The recent literature indicates that the gut microbiota may affect brain functions through endocrine and metabolic pathways, antibody production and the enteric network while supporting its possible role in the onset and maintenance of several neuropsychiatric disorders, neurodevelopment and neurodegenerative disorders.

The aim of this work is to discuss the role of probiotics, prebiotics, or synbiotics as a potential treatment for symptoms of depression, anxiety, and stress.

Pub Med database was searched using following key words: “probiotics”, “prebiotics”, “mental disorders”, “psychological disorders”.

Although the exact mechanism is unknown, there is a link between the gut and mood disorders. Psychosocial factors, such as quality of life or well-being, are greatly influenced by gut function and there is a strong correlation between psychosocial features and gastrointestinal disorders. Elevated stress, anxiety, and depression are linked to intestinal dysbiosis and mood disorders are disproportionately high in patients with functional gut disorders. So, psychobiotics may provide benefit when used in conjunction with current antidepressant medications. Probiotics may exert their therapeutic benefits by restoring microbial balance in the gut, and also by minimizing gastrointestinal complaints, allowing for the effects of antidepressant medication to not be reduced. Stress and immune responses were improved following psychobiotic intervention in stressed adults. Psychobiotics offer potential alternative treatment options in mood disorders and their accompanying symptoms.

Pro and prebiotics can improve mental health and psychological function and can be offered as new medicines for common mental disorders. However, more clinical studies are required to support the clinical use of probiotics.

No significant relationships.

Visual images and music have long been known as a means to optimize emotions (Galeev, 1976; Gotsdiner, 1993). Together (eg in audio-visual slide-films) they may help students and professional cope with the negative side of intensive workloads (fatigue, stress, anxiety).

Our study attempts a multi-level assessment of the relaxation effect of a slide-film as part of student education.

Sample - 46 psychology students. The 20 minute relaxation film was shown after lectures and discussion of a forthcoming examination. Measures: standard psychological and physiological functional state tests and a cognitive task before and after the film (Leonova & Kapitsa, 2003); an original questionnaire revealing individual associations and experiences felt during the film.

The results showed pronounced subjective discomfort and anxiety before the film. The relaxation film resulted in lowered blood pressure, increased subjective comfort, decreased fatigue and acute anxiety, and negative emotion scores, as well as higher productivity in performing the cognitive test (Student t-test, p<0.005-0.001). Concentration on the film subject, as well as the combination of the student’s thoughts and associations around the plot, showed a positive correlation with the amount of relaxation effect.

Our research showed that using the relaxation slide-film (with imagery and music) can provide positive effects on students’ functional state. It also revealed the importance of the relevance of individual experience to the subject of the film to obtain optimal positive effects.

No significant relationships.

Adolescent transitions to adulthood are a vulnerable phase for the development of mental illnesses. Additionally, there are often disruptions in psychiatric care delivery during the transition phase, potentially leading to a considerable treatment delay with a high risk of early chronification. Thus, the health care system and professionals in both child and adolescent psychiatry and adult psychiatry should give greater consideration to the transition phase.

An online-course addressing health care professionals was developed to give in-depth knowledge of “transition psychiatry”, practical guidance and to sensitize for the special challenges and needs of young adults with mental illness. Evaluation focuses on the gain of competences, benefit for practical work and user satisfaction.

Participants´ estimations and opinions on quality of the online-course, on impact of course participation to their practical work and on their competences regarding transition psychiatry are assessed with an online-survey before starting (t1) and after finishing (t2) the online-course. T1-assessment is already completed with 1924 datasets, t2-assessmend will take place 02/2022.

Analyses of t1-assessment show a high heterogeneity of participants regarding their work background and setting. Special knowledge about mental illnesses during transition and about transition psychiatry, as well as feeling confident in accompanying transition processes is on a medium level. Results of t2-assessment and comparing analyses are expected in March 2022 and will be presented.

There was high interest of the target group in participating in the online-course. Evaluation will show if the online-course is a helpful measure in delievering the necessary education of professionals in transition psychiatry.

No significant relationships.

