Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG) play a pivotal role in food intake and reward aspects of feeding. Aberrant functioning in the endocannabinoid system has been observed in patients with eating disorders (EDs). This dysfunction may influence the incentive processes stimulating behaviors towards food acquisition or the hedonic evaluation of ingested food.

The aims of this study are to compare fasting peripheral levels of AEA and 2-AG in ED patients, obese subjects (OB) and healthy controls (HCs), and to explore their association with clinical and anthropometric variables.

The sample included a total of 63 adult women. Peripheral blood samples were collected to investigate fasting levels of AEA and 2-AG in 31 ED patients: 22 Anorexia Nervosa (AN) and 9 Binge Eating Disorder (BED), compared to 21 OB and 11 HCs. Several clinical and anthropometric variables were also assessed.

Comparing groups, significant differences in AEA levels were found (p=0.001). Specifically, individuals with AN exhibited lower AEA than OB (p<0.001) and BED (p=0.007), while OB showed higher AEA than HCs (p=0.015). 2-AG was positively correlated with hostility dimension in EDs and negatively associated with impulsive traits in OB. AEA showed a direct association with body dissatisfaction in AN, contrary to OB. Finally, in AN, AEA negatively correlated with the body mass index, while 2-AG was positively associated with the fat mass.

These results suggest an interaction between biological and clinical factors defining a vulnerability pathway that could help fitting personalized therapeutic approaches in each condition.

No significant relationships.

Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear.

The aim of the study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.

The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.

At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).

Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.

This work was supported by the Carlos III Institute of Health and European Fund for Regional Development (PI08/1213, PI11/ 01977, PI14/01900, PI08/01026, PI11/02831, PI14/01621, PI08/1161, PI16/ 00359, PI16/01164, PI18/00805), the Basque Foundation for He

Cocaine consumption can induce transient psychotic symptoms, expressed as paranoia or hallucinations. Cocaine induced psychosis (CIP) is common but not developed in all cases.

To describe the Risk Factors for developing cocaine-induced psychosis in cocaine dependent patients, according DSM-IV-TR criteria.

This is the first European study about the relationship of CIP with consumption pattern variables and personality disorders, we evaluated 220 cocaine dependents over 18 years, 80'5% males, mean age 33.9 years (SD = 7.6). Patients were recluted from an outpatient clinic department and subsequently systematically evaluated using SCID I and SCID II interviews for comorbidity disorders, and a clinical-based systematic psychotic symptoms form.

A high proportion of cocaine dependent patients reported psychotic symptoms (51.8%) under influence of cocaine. The most frequent reported psychotic symptoms were paranoid beliefs and suspiciousness (42.4%). After a logistic regression analysis we found that a model consisted of high cocaine consumption (mean of 12.01 grams per week), cannabis dependence history and to use intranasal or smoked rout of administration had a sensitivity of 63.2% and a specificity of 70.2%.

We conclude that is relevant to evaluate CIP in patients consuming high amounts of cocaine, with cannabis dependence history and who do not use intranasal rout. It could be useful for preventing consequences or risks of psychotic states for themselves or others.

To expose from the clinical and welfare expectation, the experience with injectable Risperidona of long duration with three cases clinical whose principal diagnosis is of Mental Delay Moderated with alteration of the associate behavior.

I marry 1: 14-year-old Teenager of age attended in our CSM for Mental Delay and Disorder of conduct to familiar and school level.

CI = 50. It has received diverse antipsychotic and stabilizing treatments of oral form being the discontinuous capture. For one year in treatment with injectable Risperidona 50 mgr/14 days, answering favorably to the treatment, diminishing the conducts heteroagresivas that he was presenting to the beginning.

I marry 2: 15-year-old Teenager of age late Mental and disorder of the disturbing behavior with episodes d excitation, irritability and loss of control.

