The modified completion test (MCT) based on the stories by H. Ebbinghaus enables to assess cognitive functions in situation close to a real-life task with an affective load (Burlakova,2016,2020). MCT includes the following stages: 1) filling the gaps in the story; 2) reading and retelling; 3) making up a continuation and a title; 4) retelling the story and its continuation after 30–40 minutes.

The objective was to research diagnostical potential of the second stage of MCT for patients suffering from paranoid schizophrenia with hallucinatory syndrome.

The study included 42 patients (28 female, 14 male) with schizophrenia (disease onset at least 5–7 years ago), aged from 19 to 51 (average age 35±8), receiving treatment. Control group consisted of 44 people (average age 37±6), never sought psychiatric help, never diagnosed with any mental disorders. Groups were organized to be equal in gender proportions, age, and educational level.

In comparison to the control group, the psychiatric patients demonstrated: 1) lower connectedness in narration, lower ability to reproduce main elements of the plot; 2) unusual logic in introduction of new details, extensiveness of such details; 3) lower integrity of mnestic functions, lower ability to maintain concentration. The clinical group: 1) imposed on the text principally different logic, subjectively significant, yet far from the original context; 2) suddenly introduced of new ideas; 3) had confabulations; 4) were altiloquent.

The stage of retelling enables to assess semantic memory, regulatory functions, connectedness of the narration, cogitation and to examine cognitive functions in the context of patient’s personality.

No significant relationships.

Sleep is essential for an adequate neurobiological functioning, being implicated in several cognitive functions. Even in healthy individuals, sleep deprivation can lead to a number of psychopathological changes, including perceptual distortions, hallucinations and delusions. Thus, the resulting clinical picture may be similar to a psychotic disorder.

To present a clinical case of psychotic symptomatology induced by sleep deprivation.

Patient’s clinical file consultation and literature review using the search engine Pubmed® and the keywords: “sleep deprivation”, “sleep loss” and “psychosis”.

We present the case of a 41-year-old woman with a history of an episode of mood changes with psychotic symptoms that was preceded by a period of total insomnia. No psychotropic drugs since then and no relapses. In May 2020, she was admitted in psychiatry department due to clinical picture composed by significant psychomotor slowing, drowsiness, slowed speech, verbal visual, tactile and auditory hallucinations accompanied by grandiose delusions. These symptoms were preceded by total insomnia with one week of duration. In the hospital was administered quetiapine 100mg and lorazepam 2.5mg to aid in the recovery of sleep deprivation and concomitantly aripiprazole 15mg was prescribed. The patient presented a rapid and significant clinical improvement. Currently, it is without any type of medication and without psychopathological changes.

The clinical picture present in this case report was triggered after a significant period of sleep deprivation. Thus, it illustrates the role that sleep has in the development of psychiatric symptomatology, sometimes difficult to differentiate from psychiatric disorders.

No significant relationships.

Patients with schizophrenia suffer from cognitive difficulties expressed in the form of complaints as well as poor insight. The interaction of these two factors makes the management of these patients more difficult.

To assess subjective cognitive complaints in a population of schizophrenics and study its relationship to insight.

Our study was a cross-sectional, descriptive, and analytical study of 72 stabilized schizophrenics followed up at the outpatient clinic. Subjective cognitive complaints were assessed by the SSTICS, clinical symptoms by the PANSS, and insight by the SAI-E.

The mean age of our population was 46.83± 11.6 years. The patients had a low socio-economic level in 70.1%. They were unemployed in 46.9% , consumed alcohol in 23.6%, and consumed tobacco in 58,6% of the cases. the total score on the PANSS scale was 46. They had an average score of 25 on the total SSTICS score and 20,1 on the SAI-E. Cognitive complaint scores were significantly correlated with improved insight (p=0,00),low socio-economic level (p=0.04),alcoholism (p=0.001) and smoking (p=0.01)

Cognitive complaints in schizophrenia could be influenced by the level of clinical insight and reflect a deep malaise, requiring a more targeted and optimized management

No significant relationships.

