Suicide is one of the most frequent causes of death. In 1993, Bleuler emphasized its importance in his “Suicidal behavior is the most serious symptom of schizophrenia”. Since then, various studies have confirmed importance of suicide in schizophrenia, and today it's clear that his research and knowledge is one of the great challenges of psychiatry.

1. - Establish clinical-socio-demographic profile and risk factors for psychotic people with autolytic behaviors.

2. - Determine frequency of suicides in psychotic disorders in our area of care.

Retrospective study(3 years evolution) that includes psychotic patients(diagnosed according DSM IV-TR) admitted to the HCU of Valladolid. With data provided by hospital medical records, analyzed socio-demographic variables and clinics. Study consists of two groups:group of cases(those patients who have suicidal behavior) and control group (those that haven't autolytic gesture during the study period). Statistical evaluation was performed with SPSS.

1. - The sample includes 191 patients:41(21%) have attempted suicide.

2. - Of them:73% are males;88% singles;51% have basic studies;61% we re unemployed;37% were 31-40 aged;54% started disease 21-30 aged and 63.5% are schizophrenic.

3. - Considering statistical study we find that suicidal patient profile is male(p = 0.039),diagnosed with schizophrenia(p = 0.033),with previous suicide attempts(p = 0.009)and lack of social support(p = 0.007).

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1. - 21% of hospitalized psychotic patients have presented some autolytic attempt.

2. - Profile of suicidal psychotic patient is a male, single, 21-40 aged, primary education, unemployed, with a primary diagnosis of schizophrenia, particularly paranoid, with ten years evolution,without acceptable social support, number of revenues higher than non-suicidal psychotic and a personal history of previous autolytic attempts.

Ramón y Cajal Hospital is the reference hospital for area 4 (Madrid), which covers a population of more than 540.000 people. The psychiatric emergencies are one of the most frequent demands at the Emergency Department (ER)

• • Analysis of the cause of psychiatric demand and how it is made: who asks for help and who sends the patient to the hospital.

• • Analysis of the syndromic diagnosis, derivation and therapeutical attitude at discharge.

With data from sample of 145 patients attended by the emergency psychiatry staff between the 15th - 30th August 2008, we performed a descriptive analysis using SSPS 15.0 version in Spanish

• • Most common reason of consultation was nervousness (22%), being the patient the one who demanded evaluation (31,5%). Less commonly, the patient was sent from the local Mental Health Center (1,37%). Patients usually come accompanied by relatives (41%).

• • The most frequent syndromic diagnosis at discharge was “affective disorder” (23%),being usually derived to the local Mental Health Center (54%). Modifying the previous treatment after the consultation (37%) was nearly as frequent as leaving the previous one (35%).Starting a new treatment after consultation at the ER was rare (14%).

The profile of the patient attended by the psychiatry staff on duty in our hospital, is a patient who demands psychiatric evaluation, comes accompanied by relatives, consults for nervousness, is discharged with a diagnosis included in the spectrum of “affective disorders”, and is derived to the local Mental Health Center.

The objective of this study was to analyze clinical and personality differences in three groups of patients with eating disorders: binge eating disorder (BED), bulimia nervosa- purging type (BN-P) and bulimia nervosa-non purging type (BN-NP).

The participants were 102 female patients (34 BED, 34 BN-P and 34 BN-NP), mean age 28.7. Assessment measures included the following tests: EDI-2, BITE, EAT-40, SCL-90-R and TCI-R, and other clinical and psychopathological indices that were collected via semi-structured interview.

When compared all three groups, BED were the oldest group, showed more frequent familial history of obesity and current or lifetime obesity. Regarding psychopathology, BN-P patients showed the most pathological scores, followed by BN-NP patients and BED patients showing the least pathological scores. Specifically, BN-P patients showed statistically higher scores than BED patients on SCL-90-R Paranoid Ideation, EAT-40 total score, EDI-2 Impulsivity subscale, and BITE Severity subscale. No statistically significant differences were observed among groups, on personality traits. A two-step cluster analysis procedure was conducted, to determine the clinical proximity among the three diagnostic groups. The relationship between cluster classification and diagnosis was statistically different (p<0.001), so we can assume that the present classification maybe does not classify accurately eating disorders.

Even when BED patients present differential characteristics with respect to family and personal antecedents when compared to BN patients, clinical and psychopathological overlapping with BN-NP makes them similar. Likewise, our results suggest deficiencies in the current nosological system, since it does not group patients’ subgroups which are homogeneous enough.

