Psychiatry and Neuroscience Update From Epistemology to Clinical Psychiatry. Vol. IV.

GARGIULO, P.A.; MESONES ARROYO, H.L.

Springer-Nature Switzerland AG

Lugar: Cham ; Año: 2021 p. 677

978-3-030-61720-2

Preserving the tradition assumed in the previous volumes, the included chaptersare written by researchers fully dedicated to their subjects. The Part I isabout epistemological considerations regarding the study of normal andabnormal human behaviors. It includes fourteen chapters.In Chap. 1, Prof. Juan Ernesto Calderón considers that psychiatric clinicalresults should be considered behind the Popperian demarcation criterion. Theauthor prefers the other method. He proposes that it is the case of the Inferenceto the Best Explanation (IBE), suggesting that this method has enough epistemicstrength. By this way, he proposes an overcoming of Popperian falsacionism.Furthermore, this method is proposed as a tool which helps explainresearch and clinical practice, and enquire into Evidence-Based Medicine(EBM). This chapter constitutes a rigorous and interesting approach in thefield of epistemology of science.Chapter 2, written by Prof. Miriam Dolly Arancibia de Calmels, startswith some critical considerations about the notions extracted, most of thetimes decontextualized, from Kant. Recently, multiple disciplines, such aspedagogy and neuroscience, give new life to the old philosophical questionregarding freedom or determinism. In this context, this chapter tries to findnew anthropological approaches to resolve problems of today?s teachers inthe classroom. The studies of empathy according to Edith Stein is consideredand analyzed in a bright form.In Chap. 3 Prof. Ricardo Aranovich speculates in a valid way the links ofhappiness, agreeing with oneself, the life project, and the possibility andmeaning of falling in love. The imperative of fitting with the personal self,with myself, and the condition of happiness is highlighted. The notion of happinessas the unrenounceable goal of life searching for unity with itself, andovercoming difficulties of its circumstance as means of realization of the lifeproject is discussed in an interesting and profound way.The Chap. 4, written by Gargiulo and Crespo, is dedicated to a differentiationbetween causal explanations and freedom. In this chapter, the role ofnature is compared with psychological or psychoreactive influences.Ontological naturalism is described as a prevalent belief today in the world,inducing a naturalistic worldview in the narrow sense. It implies the reductionof the objects of knowledge to nature, to physical and biological things andprocesses. Some objections of philosophical origin are proposed, delimitinga level of ?understanding? independent of naturalistic explanations.PrefacexIn Chap. 5, Dr. Osvaldo Agamenonni describes in a very interesting writingthe evidences in favor of self-organized mechanisms in the brain. Thisschedule may be applied to conditioning. He starts from Perceptual ControlTheory (PCT), presented in the 1970s, aiming to try a causal explanatoryapproach to some behaviors. Special attention is given to feedback controland to self-organizing theories, starting from the cognitive cycle, alsodesigned as an action-perception loop. This author highlights the importanceof the brain?s adaptive mechanisms.In Chap. 6, Dr. María Teresa Gargiulo analyzes the concept of dynamis inthe Treaty on Ancient Medicine, a part of the Corpus Hippocraticum. Thecomplementation between philosophy and medicine is considered as an interestingparadigm. The author considers this concept of dynamis a core concepton which a particular epistemological view is built. Additionally, she considersthat a very relevant hermeneutical tradition is presented in this writing asthe birth of a scientific medicine. The author considers this concept as theorigin of an integration of a new model of scientific explanation.Prof. Dr. Rocco Genaro proposes, in Chap. 7, a rigorous analysis of consciousness,higher-order thought (HOT) theory, somatoparaphrenia, andinserted thoughts in schizophrenia. Various psychopathologies of self-awareness,such as somatoparaphrenia and thought insertion, might seem tothreaten the viability of the higher-order thought (HOT) theory of consciousnesssince it requires a HOT about one?s own mental state to accompanyevery conscious state. Somatoparaphrenia is a ?depersonalization disorder?characterized by the sense of alienation from parts of one?s body. Thoughtinsertion is the delusion that some thoughts are not ?one?s own? in somesense or are somehow being inserted into one?s mind by someone else.Gennaro argues that HOT theory has nothing to fear from thought insertionand can consistently explain what happens in this admittedly unusual case.In Chap. 8, Prof. Francisco Rego establishes neatly a relationship betweenbody and soul, following traditional concepts, and giving to this chapter abright condition. This author sustains that the