People with psychosis have a deficit in emotion recognition, what has been mainly studied in schizophrenia. However, there are little published data about reactions to emotional facial expression and its relationship with the performance in emotion recognition tasks.

To assess the emotional reactivity to faces and the recognition of emotions in people with an acute psychotic episode.

To determine if there is a relationship between emotional reactivity to faces and emotional perception in people with psychosis.

22 people -14 male (mean age 37,57;SD10,46) and 8 females(49,57;SD13.23)- with an acute psychotic episode (DSM-IV-TR) were asked to assess 20 faces from The Emotion Recognition-40 using the Self Assessment Manikin. Then, faces were projected again, asking the participants identify the emotion expressed in each image.

Valence in Anger correlates with Correct Identification (CI) of anger (τ=0.379;p=0.015). Arousal in Anger with CI of anger (τ=0.356;p=0.021) and with False Positive (FP) of anger (τ=-0.415;p=0.012). Valence in fear with CI anger (τ=0.335;p=0.023). Arousal in fear with FP anger (τ=-0.385;p=0.018). Valence in No Emotion with FP Sadness (τ=-0.38;p=0.012), FP anger (τ=-0.479;p=0.004), FP fear (τ=-0.332;p=0.013) and CI no emotion (τ=0.575;p=0.000). Arousal in No Emotion with CI anger (τ=0.50;p=0.002). Every correlation was still significant when controlling diagnosis, except arousal in anger and FP anger.

Results indicate a probable relationship between the way people with psychosis react to a fearful, angry or non emotional face and the emotion they attribute to it.

Delusional disorder has been traditionally thought to be a disorder that does not evolve to defective states. However, little empirical evidence has been obtained so far comparing these patients with other psychotic conditions. Our aim is to characterize delusional disorder patients as compared to other psychotic patients regarding to their psychopathology, neuropsychological performance and general functioning.

A total of 131 psychotic patients were included in this study. 22 patients with delusional disorder, 109 other psychosis. Psychopathology was assessed via PANSS. DKEFS Colour-Word Stroop test was used to assess neuropsychological performance. Functioning was assessed using GAF. Between groups comparisons were performed via ANOVA and post hoc tests using Bonferroni method were subsequently used. Using the inclusive criterion, PANSS's positive and negative subtypes distribution was investigated in the groups using χ2 tests.

Statistically significant differences between patients with schizophrenia and patients with delusional disorder were found for PANSS's negative scale, the scoring was significantly lower for emotional withdrawal, blunted affect, difficulty in abstract thinking and stereotype thinking. There were no statistically significant difference between the groups regarding the rest of scales of PANSS (positive and general psychopathology), neuropsychological performance and functioning.

Even though delusional disorder is considered as a clinical entity more benign than other psychoses, our data show that these patients are only less seriously affected regarding negative symptomatology. In line with the recent nosological progress, these results would support a dimensional conceptualization of psychosis.

To identify and compare the characteristics of symptoms and social functioning of patients with schizophrenia spectrum disorders with substance misuse.

A total of 122 patients admitted to a psychiatric hospital. Inclusion criteria were: age older than 18 years; the presence of’dual’ diagnosis; the appropriate category F2 and F1 ICD-10; a history of at least 10 years of follow-psychiatric service. Depending on the preferred substance, all patients were divided into two groups: 1st group consisted of 76 patients with schizophrenia who abuse alcohol; group 2 included 46 patients with schizophrenia, polydrug abuse. Severity of psychotic symptoms at admission was evaluated on a scale of PANSS, social functioning - on a scale of PSP.

The mean age of patients in the first group was significantly higher (43.0±10.1 vs 34.4±7.4, p<0.05). Drug abuse in patients with second group started in an earlier age than the first alcohol use in patients with the first group (16.5±3.4 vs 21.8±8.1, p<0.05). The age of the first manifestations of mental disorders was significantly lower in the patients group 2 (16.5±6.5 vs 20.4±9.9, p<0.05). Also the age of the first psychotic episode in the second group was lower too (22.0±5.9 vs 26.8±10.2, p<0.05). In a study of the PANSS of the second group, the average score was higher in all subscales. The average score of positive symptoms was 26.2±7.0 against 20.6±7.2, p<0.05, and on the negative symptoms subscale 26.4±4.3 vs 24.6±2.7. Differences between groups tended to significance, p=0.061. The average score on the subscale of general symptoms scores in the second group was also higher (56.4±8.4 vs 51.7±5.5, p<0.05). The level of social functioning was higher in the first group. Average score on a scale of PSP it was 37.8±11.6 vs. 28.8±14.3, p<0.05.

Symptoms of Alcohol-Induced Disorders may resemble characteristic features of Panic Attacks. It is also known that individuals with fears occasionally use alcohol as an anti-anxious agent.

