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Papers by Mercedes Sarudiansky

Neuropsychiatric Disease and Treatment

Psychogenic nonepileptic seizures (PNES) are paroxystic and episodic events associated with motor... more Psychogenic nonepileptic seizures (PNES) are paroxystic and episodic events associated with motor, sensory, mental or autonomic manifestations, which resemble epileptic seizures (ES), but are not caused by epileptogenic activity. PNES affect between 20% and 30% of patients attending at epilepsy centers and constitute a serious mental health problem. PNES are often underdiagnosed, undertreated and mistaken with epilepsy. PNES are diagnosed after medical causes (epilepsy, syncope, stroke, etc.) have been ruled out, and psychological mechanisms are involved in their genesis and perpetuation. For psychiatry, there is not a single definition for PNES; the DSM-IV and ICD-10/11 describe the conversion and dissociative disorders, and the DSM-5 describes the functional neurological disorders. However, patients with PNES also have a high frequency of other comorbidities like depression, particularly trauma and post-traumatic stress disorder. It has been postulated that PNES are essentially dissociations that operate as a defensive psychological mechanism that use the mind as a defense to deal with traumas. With the advent of VEEG in the 90s, the recognition of PNES has significantly increased, and several psychological treatments have been developed. In this manuscript, we carried out a state-of-the-art review, with the aim to provide a critical approach to the extensive literature about PNES, focusing on diagnostic aspects, the primary management, and the available treatments that have been shown to be effective for the improvement of PNES.

Psicologia USP

Resumen La perspectiva del paciente se presenta como algo importante a tener en cuenta para la co... more Resumen La perspectiva del paciente se presenta como algo importante a tener en cuenta para la comprensión del padecimiento y para lograr un tratamiento efectivo. El objetivo de la presente investigación es indagar las trayectorias terapéuticas y las experiencias durante el recorrido terapéutico de pacientes con Crisis No Epilépticas Psicógenas (CNEP) pertenecientes a un Hospital General de la Ciudad Autónoma de Buenos Aires. Se realizaron entrevistas semiestructuradas a diez pacientes diagnosticados con CNEP. Para el análisis de los datos se utilizó una metodología cualitativa basada en los principios del análisis temático. Se ha identificado una categoría central: Itinerarios terapéuticos dentro del sistema etnomédico y tres subcategorías: (1) Diagnósticos Recibidos; (2) Recursos del sistema etnomédico y (3) Evaluaciones de los recursos utilizados. La dificultad de arribar a un diagnóstico y un tratamiento que permitiera mejorar las CNEP, así como el uso de distintas medicinas, fu...

Seizure

To understand the experience of drug-resistant epilepsy in patients from Argentina, a developing ... more To understand the experience of drug-resistant epilepsy in patients from Argentina, a developing nation. Method: A qualitative approach using semi-structured interviews was used to gain an in-depth and contextual understanding of the perspectives of 20 patients with DRE. Data collection and analysis were followed by an inductive and interpretive approach informed by the principles of thematic analysis. Results: Six main themes emerged: 1) Characteristics of the illness, including seizure features-unpredictability, presence of auras, physical and cognitive consequences-and how patients relate with the use of antiepileptic drugs; 2) interactions with health system, regarding the features of the Argentine's health system, and patient's health-seeking behaviours; 3) beliefs about the illness, including psychosocial, biological and folk explanatory models; 4) beliefs about how other people perceive them, which included prejudice, responsibility and overprotection; 5) self-perception, and 6) impact of the illness on their activities. Conclusions: This information might be useful to help in the development of a conceptual model of the impact epilepsy on patients' lives. Many of the topics mentioned as relevant in Argentina coincide with those highlighted in studies that were carried out in first-world countries. However, additional topics were also reported including the role of traditional healing in health-seeking behaviour and explanatory models of illness. It is important to understand these perspectives to develop appropriate psychosocial interventions for this specific population.

