The aim of our study is to outline the demographic characteristics of the patients with a diagnosis of personality disorder that come to the ED. A second objective is to find specific risk factor for this type of patients.

We selected patients that came to the ED with the diagnosis of personality disorder, between October 2015 and February 2016. Data analysis was conducted using SPSS software. Chi2 test and t-Test were used as appropriate. A P-value < 0.05 was considered statistically significant.

Sixty-eight of the 402 patients that were attended in the ED met the criteria of personality disorder; 44.92% of these patients presented with suicidal ideation or attempt. We found in the use of drugs, statistically significant differences between men and women, using drugs all the men with a personality disorder that came to the ED except one. The most frequent reason for consult were anxiety, conduct alterations, suicidal ideation, and suicidal attempt, being these consultations the 77%.

Anxiety and suicide risk are the most common reasons for a personality disorder patient to go to an ED. We have to be even more careful due to the high rate of suicide conducts in these patients. Also, it is important to think of drug use and dual pathology when assessing these patients.

The authors have not supplied their declaration of competing interest.

We are going to explain a case of a patient diagnosed with psychopathy and his twin brother with a normal personality.

To show the controversia about psychopathy and twins.

Description of a case of psycopathy. We evaluated his psychopatology using the Psychopaty Checklist (PCL).

A 18-years-old male teenager admitted to a penitentiary facility for several crimes: drug dealing, violent theft and multiple aggressions.

Personal history: early psychological and psychiatric attention for disruptive behaviour as a child: repeated lies, low empathy, defiance to parents and teachers, indifference to punishment, robbery, aggressive behaviour, loitering, escaping from home, cruelty against animals, promiscuity, vandalism and drug abuse. Medium-high class family, well-structured family, none of them with criminal history or mental disorders, his brother is a brilliant student.

Personality assessment: We describe 20 features of his personality according to the PCL and we score them from 0 to 2. Zero if it does not apply at all, one if there is a partial match, two if there is a good match.

Features: Superficial charm, narcicism, pathological liar, manipulator, absence of guilt, superficial affection, absence of empathy, inability to accept responsibility, need for constant excitation, parasitic life, unrealistic goals, impulsivity, irresponsibility, low self-control, conductual problems since childhood, juvenile delinquency, repeal of conditional freedom, criminal versatility, promiscuity and multiple marriages.

Out of a maximum score of 40, the cut-off for psychopathy is 30.

This patient has 34 points so we can conclude he is a psychopath.

We can conclude there is not a clear relationship between twins and psychopathy.

The authors have not supplied their declaration of competing interest.

According to common-sense model illness representation regulates her coping both in somatic and mental illnesses.

As a personal reaction illness representation should partially depend not only on diagnosis and symptoms but also on personality. Aim is to identify direct and indirect effects of personality and psychopathological complaints in illness representation in mental disorders.

Eighty patients (20 males) from MMPI-2 validation sample (Butcher et al., 2001) filled revised version of Illness Perception Questionnaire and Symptom Checklist 90-R. Eleven patients met ICD-10 criteria for addictions, 28 – for mood disorders, 20 – for schizophrenia and schizotypal disorder, 21 – for acute stress reactions.

According to moderation analysis, illness-related beliefs in mental disorders are relatively independent on clinical diagnosis and specific symptoms, but are associated with the overall level of psychopathological complaints. Regardless of the clinical group and complaints, depressive traits are associated with negative and emotional appraisal of illness. Social introversion and hypomanic activation serve as moderators of the relationship between complaints, illness duration and emotional representations.

Personality and overall level of psychopathological symptoms could be stronger predictor of illness-related beliefs than specific clinical factors in mental illness. Preliminary diagnostics of personality in mental illnesses could be used to reveal high-risk group for poor insight and non-compliance due to unrealistic beliefs. Research supported by the grant of President of the Russian Federation for the state support for young Russian scientists, project MK2193.2017.6.

The authors have not supplied their declaration of competing interest.

An increased incidence of personality disorders (TP) in general, and borderline personality (BP) is currently a significant health problem because of the complexity of the clinic, the difficulty for early diagnosis, often unsatisfactory response to available treatments and the lack of clear proposals on multidisciplinary therapeutic interventions. In more serious cases, people with TP generate a high level of self and family suffering, as well as a high care burden that does not have a proportional impact on the quality of life of those affected and their families.

Establish a stable functional organization of professional and organizational resources of the Mental Health Unit of the North of Almeria that ensuring comprehensive care for people with borderline personality disorder and their families.

The program was structured:

– elemental: BP census, individual sessions with optional nurse reference;

– advanced individual: BP census, individual sessions, Nurse reference;

– advanced individual and group: BP census, Individual sessions, Nurse reference and Therapeutic Group Hospital Mental Health Day weekly applying dialectical behaviour therapy.