The objective of the study was to investigate the relationship between some common fears and Alcohol-Related Disorders. We have sorted out 61 inpatients with the diagnosis of 'Panic Disorder (PD) with Agoraphobia' according to the DSM-IV criteria.

The rate of Alcohol Dependence among first-degree relatives of the patients was quite high (24, 6%). Approximately 10% had Alcohol Abuse within 5 years prior to PD onset.

Alcohol-Induced Panic Attacks (13,1%) were accompanied by predominance of somatic symptoms and fear of a life-threatening illness. Most individuals (95,1%) have completely abandoned any experience with alcohol in the first 3 months after manifestation of PD. Some months later, the repeated Panic Attacks could lead to avoidance of a variety of situations. about one-third occasionally used alcohol when they were travelling by public transport. Some patients (9,8%) took alcohol every time they intended being alone out of home which eventually led to Alcohol Dependence (6,5%).

When agoraphobia occurred soon after special treatment (so-called 'coding from alcohol') just only the smell and view of alcohol beverages could provoke panic-like symptoms (8,2%).

Both alcohol consumption and anti-alcohol treatment may immediately precede the onset of Panic Attacks. PD alone is associated with low risk of Alcohol Use Disorders. In contrast, agoraphobic symptoms are very likely to be accompanied with the frequent use of alcohol in fearful situations.

Currently the Eating Behavior Disorders have become a social and health problem of the first kind that requires a specialized and interdisciplinary approach to these disorders. These clinical conditions are characterized by their complexity and diversity symptomatology, which implies a significant interference in their functioning in different areas of life and clinically significant distress.

Given the high burden of care in the USMC that difficult to monitor these patients at appropriate intervals, as well as the seriousness of the clinical and physical complications that can result, ultimately, in death, it seems necessary to implement group interventions to ensure greater continuity of care.

In all forms of group therapy underlying common advantages which advocate their implementation. Recent studies show that group therapy for eating disorders is equally effective as individual treatment. So in the USMC - Huelva conducted a psychotherapeutic group aimed at people with these clinical pictures. The present work is to analyze the impact of the intervention group in the eating disorder symptoms, anxiety and depression, comparing the results obtained in the tests applied before and after treatment.

Psychometric tests used were:

1. - Beck Depression Inventory (BDI)

2. - Inventory of State-Trait Anxiety Inventory (STAI)

3. - Inventory of Eating disorders (EDI)

The results reflect a clinically relevant improvement in both psychometric testing quality indicators (no hospitalizations, no emergency service attendance, adherence, etc.)

We should consider that group psychotherapy has unique properties that offer individual psychotherapy.

Hypothalamic Hamarthoma (HH) is a non-neoplastic nodule resembling the normal gray matter of the hypothalamus. It is usually recognized by its characteristic’gelastic seizures’ and central-type precocious puberty. However, detection of HH in institucionalized people with anti-social and violent behavior has laid some attention in its psychiatric manifestations.

The authors intend to report a clinical case of a patient with rage attacks who was diagnosed with HH, and to make a review of psychiatric symptoms and their treatment in this disorder.

Literature review through Pubmed and report of a clinical case.

Patient aged 39 years old with a 10-year history of epilepsy, under levetiracetam 1000 mg id, was referred to Psychiatry consult due to episodic rage attacks with physical violence. During the diagnostic investigation, the patient made a Magnetic Resonance Imaging which detected a 1cm non pedunculated HH in the III ventricle. The patient Mental State Examination was positive for mild cognitive decline and impulse control disorder with immediate regret and insight. The latter disorder was stabilized with quetiapine 300 mg SR bid and antiepileptic therapy.

This review shows the importance of Magnetic Resonance Imaging in characterization of some psychiatric syndromes. The behavioural abnormalities in patients with HH have not been specifically studied, although typical or atypical antipsychotics plus antiepileptic drugs have a favorable impact. However, aggressiveness is in most cases medically intractable and even with surgery, it can persist at a minor degree.

Mild cognitive impairment (MCI) confers a particularly high annual risk of 10-15% of conversion to Alzheimer's disease (AD). Recent findings suggest that regional brain iron concentration measured by quantitative MR relaxation rate R2' may be useful as a biomarker to evaluate the progression of AD.

In this study, we examined the impact of white matter lesion (WML) pathology measured by visual ratings on the validity of iron concentration in converting and stable MCI patients.

Retrospective magnetic resonance imaging data were collected for 65 MCI patients. All patients underwent 1.5 Tesla MRI: WML were visually rated on T2 images using the Fazekas and the Scheltens scales, iron concentrations of subcortical regions of interest (ROI) were measured on T2* maps by calculating the transverse relaxation rate R2'. Further, volumes of gray matter (GM), withe matter (WM) and cerebrospinal fluid (CSF) were calculated.

