Fragmentos aturdidos. La hibridación genérico-discursiva en 4.48 Psychosis de Sarah Kane

El presente trabajo se propone reflexionar sobre las principales problemáticas en torno a la representación de la subjetividad desplegadas en la obra de la dramaturga británica Sarah Kane a partir del análisis de su último drama, 4.48 Psychosis (1999). Con esta obra Kane lleva al extremo la búsqueda de colapsar ciertos límites para hacer de la forma y del contenido una misma cosa. La naturaleza fragmentaria del texto, la ausencia de trama o anécdota y la imposibilidad de identificar la presencia de uno o más personajes en escena, colaboran en la creación de esa atmósfera densa y ambigua que se correlaciona con el cuadro patológico del yo anticipado en el título de la pieza. Asimismo, la puesta en funcionamiento de estrategias de hibridación genérica, de apropiación, parodia y reescritura de diferentes modalidades discursivas (monólogos líricos, conversaciones entre doctor y paciente, el discurso de los cuestionarios médicos, de la psiquiatría y de las historias clínicas, citas extraídas de literatura de autoayuda o del libro bíblico del Apocalipsis, etc.) se constituye como práctica privilegiada para reflejar el descentramiento y la dispersión del sujeto y el borramiento de los límites entre realidad- ficción, sueño-vigilia, yo-otro

Fragmentos aturdidos. La hibridación genérico-discursiva en 4.48 Psychosis de Sarah Kane

El presente trabajo se propone reflexionar sobre las principales problemáticas en torno a la representación de la subjetividad desplegadas en la obra de la dramaturga británica Sarah Kane a partir del análisis de su último drama, 4.48 Psychosis (1999). Con esta obra Kane lleva al extremo la búsqueda de colapsar ciertos límites para hacer de la forma y del contenido una misma cosa. La naturaleza fragmentaria del texto, la ausencia de trama o anécdota y la imposibilidad de identificar la presencia de uno o más personajes en escena, colaboran en la creación de esa atmósfera densa y ambigua que se correlaciona con el cuadro patológico del yo anticipado en el título de la pieza. Asimismo, la puesta en funcionamiento de estrategias de hibridación genérica, de apropiación, parodia y reescritura de diferentes modalidades discursivas (monólogos líricos, conversaciones entre doctor y paciente, el discurso de los cuestionarios médicos, de la psiquiatría y de las historias clínicas, citas extraídas de literatura de autoayuda o del libro bíblico del Apocalipsis, etc.) se constituye como práctica privilegiada para reflejar el descentramiento y la dispersión del sujeto y el borramiento de los límites entre realidad- ficción, sueño-vigilia, yo-otro

Fragmentos aturdidos. La hibridación genérico-discursiva en 4.48 Psychosis de Sarah Kane

El presente trabajo se propone reflexionar sobre las principales problemáticas en torno a la representación de la subjetividad desplegadas en la obra de la dramaturga británica Sarah Kane a partir del análisis de su último drama, 4.48 Psychosis (1999). Con esta obra Kane lleva al extremo la búsqueda de colapsar ciertos límites para hacer de la forma y del contenido una misma cosa. La naturaleza fragmentaria del texto, la ausencia de trama o anécdota y la imposibilidad de identificar la presencia de uno o más personajes en escena, colaboran en la creación de esa atmósfera densa y ambigua que se correlaciona con el cuadro patológico del yo anticipado en el título de la pieza. Asimismo, la puesta en funcionamiento de estrategias de hibridación genérica, de apropiación, parodia y reescritura de diferentes modalidades discursivas (monólogos líricos, conversaciones entre doctor y paciente, el discurso de los cuestionarios médicos, de la psiquiatría y de las historias clínicas, citas extraídas de literatura de autoayuda o del libro bíblico del Apocalipsis, etc.) se constituye como práctica privilegiada para reflejar el descentramiento y la dispersión del sujeto y el borramiento de los límites entre realidad- ficción, sueño-vigilia, yo-otro

Retrospective study on structural neuroimaging in first-episode psychosis

Background. No consensus between guidelines exists regarding neuroimaging in firstepisode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT) and magnetic resonance imaging (MRI)) in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18–48 years (mean age: 29.6 years), consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI) were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI) and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification). No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age.

Reasons for cannabis use in men with and without psychosis

Psychoses are relatively low prevalence disorders that have a disproportionately negative impact on individuals and society. Cannabis use is one factor that can exacerbate the negative consequences associated with psychotic disorders. Relatively few studies have examined the effects or reasons for using cannabis self-reported by individuals with psychosis. The present study is the first known to compare directly such factors in individuals with and without psychosis, within a single study. At baseline and follow-up participants with psychosis most commonly reported using cannabis for positive mood alteration (36% and 42%), coping with negative affect (27% and 29%) and for social activity reasons (38% and 29%). The control group most commonly reported using cannabis for relaxation (34% and 43%) and social activity reasons (49% and 51%). Participants with psychosis were less likely to report relaxation as the most important effect after use ( 27%) or expect it at follow-up ( 49%) compared to the control group (53% and 70%). In both groups, addiction and positive affect enhancement were the composite variable scores correlated most consistently with concurrent amount and frequency of use.

A brief motivational intervention for substance misuse in recent-onset psychosis

Substance misuse is common in early psychosis, and impacts negatively on outcomes. Little is known about effective interventions for this population. We report a pilot study of brief intervention for substance misuse in early psychosis ( Start Over and Survive: SOS), comparing it with Standard Care(SC). Twenty-five in-patients aged 18 - 35 years with early psychosis and current misuse of non-opioid drugs were allocated randomly to conditions. Substance use and related problems were assessed at baseline, 6 weeks and 3, 6 and 12 months. Final assessments were blind to condition. All 13 SOS participants who proceeded to motivational interviewing reported less substance use at 6 months, compared with 58% (7/12) in SC alone. Effects were well maintained to 12 months. However, more SOS participants lived with a relative or partner, and this also was associated with better outcomes. Engagement remained challenging: 39% (16/41) declined participation and 38% (5/13) in SOS only received rapport building. Further research will increase sample size, and address both engagement and potential confounds.

Paradoxical association between smoking and olfactory identification in psychosis versus controls

Objective: Deficits in olfactory identification have been demonstrated in patients with schizophrenia. This study examined the interaction between smoking and olfactory identification in patients with psychotic disorders versus well controls. Method: Olfactory identification was assessed in three groups of subjects using the University of Pennsylvania Smell Identification Test (UPSIT). Sixteen patients with affective psychoses, 22 patients with nonaffective psychoses, and 21 well controls were tested. Results: There was a significant interaction between diagnostic classification (patient or control) and smoking. Patients who were smokers scored higher on the UPSIT than non-smokers, while controls who were smokers scored lower than non-smokers. Conclusions: Smoking may have a 'normalising' effect on olfactory identification in some patients with psychosis. Further studies are needed to examine the relationship between psychosis, olfactory identification and the effects of nicotine.