Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.

78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).

ADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.

ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.

The ADHD prevalence in our sample of BD and relatives weren’t higher than general population.

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- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.

- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.

Singh MK, DelBello MP, Kowatch RA, Strakowski SM.Review Article Bipolar Disorders 2006: 8: 710-720

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.

UPD is a regional referral hospital psychiatric care unit, endowed with multidisciplinary equipment. It provides care to people with light/moderate/severe intellectual incapacity coexisting with mental disease and/or severe behavioral disorders. It offers attention to patients who need a protected therapeutical environment for correcting behavior disorders. It was opened in September 2008.

Description of:therapeutic goals, inclusion/exclusion criteria, admission protocol and psychotherapeutic/pharmacological interventions.

Analysis of inpatients's sociodemographic/clinical characteristics and preliminary assessment of therapy goals.

Retrospective study(13-month) of patients admitted to UPD of Leon Hospital from its inception to date. Data are collected from medical histories.

47 referrals have been received,5 of them have been rejected not to fulfill criteria. We’ve 16 patients on waiting list.32 incomes have been realized and 22 discharges have occurred.

19 of the incomes correspond to Mild,6 to Moderate,6 to Severe and 1 to Profound mental Retardation.

Regarding co-morbidity:22 patients presented serious behavioral disorder. From this group, 2 met criteria for autistic disorder, 5 had schizophrenia or unspecific psychotic disorders, 5 presented Personality Disorder and one ADHD.

10 patients did’nt present any important behavioral disturbance. From this group 2 were diagnosed with OCD,3 presented problems due to Alcohol and Substance-related Disorders,3 had Psychotic Disorders, one met criteria for Impulse Control Disorder and one presented Mood Disorder.

Before admission, 12 patients resided in specific handicappeds center, 5 intermittently at selected centers and in family, and 15 lived with family.

Psychotherapeutic intervention and treatment were useful in most cases. It was particularly helpful in treatment of behavioral disturbances. Now we must determine effectiveness in maintenance of improvement when they return to their community.

The general model of cognitive impairment of schizophrenic patient may be summarized as follows:first difficulty interpreting signals from other(predominantly negative symptoms),and on the other an emotionally intense overinterpretation of these(predominantly positive symptomatology). These patients have greater difficulty in understanding the mental states of those around. So cognitive rehabilitation aims to build the capacity of relevant attribute mental states to others and solve specific problems and difficulties of daily life. The aim of the study is to evaluate the correlation between the ability of understanding of mental states and the ability to interpret expressions Machiavellian(manipulative purposes)

Cross-sectional data were analyzed from a study with a sample of 43 patients diagnosed with schizophrenia compared to normal controls matched for age, sex and educational level. As scale measuring instruments used Mach-IV, self-administered questionnaires and a comprehensive neuropsychological battery to assess performance and the PANSS, SAPS and SANS scales

The path analysis were used to evaluate the effects of neuropsychological functions, functional ability and level of functioning in real life. After evaluating the following functions:physical distinction-mental distinction-reality appearance, identification of intent gaze, identifying emotions, ability to deceive, ability to understand the jokes, ability to understand stories, the study showed how schizophrenic patients showed poor workability, deception or strategic thinking ability and a poor ability to “take the place of another”

Cognitive rehabilitation works to help construct representations of others and of oneself and use them flexibly to guide social behavior by encouraging the underlying social interactions involving human capacity to perceive the intentions and dispositions of the other mental functions. In short, an improvement in the therapeutic field biopsychosocial

The HDP care structures are intermediate in nature providing an active heatlth care, multidimensional, structured and intensive medical care, aimed at patients with severe and complex system of partial hospitalization in pathology, as well as those patients who do not require, at a given time, income to total time, but are not subject to appropriate outpatient therapeutic gains.

1. - To analyze the profile of psychotic patients admitted to HDP.

2. - To know the effectiveness of the intervention in HDP on psychotic patients.

