emotional response.  Her emotional response of misophonia was not treated, but when the physical reflex extinguished, the emotional response also extinguished.  This case indicates that the misophonic response includes a Pavlovian-conditioned physical reflex.  It is proposed that the trigger elicited the physical reflex and the physical reflex then elicited the conditioned emotional response that is characteristic of misophonia.  Because of the conditioned reflex nature of misophonia, it is proposed that a more appropriate name for this disorder would be Conditioned Aversive Reflex Disorder.

Notre travail de thèse porte sur l’analyse des rapports entre le normal et le pathologique à la lumière d’un trouble du comportement alimentaire : l’anorexie mentale. Nous cherchons conjointement à élaborer un modèle d’intelligibilité de l’anorexie mentale, et à déterminer ce que ce modèle nous enseigne du rapport normal et sain au corps. La normalité relève-t-elle d’une différence de nature ou de degré avec l’état psychopathologique ? Le critère de la normalité peut-il être saisi dans l’expérience antérieure au développement du trouble chez le sujet anorexique ? Peut-il être recherché dans une norme sociale extérieure au sujet ? Nous avançons que le critère de la normalité ne peut être découvert que de manière immanente, au cœur de l’expérience pathologique et de celle de la rémission. C’est donc à la conceptualisation de ces dernières que nous avons dû nous consacrer. 

Notre travail comprend la conceptualisation de l’anorexie mentale comme d’une forme de production aliénée de la subjectivité dans le contexte sociologique déterminé de l’individualisme moderne. Nous nous appuyons premièrement sur les travaux de Dorothée Legrand, qui, à partir de la notion phénoménologique de « conscience de soi corporelle », voient dans l’anorexie mentale une rupture des liens typiquement complémentaires entre le corps-comme-sujet (le corps vécu depuis une perspective interne) et le corps-comme-objet (le corps visé, perçu extérieurement, mais aussi en tant qu’il partage une matérialité commune avec d’autres objets). Le sujet anorexique est celui qui, d’après cette conceptualité, cherche à transformer, de manière contrôlée, son corps-objet, afin d’en faire une matérialisation ou expression de sa subjectivité. Paradoxalement, l’amaigrissement et même la « négation » du corps-objet sont « auto-constitutives » en ce sens qu’elles contribuent à exprimer et consolider la subjectivité. Le sujet anorexique s’affirme à travers la modification contrôlée de son corps-objet : il fait de la dimension objective de son corps une sorte de miroir de sa subjectivité. Il peut alors, à partir de cette extériorisation maîtrisée, rechercher la validation de sa condition de sujet par d’autres sujets.

C’est parce que le vécu du corps-sujet est trop faible chez la personne anorexique, et celui du corps-objet hypertrophié, qu’elle tente de contrôler le corps-objet pour en faire un support externe doué d’une capacité expressive du soi et par suite une attestation de sa propre existence. Nous pouvons alors comprendre l’anorexie mentale dans une perspective hégélienne : le sujet anorexique « travaille » son corps pour y apposer le « sceau » de son intériorité, les déterminations de sa conscience. Ce faisant, il arrache à la matérialité brute du corps son caractère d’étrangeté et peut s’y reconnaître ; de même, il peut, à l’issue de son travail, obtenir des autres sujets une reconnaissance. Nous pensons cependant que ce modèle n’épuise pas la compréhension de l’anorexie mentale.

