RESUMEN Introducción: Según el DSM-V, la pseudociesis se incluye en la categoría "otros síntomas somáticos específicos y trastornos relacionados" y se define como la falsa creencia de estar embarazada que se asocia con signos objetivos y síntomas de embarazo. La confirmación de la pseudociesis se consigue con un resultado negativo de la gonadotropina coriónica humana beta en la sangre y/o la orina asociado a un hallazgo ecográfico negativo. Materiales y métodos: se presenta el caso de mujer con síntomas y signos de embarazo que corresponden a pseudociesis, la paciente siguió creyendo que estaba embarazada debido a sus síntomas, a pesar de que las pruebas de embarazo dieron negativo. Conclusión: La pseudociesis es una enfermedad poco frecuente que a menudo se asocia a otras comorbilidades psiquiátricas y diagnósticos diferenciales poco claros. Es necesario la realización de más estudios, incluyendo series de casos y revisiones sistemáticas para comprender mejor esta infrecuente condición y sus otras variantes.

ABSTRACT Introduction: According to the DSM-V, pseudocyesis is included in the category "other specific somatic symptoms and related disorders" and is defined as a false belief of being pregnant that is associated with objective signs and symptoms of pregnancy. Confirmation of pseudocyesis is achieved with a negative blood and/or urine beta-human chorionic gonadotropin result and a negative ultrasound finding. Materials and methods: We present a case of a woman with symptoms and signs of pregnancy corresponding to pseudocyesis, the patient continued to believe she was pregnant because of her symptoms, despite negative pregnancy tests. Conclusion: Pseudocyesis is a rare condition that is often associated with other psychiatric comorbidities and unclear differential diagnoses. Further studies, including case series and systematic reviews, are needed to better understand this rare condition and its other variants.

Objective: Evidence on the relationship between depression and clinical dimensions of schizophrenia remains limited. This cross-sectional study investigated the association between depression and Positive and Negative Syndrome Scale (PANSS) dimensions in people with schizophrenia spectrum disorders. Methods: Trained assessors administered the PANSS to measure symptoms of schizophrenia and the Calgary Depression Scale for Schizophrenia to measure depression. The association of depression with overall PANSS score and related dimensions was investigated in multiple logistic regression analyses. Results: We included 231 inpatients with schizophrenia spectrum disorders (mean age: 42.4 (SD: 12.9) years; men: 58.9%; mean overall PANSS score: 82.5 (SD: 20.1); drug-free or naïve: 39.3%), including 78 (33.8%) with clinically significant depressive symptoms. Depression was associated with higher overall (regression coefficient, SE: 0.029, 0.008; p < 0.001) and general psychopathology (regression coefficient, SE: 0.118, 0.023; p < 0.001) PANSS scores. We found an inverse relationship between depression and positive symptoms (regression coefficient, SE: -0.088, 0.028; p = 0.002). No association between depression and negative symptoms was found. Conclusion: Despite some limitations, our study shows that people affected by schizophrenia spectrum disorders with depression are likely to show more overall and general psychopathology symptoms but lower positive symptoms. Additional studies are needed to explore the generalizability of our findings. Objective limited crosssectional cross sectional (PANSS Methods analyses Results 23 age 424 42 4 42. SD (SD 12.9 129 12 9 years men 58.9% 589 58 825 82 5 82. 20.1 201 20 1 20.1) drugfree drug free naïve 39.3%, 393 39.3% , 39 3 39.3%) 7 33.8% 338 33 8 (33.8% coefficient SE 0029 0 029 0.029 0.008 0008 008 0.001 0001 001 0118 118 0.118 0.023 0023 023 scores 0.088, 0088 088 -0.088 0.028 0028 028 0.002. 0002 0.002 . 002 0.002) Conclusion limitations findings 2 12. 58.9 20. 39.3 33.8 (33.8 02 0.02 0.00 000 00 011 11 0.11 0.088 08 -0.08 58. 39. 33. (33. 0.0 01 0.1 0.08 -0.0 (33 0. -0. (3 -0 ( -

