We present the case of a 22 year old male with a history of two hospitalizations in the Psychiatric ward of our hospital with psychotic symptoms that led to a diagnosis of schizophrenia, whose later evolution arose doubts about such a diagnosis and provoked a re-examination of the case, eventually leading to a diagnosis of Dissociative Identity Disorder.

To present a complex case of Identity Dissociative Disorder disguised by a myriad of psychotic-like symptom and to review the links between this kind of disorders and a personal history of trauma.

We performed an extensive review of the scientific literature available regarding the topic of Dissociative Identity Disorder, using sources both in English and Spanish languages.

Our patient experimented two admissions into our Psychiatric ward due to acute psychopathological symptoms (auditive pseudohallucinations and visual hallucinations attributed by the patient to two different people who could influence on his behaviour), then linked to a début of a Paranoid Schizophrenia. The follow-up of the patient in a Day Clinic related to our hospital revealed a close relationship between the described symptoms and a personal history of trauma, as well as a lack of effect of the antipsychotic medication prescribed, and the clinical case eventually evolved to the development of two distinct identities within our patient, leading to a new working diagnose of Identity Dissociative Disorder.

Identitive Dissociative Disorder is a complex, underestimated entity of difficult diagnosis with deep roots in personal traumatic history and whose multifaceted presentation may entail a challenge to clinicians.

No significant relationships.

The dissociative disorders are characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.

We present the case of a 22-year-old patient, who has been following up for just over a year. The patient refers that two people inhabit her body, talk to each other, exchange opinions and both have control over the body, one giving the turn to the other depending on the circumstances. To this is added delusional symptoms of grandeur and sensorial-perceptual symptoms. In turn, depressive symptoms have appeared that have led the patient to have several suicide attempts throughout the follow-up time.

During this time, the patient has required hospital admission on two occasions due to the autolytic ideation. Treatment with neuroleptics and antidepressants has been established that have helped control delusions and thoughts of death, but not the dissociative clinic.

Dissociative Identity disorder 300.14 (F44.81)

The different symptoms presented by the patient, as well as the social and occupational deterioration that he presents, make this an extremely complicated case, both in diagnosis and in treatment. Dissociative identity disorder has been very controversial, changing its diagnostic criteria over time. More studies are needed and perhaps future research can give us more clues about this disorder.

No significant relationships.

Frontotemporal dementia(FTD) is the prevalent type of primary progressive dementia. Psychiatric symptoms can be seen in FTD. So it can imitate psychiatric disorders and be misdiagnosed. However, few studies have investigated the underlying cause of misdiagnosis.

The primary aim of this study was to identify the prior psychiatric diagnoses of patients before receiving a definitive diagnosis of FTD and the main reasons to cause diagnostic delay.

We screened through the records of patients who were admitted to our psychiatry outpatient or inpatient clinic from January 1st, 2018 to June 30th, 2021. The patients with FTD were included in our study.

Our sample consisted of 13 patients with FTD(mean age= 54.77 ± 12.22, 7 females). Psychiatric misdiagnoses were depression(n=6), psychosis(n=5), bipolar affective disorder (n=5), conversion disorder(n=4), and malingering(n=1). As we looked at the first symptoms of the patients, it was revealed that 9 of 12 patients presented with depressive symptoms or at least experienced a short depressive period at the beginning of their behavioral changes. Interestingly, 8 of 12 patients had given a history of stressful life events just before their complaints emerged, which was thought the main misdirector for physicians. The average delays in diagnosis were 14.58(±16.93) months in the psychiatry clinic, 5.66(±11.02) months in the neurology clinic in our hospital.

Our study suggests that the depressive episode preceding behavioral changes may be the prodromal stage for fully developed FTD. Moreover, the depressive episode and the history of stressful life events appear to mislead clinicians in diagnosing FTD.

No significant relationships.

A frequently discussed topic today, stigma and/or discrimination are social phenomena that, in the broader context of medical discourse and especially in the current epidemiological situation, Covid-19 pandemic, appear and need a detailed examination

This study aims are to examine the literature and to present the aforementioned phenomena, comparing them with the Link & Phelan stigma model and offering pros and cons for their congruence with the model.