soul does not have to be considereda nonexistent or mythological reality. It is considered that it must not beunderstood as a sensitive reality. In the opposite way, it may be considered asa real order that links to the body as substantial formal essential principle. Itdetermines the body in the order of being and its way of being. In other words,the soul makes man to be and to be what he is. At the same time, while enliveninghim, the soul founds all his spiritual and organic activities.Prof. Consuelo Martínez Priego develops, in Chap. 9, an elegant historicalexposition of thinking about medical pathology in Spain, starting it in somatologicalmedical criteria and arriving, with the thought of Juan Rof Carballo,at its fullest psychosomatic expression. In this proposal, the key concept isthe affective warp. The author analyzes the various sources that make up thepsychosomatic perspective. She gives an important emphasis to the roleplayed by neurology, but also to ?the constitutive process? of man. This studyis mainly centered in an historical perspective. The intention is an attempt toshed light on the present, fundamentally in the neuroscientific advances butalso in the humanization of medicine, which does not always share the samefate.PrefacexiChapter 10 is dedicated by Prof. Dr. Guilherme Messas and Prof. MelissaTamelini to the basement that phenomenological psychopathology gives topsychiatry. Important attention is paid to the case of schizophrenia and itsrelation to substance abuse. A detailed phenomenological study is applied toboth realities. The notion of dialectic is developed, highlighting the consequencesof its use for clinical practice. It is a founding writing in many ways,thought with particular rigor by experienced phenomenologists with wideclinical practice.In Chap. 11, Prof. Dr. Javier Bernacer and Francisco Güell develops thenotion of person in neuroscience. They start from the notion of cognitivismleading later to a comprehensive phenomenology. They stand out clearly thatthe attribution of the category of person applied to a living being cannot beconsidered as irrelevant at all. They stand out that a person is entitled torights, dignity, and duties by law. In this chapter, a very fruitful dialogue isestablished between classical philosophers and the recent conceptions oftheory of mind.Prof. Dr. Luis Echarte Alonso raises, in Chap. 12, the theme of the relationshipbetween neuroethics and beauty. He analyzes the ideas of the theoryof knowledge of Aldous Huxley and its relationship with this topic. Prof.Echarte presents Huxley?s ideas about Science and Art relationship in a fluidand interesting manner. This analysis consists in the comparison of two ofHuxley?s distinctions. He presents, on one hand, knowledge and understanding.On the other hand are emotions and beauty. The author concludes defendingHuxley?s notions that understanding and beauty are not fully accessibleto Neuroscience, but they orientate Neuroscience in the study of the humandecision-making process.In Chap. 13, Prof. Dr. Javier García Castro proposes solutions to the ontologicaland epistemological problems of consciousness. He considers that theproblem of consciousness has been considered very late in science. This topicimplies necessary to face very diverse and complex issues. It may be consideredas the main reason of this delay. Some solution attempts are described,analyzed, and discussed. Authors conclude that there is an intrinsic difficultyin objectifying the phenomenon of consciousness. Future maturation of scientificand philosophical knowledge may be necessary to clarify the ontologicaland epistemological foundations of consciousness.In Chap. 14, Prof. Dr. Michel Bourin and Prof. Dr. Monique Bourin referto historical differences in the anxiety perception. A diagnostic considerationabout the present condition is drawn remembering that we now have morerisk factors in our environment due to stress, urban violence, and the vagariesof employment. In other words, it is attributed to modifications in the environmentalconditions. For most of us, they argue, factors such as housing,sanitary conditions, and food have been improved over time. However, anxiety,panic attacks, and fear of old age, illness, and death remain. In this chapter,an historical approach is developed in an interesting and documentedway.In the Part II of the book, bridges between basic neurosciences and thehuman brain are attempted. The first example of this is Chap. 15. In it, Dr.Luis Felipe Sarmiento Rivera and Prof. Dr. Amauri Gouveia Jr. review thePrefacexiieffects of neurotransmitters and hormones in human decision-making. Theytake into account the difficulties in approaching this human behavior, consideringthe perspectives from which these decisions have been studied. It is thecase of variables related to the cost and benefits of a decision (economic decisions),involving social bonding (social decisions), social behavior and