The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The discovery of mirror neurons, considered to be responsible for empathy, intrigued researchers all over the world. Many studies have been developed associating mirror neurons to the incidence of Autism Spectrum Disorder (ASD).

Identifying a possible influence of mirror neuron in autism.

Reviewing the recent trajectory of neuroscience in relation to the connection of impaired mirror neurons in autism.

Bibliographical review of studies in English, published in SciELO and LILACS databases, between 2008 and 2013. The keywords used were: autism, brain, cortex and mirror neuron.

Different subjects explored the influence of mirror neurons in autism as shown below (Fig. 1). Among 17 studies, 12 were bibliographical reviews and 5 involved experiments. Seventy-six percent of the studies were favorable to the influence of these neurons, while 24% were not.

There was a balance in the distribution of themes explored in the articles and few studies exploring the role of mirror neurons in autism. Even though the current research may not be conclusive, it can be said that currently neuroscientists tend to agree that mirror neurons significantly influence ASD. Recent studies suggest that, if properly stimulated, ASD individuals can develop their social skill and, consequently, be socially inserted. According to most author studied, technological development is needed in order to enable scientific advances involving mirror-neurons and ASD.

The authors have not supplied their declaration of competing interest.

Tardive dyskinesia is a collection of symptoms related to the side effects of neuroleptic medications that can mimic other types of disorders. Accurate diagnosis can be challenging, as there is no single test for tardive dyskinesia.

Female patient, 64 years old, with personal history of Chronic Myeloid Leukaemia and psychosis since forth decade, currently medicated with quetiapine 350 mg/day, risperidone IM 50 mg 15/15 days and trazodone 150 mg/day (previously medicated with haloperidol, amisulpride and olanzapine). She started with involuntary movements interpreted as tardive dyskinesia after 2 years on neuroleptic treatment. The difficult control of involuntary movements motivated the reference to ambulatory Neurology department. The review of personal history suggested a family history of involuntary movements and psychiatric illness. Physical examination showed generalized choreic movements. The analytical and imagiologic study was unremarkable. The presence of family history and involuntary movements atypical to be classified as tardive dyskinesia supported a genetic test for Huntington's disease who detected a CAG expansion with 43 repetitions in HTT gene. Despite treatment with amantadine and riluzole she maintains disease progression and evident cognitive deterioration.

The diagnostic process of involuntary movements may involve more than one physician and requires the review of a detailed medical history, a physical examination and a neuropsychological evaluation in order to determine whether one is indeed suffering from tardive dyskinesia or a different neurological disorder.

The authors have not supplied their declaration of competing interest.

Several epidemiological studies describe the association between substance abuse and appearance of psychotic symptoms. There is a higher prevalence of psychotic symptoms among cannabis and cocaine consumers compared to the general population.

The cannabinoid receptors regulate the release of dopamine and cocaine has a strong inhibitory action on reuptake of the same. This may explain the greater proportion of subjects moderately or heavily dependent on cocaine or cannabis experience symptoms of psychotic sphere.

Describing the profile of drug consumption among a group of patients diagnosed with delusional disorder.

Our data come from a case register study of delusional disorder in Andalucía (Spanish largest region). By accessing digital health data, we selected 1927 cases who meet criteria DSM 5 for delusional disorder collecting different toxic consumption habits.

It was found that 1070 (93.4%) of patients diagnosed as delusional disorder according DSM 5 did not consume cannabis, compared to 75 (6.6%) who do so. Among patients diagnosed as “other psychoses”, 243 (85%) did not use drugs and 43 (15%) consume other drugs of different types of cannabis.

In our sample, we found that the use of drugs such as cannabis and cocaine is less common among patients diagnosed with delusional disorder compared with other individuals diagnosed as “other psychosis”.

The authors have not supplied their declaration of competing interest.

The use of psychostimulants, such as amphetamines and cocaine in psychotic patients is 4 times more frequent than non-psychotic ones. It is believed that people with psychosis may use substances as a self-treatment for negative symptoms. However, early onset of substance use disorder can develop psychotic and/or negative symptoms, leading to confusion between primary or secondary psychosis.

Systematic review of the literature in English (PubMed) and patient's clinical record. Keywords: “Substance use disorder”; “psychosis”.

to highlight the importance of an adequate characterization of psychotic symptoms in patients with substance use disorder.

