Vertex Revista Argentina de Psiquiatría

Indice

Comité de Redacción — 2025-07-10

Editorial

Juan Carlos Stagnaro — 2025-07-10

Legal Situation of the Alienated in Buenos Aires in the Early 20th Century

Comité de Redacción — 2025-07-10

Incluye: Consideraciones sobre legislación de alienados. Fragmento de la Tesis para Doctorado de José Caroni. UBA, Facultad de Ciencias Médicas, 1898,

Experiences of family caregivers of people with severe mental health conditions

Marina Ayelén Fernández — 2025-07-10

Introduction: After the first crisis, family caregivers of persons with severe mental health conditions face situations that impact not only them but also affecting the recovery of these persons. Objective: To describe and analyze the experiences of family caregivers of people with severe mental health conditions after the first crisis. Methods: Qualitative research was conducted. The sample was selected intentionally. Semi-structured interviews (n=15) were carried out. The analysis was qualitative. Results: Participants explained that the experiences after the first crisis generated severe suffering in the family as a group, and the primary caregiver being the most affected. When referring to mental health workers, participants agreed that their support favors changes to the lives both of people with severe mental health conditions and the family group (and the primary caregiver included). Mental health worker´s interventions are considered an opportunity to improve their quality of life. Conclusion: It has been suggested that family caregivers are the blind spot of the mental health field. They organize and provide care, provide support during and after the first crisis, suffer with the person with severe mental health conditions, but they are invisible to mental health services.

Characterization of mental health discharges at J. M. Ramos Mejía General Hospital in the Autonomous City of Buenos Aires during the period 2018-2023

María Laura Scévola — 2025-07-10

Introduction: The number of mental health hospitalizations in general hospitals has been rising in Argentina, in the context of the implementation of the National Mental Health Law. Expanding the body of evidence on these hospitalizations is essential for monitoring this ongoing transformation. This study aimed to characterize mental health hospitalizations in a public general hospital in the Autonomous City of Buenos Aires, where psychiatric admissions occur in wards designated for other medical specialties. To this end, hospital discharge data from 2018 to 2023 were analyzed, focusing on sociodemographic, clinical, and care process variables. Methods: A quantitative approach was employed, using descriptive statistics and chi-square tests to explore associations between variables. A total of 412 cases were included in the analysis. Results: The findings show that the highest number of discharges occurred in 2023. The most frequent reasons for admission were psychotic decompensations, followed by suicide attempts. Among patients of non-Argentinian nationality, this order was reversed. Seventy-four percent of hospitalizations lasted fewer than 30 days, while 9% extended to 90 days or more. Longer hospital stays (≥90 days) were associated with being 60 years of age or older, being admitted due to a psychotic episode, having a discharge diagnosis within the F20–F29 category of the ICD-10, and the type of health coverage.

Analysis of information on hospitalization in General Hospitals in Argentina

Daniela Emilce Bonanno — 2025-07-10

Transforming the mental health care model requires robust information systems that support well-informed discussions about the progress, achievements, and challenges of implemented reforms. Globally, the World Health Organization has developed indicators for this purpose, particularly regarding mental health care in general hospitals and hospitalizations in such settings. However, data from Argentina is often missing from these global analyses. To examine the available information on mental health services in general hospitals in Argentina, a qualitative study was conducted. Six sources of both point-in-time and periodic data, spanning from 2011 to 2023 and with national coverage, were analyzed. The results reveal significant issues in the country’s mental health information systems, including low data coverage when passive data collection methods are used, and limited public access to reports and databases. The study also discusses the global indicators used for tracking mental health hospitalizations in general hospitals, and proposes alternative approaches, given their limited relevance at the local level.

Subanesthetic Dose Ketamine Infusions for Treatment-Resistant Major Depression: An Application Protocol at a Public Hospital in Argentina

Micaela Dines — 2025-07-10

Treatment-resistant major depression (TRD) poses a significant challenge in psychiatry due to the limited response to conventional therapies. Subanesthetic dose intravenous (IV) ketamine has emerged as an effective therapeutic option, providing rapid effects on depressive and suicidal symptoms. This article outlines the ketamine infusion protocol implemented in a general hospital, following international guidelines. Inclusion and exclusion criteria, dosage, administration procedure, and patient monitoring. Additionally, adverse effects and safety considerations. The implementation of this protocol optimizes the use of ketamine in TRD, ensuring both efficacy and safety.

Young population with cognitive complaint: neuropsychological performance and neuropsychiatric symptoms

Florencia Deschle — 2025-07-10

Introduction: Neurocognitive Disorders (NCD), also called Dementia, includes those disorders in which the main clinical deficit is failure in one or more cognitive functions and which are acquired. Early Onset Dementia (EOD) is defined as major NCD that begins before age 65, with diverse etiological causes and a significant impact on health costs and family quality of life. Neuropsychiatric symptoms, such as depression and anxiety, may be non- neurodegenerative causes of cognitive impairment and complaints. This study focuses on describing the performance in the Neurocognitive Assessment (NCA) and the presence of depression, anxiety, and other neuropsychiatric symptoms in young people who consult for cognitive complaints in a neurology service. Materials and methods: descriptive, retrospective study based on Cognitive Tests reports from young patients (≤64 years) who consulted for cognitive complaints between June 2018 and December 2022. Patients with a history of neurodevelopmental disorders were excluded. We classified patients into categories based on their cognitive performance and impairment in activities of daily living. Additionally, demographic data, neurological and psychiatric history were collected, and scales were used to assess neuropsychiatric symptoms. Results: of the 214 Cognitive Tests reports, 54.21 % were normal, while the remaining showed cognitive impairment. No statistically significant differences were found in the presence of depression or anxiety between the groups with normal and pathological NCD. However, 84 % of cases presented neuropsychiatric symptoms according to family reports, with depression and anxiety being the most reported. Conclusions: normal cognitive performance was obtained in more than half of the sample and some degree of cognitive impairment in the rest. A high frequency of neuropsychiatric symptoms was detected. The importance of a complete NCA and the detection of neuropsychiatric symptoms for early intervention in young patients is highlight.

