Psiquiatria Biologica最新文献

{"title":"Estimulación cerebral profunda en el núcleo accumbens y cápsula interna para depresión resistente al tratamiento: ¿una opción efectiva y definitiva? A propósito de un caso","authors":"Maria Isabel Hernández González ,&nbsp;Ana Paola Gutiérrez Polo ,&nbsp;Valentina Lara Amaya","doi":"10.1016/j.psiq.2026.100912","DOIUrl":"10.1016/j.psiq.2026.100912","url":null,"abstract":"<div><div>Treatment-resistant depression (TRD) represents a significant clinical challenge, defined as the lack of response to at least two antidepressant treatments at adequate doses and durations. It is estimated that approximately 30% of patients with depression meet these criteria. In the search for effective therapies, deep brain stimulation (DBS) has emerged as a promising therapeutic option, with open-label studies reporting improvement in up to 80–90% of cases. Its rationale lies in the modulation of dysfunctional neural networks, inducing changes in action potentials and neurotransmitter release. Although no single anatomical target has been definitively established, the nucleus accumbens is considered a key structure due to its role in the brain's reward circuitry. We present the case of a 61-year-old patient with treatment-resistant major depressive disorder, multiple hospitalizations, and suicide attempts, who underwent implantation of electrodes in the nucleus accumbens and bilateral internal capsule, showing sustained improvement during the first two years. However, he later experienced functional decline and symptomatic relapse, requiring neurosurgical reintervention. This case highlights the challenges of DBS in TRD and underscores the need for prospective studies targeting more precise fiber pathways to achieve long-term therapeutic stability.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 2","pages":"Article 100912"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explorando el correlato neurobiológico del síndrome de Cotard: evidencia desde una serie de 3 casos","authors":"Marinelly Roca-Zela ,&nbsp;Jeff Huarcaya-Victoria","doi":"10.1016/j.psiq.2026.100910","DOIUrl":"10.1016/j.psiq.2026.100910","url":null,"abstract":"<div><h3>Introduction</h3><div>Cotard's syndrome is a rare clinical entity first described in 1880, which has evolved from a monothematic delusion to a condition with multiple concomitant disorders, primarily psychotic depression. Its study remains challenging due to limited available data. This study analyzes the clinical and neurobiological characteristics of three patients.</div></div><div><h3>Materials and methods</h3><div>Data were collected from three elderly female patients hospitalized in the Psychiatry service of the Guillermo Almenara Irigoyen National Hospital, Lima, Peru, in 2023. Medical records, psychiatric evaluations, laboratory tests, and neuroimaging studies were reviewed.</div></div><div><h3>Results</h3><div>The first case involved a 64-year-old woman with no prior psychiatric history who developed a psychotic depressive episode characterized by nihilistic delusions. The second case was a 69-year-old woman with a history of bipolar affective disorder, admitted for a depressive episode with anxious and psychotic symptoms, also presenting nihilistic delusions. The third case involved a 66-year-old woman with longstanding bipolar affective disorder and multiple previous hospitalizations, who presented with a psychotic depressive episode accompanied by catatonia and a neurocognitive disorder. Neuroimaging findings revealed alterations in the frontal and temporal cortices on SPECT, along with MRI findings suggesting an underlying organic condition.</div></div><div><h3>Conclusions</h3><div>The findings demonstrate variability in cerebral perfusion, with reductions in the frontal, parietal, and temporal cortices. These results, align with previous studies suggesting that such alterations may contribute to an impaired ability to integrate external stimuli with autobiographical memories, facilitating delusional misidentification.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 2","pages":"Article 100910"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147713998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting adolescent mental health through school-based screening, psychoeducation and self-help: Study protocol for the SENSE programme","authors":"Marta Ruiz-Hernández ,&nbsp;Elvira Magide-Marco ,&nbsp;Carmen Artés ,&nbsp;David Delgado-Gómez ,&nbsp;Marta del Olmo ,&nbsp;Enrique Baca-García","doi":"10.1016/j.psiq.2026.100888","DOIUrl":"10.1016/j.psiq.2026.100888","url":null,"abstract":"<div><h3>Introduction</h3><div>Adolescence is a critical period for the emergence of mental health problems, many of which go undetected. Globally, approximately 1 in 7 adolescents experiences emotional or psychological distress, with increasing prevalence in recent years. Schools are strategic settings for early detection and intervention. The SENSE programme (Screening of Emotional Needs and Self-Help) was developed to identify common emotional disorders in educational settings and provide stepped care, ranging from psychoeducation and digital self-help to professional referral.