The diagnosis of depressive disorders has suffered important modifications throughout DSM and ICD editions. The history of those modifications is an important subject to fully understand the current diagnostic criteria and classification, with milestones often set not by scientific or theoretical data but rather by political decision and conflicting interests.

The authors propose a review of how the concept of major depression has evolved along the several DSM and ICD editions.

The results were obtained searching literature included on the platforms PubMed, Google Scholar, PsycINFO and Psychology and Behavioral Sciences Collection.

The current diagnostic entity lacks validity and utility and that is an obstacle to both scientific research and clinical practice.

The authors also discuss alternative models which may contribute to a paradigm shift more suitable to clinical reality and to provide a useful framework for all levels of research.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

After several years of research to improve the action of antipsychotic medication and to reduce its side effects, we have realized the importance of an accurate intake of antipsychotic medication and because of it we started up a program in our Mental Health Rehabilitation Service. Therefore, we can affirm that outpatients behavior influence their intake medication and also the efficiency of the drug prescription. The main consequence of inadequate treatment compliance is an increase in relapses and hospital admission.

The aim of this program is to improve adherence to pharmacological treatment, to promote the quality of life for a better social integration, to know the use of prescribed medication, to know the health resources of the network to acquire the medication and to acquire skills for greater autonomy in the management and management of medication.

We analyzed a sample of 13 outpatient diagnosed with severe mental disorder that started up into our Program “Adherence to treatment” and their stabilization (less relapses and less admissions) in two years’ time.

One of the patients have completed the aims of the program and he is living on his own, nine of them continue the program without relapses or admissions, one dropped out the program because of relapse and an another one have also completed the program but he died because of somatic disease.

The experience of this program in group format is positive, since patients acquire skills, knowledge and strategies in their own treatment in line with the recovery model in psychosocial rehabilitation.

The authors have not supplied their declaration of competing interest.

Assess the profile of side effects on sample of outpatients treated with long-lasting injection paliperidone LLIP.

Study of a population of 67 patients, 25 people are female and 42 are male. In female sample, more than 52% are diagnosed of Schizophrenia and the majority of female do not refer side effects (88%) and only a little percentage of 12 refer side effects such as amenorrhea (F20), stiffness (F20) and relapse (F25). In male sample, more than 54.7% are diagnosed of Schizophrenia and the majority of male do not refer side effects (80%) and only a little percentage of 20 refer side effects (F70) such fear of injection and sexual dysfunction (F21).

In our sample, the number of women diagnosed with schizophrenia have a greater number of side effects respects to men with the same diagnosis. However, it would be important to increase the sample size of women to conduct a comparative study men/women to assess research in this field.

The authors have not supplied their declaration of competing interest.

Ganser described a peculiar hysterical state, called Ganser's syndrome. This syndrome raises many etiological and psychopathological unresolved issues.

This article proposes to present the place of the Ganser's syndrome in the current nosographic framework throw the analyse of a clinical case and a literature review.

A 28-year-old man was admitted for fugue and memory loss. This symptomatology evolves since three days after an emotional conflict.

He complained from headache. He showed incoherent speech with approximate responses, lability, anxiety, auditory hallucinations, unstructured mild delusional ideation, cognitive difficulties, altered sleep-wake rhythm and anorexia.

Memory gaps were observed with difficulties in abstract thinking.

Symptoms totally regressed after one week under anxiolytic treatment.

Ganser's syndrome was evoked in the presence of suggestive symptoms: presence of a stressor factor, cardinal symptoms (approximate answers), associated symptoms (hallucinations + confusion + somatoform symptoms) and rapid restitution. Ganser considered this syndrome as a special case of crepuscular state, belonging to hysteria. Ganser's syndrome was included in DSM-III but located in factitious disorders against Ganser's position. In DSM-IV, it was positioned in unspecified dissociative disorders. In DSM-5, its place was reduced to a few words in the end of the introduction of dissociative disorders, and was no longer used as dissociative disorder.

Although Ganser's syndrome is not part of current diagnostic criteria for dissociative disorders, clinical descriptions of Ganser remain of clinical of interest by nosographic questions they have raised, in particular the link between simulation, psychiatric disorder and non psychiatric disorder.