Prospective naturalistic study of psychotic patients (F2X.XX) entering HDP for 24 months. As main outcome variables use: PANSS score, GAF score and CASH for insight. These scales are passed on valuation and the day of discharge device.

We identified 81 patients that have been hospitalized after an acute event (67, 82.7%). From the initial sample, 22 cases were first psychotic episodes (27.2%), 46 males (56.8%) and 35 women (43.2%), Discharge statistically significant improvement in PANSS score (p objective <0.001) in the GAF score (p> o, o, o, 1) and in CASH to awareness of illness score (p <0,0,0,1).

Intervention in day Hospital on psychotic patients improves psychotic symptoms, functionality and insight.

Alcoholic hepatitis (AH) is the most severe form of alcoholic liver disease. Although it is commonly accepted that abstinence influences long-term survival, no studies have specifically investigated the impact and predicting factors of prolonged abstinence after an episode of AH. Here, we aimed at investigated which are the clinical, psicosocial, alcoologic parameters associated with long-term abstinence and its impact on survival.

A series of 102 patients with biopsy-proven AH seen at the Hospital Clinic of Barcelona from 2000 to 2007 were included in the study. Patients were hospitalized and received standard medical care. We describe the independent association between amount of alcohol consumed and long-term abstinence. We evaluated the effect of short term and long-term abstinence on survival.

67.4% were male, and median age was 50 years. 50.5% of the study cohort remained abstinent during the follow up period, while 49.5% of the patients admitted alcohol use at some degree during follow up. A higher score on the High-Risk Alcoholism Relapse Scale increased risk of active drinking at follow-up. When stratified by amount of alcohol consumed after admission of acute alcoholic hepatitis, those with moderate survival had median survival time of 38.2 months compared to 26.4 months in patients with severe consumption.

Early alcohol consumption after an episode of AH negatively impacts survival. The High risk Alcoholism Relapse Scale is a good predictor of long-term abstinence. Short-terms interventions in patients with AH are strongly recommended in this patient population.

R Oberguggenberger1,2, N Ruiz 1, M Ortega1, C Roset1, Y Rendal1, J Salva1, Lago E1, P Herbera1

1. Hospital Son Espases, Palma de Mallorca, Spain

2. Hospital Psiquiátrico. Palma de Mallorca, Spain

Polypharmacy in patients with schizophrenia is frequent in the short term and long term treatment. Prevalence of up to 50% of polypharmacy has been shown in some clinical settings. There is scare evidence of the prevalence of polypharmacy in inpatient settings.

The goal of this retrospective study is to assess the prescription patterns of patients with schizophrenia in a Spanish inpatient setting.

Records of all admissions between 2010 until 2012 in the adult ward of a public heatlh service in Palma de Mallorca will be analysed in this study.

The results will show current prescription patterns of patients with schizophrenia in a Spanish inpatient setting.

When we want to approach eating disorders in infancy and childhood we can not forget the importance of relations with the relational patterns figures. The bond with the primary attachment figure is critical to the physical and emotional development. The “be fed” is a task essential to life, through it, it helps the child regulate their states, differ feelings / emotions. … to food and environment are created and entrenched relational patterns exist when feeding problems is essential to evaluate the interactive situation and the representational world of the attachment figure. Only then can we understand the disorder and help participants to solve (R. Feldman, Karen M., 2004).

In this paper the study of possible empathic failures in the original development of attachment in relation to disordered eating behavior is presented. To do this, we have taken a sample of 10 patients with DSM-IV criteria for an eating disorder diagnosis and valued the relationship with the attachment figure reference.

Try, therefore, to analyze the basic elements that come into play around the feeding in the first year of life: the child with its biological characteristics and temperament and adult relationship leading figure, which is the one with food to the child and gives.

Publications and studies have shown that the existence of serious mental disorders in parents is a risk in the development of children and is more common the existence of mental illness in them than in the general pediatric population. This work aims to reflect in depth on the study of the influence of psychotic parents on child development through a review of a clinical study. We present the case of 14 years old adolescent who is being treated in a mental health center, whose parents suffers from a severe mental illness. We also defend the importance of a preventive approach or treatment that impinges on the child and family environment.