Selon nous, l’anorexie mentale relève plutôt d’une stratégie à composante addictive par laquelle, tout à la fois, le sujet tente de devenir un individu performant sur la scène sociale, et échappe à une réelle expression de sa subjectivité. Nous pensons que le « soi » du sujet anorexique est une notion opaque pour lui, dont les contours sont mal définis, et qu’il ne peut par suite extérioriser les composantes de ce « soi » dans le corps-objet. Comment le pourrait-il, en effet, s’il ne se connaît pas réellement lui-même ? Nous avançons ainsi que l’anorexie mentale procède d’une angoisse fondamentale : celle de l’indétermination de la subjectivité, notamment en raison de la prévalence de l’alexithymie dans la personnalité. Or, cette indétermination subjective interne coexiste, dans les sociétés occidentales modernes, avec l’injonction, intensément ressentie par les sujets anorexiques perfectionnistes, d’être « quelqu’un » – c’est-à-dire de devenir un individu accompli et d’obtenir à ce titre une validation sociale. Enfin, comme le mettent en évidence les travaux de Hilde Bruch, les personnes anorexiques souffrent d’un « sentiment d’inefficacité » intrinsèque, qui les persuade qu’elles ne sont pas réellement capables d’atteindre l’autonomie et d’avoir une incidence positive sur le monde extérieur par leurs efforts. L’amaigrissement joue alors un triple rôle : (a) il délivre une identité de substitution (sorte de « faux-self ») à la personne anorexique qui ne parvient pas à savoir qui elle est, (b) il permet, via cette identité substitutive, d’apparaître comme un individu ultra-performant dont les qualités de discipline et de réussite sont saluées par les autres, (c) il privilégie le rapport immédiat au corps et échappe aux difficultés propres à d’autres formes d’accomplissement individuel, comme le travail, qui mettent le sujet en relation avec une réalité extérieure potentiellement aléatoire et immaîtrisable. Le corps, lui, est a priori directement soumis à la volonté du sujet.

À l’issue de nos analyses, nous pouvons mettre en évidence les articulations nodales de la rémission, qui relèvent de l’acquisition d’une réelle autonomie par le sujet. Celle-ci est indissociable (1) d’une capacité à connaître et à discerner ses états émotionnels internes et à développer une notion immanente du « soi » qui n’est alors plus indexée sur des indices externes ; et (2) corrélativement, d’une aptitude à démêler les signaux inhérents au corps et à atteindre une forme corporelle dont la norme est donnée par le corps lui-même. Quand le corps n’est plus chargé de symboliser une subjectivité dont les notions internes sont trop faibles voire inexistantes (alexithymie et faible sentiment intrinsèque du soi), il peut alors obéir à des normes qui lui sont propres, ce qui constitue le critère du rapport sain au corps. Le rapport pathologique au corps est ainsi celui qui instrumentalise le corps pour en faire la preuve externe compensatoire d’une subjectivité vécue comme inexistante et discontinue ; le rapport sain au corps est celui, qui affranchi de cette finalité d’être le marqueur externe de la subjectivité, peut se régler sur ses propres besoins.

FROM PHYSICAL FRACTURE TO EMOTIONAL RECOVERY
clinical psychologist Marius Adrian Alberti DĂSCĂLESCU
INTRODUCTION Psychological counseling for the elderly involves indepth knowledge of human nature, communication and relationship techniques, especially when our patient is a reputable doctor with a strong personality, going through a physical trauma, a neck fracture femoral.
INTERVENTION STRATEGY Identifying the strengths and vulnerabilities of the case, detailed analysis with the identification of risks and resources of the patient, to note the chances of psycho-emotional recovery of neuro-psychic tone and post-traumatic recovery. Psychiatric consultation, modification of hypnotic medication, evaluation with the help of MMSE Test, cognitive-behavioral therapy, music therapy, forgiveness and sacrotherapy, the patient's internal resources were used.
RESULTS The physical recovery after the femoral neck fracture did not give the desired performance, but the relationship between mother and daughter was emotionally restored, which is a gain for both parties.
DISCUSSIONS AND PROPOSALS Given the Covid-19 pandemic we are going through, we should value those around us more. We are all vulnerable, and if we acted psychologically preventive, we would avoid the phenomenon of isolation and we would respect each other more. Let's not forget that we are all memories makers. It would be good for them to be memorable!
Keywords: MMSE test, distress, isolation depression, coping, extrovert

RESUMEN
El presente artículo se propone dar cuenta del elusivo fenómeno de la conciencia desde la original perspectiva de la neurofenomenología de Francisco Varela, quien a partir de nociones tales como neuroplasticidad, enacción y emergencia, explica, cómo ocurren los procesos cerebrales que fundan la conciencia y la “unidad” de la vivencia. Describiendo como la conciencia aparece en el vivir encarnado: en la regulación con el cuerpo entero; en sus relaciones sensorio-motoras con el mundo y en una red ínter-subjetiva de acciones y de lenguaje.
Dr. Adolfo Vásquez Rocca
Keywords:  Neurociencias, ciencias cognitivas, ética, yo, cuerpo, neuroplasticidad, enacción, acciones corporeizadas,  biología cultural,  saber-cómo.
Neuroscience, cognitive science, ethics, self, body, neuroplasticity, enaction, actions embodied experiences, cultural biology,  know-how.
-Francisco Varela: neurophenomenology, enactive approach to cognition, minds without me and the elusive phenomenon of consciousness.
DR. ADOLFO VÁSQUEZ ROCCA