The authors have not supplied their declaration of competing interest.

In the scientific literature the relationship between psychosis and obsession has been studied on many occasions, without reaching firm conclusions. In 2004, Poyurosvsky postulated the possible diagnosis of a subgroup called “schizo-obsessive” that included both disorders.

The authors have not supplied their declaration of competing interest.

In all, 266 combat-exposed war veterans with ED (aged 37–59 years) were recruited. They met the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for PTSD according to the Structured Clinical Interview for Patients, Investigator Version. The patients were also evaluated with the Clinician-Administered PTSD Scale, both to establish the diagnosis of PTSD and to measure symptom severity. Only patients with psychogenic ED were included in the study. The patients were randomly divided into a group of 133 who received 100 mg of on-demand sildenafil 0.75–2 h before sexual stimulation, and 133 who received placebo. Patients were asked to use ≥ 16 doses or attempts at home.

Sildenafil did not produce significantly and substantially greater improvement than placebo in each of the primary and secondary outcome measures (P = 0.08). A normal EF domain score (≥ 26) at endpoint was reported by 13 (9.8%), and 11 (8.3%) of patients on the sildenafil and placebo regimens, respectively (P = 0.09). Patients treated with sildenafil had no statistically significantly greater improvement in the five sexual function domains of the IIEF questionnaire than those treated with placebo (P = 0.08). The incidences of treatment-emergent adverse events were significantly greater in the sildenafil arm than in the placebo group (P = 0.01).

Sildenafil is no better than placebo in treating PTSD-emergent ED.

The author has not supplied his declaration of competing interest.

Resilience and well-being have become commonplace and increasingly used terms in a wide range of scientific as well as mental health political contexts.

There is much confusion about the relationship of the two constructs: while some use well-being as a proxy measure of resilience, others treat one concept as a component of the other or see interchangeably one as the prerequisite of the other.

To study the definition of these two concepts in relation to each other.

Literature review.

Both ‘resilience’ as well as ‘well-being’, have so far defied universal definition and common understanding of their respective measurement. Part of the confusion around these two concepts is the overlap in their components, in particular with regard to resilience and psychological well-being, and the lack of research on these concepts both by themselves, in relation to each other and in relation to other concepts like mental health, risk or protective (or promotive) factors.

Our critical and comparative inspection of both concepts highlights the need for more conceptual cross-sectional as well as longitudinal studies:

– to uncover the composition of these constructs and to reach agreement on their definition and measurement;

– to detect their potential neurobiological underpinnings;

– to reveal how they relate to each other;

– to determine the potential role of developmental and cultural peculiarities.

Thus, the use of the terms resilience and well-being should always be accompanied by a brief explanation of their respective meanings and theoretical framework.

The authors have not supplied their declaration of competing interest.

The clinical case has been submitted because it presents a number of difficulties in diagnosis. After seven psychiatric hospitalizations, it does not present a definitive diagnosis, poor prognosis and multiple relapses.

Both analyze clinical, psychopathological and epidemiological characteristics of behavioral disorders in relation to a clinical case and review causes, incidence, prevalence, diagnostic, therapeutic tools and the importance of an appropriate differential diagnosis to reach a correct therapeutic approach.

Review of the impact literature for the last five years concerning behavioral disorders: prevalence, incidence, pathogenesis and its relationship with psychiatric disorders encoded in DSM-V.

It is evident that the patient has behavioral disorders and psychotic symptoms in the context of cocaine intoxication. Although sometimes the dose of cocaine has been very small and probably not justifies in all cases a toxic psychosis, it is true that withdrawal periods have been short; therefore difficult to assess. Also mania-like symptoms have been discussed because the patient has an increased activity, dysphoric mood, anxiety and decreased need for sleep.

Response to treatment and hyperactivity, impulsivity and inattention characteristics make us consider the diagnosis of adult Attention Deficit Hyperactivity Disorder (ADHD). ADHD in adults and adolescents have significant comorbidity with substance abuse, particularly cocaine, amphetamines and psychostimulants, also alcohol, tobacco and cannabis, and with other psychiatric disorders: oppositional defiant, personality (especially cluster B: antisocial, etc), anxiety (generalized anxiety, phobias, panic..), affective or eating disorders.