Seizure

To analyse the methods of reasoning with regard to patients' experiences of living with psychogen... more To analyse the methods of reasoning with regard to patients' experiences of living with psychogenic nonepileptic seizures (PNES) in Buenos Aires, Argentina. Method: A qualitative approach using semi-structured interviews was used to gain an in-depth and contextual understanding of the perspectives of five patients with PNES. Data collection and analysis were followed by an inductive and interpretive approach informed by the principles of thematic analysis. Results: Explanatory models and prototypes were identified from the patients' narratives. Four patients related their suffering regarding psychosocial causes-family conflicts, sexual harassment, and life changes, among others-. Hereditary and organic hypotheses appeared to be unspecific. Folk explanations were common to all participants (magic, witchcraft, energetic causes). Four patients used the term epilepsy as an illness prototype, focusing on seizures and the use of antiepileptic drugs. Three of them also compared their illness to other people's "attacks" (heart attacks, panic attacks, nervous breakdown). Only one of them referred to someone who was suspected of having epilepsy. Conclusion: Patients' psychosocial explanatory models are different from the results of previous studies because these studies indicate that most patients support somatic explanations. Patients also use folk explanations related to traditional medicine, which highlights the interpersonal aspects of the disease. Doctor-patient communication is essential for a correct understanding of PNES, resulting in better outcomes. It could also help to reduce the cultural distance between professionals and patients, leading to narrowing inequalities present in multicultural healthcare services.

REVISTA ARGENTINA DE CLINICA PSICOLOGICA

Las Crisis No Epilépticas Psicógenas (CNEP) representan un desafío clínico, debido a la complejid... more Las Crisis No Epilépticas Psicógenas (CNEP) representan un desafío clínico, debido a la complejidad de sus manifestaciones, etiología y comorbilidad. El objetivo de este artículo es presentar los tratamientos psicológicos disponibles para abordar y tratar las CNEP. Se ha llevado a cabo una búsqueda bibliográfica en las bases de datos Medline, Latindex, Redalyc, Cochrane Collaboration, EBSCO y Lilacs. Dentro de los abordajes diseñados para el tratamiento de las CNEP, se destacan tres modelos de intervención psicoterapéutica que han obtenido resultados favorables en la puesta a prueba de sus intervenciones: dos modelos cognitivo conductuales y el tratamiento aumentado de Terapia Interpersonal. Se discuten estos hallazgos en función de las limitaciones, tanto metodológicas como provenientes de los distintos estudios clínicos encontrados.

Epilepsy & behavior : E&B, Apr 28, 2017

Depression is the most frequent psychiatric co-morbidity in patients with epilepsy. Lifetime prev... more Depression is the most frequent psychiatric co-morbidity in patients with epilepsy. Lifetime prevalence of depression is reported more frequently in temporal lobe epilepsy and is estimated at 35%. This co-morbidity appears to be related with various mechanisms. The aim of this study was to determine the quality of life (QoL) of patients with pharmacoresistant epilepsy with and without co-morbid depression in an Argentinean population. Patients admitted to the video-EEG monitoring unit during the period 2010-2013 went through a standardized psychiatric assessment using SCID-I (Structured Clinical Interview for Axis I diagnoses of DSM-IV), BDI II (Beck Depression Inventory) GAF (Global assessment of functioning), and Q LES Q-SF (for quality of life). Patients were divided in two groups: with and without depression (according to DSM-IV). Sociodemographic data, BDI II scores, GAF, and quality of life (QoL) were compared between the two groups. Comparisons were made using Student's t...