Despite the high interest in affective aspects of endogenous depression, the question of overvalued ideas remains unclear.

To determine the clinical features of depression with overvalued ideas in the context of slow progressing schizophrenia.

The study involved 102 people, including 62 women and 40 men diagnosed with slow progressing schizophrenia, with moderate or severe depression, with the predominance of overvalued ideas (F21 in ICD-10). The control group had 110 people with similar distrubution by sex and age all diagnosed with a depressive state formed in the context of slow progressing schizophrenia, without overvalued ideas. Research methods were mainly clinical-psychopathological and clinical-catamnestic.

In the majority of observations (62.5%) in the comparison group, showed a uncomplicated form of depression, only limited to affective level. In the (37.5%) left, depression was characterized by a structural polymorphism, in addition to affective disorders, there were other psychopathological syndromes observed. In the main group, an inverse relationship was observed: uncomplicated depression in 29.2% of cases, while the overwhelming majority of cases (70.8%) experienced atypical depressions, disharmony of the affective triad, as well as an increase in the concomitance of neurotic and psychopathic symptoms were observed.

The cohort of patients with slow progressive schizophrenia with depression is heterogeneous, while the features of the course of the disease correlate both with the presence or absence of overvaluated formations in the picture of depression, and with the features of the modification of the overvaluated ideas during the disease.

No significant relationships.

Depressive symptoms in schizophrenia have a high prevalence – up to 20-60 %, at the different illness stages. Non-pharmacological treatment, namely rTMS, seems like a promising approach that lacks side-effects typical for antidepressants. RTMS is widely applied in the treatment of depression, however the studies within schizophrenia domain are still rather few

The aim was to examine a potential of neurophysiological data for prediction of the effects of rTMS in the treatment of patients with schizophrenia with depressive symptoms

20 male patients with schizophrenia (F20.004, F20.014, F20.414, ICD–10) were examined at the stage of incomplete remission with predominance of prolonged (more than 6 months) treatment resistant depressive symptoms. An examination (clinical and neurophysiological (oddball ERP and EEG) fragments)) was repeated twice - before and after a course of 10 Hz rTMS (left DLPC, 2000 pulses per session, 15 sessions).

Poor outcome was associated with initially higher coherence in alpha and lower - in beta1 EEG bands. The amplitudes of non-target N100 and mismatch negativity didn’t differ the groups of responders and nonresponders

The disturbances within brain networks of beta1 and alpha generators merit attention as potential neurophysiological markers with predictive value in rTMS treatment of patients with schizophrenia with depressive symptoms.

No significant relationships.

The study of the premanifest stages of the first psychotic episode with religious delusion is relevant due to the lack of clarity in differentiating normal religiosity from pathological and, as a consequence, a relatively longer period of an untreated psychotic state, which negatively affects both the course of the disease and its outcomes. Another important factor is the high risk of antisocial, autoaggressive and suicidal behavior at different stages of the disease.

The aim of the study is to identify the conditions for the formation of religious delusion in adolescence and young adults, to analyze the correlations between religiosity at the pre-manifest stage and the subsequent manifest psychotic episode with religious delusions of different content.

The 57 male patients at a young age (16-25 years) with a manifest psychotic episode (F20, F25 according to ICD-10) with religious delusion (delusion of sin (21,6 %), delusion of demonic possession (29,4 %), antagonistic and messianic delusion (39,2 %), oneiroid with religious content (9,8 %)) were studied with the clinical-psychopathological, psychometric (PAS) methods. The religiosity of patients in premorbid was assessed with the Duke University Religion Index (DUREL) questionnaire.

Of greatest importance in the formation of psychotic episode with religious content is hereditary burden, premorbid personality structure, high scores on the PAS scale.

The presence or absence of religiosity in premorbid doesn’t matter to formation of psychotic episode with religious delusion.

No significant relationships.

The relevance of this study is determined by the need to search for biological markers of schizophrenia. The detection and validation of such molecules can become the basis for the creation of additional paraclinical diagnostic methods or contribute to the creation of targets for individual pharmacotherapy, which is an important task of modern fundamental medicine.

