Early-onset schizophrenia begins before the age of 18. Drug treatments are mainly based on antipsychotics, preferably atypical antipsychotics, which have fewer side effects compared to first generation antipsychotics.

Resistant schizophrenia is defined as an inadequate response to two different antipsychotic treatments for a sufficient duration and dosage. Clozapine is the only drug treatment currently approved for patients with resistant schizophrenia, for which the risk of aganulocytosis must be monitored.

In order to derive a clear benefit, different scientific organizations, recommend the use of Clozapine as early as possible, and they state that there is little evidence to support the use of very high doses of antipsychotics.

We seek to determine the effectiveness of clozapine treatment in the management of early schizophrenia resistant to more than two antipsychotic treatments.

Description of a case of early resistant schizophrenia , in a 16-year-old girl, put on clozapine in comparison with the data of the literature.

Discussion: through articles published on google scholar, pubmed, and science direct

Treatment with clozapine, showed efficacy in the case of early schizophrenia resistant to several lines of antipsychotics, including disappearance of auditory and visual hallucinations and delusions.

The efficacy of clozapine treatment in early resistant schizophrenia raises the question of its use in first line from the beginning of the schizophrenic disease, however its side effects and its difficulty of follow-up raise questions in relation to its use.

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The majority of studies on the HIP IQ attest a heterogeneity of the IQ profile as specific to HIP. However, the samples are recruited in clinical consultations. Thus, it is important to investigate new samples from schools.

We aimed to analyze the index scores of the IQ profile of children without disorders or specific school assistance.

The WISC-V was conducted and analyzed in 80 healthy children (50 HIP vs. 30 non-HIP), aged 7-to-13 years-old (mean 10y; SD 1.8). All children were recruited in private and public schools in Paris.

All IQ index scores were significantly higher in the HIP vs. non-HIP. In both groups, the Verbal Comprehension Index was the highest index while the Processing Speed Index was the lowest. There are significantly (p=0.02) more heterogeneous IQ profiles in HIP (64%) vs. non-HIP (47%), with a significantly larger gap between the highest and lowest index (respectively: median = 29.5 vs. 21.5). There was a significant-positive correlation between IQ level in general and the heterogeneity of the profile (r = 0.42; p<0.001).

The HIP children show better verbal, visual-spatial, fluid reasoning, working memory, and processing speed index scores. However, the distribution of IQ index scores was similar in both groups. Thus, the heterogeneity of the IQ profile is not specific to HIP children, but rather related to IQ score level. This highlights the importance of considering the IQ as a continuum rather than as a categorical distribution. Moreover, it points to the interest to better understand the IQ profile by completing it with multidimensional assessments.

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Serious mental illness in adolescence that not only has a significant impact on the patient but also on other contexts such as their family. Caregivers assume almost all of the care. This responsibility exposes caregivers to intense overload with negative consequences.

To evaluate and quantify the overload of the primary caregiver in children and adolescents with severe mental disorders.

A prospective study was designed using structured interviews in caregivers of patients between 11 and 18 years of age with severe mental disorders and substance use who were evaluated in the psychiatric emergency service for 2 months. The Zarit Caregiver Burden Scale was used for quantitative assessment. Diagnosis, main caregiver, socio-health resources were recorded.

Of a total of 35 patients with serious mental illness between 11 and 16 years of age, the following was observed: intense caregiver burden in 42.2% of cases, moderate in 21%. Being the main caregiver the mother. 27.5% had adequate use of socio-health resources, while 42.7% had not requested them. The greatest need detected was economic and rehabilitation.

Serious mental disorder present since adolescence leads families to significant destabilization of the family nucleus and comorbidity of psychiatric disorders in caregivers. Good orientation and evaluation of individual cases are necessary to guide families about the resources available in the social and health network, thus avoiding a high overload of caregivers and improving the quality of life of families.

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There is still a paucity of studies exploring the impacts of teenage employment on mental health and development. In many developing countries, youths participate intensively in the teenage labor force. The involvement of adolescent in the world of work would promote the development of responsibility and prepare the young person to function more effectively in adult roles.

The purposes of the present study were to examine the adolescent separation-individuation among an understudied and vulnerable population; and to examine the Separation-Individuation Test of Adolescence (SITA) for revealing the differentiation working male group from student male group.