Objective: Some studies on schizophrenia showed an increased complexity in electroencephalography (EEG) whereas others detected a decreased complexity. Because this discrepancy might be due to the clinical features or complexity measures used, we employed two different complexity measures in a group of schizophrenics similar in illness duration (chronic) and symptom profile (residual). Methods: Right-handed chronic residual schizophrenic patients (10 male, 10 female) and age- and sex-matched 20 healthy controls were included in the study. Eyes-closed resting EEG series were measured through quantitative EEG band activities, the log energy entropy (LEE) values, and the Hurst exponents (HE) of EEG measurements were computed for each electrode site. Results: Significantly higher LEE values in the prefrontal, frontal, temporal and parietal locations were observed in schizophrenic patients compared with controls. HE values were significantly higher on the right frontal area in the schizophrenics. Patient group showed increased prefrontal, frontal and parietal delta activity, prefrontal, left temporal and right parietal theta activity and increased left temporal alpha activity. Discussion: In the present study, we found that chronic residual schizophrenia is associated with decreased complexity and increased smoothness in EEG. In addition, EEG of patients was characterized by obvious slowness at prefrontal and frontotemporal regions, dominantly. An integration of EEG complexity and frequency analysis can be proposed as an innovative tool in schizophrenia research.

Paramedics regularly respond to emergency calls for suicidal ideation and attempts. These patients are are experiencing psychological pain, referred to as a  psychache. This pain is so persistent and severe, that lethal self-harm seems like the only way to stop the pain. Until now, there were not many options for paramedics to deal with this life-threatening situation. In the last few years a volume of research indicates that the sub-anesthetic administration of ketamine, administered intravenously over 40 minutes, provides rapid alleviation of suicidal ideation and the symptoms of severe depression. This pharmacologically induced effect lasts only days to weeks, but this is enough time to get the patient “over the hump” and to allow for slower acting, longer lasting, evidence-based treatment modalities to be initiated and take hold. This article demonstrates that psychological pain is more lethal than physical pain and makes the case for prehospital treatment of psychache, which because of hospital delays and extended door to treatment times, is better initiated in the field. Ethical issues, the efficacy of ketamine for psychache, unintended consequences, and next steps are discussed. Recommendations for the prehospital administration guidelines and research considerations are included, along with a sample EMS guideline.

Resumen:
El presente artículo se propone dar cuenta del elusivo fenómeno de la conciencia desde la original perspectiva de la neurofenomenología de Francisco Varela, quien a partir de nociones tales como neuroplasticidad, enacción y emergencia, explica, cómo ocurren los procesos cerebrales que fundan la conciencia y la “unidad” de la vivencia. Describiendo como la conciencia aparece en el vivir encarnado: en la regulación con el cuerpo entero; en sus relaciones sensorio-motoras con el mundo y en una red ínter-subjetiva de acciones y de lenguaje.
Palabras clave: Neurociencias, biología cultural, ciencias cognitivas, cuerpo, mundo, ética, enacción, saber-cómo.
Dr. Adolfo Vásquez Rocca

Prompted by numerous endeavours to link a variety of brain illnesses/conditions with the introduction of palaeoart, especially rock art, the author reviews these proposals in the light of the causes of these psychiatric conditions. Several of these proposals are linked to the assumption that palaeoart was introduced through shamanism. It is demonstrated that there is no simplistic link between shamanism and brain disorders, although it is possible that some of the relevant susceptibility alleles might be involved in some shamanic experiences. Similarly, no connection between rock art and shamanism has been credibly demonstrated. Moreover, the time frame applied in all these hypotheses is fallacious for several reasons. These notions are all based on the belief that palaeoart was introduced by ‘anatomically modern humans’ and on the replacement hypothesis. Finally, the assumption that neuropathologies and shamanism preceded the advent of palaeoart is also suspect. These numerous speculations derive from neglect of the relevant empirical factors, be they archaeological or neurological.