Comparative proteomic analysis of serum in schizophrenic patients with positive and negative symptoms.

The study includes 10 healthy donors and 27 patients with schizophrenia. Samples preparation included: serum purification from major proteins via affinity chromatography, 1D-PAGE proteins separation, in-gel tryptic hydrolysis, LC-MS/MS mass-spectrometry (Orbitrap Q-exactive HF mass spectrometer, Agilent Technologies). Identification of proteins was carried out using Mascot software Ver. 2.1 («Matrix Science», USA). Proteins for quantitative analysis were selected in view of the DISGENET database. Quantitative LC-MS-SRM analysis of selected protein was performed on QQQ TSQ Vantage (Thermo Scientific) with labeled peptide standards.

Receptor-interacting serine/threonine-protein kinase 1 was selected for quantitative assessment. Significant differences were revealed in the RIPK1 concentrations in the serum of schizophrenic patients with negative and positive symptoms (p=0.02). The serum concentration of RIPK1 in patients with negative symptoms is tenfold in patients with positive symptoms.

Receptor-interacting serine/threonine-protein kinase 1 can be considered a biomarker of negative symptoms of schizophrenia based on a significant increase in serum concentration. Mass spectrometric analysis was carried out of the “Human Proteome” Core Facility of the Institute of Biomedical Chemistry Moscow. Support by Grant of RSF № 18-15-00053P.

No significant relationships.

DNA-hydrolyzing catalytic IgGs have caspase-dependent cytotoxic effects in autoimmune diseases. Recently, DNA-hydrolyzing IgGs have been discovered in schizophrenia. However, their cytotoxic properties have not been studied.

To assess the effect of serum IgGs with DNA-hydrolyzing activity of schizophrenia patients on the cell viability of the SH-SY5Y human neuroblastoma cell line.

Serum of 8 patients with paranoid schizophrenia in the acute phase and 7 mentally and somatically healthy persons were used. IgG was purified from serum by affinity chromatography on Protein-G-Sepharose columns. The DNA hydrolyzing activity of IgG was assessed by the degree of hydrolysis of the pBluescript plasmid. The cell viability of the SH-SY5Y human neuroblastoma cell line after exposure to purified IgG preparations was assessed by high-throughput screening on the CellInsight CX7 platform (Thermo Scientific, USA) using the fluorescent dyes propidium iodide and Hoechst.

Of the 8 IgG preparation obtained, 4 drugs had high DNA-hydrolyzing activity. All tested IgG preparations from healthy donors were inactive. One-way ANOVA analysis of the proportion of dead cells of the SH-SY5Y line after exposure to antibodies (0.1 mg/ml) showed no significant differences in the proportion of dead cells (p=0.688 after 24 hours; p=0.831 after 48 hours). Similar results were obtained at a higher concentration of antibodies - 0.2 mg/ml.

Thus, it has been shown in vitro that IgGs isolated from the serum of schizophrenia patients with or without DNA-hydrolyzing activity does not exhibit cytotoxic properties against the SH-SY5Y human neuroblastoma cell line. Support by Grant of RSF № 18-15-00053P.

No significant relationships.

Hyperprolactinemia is a common unwanted antipsychotic-induced adverse effect, particularly in female patients, and can induce poor adherence to treatment. Aripiprazole is an antipsychotic with partial agonist activity over the dopamine D2 receptors which can be effective in reducing hyperprolactinemia in patients treated with antipsychotics.

We investigate the efficacy of adjunctive treatment with aripiprazole for olanzapine-induced hyperprolactinemia and related hormonal side effects (amenorrhea, oligomenorrhea) in female patients with schizophrenia.

Eight female patients (22 to 40 years old) participated in this study with a diagnosis of schizophrenia and hyperprolactinemia-related hormonal side effects (amenorrhea, oligomenorrhea). Patients were treated with aripiprazole 10 mg/day added to a fixed olanzapine dose of 20 mg/day. Serum prolactin levels were measured at baseline and after 2, 4, 6, and 8 weeks. Symptoms and side effects were assessed using the Brief Psychiatric Rating Scale, Clinical Global Impressions Severity scale, Barnes Akathisia Scale.