Participants completed the SITA. The group of study 1 consisted of 618 high school and 252 university students between the ages of 14 and 24, 489 of which were girls and 381 were boys. In Study 2, participants were 269 male adolescents between the ages of 15 and 17, 141 of which were full-time worker and 128 high school students. In study 1, these results were consistent with the rapprochement subphase of the separation-individuation process in adolescence -the striking desires for intimacy and independence.

Our results support the gender specific patterns of identity formation and the argument that connectedness in close relationships plays a central role in the female identity development. Interestingly, there were no significant gender differences in the tendency to view close interpersonal relationships as threatening to their sense of independence and selfhood, and to deny or avoid dependency needs. The reason for this might be the cultural differences between the individualistic and collectivistic cultures. In study 2, working males could be distinguished from student counterparts by their increased tendency to seek close interpersonal ties with caretakers. The finding also suggested that student males reflected characteristics of the traditional view of adolescents’ independence striving. Across both studies it was found that the traditional Turkish child-rearing patterns have been characterized by an emphasis on interpersonal relationships and close ties with family than individualistic cultures

Our results revealed that the subscales of SITA –especially dependency denial, rejection expectancy, nurturance seeking, engulfment anxiety, and teacher enmeshment- can help clinicians for assessing the adolescent separation-individuation process in a reliable way. We suggested that adolescent employment would lead to the difficulties in developing bonds with parents because of the adolescents’ long work hours, the early involvement with the world of work would lead to the withdrawal from the more dependent, preadultlike student role, and student adolescents would reflect characteristics of the traditional view of adolescents’ independence striving.

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MDD is a chronic illness characterized by complex patterns of persistence, remission and relapse. Personality disorder (PD) is a negative prognostic marker MDD and its chronicity, and dynamics of STPD and BPD in adolescence occurs most severely.

The purpose of this study was to study the effect of STPD and BPD on the course of MDD in comparative groups in youth.

Clinical psychopathological interview and follow-up assessment, SCID-II, Hamilton Depression Rating Scale (HDRS). Sample: N=102 male and female with MDD in STPD and BPD into two equal groups of 51 people respectively. MDD was assessed in each of both PD groups in two time frames: current and during depressive the last 12 months in adolescence; three and more years later during adolescence. Outcome predictors included: clinical characteristics of MDD, duration of current episode, relapse rate. The average age of first MDD in both groups was 18.9±3.2 years.

The first MDD with both PD in adolescence characterized by psychopatological variety due to type PD and age factor. Depressive was more variability of affect, and shorter duration (less then 6 months N=28 (55%)) in group BPD as opposed to the sustained mood problems seen in STPD – (6-12 months N=19 (37%); 12 months and more N=21(41%)) with MDD (p=0,004; χ2= 14,997). During the subsequent follow-up assessment among patients with BPD had the highest percent recurrences once every 6 months or more (N=36 (71%)) and those with STPD significantly rarer recurrences, every 6 to 12 months (N=21(41%)), Less than once a year N=17 (33%)), (p=0,001; χ2= 23,252). Diagnosis of PD in adolescence is based on pathological traits, and impairment in the affective disorder is measurement separately. When measuring impulsivity in the BPD group, significantly higher rates BIS-11 scale were noted (74±1) than in the SPD group (61±1).

Diagnosis of PD in adolescence is based on pathological traits, and impairment in the affective disorder is measurement separately. It has been confirmed that PDs are a negative prognostic marker of the manifestation of a MDD in adolescence, and the presence of BPD is a serious prognostic predictor of its persistence.

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The prevalence of overweight and obesity in youths has increased considerably and is related to several health and psychological issues. According to a study from Public Health Institute in Albania 7.7% of children are obese (Hyska et al., Albania Public Health Institute 2013), but there are no data for adolescents.

Recently a special attention is given to psychological consequences of obesity in youths. The aim of this study was to explore body image, self-esteem and psychosocial coping of obese adolescents.

The sample consisted of 200 obese Albanian adolescents aged 12-15 years old, 134 females and 66 males. BMI was considered as the obesity index. We used WHO growth references to determine body mass index (BMI) percentiles. Participants were students enrolled in grade 6 to 9. We used Rosenberg self-esteem scale and Body Shape Questionnaire by Cooper et al. which measures recent concerns about appearance feelings and is a widely used self-report measure of body shape dissatisfaction. Also, a self-constructed questionnaire related to social interactions, stigma and psychosocial coping was distributed to adolescents.