BACKGROUND: The COVID-19 pandemic had a profound global impact, affecting individuals, including those with mental illness, through early and widespread information dissemination. Although the neurobiological basis of delusions remains unclear, external stimuli and historical events are known to influence them. The pandemic provided a unique opportunity to explore this phenomenon. AIM: To determine the prevalence of COVID-19-related delusional content, among individuals presenting for treatment of psychosis during the peak of the COVID-19 pandemic and investigate associated clinical and demographic factors. SETTING: Chris Hani Baragwanath Academic Hospital in-patient psychiatry department. METHODS: Data were extracted retrospectively from adult psychiatric admissions spanning April to September 2020 on patients whose presenting complaints included delusions. Demographic factors, symptoms, psychiatric, medical and substance use history, and a documented Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis by the attending psychiatrist were collected. RESULTS: The prevalence of COVID-19-related delusional content was 25.5%. Significant demographic association was observed with education level of Grade 12 and above (p = 0.000338). The odds of a diagnosis of schizophrenia and related disorders were 2.72 times greater than mood and psychotic disorder due to another medical condition in those with COVID- 19-related delusional content (OR 2.19, 95% CI: [1.4-3.4]. CONCLUSION: The presence of COVID-19-related delusional content in patients admitted to hospital with psychosis provides further evidence of the role of external stimuli in the formation of delusions. CONTRIBUTION: This study underscores the influence of socio-cultural factors on delusions and advocates for interventions and expanded research to address mental health outcomes.

BACKGROUND: South African drug usage demographics are rare. Substance abuse disorder patients and their families have complex interactions. This study examines family members living with drug addict. AIM: The study seeks to investigate the experiences of family members living with a substance use disorder (SUD) individual. SETTING: The research took place in a Gqeberha psychiatric facility. Low-income households were interviewed. METHODS: This research is qualitative, exploratory, and descriptive study. Recorded and transcribed in-depth patient family interviews were collected. Qualitative thematic analysis was used to analyse data. The data themes were interpreted using family systems theory. RESULTS: Each of the three main themes has subthemes. The first theme concerns family members' inadequate comprehension of addiction. The subtheme explores family members' denial and failure to recognize substance use disease symptoms. The second theme concerns variations in behaviour that challenge cultural norms. This subtheme addresses hallucinations, delusions, and fury in SUD patients. The third theme addresses the negative effects of drug use on families, potentially leading to divorce. This subtheme focuses on the family's lack of awareness of resources that may have supported them and the SUD individual. CONCLUSION: Immediate family members are crucial to patient recovery. The family seemed to be struggling living with an SUD relative. Experts should help the family to manage the addict's treatment. Healthcare education can help families cope with substance abusers. CONTRIBUTION: This study will assist the nursing administration in discovering ways to help families manage a loved one with an SUD.