Literature analysis with searching words: stigma, discrimination, Covid-19, medical and especially psychiatric pathology, in Pubmed and Google scholar engine.

The studied 32 articles provided 4 stigmatized subgroups in the social context of the pandemic: that of patients and medical staff, that of comorbidities sufferers, that of stigmatized ethnic groups, and that of stigmatized races. These groups, stigmatized directly or by overlapping with the “actual” group, were studied in the most relevant PubMed articles, and evidence for the congruence of their stigma with the model was presented in this review.

This work could also serve as a starting point for further study on combating stigma, improving the lives of our patients, colleagues affected by occupational exposure, and, finally, society at large

No significant relationships.

Few studies investigated the role of psychological variables underlying polylove.

To extend the knowledge regarding the psychological profile of polylovers.

We administered to a sample of individuals reporting to be polylovers and a sample of participants reporting to not be polylovers a battery of self-report questionnaires including the Attitude Towards Polylove scale (ATP), the Multidimensional Sexuality Questionnaire (MSQ), The Experiences in Close Relationships 12 items (ECR-12), the Couple Satisfaction Inventory (CSI), the Difficulties in Emotion Regulation Scale (DERS) and the Difficulties in Emotion Regulation Scale Positive (DERS-P).

We found that controlling for age and gender, polylovers, compared to not polylovers, scored higher on some dimensions of the DERS-P, on the ATP scores and on some dimensions of the MSQ. No others significant differences between groups emerged. Moreover, in the group of polylovers, ATP scores were positively related to sexual satisfaction, sexual self-esteem and sexual consciousness and negatively related to avoidant attachment style and difficulties in regulating positive emotions. Finally, we found that avoidant attachment style moderated the link between ATP scores and sexual self-esteem.

Emotion dysregulation and attachment appear to be central variables explaining the specificity of psychological profiles of polylovers.

No significant relationships.

Ayahuasca is an hallucinogenic tea prepared from the Amazonian vine Banisteriopsis caapi and the leaves of the plant Psychotria Viridis. Banisteriopsis caapi contains monoamine oxidase inhibitors (MAO) that render the N, N-dimethyltryptamine (DMT) of Psychotria Viridis active. This brew is being used as a sacrament in syncretic religions in urban areas of Brazil and worldwide with the purpose of enabling a spiritual experience as well as healing for a variety of conditions such as drug addiction, depression and anxiety disorders.

This work aims to provide an understanding on the potential benefits of ayahuasca in psychiatric symptoms, as well as its neuropsychological functioning, neuroimaging and adverse events.

A non-systematic review was performed on PubMed database and Google Scholar, using the key words “Ayahuasca, Drug Addiction, Psychedelics, DMT, Neuroplasticity”. The review included experimental studies in humans, observational studies, systemic review articles and clinical trials.

In a randomized placebo-controlled trial, ayahuasca had a significant antidepressant effect when compared to the placebo group. Long term ayahuasca usage was associated with structural alterations in the medial parts of the brain with no evidence of increased psychopathology or worse neuropsychological functioning. According to reviewed studies the incident of prolonged psychotic reaction among ayahuasca users is rare and the causal relation with ayahuasca is sometimes difficult to establish.

Despite the promising results, more controlled double-blinded studies with larger populations are necessary to better understand the therapeutic potentials and side effects of ayahuasca.

No significant relationships.

The sense of agency concerns the experience of controlling our actions, referring both to superior and lower levels of psychological functioning that are also related to the physical dimension of agency. Diverse clinical conditions affect the awareness of being a bodily and agentive self.

The aim of this systematic review was to provide a comprehensive evaluation of the relationship between individual sense of agency and body perception.

PsycINFO, Psycharticle, Medline, Web of Science and Scopus were systematically searched for articles published until 19/10/2020.

After removing duplicates, a total of 2.556 records was screened. Fifteen articles were selected based on the inclusion criteria fixed for the systematic review.

In the last decades, this line of research seems to attract a growing number of studies.

However, these studies are affected by a great heterogeneity in the investigation of both constructs.

Body perception and sense agency were operationalized across research in diverse ways, making the evaluation of the relationship between them very difficult. In addition, there is a paucity of studies investigating the relationship between body perception and agency among individuals suffering from specific psychopathology or physical diseases. According to literature review, the main objective for future research is to develop more robust approaches to estimate the variability of these constructs such as their relationship.

