To identify differences in personality traits (temperament and character) using Cloninger's typology according to the presence of physical illness (WONCA criteria).

404 subjects, without psychiatric pathology, from Asturias (Northern Spain) were included in the study [50% men; mean age (SD)= 40.5 (11.3)]. Assessments were made using an ad hoc interview (socio-demographic and clinical data), and the Spanish versions of the MINI International Neuropsychiatric Interview (DSM-IV criteria) (Sheehan et al., 1997), and the Temperament and Character Inventory (TCI) (Cloninger et al., 1994).

154 (38.1%) subjects have at least one diagnosis of physical illness. Subjects with physical illness scored significantly higher in: i) temperament scales: harm avoindance (HA) (17.02 vs 15.76, t= -1.968; p= 0.050); fatigability and asthenia (HA4) (3.56 vs 2.82, t= -3.652; p< 0.000), ii) character scales: transpersonal (ST2) (3.91 vs 3.26, t= -2.900; p= 0.004). However, they scored significantly lower in: i) temperament scales: attachment (RD3) (5.18 vs 5.70, t= 2.346; p= 0.019), ii) character scales: responsibility (SD1) (5.57 vs 5.96, t= 1.984; p=0.048); purposeful (SD2) (5.43 vs 5.84, t= 2.092; p= 0.037); cooperativeness (C) (31.52 vs 33.26, t= 3.166; p< 0.000); social acceptance (C1) (6.50 vs 6.89, t= 2.536; p= 0.012); empathy (C2) (4.81 vs 5.18, t= 2.484; p= 0.013); compassion (C4) (7.44 vs 7.94, t= 2.190; p= 0.019); pure-hearted (C5) (6.55 vs 7.06, t= 3.225; p= 0.001). No other significant differences were found between the groups.

Our data suggest that physical illness might influence personality traits in non-psychiatric population.

The introduction of the first atypical antipsychotic with a long acting formulation has open new therapeutic options for the treatment of schizophrenic patients. Our objective consists of comparing psychopathology levels and global functioning in patients with paranoid schizophrenia treated in monotherapy either with long-acting injectable risperidone (LAIR) or conventional depot antipsychotics (DA).

Patients attending at the community mental health center during the six-month recruitment period were eligible to enter the study. Scores achieved in positive and negative subscales of PANNS and EEAG scale of (Global Activity Evaluating Scale) were evaluated at baseline and 6 months later. Six patients treated with RLAI and six patients treated with DA were recruited. Data were analyzed both with the real sample (N=6 per group) and extrapoling the same results to a bigger sample size (N=24 per group).

Mean increase in scores for both PANNS positive and negative subscales were lower in patients treated with RLAI that in those treated with DA (positive subscale: 0.018±0.06 vs. 0.048±0.03, RLAI and DA, respectively, p=0.387; negative subscale: 0.232±0.076 vs. 0.3095±0.123, RLAI and DA, respectively, p=0.579). EEAG scores were higher for patients treated with RLAI than those treated with DA (1.250±0.56 vs. 0.333±0.225, p=0.144). When these results are extrapolated to a sample of 24 patients per group, differences in EEAG reach statistical significance (p=0.034).

After 6 months of treatment, patients treated with RLAI tend to show a greater improvement in their global activity than those treated with DA.

High prolactin blood levels is an adverse effect of neuroleptic treatment. Typical antipsychotics seem to produce it more frequently than atypical ones.

To know hyperprolactinemia prevalence in our patients related with the type of antipsychotic drug used.

171 individuals, 31 male patients and 140 female ones, with a mean age of 61,67 years old and a mean hospital stay of 18,20 years.

The sample was divided in three groups:

• – Typical antipsychotics group: 37 patients.

• – Atypical antipsychotics group: 92 patients.

• – Typical and atypical antipsychotics group: 42 patients.

Prolactin serum levels were determined (normal values: 1.5-25 ng/ml for fertile age women, 0.7-20 ng/ml for post-menopause women and 0-20 ng/ml for men).

Prevalence of hyperprolactinemia for every group, for single antipsychotic drugs, for age groups, for gender and for diagnosis were obtained.

Prevalence of hyperprolactinemia was 66.1% for the global sample. Results for the different groups were the following:

• – Typical antipsychotics group: 73.0%

• – Atypical antipsychotics group: 60.9%

• – Typical and atypical antipsychotics group: 71.4%

Statistical analysis according to concrete antipsychotic drug showed the following hyperprolactinemia percentages:

• – Risperidone: 90.0%

• – Haloperidol: 69.2%

• – Olanzapine: 44.4%

• – Quetiapine: 33%

• – Aripiprazol: 14.3%

• – Clozapine: 11.1%

Our study finds lower hyperprolactinemia blood levels in patients on atypical antipsychotic treatment than on typical antipsychotic one. Haloperidol and risperidone got the worst results in this matter while clozapine and aripiprazol showed the best ones.