The census of patients with borderline personality disorder was established in 30 people, 20 of them participating in two editions of therapeutic group. Fifty weekly sessions were carried out continuously, except holiday periods. A multidisciplinary team (nurse and two psychiatrists) were involved. The results indicate that there was an improvement in the quality of life of patients. It had been reduced hospitalisations, emergency assistance, and more than 60% of them got a job after that.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Histrionic personality disorder (HPD) is one of the most common personality disorders diagnosed in Psychiatry. This disorder, although not thoroughly researched, has been known to be present in more than 40 percent of patients. There is also a high tendency for those diagnosed with this disorder to be female.

The purpose of this case is to show all the difficulties caused by this pathology, since differential diagnosis with other personality disorders, groups of characteristics from different clusters and also, complications produced in daily routine.

The purpose is to study a clinical case of a 27-years-old woman, with a degree in journalism, who began with a depressive episode after a failed relationship. After being diagnosed of infertility, she debuted with dissociative episodes and somatization symptoms. She did not remember what she had done during the dissociative episode. After that, she suffered several depressive episodes, and a pseudo hipomaniac episode, making the diagnosis of bipolar disorder, with no pharmacological response to lithium or lamotrigine.

The authors have not supplied their declaration of competing interest.

Obsessive symptomatology can sometimes be worsened when a patient with this personality trait suffers through a period of increased stress.

To review articles in PubMed related to how vorticoxetine affects obsessive symptoms in patients with depression.

We review the case of a 45-year-old male with obsessive personality traits diagnosed of recurrent depression. He was going through a period of stress at work that had worsened his obsessive symptoms (primarily obsessive thoughts). In a previous depressive episode, he was treated with an antidepressant that triggered sexual dysfunction as a side effect. Trying to prevent another antidepressant-induce sexual dysfunction, we decided to use voricoxetine because of its low tendency to interact with the sexual function.

We started treatment with vorticoxetine reaching a dose of 10 mg/day. Three weeks later the patient reported a decrease in his levels of anxiety, a slight upturn of his mood and a relieve of his obsessive symptoms.

Vorticoxetine can be considered a good therapeutic option in the treatment of obsessive symptoms in a depressive episode with patients with a history of antidepressant-induce sexual dysfunction.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

Non-psychotic mental disorders of organic register tend to have protracted progressive course, to respond poorly to treatment. Traditionally it is explained by features of cerebral-organic process. However, affective, behavioural and cognitive disturbances can be complicated by medico-social problems including treatment-related.

To analyse efficiency and stability of results of the therapy of organic mental disorders and propose approaches and means of their improvement.

Clinical-psychopathological, epidemiological, clinical-dynamic, catamnestic, experimental-psychological, medical statistics.

The most frequent causes of decompensations of organic mental disorders in patients with positive results of the therapy were analyzed. Sixty-four percent (58 patients) after 6 months showed partial recurrence of symptoms and after a year the condition practically returned to the initial one. However, only 12.22% (11 patients) passed recommended course of maintenance therapy to sufficiently full extent, 23.33% (21 persons) have discontinued it due to subjective causes during a month after discharge, about 2/3 of patients during the first two months of the therapy. Patients showed low indicators of therapeutic compliance, low level of therapeutic alliance, little familiarity with the illness and treatment and unrealistic expectations about prospects of the therapy. During insignificant difficulties in the therapy, it usually was discontinued and renewed during relapse of symptoms. A medico-social approach with support of psychotherapeutic and psycho-corrective work and information educational programs were developed.

Proposed psychotherapeutic and educational approach heightens efficiency and stability of treatment and can serve a basis for further improvement of psychiatric, psychotherapeutic and medico-social assistance for patients with organic mental disorders.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

The authors have not supplied their declaration of competing interest.

In the last 15 years, several new waves have been described within CBT. At the same time, two constraints seem to define the role of psychotherapy: an integrative theoretical trend; an increasing incidence of chronic psychiatric disorders and psychiatric morbidity in chronic conditions.

We discuss the viability of a Complex Systems Theory perspective in fostering the theoretical integration of the new wave of CBT and in promoting the healthcare sustainability in facing with chronicity.

The aims of the present study are to:

– frame a few recurrent and relevant theoretical dimensions in psychotherapy;

– outline a preliminary cost-effectiveness analysis of a Complex Systems Theory approach to psychiatric chronicity.

We performed a non-systematic review and a meta-synthesis of selected references (identified through a citation analysis per single reference and per single scholar) of the new wave of CBT. We especially focused on theoretical handbooks, meta-analyses and reviews, clinical trials.

Complex Systems Theory describes an approach to theoretical and operational models based on adaptability, interdependency and self-organization. In defining a few integrative trends in psychotherapy, we highlighted the focus on:

– interpretation of events vs. events per se;

– processes vs. contents;

– transdiagnostic vs. pathologized models.

Furthermore, we framed economic, organizational, and educational implications of such an approach in promoting the adaptability of psychotherapy-as-a-system in dealing with the so-called double crisis of welfare state: continuous cutbacks in response to recession; longer-term pressures on health and social care.