The authors have not supplied their declaration of competing interest.

Patients who are suffering from different type of drugs have special individual and psychological problems. These changes are important for regulation and to control their behaviour.

To study the psychological characteristics and personal resources of the patients who are suffering from abuse of drugs.

Fifty patients were studied, 63.3% men and 36.7% women and in the ages of 18–21 years. Following psychodiagnostic methods are used: Kettel's sixteen personality factor test, Leonhard-Shmishek's personality test, scale of reactive and personal anxiety Spielberger-Hanin.

Amount those patients were suffering from different type of drugs: synthetic cannabinoids-66.7%, 20% were dependent on synthetic cathinone and 13.3% were dependent on opiates (heroin). According to Leonhard-Shmishek's scales, the most often of personality disorders were dysthymic type, hyperthymic type and explosive type. According to Kettel's scale were indicated the leading individually-psychological properties in more than half of the subjects is the development of abstract thinking, free thinking, impulsiveness, lack of confidence to the authorities, the high emotional tension, emotional instability and irresponsibility. An analysis of global factors indicative of the severity indices of extraversion. According to Spielberger-Hanin's scale, 80% of patients with substance abuse had mild level of situational and personal anxiety, which can be identified as an important psychotherapeutic resource.

According to scales, the most often of personality disorders were dysthymic type, hyperthymic type and explosive type. Eighty percent of patients with drug abuse had mild level of situational and personal anxiety. This feature is main of predictor as an important psychotherapeutic resource.

The authors have not supplied their declaration of competing interest.

Describe the sociodemographic and clinical profile of patients suffering from bipolar disorder and substance use disorders comorbidity and assess the consequences of this comorbidity on prognosis and evolution of bipolar disorder,

A case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups of 50 patients were individualized by the presence or not of substance use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.

Compared to bipolar patients without addictive comorbidity, those with this comorbidity had the following characteristics: we found more male, less family cohesion, more domestic violence, more criminal records, more time spent abroad, more personality disorders especially antisocial and borderline, fewer triggers of bipolar illness, more mood episodes, more psychotic features, higher impulsivity BIS-10 score, an increased need to put in a neuroleptic long term treatment, poor adherence to treatment, lower response to treatment, lower score of global assessment of functioning (GAF), more rapid cycles, shorter period of remission, longer duration of the last mood episode, poor socio-professional integration and poor quality of intervals between mood episodes.

It seems important to insist on the identification and the treatment of bipolar disorder or substance use disorders when one of them is diagnosed. This needs to set up urgently facilities and care structures for patients with substance use disorders and to create more addiction consultations.

The authors have not supplied their declaration of competing interest.

Assess the prevalence of cannabis use disorders (CUD) in patients with bipolar disorder, describe the demographic and clinical profile socio bipolar patients with comorbid addictive and assess the implications of this comorbidity on prognosis and evolution of bipolar disorder.

A case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups were individualized by the presence or not of cannabis use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.

The prevalence of CUD was 27.53% (n = 19) in our sample. Comparing bipolar patients according to the presence or absence of CUD, we found the following results with patients with CUD comorbidity: younger, mostly male, a disturbed family dynamic, low educational level, poor socio-economic conditions, more time abroad history, more suicide attempts in history, more criminal record, more psychiatric family history, an earlier onset of the disease, a longer duration of undiagnosed bipolar disorder, more personality disorder, more frequent presence of a triggering factor for bipolar disorder, more psychotic features during mood episodes, more need of antipsychotic long-term treatment.

The frequency of CUD in BD is higher than the prevalence in the general population and CUD is a factor in the evolution and prognosis of bipolar disorder and promotes the development of mood disorders in predisposed patients.

The authors have not supplied their declaration of competing interest.

Compare the level of insight in bipolar disorder (BD) with and without substance use disorders (SUD).

Case-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of SUD co-morbidity. We evaluated and compared insight with Birchwood IS scale (with its three sub-scales),

The mean age was 40.6 years (±16.4). The sex ratio was 2. Sixty-six percent of patients were diagnosed with bipolar disorder type 1 and type 2 bipolar disorder remains.