We found out an association between obesity in youths and self-esteem (77% of the sample had a low self-esteem), body image (72% reported moderate and strong concerns for their body appearance), as well as problems of social interaction. Low self-esteem was more prevalent in females (53%) compared to males (20%). There was no significant gender difference regarding body appearance concerns (p >0.05). The majority of the sample (64%) reported to be bullied, but they did not tell anyone about it.

Our findings reinforce the negative effects of obesity in early adolescence. Body image is closely related to self-esteem and this is noticeably manifested during early adolescence. Low self-esteem might be related with body shape dissatisfaction, but we didn‘t further explore the correlation. This sample of obese adolescents reported to be largely exposed to bullying (64%), still it is of great concern that none of the adolescents did confess it to family, teachers, school psychologist or friends.

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Previous researches have not distinguished between-person effects from within-person effects when exploring the relationship between self-esteem, coping styles, and anxiety symptoms among adolescents.

To address this gap, this study investigated reciprocal associations among self-esteem, coping styles, and anxiety symptoms in a three-wave longitudinal panel survey, using an analytical strategy that disaggregates within-person and between-person variance.

The data was drawn from the Longitudinal Study of Adolescents’ Mental and Behavioral Well-being Research study conducted in 10 public schools in the Guangdong province of China. All participants had a baseline visit (N = 1957, age 13.6, grades 7 and 10) and follow-up interviews at one-year intervals for 3 years. A random intercept cross-lagged panel model combined with mediation analysis was performed.

At the within-person level, following results were observed. (1) Low self-esteem and anxiety symptoms bidirectionally predicted each other. (2) Low self-esteem and negative coping style bidirectionally predicted each other. (3) Anxiety symptoms predicted subsequent negative coping style but not vice versa. At the between-person level, we obtained the following main results. (1) Significant predictive effects on the random intercept were found among all three study constructs. (2) There were sex differences regarding the association between self-esteem and anxiety symptoms and the correlation strength of females was greater than that of males. (3) Self-esteem mediated the reciprocal relations between coping styles and anxiety symptoms.

These results could be an important advance by elucidating the reciprocal relationships among self-esteem, coping styles, and anxiety symptoms at the within-person level, suggesting that interventions targeted at promoting self-esteem and cultivating positive coping style may help reduce adolescent anxiety.

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This study investigated the prevalence and comorbidities of attention deficit hyperactivity disorder (ADHD) among adults and children/adolescents in Korea.

This study used data from the Korea Health Insurance Review and Assessment Service collected from 2008 to 2018. Study participants comprised patients with at least one diagnosis of ADHD (International Statistical Classification of Diseases and Related Health Provisions, 10th revision code F90.0). Prevalence rates and psychiatric comorbidities were also analyzed.

We identified 878,996 patients diagnosed with ADHD between 2008 and 2018. The overall prevalence rate of diagnosed ADHD increased steeply from 127.1/100,000 in 2008 to 192.9/100,000 in 2018; it increased 1.47 times in children/adolescents (≤ 18 years) and 10.1 times in adults (> 18 years) during this period. Among children/adolescent and adult ADHD patients, 61.84% (95% confidence interval [95% CI] 61.74−61.93) and 78.72% (95% CI 78.53−78.91) had at least one psychiatric comorbidity, respectively.

Our results showed that the prevalence rate of diagnosed ADHD has increased in Korea; however, it is lower than the global average. Further studies are required to identify and treat vulnerable populations appropriately.

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Children and adolescents treated with corticosteroids (CS) may experience psychiatric side effects, including psychotic symptoms. These can occur at any time during treatment, including withdrawal. There is evidence in the adult literature that higher doses of CS increase this risk. However, the dose-response relationship is not clearly identifiable. This is probably a reflection of the complexity of the effects of CS on the central nervous system and the body.

the objective of this study is to discuss the psychiatric manifestations secondary to corticosteroid therapy

This is a descriptive study of 10 children with a history of somatic pathologies for which they were placed on oral, nasal, or intravenous corticosteroid therapy and who during the course of this corticosteroid therapy presented with various psychiatric manifestations.