Adjunctive treatment with aripiprazole resulted in significantly lower prolactin levels beginning at week 2. 87.5 % of patients at week 8 had prolactin levels normalize. Among 8 patients with menstrual disturbances, 75% of patients regained menstruation during the study. No significant changes were observed regarding psychopathology and adverse effect ratings.

Adjunctive aripiprazole treatment is effective for resolving olanzapine-induced hyperprolactinemia and reinstatement of menstruation in female patients, provides significant improvement and it appears to be safe with a lower risk of metabolic syndrome, without increased risk of adverse effects.

No significant relationships.

Paranoid ideas occur very often in humans (prevalence of 0.2%). According to several studies, the origin could be found in a genetic predisposition to a selective hyperdopaminergia related to the D2 receptor and dopamine neurotransmitter dysfunction.

To delve into this pathology, including origin and development, epidemiology, diagnostic criteria, clinical aspects, differential diagnosis, treatment, evolution and prognosis.

We conducted a literature review of delusional disorder.

The disease appears in middle age, between ages 35 and 55, being slightly more frequent in women. It seems to affect more economically and educationally disadvantaged social strata, and it is more frequent in immigrants. The onset is usually progressive and insidious. Correct perception but delusional interpretation: the objectivity of what is perceived is disturbed by the subjectivity of what is registered. The delirium is usually logical, contagious, and frequently credible. Patients retain their lucidity. It is very important to make a correct differential diagnosis with schizophrenia. With regard to treatment, the therapeutic relationship with the patient will be basic. If possible, psychotherapy should be combined with pharmacological treatment (second generation antipsychotics being the treatment of choice). In general, their evolution is compatible with out-of-hospital life, being considered “odd guys”.

The risk of suffering from Delusional Disorder during the lifetime is between 0.05 and 0.1%. This pathology constitutes 1-4% of all psychiatric admissions. Therefore, it is essential to know it in depth in order to be able to manage it properly.

No significant relationships.

The ongoing debate regarding the treatment efficacy for negative and cognitive symptoms in schizophrenia is a subject of continuous frustration among psychiatrists. These symptoms are reputedly hard to tackle therapeutically and their impact on long-term functional prognosis made them an important target for the maintenance treatment.

To review the literature in order to find the most adequate treatment options for negative and cognitive symptoms of schizophrenia.

A literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE, www.clinicaltrials.gov) using the search paradigm “schizophrenia” AND “negative symptoms” AND “cognitive symptoms” AND “pharmacological treatment”. All papers published between January 2000 and August 2021 were included.

The efficacy of atypical antipsychotics over cognitive dysfunctions in schizophrenia decreases with time, without significant differences between the agents. Clozapine, amisulpride, olanzapine, and risperidone have superior efficacy over positive and negative symptoms, with small to moderate effect sizes. Meta-analyses show decreased severity of negative symptoms during treatment with atypical antipsychotics, especially with clozapine, amisulpride, olanzapine, zotepine, and risperidone. Atypical antipsychotics had a superior effect over neurocognitive domains when compared to the typical antipsychotics. Newer atypical antipsychotics, with partial D2/D3 agonism, are preferred to other atypical agents, although based on a low level of evidence. Antidepressants, especially mirtazapine, may be a solution for negative symptoms, while modafinil/armodafinil is also useful as an add-on.

Although new therapeutic options are explored, there is a paucity of encouraging results from the pipeline regarding the treatment efficacy over negative/cognitive symptoms.

No significant relationships.

Caffeine acts as a competing antagonist of adenosine receptors, increasing the release of norepinephrine and the activation of noradrenergic neurons. Long-standing schizophrenia patients frequently develop a comorbidly high daily caffeine intake. This could be explained by its relationship with smoking [1,2].

To determine caffeine consumption in schizophrenia and predisposing factors.