No significant relationships.

Social cognition refers to a complex set of mental abilities that support the construction of adequate social competence and adaptation. Impairments in social cognition can be found in several psychiatric disorders, particularly in psychoses. Polygenic Risk Scores (PRSs) represent single metrics of molecular genetic risk and are a predictor of the genetic susceptibility to diseases, although they explain only a small part of the risk.

To explore the association between PRS for psychiatric disorders and social cognition.

We conducted a systematic search in PubMed and Scopus according to the PRISMA guidelines up to August 2021. We included papers evaluating PRS and social cognition with psychometric scales. Articles concerning single-nucleotide polymorphisms and biological measures of social cognition (e.g., neuroimaging, peripheral biomarkers) were excluded.

We initially retrieved 150 articles. After removing duplicates, we screened 133 titles and abstracts and preliminary selected 19 papers. Participants recruited in the papers of interest were either people with schizophrenia, ASD or ADHD, their family members or healthy subjects. Articles evaluated the association between different psychometrical measures of social cognition and PRS for schizophrenia, Autism Spectrum Disorder and ADHD.

Literature regarding the association between PRS for psychiatric disorders and social cognition is heterogeneous in terms of populations, genetic risk evaluation, and outcome tools. Given the critical role played by social cognition in the onset and progression of mental disorders and its association with real-world functioning, future research should try to disentangle the complex genetic basis of this domain.

No significant relationships.

Hope should be fostered by providing information to help service users develop an understanding of psychological difficulties and encourage an active role in their self-care. This might include providing an open caring environment, nurse presence, comfort/pain relief, and involving patients in their care.

To analyze the critical importance of hope-inspiring competence as a high-quality mental health nursing care in recovery-oriented practice.

This was a reflective and discursive study based on experiential aspects of hope in mental health recovery.

Hope and hopelessness are important determinants of mental health. Hope has a positive influence on people’s mental health, on increasing comfort and satisfaction with life and on reducing negative emotions and suicide, decreasing the predisposition to addiction, and preventing family exhaustion, with a predictive effect on subjective well-being and protection of mental health. The concept of hope-inspiring competence is introduced to denote a relatively high level of the Advanced Practice Psychiatric Nurses ability to instil and maintain hope for recovery in people with mental health disorders.

The evidence seems to point to the importance of incorporating hope in collaborative strategies to promote mental health and manage mental health disorders. Despite this recognition of the role of the specialist nurse in psychiatric-mental health in training for hope, the way it develops in the context of specialized practice lacks evidence and visibility. A vision of recovery from mental illness exists, and hope, trust and self-determination should be incorporated into all treatment models.

No significant relationships.

Infodemic is a new term which refers to rapidly spreading information from both reliable and unreliable sources in the form of news and publications regarding the COVID-19 pandemic, which requires proper management strategies on its own to prevent the spread of fake news. This is especially relevant in a global state of alert where the fear of contagion is a common denominator and is reflected upon people’s behaviors within a crisis context. Van Bavel et al (2020) affirm “Emerging research is using social science to understand and counter the spread of fake news”, and furtherly emphasize on the limitations of Fact Checking as the main approach to hinder such spread

Test the association between sociomoral cognition, religiousness and political identity, and belief in COVID-19 Fake News.

Online-based survey applied through opportunity sampling. Demographic variables political and religious orientation, RMET and B-IRI, and two dimensional utilitarian dilemmas were used and independent variables, and a selection of true and fake news in order to measure participants’ belief in the latter as a dependent variable.

Morality (R2 = 0.08, p < 0.001), social cognition (R2 = 0.05, p < 0.05), and political and religious orientation (R2 = 0.1, p < 0.000001) predicted belief in COVID-19 fake news. On the other hand, no variables were found to predict belief in fake news unrelated to the pandemic.

Higher impartial beneficence and more years of formal education point toward an evidence-based reasoning, while religiousness and affinity with right-wing ideals has been associated with intuition-based reasoning, thus affecting judgement accuracy.

No significant relationships.

Antidepressant-induced galactorrhea and increases in prolactin levels have been sporadically reported among SSRI-related side effects.