Psychological vitality has a significant relationship with self-realization, mental health, positive emotions and self-motivation, life satisfaction, and optimism. Additionally, it reduces the possibility of exposure to anxiety, depression and stress. In the same line, work pressures drive teachers to suffer from some negative emotions such as anger and lack of motivation, which in turn influence their vitality, social relations with colleagues.

The present study designed a motivational counseling-based program to improve psychological vitality among teachers in Dhofar region schools

Participants were 60 teachers obtained the lowest degrees on the psychological vitality questionnaire. They were divided randomly into two groups: experimental and control. Qusai-experimental method with two groups design was adopted. The given program consists of 18 counseling sessions at the rate of 3 sessions per week ranging from 60 to 75 minutes.

indicated that statistically significant differences at 0.01 level were found between mean scores of both groups groups on the posttest of psychological vitality favoring the experimental group. Also, statistically significant differences at 0.01 level were detected between the pre-test and post-test (experimental group) mean scores favoring the post-test. Taken together those findings confirm the effectiveness of the counseling program in improving psychological vitality Posttest and follow up test did not significantly differ which prove the continuity of program effectiveness.

To conclude, motivational counseling plays an important role in enhancing psychological vitality of teachers. Further research might use the program in alleviating other psychological disorders.

No significant relationships.

Evidence shows unemployment as a negative impact factor on a variety of health outcomes. Regarding mental health, unemployment is considered one of the most consolidated risk factors for morbidity. This relationship is considered bi-directional. Prevention and wellness promotion are essential guidelines for mental health providers.

To describe the work status in a sample of patients with anxiety disorders after two types of group mindfulness-based interventions in the MER-ACT project.

A descriptive analysis was conducted on work status before and 6 months after two types of mindfulness-based interventions. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. The employment change was calculated (percentage of change from unemployed or temporary incapacity to employed).

The work status of participants of the sample (n = 40), before and 6 months after interventions, were employed: 55% vs. 60%; temporary incapacity: 12.5% vs. 12.5%; unemployed: 25% vs. 20% and others: 7.5% vs. 7.5%. In the same period, the unemployment rate in the Spanish general population was from 13.8% to 14.5%. After 6 months the percentage of change on work status was 25% (15% improved their employment situation).

Preliminary results show worse work status of participants compared to the Spanish general population. It is recommendable to include well-established risk factor measurements to establish the effectiveness of interventions in mental health. More research is required to determine the impact of interventions on the employment status.

No significant relationships.

Exposure to violence affects employees and has implications for the quality of care provided.

This study aims to describe the effects of workplace violence on nurses in psychiatric and emergency departments.

This was a cross-sectional and descriptive study involving 60 nurses practising in the psychiatry and emergency services at the Hedi Chaker and Habib Borguiba University Hospital in Sfax. We collected the socio-demographic and professional data of the participants using a pre-established questionnaire.

The average age was 35 years and 51 % of respondents were female. Ninety-three percent of the respondents were victims of an act of violence. The violence was verbal in 90%, physical in 70%, psychological in 62% and sexual in 11% of cases. The classification of acts of violence according to the scale of seriousness of the national observatory of violence in health care revealed a predominance of level 1 violence characterised by insults (66%) and level 2 violence with threats to physical integrity (65%). Level 3 violence (physical violence) was the most frequent (70%). Two cases of level 4 violence with knives were reported. These acts of violence generated wounds in 21%, fractures in 10%, haematomas in 10% and bruises in 8% of cases. Thirty-six nurses (60%) reported that the act of violence was responsible for a feeling of insecurity.

The results of this study indicate the need for hospital center managers to set up organizational policies against workplace violence and to apply them in a rigorous and transparent manner.

No significant relationships.

Nurses may be particularly at risk of violence exposure at work which can cause psychological trauma and even develop post-traumatic stress disorder (PTSD), which is a serious mental health disorder.

The aim of this study was to determine the prevalence of PTSD among nurses in psychiatry and emergency departments and to identify the factors associated with it.