Resumen Antecedentes: El lupus eritematoso sistémico (LES) es una enfermedad auto inmunitaria crónica multisistémica con diversas manifestaciones clínicas. Siendo las mujeres la pobla ción vulnerable y con mayor afectación a nivel neurológico, al presentar mayor riesgo de convulsiones. Las manifestaciones neuropsiquiátricas ocurren en etapas tempranas de la enfermedad y del diagnóstico, ya que pueden presentarse junto con manifestaciones sistémicas o no. La frecuencia de manifestaciones neuropsiquiátricas en el lupus eritematoso sistémico se ha descrito del 14 al 75%, siendo las alteraciones cognitivas uno de los grandes síntomas a destacar1. La cual puede ir acompañada de trastornos afectivos de tipo depresión y ansiedad. Ya que la psicosis secundaria a LES se remarca por su baja prevalencia (10%)2, los estudios de laboratorio nos suelen orientar hacia el diagnóstico definitivo, siendo los anticuerpos ribosomales P los que se han relacionado más específicamente con la psicosis lúpica. La resonancia magnética es la prueba de elección y las lesiones cerebrales están dominadas por hiperintensidades de materia blanca en forma de punción3. En el siguiente reporte de caso, presentamos a una paciente de 20 años, la cual contaba con antecedentes de esteatosis hepática diagnosticado, diabetes tipo MODY y resección de ovario derecho por teratoma maduro de 9 años de evolución, pero sin antecedentes psiquiátricos de importancia para el momento de su valoración. Sin embargo, de forma aguda presentó un brote psicótico caracterizado por ideas delirantes de grandiosidad y referencia, así como alteraciones conductuales, cognitivas y afectivas. Por las que tuvieron que acudir a hospital de 3er nivel durante el periodo de contingencia sanitaria en el 2020. Tras el antecedente de presentar infección por SARS-CoV-2 tres meses antes de su patología neuropsiquiátricas. Se sospechó en síntomas neurológicos secundarios a infección por COVID-19, así como patología psiquiátrica aislada. Por lo que se realizó abordaje de estudio de primer brote psicótico, diagnosticándose lupus eritematoso sistémico con manifestaciones neuropsiquiátricas. El tratamiento se basó en un bolo de metilprednisolona y antipsicóticos, luego modificada por terapia con corticoesteroides orales y antipsicótico de depósito. Conclusión: El lupus eritematoso sistémico con manifestaciones neuropsiquiátricas es una presentación poco frecuente del padecimiento, por la amplia variación en la aparición de este, los pacientes con síntomas psiquiátricos en contexto de hospital general deben de ser tomados en cuenta para abordajes extensos4. De la misma forma, el tener este conocimiento del caso podrá ampliar nuestro conocimiento sobre las complicaciones de esta patología reumatológica. Y una de sus complicaciones más graves como la psicosis lúpica para poder realizar un mejor abordaje del primer brote psicótico en hospitales generales, donde la valoración de un especialista puede ser más complicada para mejorar las condiciones médicas de estos pacientes.

Abstract Background: Systemic lupus erythematosus is a chronic multisystemic autoimmune disease with diverse clinical manifestations. Women are the most vulnerable population and have the greatest neurological involvement with a higher risk of seizures. Neuropsychiatric manifestations occur in early stages of the disease and diagnosis since they can occur together with systemic manifestations or not. The frequency of neuropsychiatric manifestations in systemic lupus erythematosus has been described from 14 to 75%; being cognitive alterations one of the major symptoms to highlight. Which, in the same way can be accompanied by affective disorders such as depression and anxiety. Since psychosis, secondary to SLE, stands out for its low prevalence (10%), laboratory studies usually guide us towards a definitive diagnosis, being ribosomal P antibodies the ones that have been more specifically related to lupus psychosis. MRI is the test of choice and brain lesions are dominated by punctate white matter hyperintensities. In the following case report, we present a 20-year-old patient who had a history of diagnosed hepatic steatosis, MODY type diabetes and resection of the right ovary for mature teratoma of 9 years of evolution; but with no psychiatric history of importance at the time of her evaluation. However, she acutely presented a psychotic outbreak characterized by delusions of grandiosity and reference; as well as behavioral, cognitive, and affective alterations. For which she had to go to a 3rd level hospital during the period of health contingency in 2020. After a history of SARS-CoV-2 infection three months before her neuropsychiatric pathology, neurological symptoms secondary to COVID-19 infection were suspected, as well as isolated psychiatric pathology. Therefore, a study approach of the first psychotic outbreak was performed, diagnosing systemic lupus erythematosus with neuropsychiatric manifestations. Treatment was based on a bolus of methylprednisolone and antipsychotics; later modified by therapy with oral corticosteroids and depot antipsychotic. Conclusion: Systemic lupus erythematosus with neuropsychiatric manifestations is an infrequent presentation of the disease, because of the wide variation in its appearance, patients with psychiatric symptoms in a general hospital setting should be considered for extensive approaches. In the same way, having this knowledge of this case may broaden our knowledge about the complications of this rheumatologic pathology. And one of its most serious complications such as lupus psychosis to be able to make a better approach to the first psychotic outbreak in general hospitals, where the assessment of a specialist can be more complicated.

