Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-11T07:56:27.533Z Has data issue: false hasContentIssue false

Déficit emocional: un proceso adaptativo y evolutivo en infección por VIH

Published online by Cambridge University Press:  12 May 2020

C. Bungener
Affiliation:
CNRS URA 1957, Hospital de la Salpêtrière, París
J. J. Lefrère
Affiliation:
Servicio de Medicina Interna, Hospital de San Antonio, París
D. Widlöcher
Affiliation:
INSERM 302, Hospital de la Salpêtrière, París, Francia
R. Jouvent
Affiliation:
CNRS URA 1957, Hospital de la Salpêtrière, París
Get access

Resumen

El objetivo del presente estudio era valorar las perturbaciones emocionales y síntomas psicopatológicos en las primeras etapas de infección por virus de inmunodeficiencia humana (VIH). Setenta y un sujetos homosexuales positivos al VIH y dos grupos de sujetos negativos al VIH (32 homosexuales y 26 heterosexuales) fueron valorados en una entrevista estructurada por dos evaluadores adiestrados. Los resultados mostraron la presencia de perturbaciones emocionales ya en individuos asintomáticos positivos al VIH, incluso en ausencia de depresión y/o ansiedad caracterizadas. Este déficit emocional parecía ser más importante en etapas más avanzadas de la enfermedad. Los síntomas depresivos y ansiosos parecían tener una presencia ligera pero significativa en ambos grupos de hombres homosexuales. Este déficit emocional podría ser el reflejo de un proceso adaptativo a las consecuencias amenazantes de la infección por VIH. No se deben descuidar las perturbaciones emocionales, incluso leves, porque su reducción contribuye al bienestar psicológico de los sujetos positivos al VIH.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografia

Abrams, R, Taylor, MA, A rating scale for emotional blunting. Am J Psychiatry 1978; 135: 226–9.Google ScholarPubMed
Alpert, M, Rush, M, Comparison of affects in Parkinson's disease and schizophrenia. Psychopharmacol Bull 1987; 19: 119–20.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd Ed Revised (DSMIII- R). Washington DC: American Psychiatric Association, 1987.Google Scholar
Angrist, B, D’Hollosy, M, Sanfilipo, M et al, Central nervous System stimulants as symptomatic treatment for AIDS related neuropsychiatric impairment. J Clin Psychopharmacol 1992; 12: 268–72.CrossRefGoogle ScholarPubMed
Berger, JR, Kumar, M, Kumar, A, Fernández, JB, Levin, B, Cerebrospinal fluid dopamine in HIV-1 infection. AIDS 1994; 8: 6771.CrossRefGoogle ScholarPubMed
Bungener, C, Kosmadakis, C, Jouvent, R, Widlöcher, D, Emotional and psychopathological disturbances in HlV-infection. Progr Neuro-Psychopharmacol Biol Psychiatry 1993; 17: 927–37.CrossRefGoogle Scholar
Bungener, C, Lacour, C, Carton, S, Lefrère, JJ, Jouvent, R, Widlöcher, D. Emotional blunting and sensation seeking in HlV-infected individuais. Eur Psychiatry 1991; 6: 99102.Google Scholar
Catalan, J, Psychiatric manifestations of HIV disease. Baillière's Clinical Gastroenterology 1990; 4: 547–62.CrossRefGoogle ScholarPubMed
Center of Disease Control. Revision of the CDC surveillance definition for acquired immunodeficiency syndrome. MMWR 1987;36 (suppl SI): 3S15S.Google Scholar
Fell, M, Newman, S, Hems, M et al, Mood and psychiatric disturbances in HIV and AIDS: change over time. Br J Psychiatry 1993; 162: 604–10.CrossRefGoogle Scholar
Fernández, F, Adams, F, Levy, JK, Cognitive impairment due to AIDS-related complex and its response to psychostimulants. Psychosomatics 1988; 29: 3846.CrossRefGoogle ScholarPubMed
Fernández, F. Anxiety and the neuropsychiatry of AIDS. J Clin Psychiatry 1989; 50: 11 (supl): 914.Google Scholar
Fernández, F, Levy, J. Psychiatric Diagnosis and Pharmacotherapy of Patients With HlV-infection, AIDS and HIVinfection. In: Tasman, A, Goldfinger, S, Kaufmann, C, eds. Review Psychiat, vol 9. Section V. American Psychiatry Press 1991; 614–30.Google Scholar
Gala, C, Pergami, A, Catalan J et al, The psychosocial impact of HlV-infection in gay men, drug users and heterosexual. Br J Psychiatry 1993; 163: 651–9.CrossRefGoogle Scholar
Holmes, V, Fernández F, Levy, JK, Psychostimulants response in AIDS-related complex patients. J Clin Psychiatry 1989; 50: 58.Google Scholar
Jouvent, R, Partiot, A, Ammar, S, Pierson, A, Renault, B, Widlöcher, D, The dichotomy of anxious agitated/impulsive versus retarted/blunted depression: a new paradigm for biological and pharmaco-clinical research. The uses of fluoxetine in clinical practice. In: Freeman HL, ed. Royal Society o f Medicine Services International Congress and Symposium Series 1991; 183: 3544.Google Scholar
Jouvent, R, Vindreau, C, Montreuil, M, Bungener, C, Widlöcher, D, La clinique polydimensionelle de l‘humeur dépressive. Nouvelle version de I'échelle EHD. Psychiatr Psychobiol 1988; 3: 245–53.Google Scholar
Levenson, AL, Psychiatric aspects of AIDS. Psychiatric Hosp 1988; 3: 109–13.Google Scholar
Lipman, RS, Covi, L, Downing, RW, Pharmacotherapy of anxiety and depression: rationale and study design. Psychopharmacol Bull 1981; 17: 91–5.Google Scholar
Lisoprawsky, A, Jouvent, R, Agonistes dopaminergiques et émoussement affectif. L’Encéphale 1988; 15: 197200.Google Scholar
Maj, M, Psychiatric aspects of HIV-1 infection and AIDS. Psychol Med 1990; 20: 547–63.CrossRefGoogle ScholarPubMed
Mc Allister, RH, Hems, MV, Harrison, MJ et al, Neurological and neuropsychological performance in HIV seropositive men without symptoms. J Neurol Neurosurg Psychiatry 1992; 55: 143–8.Google Scholar
Montgomery, SA, Asberg, MA, A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382–9.CrossRefGoogle ScholarPubMed
Naber, D, Perro, C, Shick, U et al. Psychiatric Symptoms and Neuropsychological Deficits in HlV-infection. In: Bunney, et al, eds. Neuropharmacology.Berlin, Heidelberg: Springer Verlag, 1990; 745–55.Google Scholar
Ostrow, DG. Models for Understanding the Psychiatric Consequences of AIDS. In: Bridger, TP et al, eds. Psychological, Neuropsychiatric and Substance Abuse Aspects of AIDS. New York: Raven Press, 1988; 8594.Google Scholar
Ostrow, DG. Behavioral Aspects of AIDS. New York, London: Plenum Medical Book Company, 1990; 260.CrossRefGoogle Scholar
Perry, S, Fishman, B, Jacobsberg, L, Frances, A, Relationship over 1 year between lymphocyte subsets and psychosocial variables among adults with HlV-infection by human immunodeficiency vims. Arch Gen Psychiatry 1992; 49: 396401.CrossRefGoogle Scholar
Rabkin, JG, Williams, JB, Remien, RH, Goetz, R, Kertzner, R, Gorman, JM, Depression, distress, lymphocyte subsets, and human immunodeficiency virus symptoms on two occasions in HlV-positive homosexual men. Arch Gen Psychiatry 1991; 48: 111–9.CrossRefGoogle Scholar
Stein, M, Miller, AH, Trestman, RL, Depression, the immune system, and health and illness. Findings in search of meaning. Arch Gen Psychiatry 1991; 48: 171–7.CrossRefGoogle ScholarPubMed
Widlöcher, D. Le Ralentissement Dépressif. Paris: Presses Universitaires de France, 1983; 95.Google Scholar
Wilkie, F, Eisdorfer, C, Morgan, R, Loewenstein, D, Szapocznick, J, Cognition in early human immunodeficiency vims infection. Arch Neurology 1990; 47: 433–40.CrossRefGoogle Scholar
Williams, JB, Rabkin, JG, Remien, RH, Gorman, JM, Ehrhardt, AA, Multidisciplinary baseline assessment of gay men with and without HlV-infection II: standardized clinical assessment of current and lifetime pathology. Arch Gen Psychiatry 1991; 48: 124–30.CrossRefGoogle Scholar