This chapter provides a brief overview of the history of behavioral neurology, dividing it roughly into six eras. In the ancient and classical eras, emphasis is placed on two transitions: firstly, from descriptions of head trauma and attempted neurosurgical treatments to the exploratory dissections during the Hellenistic period and the replacement of cardiocentrism; and secondly, to the more systematic investigations of Galenus and the rise of pneumatic ventricular theory. In the medieval through post-Renaissance eras, the scholastic consolidation of knowledge and the role of compendia are emphasized, along with the use of new methods from within a mechanistic framework. With the discovery of electrical conductance and the rise of experimentalism, we frame the modern era as period of intense debate over localization, decomposition, and other mechanistic principles, and marked by rapid discovery about the brain. The chapter ends with a discussion of the contemporary era, focusing on ...

Background:
Individuals with mild cognitive impairment (MCI) have a substantially increased risk of developing dementia due to Alzheimer's disease (AD). In this study, we developed a multivariate prognostic model for predicting MCI-to-dementia progression at the individual patient level.

Methods:
Using baseline data from 259 MCI patients and a probabilistic, kernel-based pattern classification approach, we trained a classifier to distinguish between patients who progressed to AD-type dementia (n = 139) and those who did not (n = 120) during a three-year follow-up period. More than 750 variables across four data sources were considered as potential predictors of progression. These data sources included risk factors, cognitive and functional assessments, structural magnetic resonance imaging (MRI) data, and plasma proteomic data. Predictive utility was assessed using a rigorous cross-validation framework.

Results:
Cognitive and functional markers were most predictive of progression, while plasma proteomic markers had limited predictive utility. The best performing model incorporated a combination of cognitive/functional markers and morphometric MRI measures and predicted progression with 80% accuracy (83% sensitivity, 76% specificity, AUC = 0.87). Predictors of progression included scores on the Alzheimer's Disease Assessment Scale, Rey Auditory Verbal Learning Test, and Functional Activities Questionnaire, as well as volume/cortical thickness of three brain regions (left hippocampus, middle temporal gyrus, and inferior parietal cortex). Calibration analysis revealed that the model is capable of generating probabilistic predictions that reliably reflect the actual risk of progression. Finally, we found that the predictive accuracy of the model varied with patient demographic, genetic, and clinical characteristics and could be further improved by taking into account the confidence of the predictions.

Conclusions:
We developed an accurate prognostic model for predicting MCI-to-dementia progression over a three-year period. The model utilizes widely available, cost-effective, non-invasive markers and can be used to improve patient selection in clinical trials and identify high-risk MCI patients for early treatment.

This paper is the last one in this short project, an addition to An Unusual Power, and looks at how psychiatrists developed their views, seeing their clients/patients as objects, relying on poor science, driven, I suggest by ideology not evidence based analysis. This paper describes the evolution of different strains of psychiatry-Proprietor, Asylum, Dynamic, and Biological, or as I have identified it, Laboratory. It will describe a professional group, often from the same demographic, driven by a search for status, defining itself through dogma and power, and expressing limited insight into the human condition. I will, apart from looking at and analysing the historical evidence, employ personal anecdotes, using client witness to treatments, and attempt to understand the significance of psychiatric case-studies, what they say about the profession, considering also an economic understanding of medicine and medical care. In the process, I will look at child prostitution in Victorian London, asylums in the UK and America, Freud, principal Victorian psychiatrists, Proprietor, Asylum, Dynamic and Biological-Laboratory Psychiatry and the economics related to psychiatric ideas and practices. This paper holds that the history of Asylum Psychiatry, the now dominant form, was and remains a search for legitimacy, not the history of a science.

Majority of the physiological processes in the human organism are rhythmic. The most common are the diurnal changes that repeat roughly every 24 hours, called circadian rhythms. Circadian rhythms disorders have negative influence on human functioning. The aim of this article is to present the current understanding of the circadian rhythms physiological role, with particular emphasis on the circadian rhythm sleep-wake disorders (CRSWD), principles of their diagnosis and chronobiological therapy. The guidelines are based on the review of
recommendations from the scientific societies involved in sleep medicine and the clinical experiences of the authors. Researchers participating in the preparation of guidelines were invited by the Polish Sleep Research Society and the Section of Biological Psychiatry of the
Polish Psychiatric Association, based on their significant contributions in circadian rhythm research and/or clinical experience in the treatment of such disorders. Finally, the guidelines were adjusted to the questions and comments given by the members of both Societies. CRSWD have a significant negative impact on human health and functioning. Standard methods used to assess CRSWD are sleep diaries and sleep logs, while the actigraphy, when available, should be also used. The most effective methods of CRSWD treatment are melatonin administration and light therapy. Behavioral interventions are also recommended. A fourteen-day period of sleep-wake rhythm assessment in CRSWD enables accurate diagnosis, adequate selection of chronobiological interventions, and planning adequate diurnal timing of their application. This type of assessment is quite easy, low-cost, and provides valuable indications how to adjust the therapeutic approach to the circadian phase of the particular patient.