Despite further studies are needed, we maintain that psychiatry may benefit from a Complex Systems Theory perspective.

The author has not supplied his/her declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

What ties Ahab, the notorious captain of the Pequod in Herman Melville's 1851 novel, Moby-Dick, to King Lear, the desperate old regent from William Shakespeare's eponymous play published in 1608, is not only their overabundant quest for meaning, or their obsession with pursuing their targets, but their idiosyncratic experiencing of themselves in their personal realities.

Captain Ahab is put in relation with King Lear, in order to show in what way issues of identity and of existence emerge in the course of their fictional lives. Lear is considered to have had deep influence on Melville the author in creating the character of Ahab. Since, in terms of present-day psychopathology, both fictional characters present with symptoms, their issues when put in historical context can untangle their personal realities.

Through a close reading of the characters’ behaviour and experiencing in historical context, issues of identity and of existence are elaborated on in order to advance to the psychodramatic substrate.

Whereas at the beginning of the seventeenth century conflicts are newly transposed to characters’ minds instead of surroundings, the nineteenth century still sees Ahab's monomania on the outside. Identity and existence have increasingly been placed in individual psyche, though.

A paradigmatic change in personality concept at the turn of the modern epoch enables psychiatry and psychopathology to conceptualize the individual and to derive identity and existence from. Collective identity gives way to personal identity. With that, choice, interpretation, and failing are individualized.

The author has not supplied his/her declaration of competing interest.

Difficult adolescent is a clinical category, defined by psychiatrists’ expertise and referred to psychoanalytical concepts. Since the end of the 1990s, it has been extensively used to describe a marginal population in public institutions managing youth deviancy in France. This success occurs against a backdrop of institutional reforms, converging towards politics of suffering and risk management.

Contributing to the anthropology of mental health, this communication provides comprehensive elements to this success.

Interconnected networks of 49 documents were analyzed using a genealogical method based on Foucault's late conceptions and Ian Hachking's works on constructivism.

Results have shown that the category of difficult adolescents found its ecological niche in the 1960s, revealing a moral tension in the use of constraint. At that time, the introduction of the psychoanalytical notions of transference and counter transference depicted a clear distinction with previous categories such as the “abnormals” or “maladjusted youth”. Since then, it has defined an ambiguous condition, suspended between the trouble of caregivers and the adolescents’ individual disorder. In addition, the extension of clinical expertise silences social issues, such as gender discriminations, ethnicity and access to employment.

The reforms of custodial treatments represented the initial conditions of detection for difficult adolescents, raising new problems of intractable individual and institutional linkage. Driving towards a biographical personalization, the category allows new forms of regulation in the use of institutional power.

The author has not supplied his/her declaration of competing interest.

Love has been one of the topics most discussed by philosophy, literature, anthropology, religion, psychology and medicine. “The feelings of love and hate are present in the background of all psychiatric disorders; love has been associated, in one way or another, in all patients that I have had” Dr. Perez Lanzac Trujillo.

(1) Analyze the possible relationship between psychotic symptoms and breakup (stressor). (2) Review the neurotransmitters involved in psychotic episodes and in love. (3) Postmodern culture and sexuality (agony of Eros and liquid love).

A 17-years-old female patient, who presented psychotic symptoms without psychiatric history. We hypothesize that the affair was the symptom and the stressful event was the breakup. We believe that early bond with the mother is a decisive factor in shaping the psychic structure of every human being factor. In this case, it seems that there is an insecure attachment: absent parent + overprotective mother.

True love draws three triangles: records (demand, drive and desire); dimensions (beliefs, significant and encounter) and emotions (pride, hope and desire).

Most psychiatric disorders are especially alterations in the way of experiencing emotions. Some neurotransmitters involved in her psychosis and addiction are key players in the neurobiology of love.

True love is the neurotic experience closer to psychosis.

Overexcitement in today's society is a trauma for the psychic apparatus and it has consequences on the internal world, psychosexuality and loving bond.

The crisis of art and literature can be attributed to the disappearance of the other, to the agony of Eros.

The authors have not supplied their declaration of competing interest.

It has been universally regarded that Leonardo da Vinci was one of the all-time geniuses in terms of his contribution to art and sciences. A number of theories have been proposed to explain his genius that range from neurological, psychological uniqueness, and enhanced functional intelligence.

The primary aim is to explore these theories in detail and register their pros and cons alongside contextualizing their credibility and weightage against the extant evidence in science.

A detailed literature search has been undertaken to identify variety of models and theories either:

– dealing with neurological, psychological or neuro-philosophical explanations;

– have been proposed by psychiatrist or psychologist and neurologists pertaining to Leonardo's brain or mind;

– theories around occult and religion have been excluded.

The results are synthesized and presented in a tabular form. The discussion expand son the various theories and the relevance of Leonardo da Vinci to the merging unified field of neurology, psychology, technology and philosophy (consciousness studies).

The author has not supplied his/her declaration of competing interest.