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Actas Esp Psiquiatr. 2006 Jul-Aug;34(4):264-76.
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[Evolutionary aspects of affective disorders, critical review and proposal of a new model] Ver PDF
[Article in Spanish]
Montañés F, de Lucas Taracena MT.
Fundación Hospital Alcorcón y Departamento de Psicobiología, Universidad Complutense de Madrid. fmontanes@fhalcorcon.es
Evolutionary psychopathology incorporates psychiatry into biology via theory of evolution, generating new etiological hypothesis for mental disorders. For evolutionary psychopathology emotions are a response system or a genetically programmed, specialized state of functioning, formed by natural selection, that allows us to adapt to the environment, increasing the ability to cope with threats and opportunities. Emotions exert their function by coordinated physiological, psychological and behavioral changes. Many functions have been suggested for low mood or depression, including communicating a need for help, signaling yielding in a hierarchy conflict, fostering disengagement for commitments to unreachable goals, regulating patterns of investment, parallelism with despair phase of separation from mother situation in monkeys, hibernation, etc. Despite other evolutionary models, our model not only tries to explain depression but mania, hypomania and other affective disorders as well. For us, most affective disorders are pathological states (and not adaptive ones), due to dysfunction of an innate precipitating mechanism (IPM). IPM function is to regulate energy and activity levels according to intensity and duration of light (namely IPM-A). This IPM-A is responsible for vegetative, endocrine and behavioral responses that are present in humans and more ancient phylogenetic animals. More recently in the phylogeny, other mechanisms (IPM-AA) have coupled to this IPM-A. In the human being, the precipitating factors of IPM-AA are predominately social. IPM-AA add new responses (such as mood) to the older responses of IPM-A.
PMID: 16823688 [PubMed - indexed for MEDLINE]
[Swallowing phobia: symptoms, diagnosis and treatment]
de Lucas-Taracena MT, Montañés-Rada F
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[Swallowing phobia: symptoms, diagnosis and treatment]
Actas Esp Psiquiatr. 2006 Sep-Oct;34(5):309-16
Authors: de Lucas-Taracena MT, Montañés-Rada F
INTRODUCTION: Choking phobia (or swallowing phobia) is characterized by a fear of swallowing foods, liquids or pills, sometimes after an episode of choking on food. METHODS: Forty-one case reports on swallowing phobia from 1978 to 2005 were studied. Clinical and therapeutic variables of the disorder were studied. RESULTS: It appears to occur more often in females (two-thirds of the cases) and has a high comorbidity with anxiety disorders (panic disorder, 41 %; obsessive conditions, 22 %, and separation anxiety, 15 %). Life-events and eating traumatic antecedents are frequently present (44% and 56% cases, respectively). Cognitive-behavioral treatments have been of proven efficacy, as well as anti-panic drugs (alprazolam, lorazepam, bromazepan, imipramine, clomipramine, fluoxetine, paroxetine) with a remission rate of 58.5%. Gender and treatment differences are also analyzed.
PMID: 16991019 [PubMed - indexed for MEDLINE]
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Violence in mental disorders and community sample: an evolutionary model related with dominance in social relationships.
Montañés-Rada F, Ramírez JM, De Lucas Taracena MT
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Violence in mental disorders and community sample: an evolutionary model related with dominance in social relationships.