Current rapport presents a case of 39 y.o. female who developed several adverse effects on paroxetine - including galactorrhoea - which improved on discontinuation of the drug.

Case discussion of 39-year old woman who was treated with paroxetine for her panic disorder and developed galactorrhoea with hyperprolactinemia that resolved upon discontinuation of the drug. Additionally, authors performed the literature search using PubMed and Embase to review the similar cases and used PDSP Database to assess the latest pharmacodynamic (PD) properties of paroxetine and other SSRI’s.

Literature review (1966–2020) revealed 24 prior published case reports of SSRI-induced galactorrhea in users of paroxetine (n=4), escitalopram (n=4), sertraline (n=2), citalopram (n=2), fluoxetine (n=3), fluvoxamine (n=2) and other non-assessable reports (n=7). Elevated prolactin levels were mostly observed with paroxetine and escitalopram and rarely with fluoxetine, fluvoxamine and sertraline. PD-assessment showed the highest binding affinity of paroxetine and escitalopram to SERT (kPi = 0.07-0.2 and 0.8-1.1 nmol/L respectively) compared to other SSRI’s, in absence of other relevant PD-properties

Increasing body of evidence shows that galactorrhea does occur among paroxetine female users. Pharmacodynamic mechanism of action is poorly understood but given the modern insights in relationship in serotonin and dopamine circuits, we suggest that strong SERT inhibitory properties of paroxetine might lead to a tonic suppressive influence on dopamine neurotransmission. This physiological link may explain an increase in prolactin levels through dopamine depletion in the tuberoinfundibular pathway.

No significant relationships.

Physical restraint is a therapeutic procedure allowing to immobilize an agitated patient.Although it is an effective method especially in the states of psychomotor instability, its practice is not devoid of risks which imposes a codified technique with particular monitoring.

The aim of this work was to evaluate the knowledge of nurses and nursing assistants in the practice and monitoring of physical restraint and to establish a suitble protocol codifing it.

Our study was a descriptive cross-sectional study based on a questionnaire grouping together a set of questions on general and professional characteristics, the decision of physical restraint, its prescription, its means, its monitoring, informing the patient and his relatives, physical restraint’s risks, the patient’s experience, the caregiver’s experience as well as the relationship between caregiver and patient. Our target population was composed of nurses and orderlies of the psychiatry department <<D>> of the Razi hospital in Manouba.

We collected 30 professinals.90% of them were women. 30% of our sample had less than five years of experience. Only 23.30% of caregivers had mental health training at the beginning of their professional career. 50% of them received training focused on physical restraint.83.30% reported using physical restraint for psychomotor agitation.56.6% ignored the psychological effects of the physical straint on patients. 73.3% of caregivers informed patients before straint.

A physical restraint protocol, codifying the technique of implementation and monitoring parameters is needed in order to improve the relation patient-cargiver and ensure an optimal care .

No significant relationships.

The delusional misidentification syndromes (DMS) are uncommon but fascinating neuropsychiatric disorders. One particularly intriguing form of DMS is called the mirror sign or mirror delusional misidentification (MDM).

We aim to present a case on MDM and a review on MDM and its correlation with neurological lesions.

Non-systematic review of the literature and case report.

A 72 years old patient was admitted to the emergency department with disorientation, behavioral changes and persecutory delusional ideation. The patient was also unable to recognize his face in the mirror, claiming to be his son. On neuroimaging tests, the patient presented with moderate diffuse cortical-subcortical cerebral atrophy associated with mild diffuse cortical cerebellar atrophy, as well as atheromatous calcifications in carotid siphons. In the MDM, the patient treats the mirror image as separate from the self. It is commonly seen in patients with dementia. Unlike Capgras syndrome, MDM is typically associated with neurological illness, particularly with neurodegenerative conditions. Findings on neuroimaging have shown a pattern of right hemisphere cortical and subcortical lesions. the most common findings included the following: generalized or localized atrophy on Magnetic Resonance Imaging, ventricular dilatation on Computed Tomography scan, and slowing on Electroencephalography.

Mirror delusional misidentification differs from other forms of DMS as it is seen exclusively in patients with neurological disease. While right hemisphere dysfunction appears to be a requirement for MDM, patients with this condition do not show consistent enough neuroimaging findings to allow for a localization within the right hemisphere.