mating,and moral decisions that relates moral principles. In this chapter, theyfocus on the specifically induced actions of neurotransmitters (dopamine,Arginine-Vasopressin) and neuro-hormones (oxytocin, testosterone, stresshormones). The psychobiological interaction between such hormones andneurotransmitters and their relations in the decision-making process isdetailed and commented in a lucid and interesting manner.In Chap. 16, Occhiepo and coworkers, directed by Prof. Dr. ClaudiaBregonzio, describe in depth the role of glial cells in schizophrenia. The roleof Angiotensin II is focused. They begin with the fact that it is well knownthat schizophrenia illness has been related to a wide pluri-factorial etiopathogenesis(gene factors, neuroinflammation, and the brain microenvironment?salterations, etc.). Glial cells are considered important elements in the brainmicroenvironment. They have a relevant role in synaptic establishment andfunction, neuroinflammation, metabolic and ion homeostasis, among others.They are today an important topic of study in numerous researches on schizophreniaetiopathology. The role of Angiotensin II in this context is carefullydescribed. Angiotensin II has been involved in several pathologies, and nowits role in schizophrenia is proposed. A special reference to AT1-R involvementis developed regarding this illness. The chapter is written in a lucidmanner.The workgroup directed by Dr. María Graciela López Ordieres describes,in Chap. 17, the possible role of Somatostatin and Neurotensin systems inschizophrenia. Due to its complexity, it is thought that the pathophysiology ofthis illness goes beyond dopamine dysfunction, including also glutamate,GABA, serotonin, and acetylcholine systems. These neurotransmitters maybe interacting with neuropeptide systems. In schizophrenic patients it hasbeen reported that GABA interneurons, containing parvalbumin and somatostatin,are reduced, suggesting that it may be related to this illness.Neurotensin is closely related to dopamine transmission. After central administrationit produces biochemical and behavioral effects that resemble thoseobserved in a systemic administration of antipsychotic agents. Since peptidesdo not cross the blood-brain barrier properly, new peptide analogues are synthesized,aiming to resist enzymatic degradation, and entering to the braincrossing barriers. The above-mentioned peptides interact with neurotransmittersystems that has been related to pathophysiology of schizophrenia. Thesefacts improve our knowledge of this psychosis and may constitute new alternativesfor its treatment.Prof. Dr. Michel Bourin actualizes, in Chap. 18, our conceptions about themechanism of action of benzodiacepines. The role of these drugs on GABAand serotonin receptors, the action of serotonin reuptake inhibitors, and glutamineand neuropeptides are described and analyzed. The action ofNeuropeptides in anxiety is a matter of extensive review (cholecystokin,corticotropin-releasinghormone, substance P and neurokinins, galanin, oxy-Prefacexiiitocin, atrial natriuretic peptide). Some interactions are studied (glutamateregulating GABA activity, Adenosine interactions with serotonin and GABA).The effect of a high number of neurotransmitters and hormones on anxiety isreviewed, giving an interesting preclinical and clinical relevance to thischapter.In Chap. 19, the group led by Prof. Dr. Mariela Pérez focuses on the learningprocesses involved in benzodiacepine dependence. From its prescriptionto dependence is studied in a rigorous manner. The context-dependent associativelearning process underlying BZD tolerance and dependence is analyzed.Authors postulate that long-lasting neuroadaptations are present in thelimbic system. Repeated drug exposure is necessary aiming to induce alterationsin synaptic plasticity, such as glutamate synaptic modifications in brainstructures related to memory formation. These structures are mainly the hippocampus,the reward system, the ventral tegmental area, the nucleus accumbens,and the frontal cortex. The chapter is clear and comprehensive, withscientific and didactic merits.The group of Prof. Dr. Mariela Pérez contributes again in Chap. 20,describing the molecular mechanisms implied in acute traumatic brain injury(TBI). A description of the effects of neuro-inflammation in higher-ordercognitive processes is described. The fact that an important number of patientsreport chronic disabilities long after the initial injury event is analyzed andexplained mentioning mechanisms acting after the early mechanical damage.A secondary brain injury is described as caused by metabolic, synaptic andvascular alterations, neuro-inflammatory processes, and oxidative stress.Behavioral, affective, cognitive, and general psychological changes areclearly detailed by authors. This chapter constitutes an interesting linkbetween neuropathology and altered human behavior.Prof. Dr. Michel Bourin contributes again with a very