Med Hypotheses. 2006;67(4):930-40
Authors: Montañés-Rada F, Ramírez JM, De Lucas Taracena MT
The major risk determinants of violence are to be young and male, to have low socioeconomic status and suffering substance abuse. This is true whether it occurs in the context of a concurrent mental illness or not; i.e., mental disorders are neither necessary, nor sufficient causes for violence. Intense motivation is a facilitating factor for violence in clinical and non clinical samples. This explains why 'normal' people, are implicated in planned violence at higher rates than mentally ill (e.g. in criminal acts against property). However mentally ill patients are more easily implicated in impulsive violence or in violence without obvious cause due to veiled motivation fuelled by unidentified symptoms. Subjective or real awareness of competitive disadvantage increases motivation for violence (e.g. paranoid, narcissistic symptoms, etc.). Many psychiatric disorders as antisocial disorder, borderline, schizophrenia, have most of the factors that facilitate the appearance of violence. Antisocial disorder is a good model to study determinants of violence in normal samples as it is present in young males that do not have any psychotic symptom, have stable symptomatology, self control under scrutiny, and their motivations are similar to normal samples. Our evolutionary model suggests that there is a non random association of genetic factors (genes, pseudogenes, promoting areas, etc.), that is, a genetic cluster (cluster DO), whose phylogenetic function is to motivate to be the dominant in social relationships. To be the dominant is a major psychological feature present in many social groups of animals, included primates. DO cluster have sense from an evolutionary viewpoint: when expressed in no pathological way it increases inclusive fitness (transmission of the genes of a person genotype whether by oneself or by relatives reproduction). Features of cluster DO in humans are expressed differently according to sex, age, moral education, level of intelligence, etc. Cluster DO has higher phenotypical expression in males and young people. Primary antisocial personality disorder and other related disorders (cluster B personality disorders, disocial, defiant disorder, etc.), are a pathological manifestation of this cluster DO. Some other genetic clusters that causes the genetic liability to some disorders (e.g. attention deficit disorder) are non random associated with cluster DO, thus explaining clinical comorbidity. According to our model, motivation for dominance usually prevails over motivation for material benefit or antinormative behaviour, this explains some incongruent behaviour in antisocial patients not elucidated by other models. Along with the primary expressed feature of dominance of cluster DO there are other secondary features that have been identified by psychobiological studies: novelty seeking, intolerance for frustration, impulsiveness, fearless, aggressiveness, higher threshold for activation of the sympathetic system, lack of empathy, egoism, non acceptance of rules, defiant and rebellious behaviour, manipulation in social interactions, selfishness and deficits in altruism or in social co-operation.
PMID: 16781823 [PubMed - indexed for MEDLINE]
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[Treatment of Tourette syndrome and its comorbidity: experience with 17 cases]
Martínez-Granero MA, Montañés Rada F, García Pérez A, de Lucas Taracena MT, Sánchez Romero S, Rafia S, Granados A, Parra Cuadrado

[Treatment of Tourette syndrome and its comorbidity: experience with 17 cases]
Neurologia. 2005 Dec;20(10):678-85
Authors: Martínez-Granero MA, Montañés Rada F, García Pérez A, de Lucas Taracena MT, Sánchez Romero S, Rafia S, Granados A, Parra Cuadrado E
INTRODUCTION: Clinical characteristics and comorbid disorders of Tourette syndrome (TS) are reviewed along with a presentation of our experience with 17 cases. MATERIAL AND METHODS: We carried out a retrospective study of pediatric patients with TS admitted from 1998 to 2004 in Fundación Hospital Alcorcón. RESULTS: Seventeen patients were obtained, 16 of whom were men and there was only 1 woman. Present age ranged from 7 to 17 years old. Most frequent comorbid disorders were attention deficit disorder (ADD) in 9 patients, (53%), obsessive-compulsive disorder in 8 (48%) and anxiety in 7 (41%). Learning disorders were found in 7 patients (41%), 5 of whom have concurrent ADD and 1 severe obsessive compulsive disorder. Psychopharmacological treatment was withdrew in the 2 cases treated with halloperidol due to the presence of severe extrapyramidal symptoms (EPS) and in 3 of the 7 cases treated with pimozide (one of them was withdrawn due to EPS). No EPS was found with atypical neuroleptics, but sedation and weight gain was common. Methylphenidate was administered to 7 patients without an increase in tics. CONCLUSIONS: In our sample the most common comorbid disorders were ADD, obsessive-compulsive disorders, anxiety and learning disorders. Atypical neuroleptics were better tolerated than classic ones, although the incidence of side effects is elevated. Methylphenidate was not associated with tic worsening.
PMID: 16317589 [PubMed - indexed for MEDLINE]
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Venlafaxine, serotonin syndrome, and differential diagnoses.
