The prevalence of psychotic experiences (PEs) is higher in low-and-middle-income-countries (LAMIC) than in high-income countries (HIC). Here, we examine whether this effect is explicable by measurement bias.

A community sample from 13 countries (N = 7141) was used to examine the measurement invariance (MI) of a frequently used self-report measure of PEs, the Community Assessment of Psychic Experiences (CAPE), in LAMIC (n = 2472) and HIC (n = 4669). The CAPE measures positive (e.g. hallucinations), negative (e.g. avolition) and depressive symptoms. MI analyses were conducted with multiple-group confirmatory factor analyses.

MI analyses showed similarities in the structure and understanding of the CAPE factors between LAMIC and HIC. Partial scalar invariance was found, allowing for latent score comparisons. Residual invariance was not found, indicating that sum score comparisons are biased. A comparison of latent scores before and after MI adjustment showed both overestimation (e.g. avolition, d = 0.03 into d = −0.42) and underestimation (e.g. magical thinking, d = −0.03 into d = 0.33) of PE in LAMIC relative to HIC. After adjusting the CAPE for MI, participants from LAMIC reported significantly higher levels on most CAPE factors but a significantly lower level of avolition.

Previous studies using sum scores to compare differences across countries are likely to be biased. The direction of the bias involves both over- and underestimation of PEs in LAMIC compared to HIC. Nevertheless, the study confirms the basic finding that PEs are more frequent in LAMIC than in HIC.

Using as a starting point a clinical case, the authors performed a literature review to clarify the relationship between Behçet disease and acute psychosis.

Analysis of the patient's clinical process and brief review of the latest available literature on the subject, published in PubMed/Medline databases.

Male patient, 55 years old, brought to the emergency room by fever, headache, hetero-aggressive behavior, disinhibited behavior, mood swings, euphoria, persecutory delusions and insomnia, in the last 4 days. He had no insight into his illness. There was no personal or family history of psychiatric illness and toxicological habits were irrelevant. Due to the personal history of posterior uveitis with bilateral macular edema, retinal vasculitis, genital aphthosis, papulo-vesicular lesions and recurrent bipolar aphthosis, the hypothesis of neuro-behçet was raised.

Behçet's disease can present with neurological involvement - neuro -behçet - and can manifest itself with several psychiatric symptoms (euphoria, lack of insight, disinhibited behavior, agitation or psychomotor retardation, persecutory delusions, obsessive thoughts, anxiety, depression, insomnia or memory changes). Fever and headache usually appear in the prodromal stage and can be signs of onset or recurrence of the disease. The prevalence of neuro-behçet ranges from 2 to 50% and usually occurs 1 to 10 years after the first symptoms of the disease. Since it appears as the first manifestation of the disease in only 3% of cases, it is difficult to diagnose. The literature suggests that symptoms are generally resistant to treatment with conventional psychotropic drugs and so it is an important cause of morbidity and mortality.”

The main objective of this work was to compare the emotional and behavioral problems reported by adolescents with and without psychotic-like symptoms.

The sample was composed of 1,713 non-clinical adolescents with a mean age of 14.7 years (SD = 1.7), of which 832 (48.6 %) were males.

The results showed that the participants with psychotic-like symptoms reported a higher number of emotional and behavioral problems compared to the participants who did not inform of said experiences.

The findings converge with data from previous studies of patients with schizophrenia as well as in schizophrenia-prone individuals, offering support to the dimensional models of psychosis, and have clear implications with a view to establishing primary prevention strategies for these high-risk individuals.

The main objective of the present study was to compare the coping strategies used by adolescents with and without subclinical psychotic symptoms.

The sample was composed of 1,713 Spanish adolescents, 881 (51.4%) females, with a mean age of 14.7 years (SD = 1.7).

The results showed that the adolescents with subclinical psychotic symptoms used Avoidance-type coping strategies more frequently and Positive-type coping strategies less frequently in comparison to the control group.

These findings indicate a pattern of deficit in the strategies used to cope with stress similar to that of patients with schizophrenia, which is very interesting with a view to establishing lines of intervention within early detection and treatment programs for high-risk individuals aimed at modifying these patterns of deficit in coping with environmental stimuli in these populations.

A clear distinction between schizophrenia and some clusters of dementia is sometimes difficult to do in clinical practice.

A 38-years-old-male patient, with history of alcohol dependence, was admitted in our unit for generalized tremor, sweating, agitation, auditive, visual and cenestesic hallucinations, thought broadcasting and persecutory delusion. Agitation and the vegetative symptoms gradually subsided within 48 hours. Lab work showed no clinically significant changes. EEG and EKG were normal. MRI showed augmented cortical encephalic sulci. 5 days after the admission 10 mg of olanzapine was prescribed due to psychotic symptoms persistence. Haloperidol was stopped. A gradually improvement occurred and 26 days after the admission the patient was discharged home asymptomatic. Neuropsychological testing revealed severe fronto-temporal cognitive defect suggestive of alcoholic dementia.