interesting chapterstarting from the physiology and following with the pharmacology of melatonin.Chapter 21, didactic and detailed, starts with historical considerationsabout the role of melatonin. Prof. Bourin also describes an important numberof pharmacological properties of melatonin, such as antioxidant effects,oncostatic, anti-aging, an agent in the immune system, and, recently, a hypnoticpower of melatonin as a ?sleep hormone.? Its role as a hypnotic inwomen and the elderly is referred. The role of melatonin in the resynchronizationof our biological clock is detailed. Its efficacy has been observed in thetreatment of the circadian rhythm desynchronization syndromes. In thesecases it must be emphasized that a melatonin intake may be useful in thetherapeutic arsenal of the management of insomnia. It may also be interestingpromoting a better sleep.In Chap. 22, Daniel Cardinali and Daniel Vigo postulate a cytoprotectiveeffect exerted by melatonin. They consider the metabolic syndrome (MS) asan example. In this clinical entity, an important number of risk factors forcardiovascular disease are recognized. It is the case of elevated blood pressure,hyperinsulinemia, glucose intolerance, and dyslipidemia. The authorsdiscuss the role chronobiotic/cytoprotective properties of melatonin mayhave in the prevention and treatment of MS. As a relevant fact, Melatoninlevels are consistently reduced in MS. Improvement of sleep efficiency andPrefacexivantioxidant and anti-inflammatory properties that derive partly from its roleas a metabolic regulator and mitochondrial protector have been highlighted.The chapter analyzes the actions of melatonin that are relevant for the attenuationof inflammatory responses in MS. It is found that melatonin is effectivein curtailing MS in animal models of hyperadiposity and ischemic and nonischemicheart failure.José Burgos and Juan Galeazzi review, in Chap. 23, a neural-network simulationmodel of a possible role of the hippocampus in Pavlovian conditioning.In this model it is suggested by authors that the hippocampus sends adiffuse discrepancy signal. It would lead to modifications in modulation efficacies,starting from synapses of primary-sensory areas and to exerting effectson polysensory areas. The authors hypothesize that such modulations significantlymodify signal Pavlovian conditioning. Additionally, it may be thinkthat Hippocampal lesions have detrimental effects. The study was conductedusing two computer simulations. Finally, the authors discuss the limitationsand future directions of the model.In the next four chapters, natural compounds are studied aiming to findpsychopharmacological effects. A group of three chapters is dedicated to thesearch for compounds with biogenic effects. Two chapters were written bymembers of the Faculty of Agrarian Sciences of the National University ofCuyo, one comes from the Hong Kong Polytechnic University, and a finalclinical chapter evaluates the possible application of natural compounds.The first of these chapters, Chap. 24, is directed by Prof. Alejandra BeatrizCamargo. The team search for neuroprotective compounds in Brassica vegetables.This Brassicaceae family includes several vegetables such as broccoli,cabbage, cauliflower, radish, kale, and rocket, among others. This group hasbeen associated with antioxidant, anti-inflammatory and anticarcinogeniceffects. Brassica plants are rich in several neuroprotective compounds likeisothiocyanates, phenolic compounds, vitamins, minerals, and carotenoids.The authors present a review of the main compounds and demonstrate theneuroprotective effects of Brassica vegetables. Their mechanism of action isalso analyzed. Some considerations on their positive effects in neurologicaldisorders are also given.The second study in this line is Chap. 25, written by the team directed byLeonor Deis. In this chapter, the biological action of colored compoundspresent in fruits and vegetables is reviewed. The action of carotenes, lycopene,anthocyanins, flavanols, and lutein is evaluated. The authors mentionprevious studies in which the intake of plant foods like blueberries decreasesthe risk of obesity, diabetes, heart disease, and, mainly, overall mortality. Theauthors recommend the consumption of five portions of fruit and vegetablesper day. They conclude that an important number of active biological compoundsare present in vegetables, highlighting polyphenols. They mentionepidemiological studies and associated meta-analyses strongly suggestingthat long-term consumption of diets rich in plant polyphenols offer protectionagainst development of cancers, cardiovascular diseases, diabetes, endothelialdysfunction, osteoporosis, and neurodegenerative diseases. Furthermore,it has been postulated that polyphenols may have relevant effects as antihypertensive,anti-inflammatory, bactericide, antimutagenic, and antitumoralPrefacexvagents. The study constitutes an interesting set of arguments in favor of