There is no statistically significant difference between bipolar with and without SUD in terms of quality of insight.

As for the subscales, bipolar patients with comorbid SUD had lower scores of awareness of any symptoms, whereas there was no significant difference regarding the awareness of illness and the need for treatment between the two populations.

Co-morbid SUD can affect the quality of insight in individuals with BD. Patients with this co-morbidity should be targeted for intensive psycho-educational measures and psychotherapeutic interventions focused on the improvement of insight.

The authors have not supplied their declaration of competing interest.

Case-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity.

The average age of patients with SUD was 44.02 years that of the patients without SUD was 44.12 years.

The sex ratio of patients with SUD was 5.25 and that of patients without SUD were 0.61.

Twenty-six percent of patients with SUD comorbidity had a history of suicide attempts. Fourteen percent of patients without SUD had a history of suicide attempts.

The association between SUD and history of suicide attempts was not significant (P = 0.134).

The average suicide attempts were 3.08 for patients with addictive behaviors and 2.00 for patients without SUD.

The association between SUD and the number of suicide attempts was not significant (P = 0.375).

The means of suicide attempts used were drugs in 12% of cases, 3% of cases by phlebotomy, 3% of cases by hanging, 3% of cases immolation, 2% of cases of organophosphate ingestion, 3% of cases by defenestration, 3% of cases by the precipitation front of a vehicle and 1% of cases by drowning.

Co-morbid SUD in individuals with BD is significantly associated with suicide attempts. Individuals with this co-morbidity should be targeted for intensive suicide prevention efforts.

The authors have not supplied their declaration of competing interest.

Recent evidences of clinical overlap, familial co-aggregation, and shared genetic alterations support a neurodevelopmental deviation to represent a probable common vulnerability factor not only for the psychiatric disorders included in the meta-structure of neurodevelopmental disorders, but also for other major psychiatric disorders, including schizophrenia.

The present paper reviews the literature to identify (1) positive and negative implications of the increasing enlargement of the group of neurodevelopmental disorders and (2) most useful clinical aspect for re-defining diagnostic boundaries between syndromic groups.

The search purpose was reached through a systematic mapping of literature.

The last years’ trend to increasingly enlarge the number of psychiatric features comprised in the autism spectrum should be better evaluated for potential negative impact on research and clinical resources for those autistic syndromes more reliable with Kanner's descriptions or associated with lower personal functioning profiles and different level of ID.

Crucial clinical aspects for the differentiation resulted to be age of onset, interest towards others, main positive symptoms, and anatomical anomalies of the central nervous system.

While on one hand the neurodevelopmental perspective might contribute to a better understanding of the multifactorial aetiopathogenetic mechanisms underlying many psychiatric disorders and provide new intervention strategies, on the other hand it might determine a premature abandonment of the traditional nosology and the appearance of very broad spectrum conditions covering all the range of current psychopathology.

The authors have not supplied their declaration of competing interest.

Psychiatric disorders in obese patients range from 20% to 60%, with a lifetime prevalence as high as 70%. Bariatric surgery (BS) is an effective therapy for long-term weight control and ameliorates comorbidities. After BS, psychiatric outcomes are still a matter of controversy. Moreover, while psychosocial pre-surgical evaluation is mandatory, post-operatively psychiatric follow-up programs are lacking. Aim of this prospective study was to examine changes in psychiatric symptoms and weight over 1 year of follow-up among a population of individuals submitted to BS.

One hundred forty eight participants were enrolled, 98 women and 50 men; mean age was 46 (SD = 10.7), and mean BMI was 46 (SD = 7.7). Clinical interview and self-report instruments were administered before and one year after BS. Depressive symptoms were measured using Beck Depression Inventory (BDI), Binge Eating Disorder was measured using Binge Eating Scale (BES).

One year after surgery 86% of patients achieved a percentage excess weight loss (%EWL) ≥40%. Rate of psychiatric comorbidities declined from 41% at pre-surgery to 12% at 1 year post-surgery, P = 0.01. BDI mean score declined from 12 to 8, P > 0.000. After BS, binge eating, depressive symptoms, and age were independent and significant predictors of %EWL (F6,523 = 79.599, P < 0.0001, adjR2 = 0.471).