To determine which factors are associated with compliance with outpatient follow-up plan of discharged patients from a psychiatric ward of a general hospital.

A sample of 120 patients consecutively admitted to a psychiatric general ward, and referred to an outpatient clinic after discharge formed the sample.

To explore the factors predicting whether patients attended or did not attend to the outpatient clinic, a logistic regression analysis was conducted.

After controlling for age, gender, and overall clinical case severity (assessed by the Severity Psychiatric Illness Scale), have been previously attended in the outpatient clinic was the only factor that predicted the compliance with post-discharge outpatient plan (as dichotomous variable: attended/not attended), Odds Ratio (OR) = 12.53, P=0.042. Overall clinical case severity did not predict attendance to the outpatient clinic after discharge, OR=0.937, P=0.452.

Patients who were attended in an outpatient clinic prior to admission had 12-fold more likely to adhere with post-discharge outpatient plan than patients who were not previously attended. This result highlights the importance of strengthening community-hospital liaison strategies.

To verify whether most compliant patients with outpatient postdischarge follow-up plan remain in the community longer before readmission than those who don't adhere to outpatient follow-up plan.

From a total of 120 consecutive admissions to a psychiatric general ward, 63 patients were consecutively readmitted along a 2 year period after their reference first admission.

Out of the 63 patients, 25 patients were attended in an Outpatient Unit (OU) previously to their re-admission (group A), whereas 38 patients had not been attended in the OU between reference admission and readmission (group B). Patient's socio-demographic data (age, gender, marital status, and years of education) were obtained and a case-mix scale (Severity Psychiatric Illness Scale) was administered. Length of survival in community of both groups was compared by means of Analysis of Covariance, controlled for gender, age, diagnosis, clinical severity and number of previous admissions.

Group A had a mean length of survival in the community of 47.7 days (SD=44.3). Group B had a mean length of survival in the community of 23.2 days (SD=37.9). This difference was statistically significant (F=4.74, df=6, 63, p=0.034).

Being attended by OU after the discharge of reference admission lengthen significantly survival in the community after controlling for gender, age, diagnosis, clinical severity and number of previous admissions. Further research will be conducted to determine the cause of the observed differences in patient attendance to post-discharge appointments.

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.

To review the current knowledge about Diogenes symptoms and organic personality disorder through systematic review of the literature and the analysis of a case.

Case report. Review. Literature sources were obtained through electronic search in PubMed.gov database of 10 last years.

Background: Diogenes syndrome is a behavioral disorder characterized by severe self-neglect, hoarding, domestic dirt, and lack of shame regarding one's living state. Patients may present due to a range of reasons, few studies has been described hoarding symptoms secondary to brain injury. Early management could reduce their high-mortality condition.

We present a case of a 67-year-old Caucasian female known with a organic personality disorder secondary to a head trauma with obsessive hoarding symptoms. After being hospitalizated, we were authorized to explore her personal items trough photographs. Her handbag and her house were filled with rubbish and rotting food. Our patient had no insight into any self-hygiene or public health problems.

Information of the characteristics of Diogenes syndrome can help in earlier recognition of such persons, in order to decrease their morbidity and mortality.

The authors have not supplied their declaration of competing interest.

Insomnia is the most frequent sleep disorder in late life. Forty-two percent of elderly people in the United States often complain about difficulties to get or maintain sleep, or awakening too early. Insomnia is frequent in old people greatly due to frequency of concomitant medical illnesses and polypharmacy, rather than because of age.

The objective of our research was to revise the current state of knowledge about management of insomnia in people above 65 years of age.

For that, a bibliographical search through PubMed.gov has been made. From the obtained results, the 14 which best suited for our goals were selected, 10 of them dealing with people above 65 years and the rest with people above 75 or 80 years of age.

Based on the literature reviewed, the current options of management of late-life insomnia are based on behavioral or pharmacological therapy. The combination of behavioral therapies shows results and is currently considered as an option, especially given the possibility of medicine interaction and the secondary effects hypnotic and sedative medicines might produce. There is a paucity of long-term safety and efficacy data for the use of non-benzodiazepine sedative-hypnotics. There are no criteria for the use of antidepressant sedatives in elderly people without diagnosed depression, although they are still used in practice.