The majority of the children studied were male, i.e., 7 boys to 3 girls, six children either 60%, were on nasal corticosteroids; 20% on intravenous corticosteroids, ., 20% orally.

The psychiatric manifestations noted were represented by : depressive disorder in 8 childrens Anxiety in 7 childrens a psychotic disorder in one child ADHD in 3 childrens.

A causal role of corticosteroid therapy in the development of mental disorders in children and adolescents has been widely discussed but the results are controversial with respect to the route of administration, the relationship with the dose and the chronology of the development of mental disorders.

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Autoimmune diseases play a role in the etiology of a range of psychotic disorders which has attracted increasing interest in recent decades. This hypothesis is supported by genetic findings linking markers related to the immune system and mental disorders, and by clinical studies revealing increased levels of inflammatory markers in patients with mental disorders

The objective of our work is to discuss the involvement of autoimmune diseases in the development of mental disorders in children and adolescents.

We conducted our study through the analysis of three clinical observations.

These were three patients followed in the child psychiatry department for a characterized depressive disorder, an ASD and an acute psychotic attack, and in whom an autoimmune disease was revealed either in the history or on paraclinical explorations.

It appears legitimate to evoke and search for these autoimmune pathologies among the other organic etiologies, in front of any child or adolescent presenting acute and atypical psychiatric symptoms, tables of cognitive regression and resistances to the usual treatments. Biological immunological examinations, even invasive ones, should be repeated, if necessary.

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Antipsychotics have shown their interest in several pathologies of the child and the adolescent. However, in this vulnerable population, they are not without adverse effects. Depending on the type of molecule used, classical neuroleptics or second generation antipsychotics, but also within these own classes, the profile of tolerance and adverse effects differs. In this sense, children treated with psychotropic drugs have a higher risk of developing metabolic syndrome compared to children who do not take this treatment.

The aim of this work is to discuss the metabolic syndrome in children treated with psychotropic drugs and this through three clinical vignettes.

we conducted our study through an analysis of three clinical cases

It is about three children followed in the service of child psychiatry of the hospital Ar-razi of salé, aged respectively 11, 13 and 14 years, these children were put under psychotropic drugs for various mental disorders and developed during the evolution of metabolic side effects in particular a dyslipidemia, a diabetes of type 2 revealed by a diabetic ketoacidosis and a hyperprolactinemia.

Systematic monitoring and preventive programs targeting weight gain and metabolic side effects should be an integral part of the overall management of adolescents on psychotropic medications.

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Psychosis and dissociative disorders are both described in the DSM-5 as different diagnostic categories. However, a high comorbidity of these diagnoses has been observed in different studies, perhaps due to the overlapping of symptoms between them.

A systematic review about overlapping symptoms in psychotic spectrum and dissociative disorders

Presentation of the case of a patient and review of the existing literature on the differential diagnosis between dissociative disorder and other psychotic spectrum disorders.

Both similarities and differences have been found between both diagnoses. Patients with dissociative disorder experienced more dissociative and positive symptoms while those on the psychotic spectrum experienced more negative symptoms. The literature reflects that the two entities overlap on many of their diagnostic symptoms. On some occasions, more dissociation has been detected in patients diagnosed with the psychotic spectrum than those with a diagnosis of dissociative disorder.

Despite the fact of being different diagnostic entities, the literature does not reflect clear boundaries between psychosis spectrum symptoms and dissociative disorder.

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In recent research, psychological disorders have been increasingly defined as complex dynamic systems in which symptoms are interconnected and influence each other, thereby forming symptom networks. This paradigm shift calls for the analysis and interpretation of relationships between symptoms that are complex, potentially non-linear, and dynamic. Dynamic Time Warping (DTW) is used to measure similarity in temporal sequences, and has recently been found effective in modelling psychopathology symptom networks.

We aim to demonstrate that DTW could also be used to model the network structure in Ecological Momentary Assessment (EMA) data.

355 participants of the Netherlands Study of Depression and Anxiety (NESDA), of which 100 with and 255 without current disorder, completed EMA assessments of 20 symptoms (e.g., feeling sad, tired, satisfied) five times a day for two weeks. DTW analysis was performed on the group level, comparing participants suffering from mood disorders to healthy controls. DTW distances were visualized as an undirected symptom network, in which we adjusted for the average symptom severity per item per person.