Cross-sectional study designed on a sample of 68 outpatients with a follow-up of at least 5 years at the Mental Health Unit, aged between 18 and 65 years, diagnosed with schizophrenia (ICD-10). Average daily caffeine intake was quantified by reference values for each beverage: coffee (66.7mg/100ml), tea (30mg/100ml), soft or energy drinks (11.5mg/100ml). High intake was defined as a consumption of ≥200mg of caffeine per day. Retrospective review of medical records revealed tobacco use and negative symptoms observed on the PANSS scale. Statistical analysis were performed using SPSS v21.0 (significance p<0.05).

88.2% of the subjects were daily caffeine consumers with a mean intake of 146.7mg/day (SD=5.8), and a mean consumption time of 6.2 years. Coffee was the predominant beverage in 66.7% of the cases, followed by soft or energy drinks (25%) and tea (0.1%). 45% of participants also had a high caffeine intake of ≥200 mg/day. Comorbid smoking was found in 93% of these patients. Negative symptomatology prevailed among caffeine consumers (PANSS-N= 41.3).

Xanthine abuse seems to be highly prevalent in people with schizophrenia, and there may be a relationship with smoking and negative psychotic symptoms.

No significant relationships.

Alterations in a variety of immune parameters, including abnormal cytokine levels, are known to be found in schizophrenia. These changes can be useful in identifying patients with the most severe immune abnormalities.

To develop approaches to stratification of schizophrenia patients based on cytokine levels using cluster analysis.

We recruited 53 patients (25 women/28 men) with a verified diagnosis of simple or paranoid schizophrenia and 37 healthy individuals (19 women/18 men) in our study. Serum levels of IL-1β, IL-2, IL-4, IL-6, TNFα, INFα, BAFF, GM-CSF, NGFβ, NRG1, and GDNF were determined using a MAGPIX multiplex analyzer (Luminex, USA). Statistical analysis was performed in Statistica 10.

Principal component analysis and partial least-squares discriminant analysis showed that the combined multi-cytokine profiles of the studied groups differ. The results of the k-means cluster analysis are presented in Table 1 The most reliable results are obtained by a combination of 4 variable: IL-1β, IL- 4, BAFF and GDNF. Table 1 Percent of individuals classified in different clusters depending of number of parameters using for classification.

A subgroup (сluster 1) of schizophrenic patients with severe immune abnormalities was identified using data on the levels of IL-1β, IL-4, BAFF and GDNF. Anti-inflammatory therapy is recommended for this subgroup of patients. Support by Grant of RSF № 21-75-00102.

No significant relationships.

The detection of the initial prodrome of schizophrenia (SK) before the first episode psychosis remains a major concern in current psychiatric research.

In this paper we aimed to analyse clinical and psychopathological aspects of prodromes leading to first-lifetime psychotic episodes and to highlight the high-risk features in order to establish preventive strategies and to provide early intervention in SK.

This is a retrospective observational descriptive study conducted in the ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry in Bucharest, Romania. We collected data from the medical records of 139 patients previously diagnosed with SK who were admitted to our clinic. For all included patients, diagnoses were recorded according to the DSM-IV TR and ICD-10 classification criteria. Data collected included patient demographics and clinical information. All analyses were conducted using SPSS package.

Of the 139 patients included in this study, 130 patients (93,5%) presented prodromal symptoms. 73 of these patients (52,5%) presented with negative symptoms that were more common in our study in single male patients that had low academic performance and a family history of mental illness, findings consistent with the literature. A decline in social functioning decline was observed in 64 patients (46%) prior to their first admission. 87 patients (62,6%) had a prodromal phase which lasted more than one year.

These findings support the value of early psychopathology in predicting the diagnosis of SK, but clinical guidelines are needed for a more systematic evaluation of the SK prodrome.

No significant relationships.

Technologies such as the phone , the computer , and social media network nowadays are becoming more and more available to everyone including patients with mental illnesses.

Our study aimed to examine the prevalence of technology use in individuals with schizophrenia and schizoaffective disorder.