Estado Politica Social Y Cultura Reflexiones Sobre Los Servicios Sociales Y De Salud 2011 Isbn 9788492613694 Pags 113 132, 2011

Psicologia Iberoamericana Num 2 Vol 21, 2015

Ansiedad, angustia y neurosis. Antecedentes conceptuales e históricos Anxiety, Angustia and Neuro... more Ansiedad, angustia y neurosis. Antecedentes conceptuales e históricos Anxiety, Angustia and Neurosis. A Conceptual and Historical Background Mercedes Sarudiansky 1 consEjo nacional dE invEstigacionEs ciEntíficas y técnicas facUltad dE psicología UnivErsidad dE bUEnos airEs RESUMEn La ansiedad es uno de los conceptos más estudiados e investigados en el campo de la salud mental, sobre el cual algunos autores han destacado su carácter multívoco y ambiguo. En este artículo se realiza un recorrido etimológico y conceptual sobre la ansiedad, intentando reflejar la variabilidad de contenidos que presenta este término en la actualidad, en sus distintos planos de abordaje. En primer lugar, se hace referencia a los antecedentes lingüísticos del vocablo "ansiedad", destacando las problemáticas surgidas a partir de la traducción de términos clave. En segundo lugar, se da cuenta de la perspectiva de distintos referentes de la psicopatología occidental sobre este concepto, así como de los criterios de clasificación propuestos. Posteriormente, se señala la relación del concepto de neurosis con las descripciones actuales sobre la ansiedad. Para finalizar, se destaca la importancia de considerar estas cuestiones tanto en el área clínica como en los terrenos académicos y de investigación.

Transformaciones Del Estado Social Perspectivas Sobre La Intervencion Social En Iberoamerica 2011 Isbn 978 84 92613 68 7 Pags 199 224, 2011

Mitologicas, 2007

based on original materials, the authors analyze the phenomenon of therapeutic complementariness ... more based on original materials, the authors analyze the phenomenon of therapeutic complementariness between cognitive psychotherapy and yoga practice. Specially, they focus on the grounds for psychotherapists' selection of yoga as a good strategy to their patients, in order to combine with psychotherapy. In this aim, they explore the professional's representations of yoga. Then, based on the material recovered among yoga users and therapists, they present yoga ideas and praxis about illness and health. After comparing the data from the two kind of specialists, they remark the difference between yoga and psychotherapy bases and theories, and at the same time which are the clues to the success of this treatment combination.

Investig Psicol, Aug 1, 2010

Neuropsychiatric Disease and Treatment

Psychogenic nonepileptic seizures (PNES) are paroxystic and episodic events associated with motor... more Psychogenic nonepileptic seizures (PNES) are paroxystic and episodic events associated with motor, sensory, mental or autonomic manifestations, which resemble epileptic seizures (ES), but are not caused by epileptogenic activity. PNES affect between 20% and 30% of patients attending at epilepsy centers and constitute a serious mental health problem. PNES are often underdiagnosed, undertreated and mistaken with epilepsy. PNES are diagnosed after medical causes (epilepsy, syncope, stroke, etc.) have been ruled out, and psychological mechanisms are involved in their genesis and perpetuation. For psychiatry, there is not a single definition for PNES; the DSM-IV and ICD-10/11 describe the conversion and dissociative disorders, and the DSM-5 describes the functional neurological disorders. However, patients with PNES also have a high frequency of other comorbidities like depression, particularly trauma and post-traumatic stress disorder. It has been postulated that PNES are essentially dissociations that operate as a defensive psychological mechanism that use the mind as a defense to deal with traumas. With the advent of VEEG in the 90s, the recognition of PNES has significantly increased, and several psychological treatments have been developed. In this manuscript, we carried out a state-of-the-art review, with the aim to provide a critical approach to the extensive literature about PNES, focusing on diagnostic aspects, the primary management, and the available treatments that have been shown to be effective for the improvement of PNES.