We reported an improvement of psychiatric symptoms through 1 year after BS. Post surgical binge eating disorder and depression were associated with less weight loss after surgery, adding to the literature suggesting that psychiatric disorder after surgery, unlike pre-surgery, are related to suboptimal weight loss.

The authors have not supplied their declaration of competing interest.

Patients with co-existing substance use and mental disorder (dual diagnosis) have complex and challenging care needs. Acute psychiatric care settings play a vital role in providing services for patients with dual diagnosis as they often do not voluntarily seek treatment. This is significant in that recent data reveals that 57% of the psychiatric inpatients at an inner city hospital in Vancouver, Canada are characterized as dual diagnosis.

To develop an educational module which will equip nurses/practitioners with the skills and knowledge required to deliver evidence-based dual diagnosis care in acute psychiatric settings.

A survey of 74 nurses working in acute psychiatric settings was completed to identify their learning needs and challenges. This was followed by a comprehensive review of evidence from literature to identify competencies, knowledge and skills needed to deliver dual diagnosis care. Content for the educational module was then validated by a panel of leading international experts on dual diagnosis. Two focus groups of acute psychiatric nurses were then conducted to discuss content. An 8 hour educational session was then developed and piloted using the content that was reviewed and validated.

Thirteen content areas were identified and validated by experts. Evaluations from participants of the educational session suggest improved knowledge, skills and competencies in dual diagnosis care.

This project translates evidence into practice, contributes to the body of knowledge on dual diagnosis care and improves practitioners’ confidence and competency in delivering evidence-based care which also will improve patient care outcomes and experiences.

The author has not supplied his declaration of competing interest.

Several psychotropic medications (i.e. antipsychotics, antidepressant) have been recently associated with QTc prolongation. Despite literature data report only mild prolongation of QTc following the use of antidepressants or typical antipsychotics, post-marketing studies have clearly evidenced an increased risk of QTc prolongation and potentially lethal arrhythmias (i.e. torsade de pointes) in psychiatric patients.

We aimed to evaluate the prevalence of prolonged QTc and to identify potential predictors influencing QTc in a psychiatric inpatient population.

Medical records of 200 patients admitted to our psychiatric ward between 2007 and 2012 were retrospectively reviewed.

Prevalence of prolonged QTc at admission was very low (0.1%). No significant differences in QTc interval were observed between patients taking or not antipsychotics (P = 0.66), mood stabilizers (P = 0.36), or antidepressants (P = 0.07). A statistically significant difference was observed between patients on depot formulation and patients who were taking oral antipsychotic (P = 0.02). However, the pharmaceutical class of the medications appeared not significant.

We observed a very low rate of QTc prolongation in psychiatric inpatients at admission. Surprisingly we did not find a significant effect of specific medications; however, in our sample intramuscular formulation was associated with lower QTc interval.

The authors have not supplied their declaration of competing interest.

Internet addiction is a serious problem especially for children and adolescents. It is described by an individual's inability to control the Internet, which causes distress and functional impairment. Internet addiction symptoms can be Internet surfing, computer gaming, chatting and gambling by using Internet. Previous studies regarding Internet addiction can interfere with some psychiatric disorders; such as bipolar disorder, depression, anxiety or attention deficiency disorder (ADHD). Some researchers emphasized that psychiatric disorders and Internet addiction can be seen together and excessive use of the Internet has been associated with attention deficit hyperactivity disorder.

19 years old male patient discussed in this paper who was admitted to our psychiatric service for the first time in his life, complaining about uncontrollable use of internet. He spent time more than 10 hours/day. His family finally opposed and took his computer from him, just before he got depressive symptoms. We diagnosed him ADHD by using psychometric tests and psychiatric evaluations. After medical therapy and psychotherapy, we discussed changes his psychiatric situations and symptoms.

This case emphasized possible relationship between Internet addiction and symptoms of ADHD.

The authors have not supplied their declaration of competing interest.