This was a cross-sectional, descriptive and analytical study. It concerned 60 nurses working in the psychiatry (35 nurses) and emergency (25 nurses) departments of the Hedi Chaker and Habib Borguiba University Hospital in Sfax. The screening of PTSD was carried out by the « post-traumatic stress evaluation questionnaire » (PTSQ).

Direct trauma exposure was reported by 93% of participants, of which 48.3% experienced the act of violence more than 4 times. According to the PTSQ, 48.3% of the nurses had PTSD with a mean score of 50.93. Hyper-arousal was the most frequently observed outcome in victims (85%), followed by re-experience (83%) and avoidance (80%) symptoms. The presence of PTSD was correlated with female gender (p=0.002), the young age of the nurse (p=0.04), and the absence of peri-traumatic reactions (p=0.001).

Our study shows that PTSD is a pathology frequently encountered in psychiatric and emergency nurses. Hence the need to put in place strategies against violence in hospitals and to apply them rigorously in order to better manage this phenomenon and manage its repercussions on health workers .

No significant relationships.

Violence is recognised by the WHO as a major and ubiquitous public health problem, that is constantly worsening.

The aim of our work was to estimate the frequency of aggressions against nurses in psychiatric and emergency departments, and to identify the factors associated with it.

This was a cross-sectional, descriptive and analytical study. It took place between January and March 2021, at both hospitals of Sfax (Tunisia).This study targeted 60 nurses in the psychiatry and emergency services.

The sample comprises 35 nurses (58%) from psychiatric services and 25 nurses (42%) from emergency services, mainly females (51%) and with average age of 35 years.(+/-9). The nurses interviewed were exposed to violence quite often, in 93% of cases. Almost all nurses (90 %) experienced verbal violence, 70 % experienced physical violence and more than half (62 %) experienced psychological violence. Nearly 11% of nurses reported a sexual violence. Factors that explain or contribute to violence mentioned by the participants were as follows; The Verbal violence was significantly correlated with poor reception conditions (p=0.013). The Sexual violence was significantly correlated with young age of nurse (p=0.005). As for psychological violence, it was significantly correlated with work overload (p=0.004), a poor caregiver-patient relationship (p=0.02) and poor patient care (p=0.04).

Our study showed that violence against nurses was frequent in psychiatric and emergency departments. Various factors could modulate their occurrence such as training and improvement of the working conditions.

No significant relationships.

The mild encephalitis (ME) hypothesis of severe mental disorders, ME to be caused by infections, autoimmunity , toxicity and trauma ( Bechter 2001, updated Bechter 2013), is now emergingly supported from neuroimaging and CSF and postmorten findings.

Review about the present status of ME hypothesis and autoimmune psychosis and remainig challenges to assess and categorize mild neuroinflammation.

expert review

Autoimmune Encephalitis presenting with exclusive psychiatric symptoms and all cases of Autoimmune Psychosis (international consensus criteria in Pollak et al, Lancet Psychiatry, 2020) match the proposed ME criteria ( Bechter 2001 & 2013). Majority of these cases of an autoimmune type of ME are well treatable with immune modulatory treatments. It remained unclear, whether CNS antibodies are causal or contributive by shaping the observed clinical syndrome. The increasing evidence of mild neuroinflammation present in considerable subgroup of schizophrenia or psychosis spectrum cases from ongoing clinical studies, including CSF ( Bechter et al 2010, Endres et al 2018, 2020, aso.) and neuroimaging plus the observed clinical improvement with immune modulytory therapies, strongly support ME hypothesis, potentialy even in considerably larger subgroup of SMDs,supported by brain biopsy (Najjar et al ,several papers) and post mortem studies (Bogerts et al group ,Weickert et al group, several papers).

Beyond ME even more refined categories of mild neuroinflammation, including parainflammation ( proposed by Medzhitov 2008) and neuroprogression ( proposed by Berk et al 2010/11) need to be considered in further research on the possible role of mild neuroinflammation in SMDs (Bechter 2020, Frontiers Psychiatry).

No significant relationships.