Possibility of using behavioral therapy as first option. In case of polymedicated or multi-pathological patients, pay special attention when starting a pharmacological treatment, choose the most suitable one and supervise it closely.

The authors have not supplied their declaration of competing interest.

Anorexia nervosa is a disorder of eating behavior that is a major health problem on our society. It is characterized by three main criteria: self-induced starvation, desire for thinness or fear of obesity, and the presence of medical signs and symptoms due to improper feeding. This work is focused on its treatment. The biopsychosocial approach allows the design and application of effective therapeutic strategies and a multidisciplinary team collaboration is essential.

Research of current pharmacological and psychotherapy treatments options of the disease.

Literature review based on articles and publications on this topic.

In anorexia nervosa, it is necessary to establish a therapeutic alliance between doctor and patient. Patient usually feels no motivation to improve. The different treatments options to combine, in terms of the patient status, are: nutritional rehabilitation, cognitive-behavioral, family and interpersonal psychotherapies and pharmacological treatment. It can be carried out at the ambulatory, at the day-hospital or by medical stay, even beyond patient will.

Nowadays, the nutritional rehabilitation is the best treatment established and it is the core treatment. About the psychotherapies, the cognitive-behavioral is the most used because it has exposed better results in all different studies proved and in clinical practices, followed by the family therapy which is the responsible of the patient family's treatment. Pharmacological treatment should not be used systematically and its exclusive use is not enough to resolve anorexia nervosa as there are needed also other treatments combined.

The authors have not supplied their declaration of competing interest.

Capgras syndrome is the most frequent delusional misidentification syndrome (DMS) which was first described in 1923 by Capgras and Reboul-Lachaux as ‘L’illusion des sosies’. Consists of believe that close relatives have been replaced by nearly identical impostors. It can occur in the context of psychiatric disorders (schizophrenia, major depression) such organic, in which onset of delirium is usually later coinciding with neurological damage or neurodegenerative disease.

Woman 73-year-old diagnosed of schizophrenia since more than thirty years ago. Her family talk about general impairment of the patient in the last two years. She needed a couple of psychiatric hospitalizations because of her psychiatric disease, and probably onset of cognitive impairment. In this context, we objectified the presence of a Capgras syndrome.

To review the literature available about Capgras syndrome in elderly and illustrate it with a clinical case.

Review of literature about Capgras syndrome in elderly by searching of articles in the PubMed database of the last five years to illustrate the exposure of a single case report.

The etiology of this syndrome is not yet well understood. Advanced age is frequently found Capgras syndrome with or without the concomitant presence of an obvious cognitive impairment.

Since it is a complex process an etiological model that combines cognitive and perceptual deficits, organic impairment and psychodynamic factors should be proposed. And it is important to make a correct differential diagnosis that allows us to carry out the best possible treatment.

The authors have not supplied their declaration of competing interest.

Schizophrenia has traditionally been considered to strictly be an early-onset disorder. Current nosologies, including DSMV, are not restrictive with age of onset in schizophrenia and all patients that satisfy diagnostic criteria fall into the same category. Since 1998, International Late-Onset Schizophrenia Group consensus, patients after 60 are classified as very-late onset schizophrenia-like psychosis. Female overrepresentation, low prevalence of formal thought disorder, and a higher prevalence of visual hallucinations are associated with later age at onset. Atypical antipsychotics represent the election treatment because of the reduced likelihood of EPS and tardive dyskinesias, and should be started at very low doses, with slow increases.

To review the current knowledge about very late-onset schizophrenia through systematic review of the literature and the analysis of a case.

Case Report. Review. Literature sources were obtained through electronic search in PubMed database of last fifteen years.

We present a case of a 86-year-old woman suffering from delusions and hallucinations, diagnosed with very late-onset schizophrenia-like psychosis, after differential diagnosis with other disorders. We analyze ethiology, epidemiology, clinical features and treatment in geriatric patients with schizophrenia.

Reluctance to diagnose schizophrenia in old people is still present today, probably in relation with the inconsistency in diagnostic systems and nomenclature, and consideration of medical conditions in the diagnosis. Identification of these patients is really important in order to start an appropriate treatment, which can lead to patient clinical stability.

The authors have not supplied their declaration of competing interest.

Accident rate have a high social cost. Cocaine consumption increases the risk of traffic crashes (Monras, 2011; Fierro, 2011). However, there is not extensively studies in addicts.

Compare and analyze the history of accidents and risk behaviors while driving in cocaine dependent patients (DC) and of other substances (OtherD).