RESUMEN:

1.-  "En cuanto a la doctrina de la represión, es seguro que la concebí yo independientemente; no sé de ninguna influencia que me haya aproximado a ella, y durante mucho tiempo tuve a esta idea por original, hasta que Otto Rank nos exhibió aquel pasaje de El mundo como voluntad y representación, de Schopenhauer, donde el filósofo se esfuerza por explicar la locura. Lo que ahí se dice acerca de la renuencia a aceptar un fragmento penoso de la realidad coincide acabadamente con el contenido de mi concepto de represión, tanto, que otra vez puedo dar gracias a mi falta de erudición libresca, que me posibilitó hacer un descubrimiento. No obstante, otros han leído ese pasaje y lo pasaron por alto sin hacer ese descubrimiento, y quizá lo propio me hubiera ocurrido si en años mozos hallara más gusto en la lectura de autores filosóficos. En una época posterior, me rehusé el elevado goce de las obras de Nietzsche con esta motivación consciente: no quise que representación-expectativa de ninguna clase viniese a estorbarme en la elaboración de las impresiones psicoanalíticas. Por ello debía estar dispuesto-y lo estoy de buena gana-a resignar cualquier pretensión de prioridad en aquellos frecuentes casos en que la laboriosa investigación psicoanalítica no puede más que corroborar las intelecciones obtenidas por los filósofos intuitivamente. La doctrina de la represión es ahora el pilar fundamental sobre la que descansa el edificio del psicoanálisis".
FREUD, S. Contribución a la historia del movimiento psicoanalítico.(1)

2 - “Schopenhauer dio una sacudida, anticipándose a Freud en medio siglo, a la filosofía de la conciencia que había predominado en el pensamiento occidental. En Schopenhauer aparece por vez primera una filosofía explícita del inconsciente y del cuerpo.”
SAFRANSKI, Rüdiger,  Schopenhauer y los años salvajes de la filosofía. Tusquets Editores, Barcelona, 2008. Introducción.

3.- “Schopenhauer fue el primer filosofo de categoría en darse de baja de la iglesia occidental de la razón. Junto a Marx y a los jóvenes hegelianos fue quien fundamentalmente llevó a cabo la ruptura revolucionaria en el pensamiento del siglo XIX. Con él da comienzo la larga del buen motivo, dando así una despedida concisa a las teologías griegas y judeo-cristiana. Lo más importante de todo había sido dejar de ser para él una entidad espiritual divina y racionalmente justa. Con su doctrina de la voluntad salta por los aires la teoría del fundamento del mundo en torno al racionalismo religioso, tal como seguía en vigor desde los tiempos de Platón, para pasar a un reconocimiento de lo irracional marcado por el horror y el asombro: Schopenhauer es el primero en intuir la naturaleza energética e impulsiva, exenta de razón, del ser. En esto es uno de los padres del siglo psicoanalista … fundador de una época sistémica y teorizante del caos. En el hecho de que abrió las puertas europeas con gran respeto a las doctrinas asiáticas de la sabiduría, en especial al budismo, podría radica a largo plazo su repercusión más importante en la historia intelectual. Puede que, en el anhelo de vida de la humanidad en el primer mundo actual, la doctrina de Schopenhauer de la resignación de la voluntad suene por fuerza aún más sorprendente que a sus contemporáneos, los positivistas progresistas y los revolucionarios creyentes en la humanidad; pero en la actualidad sigue recordando que el anhelo desatado de vida no podrá solucionar, mediante su intensificación, los problemas que crea  su desbordamiento libre. De Schopenhauer podría proceder la frase: sólo la desaparición puede salvarnos aún; claro está que él no habló de desaparición, sino de renuncia. Para los modernos, “renuncia” es la palabra más difícil del mundo. Schopenhauer la invocó contra viento y marea. Tras él, las cuestiones éticas están abiertas de una manera más radical de lo que nunca lo había estado hasta entonces.”
SLOTERDIJK, Peter, Temperamentos filosóficos. De Platón a Foucault,  Madrid, Siruela, 2010.

