Neuroleptic Malignant Syndrome (NMS) comprises several systemic manifestations which can be life threatening. Its pathogenesis is unknown but it is known to be associated with the use of antipsychotic drugs. Some cases are still seen in General Hospitals despite the extended use of atypical neuroleptics. The main clinical features includes mental status changes, fever, rigidity and autonomic instability. Due to the potential gravity, the identification of risk factors and early clinical diagnosis is essential in order to prevent or treat it successfully.

The objective of this study is to analyze the profile of patients who present NMS and the related risk factor described in the literature.

A sample of patients diagnosed with NMS was selected. They were hospitalized in the 12 de Octubre Universitary Hospital of Madrid over the last 10 years. The demographic variables, signs and symptoms and the risk factors were evaluated by a retrospective and descriptive analysis.

the clinical manifestations were similar to those reported in other series. Several risk factors reported in the literature were observed.

1. 1. It is essential the early suspect of this syndrome in patients with risk factors.

2. 2. In patients in whom the disorder is suspected, treatment should be initiated immediately.

The distribution of the demand from primary care in the mental health units could be a way of facilitating the coordination and improving the attention to patients. For this reason, in our unit we have made a repartition of the areas among the different psychiatrists.

To analyze if there was a correlation between the geographical origin of the patients or their primary care areas and the referrals, and between them and their attendance.

This is an epidemiological, analytic, prospective study of patients referred to our department. The following variables were collected: (1) referral protocol, (2) reason, (3) demographic data (origin, gender, age), (4) Primary Care area, (5) attendance to appointment, (6) diagnosis impression and (7) destination of referral. The SPSS 19.0 was used to analyze the data.

A total of 1048 patients were sampled. A statistically significant relationship hasn’t been found between place of residence, primary care area or areas of distribution in the Unit and attendance (Chi2). If we analyze the population of each distribution, we can describe similar percentages depending on the size of these.

Although a different distribution and a relationship is thought between some areas and the attendance or the number of referrals, we didn’t find out them in our sample.

The authors have not supplied their declaration of competing interest.

Referrals to psychiatry from primary care has increased in recent years. This can be the result of the global economic situation and represents a problem for specialized care, because patients can’t usually be correctly attended to. On the other hand, patients who don’t come to visits make up other important issues that we must analyze.

To analyze the differences between patients who did not come for their first visit and those who did in order to try to describe variables that could be affecting them.

This is an epidemiological, analytic, prospective study of patients referred to our department. The following variables were collected: (1) referral protocol, (2) reason, (3) demographic data, (4) attendance to appointment, (5) diagnosis impression and (6) destination of referral. The SPSS 19.0 was used to analyze the data.

We studied a total of 1.048 patients for 15 months, of which 20.6% did not come to their first visit. A statistically significant relationship between attendance and gender, year of the appointment, adequate demand or not, previous follow-up and diagnosis was found (Chi2). However, if a logistic regression was carried out, only the adequacy of the demand was included in the model.

Coordination with general practitioners is essential to improve referrals and, most importantly, the attention to patients. If we can agree on the referral criteria, a better-personalized assistance can be offered to patients who have more difficulties in coming (because of characteristics of illness, place of residence, and other variables).

The authors have not supplied their declaration of competing interest.

Dissociation has been related to emotional dysregulation and eating psychopathology. Dissociation may interfere with the learning process, affecting at the therapy negatively. The aim of the study is to analyse if at the eating disorders (ED), dissociation is linked to temperamental traits or also to character traits, which are susceptible to be modulated during the therapeutic process.

We studied 119 females that started an outpatient program for their ED. We used the Dissociative Experience Scale (DES), Temperament and Character Inventory (TCI), Eating Attitudes Test (EAT-40), and the State Trait Anxiety Inventory (STAI). We used multiple regression analysis.

Dissociation was associated with high scores on the EAT-40, even controlling the effect of anxiety traits, which also was related to dissociation. The temperament dimension “searching for novelty”, has been related in an opposite way to the DES. Also, the “dimension of transcendence “character and “self determination” influenced on the DES.

This study confirms the importance of improving Self Determination levels at ED therapy, which influence on a lot of prognostic aspects, such as protecting from dissociation, which is related to anxiety and alimentary psychopathology and can interfere with the therapeutic progress.

The authors have not supplied their declaration of competing interest.

Actually psychiatrists around the world are treating children and adolescents (despite limited medical indications in this age group) with atypical antipsychotics at increasing rates for a range of psychiatric illnesses (schizophrenia, bipolar disorder, behavioral changes…). Over the last few years, a number of new long-term injectable treatments (ILD) have emerged, the advantages of which are found in adult (adherence, functionality, consistent blood level without daily peaks…) but we do not have enough data in minors.

Discuss utility of ILD in adolescents.

We expose a case report about a 17-year-old man, when he was a child he was diagnosed with attention deficit disorder and autism spectrum disorder and also he had a story of disrupted behavioural and aggressively. After been hospitalized in our hospital we remake his clinic history and he was diagnosed with schizophrenia. Before the injectable treatment (ABILIFY MAINTENA®) this patient tried various treatments (mood stabilizers, antidepressants…) and many hospitalizations.

After the ILD, our patient has good functionality, he is now living with his parents and studying in the high school. He has not needed another hospitalization after the last one.

The ILD in adolescents must be a therapeutic option in mental disease, in this group is very difficult the complementation of the treatment, it's frequent the comorbid use of substances, this population are not used to take medications… so every treatment that facility this kind of problems must be a perfect weapon to improve their mental health and to prevent relapse and hospitalization.

The authors have not supplied their declaration of competing interest.

The first time when people attempt suicide first contact is critical. Psychiatrists must decide to hospitalize them or follow-up in mental health units and the bases of a doctor-patient relationship are formed.

An analysis of referrals to psychiatry from the emergency room (ER) was developed. Our objective was to discover if there was a statistical correlation between gender and other variables, especially repeated visits and admissions.

Our sample was composed of patients who visited the ER for suicidal tendencies for 20 months. We carried out an observational retrospective study. The variables collected were: age, gender, cause, repeated visit (visit to the ER in the following two months), previous attempts, previous follow-up, method used, use of toxic substances during the attempt, intentionality, referral from the ER, later follow-up and diagnostic impression at the ER.

A total of 620 patients were sampled. The relationship between gender and repeated visit, previous attempts, dysfunctional personality traits, use of substances and later follow-up was found (Chi2). Although the relationship between admissions and gender were not statistically significant, influence by gender (over all in males) can be observed in logistic regression models. As well as, in patients who visited the ER several times, dysfunctional personality traits seem to be the most common but gender marks significant differences between groups.

The data obtained is consistent with those reported in previous studies. To know who the riskier groups are can allow professionals to plan protocols and unify admission criteria.

The authors have not supplied their declaration of competing interest.