theconsumption of natural products of plant origin as inducers of psychotropiceffects.Chapter 26, directed by Professors Benjamin Yee and William Chi-SingTai, gives additional arguments in the same line. They formulated an inputfrom herbal medicines in the gut-brain communication perspective. Thischapter is centered on herbal medicine, depression, anxiety, microbiome, andgut-brain axis. Herbal remedies are here proposed in neuropsychiatric diseases.The microbiota transplantation and the possibility of a herbal modificationsof the gut microbiota are studied in an interesting and detailed manner,suggesting new treatment ways. Potential benefits of herbal medicines andrelated supplements are postulated as possible novel therapeuticperspectives.In Chap. 27, Prof. Dr. Eric Wainwright proposes new treatment possibilities,including natural compounds. He analyzes the role of the Mediterraneandiet, omega-3, and nutrigenomics in primary prevention. He recommendsphysical exercise as a cornerstone in the management of many disorders. It isthe case of Alzheimer?s disease, Parkinson?s disease and stroke. He clearlypoints out that neurodegenerative disorders are frequently comorbid withdepression. He proposes new strategies like modifiable lifestyle factors andpsychoeducation. It is postulated here that these variables should improvecurrent treatment results. This chapter constitutes a relevant place for reflectionon new therapeutic possibilities.Prof. Dr. Gustavo Tafet and Dr. Diego Feder review, in Chap. 28, the relationshipsbetween environmental and psychoneurobiological factors. Thisstudy emphasizes the role of environmental and psychoneurobiological factorsin the interface between stress and depression. The relevance of resiliencein this situation is highlighted. They remind us that chronic stress isinvolved in the origin and development of depression. The authors also discusslong-lasting effects of stressful experiences throughout life, and mainlyin the early stages of life. Increased activation of the HPA axis, leading tohypercortisolism, plays a role in chronic stress and depressive disorders. Thischapter is interesting, and links in a valid manner neurobiological findingsand clinical situations.In Chap. 29 the workgroup of Prof. Dr. Francisco Barrantes gives interestingevidences about the impact of Apolipoprotein E (ApoE) allelic variantson Alzheimer?s disease (AD). ApoE is a lipid-transport protein. The mainfunction of ApoE is to deliver lipids to cell-surface receptors. The authorspropose that it is involved in the pathogenesis of AD. They propose that carriersof the APOEε4 isoform of the gene are at higher risk than APOEε3 carriersdeveloping sporadic AD. ApoE is a lipid-transport protein. Its mainfunction is to deliver lipids to cell-surface receptors. This chapter proposesnew possibilities of late-onset variant of AD (LOAD) diagnostic and potentialnew therapeutics.The group directed by Prof. Dr. Claudia Hereñú develops, in Chap. 30 ananalysis of cognitive and emotional status in Parkinson?s disease (PD). Theyclaim that regardless of the well-characterized, well-known motor symptoms,the presence of non-motor symptoms (cognitive dysfunctions and emotionalPrefacexvidisturbances) are underestimated. The pathophysiology of PD (degenerationof the nigrostriatal dopaminergic pathway) implies affectation of other criticalareas, such as basolateral amygdala and hippocampus. Recent studies areaddressed. Neuro-circuitries, regulation networks, and possible therapeuticapproaches in different Parkinsonism experimental models are discussed.The chapter constitutes an interesting example of correlations between neuralpathology and behavior.In Part III the relationship between neurosciences, teaching, and the roleof social environment are considered. In Chap. 31, written by LucasRodríguez, José Eduardo Moreno, and Belén Mesurado, relationships in childrenand adolescents are studied. Authors considere that positive developmentcontributes to mental health problems prevention. Actually, socialabilities improve the contact and relation with other persons. They propose,citing concepts of Harry Stack Sullivan, that friendship is an opportunity tolearn about conflict and negotiation. In this context, authors sustain that childrenand adolescents develop perspective taking skills and empathic concern.Using specific tests, the chapter highlights the role of honesty, perspectivetaking, and empathic concern as predictors of friendship quality. This studycontains a relevant set of findings applicable by parents and educators.Santiago Resett and Belén Mesurado analyzes bullying and cyberbullyingin adolescents in Chap. 32. A meta-analysis is done about the effectiveness ofinterventions. The intention is to critically evaluate the effectiveness of interventionsdirected to reduce behaviors like bullying, victimization, cyberbullying,and cybervictimization in adolescents. They found that bullyingprograms were a bit more