Psicologia USP

Resumen La perspectiva del paciente se presenta como algo importante a tener en cuenta para la co... more Resumen La perspectiva del paciente se presenta como algo importante a tener en cuenta para la comprensión del padecimiento y para lograr un tratamiento efectivo. El objetivo de la presente investigación es indagar las trayectorias terapéuticas y las experiencias durante el recorrido terapéutico de pacientes con Crisis No Epilépticas Psicógenas (CNEP) pertenecientes a un Hospital General de la Ciudad Autónoma de Buenos Aires. Se realizaron entrevistas semiestructuradas a diez pacientes diagnosticados con CNEP. Para el análisis de los datos se utilizó una metodología cualitativa basada en los principios del análisis temático. Se ha identificado una categoría central: Itinerarios terapéuticos dentro del sistema etnomédico y tres subcategorías: (1) Diagnósticos Recibidos; (2) Recursos del sistema etnomédico y (3) Evaluaciones de los recursos utilizados. La dificultad de arribar a un diagnóstico y un tratamiento que permitiera mejorar las CNEP, así como el uso de distintas medicinas, fu...

Seizure

To understand the experience of drug-resistant epilepsy in patients from Argentina, a developing ... more To understand the experience of drug-resistant epilepsy in patients from Argentina, a developing nation. Method: A qualitative approach using semi-structured interviews was used to gain an in-depth and contextual understanding of the perspectives of 20 patients with DRE. Data collection and analysis were followed by an inductive and interpretive approach informed by the principles of thematic analysis. Results: Six main themes emerged: 1) Characteristics of the illness, including seizure features-unpredictability, presence of auras, physical and cognitive consequences-and how patients relate with the use of antiepileptic drugs; 2) interactions with health system, regarding the features of the Argentine's health system, and patient's health-seeking behaviours; 3) beliefs about the illness, including psychosocial, biological and folk explanatory models; 4) beliefs about how other people perceive them, which included prejudice, responsibility and overprotection; 5) self-perception, and 6) impact of the illness on their activities. Conclusions: This information might be useful to help in the development of a conceptual model of the impact epilepsy on patients' lives. Many of the topics mentioned as relevant in Argentina coincide with those highlighted in studies that were carried out in first-world countries. However, additional topics were also reported including the role of traditional healing in health-seeking behaviour and explanatory models of illness. It is important to understand these perspectives to develop appropriate psychosocial interventions for this specific population.

Seizure

To analyse the methods of reasoning with regard to patients' experiences of living with psychogen... more To analyse the methods of reasoning with regard to patients' experiences of living with psychogenic nonepileptic seizures (PNES) in Buenos Aires, Argentina. Method: A qualitative approach using semi-structured interviews was used to gain an in-depth and contextual understanding of the perspectives of five patients with PNES. Data collection and analysis were followed by an inductive and interpretive approach informed by the principles of thematic analysis. Results: Explanatory models and prototypes were identified from the patients' narratives. Four patients related their suffering regarding psychosocial causes-family conflicts, sexual harassment, and life changes, among others-. Hereditary and organic hypotheses appeared to be unspecific. Folk explanations were common to all participants (magic, witchcraft, energetic causes). Four patients used the term epilepsy as an illness prototype, focusing on seizures and the use of antiepileptic drugs. Three of them also compared their illness to other people's "attacks" (heart attacks, panic attacks, nervous breakdown). Only one of them referred to someone who was suspected of having epilepsy. Conclusion: Patients' psychosocial explanatory models are different from the results of previous studies because these studies indicate that most patients support somatic explanations. Patients also use folk explanations related to traditional medicine, which highlights the interpersonal aspects of the disease. Doctor-patient communication is essential for a correct understanding of PNES, resulting in better outcomes. It could also help to reduce the cultural distance between professionals and patients, leading to narrowing inequalities present in multicultural healthcare services.

REVISTA ARGENTINA DE CLINICA PSICOLOGICA

Las Crisis No Epilépticas Psicógenas (CNEP) representan un desafío clínico, debido a la complejid... more Las Crisis No Epilépticas Psicógenas (CNEP) representan un desafío clínico, debido a la complejidad de sus manifestaciones, etiología y comorbilidad. El objetivo de este artículo es presentar los tratamientos psicológicos disponibles para abordar y tratar las CNEP. Se ha llevado a cabo una búsqueda bibliográfica en las bases de datos Medline, Latindex, Redalyc, Cochrane Collaboration, EBSCO y Lilacs. Dentro de los abordajes diseñados para el tratamiento de las CNEP, se destacan tres modelos de intervención psicoterapéutica que han obtenido resultados favorables en la puesta a prueba de sus intervenciones: dos modelos cognitivo conductuales y el tratamiento aumentado de Terapia Interpersonal. Se discuten estos hallazgos en función de las limitaciones, tanto metodológicas como provenientes de los distintos estudios clínicos encontrados.