Psychotherapy is considered the primary treatment for Borderline Personality Disorder (BPD) and Dialectical Behavior Therapy (DBT) is one of the most effective, based on empirical data (Lieb et al.,2004). Pharmacotherapy strategies have been successful in decreasing some core symptoms like impulsivity (Oldham,2005). Topiramate has been effective against BPD anger, considered as an expression of affective instability and a proxy measure of impulsivity (Nickel et al.,2004;2005).

To analyze the topiramate contribution in the aggressive impulsivity decrease with BPD patients treated by DBT.

23 BPD patients, treated with DBT, participated in the study. Patients were evaluated with SCID-I and SCID-II. Topiramate dosage was adapted to the frequency and severity of self-aggressive impulsive behaviors.

The influence of topiramate in behavior outcomes was analysed using step by step multivariated regression analysis.

Topiramate didn't decrease suicidal attempts number, but had strong influence in parasuicidal behaviors (Standarized Betha=0.57;t=3.16,p<0.05) and in the reduction of emergencies visits (Standarized Betha=0.22;t=2.151, p<0.05). The medium topiramate dosage was 200 mg UID (100-500mg).

Topiramate can be helpful, as a symptom-targeted pharmacotherapy, for self-aggresive impulsive behavior with BPD patients treated by DBT.

Given the clinical similarity and the frequent comorbidity between impulse control disorders and certain eating disorders (ED) such as bulimia nervosa, we aimed to compare personality and clinical profiles of individuals with and without substance use disorders (SUD) who had primary diagnoses of ED or impulse control disorders, namely pathological gambling (PG).

1096 ED [91.8% females] and 1120 PG [92.4% males] patients were assessed for the presence of SUD. All patients were consecutively admitted to our Psychiatry Department and diagnosed according to DSM-IV-TR criteria. We administered the Temperament and Character Inventory-Revised (TCI-R), the Symptom ChekList-90-Revised (SCL-90-R), and other clinical indices. Lifetime substance use included alcohol and other substances and was measured with the SCID-I. Student-Fisher t-tests were used to compare clinical features. Binary logistic regression models were used to analyse personality predictors of comorbidity with SUD. Adjustments for sex, age, and specific diagnosis were applied.

High Novelty Seeking, low Reward Dependence and low Self-Directedness were predictive of SUD in the whole sample independent of diagnosis (p<0.01). In the PG sample only, after adjustment for sex and age, Reward Dependence was no longer associated with SUD. Patients of both clinical samples with SUD showed higher SCL-90-R scores and severer eating and gambling symptoms (respectively).

Our results suggest that high Novelty Seeking, low Reward Dependence and low Self-Directedness are associated with lifetime SUD, which is also associated with a severer presentation of the primary disorder. This pattern holds across different populations such as ED and PG.

The coexistence of comorbidity in schizophrenia (somatic, dual pathology, personality…) can conditionate evolution and prognosis in this severe mental illness, those aspects should be taken in account to planify treatments and follow up issues.

We are interested in this work in evaluate previous and developed comorbidity in schizophrenic patients; we also analyzed comorbidity consequences in clinical, therapeutical management, treatment adherence, relapses and hospitalizations.

In 50 Schizophrenic patients (DSM-IV TR Diagnostic criteria) with at least one previous psychotic episode we have studied longitudinal and transversally sociodemographic, clinical and therapeutical variables, related comorbidity (somatic, drugs related and dual pathology) and evolution, prognosis, clinical, treatment adherence and tolerance variables were also studied. We also evaluate psychopathologic and medical status (EEG, EKG, Chest RX, BMI, body weight, general analysis) secondary effects were registered. Uxue and CGI were the scales used.

Between 20% and 25% had other medical conditions, and 25-30% had some kind of drug abuse, those were who had worse prognosis, more secondary effects and usually were treated with classic antipsychotics.

The results are discussed, and we propose integrative treatments for schizophrenia and the co morbidities, focusing on affectivity and tolerance.

Numerous organic pathologies may appear as single or first psychiatric symptomatology manifestations. That is why we must perform a detailed exploration in these type of patients; anamnesis, a physical examination and supplementary tests.

This poster describes the case of a 24 year old woman who unexpectedly manifests behavioural disorders(psychomotor disinhibition, myoclonus, opsoclonus), speech disturbances (inconsistent content) and a decreased level of consciousness.

We highlight the importance of a sequentially well arranged full assessment and conclude with an accurate diagnosis. Additionaly, we emphasize on differential diagnosis something we ought to take into account in these patients.