effective than cyberbullying programs. Additionally,they found that the effect size of the intervention programs on victimizationand cybervictimization was similar. The authors finally give some suggestionsfor future studies. This chapter, like the previous one, is a study of highinterest for educators.In Chap. 33 Celina Korzeniowski, Mirta Ison, and Hilda Difabio proposean interesting summary of the developmental trajectory of executive functionsfrom birth to adulthood. They characterize firstly the concept of executivefunctions (EF), and its role in cognitive and socio-emotional advance.These authors point out that longitudinal design studies have shown the relevanceof adequate EF development during childhood. They consider, accordingto the mentioned studies, that EF are reliable indexes as predictors ofimproved health, higher academic achievements, and better employment status.Conversely, these EF may be considered as acceptable indexes of a lowerincidence of disruptive social conduct, addictions, behavioral problems andpsychopathology in adulthood. The value of a measure of these functionsseems a relevant predictive value, and prevention should be influenced bythem.Our group presents, integrated with Prof. Dr. Jesús Escanero Marcén,María Soledd Soria, Manuel Guerra, and Pascual Ángel Gargiulo, in Chap.34, a review regarding approaches to learning at university, with special referenceto learning to learn. According to the Bologna reform, which points outthat teaching must be student-centered learning, we study here the competenceof ?learning to learn.? Metacognition is the central topic in this chapter.PrefacexviiIt begins remembering the contributions of our group in ?learning to learn,?working with learning styles, and the creation of a new questionnaire(CESEA, acronym in Spanish of the Questionnaire of Escanero and Soria) forexploration. The final purpose is to facilitate efficient learning for students.We mention also here contributions of our group. We worked with questionnairesexploring metacognitive and cognitive strategies. The intention was toprovide students with the best means for meaningful learning. Additionally,we recommend some methodologies to teachers. The self-perceptionapproach in students is also considered. Another goal here is improvement inteaching.In Chap. 35, an interesting study about the labor conditions of state schoolteachers is realized by Víctor Quiroga Calegari and Carlos A. Bonantini. Theypresent a comparative cohort study of Burnout Syndrome (BS). They assayan approach from psychosociology. In this interesting chapter, they displaypart of their study based on considering 9 cohorts (2008/2016). These cohortswere tested by a methodological triangulation, including application ofMaslach Burnout Inventory (MBI) as a psycho-technical tool, and, simultaneously,the analysis of observations and interviews of the Areas of Work LifeSurvey (AWS). They conclude with some suggestions for prevention at theinstitutional level, considering the dimensions of the syndrome.In Chap. 36, Prof. Dr. Raúl Gagliardi formulates a detailed review abouttraumatic situations and mental disorders in migrants, refugees, and asylumseekers. He meets here an important number of social problems. He mentionsand relates migrants? mental health, mental health problems, traumatic situations,adaptation, cultural consonance, ethnic density, asylum seekers, refugees,children, adolescents, and the socio-cognitive niche. He mentions anumber of important mental health problems that may be observed inmigrants. The mental issues discussed here are psychosis, depression, stress,anxiety, post-traumatic stress disorder (PTSD), and paranoid-like states. Inhis reflection, Gagliardi uses different approaches. ?Cultural consonance,??ethnic density,? and ?socio-cognitive niche? are discussed The experienceand sharp observations of a scholar in this subject are presented in a veryacute way.In Part IV, an effort to explain human pathological behaviors, tendencybridges from brain disorders to psychopathology is made. Here clinical projectionlines are cultured. The first chapter of the part, Chap. 37, is headed byGuillermo Alfonso and directed by Pascual Ángel Gargiulo. It is about thetransition to a dimensional system for Personality Disorders. In it, the mainadvances and limitations are considered. Starting from the debate betweencategorical and dimensional systems, the authors consider the position ofDSM-V. Here we retain the categorical classification of previous editions forPersonality Disorders (PD). However, an alternative evaluation system withdimensional bases is proposed. It is considered that this ?compromise solution?between the need to preserve the clinical tradition and the imperative ofovercoming important diagnostic restrictions opened the doors for a betterapproach. The authors conclude that dimensional alternatives do not solve allthe clinical problems but provide valuable resources