</div></div><div><h3>Methods</h3><div>This is a prospective, longitudinal, multicentre study conducted in eight educational centres in Spain (secondary schools, high schools, and vocational training centres). Participation is voluntary. Students will be screened at baseline and every trimester using validated tools assessing anxiety, depression, and emotional dysregulation. Based on results, participants will be assigned to support pathways: access to digital self-help materials, small-group interventions, or referral to in-school or external mental health professionals. Follow-ups will assess changes in symptomatology, use of self-help tools, and help-seeking behaviours. Quantitative analyses will evaluate feasibility, adherence, effectiveness, and cost-effectiveness.</div></div><div><h3>Results</h3><div>The study aims to generate evidence on the program's acceptability, adherence, and impact in reducing common emotional symptoms. It will also provide data on the prevalence of previously undetected problems, engagement with digital self-care tools, and the effectiveness of early professional referrals.</div></div><div><h3>Conclusions</h3><div>The SENSE programme may serve as a scalable, cost-effective model for school-based early detection and intervention in adolescent mental health. Its implementation could optimise resource allocation, shorten referral times, and inform public policies on youth mental health from a preventive approach.</div><div><strong>Trial registration</strong>: This protocol was registered in <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> on July 18, 2025.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 2","pages":"Article 100888"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile and treatment outcomes of Pa Leng (Frigophobia): A systematic review and case report from India","authors":"Christopher Peter,&nbsp;Abdul Qadir Jilani,&nbsp;Akanksha Sharma,&nbsp;Aditi Bhatia","doi":"10.1016/j.psiq.2026.100889","DOIUrl":"10.1016/j.psiq.2026.100889","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the presentations and outcomes of patients with Pa Leng (Frigophobia) and to present a case report of the same from India.</div></div><div><h3>Methods</h3><div>We conducted a descriptive systematic review of case reports/series on Pa Leng (Frigophobia) following PRISMA guidelines, extracting data on patient demographics, comorbidities, clinical course, and outcomes while assessing case quality using a standardized tool. Additionally, we present a clinical case of a 39-year-old married Indian woman with Pa Leng (Frigophobia), marked by intense fears of cold and panic attacks. She experienced a profound fear that exposure to cold air, especially on her back, would result in severe health consequences, including death.</div></div><div><h3>Results</h3><div>Cases of Pa Leng (Frigophobia) were examined in four studies from Asia, including case reports from Singapore and Turkey and a case series from Sri Lanka. Among the 113 cases analyzed, 69% were female. Patients exhibited avoidance behaviors, such as staying indoors and avoiding cold environments, and compensatory behaviors like wearing excessive clothing and using external heat sources. The condition followed a chronic course, with some experiencing continuous symptoms for years. Treatment approaches varied, with psychotherapy, psychoeducation, and low-dose anxiolytics or antidepressants used in different cases, though outcome data remained limited.</div></div><div><h3>Conclusion</h3><div>This review highlights the underexplored condition of Pa Leng (Frigophobia), emphasizing its clinical features, cultural influences, and chronic course. Cultural beliefs and life experiences play a key role in its development, while treatment with antidepressants and psychological interventions shows promise. Further cross-cultural research is needed to improve understanding and treatment strategies.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 2","pages":"Article 100889"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota alterations in patients with ADHD and depression: Asystematic review","authors":"Jhoan Vidal Utria-Castro ,&nbsp;José Carlos Montes-Correa ,&nbsp;Juliana Andrea Adarme-Malaver ,&nbsp;Mariana Castro-Muñetón ,&nbsp;Mariana Sánchez-Gómez ,&nbsp;Juan Pablo Alzate-Granados","doi":"10.1016/j.psiq.2026.100908","DOIUrl":"10.1016/j.psiq.2026.100908","url":null,"abstract":"<div><div>The gut microbiota is a complex ecosystem that contributes to neuroimmune signaling and the gut–brain axis. Growing evidence links intestinal dysbiosis to neuropsychiatric conditions, including Attention-Deficit/Hyperactivity Disorder (ADHD) and Major Depressive Disorder (MDD), which frequently co-occur; however, shared microbial patterns underlying this comorbidity remain unclear. We conducted a systematic review following PRISMA guidelines to summarize gut microbiota alterations reported in ADHD, MDD, or both. PubMed, Scopus, Web of Science, and PsycINFO were searched for peer-reviewed human studies (case–control, cohort, or clinical trials) assessing gut microbiota composition, including taxonomic changes and