One hundred and eighty-two patients seeking treatment since January 2014 to September 2015. Sociodemographic and accident-related variables were collected, also administered the MDBQ. Descriptive analysis and bivariate analysis using Chi-square test for categorical variables and Student t test was performed for quantitative.

Of women, 30.3%, and 69.7% men, mean age 43.67 years (SD = 13). 65.6% currently driving or above. 45.2% DC vs. 54.8 DOther (35.6% alcohol, cannabis 8.3%, 5.8% opioid and 5.1% other drugs).

Comparing accident rate on the DC is a tendency to have suffered more accidents (χ2: 2.62 P=.072). Patients addicted to cocaine referred further potentially dangerous activities both under the influence of consumption (65.9% vs. 33.3%) and abstinence (41.7% vs. 12%).

As for the results of MDBQ, it has been detected that cocaine addicts show more errors and traffic violations. No differences in the lapses identified by patients of different groups.

Patients with cocaine dependence have more accidents, reduced risk perception and recognize more mistakes and traffic violations. Cocaine implies a high risk of road accidents and exposure to high-risk situations compared to the use of other substances.

References not available.

The authors have not supplied their declaration of competing interest.

Clozapine (CZP) is the only antipsychotic approved for resistant schizophrenia 1. Due to its side effects, CZP is not the first therapeutic option in a psychotic episode. Its anticholinergic effects often cause constipation, however, diarrhea have also been described in literature.

We describe a patient with two episodes of severe diarrhea after clozapine initiation, which lead to CZP discontinuation.

Discuss about the differential diagnosis of diarrhea in CZP patients and the needing of a further studies for clarify the more appropriate management in CZP induced diarrhea.

We present a case report of a 46 years man diagnosed with schizoaffective disorder who presented two episodes of severe diarrhea with fever, which forced his transfer to internal medicine and UCI after CZP initiation.

At the first episode analytical, radiological and histological findings led to Crohn's disease diagnosis, which required budesonide and mesalazine treatment. In the second episode, the digestive team concluded that the episode was due to clozapine toxicity despite the controversial findings (clostridium toxin and Crohn's compatible biopsies)

Diarrhea caused by CZP has been controversial in the literature. However due to the severity of digestive episodes and the paucity of alternative treatments further studies for a better understanding of its physiopathology are warranted.

The authors have not supplied their declaration of competing interest.

Janssen-Cilag research study.

Serial killer's (SK) familiar relations often present a disorganized adherence characterized by the paternal absence and the excessive maternal coldness or over-protection. This familiar diagram, joined to mistreatment situations, could generate different antisocial conducts in the child because of the vacancy of a significant strong figure.

To study, in the SK, the relation between having suffered childhood mistreatment and the sexual aggression to the victims before killing them.

A study is realized between the variables of childhood mistreatment and sexual aggression to the victims. The data has been extracted from 100 protocols of SK with different nationalities elaborated by the unit of analysis of criminal behavioral (University of Salamanca, Spain).

The results show a significant relation between both variables.

It can be confirmed that the SK who have suffered childhood mistreatment sexually attack their victims before killing them while those who did not experiment it during their childhood do not realize that conduct.

The authors have not supplied their declaration of competing interest.

Cannabinoid hyperemesis syndrome (CHS), is characterized by recurrent episodes of severe nausea and intractable vomiting, preceded by chronic use of cannabis. A pathognomonic characteristic is compulsive bathing in hot water. The resolution of the problem occurs when cannabis use is stopped. However, patients are often reluctant to discontinue cannabis. Treatment with anti-emetic medication is ineffective. Case series suggested haloperidol as a potential treatment. Other antipsychotics as olanzapine has been used as anti-emetic treatment in chemotherapy.

To describe three cases of patients with CHS whom showed a successful response to olanzapine, even when, haloperidol had failed.

To present an alternative treatment for CHS which can offer benefits over haloperidol.

We present three cases of patients who suffered from CHS and were admitted to emergency department. All patients were treated with olanzapine after conventional anti-hemetic treatment failure. One patient was also unsuccessfully treated with haloperidol.

All three patients showed a good response to olanzapine treatment. Different presentations were effective: velotab and intramuscular. Their nausea, vomits and agitation were ameliorated. They could be discharge after maintained remission of symptoms.

Olanzapine should be considered as an adequate treatment for CHS. Its suitable receptorial profile, its availability in different routes of administration and its side effects profile could offer some benefits over haloperidol.

The authors have not supplied their declaration of competing interest.