We have previously shown that the association between frequent cannabis use and psychosis is more likely in subgroups with low-grade inflammation than subgroups without (PMID: 33736715). The role of immune-related polymorphisms remains unknown.

To explore whether polymorphisms affecting the function of key immune regulatory proteins moderate the association between cannabis and psychosis, namely: ENTPD1 and NT5E, involved in the synthesis of CD39, CD73, respectively, and anti-inflammatory adenosine; CTLA4 and FOXP1, essential for Treg functional capacity.

We genotyped blood samples from 283 community-based controls and 140 recent-onset psychosis patients in Brazil (EU-GEI consortium, Ribeirão Preto/SP) for twelve polymorphisms (ENTPD1: rs3814159, rs3176891, rs10748643; NT5E: rs9444348, rs2295890; CTLA4: rs3087243, rs231775, rs5742909, rs4553808; FOXP1: rs6803008, rs6786408, rs830599; Illumina Human Core Exome-24). Cannabis frequency (daily, less than daily, never) was assessed by self-report (Cannabis Experience Questionnaire). Binary logistic regression models (OR,95%CI) included case status as the outcome, genotype (dominant model), cannabis frequency, and an interaction term between the two as exposure, adjusting for confounders (age, sex, ethnicity, tobacco smoking).

We found significant interactions between cannabis use and polymorphisms for ENTPD1 (rs3814159), NT5E (rs9444348), and FOXP1 (rs6786408). Less than daily or daily use were, in a dose-response fashion, only associated with psychosis in those with the variant and heterozygous genotypes; less than daily: ENTPD1 AG/GG (3.34,1.71-6.50); NT5E AG/AA (3.71,1.87-7.33); FOXP1 AC/CC (2.98,1.54-5.77); daily: ENTPD1 AG/GG (16.81;5.89-47.96); NT5E AG/AA (21.20,6.81-66.01); FOXP1 AC/CC (13.75,5.22-36.21).

Variation in genes that affect Treg function appears to modify the effect of cannabis consumption on psychosis in keeping with Treg hypofunction hypothesis (PMID:33713699).

No significant relationships.

The overall goal was to determine the degree of mental, neuromuscular and statodynamic functions disorders resulting from toxic effect of mercury and its compounds, to study relationship between the degree of loss of professional ability to work as a result of occupational disease with the presence of complications due to concomitant diseases.

The relevance of studying the degree of violations of the main indicators of vital activity due to the toxic effect of mercury and its compounds is due to the persisting high level of loss of professional ability to work, and in some cases, and disability of this contingent. Analysis of indicators of primary and repeated disability due to occupational diseases showed that a sufficiently high number of persons recognized as disabledю

We studied the dynamics of psychopathological disorders: violation of the emotional sphere, thinking, perception, attention, volitional activity and cognitive functions. The functional and metabolic activity of segmented neutrophils in the peripheral blood of 42 patients, men and women aged 43 to 64 years, and 22 healthy donors were studied.

Long-term exposure to chronic industrial mercury intoxication led to persistent disorders of mental functions, suppression of phagocytic activity of neutrophils up to 42.3+-4.7 per cent and inhibition of the reaction with nitro blue cytosol 4.2+-0.1 per cent..

The revealed violations of the emotional-volitional sphere and cognitive mental functions are possibly associated with the suppression of nonspecific cellular reactions of microphages. Violations of neuroimmune interactions in mercury intoxication require further study.

No significant relationships.

The incidence of Anti-NMDA receptor encephalitis is 1.5 per million population per year but it has only been described sporadically in the paediatric population. The median age of onset is 21 years old. In children, seizures, abnormal movements, insomnia, and irritability are more frequently identified than psychosis or abnormal behavior. Early detection and treatment can improve treatment outcomes.

Presentation of a case of a paediatric patient with Anti-NMDA receptor encephalitis displaying homicidal behavior towards her family members

Case report

A 12 year old with no significant past psychiatric and medical history, was brought in by police to the hospital after she attempted to stab her mother with a knife. She had low grade fever, headaches and lethargy prior to presentation. Organic workup revealed serum and CSF anti-nmda receptor to be positive. She received early treatment with steroids and intravenous immunoglobulins and no longer harboured further homicidal ideations.