A way of community work, in coordination with the different teams (social services, educational services, etc.) allows more efficient and appropriate treatment, using various resources. When risk factors for developing mental health problems in childhood, family history and especially the existence of one or both parents of mentally pathology type schizophrenia or other psychoses are studied become important. It seems essential to address as a priority to the social group have called “high-risk group of psychosis’, and in particular to the” sons of patients diagnosed with psychosis”, both for its size and the severity and chronicity of psychopathology if developing means for early psychosocial care does not occur.

The authors have not supplied their declaration of competing interest.

The approach to mental illness and specifically in serious mood disorders, long-term treatments that improve adhesion as continuous treatments ensure compliance are needed, they minimize the risk of relapse and readmission and therefore increase the chances to have a good fit and social, relational and even occupational functioning.

We analysed a sample of 42 male diagnosed with schizophrenia, schizoaffective disorder, chronic delusional disorder that starts treatment with Paliperidone Palmitate in outpatients. It is analysed the dose of paliperidone palmitate employed for stabilization and family satisfaction at the time of stabilization is analysed in the study.

The mean dose of Paliperidone Palmitate is 138 mg. The patient diagnosed with schizophrenia are 47.6% and the average dose is 132.5 mg. Chronic delusional disorder is 2.3% and the mean dose 50 mg. Other comorbility mood disorders are 21.4% and the mean dose is 183 mg. Other disorders (F70, F72…) are 28.5% and mean dose 133 mg. The average family satisfaction (minimum 1 up to 5) is 4, with the highest score among patients diagnosed with F20 Schizophrenia.

Long lasting injectable medications achieve important adherence and a high percentage of antipsychotic monotherapy, thus reducing the side effects, although in our sample 8% which has occurred was removed therefrom.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

A. is a 10-year-old girl of Moroccan origin appearing in pediatric specialist of A.P repeatedly by unspecific stomachache, nausea and vomiting. After several visits to the same reason for consulting an exploratory interview alone with the patient in that regard that “sometimes when calms nervous scratching the walls and eating them” is performed. The mother says intrafamily difficulties. Information reported by the patient's mother confirms next visit also providing pictures on the wall of your room is returned. Referral to child and adolescent mental health is decided.

There is no single test for pica. It is carried out systematic blood, biochemical (iron, zinc, lead…) to assess toxic substances and nutritional levels. Abdominal Rx. Both normal.

Pica (F98.3).

Ingestion of nutrients can occur in the course of other mental disorders (for example, a pervasive developmental disorder, schizophrenia), mental retardation, in the Kleine–Levin syndrome… In these cases, should only be established an additional diagnosis of pica if the feeding behavior is sufficiently severe to warrant independent clinical attention.

Pica disorder has been studied by pediatricians, gynecologists, dermatologists, psychiatrists, psychologists, nutritionists, anthropologists, etc., which has been interpreted as a conduct disorder, food, mental illness, poverty, hunger… but really the cause it is unknown. Although morbidity and mortality is unknown and difficult to study, include poisonings, parasitosis and surgical abdomen as serious complications. Finally, like all other eating disorders, the overall management of this entity requires the coordinated intervention of various professionals.

The authors have not supplied their declaration of competing interest.

To know the magnitude and characteristics of the use of legal drugs (alcohol and snuff) and illegal (marijuana, cocaine, heroin, inhalants) in the – adolescent/child – population who come regularly to addictive behavior unit of a rural environment.

Descriptive study of a sample of adolescent patients (n = 30) who came in the past two years to addictive behavior unit. Data collection of such patients is performed by assessing sociodemographic characteristics (age, sex, population, education level…), age of onset and type of use of psychoactive substances, and comorbidity of psychiatric disorders.

The average age of the adolescent patient is 14.5 years (SD 1.09) with an age of onset in the consumption of toxic 13.6 years (SD 1.03). As for sex, 20% were women. The dropout among adolescents of this sample is 43.3% (SD 1.05). A complete prevalence of marijuana use (100%), and mono-consumers only 10% was observed. Seventy percent of the sample has associated psychiatric disorders and 46.15% in psychiatric family history there; 38.4% up to legal problems are collected.