Not clinical stabilization with oral treatment for lack of familiar adherence. We introduce injectable Risperidona, 7,5 mgr/14 days, pupil to the family to mint of the importance of the treatment and the facility of administration. It improved the adherence to the center and therefore, clinical improvement.

I marry 3: Preadolescente and 13 years and age with compatible symptoms late Mental Moderates do and autistic features with important estereotipias and autoaggressions. For a few months in treatment with Risperidona inyecable 37,5 mgr/14 days with clinical improvement.

El following work tries to show the difficulty of adherence to the treatment of our patients and the factors that influence the same one.

To establish an alliance terapeútica in a patient with diagnosis of paranoid Esuizofrenia submitted to dialysis with void conscience of disease.

Secondary chronicle treats itself about a 49-year-old male diagnosed of paranoid Schizophrenia with a renal disease to a chronic familiar GN in phase V in dialysis nowadays. He does not arouse of mental illness.

Renal chronic insufficiency in daily dialysis. Badly TA’s control and irregular follow-up of the diet. From Nefrología’s consultation they request interconsultation and psychiatric treatment.It is sent for nefróloga for valuation of pharmacological treatment by the aim to improve the adherence to his dialysis. From the first moment it considers to work together with nefrología to adapt treatment, being the mediating one the sister-in-law. We initiate treatment with paliperidona 3mgr/día. We remind that it of the nefróloga every day on having come to dialysis. Later we initiate treatment with injectable Risperidona of long duration 25mgr/14 days in increasing dose up to 75mgr/14días with good response.

Though it keeps small conscience of presenting a mental illness, he accepts the treatment, improving both the psychotic symptomatology and the acceptance of his physical ailments.

The multidisciplinary attention in the psychiatric patient and especially in the mental serious patient it is fundamental to obtain a good alliance and adherence to the treatment, and therefore to improve the forecast.

While any type of victimization can produce psychological effects, in the case of battered women by their partners, the impact of this increase due to the following characteristics: violence often involves a combination of abusive acts of physical, psychological and/or sexual kind; it usually has a progressive and chronic character; it occurs repeatedly and intermittent, within the home and the person whom ones lives with. The high impact on the health of those who suffer it are forced to consider this form of violence as one of the major issues of health and human rights.

To determine the most relevant circumstances of abuse from a psychopathological perspective.

The goal of this study is examining which sociodemographic factors and specificity of abuse are associated with greater mental health.

Participants: 97 battered women. Instruments: GHQ-12, consists of 12 items, each one assessing the severity of a mental problem. Specific interview developed for the study (history of the problem and physical health).

Battered women who are living with their partner have better health offending than non-living.

The results could be explained by the need to be alert and in good physical and mental strength to withstand the abusive situation.

Violence gender has caused considerable social alarm. Better awareness of the characteristics and problems of the female victims is necessary to be able to provide adequate psychological attention.

To identify the specific characteristics of PTSD in female victims of gender violence, stating what are the symptoms of this disorder are usually present, identify some of the most important variables that characterize women seeking assistance this problem.

The goal of this study is examining PTSD in battered women.

Participants: 100 Chilean and 170 Spanish battered women.

Instruments:

1. - Semi-structured interview for victims of abuse: assesses sociodemographic characteristics of victims and circumstances of abuse, it was designed for this research.

2. - The PTSD Symptoms Severity Scale (Echeburúa et al., 1997): assesses the severity and intensity of the symptoms of this disorder according to the diagnostic criteria of the DSM-IV-TR in victims of different traumatic events.

The results show that the most typical symptoms of PTSD are: re-experiencing (the presence of unpleasant and recurring memories about the abuse and psychological and physiological distress on recalling the events); avoidance symptoms (avoidance of thoughts, feelings or conversations related to what has been experienced, loss of interest in significant activities and restriction of emotional life); and hyperactivation symptoms (permanent state of hypervigilance and startle response).

This data will be useful to understand the problems and consequences of abuse and to target interventions to be made to alleviate the plight of these women in cases where it appears PTSD.