Montañes-Rada F, Bilbao-Garay J, de Lucas-Taracena MT, Ortiz-Ortiz ME
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Venlafaxine, serotonin syndrome, and differential diagnoses.
J Clin Psychopharmacol. 2005 Feb;25(1):101-2
Authors: Montañes-Rada F, Bilbao-Garay J, de Lucas-Taracena MT, Ortiz-Ortiz ME
PMID: 15643112 [PubMed - indexed for MEDLINE]
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[Assessment of Machiavellian intelligence in antisocial disorder with the MACH-IV Scale]
Montañés Rada F, de Lucas-Taracena MT, Martín Rodríguez MA

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[Assessment of Machiavellian intelligence in antisocial disorder with the MACH-IV Scale]
Actas Esp Psiquiatr. 2004 Mar-Apr;32(2):65-70
Authors: Montañés Rada F, de Lucas-Taracena MT, Martín Rodríguez MA
INTRODUCTION: The objective is to evaluate the presence of Machiavellian intelligence with the MACH-IV Scale in antisocial patients versus community controls. MATERIAL AND METHODS: Categorical diagnosis and dimensional evaluation program according to IPDE were obtained from 26 controls from the community and 40 patients from a methadone program. Both groups were evaluated on cooperation with TCI and on Machiavellian intelligence with MACH-IV. RESULTS: Higher figures in MACH-IV Global Score, Tactics subscale (to manipulate others), Visions subscale (interpretations on Machiavellian behavior of others) were found in the 20 antisocial patients compared with the 26 community controls achieving statistical significance. No statistical differences were found for Morality subscale scores (abstract morality) between groups. Dimensional evaluation of antisocial disorder according to IPDE shows statistically significant positive correlations for Tactics subscale, Visions subscale and Global Score of MACH-IV scale, but no statistically significant correlation was found for Morality subscale. There is a statistically significant negative correlation between MACH-IV Tactics subscale and TIC altruism subscale. CONCLUSIONS: Antisocial patients have the same level of abstract moral attitudes as controls but are prone to use Machiavellian intelligence to interpret the actions of others, rationalize their own conduct and manipulate the behavior of others to get a benefit. These data support the hypothesis that many of the features of the antisocial syndrome may be explained by an abnormal development of an innate predisposition to be dominant in social relationships.
PMID: 15042465 [PubMed - indexed for MEDLINE]
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[Antisocial personality disorder evaluation with the prisoner's dilemma]
Montañes Rada F, de Lucas Taracena MT, Martín Rodríguez MA

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[Antisocial personality disorder evaluation with the prisoner's dilemma]
Actas Esp Psiquiatr. 2003 Nov-Dec;31(6):307-14
Authors: Montañes Rada F, de Lucas Taracena MT, Martín Rodríguez MA
INTRODUCTION: The aim of this study is to evaluate cooperation problems in antisocial disorder with the prisoner's dilemma game, which, in mathematical game theory, is the paradigm of the <<non-zero>> games (mutual benefit from cooperation). METHODS: We have designed a computer version of the prisoner's dilemma (CDT-BD) that confronts the patient to a simulation of a reciprocal exchange situation. IPDE provided us a categorical and dimensional evaluation of 26 controls from the community and 40 methadone patients. Only methadone patients obtained an antisocial diagnosis: 20 in the category of positive antisocial and 10 in the probable antisocial category. Patients also fullfilled TCI and MACH-IV. RESULTS: CDT-BD is, according to the parent's opinion (mothers), a good correlation of real life behavior. CDT-BD shows a statistically significant poorer cooperation of antisocial patients this is catego rical evaluation (ve rsus in controls) and in dimensional evaluation true both for variables that measure non-cooperation due to the patient's initiative and those as a response to the computer provocation. This may be due to a tendency of antisocials to use interchange situations <<zero game>> strategies (you win what the other player loses) instead of non-zero games strategies. Non-cooperative responses are correlated to high scores on the MACH-IV scale (manipulative behavior and cognition) and revengeful in Treatment and Character Inventory (TCI). CONCLUSIONS: CDT-BD allows us to generate and test new hypotheses on the causes of the cooperation problems in antisocial patients using game theory paradigms.