The difficulty to clearly distinct schizophrenia from some dementias may be because, as Kraepelin stated in the 19th century, schizophrenia is itself a form of early dementia. His concept of dementia praecox is supported nowadays by the knowledge acquired from several neuropsychological and neuroimaging tests that a progressive cognitive deterioration appears to occur in schizophrenic patients.

Men and women who develop schizophrenia are at increased risk, compared with the general population, to engage in violence toward others and, in so doing, often lay waste to their own lives. The reasons for this finding remain obscure.

The present work aims to analyze the relationship between active symptoms of the disease, substance abuse and violence in schizophrenic patients admitted to a forensic ward in our country (Portugal).

A population of inpatients (male and female) from two forensic wards was studied as to personal and psychiatric history, substance abuse, social and cultural background, family history, symptoms at the time of the violent behavior and patient's insight.

The prevalence of offenses was the highest among male schizophrenic subjects with coexisting substance abuse, and more than half of the schizophrenic offenders also had problems with substance abuse. Most perpetrators were acutely ill at the time of the offence but only a small number was under mental healthcare.

Our results were consistent with those found in classic literature. We hope this will help us start a structured programme in our hospitals in which behavioral factors, substance misuse and social dislocation are managed together with the active symptoms of the disorder in order to prevent such violent behavior and to promote adequate treatment of schizophrenic patients.

Different psychoeducational and family-based interventions have been shown to improve chronic physical diseases, such as asthma. There is an increasing consistency of therapeutic effects in these programmes, across the literature. However, scientific validation of the benefits of each programme and what is the best model/method are required.

To evaluate the effects of Multifamily/MG and Psychoeducational/PG interventions for asthma on psychological, biological and morbidity outcomes.

A sample with 299 outpatients with asthma diagnosis from a University Hospital was recruited consecutively. Patients with moderate/severe asthma were included in a five-month randomized controlled study with simple occultation. There was a balanced inclusion of 141 patients allocated to three groups: MG, PG and control group/CG. All patients continued usual pharmacological treatment. Anxiety (SAS/STAIY), depression (BDI), coping mechanisms (WCAEL), quality of life (MiniAQLQ), asthma control (ACQ), lung function (FEV1/PEF), airway inflammation (FeNO), asthma severity and morbidity were assessed at the beginning and the end of the study.

Both MG and PG improved asthma control. The overall quality of life score increased in MG (0.5 U) and PG (0.8 U), but not in the CG. A significant decrease was also found in the use of oral steroids in MG and in the hospitalization in PG. The behavioural changes improved psychological parameters (anxiety, depression, coping), and lung function.

Multidisciplinary group interventions seem to improve physical/psychological parameters in asthma, and assessment of efficacy is necessary after a longer follow-up period, as is identification of patients’ clusters which benefit the most from each intervention.

Endocannabinoid System (ECS) has been highlighted as one of the most relevant research topics by neurobiologists, pharmacists, basic scientists and clinicians (Skaper and Di Marzo, 2012). Recent work has associated major depressive disorder with the ECS (Ashton and Moore, 2011). Despite the close relationship between depression and bipolar disorders, as far as we know, there is no characterization of ECS and congeners in a sample of patients with bipolar disorders.

The objective of this work is to characterize the plasma levels of endocannabinoids and congeners in a sample of patients with bipolar disorders.

The clinical group was composed by 19 patients with a diagnosis of bipolar disorders using SCID-IV (First et al., 1999). The control group was formed by 18 relatives of first- or second-degree of the patients.

The following endocannabinoids and congeners were quantified: N-palmitoleoylethanolamide (POEA), N-palmitolylethanolamide (PEA), N-oleoylethanolamide (OEA), N-stearoylethanolamide (SEA), N-arachidonoylethanolamide (AEA), N-dihomo-γ-linolenoylethanolamide (DGLEA), N-docosatetraenoylethanolamide (DEA), N-linoleoylethanolamide (LEA), N-docosahexaenoylethanolamide (DHEA), 2-arachidonoylglycerol (2-AG), 2-linoleoylglycerol (2-LG), and 2-oleoylglycerol (2-OG).

The result showed statistically significant lower levels of AEA, DEA and DHEA in clinical sample. Previous research also identified lower levels of AEA in depressed women (Hill et al., 2008, 2009). Until date, it is unknown if DEA and DHEA have some effect on EC receptors, and whether they have some direct effects on endocannabinoids.

It would be necessary to carry our other research with a larger sample, which could allow the control of potential confounding variables.

The authors have not supplied their declaration of competing interest.