Of 65 subjects, 25 converted to AD during a follow-up of 19.2±7.4 months and 40 remained stable. Converters had significantly more WML in periventricular regions and the temporal lobe as well as lower volume of WM and a higher volume of CSF. In contrast, ROI analysis of iron deposits showed higher iron concentration in the globus pallidus, the insula, the hippocampus and the substantia nigra in non-converters compared to converters.

Our results suggest that the validity of the measurement of iron deposits as a biomarker for the imminent conversion from MCI to AD may be limited by the presents of WML pathology.

Early detection of cognitive change is essential for the diagnosis and timely onset of treatment in a variety of neuropsychiatric disorders. Since changes in executive function (EF) are contingent upon age and may compromise assessment accuracy, psychiatric patients and normal controls were compared in terms of cognitive decline rates. EF is measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB), that has adapted several standard cognitive tests for computerized administration and scoring.

Specification of the relation between psychopathology, cognition and aging.

Cross sectional examination of the age related executive changes in a sample of adults with a history of psychiatric illness using the CANTAB.

A total of 406 patients (18-72 years), diagnosed with (a) affective disorders (N=153), (b) substance related disorders (N=112), (c) personality disorders (N=82), or (d) pervasive developmental disorders (N=59), completed CANTAB executive function tests of working memory (SWM), strategic planning (SOC) and set shifting (IED). Test performances were compared with those of 52 healthy adults.

Both in the patient groups and the healthy participants, similar rates of executive decline were found.

The present research indicates that the decline of executive skills in populations with psychiatric conditions does not exceed the age related executive changes typically seen in healthy aging adults. Still, compared with the latter, patients seem to earlier reach the critical threshold at which functional deficits emerge, notwithstanding the comparable decline rates. Understanding aging and its interaction with cognition in later life may refine treatment design for the elderly patient.

Hedonic eating is characterized by the consumption of food uniquely for its gustatory rewarding properties and not for the occurrence of short-term energy depletion. Eating a piece of cake after a satiating meal is a typical example of hedonic eating. It is intuitive that hedonic eating may stimulate powerfully food intake; hence, understanding its physiological modulation could help to contrast obesity and other eating disorders.

To explore the role of endogenous appetite and/or reward modulators in hedonic eating.

We measured plasma levels of ghrelin, endocannabinoids, colecystokinin-33 (CCK) and peptide YY3-36 (PYY3-36), in 8 satiated healthy subjects after ad libitum consumption of high palatable food as compared to the consumption of isoenergetic non-palatable food.

Hedonic eating was characterized by increased levels of ghrelin and the endocannabinoid 2-arachidonoyl glycerol (2-AG) but a decreased secretion of the satiety hormone CCK. Levels of other endocannabinoids and PYY3-36 did not significantly differ between hedonic and non-hedonic eating.

Present findings suggest that, when motivation to eat is generated by the availability of high palatable food and not by food deprivation, the increased levels of the hunger hormone ghrelin and the reduced secretion of the satiety hormone CCK could promote eating in spite of no energy need. Otherwise, the increased secretion of ghrelin and 2-AG could promote the ingestion of high palatable food via the activation of the endogenous rewarding system.

Sloppiness refers to the indeterminate, untidy or approximate qualities of the exchange of meaning between patient and psychotherapeutics (Boston Change Process Study Group, 2005). In an institutional’good-enough’ Day-Hospital, patients move around psychiatry, physicians, phychotherapists, rehabilitation groups giving arise a relational field where something happens. Beyond known therapeutic factors,’something else’ arises from intrinsic indeterminancy of the relationship among minds.

Our work is an attempt to elaborate and explore the idea of sloppiness and co-creativity as a model of therapeutic teamwork organization in an institutional Day-Hospital.

The sloppiness as a model of teamwork organization may permit to individuate features relevant in a co-creation process among teamwork members and patient in severe psychiatric disorder.

We present four case reports belonging to different diagnostic classes: psychosis, affective disorder, personality disorder and anxiety disorder.

Long time clinical observation suggests that different features significantly affect clinical outcome in different patients. So, sloppiness has a pivotal role in the therapeutic process leading to a change because,’playing’ among teamwork in a unstructured relational space, patients drawn on what they authentically need.

Sloppiness and co-creativity might represent’something else’ which allow patient to create his personal therapeutic pathway, and teamwork to fine-tune dynamically therapeutic act on patient. So sloppiness, as a tool of encounter between patient and teamwork in an institutional Day- Hospital, might advance co-creativity process leading to an individual care pathway good-fitted on patient.

Concerns about the body and food are present in much of the population. Furthermore, alteration in eating behavior as a symptom may be part of the symptomatology of various clinical profiles. And, of course, is the main symptom of eating disorders.

