Trastornos Sensoriales y del Yo

• These notes discuss various topics related to processes of sensory information, disorders of the body and self, mental disorders, sleep disorders, and schizophrenia.

Sensory Information and Related Disorders

• Nosia refers to sensory information processing.
• Agnosia is the failure to process sensory information.
• Asomatognosia is the lack of recognition of one's own body.
• Asterognosia is the inability to recognize objects through touch.
• Prosopagnosia is the inability to recognize familiar faces.
• Agnosia digital is the inability to recognize one's own hand.
• Anosognosia is a lack of awareness of one's own disease.

Disorders of the Self

• Disorders of the bodily self include anosognosia, phantom limb syndrome, and asomatognosia
• Disorders of the psychic self are characterized with having an erroneous concept of who you are.
• Disorders of the governance of the self involve a sensation of being incapable of directing one's actions and thoughts.
• Depersonalization is when one feels different or changed.
• Derealization is when there is a sense of strangeness towards the external world

Mental Disorders

• Anxiety disorders include anxiety and anguish.
• Psychotic disorders include schizophrenia, delusions, and hallucinations.
• Affective disorders include mania and bipolar disorder.
• Somatoform disorders include hysteria.
• Obsessive-compulsive disorder (OCD) involves obsessions (ideas) and compulsions (rituals).
• Phobias are characterized by fear.
• Hypochondria is having concerns about diseases and illnesses.
• Dysmorphophobia is characterized by obsession about perceived defects with their own body.
• Somatoform disorders can manifest as conversion disorders from hysteria.

Schizophrenia

• Schizophrenia is a mental disorder characterized by distortions in reality.
• Positive symptoms of Schizophrenia: Delusions, hallucinations and thought disorders.
• Negative symptoms of Schizophrenia: Emotional dulling, poverty of speech, decline in motivation.
• Disorganized Symptoms of Schizophrenia: Disorganized or nonsensical speech or behavior.
• Prodromal phase: Symptoms before the full manifestation of the illness.
• Active phase: Presence of psychotic symptoms like hallucinations and delusions.
• Residual phase: symptoms no longer prominent.

Mood Disorders

• Mania: Includes elevated mood, racing thoughts.
• Hypomania: a milder form of mania.
• Bipolar Disorder: Cycles between mania and depression.
• Depression: Characterized by intense sadness.
• Delirium: The person may have false beliefs in relation to negation of the world.
  • Cotard Syndrome: A kind of delusion involving negation.
  • Ruin: Future full of unhappiness and fatalities.
  • Guilt: The person might think and feel they’ve done a horrible action and take the blame.
  • Catastrophe: believing the end of the world and destiny for destruction.
  • Hypochondriac: Believing that you have an illness when you are healthy.

Consciousness Disorders

• Quantitative: alterations of consciousness
  • Obnubilation: Clouding of consciousness.
  • Somnolence: Excessive sleepiness or drowsiness.
  • Sopor: State of reduced awareness or responsiveness.
  • Coma: A deep state of prolonged unconsciousness.
• Qualitative: alterations of consciousness
  • Delirium: A state of acute confused state.
  • Twilight state: Altered state of consciousness.
  • Stupor: State of unresponsiveness.
• Consciousness of the self - can be divided into:
  • Bodily self: This includes one’s identification with their own body
  • Psychic self: Including one’s self-perception and individual memories
  • Unity between self and world: The subjective relationship between oneself and the outside world

Sleep Disorders

• Circadian rhythm is nictemeral (day/night), and light marks the rhythm.
• The hypothalamus is the "clock."
• Substances that are cofactors of sleep: serotonin, acetylcholine, and GABA.
• Substances that maintain wakefulness: adrenaline, noradrenaline, dopamine, and catecholamines.
• Hormones involved in sleep: cortisol, prolactin, melatonin, and growth hormone.

Sleep Stages

• Non-REM (NREM) sleep allows the body to recover:
  • Stage 1: Light sleep, few minutes, somnolence and relaxation, but not fully asleep.
  • Stage 2: Light sleep, fully asleep, can be awakened easily.
  • Stage 3: Deep sleep, difficult to wake up, confusion and disorientation.
  • Stage 4. Very deep sleep, hard to despert, can suffer sleepwalking, and night terrors.
• REM (Rapid Eye Movement) sleep helps the psychic part recover:
  • Dreams occur, with increased cerebral activity, rapid eye movements, and increased heart rate.
  • Consolidates learning and memory. Lack of sleep contributes to dementia.
• The sleep cycle lasts 70-80 minutes.
  • Stage 1: 5%
  • Stage 2: 25%
  • Stages 3 and 4: 45%
  • REM: 25%
• In elderly people, sleep fragmentation occurs, with decreased time in deep sleep (Stage IV).

Duration of Sleep

• Duration of sleep includes sleep efficiency, time spent in bed asleep, sleep latency, and wake-ups.

Sleep disorders include dyssomnias and parasomnias.

• Dyssomnia, quantity and quality issues.
• Parasomnias are like nightmares during REM sleep.
• Insomnia: present at least 3 times per week for one month.
  • Can affect concentration, irritability, and mood.
  • Widespread in the elderly.Types of insomnia are classified by the moment of appearance and duration: conciliation or maintenance.
  • Conciliation insomnia- Difficult to fall asleep.
  • Maintenance insomnia- Waking up during the night and it takes some time or cannot fall asleep. -Transient: lasting less than 1 week.
  • Short Duration: lasting up to 3 weeks.
  • Chronic: Occurring for more than a month.
• Insomnia treatment includes hypnotics (benzodiazepines).
• Hyperinsomnia: Extended duration of sleep.
• Myoclonias: Sudden, involuntary muscle jerks
• Restless Legs Syndrome: Periodic sensations in the legs.
• Sleep medications affect a patient's memory, alertness, cognition.