Study participants were recruited from the outpatient unit of the department C of psychiatry in Hedi Chaker hospital of Sfax , Tunisia. A total of 38 male patients were recruited , from whom the diagnosis of schizophrenia or schizoaffective disorder according to the DSM-5 criteria had been confirmed. Socio-demographic and clinical information as well as details about their technology use were was collected from all the patients.

Of the 38 study participants, 65.8% owned a cell phone , and 52.6% used the cell phone to send or receive messages. A rate of 21.1% owned a computer , 34.2% had internet access and 28.9% had an email account. A rate of 23.7% used social media. Facebook was the most popular social media site. 72% of cell phone owners would like to communicate with their doctor via text messages , and 68% would like to be reminded of their appointments via text messages. Among social media users , 55.6% expressed their interest in a social-media-based doctor-patient communication and appointment reminders.

Our findings suggest that these technologies afford an opportunity to improve the management of these patients.

No significant relationships.

Nonadherence to antipsychotic medications and disengagement from psychiatric services are frequent among people with psychosis. Research indicates how the beliefs of people with psychosis about the etiology of their symptoms, or their causal beliefs, affect treatment choice and outcomes. Yet, there is less research on causal beliefs of clinicians or on the impact of patient–clinician disagreements on treatment and adherence.

This review aimed to explore the scope of the literature focusing on clinicians’ causal beliefs and to map the degree of patient–clinician concordance in causal beliefs.

A systematic literature search of PubMed, Embase, Scopus, PsycInfo, and ASSIA and a grey literature search of PsyArXiv and MedNar yielded 11,821 eligible references.

Forty-two articles indicated that whereas clinicians endorse mainly biogenetic beliefs (9/15 articles, 60%), patients endorse mainly psychosocial causal beliefs (16/31, 52%) and other non-biogenetic causal beliefs (8/31, 26%). Most studies did not compare causal beliefs of people with psychosis and their treating clinicians.

While clinicians and people with psychosis often hold complex causal models, a gap in causal beliefs between these groups appears to exist, which may affect the therapeutic relationship and pose barriers to treatment adherence. Future studies should address this gap by developing interventions that facilitate open communication about causal beliefs to promote treatment alliance and an agreed-on treatment plan.

No significant relationships.

Alterations of glutamate, energy and glutathione metabolism contribute to the pathogenesis of psychotic disorders

Revealing clinical-biological correlations in patients with late onset schizophrenia and delusional disorder by determining clinical parameters and activity of platelet enzymes of energy, glutamate, and glutathione metabolism.

27 women of 45-80 years old were studied, with late onset schizophrenia or delusional disorder. Activity of platelet cytochrome c-oxidase (COX), glutamate dehydrogenase (GDH), glutathione reductase (GR) and glutathione-S-transferase (GST), and scores by PANSS, HAMD, MMSE, and CGI-S were evaluated twice: before and after the 28-th day of treatment. Activity of COX, GDH, GR, and GST was measured once in 23 women of 44-81 years old comprising the control group.

As compared with controls, only GDH activity was found significantly decreased (before and after treatment, p<0.001). Clusterisation of patients by enzymatic activities resulted in 3 clusters significantly different by COX, GDH and GST. Significant correlations were found between enzymatic activities and scores by psychometric scales: in the cluster 1 (n=9) baseline COX activity correlated with scores by PANSS positive subscale (R=0.9, p=0.001) and with scores by MMSE (R=-0.9, p=0.002); in the cluster 2 (n=12) GR activity after treatment negatively correlated with scores by PANSS (R=-0.9, p=0.001), PANSS negative subscale (R=-0.8, p=0.004), and CGI-S (R=-0.9, p=0.001).

The revealed correlations between enzymatic activities and clinical parameters give hope on detection of useful biochemical markers which, after enlargement of patients’ group with late onset psychotic disorders, would be validated for prediction of the pharmacotherapy efficiency and outcome of treatment.

No significant relationships.

The occurrence of a first episode-psychosis in adolescents or young adults represents a difficult struggle with an uncertain and divergent outcome, since the clinician does not have at his disposal the clinical elements sufficient to predict these different disease trajectories.