DTW analysis of close to half a million symptom scores yielded six symptom dimensions based on their aggregated similarity of changes over time within the participants. Surprisingly, negative affect symptom networks were found to be less strongly connected in those currently suffering from mood disorders than in controls, whereas the network density of (reverse-coded) positive affect symptoms was more closely connected in this group. This is contrary to the results of previous studies, where negative affect-related symptom networks of those with mood disorders were found to be more strongly interconnected.

DTW is a promising new technique for analyzing EMA data and modeling dynamic symptom networks at both the individual and group levels. Using EMA data, symptom networks and dimensions can be modeled with great structural and temporal detail. Incorporating the temporal symptom dynamics may highlight the importance of the independent trajectories of negative mood symptoms.

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The history of psychiatry is the history of the unitary psychosis concept. Recent studies on this subject by prominent authors (Huda, Stanghellini, Broome, etc.) confirm that the problem has not been resolved but that it reappears now with more force from skeptical positions, based above all on the insufficiency of the classification criteria official (ICD-10, DSM-V). This skepticism has led to an attempt to make the line that separates normality from mental illness disappear with the weak argument that isolated psychotic symptoms are detected in the general population.The proposals to stop these movements that border on the denial of mental illness try to provide more information on the contextual and subjective factors of mental illness, thus reinforcing the so-called biopsychosocial model formulated by Engel in 1976, whose conceptual imprecision is largely responsible for the problems before indicated as well as other more serious ones for the organization of psychiatric care.

Point out the insufficiencies of the biopsychosocial model.-Point out the advantages of acquiring a classic evolutionary approach such as the one designed by Iván Pavlov besides the Volga and improved by some followers.-highlight the differences between researching in psychopathology, a true science, or doing it in clinical psychiatry, its practical application. This distinction is essential.

The works of some authors who have approached this conflict with dedication and rigor will be reviewed.Research lines followed during last hundred years in psychiatry will be contrasted with the results obtained.

New points of view and new tools need to be incorporated to solve this conflict that confuses experts so much are proposed.Ways of working are indicated that should avoid confusion between psychopathology and clinical psychiatry

A psychiatric diagnosis must be established on solid conceptual basis that we currently lack.-Both Kraepelin and Kurt Schneider are two key figures to recover and keep current in our daily practice.-The importance of patient’s subjectivity when taking an anamnesis of their problems seems very important. The question is how to manage that subjectivity in order to analyze it from a classical scientific model, Pavlov’s great desire.-A revisiting of Husserlian phenomenology is essential in the training plans of young psychiatrists and in daily psychiatric care. But this is not enough. We need new tools and new conceptual frameworks so that the phenomenological perspective can contribute to put light in problems as important as those generated by the constant change of diagnosis that is carried out with many patients.If we want a scientific psychiatry we cannot handle with tools that have failed since their creation.

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Climate change is increasing the frequency of extreme weather events – such as heatwaves, droughts, floods, and wildfires – and undermining the mental health and wellbeing of global populations, but the dimensions and scope of this burden remain under-studied.

To identify the distinct but overlapping mental health domains that are being impacted by climate change-related stressors and how these domains relate to and interact with one another.

A narrative synthesis of conceptual and empirical studies of climate change and mental health.

We find strong empirical evidence that climate change is already harming mental health across multiple mental health domains, including through increased rates of psychiatric disorders (e.g., PTSD, depression, anxiety), sub-clinical psychological distress, harmful substance use, self-harm/suicidal behaviors, and worry about the observed and anticipated impacts of climate change. Most of the mental health burden is likely to occur in the form of sub-clinical symptoms, including lowered resilience and subjective well-being, while negative psychological states (e.g., eco-anxiety) are likely to constitute a smaller proportion of the overall burden. We argue that the mental health burden can be helpfully conceptualised within a dual-continuum model that considers the presence/absence of psychiatric diagnosis on the one hand, and high/low psychosocial wellbeing on the other.

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Climate change is already harming the mental health of global populations across multiple functional domains. Defining and tracking the scope of this growing burden is essential so that effective preventive and adaptive action can be taken.