Use of Psychopharmaceuticals for Treating Anxiety During COVID-19 isolation in Detained Women in Santa Fe in 2020

M. Virginia Canto — 2025-07-10

Introduction: This study investigates the implementation of psychopharmacological treatments for anxiety in incarcerated women during the Preventive and Mandatory Social Isolation (PMSI) in the COVID-19 pandemic, in the Penal Unit No. IV of the city of Santa Fe, from January to June 2020. Objective: The objective of this research is to characterize the profile of psychopharmacological use and to evaluate if there were variations during the PMSI compared to the pre-pandemic period and analyze through a documentary review of clinical histories from a quantitative perspective based on existing data on the prescription of psychotropic drugs. Method: A descriptive and comparative approach is proposed to describe the profile of anxiety symptoms in incarcerated women in the city of Santa Fe during the mentioned period. The potential impact of the PMSI on the mental health of detained women justifies the research. Results: The results reveal an increase in the number of treatments during the PMSI, with 29% of detained women presenting anxiety symptoms that required psychopharmacological treatment. Reactive anxiety was the main reason for prescription, both before and during the PMSI. In addition, a significant variation in the use of psychotropic drugs was observed, where sedative-profile antipsychotics were used in combination for treatment. Conclusion: These findings support the hypothesis that there is a relationship between the PMSI, the presence of anxiety symptoms, and the increase in the implementation of psychopharmacological treatments in detained women during the COVID-19 pandemic in Santa Fe, Argentina.

Frequency of obsessive-compulsive symptoms (OCS) in medical students and their possible association with a history of repeated pharyngitis

Juan Manuel Duarte — 2025-07-10

Introduction: obsessive-compulsive disorder (OCD) is characterized by obsessions and related compulsions, with a prevalence of 2.5 % in the general population and a predominance in men (3:1). Despite numerous hypotheses, its aetiology remains unknown. This study explored the frequency of obsessive-compulsive symptoms (OCS) among second-year medical students at the University of Buenos Aires, and investigated its possible association with a history of repeated pharyngitis. Materials and methods: this study involved a sample of 494 Physiology and Biophysics students from 2023. The participants completed self-administered questionnaires assessing demographic data, medical history, and the DOCS questionnaire for the assessment of OCD. Inclusion and exclusion criteria were applied, and statistical analyses including chi-square, odds ratio, and multivariate logistic regression were performed using IBM SPSS®. Results: among the 494 participants analyzed, the frequency of OCS was 26.92 %. Bivariate analysis revealed associations between SOC and gender, recurrent sore throat in childhood, and recurrent sore throat in adulthood. Multivariate analysis confirmed the association between SOC and recurrent sore throat in adulthood, challenging the notion that PANDAS manifests primarily during childhood. Conclusion: this study suggests a possible link between immune-mediated OCD and repeated streptococcal infections in adulthood, emphasizing the need for further research on specific antibodies and therapeutic interventions. These findings open avenues for larger, more focused studies to validate these results and explore new therapeutic strategies.

Factors associated with cyberchondria in Peruvian medical students: an analytical cross-sectional study

Rodrigo Robles-Mariños — 2025-07-10

Introduction: Cyberchondria is defined as increased anxiety or distress after excessive or repeated searching for health-related information on the Internet. No studies have been found that explore the factors associated with cyberchondria in Hispanic medical students. The objective was to determine the factors associated with cyberchondria in medical students from a Peruvian university in 2018. Materials and Methods: An analytical cross-sectional study was conducted with 657 medical students from a private Peruvian university. The students responded to a survey in which information about cyberchondria levels was collected using the Cyberchondria Severity Scale - 12. Linear Regression was used to calculate the betas with 95 % confidence intervals. Results: The mean cyberchondria score was 25,1±9,1. An association between cyberchondria and the year of study was evidenced (p<0,001), with the second year reporting the highest scores and the sixth year reporting the lowest. Likewise, students with a first-degree medical relative reported lower levels (p=0,01). A weak inverse correlation with age was evidenced (p<0,001). No association was found with sex, place of birth, smoking or having a first-degree relative that is a health worker. Conclusions: It was found that age, year of studies, and having a first-degree medical relative were associated with cyberchondria. Further studies are needed, especially of a longitudinal nature.

First Argentine Consensus on the Management of Attention Deficit Hyperactivity Disorder in Adults. Part Three: Comprehensive Treatment of ADHD in Adults

Andrea Abadi — 2025-07-10

This document corresponds to the third and final part of the First Argentine Consensus on the management of attention deficit hyperactivity disorder in adults, focused on summarizing the current evidence on therapeutic approaches to this pathology in adult patients. Following the methodology described in the first and second parts of the Consensus, the panel of experts conducted an exhaustive review of the literature and, as a result of a subsequent debate on the available information, the final part of this document was prepared, covering the comprehensive treatment of adults with this disorder. During the debate and discussion stage, it was decided to structure this final section of the consensus with some points that we believe will be of great use to the interdisciplinary team responsible for managing adult ADHD patients. In this section of the document, you will find general recommendations for pharmacological treatment and the management of adverse effects, comorbidity treatment, non-pharmacological interventions (NPI), as well as the impact of untreated ADHD

The tragedy of mental health institutions

Juan Carlos Stagnaro — 2025-07-10

Reseña del libro: La tragedia de las instituciones de Salud Mental : memorias del manicomio, de Juan A. Garralda. Letra Viva, 2024.