Initial suspicion of anti-NDMA receptor encephalitis should be raised and early auto-immune workup performed in paediatric patients presenting with acute change in behavior especially in young females with no past medical or psychiatric history

No significant relationships.

The clinical and biological studies indicate the involvement of inflammation in the pathogenesis of endogenous mental disorders. The inflammation markers leukocyte elastase, α1-proteinase inhibitor, and autoantibodies to neuroantigens reflect the severity of the pathological process in the brain. Systemic endotoxemia is a pathological process caused by an excess of endotoxins in the systemic circulation, can be considered as one of the components of the inflammatory process in endogenous psychosis.

To evaluate the association between systemic inflammation markers and indicators of systemic endotoxemia in patients with endogenous psychosis.

The study included 25 patients aged 23-49 with endogenous psychoses (F20, F25) and 25 healthy people. The severity of symptoms was assessed using PANSS. We detected the activity of leukocyte elastase and a1-proteinase inhibitor, antibodies to neuroantigens, endotoxin (ET) concentration, and antibodies to endotoxin (aEТ) in serum.

In 24% of cases, an increase of inflammation markers activity, ET concentration, and aET deficiency were observed (p<0.05), which is an unfavorable factor that aggravates the clinical course of the disease. In 76% of cases, ET concentration remained within control values (p>0.05) but associated with different levels of aET, which is likely to be a consequence of previous endotoxin aggression. There were correlations between ET concentration and antibodies to neuroantigens S-100B and MBP. We also revealed the association between the activity of the inflammatory marker with the severity of clinical symptoms in patients.

Results suggest the relationship between systemic inflammation markers and indicators of systemic endotoxemia and their involvement in the pathogenesis of endogenous psychosis.

No significant relationships.

Ovocystatin has beneficial properties for cognitive function in young rats and might prevents aging-related cognitive impairment in older animals, as well as reduces memory decline in APP/PS1 mice model.

Our study aimed at assessing the impact of ovocystatin on microglia activation and neurogenesis.

Immunoactivation: Mouse wild type microglia were stimulated with ovocystatin at dose of 100 micrograms/ml. The effect of ovocystatin on nitric oxide production and interleukin 1 beta secretion were determined. Neurogenesis: Primary rat hippocampal neurons of H19-7 cell line was used. The impact of ovocystatin on proliferation, nitric oxide production, and expression of markers of neurogenesis: microtubule-associated protein 2 (MAP2, isoforms A/B and C/D) and Synapsin 1, were determined.

It was shown that ovocystatin does not stimulate microglial cells to produce inflammatory mediators. Whereas, no toxic effect of ovocystatin (1-100 ug/ml) on H19-7 cells viability, and dose-dependent down-regulation of proliferation were demonstrated. It was also shown that in primary hippocampal neurons of H19-7 cells incubated with ovocystatin (100 micrograms/ml), the expression level of MAP2 C/D (75kDa) - characteristic form of immature neurons is unchanged. However, the increased expression of MAP2 A/B protein (280 kDa) – characteristic for mature neurons was observed after 6 and 24h incubation with ovocystatin. Relatively to MAP2 A/B, increased expression of synapsin 1 was observed.

The ovocystatin might be a potential activator of molecular mechanisms in primary hippocampal neurons, participating in regulation of neurogenesis. Nevertheless, further studies are needed.

No significant relationships.

The 22q11.2 deletion syndrome (22q11DS) defines a set of developmental abnormalities due to a loss of genetic material. Phenotypic expression is highly varied. The immunological alterations that present as a severe combined immunodeficiency and the neurodevelopmental alterations stand out, especially the psychotic symptoms. It is the best described genetic alteration for the development of psychosis, presenting up to 30% of patients with compatible symptoms, with various hypotheses that justify it.

General objective:

1. Justify that SD2q11 can be used as a model for human research on the origin of psychosis.

1. Describe the pro-inflammatory state present in SD2q11.

2. Describe differences at the immunological level in SD2q11 among those patients with presence of psychotic symptoms of those who do not present them.