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For most countries it is currently unknown to what degree concentrations of psychotropic drugs in surface water exceed environmental threshold concentrations (ETCs) [MOU1] for ecosystems and what risk mitigation could be applied. ETCs are defined as per-compound threshold concentrations above which detrimental effects on reproduction, growth, and mortality of aquatic organisms cannot be exclude

To quantify levels of antidepressants, antipsychotics, mood stabilizers, and benzodiazepines in surface water, investigate their sources and assess whether these levels exceed ETCs.

Cross-sectional analysis of measured and modeled data. Environmental levels were compared to ETCs to evaluate their risks for the aquatic environment. Finally, sources of psychotropic drugs were investigated.

All available Dutch water monitoring data from all regional and national monitoring campaigns of 2019, the last year before the COVID-19 pandemic.

Concentrations of aripiprazole, carbamazepine and its metabolites, clozapine, diazepam, (es)citalopram, fluoxetine, haloperidol, nortriptyline, olanzapine, oxazepam, temazepam, quetiapine, sertraline, valproic acid, and venlafaxine.

The main outcomes were measured and modeled concentrations of the aforementioned agents in surface water. As a secondary outcome, where possible, average risk quotients (RQs) were calculated by dividing the measured or modeled concentrations by the ETC. An RQ > 1 was interpreted as a risk to the environment.

Psychotropic drug samples (n=1201; 14-520 measurements per drug) showed the highest average concentrations for oxazepam (0.91 μg/L; RQ = 1.89) and carbamazepine (0.74 μg/L; RQ = 1.48), with individual measurements exceeding ETCs. For other drugs, measured concentrations did not reach the detection limit (amisulpride, (es)citalopram, quetiapine, and venlafaxine) or did not exceed the ETC (fluoxetine). Furthermore, households contributed most to psychotropics in surface water. Finally, psychotropics were cleared less efficiently from a wastewater treatment plant than other medications.

Psychotropic drugs are present in surface water, are primarily emitted by households, and may put organisms at risk. We signal a need to reduce concentrations of several psychotropic agents in the environment. Our findings set the stage for policies and research aimed at curtailing emissions of psychotropic drugs into the environment and highlight a need for responsible prescribing and waste measures.

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There is an urgent need for sustainable thinking and practices in healthcare systems to meet the challenge of climate change (Charlesworth & Jamieson, 2019; Corvalan et al., 2020; Luykx & Voetterl, 2022; Madden et al., 2020). This need is accelerated by the recent energy crisis. According to an international NGO policy paper (Karliner et al., 2019) healthcare institutions are large energy consumers and major emitters. The (mental) health sectors of the Netherlands and Flanders, the northern part of Belgium, also greatly contribute to the global climate crisis. Both regions have per capita emissions (between the 0.50t and 1t) that fall just below the world’s healthcare top emitters.

To evaluate the state of sustainability in Dutch and Flemish mental health institutions (including psychiatric hospitals, rehabilitation centers, and community mental health centers) and assess whether certain differences can be found in the climate policies of these institutions between both regions.

Board members of mental health institutions were asked to complete a 20-item online survey in which concrete actions, objectives and ambitions in the field of sustainability were questioned. Frequencies and percentages were calculated for each question. For certain topics chi-squared tests were performed to test differences in sustainability issues addressed in the questionnaire between Dutch and Flemish mental healthcare institutions.

Survey response rates for Dutch and Flemish mental health institutions were 38% and 20%, respectively. Ninety-five percent and 38% of respectively the Dutch and Flemish institutions fully agreed that sustainability is a very important theme (χ2(1)=2,25, p=0,13). Key focus areas in both regions included sustainable energy transition (with half of the mental health institutions sourcing at least half of their energy via renewable energy resources and technologies) and recycling (almost 80% of the institutions). Statistically significant differences were found between both regions with regard to monitoring the environmental impact (Flanders 24% vs. The Netherlands 60%, χ2(1)=6,41, p=0,01) and fostering more sustainable commutes (Flanders 72% vs. The Netherlands 15%, χ2(1)=17,35, p<0,0001). The climate impact of medicines and food, as well as investments in sustainable projects, received little attention.

Although a substantial part of Dutch and Flemish mental health institutions consider sustainability (very) important, a systemic ‘transformation’ will be necessary to make them climate neutral, as tenets of practicing mental healthcare sustainably include more than sustainable energy transition and recycling (Monsell et al., 2021). Moreover, a lack of sufficient investment opportunities, partly due to a lack of financial resources, seems to be the main barrier for many mental healthcare institutions for quickly reaching sustainability goals.