Social support is an important variable involved in the process of health/disease. In the particular case of immigrants, social support is also related to the success of their life project and the integration in the society that received them.

Although Duke-UNC Functional Social Support Questionnaire is one of the most used with immigrants (e.g. National Health Survey), it has never been adapted to this population. In this research, Duke-UNC was adapted to Romanian immigrants living in Spain, in order to analyze the relationship between social support and mental health.

Verify the factorial structure and the psychometric properties and analyze the relationship between social support and mental health.

We administered Duke-UNC and GHQ-12 to a sample of Romanian immigrants (N = 116, mean age = 33.26; SD = 11.04), and conducted an exploratory factor analysis.

In the case of Duke-UNC, the results showed a structure of one factor that accounts for 51.46% of the variance. Cronbach's alpha value was .90. A significant negative correlation was found between the social support and the mental health (r = -0.34, p < .000). This shows that people who have more social support also enjoy better health state.

This study demonstrates that Duke-UNC is a practical instrument that can be used to assess Romanian immigrants'social support. This variable has to be taken into account when therapeutic interventions and health programs are created for immigrants because of its relationship with mental health.

Parkinsonian motor signs are the most frequent of the genuine motor abnormalities present in drug-naïve patients with schizophrenia, and are also present in patients with a first-episode of psychosis (FEP).

To study whether there are differences in basal ganglia volumes depending on the presence of Parkinsonism in FEP.

Forty-six patients with a FEP were included in the study. Twenty-three controls were included to normalise patients’ brain volume data. Parkinsonism was assessed with the UKU scale. Brain volumes were obtained with MRI (1.5 Tesla Siemens Avanto). Reconstruction and volumetric segmentation was made with the Freesurfer© software (http://surfer.nmr.mgh.harvard.edu/). Patients were divided into two groups, considering the presence/absence of Parkinsonism (UKU total score cutoff point = 4). Patients have been treated with antipsychotics a mean of less than 2 months. There were not significant differences in the total exposure to antipsychotics between both groups. ANCOVAS were performed including gender as covariate.

Patients with Parkinsonism showed a trend towards significance to exhibit reduced volumes in the left caudate and right putamen (Fig. 1).

FEP patients who exhibit Parkinsonian signs tend to show reduced left caudate and right putamen volumes in the early phases of psychotic illness, after correcting by gender.

The authors have not supplied their declaration of competing interest.

Alcohol consumption represents a significant factor for mortality in the world: 6.3% in men and 1.1% in women. Alcohol use disorder is also very common: 5.4% in men and 1.5% in women. Despite its high frequency and the seriousness of this disorder, only 8% of all alcohol-dependents are ever treated. One potentially interesting treatment option is oriented toward reducing alcohol intake.

To describe one case who has improved his alcohol consumption after starting treatment with nalmefene, an opioid receptor antagonist related to naltrexone.

A 35-year-old male with alcohol use disorder since 2001 came to our consult in November 2015. He was in trouble with his family and he had a liver failure. We offer a new treatment option with nalmefene 18 mg to reduce alcohol consumption.

Before to start nalmefene he drank 21 drinks/week. Six-month later, he decreased alcohol intake until 5 drinks/week with better family relationship and liver function. After starting nalmefene he complained of nausea, so we recommend to take the middle of the pill for next 7 days. After this time he returned to take one pill with good tolerance and no more side effects or withdrawal syndrome.

Nalmefene appears to be effective and safe in reducing heavy drinking and in preventing alcohol withdrawal syndrome due to its opioid receptor antagonism. This case suggests nalmefene is a potential option to help patients, who do not want or cannot get the abstinence, in reducing their alcohol consumption.

The authors have not supplied their declaration of competing interest.

Neurosarcoidosis is an uncommon cause of psychosis. It courses with an affectation of the brain, the spinal cord and other areas of the nervous system. It associates both neurological and psychiatric symptoms: cranial mononeuropathy, myelopathy or radiculopathy meningitis, neuroendocrine dysfunction, dementia, delusions, hallucinations.