3. Describe possible biomarkers.

A systematic review of the literature in the last 5 years using electronic resources (PubMed and WOS) until June 2021 following the PRISMA recommendations.

Three original articles were reviewed. There is a very marked pro-inflammatory state in 22q11DS patients with psychotic symptoms. They present an increase in subpopulations of CD4. The IL-17 is important in the formation in primitive stages of the hippocampus, its ease of breaking the blood-brain barrier (BBB). The neutrophil / lymphocyte ratio is presented as a possible biomarker to predict patients at high risk of developing psychosis.

There is sufficient evidence that patients with 22q11DS can be used as a research model regarding possible hypotheses about the genesis of psychosis.

No significant relationships.

It has been suggested that the activation of systemic inflammatory response in depression is associated with inflammatory changes in the brain (neuroinflammation) and may reflect the severity of the clinical symptoms in patients.

To study the relationship between clinical and immune parameters in patients with endogenous depressive disorders for the possible use of these indicators for diagnostics of these conditions.

Patients with bipolar affective disorder (group 1) and recurrent depressive disorder (group 2) (F31, F32, F33) were examined before the therapy. Mentally healthy age- and gender-matched persons were investigated as controls. The severity of depressive symptoms was assessed by HDRS. The activity of inflammatory indicators (leukocyte elastase (LE) and 1-proteinase inhibitor (ɑ1-PI)), as well as the level of autoantibodies (AB) to S-100B and MBP, were measured in plasma.

Group 1 was characterized by an increase of LE and ɑ1-PI activity in comparison with the control group (р<0.001; р=0.002) and group 2 (р<0.05). No significant difference in AB to neuroantigens was found. Group 2 was distinguished by the increase in activity of the inflammatory indicators (р<0.01; р<0.05) as well as the autoimmune reactions to neuroantigens compared with control one (р=0.03). The correlations between complex assessment of the immune system and the severity of depressive symptoms in both groups were revealed (χ2=6.1; p=0.013; χ2=4.8; p=0.05).

Revealed correlations suggest that inflammatory markers are involved in the pathogenesis of endogenous depressive disorders and can be used as an additional differential diagnostics criterion for the assessment of the clinical state of patients.

No significant relationships.

Early stages of autoimmune encefalitis (AE) often present cognitive and neuropsychiatric symptoms such as personality change, irritability, axiety, depression, behavioral disorders, hallucinations, disorientation, sleep-wake cycle reversals, …). Thus often these cases are first treated as psychiatric disorders.

A literature review throughout a case report presentation.

We present the case of a 25-year old female with a medical history of iron-deficiency anemia who arrives at the emergency service. She presents the following one week of evolution clinical picture: complex auditive hallucinations, behavioral disturbances, sleep disorder and short term memory impairment. Neurological examination, LP and craneal CT are all normal. CSF analysis has no abnormalities. Thus she entered the psychiatric ward. There she was treated with neuroleptics with no improvement of symptoms presenting a severe psychomotor agitation and language impairment. After neurology interconsultation AE is suspected.

She was performed an EEG (left temporal epileptiform activity), CSF (inflammatory pattern), MRI (bilateral temporal lobe hyperintensity). Suspecting limbic encephalitis the presence of anti-NMDAR antibodies was tested , which turned out to be positive. First she was treated with corticotherapy with mild results. Then she was treated with intravenous immunoglobulin improving significantly.

Anti-NMDAR encephalitis is usually a multistage illness. Early in the course of disease psychiatric manifestations are not rare. Therefore the proper diagnosis and approach of AE may requiere a highly organized assessment, starting with detailed history and physical examination and an appropriate testing to exclude other possible relevant pathologies.

No significant relationships.

Schizophrenia affects approximately 1% of the world population, having a devastating impact not only in patients but in all society. As a result, it has been subject of extensive investigation and the presence of certain genes was associated with an increased risk of developing schizophrenia. However, the presence of these genes is not sufficient, therefore, other factors are necessarily involved.Observation of the association between schizophrenia and inflammatory states of the Central Nervous System led to the hypothesis that a dysfunction of the immune system may play a central role in this process.