tendency to a constantrefinement in this discipline.PrefacexviiiIn Chap. 38, headed by Ángel José Martín Gargiulo and directed byLuciana D´Alessio, a range of the psychiatric comorbidities of epilepsy arerevealed. New approaches and perspectives are provided. The coexistence ofepilepsy, depression, stress, anxiety, and psychosis is exposed in a detailedand interesting manner. The relevant role of depression is highlighted becauseit affects patient?s quality of life in a significant way. In the second place areanxiety disorders. They often generate severe problems that are sometimesunderestimated at the clinical level, despite the abundant evidences supportingtheir relevance. The problem of psychotic disorders in epilepsy is eventoday often controversial. A low number of studies on this subject have beenrealized. Furthermore, the psychopathological mechanisms behind themremain largely unknown. The problem of diagnoses and management of psychogenicnonepileptic seizures is also reviewed. The chapter constitutes avery relevant review of psychiatric comorbidity of epilepsy. Finally, theauthors argue that the management of stress and emotions in epileptic patientshas a direct impact on their quality of life.The group directed by Prof. Dr. Svetlozar Haralanov, in Chap. 39, proposesa very novel method in psychiatry. They present an integrative objectivequantification of individual locomotor behavior (LMB) during theexecution of the stepping test of Unterberger. It is here used in depressivepatients. Empirical data from 200 depressive patients compared to 200matched healthy controls was collected. The results demonstrated two contrastingpoles of affective psychoses, overinhibited (hypolocomotion) andoveractivated (hyperlocomotion). They propose a new dopamine hypothesisthat links hypolocomotion with underlying hypodopaminergia, and hyperlocomotionwith underlying hyperdopaminergia. Their findings and conceptualanalyses are discussed in the light of their clinical implications. The authorspostulate that the present method allows a more personalized treatment selection.The implications for their stratification and personalized treatment monitoringare here discussed.In Chap. 40, the group headed by Prof. Dr. Antonio Lobo describes thePsychosomatic and Liaison Psychiatry as the contribution from Psychiatry tothe general field of Medicine. In this analytical chapter, they postulate thatthis discipline is based on the traditional humanistic medical view but also onthe empirical or evidence-based approach. Using data coming from epidemiologicalresearch, they present examples of this approach. It has contributedto document the prevalence and incidence of psychiatric morbidity inmedical settings. The authors also mention other benefits of this methodology.They sustain that it contributes to the establishment of outcome, to theactuarial assessment of morbid risk, and to the efficacy of the treatment ofpsychiatric problems in medical patients. They also postulate that it may contributeto the conceptual construction of diagnosis and classification. Thetranscendence in this thought should be noted.Prof. Dr. Michel Bourin contributes, in Chap. 41, to the study of emotionsand cognitions in bipolar disorder (BD). The author remarks that organic orfunctional disturbances of processes of cognitive activities and the control ofthe emotional experience are likely to induce pathologies clinically characterized.Cognitive functioning and affective driving are commonly disturbed inPrefacexixBD. They imply behavioral disorders, social interactions being one of themain alterations. These alterations may be observed during acute episodesbut may also persist during the euthymic period. Emotional disturbances mayinfluence cognitive functioning. He concludes that functional abnormalitiesof cortico-subcortical neural networks could be at the origin. As a consequence,improving cognitive and emotional processes is an objective of therapeuticmanagement. The chapter opens new and interesting dimensions oftherapeutic objectives.The link between cannabis and psychoses is treated by Prof. Dr. EduardoLeiderman in Chap. 42. He sustains that, despite initial controversies, a causalrelationship may be established between tetrahydrocannabinol (THC) andpsychoses. This author alerts about the fact that the concentration of this substanceis increasing in confiscated cannabis products. The cause-effect associationbetween cannabis and psychosis is possible due to the strength ofevidences. It may be also be outstanding the consistency along the studies,biological gradient, temporality, plausibility, coherence, experimentation,and analogies. It has been observed that cannabis increases symptoms? severity,relapse, and length of hospitalization. Its use also deteriorates the functionalityof those individuals already affected by psychotic disorders. Presentfindings contraindicate the use of cannabis in relatives of patients sufferingschizophrenia, and