Abstract The frequency of psychotic symptoms in older adults is high, mainly in neurocognitive cognitions of the most varied etiologies. Objectives: This study aimed to review the studies that analyze the frequency of the types of delusions, hallucinations, and misidentifications in dementia conditions of different etiologies. Methods: A systematic review was conducted on August 9, 2021, in the PubMed, PsycInfo, Embase, Web of Science, and Scopus databases with the following descriptors: (dementia OR alzheimer disease OR dementia with Lewy bodies OR frontotemporal dementia OR mixed dementia OR vascular dementia OR major neurocognitive disorder OR parkinson disease dementia) AND (psychotic symptoms OR psychosis OR hallucinations OR delusions OR psychopathology OR misidentification) AND (prevalence OR epidemiology). Results: A total of 5,077 articles were found, with a final inclusion of 35. The overall frequency of psychotic symptoms ranged from 34 to 63% in dementia conditions of the most varied etiologies. Alzheimer’s disease (AD) presents more delusions and hallucinations and has a higher frequency regarding the presence of misidentifications. On the contrary, Dementia with Lewy bodies (DLB) seems to present more hallucinations, even auditory, when compared to the other dementias, concomitantly with delusions. Vascular and frontotemporal dementia present fewer psychotic symptoms than DLB and AD. Conclusions: We identified a gap in the literature on the description of the psychotic symptoms of dementia, mainly in those of non-AD etiologies. Studies that assess the neuropsychiatric symptoms of dementias deeply might contribute in a more definite manner to the causal diagnosis of dementia. high etiologies Objectives Methods 9 2021 PubMed PsycInfo Embase Science descriptors misidentification prevalence epidemiology. epidemiology . epidemiology) Results 5077 5 077 5,07 found 35 3 63 Alzheimers Alzheimer s AD (AD contrary (DLB auditory Conclusions nonAD non 202 507 07 5,0 6 20 50 0 5, 2

RESUMO A frequência de sintomas psicóticos em idosos é alta, principalmente em cognições neurocognitivas das mais variadas etiologias. Objetivos: Revisar os estudos que analisam a frequência dos tipos de delírios, alucinações e erros de identificação em quadros demenciais de diferentes etiologias. Métodos: Foi realizada uma revisão sistemática em 9 de agosto de 2021, nas bases de dados PubMed, PsycInfo, Embase, Web of Science e Scopus, com os seguintes descritores: (demência OR doença de alzheimer OR demência com corpos de Lewy OR demência frontotemporal OR demência mista OR vascular demência OU transtorno neurocognitivo maior OU demência da doença de Parkinson) E (sintomas psicóticos OU psicose OU alucinações OU delírios OU psicopatologia OU identificação errônea) E (prevalência OU epidemiologia). Resultados: Foram encontrados 5.077 artigos, com inclusão final de 35. A frequência geral de sintomas psicóticos foi de 34 a 63% em quadros demenciais das mais variadas etiologias. A doença de Alzheimer (DA) apresenta mais delírios, alucinações e maior frequência quanto à presença de erros de identificação. Por outro lado, a demência com corpos de Lewy (DCL) parece apresentar mais alucinações, inclusive auditivas, quando comparada às demais demências, concomitantemente aos delírios. As demências vascular e frontotemporal apresentam menos sintomas psicóticos do que a DCL e a DA. Conclusões: Identificamos lacuna na literatura quanto à descrição dos sintomas psicóticos das demências, principalmente naquelas de etiologia não DA. Estudos que aprofundem os sintomas neuropsiquiátricos das demências podem contribuir de forma mais definitiva para o diagnóstico causal da demência. alta etiologias Objetivos Métodos 2021 PubMed PsycInfo Embase Scopus descritores Parkinson errônea prevalência epidemiologia. epidemiologia . epidemiologia) Resultados 5077 5 077 5.07 artigos 35 3 63 DA (DA lado (DCL auditivas Conclusões 202 507 07 5.0 6 20 50 0 5. 2

