Lucía Gallego

Until 2020, only Belgium, Luxembourg, Switzerland, and the Netherlands admitted, under differentiated legal coverage, requests for euthanasia and / or assisted suicide in patients with non-terminal illnesses, and for reasons of intractable and unbearable suffering. Since March 2021 this is also possible in Spain. The objective of this work is to review the existing studies and characteristics of the practice of euthanasia and assisted suicide ( ESA) in people with mental disorders (TM) and / or dementia (D) and see if the legal requirements essential in ESA applications in these patients are to be met. The hypothesis is that compliance with these requirements is especially difficult in patients with TM-D, either because of the characteristics of the disease itself, or because of the recognized legal security failures. Likewise, there may be sources of fraud not actually prosecuted by the State, either due to the complicity of society and / or due to the necessary cooperation of Medicine. As a result of this review, we raise critical ethical-deontological considerations about the approval of ESA for patients with TM-D, and its errors and consequences, to the reflection of the readers. We propose as an alternative to ESA the so-called "palliative psychiatry", which aims at improving the quality of life of patients and their families by facing the problems associated with severe persistent mental illness -potentially fatal- through the prevention and relief of suffering.

Human immunodeficiency virus-infected patients have high rates of psychiatric disorders, including substance and alcohol abuse. Prompt identification and effective management of mental disorders can improve the quality of life and antiretroviral adherence in HIV patients. Additive side effects and drug interactions may complicate the psychopharmacological treatment in this population. This article reviews the indications and precautions needed when prescribing psychoactive drugs to HIV patients with mental disorders.

Two patients suffering Capgras Syndrome (CS) were evaluated with neuroimaging and neuropsychological tests, the results of which are compared with the existing etiopathogenic theories. To date, the etiopathogeny of the CS continues to lack satisfactory explanation. However, several holistic models have been proposed to better understand the many different theoretical proposals circulating for CS. These theories are discussed and the psychosocial consequences of aggressiveness, an aspect not frequently commented in the literature, are analyzed. Risk for aggressiveness and its negative consequences should be taken into consideration upon diagnosis of CS in order to design effective preventive measures.

The prevalence of neuropsychiatric disorders is high in HIV-infected individuals. Despite being frequent, these disorders are often underdiagnosed and undertreated. Many of these conditions show differential clinical features as compared with HIV-uninfected individuals. The main neuropsychiatric disorders observed in HIV patients are described. Routine psychiatric evaluation of HIV-infected persons may enhance adherence to antiretroviral treatment, decrease risk behaviors, reduce medical complications and use of hospital services and, ultimately, may improve the quality of life.