diversity metrics. Eight studies met the inclusion criteria, and none directly examined individuals with comorbid ADHD and MDD. Across ADHD studies, findings suggested increased representation of Proteobacteria and reduced microbial diversity, particularly in pediatric samples. In MDD, studies more consistently reported decreased abundance of short-chain fatty acid (SCFA)-producing genera (e.g., Faecalibacterium, Coprococcus, Dialister) alongside higher levels of taxa associated with pro-inflammatory profiles. One study reported that Agathobacter abundance correlated with depressive symptoms among children with ADHD, supporting potential overlap between conditions. Despite heterogeneity in populations and methods, convergent signals included reduced SCFA-producing bacteria and increased Proteobacteria, pointing to inflammatory and metabolic pathways that may contribute to emotional and attentional dysregulation. The lack of studies focused on dual diagnoses represents a major gap. Future research should prioritize well-designed longitudinal and comorbidity-focused studies and evaluate microbiota-targeted interventions (e.g., probiotics) as potential adjunctive strategies for shared symptom domains.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 2","pages":"Article 100908"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147713999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La duloxetina desde la experiencia psiquiátrica a través del paciente con depresión. El dilema de los comprimidos frente a las cápsulas y su impacto en la adherencia al tratamiento","authors":"Cielo García-Montero ,&nbsp;Miguel A. Ortega ,&nbsp;Óscar Fraile-Martínez ,&nbsp;Miguel Angel Alvarez-Mon","doi":"10.1016/j.psiq.2026.100909","DOIUrl":"10.1016/j.psiq.2026.100909","url":null,"abstract":"<div><div>Duloxetine is a serotonin and norepinephrine reuptake inhibitor (SNRI) used in the treatment of various conditions, including major depressive disorder (MDD), generalized anxiety disorder (GAD), and neuropathic pain. Its mechanism of action increases the levels of serotonin and norepinephrine in the brain, thereby improving mood and relieving pain. Duloxetine is available in both tablet and capsule formulations, with common dosages of 30 mg and 60 mg, depending on the condition being treated. In addition to its therapeutic efficacy, treatment adherence is influenced by factors such as the patient's preference for a particular pharmaceutical format. Tablets are more stable and require fewer excipients, while capsules are easier to swallow and allow for extended release, although they are more expensive and less stable. Since adherence is a key factor in treatment effectiveness, the question arises: How do pharmaceutical format preferences influence adherence to duloxetine? To address this issue, a structured 25-item multiple-choice survey was administered to psychiatrists to assess their perception of how duloxetine's pharmaceutical format (tablets vs. capsules) impacts adherence, patient satisfaction, and the overall treatment experience. The findings aim to optimize prescribing strategies based on patients' needs and preferences, ultimately improving adherence and treatment effectiveness.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 2","pages":"Article 100909"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147713463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifestaciones psiquiátricas y virus de la inmunodeficiencia humana","authors":"Valentina Belalcazar Vivas ,&nbsp;Jordi Blanch Andreu","doi":"10.1016/j.psiq.2025.100757","DOIUrl":"10.1016/j.psiq.2025.100757","url":null,"abstract":"<div><h3>Introduction</h3><div>Due to the advent of antiretrovirals, the morbidity and mortality associated with HIV have been significantly reduced in the past decades. A discernible connection exists between the infection and psychiatric disorders, primarily due to the compromise of the central nervous system, from which various psychiatric complications arise. These complications may be organic, such as HIV-associated neurocognitive disorders or organic mood disorders, or they may result from environmental and sociodemographic factors associated with the challenges of living with this disease.</div></div><div><h3>Methods</h3><div>This narrative review aims to explore the most common psychiatric manifestations in patients with HIV, with specific objectives focused on understanding how these conditions affect adherence to pharmacological treatment and overall quality of life.</div></div><div><h3>Results</h3><div>Depression is the most frequently reported psychiatric comorbidity in these patients. Mental health disorders have a negative impact on treatment adherence but treating them reduces the likelihood of poor adherence. Individuals with these comorbidities report a lower quality of life compared to their peers; however, good adherence contributes to improved quality of life scores.</div></div><div><h3>Conclusion</h3><div>It is important that governments strengthen their health programs to address HIV and psychiatric comorbidities, ensuring the protection of the human and civil rights of this population, so they can enjoy a long and dignified life.