No significant relationships.

The process of professional self-determination in adolescence is a key developmental task, the successful resolution of which determines the psychological health and well-being. Professional self-determination includes 1) the formation of a professional identity on the base of exploration the possibilities of professional choice, 2) making a decision for professional future

1) to study the features of a personal professional perspective in adolescence; 2) to reveal status of identity in the field of professional self-determination; 3) to study the relationship between the status of identity and the personal professional perspective.

The modified Personal Professional Perspective technique (N.S.Pryazhnikov) and the interview to determine status identity in the professional field (D.Marsia) were used. The study involved 144 respondents aged 15 to 17 years.

The heterochronicity of the formation of the components of the personal professional perspective (PPP) among adolescents is revealed. The connection of the high status of identity in the professional sphere with the formation of PPP has been proved. The formation of all components of the PPP among adolescents with the status of a moratorium and status of achieved identity is higher than in group with diffusion status (U criterion, p = 0.00).

The high status of identity in the professional sphere (moratorium and achieved identity) is associated with a high level of formation of a personal professional perspective.

No significant relationships.

Children with ASD may present their parents with several challenges, most notably aggressive and destructive behaviors. Parents of children with ASD typically experience more stress, depressive and anxiety symptoms than other parents. Mindfulness-based interventions are reported to be effective in reducing parental stress along with improving the challenging behaviors of their children

The current review aimed to investigate if the use of mindfulness-based interventions is beneficial to reduce parental stress when caring for children with ASD.

The databases of PsycINFO and PubMED were used. The variables studied in this systematic review were Autism, Parental stress, and Mindfulness. Inclusion criteria were that all articles should be academic journals, and with a full text available in English during the last 20 years.

Compared to other behavioral approaches, mindfulness-based interventions showed statistically significant results in reducing the stress levels of parents as well as improving their children’s challenging behaviors.

Most of the studies in the current review indicated that mindfulness-based interventions are beneficial in improving the stress level of parents.

No significant relationships.

Acute measles encephalitis is a pathology of the central nervous system. It is most frequent in children but can also be described in adults. Given the rarity of this pathology, we present the case of this patient.

present a rare neuropsychiatric complication of measles

Présentation d’un cas clinique d’encéphalite rougeoleuse et revue de la littérature

Mrs. HJ, 45 years old, without any somatic history, was followed for an antisocial personality with a substance use disorder. She consulted the emergency for psychomotor agitation, a fever of 39, and a rash on the face, thorax, and limbs. At the psychiatric interview, she was disoriented and very unstable. She seemed to be hallucinating.

The brain imaging and the lumbar puncture (CT scan and brain MRI) were without abnormality. The rapid test (HIV) was negative and the biological check-up showed a hyperleukocytosis at 12660 and a crp at 138. The patient was put on double antibiotic therapy.

The evolution was marked by the non-improvement of the symptomatology with the persistence of agitation. Her speech was almost absent with a refusal to answer and to execute orders. She maintained certain postures. The patient was put on 400 mg of amisulpride.

After recovery of the viral serology, the diagnosis of a measles encephalopathy was confirmed (IgM positive) and the patient improved after a few days of hospitalization and was addressed to the psychiatric outpatient clinic.

Measles encephalitis is a rare but serious complication that requires multidisciplinary management

No significant relationships.

In Ecuador, the first case of covid19 was reported on February 29th of 2020, forcing people to remain in lockdown, which increased gender violence; post-traumatic stress disorder (PTSD) and depression.

Determine the cases during the lockdown caused by the covid-19 pandemic we found victims of some type of gender-based violence, depression, and PTSD.

An observational, cross-sectional descriptive study was carried out based on surveys conducted online, the study was conducted on January 29th of 2021, in the province of Guayas-Ecuador. Performed with “google forms” platform, data on affiliation, the situation of intimate partner violence and the Davidson trauma test (PTSD) and the Beck test (depression) were collected.

A total of 411 samples were obtained, classified according to age, sex, number of children, education, occupation, intimate partner relationship, whether they had suffered gender violence and types of violence. 88 (21.41%) people reported having suffered some type of violence, of which 25 (28.42%) were men and 62 (70.45%) were women. The most common was psychological with 53 (60.23%) people. 82 respondents tested positive to Davidson test for PTSD, equivalent to 20% of the total sample. 51 people (12%) reported suffering from mild depression, 53 (13%) reported suffering from moderate depression and 38 people (9%) reported major depression with Beck test.