One of the features offered by these tables is the high comorbidity posing with axis I disorders and Axis II. According to the literature, about half of women with ED experience anxiety disorders. Regarding affective disorders, between 20 and 80% developed at least one major depressive episode during their lifetime. Personality disorders are highly prevalent in this population, mainly the cluster B and C, linking the first and second BN with AN.

The overall goal of this work is to analyze the comorbidity of these diagnosis.

Our research is a descriptive analysis of a sample of 30 patients from the USMC-Huelva with different diagnoses of eating disorders.

The variables studied are:

1. - Main diagnosis

2. - Comorbidity

3. - No. of entries at Unit Mental Health Hospitalization

4. - Consultations in the Emergency Department

The results show that the majority of patients have been diagnosed with anorexia nervosa purging type. These patients, mostly, have another disorder, highlighting dependence disorders and / or substance abuse, anxiety disorders and personality disorders. In the sample studied, three of the subjects required hospitalization in Mental Health, and of these, only one was due solely to own principal diagnosis criteria (malnutrition).

The importance of a comprehensive approach that includes history of each patient and associated disorders.

In last years, studies on the families of patients with eating disorders (ED) have tried to identify family needs, as well as to determine their coping strategies.

To identify the coping strategies in families of patients with eating disorders.

Forty relatives were evaluated (mean age=49.4 years, S.D.=6.7); 52% women and 48% men; 94.6% married. COPE scale (Carver et al., 1989) was used to measure individual coping strategies, and F-COPES scale (Olson and Larsen, 1987) was used to evaluate family coping strategies. Statistical analysis was realized using SPSS.19.

The relatives had higher scores in the following COPE subscales: planning, suppression of competing activities, active coping; they had lower scores in drug/alcohol intake, behavioral disengagement and denial. In F-COPES subscale the higher scores were in reframing and the lower ones in passive appraisal.

It of patients relatives faces their trying change, avoiding other activities or thoughts that distract them. As family, they identify the problems and try to handle them looking for support in nearby persons.

The management of non-linear and grey clinical data, so frequent in psychiatry, needs the development of new statistical tools, able to give value to subjectivity and complexity of the observed changes.

A comparison between soft computing models, psychodynamic theory and clinical observations in the experience of psychiatric rehabilitation.

To test the use of some dynamic fuzzy algorithms (like clustering, ellipsoidal rules, least square method) in order to improve data analysis in the field of clinical research in psychiatry.

The role of slow, evolutionary, multifactorial, minute movements and their potential significance become readable, especially referred to the subjective observations of the clinical operators.

In this work, that it's necessary to consider only a first step, seems that Dynamic Fuzzy Functions may have a future role in the development of new assessments of clinical data in psychiatry.

The department of Psychiatry at Hamad Medical Corporation (HMC) in Qatar, and guided by the national mental health plan, initiated a plan for suicide registry for the country.

Collect information on the patients presenting with self-harm and suicidal behaviors to the Emergency Department (ED), the primary emergency facility in Qatar.

Collection of data on the characteristics of the patients presenting to ED with intentional or accidental self-harm.

Retrospective chart review of all the cases presented to ED with self-harm, suicide attempts or committed suicide during the period between July 2011 and July 2012. Questionnaires were developed to collect the socio-demographic and clinical data available.

A total of 470 cases were identified (48 completed suicide, 165 admitted/suicide attempts, 105 intentional self-harm/not admitted and 152 accidental self harm). The majority of completed suicide were males, expatriates, in their mid 30s and died by hanging. In the admitted suicide attempters, the method was overdose; the male/female ratio was equal, mostly single, employed expatriates, and no past psychiatric diagnosis, substance abuse or previous suicide attempts. The majority of accidental self-harm were secondary to intake of high doses of non-opiate painkillers. Data on many variables were missing. More comparisons will be presented in relation to the demographics in Qatar.

The data suggest that the single male immigrants in Qatar should receive more support and more screening. More prospective data are needed with adequate collection of data to improve the quality of the registry and thus design better prevention programs.

Despite the high prevalence of obsessive-compulsive symptoms located around 2-3% of the population, there continue to be cases where the characteristics of the patient or the circumstances of their environment, they fall short queries mental health or when they do not for the disorder itself, but for another reason obsessional symptoms worsen.

Expose using clinical case, the existence of patients with obsessive pathology whose characteristics do not seek mental health consultation, until this is associated with a new disease that interferes significantly in vital organization.

We report the case of a man of 88 years old, married at 60, was admitted to the psychiatric consultation at the request of his wife 29 years his junior, for behavioral disorders several years of evolution and history of obsessive symptoms compulsive, which did not interfere with their daily lives by the lack of insight and poor social environment

OCD is included in anxiety disorders.

It is characterized by the presence of obsessions and compulsions that interfere with personal, work and / or patient's social.

There are cases that own personality traits of the patient, this disorder is not diagnosed early and choose to go only when associated with worsening cognitive impairment rituals and interfere with family life.