To review in Pub-Med about neuropychiatric manifestarions of neurosarcoidosis.

We describe the case of 60-year-old woman diagnosed with long evolution schizoaffective disorder with a recent decompensation in the context of a stressful situation. As somatic background to highlight: cognitive impairment (encephalic bilateral and symmetrical frontal atrophy in cranial magnetic resonance) and a probable sarcoidosis with hilia and mediastinal lymph nodes without histologic confirmation. She was hospitalized at the acute care unit because of a descompensation of her schizoaffective disorder. The patient was distressed, with delirious speech, sensoperceptive hallucinations, hypothymia and weigth loss.

Firstly we evaluate the lack of clinical improvement with an anti-psychotic drug in previous hospitalizations. For that reason, we thought in organic mental disorder as an alternative diagnosis. We started treatment with corticosteroids in spite of we did not observe a decompensation of sarcoidosis. In a few days it was remarked a clinical improvement and remission of the delusional and affective clinic.

It is needed to complete the study and continue the monitoring of the patient to see the evolution and drug response. The diagnosis of neurosarcoidosis should be kept in mind for patients with both neurologic and psychiatric symptoms.

The authors have not supplied their declaration of competing interest.

Hyperthyroidism may lead to high anxiety status, emotional lability, irritability, overactivity, exaggerated sensitivity to noise, and fluctuating mood, insomnia and hyporexia. in extreme cases, they may appear delusions and hallucinations as psychiatric symptoms.

we report the case of a 53-year-old female who was diagnosed of hyperthyroidism and generalized anxiety disorder. The patient went to emergency department because of high levels of anxiety, with heart palpitations, trembling, shortness of breath and nausea. She was presenting auditory hallucinations and delusions as psychiatric symptoms. an urgent thyroid profile was made and it was observed the next results: TSH < 0.005; T4:4; T3:21. Due to a severe thyroid malfunction, the patient was admitted and treated with antithyroid agent, improving the psychiatric and somatic symptoms.

in this case, a patient diagnosed of hyperthyroidism and generalized anxiety disorder presented very severe psychiatric symptoms, with hallucinations and delusions. These symptoms may be produced by primary psychiatric disorders, but is very important to look for thyroid alterations, because if they are the cause, the acute treatment of thyroid malfunction is the correct management of the patient.

Hyperthyroidism is very common in general population, being infradiagnosed most of times. in patient with anxiety or other psychiatric symptoms, it is very important to make a thyroid function tests before the diagnosis of a psychiatric disorder. in extreme cases, hyperthyroidism status may lead to severe psychiatric and somatic complications.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Paraphrenia is a poorly defined process whose uncertain origins date back to the German psychiatry mid-nineteenth century. Paraphrenia would be a subtype of schizophrenia characterized by a more benign clinical course in terms of volitional and emotional involvement. Certain types of serious sensoperceptive distortions and paranoid symptoms are characteristics of this clinical variant. Despite its diverse presentation, its chronic development and its presence in the daily lives of the patient, the overall functionality is not deeply affected.

To discuss the validity of this and other clinical processes based on classical clinical descriptions for diagnostic approach of our current patients, in contrast to the common use simplified concept (forgetting in ICD-10 or disappeared in American manuals).

Clinical case a middle-aged woman diagnosed with longstanding paranoid schizophrenia who suffered from a highly systemized delusional and hallucinatory syndrome with chronic evolution after a first relapse due to abandonment of treatment, but keeping high functional performance even during phases of partial remission.

Schizophrenia presents multiple symptomatic and prognostic paths. Classical authors named these different subtypes. Revisiting these subtypes could be useful as a complementary tool for predicting clinical outcome based on their descriptions, especially in the absence of reliable material instruments.

The authors have not supplied their declaration of competing interest.

Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.

The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.

At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).

Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.