The authors have not supplied their declaration of competing interest.

C. is a 14 teenager who comes to a mental health center for the first time a year ago for having numerous self-injuries in the forearm. She says that she cannot avoid doing so in moments of anxiety and that, in addition, when she is hurt she calms down. Throughout the interviews, C. relates that after the death of her best friend in a traffic accident she is alone and with episodes of anxiety.

It is important to analyze the risk factors of self-injurious behaviors in adolescence such as:

– personal characteristic;

– psychiatric disorders;

– family characteristics;

– mass media.

Depressive episode (F32).

In general, self-injury is considered as a symptom or characteristic of a specific psychiatric disorder. Stereotyped self-injury is characteristic of processes of cognitive deficit of the level of severe and profound mental retardation. Compulsive self-harm involves symptomatic habits such as severe scratching of the skin or already differentiated psychiatric entities, such as trichotillomania, onicofagia or delusional parasitosis… Important psychotic disorder.

Following the Task Force's criteria, in relation to probably effective therapies, it can be concluded that the therapy based on mentation for adolescents (MBT-A) is the first effective treatment for the treatment of self-harm in adolescents.

The authors have not supplied their declaration of competing interest.

Patient 10-year-old pediatrics sent from service due to history of frequent admissions for recurrent abdominal pain. In the bypass request indicate that this is a patient of perfectionistic traits; detect dysfunctional family dynamics highlighting the rivalry in the phratry, and with an equal difficulty in the field. From 2010 to 2016, he has made more than 30 visits to hospital emergency combined intervention of psychiatry and psychology and multidisciplinary service available with a pediatric surgery and pediatrics is performed.

From 2011 to 2016, it has made 44 blood tests, sonograms 9 full abdomen, abdominal renal scintigraphy without significant findings.

F45.5 pain disorder.

Symptoms due to a medical condition. Other symptoms substance-induced mental disorders: non-specific conversion disorder, pain disorder, hypochondriasis, body dysmorphic disorder, somatization disorder, simulation, factitious disorder, medical symptoms…

Psychosomatic disorders are one of the most common clinical forms of mental disorders in childhood and adolescence expression. Knowing the stages of development and operating characteristics. In clinical practice, mainly in primary care, tend to find an organic cause somatic complaints in children, so prevalence data and/or referral to specialized services vary depending on mental consulted sources is critical to understand the pathogenesis of these disorders.

The authors have not supplied their declaration of competing interest.

To assess the prescription of benzodiazepines (BZD) in elderly patients, and to explore any gender differences.

Six hundred and fifty-four patients (≥ 65) admitted in an emergency service of a general hospital due to a fall. BZD use information was collected (dose, half-life profile).

BZD are significantly more prescribed to women (47.6%) than men (36.1%) (X2 = 8.097, P = 0.004). We conducted a logistic regression analysis using as dependent variable taking or not BZD and sex as the independent one, covariating the model by age. We noted that sex remains significant despite enter the age variable in the model (OR = 1.5, P = 0.013). A total of 21.6% of patients consumed intermediate or long half-life BZDs, appearing a greater tendency to prescribe such BZD to women (X2 = 3.606, P = 0.058). In the 58.0% of prescriptions, prescribed dose was higher than the recommended for the elderly. The percentage is significantly higher for men (70.0%) than women (53.1%). Furthermore, a total of 54 prescriptions (15.8%) were even higher than the recommended adult dose, with no significant differences between men and women.

We found evidence of a higher prescription of BZD in women independently of age. Despite not being recommended, prescription of intermediate or long half-life BZD continues, in a slightly higher manner in women. BZD are prescribed above the recommended dose for elderly in a large number of patients, especially in men. A considerable proportion of elderly patients (15.8%) consume BZD doses even higher than the recommended for adults.

The authors have not supplied their declaration of competing interest.