In this work we intend to make a brief review of the existing literature related to the immunological theory of schizophrenia.

A bibliographic research was conducted in Medline library using the following terms: “schizophrenia and immune system”; “schizophrenia and inflammation” and “schizophrenia and neuroinflammation”.

The survey results reveal increasing evidence of the key role of the immune system in schizophrenia. Several studies show benefits of treatment with anti-inflammatory drugs in patients at an early stage of the disease. In the same way, it was verified that pro and anti-inflammatory cytokines influence glutamatergic transmission and tryptophan metabolism. Furthermore, the decrease in microglial activity appears to have a beneficial effect on schizophrenia.

Future will say if neuroimmunology mechanisms are primary or a secondary consequence in Schizophrenia. Recent discoveries in this area are encouraging and open the possibility of new therapeutic targets and new therapeutic approaches to this disease.

No significant relationships.

Psychotic episodes characterized by sudden onset of polymorphous psychotic symptoms and fast resolution have been a subject of interest of many psychiatrists throughout the History. Controversies about the diagnostic criteria and nomenclature of cycloid psychoses persist nowadays, what has hampered its study. In last years, several reports associating this disease with autoimmune pathologies have been published, revealing a possible association between them.

To contribute to the knowledge of cycloid psychoses, reporting a case of motility psychoses and exploring its possible association with autoimmune diseases.

Case report and literature review.

A 48-years-old woman presents a history of eleven admissions at the Psychiatry nursery in the last nineteen years, due to psychotic episodes. Usually, these episodes follow a default in psychopharmacological therapeutic, and are characterized by rapid onset of psychomotor agitation, with prominent nonpurpuseful exuberant movements, incoherent speech, mood oscillations and polythematic delusion. Between these decompensations, she recover her normal functioning, being medicated with lithium and an antipsychotic. During one of her admissions, at 2015, she developed fever and a stuporous state. The magnetic resonance and lumbar puncture were normal, the electroencephalogram revealed generalized lentification. Autoimmunity investigation evidenced positive antithyroid antibodies (with normal thyroid function) and the echography validated the diagnosis of Hashimoto’s thyroiditis.

This case report reveals a possible relationship between cycloid psychoses and Hashimoto’s thyroiditis. We need to share more knowledge to understand if it represents a comorbidity or a pathogenic process with the same etiology, what will influence the treatment of these patients.

No significant relationships.

Autoimmune encephalitis are inflammatory diseases of the CNS mediated by antibodies that attack neurotransmitter receptors or proteins on the surface of neurons, usually in the limbic system. The clinic is different according to the antineuronal Ac involved.

To make a correct differential diagnosis between autoimmune encephalitis and primary psychiatric pathologies that may be similar in symptoms through a complete study of the patient including anamnesis, physical examination, imaging tests, cerebrospinal fluid and serum studies.

Description of a clinical case. A 31-year-old female patient, with no previous history of interest, was brought to the emergency department for a suspected seizure. The previous days she had presented emotional lability, difficulty in concentration and reading, blurred vision, confusion and hemicranial headache. Two days later she returned to the emergency room for insomnia, dysarthria, difficulty in reading, comprehension, naming, and excessive rumination of her problems. Incoherent and repetitive language. The Emergency service requested to rule out a conversive disorder.

Neuropsychiatric manifestations (anxiety, depression, behavioral disturbances, insomnia, memory deficits, psychomotor agitation, mania, auditory and visual hallucinations, delusions) are the first symptom in 70% of autoimmune encephalitis due to anti-NMDA antibodies and usually respond poorly to psychiatric treatment, making the treatment of the primary cause necessary for the remission of these symptoms.

Given their increasing recognition and prevalence, autoimmune causes should always be taken into account in behavioral changes, cognitive or consciousness impairment of subacute installation, especially in young patients and once infectious, metabolic and vascular causes have been ruled out with an appropriate complementary study.

No significant relationships.