In this study we evidenced that although the interviewers claimed they had never suffered gender violence , it was observed that the results were incongruent, so it is important to highlight that talking about gender violence is still considered a stigma in our society.

No significant relationships.

Lysergic acid diethylamide (LSD) a semi synthetic hallucinogen, was first synthetized by Albert Hofmann in 1938 and its psychological properties were not discovered until 1943. There was a brief renaissance of its use in psychiatry, specifically in assisted psychotherapy for the treatment of alcoholism, neurosis and psychosomatic disorders. However, research with LSD and others psychedelics substances rapidly came to an end with its broad international prohibition in the 1970´s.

This work aims to provide an understanding on the potential benefits of LSD in mental disorders, as well as its mechanism of action and effects on human brain.

A non-systematic review was performed on PubMed database, using the key words “LSD, mental disorder, neuroimaging, cerebral plasticity, psychedelics, substance use disorder”. Websites of the Berkley Foundation and Multidisciplinary Association For Psychedelic Studies (MAPS) were also searched.

Significant evidence has emerged that LSD may have a role in the treatment for some mental disorder, including drug and alcohol dependence and anxiety associated with life threatening diseases. Evidence based on modern neuroimaging technique suggest that LSD alters the brain blood flow, electrical activity, and network communication patterns. Preclinical evidence also demonstrated that psychedelics affect neuroplasticity after acute and chronic administration.

Based on the available evidence LSD when administered safely in a methodologically supervised psychotherapeutic setting can have a potential use for certain psychiatric conditions, suggesting that larger controlled studies are warranted

No significant relationships.

Attention-Deficit/Hyperactivity Disorder (ADHD) was classically considered a childhood-onset neurodevelopmental condition. Over the past 40 years, it became evident that it can persist during adulthood.

The purpose of the authors is to describe the characteristics of ADHD in adults and the specific comorbidities, proposing an approach to these patients.

A brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.

Only 40-50% of children and adolescents with ADHD will have symptoms that persist into adulthood (estimated adult prevalence of 2.8% across 20 countries; 25% in prisons). A more subtle presentation in adults and the difficulty to access past medical history, lead to diagnosis and treatment rates of lower than 20% (versus 50% in children). Well-characterized core symptoms in children evolve into a predominance of inattention symptoms. They became adults with marked disorganization, difficulties in completing tasks and managing time. Emotional dysregulation is a very prevalent symptom in this population. The comorbidities rate increase over time (reaching 75% of patients).

Adults (or even older subjects) with cognitive and/or behavioural complaints should be submitted to systematic screening for ADHD. Non-treated ADHD symptoms in adulthood are associated with severe impairment, therefore adjustments in the health care system to support the transition from child to adult services are needed.

No significant relationships.

Childhood Apraxia of Speech (CAS) was declared as a motor speech disorder by ASHA (2007). The prevalence of CAS is yet to determined due to difficulties in reliable diagnosis, however 63.6% of children with ASD were found to Apraxic (Tierney et al, 2015), hence prevalence would be at least 1/100 (ASD prevalence is 1/54).

The consequences of inability to speak in early and advanced developmental age are many and might include frustration, anger, depression, communication deficit, language delay, poor social skills and behavioural problems. Not only treating motor speech disorder is challenging enough, the external consequences make it far more difficult.

The VML method (Verbal Motor Learning) was designed to treat the motor aspect of speech. It uses manual techniques and motor learning principles in order to directly teach the basic milestones of speech for children with CAS. In addition, the importance of the manner of the practice was established over the years, extracting 16 unique treatment principles. These principles guide the therapist regarding HOW to perform the practice, while giving an answer to the external CAS consequences.

The principles are the platform, managing energy levels, relationship, attention, goal-oriented thinking, emotional safety, treatment structure, rhythm, timing, threshold point, support, dynamic thinking, ecological treatment, proactivity, clarity and commitment.

The lecture will introduce the 16 principles briefly, and demonstrate the use of them via treatment videos.

I am the founder of the VML method and I teach it in various countries.