PMID: 14639506 [PubMed - indexed for MEDLINE]
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[Olanzapine in Tourette's syndrome: a report of three cases]
Lucas Taracena MT, Montañés Rada F
Hoy, 04:58 AM

[Olanzapine in Tourette's syndrome: a report of three cases]
Actas Esp Psiquiatr. 2002 Mar-Apr;30(2):129-32
Authors: Lucas Taracena MT, Montañés Rada F
We report three cases of Tourette syndrome, that were antipsychotic-naive or non-respondent to other drugs. They were treated with low doses of olanzapine (2.5 mg to 10 mg daily). They reached an important reduction in tic symptoms and social adaptation. The only side effects were mild sedation and weight gain.
PMID: 12028946 [PubMed - indexed for MEDLINE]
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[Efficacy of gabapentin in a sample of bipolar patients]
Montañés Rada F, de Lucas Taracena MT
Hoy, 04:58 AM

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[Efficacy of gabapentin in a sample of bipolar patients]
Actas Esp Psiquiatr. 2001 Nov-Dec;29(6):386-9
Authors: Montañés Rada F, de Lucas Taracena MT
INTRODUCTION: Field studies support the idea of gabapentin being helpful in the maintenance, and in the treatment of some symptoms in bipolar patients. Our study evaluates relapse rates previous and after gabapentin administration in severe bipolar patients. METHODOLOGY: Gapabentine was administered to all consecutive bipolar patients from a relapse prevention program who could not be given lithium, valproic acid or carbamacepin because of his current medical condition or his past history of secondary effects or lack of response to those treatments. Number and severity of relapses were evaluated before and after gabapentin administration. RESULTS: Seven patients were included in the study. Medium maintenance period with gabapentine was 9 months. In the gabapentin period, relapses per month increased from 0.18 in the previous three years to 0.29. This may be due because six patients interrupted abruptly previous treatment in less than 1 week. Relapses severity, evaluated by measuring length and number of hospitalisations, and number of interviews by month, was similar to the three previous years, and better than the period from the beginning of the condition. Clinical Global Impression evaluated gabapentin as similar to previous mood stabilizers in five patients and better in two. Irritability and dysphoria improved in all the patients. CONCLUSION: Although gabapentin may be helpful in some patients, a clinical essay that shows its efficacy as add-on treatment is need.
PMID: 11730576 [PubMed - indexed for MEDLINE]
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[Compulsive buying: a new disorder?]
de Lucas Taracena MT, Montañés Rada
[Compulsive buying: a new disorder?]
Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1998 Jul-Aug;26(4):264-72
Authors: de Lucas Taracena MT, Montañés Rada F
Despite its high frequency and its severe financial, social and personal complications, compulsive buying is rarely described in the psychiatric literature. We reviewed all the published papers on this syndrome to describe its clinical features, epidemiology and response to drug or psychological treatment. Psychiatric comorbidity is also reviewed and nosologic implications are analyzed.
PMID: 9807861 [PubMed - indexed for MEDLINE]
LEVETIRACETAM AS AN ALTERNATIVE THERAPY FOR TOURETTE SYNDROME Ver PDF
Martínez-Granero MA, García-Pérez A , Montañes F. Neuropsychiatric Disease and Treatment 2010:6 1–8
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Hiperactividad, déficit de atención y conducta desafiante. Guía psicoeducativa y de tratamiento. Manual práctico para padres y profesionales. Editorial Ars XXI. (ars xxi ha hecho una ERE y ni reedita ni paga (es poco pero es un feo detalle) ni na, para obtenerla clic en el libro).
En todo caso próximamente tenemos pendiente la publicación de dos nuevas guías y una actualización de tratamientos.
Montañés Rada F, de Lucas Taracena MT Trastornos del sueño, alimentación y control de esfínteres. En: Manual de Neurología Infantil. 2008
de Lucas Taracena MT Montañés Rada F. Trastornos conversivos y simulación. Psicosis infantiles. Depresión En: Manual de Neurología Infantil. 2008
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