The concept of nemesis in psychoneurosis

Abstract

-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...

Conceptualisations of neurodiversity and barriers to inclusive pedagogy in schools: A perspective article

“…While diagnosis is helpful when it results in the provision of additional support, the inherent heterogeneity of neurodevelopmental conditions and the presence of co-occurring factors often elude recognition within diagnostic assessments and EHCPs. Notwithstanding the need for ongoing diagnosis and individualised provision of adaptive learning opportunities and the recognition of the preference by some individuals to self-define in terms of pathologisation (Chapman, 2021b), rather than a complete reliance on diagnosis and treatment, there are many advantages to the neurodiversity approach (Sonuga-Barke & Thapar, 2021). The current paper underscores the need to reconcile with the inadequacies of current governmental funding for diagnostic evaluations and educational support.…”

“…Instead, a balanced perspective that recognises both strengths and challenges may provide a more holistic understanding of individuals and enable the fostering of environments that nurture their unique abilities. The real strength of neurodiversity is that it values differences between people and accepts and supports unmet needs without judgement or normalisation (Chapman, 2021b;Fletcher-Watson, 2022). In the field of inclusive pedagogy, it is therefore a priority for research to explore teacher conceptualisations (including misinterpretations) of neurodiversity and its relationship to inclusive practice.…”

Anniversary Reactions in Medical Patients

“…Anniversaries do not need to be tied to age but may be related to other periodicities. The concept of nemesis (Chapman, 1959) is closely related to anniversary reactions. The patient believes he/she is destined to repeat in his/her life the pattern of a significant person's life that ended in tragedies or catastrophe.…”

“…The Diagnostic Criteria for Psychosomatic Research (DCPR), a set of diagnostic criteria that were developed and validated by an international group of investigators to identify psychological constructs that derived from psychosomatic research (Porcelli and Rafanelli, 2010;Porcelli and Sonino, 2007), defined anniversary reaction with the three criteria shown in Table 1 based on the available clinical descriptions (Chapman, 1959;Engel, 1975;Hilgard, 1953;Hilgard and Newman, 1959;Weiss, 1958). The DCPR criteria for anniversary reaction may be a special form of conversion (Engel, 1970) and may encompass other types of somatization.…”