mainly in teenagers, since they are the most vulnerableage group. Effort must be made to discourage the use of cannabis and treataddiction. The important risks related to its use are clearly exposed.In Chap. 43, the group integrated by Lic. María Andrea Delgado, Lic.Adriana Fochesato, Prof. Dr. Luis Isaías Juncos, and Prof. Dr. Pascual ÁngelGargiulo develops the theme of gut microbiota biomarkers in AutismSpectrum Disorders (ASDs). ASDs are considered here as a complex neurodevelopmentalgroup of disorders characterized by impairments in social andcognitive functions. The etiology is not clear, but it is thought that they arecaused by a combination of genetic predisposition and environmental factors.ASD patients present frequently comorbid medical conditions like gastrointestinal(GI) symptoms. Relevant evidences allow to sustain the importanceof the ?gut-brain axis? in the pathogenesis of ASDs. Interestingly GI disordersare correlated with severity of the brain disorder. Gut microbiota producesmetabolic products that may influence brain function and the correlativebehavior using diverse humoral mechanisms. The importance of consideringthese mechanisms and their consequences in the clinical picture is highlightedin this chapter, opening possibilities for the diagnosis and control ofthese clinical entities.Following with this thematic of child psychiatry, the group headed by Dr.Nicolás Fayed describes in Chap. 44 the findings of brain magnetic resonanceimaging in attention-deficit/hyperactivity disorder (ADHD). It is characterizedby attention deficiency, hyperactivity, and impulsivity. These symptomsare not present in all cases. New genetic findings are suggesting that ADHDmay be a hereditary disease in most cases. However, the etiology appears tobe multifactorial, but with a neurobiological base. Diverse elements likegenes interaction, environmental, perinatal, and psychosocial factors are usuallyhighlighted when considering its origin. In this chapter the authors reviewPrefacexxa series of MR techniques, including functional MRI and MR spectroscopy.A relevant number of functional MRI studies in ADHD have shown abnormalblood flow or abnormal metabolism within the brain. Findings are not specific.However, the authors postulate that larger series and standardizedmethodologycould delimitate groups and allow comparisons and generalization.An interesting group of complementary examinations are proposed hereaiming to reaffirm the clinical diagnostic.Continuing with the topic of complementary diagnostic methods in psychopathology,Dr. Fayed points in Chap. 45 the interest recently awakened byneuroimaging techniques applied to psychopathology. Among them,Magnetic Resonance Spectroscopy (MRS) stands out today. It obtains informationby applying magnetic waves to living tissues and, particularly, to thecentral nervous system. The fact that it allows characterizing metabolic orchemical abnormalities in some nosological entities enables an outstandingpresence to this complementary method of diagnosis in psychopathology.The authors detail their findings using hydrogen Magnetic ResonanceSpectroscopy. This method has been used in a number of important disorders,like autism spectrum disorders, delayed psychomotor development, mildcognitive impairment, and attention-deficit/hyperactivity disorder in childhood.In the elderly it has been applied to Alzheimer?s disease and Parkinson?sdisease studies. In the adult it has been used in somatoform disorders andfibromyalgia. The chapter gives additional relevance to the complementarymethods in psychiatry.In Chap. 46, Prof. Dr. Michel Bourin addresses the issue of prescriptionsin the elderly. Important modifications in the pharmacokinetic and pharmacodynamicparameters must be considered in the elderly subject. Some of themain modifications are kidney functions. Furthermore, aging can alter thesensitivity of receptors in the central nervous system. It mainly compromisesdopaminergic receptors. To address these changes, the author suggests somepsychopharmacological strategies in the elderly. Anxiety should be treatedwith selective serotonin reuptake inhibitors (SSRIs), paying special attentionto the doses. Hypnotics should be used with special care, due to the risk offalls during night. In the case of depressive disorders, all the tricyclics andtetracyclics can be used. However, it is important to note that they have atropiniceffects. The author mentions that SSRIs have not yet demonstrated efficacyin depression in the elderly. Mood stabilizers may be used, but with thesame care and limitations as in adults. Antipsychotics may be used in confusedor delirious states. Haloperidol must be applied in low doses due to therisk of drug-induced Parkinsonism. The chapter represents the synthesis of anexpert in psychopharmacology and clinical psychiatry, on a relevant topic.Mendoza, Argentina Pascual Ángel GargiuloBuenos Aires, Argentina Humberto Luis Mesones Arroyo