Bibliographic review of a clinical case of limbic encephalitis Review.

This poster describes the case of a 24 year old woman who unexpectedly manifests behavioural disturbances (psychomotor deshibición, myoclonus, opsoclonus), speech disturbances (Inconsistent content) and a decreased level of consciousness.

These symptom characteristics are consistent with those we found in our literature review on this pathology (PubMed) and in addition it highlights the important of bearing in mind the organic pathology while examining psychiatric patients.

Organic mental disorders are conditions that we should keep in mind while making an initial psychiatric assessment.

Paraneoplastic limbic encephalitis is a neurological condition that can present psychiatric symptoms, and that requires a complete organic diagnosis (biochemistry, blood count, urinary toxic, EEG, cranial CT and thoraco-abominopelvic, cranial MRI, CSF antibodies).

In order to perform a correct diagnostic it is crucial that we consider a couple of differential diagnosis.

Fantasies, despite their constant presence in the human being, are a phenomenon which has a scarce interest in academic psychology (Kinsey y cols, 1948; 1953). Unlike sexual fantasies, where there are systematized studies from the 1940s, in relation to latent aggressiveness there is an important vacuum.

This study will try to throw evidences about the relation between different types of personality and the level of sadism and/or latent aggressiveness that prevails in each one of them, as well as the modus operandi that can be attributed to them. It also aims at check the evolution of the latent aggressiveness in relation to age.

Have been applied in the evaluation of the sadistic fantasies and aggressiveness the test MCMI (Millon, 1983), the test MACI and the Questionnaire of Sadism and Criminality (CSyC, 2013) which allows to predict certain criminal behaviors as well as know their modus operandi if they are carried out. The sample was formed by a group of adolescents aged between 13 and 18 years old and another group of adults from 40.

Latent aggressiveness levels seem to point a normal curve, being established the maximum peak in adolescence. Further, the qualitative study reflects relations between certain psychopathological profiles of personality and particular modus operandi.

The results of this study show the evolution of the levels of sadistic fantasies according to the age and the role that personality has in different criminal acts.

The cognitive processes are rather relevant in order to achieve a comprehensive and integrative recovery in schizophrenia and other psychosis.

To research the different variables implied in cognitive outcomes in psychosis in order to increase our knowledge to establish therapeutic interventions in this field.

An overall of 73 patients were included in the study. We used the SCIP and STROOP tests to measure the cognitive processes. We applied a comprehensive questionnaire for clinical and epidemiological variables including PANSS, SGPTS, GAF and SIX. After that, we constructed a binary logistic regression model with the following variables: positive, negative and general psychopathology PANSS subscales, PANSS subtype, first or second generation antipsychotic, stimulant drugs use, tobacco use, sex, age, onset age, number of psychotic episodes, global functioning and family history.

Having more than two family members affected by any psychiatric disease was associated to a lesser outcomes in short-term and immediate memory. Likewise higher scoring in positive subscale PANSS was also associated to a worse performance in short-term and long-term memory, so stimulant drugs use was also related to a lesser immediate memory and working memory. Finally, a better global functioning appeared as a factor related to a better overall learning.

Our data show that a heavy genetic factor exists as a variable influencing cognitive performance. Moreover, stimulant drugs use and positive symptoms are another variables which can be controlled in order to improve cognitive performance.

The term contrail is a contraction of condensation and trail, as chemtrail is of chemical and trail. The first one is used to name trails left in the sky by aircrafts under certain atmospheric conditions. Some people argue that when contrails do not dissipate quickly is because contain substances added and sprayed for sinister purposes undisclosed to the population (weather modification and biological and/or chemical war are the most common).

Exist various versions of the chemtrail theory, most of them propagated via the internet in discussions forums or websites, and to a lesser degree by the mass media such as TV and radio programs. The outspread popularity and diffusion of the theory has already become a reality. Scientific community has repeatedly rejected that chemtrails exist, insisting that are just contrails. We analyze this phenomenon.

We made a exhaustive literature review in Journals of Meteorology and Aviation, about the formation of condensation trails, in Social Pychology Journals about the genesis and dissemination of the chemtrails theory. Finally, we will make a brief presentation of documentation built around the theory of chemtrails in the province of Zamora (Spain), where is one of the most active spots in southern Europe.

official statements on the non-existence of chemtrails have not discouraged the proponents of the theory of chemtrails.

The authors have not supplied their declaration of competing interest.

Attention-deficit/hyperactivity disorder (ADHD) is a psychiatric chronic disorder of childhood that persists into adolescence and adulthood in the most part of cases. There are various ways of treating ADHD.