A 29-year-old man, with psychostimulants and cannabis abuse since adolescence and very short abstinence episodes. Later on, he developed paranoia symptoms that slightly improved once he decreased drugs dosage, but they were still present even on complete abstinence. Over the last year he has showed negative and psychotic symptoms that have been worsening with aggressive behavior during the last months, so he had to be hospitalized. During this period, he has been treated successfully with aripiprazol depot once monthly. His evolution has been positive, it has disappeared psychotic symptoms and paranoia, and after discharge he has managed to remain abstinent to psychostimulants.

Adequate characterization of patients with psychotic symptoms and substance abuse is essential to determine whether the psychotic disorder is associated with primary or induced TUS. Therefore, it is essential a thorough clinical evaluation to make an accurate diagnosis and to draw an individualized treatment plan.

The authors have not supplied their declaration of competing interest.

Asthma is a major public health problem and its prevalence has increased in both developed and developing countries during the last few years. Once it is a chronic illness, it has also revealed psychological consequences. Moreover, recent studies have suggested an association between asthma (especially of severe grade) and mental disorders.

The authors pretend to make a brief review concerning psychiatric disorders among asthmatic patients.

To understand and to be able to deal with the psychiatric disorders among chronic asthmatic patients.

The review was based on scientific documentation published in PubMed database, using the following terms as keywords: “asthma”, “depression”, “anxiety” and “panic disorder”.

Compared to the general population, both anxiety and mood disorders rates are at least two times those observed in asthmatic patients. Moreover, certain psychiatric disorders rates, including panic disorder (PD) and major depressive disorder, are as much as six times more prevalent among asthmatics when compared to the general population. The association between psychiatric disorders and poor asthma control and asthma-related quality of life could occur through several pathways, such as behavioural pathways; cognitive or perceptual pathways; or through the direct physiological effects of depression and anxiety on the autonomic nervous system (ANS) and immune systems which increase asthma symptomatology.

There is a close correlation between anxiety, PD and depression, and a poor controlled asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.

The authors have not supplied their declaration of competing interest.

Opioids are the most powerful drugs commercialised for acute and chronic pain relief. The main emerging problem in our midst is the abuse and addiction to synthetic opioids iatrogenically established in general population.

We report the case of a female patient aged 48 admitted to the Acute Psychiatric Unit after a suicide attempt. She refers she finds herself more irritable and depressed since she began a treatment with oxycodone after she was diagnosed with fibromyalgia. She has lost a lot of weight, is not able to get to sleep and has become socially isolated.

During the first few days, the patient is uncooperative and shows a marked self-referentiality and verbalises delusional ideation related to her immediate surroundings. Once the treatment with opioids was withdrawn and we had prescribed paliperidone ER, she seemed more cooperative and calmed. She was discharged from the Psychiatric Day Hospital showing a good evolution.

Paranoid personality disorder (F60); mental and behavioural disorders due to use of opioids (F11); recurrent depressive disorder, current episode moderate (F33.1); fibromyalgia (M79.7).

The use of synthetic opioids (tramadol, fentanyl, oxycodone) in easy-to-use formats (patches, pills, dispersible tablets, lollipops) and their dissemination in pain treatment, is leading to an increase of problems related to it, both their side effects (psychotic symptoms) and the generation of misuse and addiction. We should pay greater attention to the prescription of opioids to patients with dysfunctional personality traits.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Quality of life (QoL) is a complex concept that depends on many factors such as life style, past experiences, expectations, future plans and ambitions. It may be altered in patients suffering from chronic disease.

Assess QoL in patients with asthma as well as associated factors.

We conducted a cross-sectional, descriptive and analytic study, including 30 patients followed for asthma at pulmonary outpatient department, Hedi Chaker Hospital, Sfax, Tunisia. Asthma control level was evaluated by the Asthma Control Test (ACT). QoL was assessed using the 36-item Short Form Health Survey (SF-36), that contains 36 questions grouped into 8 domains (D1: Physical Functioning, D2: Role limitations due to physical problems, D3: Bodily Pain, D4: General Health, D5: Vitality, D6: Social Functioning, D7: Role limitations due to emotional problems and D8: Mental Health).

The mean age was 51 ans. The mean duration of disease was 11 years. The average ACT score was 16.8 points. Asthma was uncontrolled in 1/3 of patients. The mean of average overall scores SF-36 was 46.22. QoL was altered in 83.3% of patients. The most altered domains were D8 followed by D7then D4 and D2. The average overall score SF-36 was correlated to ACT score (P < 0.001), early age of onset of the disease (P = 0.049) and poor asthma control (P < 0.001). Altered QoL was associated to advanced age (P = 0.016), long duration of disease (P < 0.001) and low ACT score (P = 0.034).