Our aims are to describe the socio-demographic, clinical characteristics and the short and long-term outcomes of a first episode-psychosis and to identify the predictive factors of the transition to schizophrenia.

We conducted a retrospective study about 117 patients hospitalized for a first episode-psychosis in the Psychiatric Department of Monastir (Tunisia). Sociodemographic and clinical features were collected using a pre-established form.

First-episode psychosis affected young male subjects with low educational level. Stressors were present in 54.7%. An 8-week prodromal phase preceded the onset of the disorder in 59%. The disorder course included diagnosis of: Brief psychotic disorder (32.5%), schizophrenia (31.6%) and bipolar disorder (18.8%). The short-term outcome was characterized by a complete remission rate of 58.1% at 3 months and 37.6% at 6 months. The long-term outcome was marked by a high rate of lost to follow-up: 70.8% after 5 years. The transition to schizophrenia was linked to the presence of delirium of influence and the absence of favorable course at 3 months.

Our results led to the identification of the profile of patients with a first episode-psychosis and the factors correlated with a diagnosis of schizophrenia. Indeed, the determination of risk factors would make it possible to adapt earlier the care.

No significant relationships.

Delusional parasitosis, first documented in 1946, is a rare psychiatric illness described as both a stand-alone diagnosis, as well as a secondary condition to an underlying psychiatric or medical pathology, or substance use. Interestingly, the fixed false belief of being infested has also been identified in partners of individuals with the disease, and in some cases the delusion permeated families and was thus given the name “folie en famille”.

To describe the first reported case of delusional disorder, somatic type, with similar delusional symptoms in the patient’s husband, in the State of Qatar.

Patient and her husband were interviewed. Her file was reviewed for past history and medications.

34-year-old female with no past psychiatric history, 5 months post-partum, reported fixed beliefs of insect infestation in her baby’s skin, hers, and her husband’s, of 2 months duration. She reports a pruritic rash, and perceives proliferating insects in different life stages. The family relocated 5 times in 2 months. They bathe in vinegar several times a day to exterminate the insects. Husband mirrors her account of infestation with milder symptoms. Repeated medical investigations were insignificant. OCD, mood disorder, and other psychotic illnesses were ruled out.

Delusional parasitosis presents a unique therapeutic challenge to psychiatrists. It is necessary to build rapport with patients, rule out comorbidities, and conduct randomized controlled trials to evaluate the effectiveness of psychotropic drugs in its treatment. In cases of shared delusions, identifying the primary patient is crucial for treatment of all the individuals that share the delusion.

No significant relationships.

Successful stabilization of patients with mental disorders requires most of the times the use of more than one antipsychotic medications with increase prevalence of clozapine in refractory cases. Constipation consists one of the most debilitating side effect of the therapy, which gradually progresses to a chronic state of bowel movement dysfunction, with recurrent episode of paralytic ileus of various severity.

We describe the case of a middle age male treated with clozapine for refractory mental disorder, who developed ileus and subsequent bowel dysfunction not amenable to laxatives.

The acute episode have been treated conservatively with nasogastric decompression, intravenous replacement of fluids and electrolytes, antibiotics chemoprophylaxis and low molecular weight heparin. His overall physical status was unremarkable for obesity, diabetes, hypertension, allergies, previous operations and a former endoscopic evaluation conducted in the recent past, which had ruled out malignant neoplastic disease.

A course of per os prucalopride have been instituted, which showed preliminary promising results in restoring proper bowel movements, without any serious side effect and without the need to discontinue his course with antipsychotics. Prucalopride is a 5 HT4 agonist which selectively binds to the receptors of the intestine, resulting in muscular contractions as well as clorium secretion from the mucosa promoting an osmotic defecation.The substance has been extensively use in the treatment of irritable bowel disease of the chronic constipation type.

We suggest the more systematic use of this agent in this group of patients after proper endoscopic evaluation and restoration of all secondary causes of constipation.

No significant relationships.