Assess the effectiveness and tolerability of atomoxetine long-term and routine clinical practice in adult ADHD treatment. Study the clinical profile of the patients who take atomoxetine.

The aim of this is to study the treatment of ADHD in adults with a non-stimulant drug atomoxetine.

We obtain results from 126 patients recruited from July 2009 to May 2013 who have been prescribed Atomoxetine as a treatment for ADHD from the hospital pharmacy.

Comorbid disorders were presented in 57.1% of the patients included at the study (25.3% of which belong to the group of anxiety disorders). The use of other psychotropic drugs associated with atomoxetine was observed in 54.8% of patients. The 62.7% of the patients concerned continued treatment beyond 225 weeks (4 years 3 months) of observation. The Clinical Global Impression Improvement scale (CGI-I) and side effects determine monitoring treatment. A total of 61.9% of patients responded satisfactory to treatment with atomoxetine getting the CGI-I scale a score of 1-2. The duration of therapy and patient age are factors that influence the response. Furthermore, the clinical profile of patients treated with atomoxetine is characterized by different comorbidities, anxious symptomatology and personality disorders. Atomoxetine treatment with has also been shown its effectiveness and safe despite the presence of concomitant comorbidities and psychopharmacological treatment.

Atomoxetine treatment with has been effective and has proven good tolerability profile during treatment.

The authors have not supplied their declaration of competing interest.

Narcolepsy is a neurological disorder characterized by disturbances in REM sleep. The symptoms that the patient could present are excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations and disrupted nocturnal sleep. Its etiology is unknown. Currently, there is established pharmacotherapy for symptomatic treatment, which are often unsatisfactory.

Review of new treatments for narcolepsy based on recent advances about its ethiopathogenesis.

Seventy-five year-old female with a personal history of arterial hypertension and obstructive sleep apnea syndrome. The patient presented several episodes of abrupt muscular weakness, nightmares, sleep paralysis and excessive daytime sleepiness. Diagnosed of narcolepsy and treated with methylphenidate immediate-release (IR) 10 mg, alprazolam 1 mg, and trazodone 100 mg with good response.

Due to persistent symptoms, treatment was modified to osmotic-release oral system (OROS) – methylphenidate resulting on a substantial weight loss (12 kg) and persistence of symptoms. Another methylphenidate preparations were unsuccessfully tested. Currently she continues treatment based on methylphenidate release-release and she improved significantly though she sometimes presented daytime sleepiness.

Recent studies have shown that a loss of the hypothalamic neuropeptide hypocretin causes Narcolepsy with cataplexy and that an autoimmune mechanism may be responsible for this loss (related to HLA DQB*0602). Pathophysiology of narcolepsy without cataplexy is less understood.

Although amphetamines and its derivatives are the mainstay of management, therapies that involve hypocretine seems to be hopeful (intranasal, peripherical or hipocretin cell transplantation). Monotherapy with GHB, H3 antagonist receptors, TRH analogs and immunotherapy are also being studied.

The authors have not supplied their declaration of competing interest.

The aim of this study is to describe the features of cocaine-dependent patients who have had cocaine-induced tactile/somatic hallucinations (CITSH), and to analyze the association with addiction-related variables and psychiatric comorbidity, comparing patients with CITSH, patients with cocaine psychotic symptoms (CIP) and no CITSH, and patients without any psychotic symptom.

A cross-sectional study was conducted in 767 cocaine-dependent patients in an outpatient treatment center for addictions. The following data were obtained: sociodemographic characteristics, CIP information, addiction-related variables and psychiatric comorbidity. A bivariate and multivariate analysis was performed.

Of the whole sample, 6.6% reported CITSH at some point of their lives, 48.4% had suffered some CIP other than CITSH, and 45% had not experienced any psychotic symptom. According to multivariate analysis, risk of overdose increases by 12.1 (OR) times the probability of having had CITSH compared patients with CIP-no-CITSH. Other variables associated to patients with CITSH were: age of drug use onset, presence of episodes of overdose, prevalence of psychotic disorder induced by cocaine. In general, in all variables studied, patients with CITSH presented worse clinical features (addiction variables and psychiatric comorbidity) than patients with CIP without CITSH and non-CIP group.

CITSH are usually associated with other psychotic symptoms induced by cocaine. The patients who experienced CITSH are more severe cases compared both with patients with CIP without CITSH and patients without CIP. Increased risk of overdose is an important issue in this type of patients.