Optimum asthma and associated comorbidities support would improve control and therefore the patient's quality of life.

The authors have not supplied their declaration of competing interest.

Alcohol consumption associated with other psychiatric disorders in outpatient psychiatric comorbidity is a common, yet often underdiagnosed and undertreated, resulting in a worse prognosis of both diseases.

To evaluate the prevalence of alcohol consumption in psychiatric outpatient consultations and compared to drug addiction consultations.

A total of 25 outpatient psychiatrists of Extremadura and 10 doctors of substance abuse centers of Extremadura (CEDEX) participated in the study. They were included in the study a total of 373 patients, 244 who were in treatment at mental health center and 129 as a center of drugs.

The mean age of patients in psychiatric consultations was 50.05 years and 42.60 years of CEDEX. The percentage of women was 54% of cases in psychiatric consultations and 18.6% in the CEDEX. Diagnoses included in psychiatric consultations were: anxiety disorders (17.2%), depressive disorders (46.3%); personality disorders (7.8%); mild mental retardation (2.5%); psychotic disorders (12.3%); dementia (2.5%); bipolar disorder (6.1%); and ADHD (1.2%). In the consultations of drugs they were: 45.4% alcohol dependent; 15.7% to cannabis; 13.3% cocaine; 10.9% heroin; 8.1% more heroin to cocaine; and 6.6% to other addictions. A total of 18.9% of patients in psychiatric consultations had a score of 2 or more in the CAGE and 62.8% of the CEDEX.

We found nearly a fifth of the patients attending psychiatric outpatient clinics which have a hazardous drinking, harmful or alcohol dependence, for almost two thirds of drug queries.

The authors have not supplied their declaration of competing interest.

Depression and alcohol problems are common in psychiatric outpatients, but there are few studies including patients with anxiety disorders.

To study the prevalence of problematic alcohol consumption in a sample of patients diagnosed of anxiety or depressive disorder and treated in a mental health clinic and to analyze clinical and sociodemographic variables associated to alcohol consumption.

The sample studied included 194 outpatients (31.9% men and 68.1% women) treated in an outpatient clinic and diagnosed of any anxiety or depressive disorder included in DSM-IVTR as main diagnose. Instruments used were Beck Depression Inventory (BDI), and the Alcohol Use Identification Test (AUDIT). Other variables studied included age, civil status, level of studies, and specific psychiatric diagnoses.

A total of 64.9% were diagnosed of anxiety disorder and 35.1% were diagnosed of depressive disorder. The prevalence of problematic alcohol consumption was 7.8%, being more frequent in men, especially in men and in middle ages. Problematic alcohol consumption was found with more frequency in patients with generalized anxiety disorder and major depression, in this order. Patients with other comorbidity disorders in Axis II presented the highest prevalences of problematic alcohol consumption.

Problematic alcohol consumption presents high prevalence in patients with anxiety or depressive disorders and dual diagnose usually is associated with poor prognosis. It is necessary to make efforts to detect alcohol problematic consumption in psychiatric patients and develop specific treatment programs directed to this group of patients in both primary and specialized care units.

The authors have not supplied their declaration of competing interest.

Previous studies inform that psychiatric patients often report problems with their sleep and alcohol increase sleep disturbances.

To analyze the prevalence of sleep disturbances in patients diagnosed of Alcohol Abuse or Dependence and to study clinical and sociodemographic variables associated with sleep disorders.

The sample is composed of a randomized sample of patients diagnosed of Alcohol Abuse or Dependence following DSM-IV-TR criteria and treated in a Mental Health Clinic in a period of 3 years. Medical records were reviewed. Quality and patterns of sleep were evaluated using the Pittsburg Sleep Quality Index (PSQI) with a cut-off point 5-6.

A total of 102 patients were included in the study, 69% were male and 31% were female. Mean age 39.4 years (SD 9.26).

Sleep disorders were found in 91.6% of patients. The most altered subscales in the overall sample were the Use of Sleeping Medication and Sleep Disturbances. Women presented worse sleep quality compared to men (P < 0.01) with higher number of altered subscales. The most altered subscales in women were Subjective Sleep Quality (P < 0.005) and Sleep Disturbances (P < 0.02).

Comorbidity with other psychiatric disorders and other clinical and sociodemographic variables are analyzed.

