-Machado de Assis's own writings about his epilepsy are here given. They come from his correspondence with his friend Mario de Alencar during the last 8 months of Machado de Assis's life. These are the only places where Machado de Assis dealt clearly with his epilepsy during his entire life.KEY WORDS: epilepsy, Machado de Assis. Os escritos de Machado de Assis sobre a sua epilepsia: breve nota clínicaRESUMO -Os escritos de Machado de Assis sobre a sua epilepsia são analisados aqui. Eles provêm da sua correspondência com seu amigo Mario de Alencar, durante os últimos 8 meses da vida de Machado de Assis. Este é o único lugar em que Machado de Assis tratou claramente da sua epilepsia durante toda a sua vida.
-In young mothers an obsession of infanticide, that is, fear that they may murder their children, may be coupled with an obsession of imminent psychosis, that is, fear that the first obsession is a sign of approaching insanity. Sixteen mothers with this clinical picture were evaluated in interviews. Seven of them entered psychotherapy and improved. The causative factors in childhood and adolescence wich led to the later development of these obsessive difficulties are analyzed. Even when psychotherapy was not possible, as was the case in nine patients, they should be strongly reassured and explanations should be given about the nature of the problem, for such encouragement and clarification helps them to improve to a significant extent. The prognosis of patients who have systematic psychoterapy is good.KEY WORDS: obsession, infanticide, psychotherapy.A special type of obsession in women is the persistent fear that they will kill their children. This is usually accompanied by a fear of suddenly becoming insane. These two obsessions reinforce each other. These mothers fear that the thought of killing their children indicates psychosis, and that a consenquence of abruptly ocurring psychosis will be the murder of them 2 .It should be emphasized that these patients do not have urges to kill their children; they have instead an ever present dread, that they may do so 7 . None of the patients reported here had a history of violent acts against persons, animals or things; they had never attacked people, or abused pets or broken household objects. In addition, none of them had ever directed violence against themselves in suicidal threats, gestures or attempts. They were, on the contrary, passive women who rarely resorted to even mild verbal expressions of anger or resentment. Deciding whether a woman has urges to kill her children or obsessive fears that she will do so is usually not a difficult decision for the clinician when both the patient and a near relative are carefully interviewed.*From the Samur Hospital and the Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista, Bahia, Brazil. Aceite: 27-novembro-1195.Dr. A H Chapman -Hospital Samur -Caixa Postal 98 -45100-000 Vitória da Conquista BA -Brasil Obsessões de infanticídio e psicose iminenteRESUMO -Em mães jovens, uma obsessão de infanticídio, ou seja, medo de que possam vir a matar seus próprios filhos pode estar associada a uma outra obsessão, de uma psicose iminente, isto é medo de que a primeira obsessão esteja sinalizando um perigo iminente de psicose. Dezesseis mães com este quadro foram avaliadas por meio de entrevistas clínicas. Sete puderam submeter-se a psicoterapia e melhoraram bastante. São analisados os fatores interativos que, na infância e adolescência, concorrem para o desencadeamneto desses comportamentos obsessivos; mesmo quando não seja possível a situação ideal de uma psicoterapia mais extensa, como ocorreu com nove pacientes, elas devem ser tranqüilizadas e animadas por meio de explicações quanto à natureza do problema, pois...
-Narcolepsy main symptoms include excessive daytime sleepiness and cataplexy. Its chronic course is accompanied by psychosocial impairment added to the difficulties and side effects of stimulants and tricyclics long term use. Depressive complaints are occasionally reported. The aim of this paper was to evaluate objectively the possibility of depression in a sample of 12 narcoleptics (7F;5 M), with mean age of 53 years (12 years SD), using the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HAM-D). The results showed absence of depressive disorder in 75.0% of the cases according to BDI (or 58.3% according to HAM-D). The remaining patients had mild depression (only one patient presented major depression). The findings showed no correlation between narcolepsy and major depression.KEY WORDS: narcolepsy, depression, sleep, sleep disorder, Beck Depression Inventory, Hamilton Rating Scale for Depression. Narcolepsia e depressãoRESUMO -Narcolepsia é um distúrbio do sono caracterizado por sonolência diurna excessiva e ataques de cataplexia. Sendo crônico, traz uma série de dificuldades psicossociais às quais se aliam aquelas geradas pelos efeitos colaterais dos estimulantes e tricíclicos utilizados. Queixas depressivas são encontradas ocasionalmente. Esta pesquisa buscou verificar objetivamente a ocorrência de depressão em narcolépticos. Foi avaliado um grupo de 12 pacientes narcolépticos (7F; 5M) com média de idade de 53 anos (DP 12) usando-se como instrumentos o Inventário de Beck para Depressão (BDI) e a Escala Hamilton de Depressão (HAM-D). Os resultados demonstraram ausência de distúrbio depressivo em 75.0% dos pacientes avaliados pelo BDI e em 58.3% pela HAM-D. Os demais escores evidenciaram depressão leve ou disforia; depressão maior foi encontrada em apenas um caso. Tais achados não sugerem correlação entre narcolepsia e depressão. PALAVRAS-CHAVE: narcolepsia, depressão, sono, distúrbio do sono, Inventário de Beck para Depressão, Escala Hamilton de Depressão.Narcolepsy clinical characteristics include excessive daytime sleepiness and cataplexy. These symptoms impair daytime functioning and may be detected by the Multiple Sleep Latency Test, which also shows the presence of sudden onset REM periods. Cataplexy, the loss of muscle tone, may be triggered by sudden emotions like anger, fear, or happiness. Some of these patients also experience sleep paralysis and hypnagogic hallucinations 11 .The chronic treatment encompasses stimulant drugs for the excessive daytime sleepiness, and tricyclics antidepressants for the cataplectic attacks. These drugs are used when necessary, therefore there may be periods of improvement in which the drugs are withdrawn. As side effects of these medications, cholinergic symptoms, hipertension and impotence are found. Sexual dysfunction is also reported as consequence of cataplectic attacks during intercourse 6 . Stimulant drugsamphetamine and metilphenidate -are known for tolerance and dependence potential, therefore careful chronic management is n...
SUMMARY -The nature and technique of the tentative interpretation are described. Its usefulness and advantages are outlined, and its field of application in psychotherapy is discussed.K E Y W O R D S : psychotherapy, tentative interpretation, nature and technique, usefulness and advantages.Interpretações tentativas em psicoterapia RESUMO -A natureza e o método da interpretação tentativa são descritas. A sua utilidade e as suas vantagens são esboçadas e o seu uso em psicoterapia é examinado. P A L A V R A S -C H A V E : psicoterapia, interpretações tentativas, natureza e método, utilidade e vantagens.The proper timing of interpretations is a major problem in psychotherapy 1^5
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