Impulsividad y agresión: Aspectos clínicos, neurobiológicos y terapéuticos

Authors

  • Rodrigo Arrau Hospital Clínico Universidad de Chile. Clínica Psiquiátrica Universitaria
  • Patricia Rentería Hospital Clínico Universidad de Chile. Clínica Psiquiátrica Universitaria
  • Daniella Dellarossa Hospital Clínico Universidad de Chile. Departamento de Neurología y Neurocirugía
  • Carlos Tellez Hospital Clínico Universidad de Chile. Clínica Psiquiátrica Universitaria

Abstract

Agitation is a common prob/em in psychiatric patíents, results trom the interactíon of mu/tiple systems. Agítation is usual/y part of an ambíguous constellatlon of cognit/ve and psychíatríc symptoms, wíth a fluctuatíng clínica/ course. Jt can be c/assified as:r11 predatory, premedítated or p/anned aggression this is best understood within psychosocial and interpersonal theories ot aggression,12' medícal/y related-aggression is a symptom of another medica/ disorder, if the pr/mary disorder is properly treated, the aggressive symptoms disappear and'31 aggressive impu/sive, this involves" hairtrigger "responses to provocations with /oss of behavioral control and agitation. The /oss ot control in impulsive aggression is not secondary to recognized medica/ (including psychiatric) disorders and by virtue of the spontaneity of the act, is not p/anned. These three types ot aggression may co-occur with each other, and impulsive and premeditated aggression may be comorbid with other medica/ disorders. Clinical impulsivity has been characterized in both dimensional (spectrum) and categorical terms [DSM). The likelihood ot aggression is increased by environmental overstimulation or stress, transmitter balances tavoring dopamine and excitatory amino acid transmission over serotonin and gamma-aminobutyric acid transmission, and the presence ot problems related to impulsivity. Treatments far aggression combine pharmacologic and environmental or psychotherapeutic measures. Furthermore, long-term treatment requires the effective pharmacologic and nonpharmacologic treatment of under/ying chronic or recurrent illnesses, combined when needed with behavioral strategies aimed at reducing aggressive or impulsive behavior.

Keywords:

Agresión/fisiología, Conducta Impulsiva/fisiología, Conducta y Mecanismos de Conducta, Síntomas Conductuales