Epilepsy & behavior : E&B, Apr 28, 2017

Depression is the most frequent psychiatric co-morbidity in patients with epilepsy. Lifetime prev... more Depression is the most frequent psychiatric co-morbidity in patients with epilepsy. Lifetime prevalence of depression is reported more frequently in temporal lobe epilepsy and is estimated at 35%. This co-morbidity appears to be related with various mechanisms. The aim of this study was to determine the quality of life (QoL) of patients with pharmacoresistant epilepsy with and without co-morbid depression in an Argentinean population. Patients admitted to the video-EEG monitoring unit during the period 2010-2013 went through a standardized psychiatric assessment using SCID-I (Structured Clinical Interview for Axis I diagnoses of DSM-IV), BDI II (Beck Depression Inventory) GAF (Global assessment of functioning), and Q LES Q-SF (for quality of life). Patients were divided in two groups: with and without depression (according to DSM-IV). Sociodemographic data, BDI II scores, GAF, and quality of life (QoL) were compared between the two groups. Comparisons were made using Student's t...

Estado Politica Social Y Cultura Reflexiones Sobre Los Servicios Sociales Y De Salud 2011 Isbn 9788492613694 Pags 113 132, 2011

Psicologia Iberoamericana Num 2 Vol 21, 2015

Ansiedad, angustia y neurosis. Antecedentes conceptuales e históricos Anxiety, Angustia and Neuro... more Ansiedad, angustia y neurosis. Antecedentes conceptuales e históricos Anxiety, Angustia and Neurosis. A Conceptual and Historical Background Mercedes Sarudiansky 1 consEjo nacional dE invEstigacionEs ciEntíficas y técnicas facUltad dE psicología UnivErsidad dE bUEnos airEs RESUMEn La ansiedad es uno de los conceptos más estudiados e investigados en el campo de la salud mental, sobre el cual algunos autores han destacado su carácter multívoco y ambiguo. En este artículo se realiza un recorrido etimológico y conceptual sobre la ansiedad, intentando reflejar la variabilidad de contenidos que presenta este término en la actualidad, en sus distintos planos de abordaje. En primer lugar, se hace referencia a los antecedentes lingüísticos del vocablo "ansiedad", destacando las problemáticas surgidas a partir de la traducción de términos clave. En segundo lugar, se da cuenta de la perspectiva de distintos referentes de la psicopatología occidental sobre este concepto, así como de los criterios de clasificación propuestos. Posteriormente, se señala la relación del concepto de neurosis con las descripciones actuales sobre la ansiedad. Para finalizar, se destaca la importancia de considerar estas cuestiones tanto en el área clínica como en los terrenos académicos y de investigación.

Transformaciones Del Estado Social Perspectivas Sobre La Intervencion Social En Iberoamerica 2011 Isbn 978 84 92613 68 7 Pags 199 224, 2011

Mitologicas, 2007

based on original materials, the authors analyze the phenomenon of therapeutic complementariness ... more based on original materials, the authors analyze the phenomenon of therapeutic complementariness between cognitive psychotherapy and yoga practice. Specially, they focus on the grounds for psychotherapists' selection of yoga as a good strategy to their patients, in order to combine with psychotherapy. In this aim, they explore the professional's representations of yoga. Then, based on the material recovered among yoga users and therapists, they present yoga ideas and praxis about illness and health. After comparing the data from the two kind of specialists, they remark the difference between yoga and psychotherapy bases and theories, and at the same time which are the clues to the success of this treatment combination.

Investig Psicol, Aug 1, 2010