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Ayahuasca is a traditional brew containing the psychedelic 5-DMT (a tryptamine that acts as a 5HT2A-R agonist) used to achieve non-ordinary states of consciousness, with a long tradition among various cultures in ritual and therapeutic contexts. Ayahuasca is being studied as potential treatment in Mental Health, which has led to non-controlled and recreational use. This has led to a rise in the description of side effects, such as substance-induced psychosis.

To describe a case of a possible psychotic episode related to the intake of ayahuasca brew in a ritual context.

Clinical assesment and bibliographic review of pertinent literature.

We will present the case of a 43 year old woman, who participated in three ayahuasca sessions in three consecutive months. Two days after the last session, she suffered and episode of loss of consciousness, convulsions, loss of streng and paraesthesia in right forearm and righr side of the face and head; and apparition of perceptual alterations and delusions that she did not experience during the trip. Such alterations included the perception of electromagnetic fields (EMF) robbing her of her vital energy and lifeforce. She required ICU treatment for four days, after which se was hospitalized in Internal Medicine Unit and was assessed by Mental Health team. Though the symptoms were coherent with the previous beliefs of the patient, they were clearly exacerbated and interfered with her normal and previous functioning. She was treated with risperidone 1,5 mg, with complete symptom remission.

The case presented is consistent with other reports of ayahuasca-induced psychotic symptoms, though with less intensity and duration. We discuss prevalence and repercussions of the rising use of this powerful substance; that must be taken into consideration by clinicians worldwide.

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Amyotrophic lateral sclerosis (ALS), the most common disease within motor neuron diseases (MND), and frontotemporal dementia (FTD) belong to a broad spectrum of neurodegenerative diseases that are sometimes clinically overlapping.

The aim of the description of this case report is to sensitize professionals to this type of presentation and encourage the investigation of signs and symptoms of motor decline in patients with suspected FTD.

Research in the patient’s clinical process. Framing the clinical case in the current literature, searching the terms “frontotemporal dementia” and “amyotrophic lateral sclerosis” in the Pubmed database.

A 71-year-old patient, followed in psychiatry for several years for Dysthymic Disorder. At the end of 2020, he presented cognitive and behavioral changes, with rapid progression, with a marked loss of functionality, compatible with dementia. In 2021, it was noticed a motor decline, which progressively worsened. In this sense, an electromyographic study of the limbs was performed with an abnormal result, compatible with a diagnosis of Motor Neuron Disease.

A significant overlap of these two disorders has been observed clinically. Thus, the presentation of a patient with dementia, specifically suspected of having FTD, should ring the bell to the presence of signs and symptoms of motor impairment.

Several studies have been carried out in order to understand the relationship between these entities, and the discussion remains whether their presentation together constitutes or not a form of phenotypic presentation of ALS.

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Severe mental illnesses such as schizophrenia, bipolar disorder and depressive disorder are common worldwide and often have a chronic course.

Due to psychiatric ( for example : substance use disorders ) and somatic ( for example : obesity, cardiovascular disease, diabetes ) comorbidities, mortality is higher in these patients than in the general population.Viral diseases are, in addition to cardiovascular diseases and metabolic alterations, among the most common somatic comorbidities in people with severe mental illness.

The objective of our work was to study the prevalence of vaccination against the viral hepatitis B virus in these patients.

For this purpose, we conducted a cross-sectional study of 200 patients hospitalized in the emergency department of our training center. First, we collected sociodemographic and clinical data on patients admitted to psychiatric emergencies: sex, age, diagnosis, duration of evolution, history (medical and surgical, psychiatric, suicide attempts, problematic substance use, previous incarceration). In a second step, we tested for anti-HBS antibodies.

the majority of our patients were male, the first diagnosis was schizophrenia.

92% of our patients had a substance use disorder, mainly tobacco, followed by cannabis and then alcohol.

Several patients reported having unprotected sex.

58% of patients were vaccinated against hepatitis B, these patients were young for the most part. the majority of our patients were male, the first diagnosis was schizophrenia.92% of our patients had a substance use disorder, mainly tobacco, followed by cannabis and then alcohol.Several patients reported having unprotected sex.58% of patients were vaccinated against hepatitis B, these patients were young for the most part.

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