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 1","pages":"Article 100757"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síndrome de Cotard. Desafío del diagnóstico diferencial: a propósito de un caso","authors":"Ana Pérez Romero ,&nbsp;Rocío Ramallo Castillo ,&nbsp;Ana Ruiz Moliner ,&nbsp;Celia Muñoz Cauqui ,&nbsp;Ana Piña Baena","doi":"10.1016/j.psiq.2025.100871","DOIUrl":"10.1016/j.psiq.2025.100871","url":null,"abstract":"<div><div>Cotard's syndrome is defined as a nihilistic delusion that one is dead, has lost one's soul, lacks functioning organs, or is rotting internally. It usually reflects severe brain dysfunction, especially in areas related to self-perception, emotion, and sensory integration. It has been identified more frequently in older adults and has been linked to several psychiatric, neurologic, and autoimmune disorders. There is limited literature pointing towards association with catatonia. However, catatonia may have neurobiological foundations that could explain certain similarities in symptoms and response to treatment. For example, right parietal lobe involvement. Below, we present a clinical case that showcases differential diagnosis between depression with psychotic symptoms and dementia, or between both in comorbidity. In its initial stages, the symptoms may be similar and the neuroimaging insignificant, as is the case of our patient. In these cases, only the evolution of the symptoms and the response to treatment can clear up the diagnosis. Electroconvulsive therapy should be considered as an option given its effectiveness in severe and prolonged depression and the absence of contraindication in dementia.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 1","pages":"Article 100871"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An observational study of long-term psychotropic use: patient perspectives of benefits and adverse effects","authors":"Kothai Ramalingam ,&nbsp;Pradeep Chandrasekaran ,&nbsp;Akash Thirumalai ,&nbsp;Balaji Kumar ,&nbsp;Bergin Vinads Aliver ,&nbsp;Nagappan Andiappan ,&nbsp;Arul Balasubramanian","doi":"10.1016/j.psiq.2025.100887","DOIUrl":"10.1016/j.psiq.2025.100887","url":null,"abstract":"<div><div>Psychotropic medications have improved the lives of people with mental disorders, and many people have gone on to live full lives with the help of these medications. Psychotropic medications have been associated with a variety of side effects, including neurotoxicity. It was an observational study with the aim of analyzing the patients’ perception of the benefits and adverse effects of long-term use of psychotropic drugs. This study was conducted for the period of 6 months (January – June 2023) and data of n = 101 were collected from the patients who had attended both the outpatient and inpatient psychiatric department of a tertiary care hospital. All the side effects are analyzed by using the Toronto side effect scale (TSES), and the data were analyzed with SPSS (version 27). In this study, 27 different psychotropic medications were prescribed. The most prescribed psychotropic medications are Clonazepam, Risperidone, and Sertraline. The overall Toronto side effect scale adverse effect frequency and severity were 35.24 ± 4.22 and 35.02 ± 3.85. The comprehensive qualitative response of the patients is categorized as medication helped them to cope with life: Helped to get by (n = 55), Helped to function well (n = 15), Problems with psychotropic treatment: withdrawal (n = 15), and Impact on self (n = 15). From this study, it was concluded that long-term use of psychotropics caused mild adverse effects as per the Toronto side effect scale. The quality of life after the treatment with psychotropics was found to be improved in all the patients.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 1","pages":"Article 100887"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trastorno neuropsiquiátrico autoinmune en pediatría: a propósito de un caso","authors":"María Albors Rossi,&nbsp;Laura Prieto Arenas,&nbsp;María Concepción Fernández Milián,&nbsp;Lucía Ros Pérez-Salamero,&nbsp;Pablo de Fez Febre","doi":"10.1016/j.psiq.2025.100880","DOIUrl":"10.1016/j.psiq.2025.100880","url":null,"abstract":"<div><div>The case of a 7-year-old patient is presented, with sudden onset of multiple motor and vocal tics following a streptococcal infection, suggesting PANDAS syndrome. On medical examination, elevated ASO levels were found. Other test, including CT, EEG, and ECG, were normal. The patient has received treatment with guanfacine, with improvement of symptoms observed. PANDAS syndrome is a neuropsychiatric disorder triggered by an autoimmune response following a streptococcal infection, with differential clinical diagnosis from Sydenham's chorea, tic disorder, and Tourette syndrome. Its treatment is comprehensive and includes cognitive-behavioral therapy, antibiotics, and psychopharmacological agents. Further studies are needed to better understand its pathophysiology and management.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"33 1","pages":"Article 100880"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}