SCHOPENHAUER:
EL DESCUBRIMIENTO DE LO INCONSCIENTE,
LA METAFÍSICA DE LA VOLUNTAD
Y LA ETIOLOGÍA DE LAS NEUROSIS.

INFLUENCIA SOBRE FREUD
Y CONTRIBUCIONES A LA PSIQUIATRÍA MODERNA.
____________________________________________________
Dr. Adolfo Vásquez Rocca

Freud's 'Project for a Scientific Psychology' and 'metapsychology' are reviewed. Reference is made to neuroscience literature highlighting the contemporary relevance of his ideas. Freud's core concepts are presented: biological needs; hierarchy of regulating systems; primary and secondary process thinking, unconscious and conscious systems; relation of mental systems to neuro-anatomical locations; and, communication between the two systems, including repression and dreaming. His ideas are summarised in terms of homeostasis and a hierarchy of characteristically different regulatory 'mental' systems.

The author examines the history of psychiatric classifications until the impasse caused by the DSM-III-R polythetic diagnostic criteria, which lead to broad comorbidity, overlapping treatment and absence of biological markers, and questions the notion of a nosological entity. In transition to the DSM-V, researchers have been working on the concept of dimension. The related concept of spectrum, which takes the name of a prototypical disorder, is attracting more and more followers. However, there are no clear criteria that underlie the grouping of various pathologies in each spectrum. The author proposes that the major psychopathological mechanisms should be considered as a criterion for this grouping. These mechanisms emerge from the response to five key questions that correspond to the vital functions of organisms and have some relationship with the hierarchy of human needs and with the distinction of encephalic stages: 1. Does the subject recognize his territory? (delirium and dementia spectra), 2. Does the patient accurately recognize himself and the other? (autism and schizophrenia spectra), 3. Is the subject synchronized with the environment and other people? (bipolar spectrum) 4. How does the subject feel about and react to threatening events? (anxious-phobic and paranoid spectra) 5. How does the subject react to conflicting experiences? (obsessive-compulsive and impulsive-dissociative spectra).

Background: Conversion Disorders (CD) are prevalent functional disorders. Although the pathogenesis is still not completely understood, an interaction of genetic, neurobiological, and psychosocial factors is quite likely. The aim of this study is to provide a systematic overview on imaging studies on CDs and investigate neuronal areas involved in Motor Conversion Disorders (MCD). Methods: A systematic literature search was conducted on CD. Subsequently a meta-analysis of functional neuroimaging studies on MCD was implemented using an Activation Likelihood Estimation (ALE). We calculated differences between patients and healthy controls as well as between affected versus unaffected sides in addition to an overall analysis in order to identify neuronal areas related to MCD.

Introduction: The publication of Hecker's article on hebephrenia in 1871 was a fundamental milestone for clinical psychiatry. Despite the initial recognition, many voices were raised against this diagnostic category and its limits were attenuated throughout the 20th century until its disappearance at the beginning of this century -with the rest of the subtypes of schizophrenia- in DSM and ICD. Discussion: However, the consistency of the clinical picture makes it possible for other criteria to emerge to continue or restart its systematic study. In this sense, the concepts of deficit schizophrenia, hebephrenia as a replacement for schizophrenia, and Leonhard's hebephrenias as systematic schizophrenias stand out. This article discusses the main diagnostic conflicts of the category of hebephrenia over time, emphasizing the problems of recent decades. Conclusions: The concept of hebephrenia began to be revalued in recent years, and the concepts of deficit schizophrenia, of hebephrenia as a major category, and of systematic hebephrenias allow further investigation of this foundational picture of clinical psychiatry.

RESUMEN:
En la amplia biografía de Ernest Jones sobre la vida y la obra de Freud, el autor menciona en varios párrafos las ideas de Nietzsche, algunos aforismos, e incluso señala influencias (aun en contra de la opinión del propio Freud). Es de marcar también la estrecha relación de Freud con Lou Andreas Salomé, que había sido amiga y admiradora de Nietzsche, y que además escribió una biografía del filósofo. Las Actas permitirán al lector seguir la evolución que transformó al grupo de asistentes a las “reuniones de los miércoles”; un conjunto heterogéneo de intelectuales de distintas disciplinas que se reunían semanalmente en casa de Freud- en una sociedad de psicoanalistas.
Dr. Adolfo Vásquez Rocca

Leon Eisenberg, M.D., D.Sc. (August 8, 1922 – September 15, 2009) was an American child psychiatrist, social psychiatrist and medical educator who "transformed child psychiatry by advocating research into developmental problems"

He is credited with a number of "firsts" in medicine and psychiatry - in child psychiatry, autism, and the controversies around autism, randomized clinical trials (RCTs), social medicine, global health, affirmative action,[4] and evidence-based psychiatry. Having retired in 1967 from Johns Hopkins Hospital Department of Child and adolescent psychiatry (he was the chairman of the department after Leo Kanner)[5] and from Harvard Medical School in 1988, he continued as The Maude and Lillian Presley Professor of Social Medicine and Psychiatry Emeritus (and actively serving - lecturing, researching and writing, and mentoring) in the Department of Global Health and Social Medicine of the Harvard Medical School in the Longwood Medical Area of Boston until a few months before his death in 2009. He received both his BA and MD degrees from the Perelman School of Medicine at the University of Pennsylvania, taught previously at both the University of Pennsylvania and Johns Hopkins University, and was Chief of Psychiatry at both Johns Hopkins Hospital in Baltimore and the Massachusetts General Hospital in Boston during formative periods in psychiatry for each institution.

Central nervous system (CNS) malignancies contribute significantly to the global burden of cancer. Brain tumors constitute the most common solid organ tumors in children and the second most common malignancies of childhood overall. Accounting for nearly 20% of all pediatric malignancies, these are the foremost cause of cancer-related deaths in children 0-14 years of age. This book chapter provides a state-of-the-art overview of pediatric brain tumors. It discusses their morbidity and mortality and introduces the WHO 2021 classification of CNS tumors, which is critical to therapeutic decision-making. It then describes the modern understanding of tumor grading and its clinical implications, followed by the general principles of diagnosis and management. The chapter then discusses, in detail, those brain tumors which have the highest disease burden in children, including medulloblastoma, astrocytoma, ependymoma, schwannoma, meningioma, amongst others. The landscape of treatment of pediatric brain tumors has been rapidly evolving, with several effective therapies on the horizon.

Referring to neurological structures and functions within the brain, as well as thought operations and behaviors coming from the brain, this short paper distinguishes between the Body and the Soul, and between the Soul and the Spirit.  Materialists, attempting to describe the fully functioning human being, argue there is only Body. Dualists argue there is only Body and Soul. The Spiritual/Tripartite view is that humans exist as Body, Soul, and Spirit. There are scientific indications, as well as literary/philosophical/theological indications that human beings exist at all three levels. The scientific indications come from brain scans, thought operations, and complex behaviors. The Soul develops from the Body, and the Spirit develops from the Soul, but that does not mean that (once formed) they can be reduced to one another. This paper attempts to move the reader from a “substance” orientation (materialism) to a “functional” orientation (measurable abilities).  Reductionistic materialism does violence to the functional integrity of the human being. What hangs over this whole discussion is the materialistic “substance” metaphysics of the 1600s.  Unless you can specify a tangible, measurable “substance”, then whatever you are talking or writing about is not really “real.”    This position is, of course, nonsense.  Anyone who knows about the electro-magnetic forces, clouds, speeds, positions, transformations, sudden appearances and disappearances in particle physics knows that the era of a “single observable stuff universe” is long over.  What supplies a much more complete, understandable, and satisfying perspective is a functional orientation, where the focus shifts from “material substances” to “observable functions and outcomes.”  This is the descriptive orientation of this paper.  Yet, often, if you bring this up this newer orientation, you will instantly be called “unscientific.”  What is truly “unscientific” is refusing to question assumptions and refusing to look at life through anything but a “substance” lens.  If ever we are to have what Abraham Maslow called “a Science of Persons”, we are going to have to get past our obsession with material “substance” and accept/welcome an Analysis of Functions.