Introduction: L’idéal du réductionnisme neurobiologique en psychopathologie implique l’idée que la schizophrénie peut être comprise simplement comme le produit d’altérations du fonctionnement cérébral. D’autre part, et critiquant cette tradition, l’approche phénoménologique propose que la schizophrénie soit comprise comme un trouble de soi. Bien que les deux traditions soient pertinentes aujourd’hui, nous pensons qu’une compréhension complète du phénomène psychotique implique une intégration des deux. Objectif: Cet article soutient que l’hypothèse de la saillance aberrante est un bon candidat pour unifier les traditions phénoménologique et neuropsychiatrique dans l’étude de la schizophrénie. Procédure: Après avoir examiné en profondeur l’hypothèse en question, nous explorons comment elle pourrait expliquer certains des symptômes positifs de la schizophrénie d›une manière cohérente avec leurs descriptions phénoménologiques. Conclusions: Enfin, quelques considérations générales sont proposées concernant les conséquences de notre analyse pour le domaine de la psychopathologie. Introduction Lidéal L idéal lidée l idée daltérations d altérations cérébral Dautre D autre part tradition lapproche approche soi aujourdhui, aujourdhui aujourd hui, hui aujourd’hui quune qu Objectif lhypothèse hypothèse létude étude Procédure question dune phénoménologiques Conclusions Enfin

Introdução: A popularização do reducionismo neurobiológico na psicopatologia traz a ideia de que a esquizofrenia pode ser entendida simplesmente como o produto de alterações na função cerebral. Por outro lado, e criticando essa tradição, a abordagem fenomenológica propõe que a esquizofrenia seja entendida como uma desordem do eu. Embora ambas as tradições sejam relevantes hoje, acreditamos que uma compreensão completa do fenômeno psicótico envolve uma integração de ambas. Objetivo: Este artigo argumenta que a hipótese da saliência aberrante é uma boa candidata para unificar as tradições fenomenológica e neuropsiquiátrica no estudo da esquizofrenia. Procedimento: Depois de examinar a hipótese em questão em profundidade, exploramos como ela pode explicar alguns dos sintomas positivos da esquizofrenia de maneira consistente com suas descrições fenomenológicas. Conclusões: Por fim, são oferecidas algumas considerações gerais sobre as consequências de nossa análise para o campo da psicopatologia. Introdução cerebral lado tradição eu hoje Objetivo Procedimento profundidade fenomenológicas Conclusões fim

Background: The popularization of neurobiological reductionism in psychopathology involves the idea that schizophrenia can be fully understood as the mere product of brain-functioning alterations. Criticizing this tradition, the phenomenological approach proposes that schizophrenia should be understood as a self-disturbance. Although both traditions are relevant, we believe that a comprehensive understanding of schizophrenia involves the integration of these two frameworks. Aim: This article proposes that the aberrant salience hypothesis is a good candidate for unifying the phenomenological tradition with the neuropsychiatric approach to psychosis. Methods: After examining the aberrant salience hypothesis in detail, we explore the way in which it can explain the positive symptoms of schizophrenia respecting being consistent with their phenomenological descriptions. Conclusion: we conclude with some considerations about the consequences of our analysis for the field of psychopathology. Background brainfunctioning brain functioning alterations selfdisturbance. selfdisturbance self disturbance. disturbance self-disturbance relevant frameworks Aim psychosis Methods detail descriptions Conclusion

Introducción: La popularización del reduccionismo neurobiológico en psicopatología conlleva la idea de que la esquizofrenia puede entenderse simplemente como el producto de alteraciones en el funcionamiento cerebral. Por otro lado, y criticando esta tradición, el enfoque fenomenológico propone que la esquizofrenia debería entenderse como un trastorno del yo. Si bien ambas tradiciones son relevantes en la actualidad, creemos que una comprensión completa del fenómeno psicótico envuelve una integración de ambas. Objetivo: Este artículo plantea que la hipótesis de la saliencia aberrante es un buen candidato para unificar la tradición fenomenológica y la neuropsiquiátrica en el estudio de la esquizofrenia. Procedimiento: Luego de examinar la hipótesis en cuestión en profundidad, exploramos la forma en que podría explicar algunos de los síntomas positivos de la esquizofrenia de forma consistente con sus descripciones fenomenológicas. Conclusiones: Finalmente, se ofrecen algunas consideraciones generales respecto de las consecuencias de nuestro análisis para el campo de la psicopatología. Introducción cerebral lado yo actualidad Objetivo Procedimiento profundidad fenomenológicas Conclusiones Finalmente

RESUMEN Introducción: El entrenamiento metacognitivo (EMC) de Moritz et al., una nueva dirección en terapia, es un programa de entrenamiento grupal manualizado, dirigido a corregir los sesgos cognitivos implicados en la formación y el mantenimiento de los síntomas psicóticos, principalmente los delirios. El objetivo de este estudio es evaluar la eficacia del EMC en una muestra chilena de personas con esquizofrenia. Métodos: Se aleatorizó a 50 pacientes ambulatorios del Hospital Del Salvador de Valparaíso, Chile, al grupo de intervención que recibió el EMC o al grupo de control que solo recibió el tratamiento habitual. Se evaluó a los sujetos al inicio y al término del estudio mediante la escala de los síndromes positivo y negativo (PANSS), el cuestionario de sesgos cognitivos para psicosis (CBQ) y la escala de insight cognitivo de Beck (BCIS). Resultados: En el grupo de EMC se registraron mayores mejorías estadísticamente significa tivas, tanto en síntomas y sesgos cognitivos como en insight cognitivo, que en el grupo de control. Al comparar ambos grupos, solo se observaron resultados significativos a favor del EMC en los síntomas positivos. Conclusiones: Los resultados de este estudio indican que el EMC es superior al tratamiento habitual en el tratamiento de los síntomas positivos. No fue posible demostrar su superio ridad en la mejoría de los sesgos cognitivos y el insight cognitivo.

ABSTRACT Introduction: Moritz et al.'s metacognitive training (MCT), a new development of cognitive therapy, is a manualized group training program, designed to correct cognitive biases involved in the formation and maintenance of psychotic symptoms, especially delusions. We report on the efficacy of MCT in a Chilean sample of people with schizophrenia. Methods: 50 outpatients from the Hospital Del Salvador at Valparaíso, Chile, were randomly assigned to the intervention group (MCT), or the control group, that only received treatment as usual (TAU). Subjects were assessed at the beginning and end of the study with the Positive and Negative Syndrome Scale (PANSS), Cognitive Biases Questionnaire for Psychosis (CBQ-P) and Beck Cognitive Insight Scale (BCIS). Results: In the MCT group, we found larger, statistically significant improvements, in symp toms, cognitive biases and cognitive insight, than in the control group. However, after a direct comparison of both groups, only the improvement in psychotic symptoms for the MCT group, remained significantly different. Conclusions: The results of this study suggest superiority of MCT over TAU in the amelioration of positive symptoms. We could not, however demonstrate its superiority in the improvement of the cognitive biases and cognitive insight.

RESUMEN En los últimos arios ha crecido exponencialmente el cuerpo de literatura que se ocupa de ensayar diversas maneras de integrar la espiritualidad en la práctica psicoterapéutica. Probablemente el interés por esta temática haya surgido a propósito de la inclusión en el DSM-IV de la nueva categoría «Problema religioso o espiritual» (código V62.89). Hasta entonces las cuestiones religiosas o espirituales habían sido objeto de la clínica en tanto síntomas de algunas enfermedades mentales, como los delirios con contenidos religiosos propios de los esquizofrénicos. Pero con la cuarta edición del citado manual comienza a interesar el estudio de la espiritualidad en tanto que expresa un aspecto fundamental de la personalidad. En esta línea, se han formulado diversos modelos de integración de la espiritualidad y la psicoterapia. Nuestra intención es estudiar el problema de la inconmensurabilidad como uno de los problemas epistemológicos y metodológicos medulares que supone un proyecto de este tipo. Presentamos los escritos de los Padres del desierto como un modelo explicativo que garantiza una integración epistemológicamente legítima de las tradiciones espirituales con la práctica psicoterapéutica. Y por eso mismo argumentamos que sus escritos podrían constituir una vía superadora de la relación de mutua inconmensurabilidad que aparentemente existe entre la racionalidad científica y la espiritualidad.

ABSTRACT In recent years, the body of literature that deals with trying different ways of integrating spirituality into psychotherapeutic practice has grown exponentially. Probably the interest in this topic has arisen with regard to the inclusion in the DSM-IV of the new category "Religious or Spiritual Problem" (Code V62.89). Until then, religious or spiritual issues had been viewed in the clinical practice as symptoms of some mental illnesses like, for example, the delusions with religious content typical of schizophrenics. But with the fourth edition of the aforementioned manual, there began to be an interest in the study of spirituality as it expresses a fundamental aspect of personality. In this vein, various models of integration of spirituality and psychotherapy have been formulated. Our intention is to study the problem of incommensurability as one of the epistemological and methodological problems that supposes a project of this type. We present the writings of the Desert Fathers as an explanatory model that guarantees an epistemologically legitimate integration of spiritual traditions with psychotherapeutic practice. And for that reason, we argue that their writings could constitute a way to overcome the relationship of mutual incommensurability that apparently exists between scientific rationality and spirituality.

Resumen 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.

Abstract 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.

Resumen Realizamos una selección de películas sobre los celos patológicos buscando films de calidad, de distinta procedencia y época de realización. Finalmente analizamos ocho películas procedentes de Estados Unidos (4), México, Italia, Francia y Corea del Sur, de directores muy distintos realizadas desde 1927 a 2005, pero todas ellas nos presentan las características del enfermo de celos, sus desencadenantes y reacciones típicas de ansiedad, acoso, vigilancia, persecución, episodios violentos, en ocasiones ideas delirantes y alucinaciones y un final muchas veces trágico. La visualización y el análisis de estas películas pueden ser útiles para la docencia en ciencias de la salud pudiendo también ayudar a conocer y prevenir situaciones derivadas de los celos enfermizos.

Abstract We make a selection of films about pathological jealousy looking for quality films, from different sources and times of production. Finally, we analyze eight films from the United States (4), Mexico, Italy, France and South Korea, by very different directors made from 1927 to 2005, but all of them present us with the characteristics of jealousy with their triggers and typical reactions of anxiety, harassment, surveillance, persecution, violent episodes, sometimes delusions and hallucinations and often with a tragic ending. The visualization and analysis of these films can be useful for teaching in health sciences and can also help to know and prevent situations derived from unhealthy jealousy.

RESUMEN La inducción de psicosis por ayahuasca es un evento poco frecuente. Sin embargo, debido a un aumento en el acceso y la distribución de esta sustancia, resulta menester destacar los casos en que se presenta. Se describe el caso de un paciente varón de 26 arios que ingresó al servicio de psiquiatría por un cuadro clínico de 7 meses de evolución dado por cambios en el comportamiento, ideas delirantes y posterior exacerbación de los síntomas, tras participar en una ceremonia ritual en la que consumió por vez primera un brebaje de ayahuasca. Requirió inicialmente tratamiento hospitalario para controlar el episodio psicótico agudo, con buena respuesta y tolerancia al tratamiento farmacológico, lo que permitió continuar su seguimiento clínico ambulatorio.

ABSTRACT Psychosis induced by ayahuasca is a rare occurrence. However, due to an increase in the access and distribution of this substance, it is necessary to highlight the cases in which it occurs. We describe the case of a 26-year-old man who was admitted to the psychiatric service after seven months of changes in behaviour, delusions and the subsequent exacerbation of symptoms, after participating in a ritual ceremony during which he consumed an ayahuasca concoction for the first time. Initially, he required hospital treatment to control the acute psychotic episode, but after tolerating and responding well to the antipsychotic treatment, he was discharged with an outpatient follow-up.

RESUMEN En 1880 Jules Cotard describió un conjunto de delirios en forma de negaciones que luego se denominó síndrome con su apellido como epónimo. Se trata de una condición infrecuente que se caracteriza por delirios nihilistas en los cuales la persona piensa que «se encuentra muerta o que el mundo ya no existe». En este documento se realiza el seguimiento de un par de casos en los que se evidencia una semiología amplia y enriquecedora desde el punto de vista descriptivo, lo que permite revisarlos junto con el delirio de Cotard a la luz de la psiquiatría moderna. El primero corresponde a un trastorno depresivo y el otro se da en el contexto de un trastorno psicótico no afectivo. Se plantea la revisión de la literatura desde lo descrito por Cotard hasta llegar a las clasificaciones psiquiátricas actuales

ABSTRACT In 1880, Jules Cotard described a set of delusions in the form of negations that later became his eponymous syndrome. Cotard's syndrome is an uncommon condition characterised by the presence of nihilistic delusions in which the person thinks that "they are dead or that the world no longer exists". This document describes two cases in which a broad and enriching semiology is evidenced from a descriptive point of view, which allows us to review them together with Cotard's syndrome in the light of modern psychiatry. The first case corresponds to a depressive disorder and the other occurs in the context of a non-affective psychotic disorder. A review of the literature is presented from what Cotard described until the current psychiatric classifications.

Resumos Os autores, clínicos e pesquisadores em psicopatologia, desenvolvem um fenômeno psíquico transestrutural encontrado em pacientes obesos submetidos à cirurgia bariátrica: fantasias e delírios de fragmentação do corpo. Com base em um caso clínico de neurose e outro de psicose, será estudado o impacto psíquico da cirurgia bariátrica, destacando uma alteração na imagem do corpo e suas sensações, que estariam na origem desse fenômeno de fragmentação.

The authors, clinicians, and researchers in psychopathology, developed a trans-structural psychic phenomenon found in obese patients who have undergone bariatric surgery: fantasies and delusions of body fragmentation. The psychic impact of bariatric surgery was studied based on a clinical case of neurosis and another one of psychosis, highlighting an alteration of body image and its sensations which would be at the origin of this phenomenon of fragmentation.

Los autores, clínicos e investigadores en el campo de la psicopatología, desarrollan un fenómeno psíquico transestructural encontrado en pacientes obesos sometidos a la cirugía bariátrica: fantasías y delirios de fragmentación del cuerpo. Desde un caso clínico de neurosis y otro de psicosis, se estudiará el impacto psíquico de la cirugía bariátrica, destacando una alteración de la imagen corporal y de sus sensaciones, que serían el origen de este fenómeno de fragmentación.

Les auteurs, cliniciens et chercheurs en psychopathologie, développent un phénomène psychique transtructurel rencontré chez des patients obèses opérés d’une chirurgie bariatrique: des fantasmes et des délires de morcellement corporel. C’est à partir d’un cas clinique de névrose et un autre de psychose, que l’impact psychique de la chirurgie bariatrique sera étudié, avec la mise en lumière d’une altération de l’image du corps et de ses sensations qui serait à l’origine de ce phénomène de morcellement.

Resumo Introdução: A perturbação obsessivo-compulsiva é uma patologia heterogénea em que podem surgir períodos de perceção alterada ou ideias delirantes. De igual forma, indivíduos com perturbações psicóticas podem apresentar sintomas obsessivo-compulsivos. Caso clínico: Um adolescente do sexo masculino recorreu ao Serviço de Urgência (SE) por sintomatologia obsessiva com três meses de evolução. Regressou ao SE após três semanas por agravamento do quadro e relato de ideias delirantes, tendo sido internado para clarificação do diagnóstico. Nunca foram objetivados sintomas positivos durante o internamento. Em consulta de seguimento, o jovem relatou um episódio de aparente perceção delirante que associou ao início da sintomatologia, levantando novamente a dúvida quanto à presença de um episódio psicótico. Discussão/Conclusões: A distinção entre perturbação obsessivo-compulsiva e psicose nem sempre é clara, e a comorbilidade entre ambas é significativa. É necessária uma avaliação meticulosa do doente para um diagnóstico precoce e intervenção apropriada.

Abstract Introduction: Obsessive-compulsive disorder is an heterogeneous condition in which periods of altered perception or delusions may arise. Similarly, individuals with psychotic disorders may have obsessive-compulsive symptoms. Case report: A male adolescent presented to the Emergency Department (ED) with obsessive symptomatology with three months of evolution. Three weeks later, he returned to the ED showing symptom worsening and reporting delusions, being admitted to the inpatient unit to clarify the diagnosis. No positive symptoms were reported during hospitalization. During follow-up, the patient reported an episode of apparent delusional perception that he associated with the beginning of symptoms, again raising the question of whether a psychotic episode was present. Discussion/Conclusions: The distinction between obsessive-compulsive disorder and psychosis is not always clear, with obsessive-compulsive disorder being a significant comorbidity in patients with a first psychotic episode. Close patient assessment is required for early diagnosis and appropriate intervention.