Sturge-Weber syndrome or encephalotrigeminal angiomatosis is an uncommon neurocutaneous syndrome that manifests with vascular malformations involving the brain, eye and skin; Severe cases present with refractory seizures, sometimes requiring major surgery such as hemispherectomy. Most of the times, some degree of mental retardation and behavioral problems are associated, requiring use of psychotropic medication and other contention strategies. This report describes the case of a 19-year-old boy who was submitted to a left hemispherectomy by the age of one, and was still able to successfully complete basic education. He started presenting severe behavioral problems, with aggressive outbursts, by the beginning of adulthood, having been committed to psychiatry ward. By the age of 22, the patient finds himself calm and functional considering his limitations, with no need for hospital admission for 2 years.

To describe a clinical case whilst reviewing literature concerning this matter.

Case report with complete clinical history and medical data. Non-systematic review of PubMed database under the terms “Sturge-Weber disease”, “Hemisferectomy”, “behavioral disorder due to organic causes”, “post hemisferectomy out-comes”.

Although presenting with severe arteriovenous malformation, refractory epilepsy and left hemispherectomy, the patient was able to conclude basic instruction; He has lived with his family until the age of 19, when he started displaying disruptive behaviour; after 3 hospital admissions and perfecting psychotropic drugs treatment, the patient was admitted to an institution for rare diseases patients Since then he has experienced a calm and functional life, with trained professionals who can offer the non-pharmacological approaches he needs.

The authors have not supplied their declaration of competing interest.

Comorbidity between alcoholism and depression has long been acknowledged, and the possibility that similar brain mechanisms, involving both serotonergic (5-HT) and noradrenergic systems (NE), underlie both pathologies has been suggested. Thus, inhibitors of NE and 5HT uptake have been proposed for the treatment of alcoholism, as they have shown to reduce alcohol intake in various animal models. However, most of the studies mentioned were carried out acutely and there is a lack of knowledge of the possible long-term effects. Clinical studies report an overall low efficacy of antidepressant treatment on alcohol consumption, or even a worsened prognosis. In addition, several cases of alcohol dependence following antidepressant treatment have been reported in the literature.

We aimed at comparing the acute and chronic effects of the treatment with the antidepressant drug reboxetine on alcohol consumption.

We used a rat model of alcohol self-administration, and two different schedules of reboxetine administration (acute and chronic).

Our results confirm the acute suppressant effects of reboxetine on alcohol consumption but indicate that, when this drug is administered chronically in a period of abstinence from alcohol, it can significantly increase the rate of alcohol self-administration.

These results are important for the understanding of the clinical reports describing cases of increased alcohol consumption after antidepressant treatment, and suggest that much more research is needed to fully understand the long term effects of antidepressants, which remain the most widely prescribed class of drugs.

The authors have not supplied their declaration of competing interest.

Case report of a patient with Anorexia Nervosa and bizarre behavior.

Clinical observation in hospital.

Woman with 43 years old, with a peace of 65 years, who was hospitalized in Psychiatric Service – Eating Disorders, in August 2015, because of its extreme thinness, with difficulty to walk and with severe edema of the feet, ankles and legs. At the entrance, she weighed 29 kg, after 4 days her weight reduced to 23 kg, reaching a BMI of 8.5 kg/m2. In the first week, she showed a high cognitive impairment, confusional state and detailed and ruminative speech about food. She had developed multiple techniques to hide food and to hide and take dietary supplements for weight loss. Furthermore, she had a bizarre behavior and marked social isolation, not interacting with other patients.

Although the low prevalence of EDs, these have a high morbidity, and are one of the psychiatric disorders that most often leads to a fatal outcome. Treatment is lengthy and cumbersome, requiring serious investments under the personal point of view, family and clinical, yet still, these patients can have a full life and quality.

The authors have not supplied their declaration of competing interest.

Mephedrone is a synthetic cathinone derivative included in the class of “New-Novel Psychoactive Substances”. Synthetic cathinones are marketed as “bath salts” or “plant food” and gained notable popularity for similar effects to 4-methylenedioxymethamphetamine (MDMA, ecstasy), or amphetamines. Mephedrone is commonly consumed simultaneously with alcohol.

The aim of the present study was to evaluate the interactions between mephedrone and ethanol in humans.

Twelve healthy male, recreational users of psychostimulants participated as outpatients in four experimental sessions. They received a single oral dose of mephedrone (200 mg) and alcohol (0.8 g/kg), mephedrone placebo and alcohol (0.8 g/kg), mephedrone (200 mg) and placebo alcohol, and both placebos. Design was double-blind, double-dummy, randomized, cross-over and controlled with placebo. Study variables included: vital signs (blood pressure, heart rate, temperature, and pupil diameter), subjective effects (visual analogue scales-VAS, ARCI-49 item short form, and VESSPA questionnaire).

The combination produced an increase in the cardiovascular effects of mephedrone and induced more intense feeling of euphoria and well-being in comparison to mephedrone and alcohol. Mephedrone reduced the drunkenness and sedation produced by alcohol.

These results are similar to those obtained with the combination of other psychostimulants as amphetamines and MDMA. Abuse liability of the combination is greater that induced by mephedrone.

The authors have not supplied their declaration of competing interest.