Sleep disorders have high prevalence in patients with alcohol abuse of dependence, especially in women and patients with other psychiatric comorbidity. Poor quality sleep may have a powerful impact on the global functioning and prognosis of these groups of psychiatric patients.

The authors have not supplied their declaration of competing interest.

The existence of independent services and facilities for mental health and for addictions in Andalusia stand in the way of addressing dual pathology. The strong comorbidity between substance use and early psychosis has been deeply studied in recent literature. The aim of this paper is to analyse a group of consumers in the First Episode Psychosis Program (FEP) to address the lack of the actual interventions performed.

Descriptive statistical analysis of demographic and clinical variables of a group with drug consumption (n = 17) is compared to a non-consumer group (n = 7).

Our sample of patients included, consumers who represent 71% of the sample. All consumers were users of cannabis or derivatives and 35% of consumers were diagnosed at some point of Toxic psychosis. Only 23% received care in drug addiction centers. They have less education. The duration of untreated psychosis (DUP) is greater than in non-users and only 35% of the cases were detected in Primary Care. PANSS with higher scores. Greater differences in general psychopathology. The Social Functioning Scale (SFS) were worse in the Isolation scale. The Family Questionnaire (FQ) showed more difficulties in the family setting. Finally the Global Assessment of Functioning (GAF) gives an average of 8 points lower (severe symptoms).

We would like to point out the low percentage of users who receive specialized care for their addiction. Better collaboration with Primary Care is required to improve the capacity of detection to reduce the time slot of untreated symptoms.

The authors have not supplied their declaration of competing interest.

Porphyrias are rare inherited disorders due to specific enzyme abnormalities of heme biosynthesis. Among the hepatic forms, three of them are clinically characterized by acute abdominal pain and neuropathy, sometimes associated with psychiatric disorders like mood changes, organic brain syndrome and psychosis.

Here, we present a 38-year-old male patient with intermittent porphyria and chronic psychosis who was hospitalized. He had been treated by benzodiacepines and neuroleptic medication for several years. Exposure to certain drugs, dieting, starvation and infection may precipitate AIP attacks.

Underlying organic causes of psychiatric disorders such as psychosis should be considered among patients with atypical symptoms and/or resistance to standard therapy.

It is important to increase awareness amongst psychiatric and neurological professionals with regard to certain inborn errors of metabolism. Early detection of porphyria may diminish morbidity and mortality rates, and perhaps heal some chronic atypical psychiatric illnesses.

The authors have not supplied their declaration of competing interest.

Despite recent findings pointing toward cannabis psychosis as one area where gender differences may exist, there has been a widespread lack of attention paid to gender as a determinant of health in both psychiatric services and within the field of addiction.

To explore gender differences in treatment presentations for people with cannabis psychosis.

To use national data sets to investigate gender differences.

Analysis of British Crime Survey data and a Hospital Episode Statistics data set were used in combination with data from previously published epidemiological studies to compare gender differences.

Male cannabis users outnumber female users by 2:1, a similar gender ratio is found for those admitted to hospital with a diagnosis of schizophrenia or psychosis. However this ratio increases significantly for those admitted to hospital with a diagnosis of cannabis psychosis, with males outnumbering females by 4:1.

This research brings into focus the marked gender differences in cannabis psychosis. Attending to gender is important for research and treatment with the aim of improving understanding and providing gender sensitive services.

The authors have not supplied their declaration of competing interest.

Mental health disorders and parkinsonism (mobility slowness, rigidity, rest tremor, gait instability) often co-exist. Approximately 40% of the 7-10 million people living with Parkinson's disease globally experience co-existent depression and/or anxiety. Furthermore, people treated with dopamine-blocking medications (antipsychotics, antiemetics) or those who suffer vascular, infectious, toxic, or structural brain insults may have symptoms of “secondary” parkinsonism.

To describe the existence of parkinsonism among Latino immigrants with behavioral health and substance abuse problems.

Data from the International Latino Partnership (ILRP) gathered at primary care clinics in Boston, Madrid, and Barcelona included 4 parkinsonism screening questions.

A total of 151 participants out of 567 (26.6%) screened positive for at least one parkinsonism question and 15 (2.6%) screened positive for all 4 questions. A small group of participants who screened positive for parkinsonism had co-existent schizophrenia, schizoaffective disorder, bipolar disorder, and/or exposure to lithium or valproic acid. We found that age 50+, depression, and anxiety were more often associated with people having parkinsonism (P < 01). