Revista médica de Chile
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Revista médica de Chile · Nov 2022
[A review about the putative mechanisms of action of electroconvulsive therapy in schizophrenia in human research].
Electroconvulsive therapy (ECT) has multiple uses in psychiatry, but its mechanisms of action (MA) in patients with schizophrenia (PS) are poorly understood. We synthesize and discuss the available evidence in this regard. We conducted a search for primary human studies and systematic reviews searching MA of ECT in PS published in PubMed/Medline, SciELO, PsycInfo, and the Cochrane Library, including 24 articles. ⋯ Most of the included studies are observational or quasi-experimental, with small sample sizes. However, they show simultaneous changes at different neurobiological levels, with a pathophysiological and clinical correlation. We propose that the research on ECT should be carried out from neurobiological dimensions, but with a clinical perspective.
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Cancer is a public health priority in Chile. ⋯ Cancer generates costs to the health system, which obliges health planners to allocate a significant proportion of the health budget to this disease. The expected costs estimated in this study are equivalent to 8.9% of all health expenditures and 0.69% of the Gross Domestic Product. This study provides an updated reference for future research, such as those aimed at evaluating the current health policies in cancer.
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Revista médica de Chile · Nov 2022
[Being Depressed or Having Depression. The biomedical model and the difference between mood and illness].
Along with the increase in reported figures of depression in the world's population, organizations such as the WHO have begun to promote screening and pharmacological treatment of mild symptomatic cases. The problem in this context is that the manifestations of 'normal' and 'pathological' depressive mood do not differ much from each other, which creates difficulties at a diagnostic and scientific level. ⋯ In turn, the greater the intensity of the stressors (psychological, social, etc.), the greater the neuroinflammation, which would diminish neuronal plasticity and the possibilities of mood compensation and behavioral change of the subject. The existence of this neurobiological alteration (decreased neuronal plasticity), rather than depressive mood, would help us to categorize depression as a disease.
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Revista médica de Chile · Nov 2022
[Knowing better, knowing the why, and knowing how to do: assumptions of depression in psychiatry].
1) Empirical psychiatric research has failed to validate or verify the causes of depressive disorder. 2) Historically, psychiatry has been looking for many causes and is currently favoring a model of multi-causality, acting at various levels of interaction with diffuse limits. 3) Purely scientific psychiatry is based on the concept that a person is an "entity in itself" that presently suffers from a disorder caused by modifications in the impulses of the neurons in its brain. 4) The question that remains is whether depression is a real entity independent of human activities, a pragmatic entity employed for reasons of utility, or an entity constructed by the prevailing social forces in Western civilization. 5) The rationale for depression can be answered if we understand a human being as a being-in-the-world that a] is projected into the future to enact its existence, b] is placed in a condition that determines him and hinders his self-determination and c] lives among others that impel him to submit to the rules valid for "common people.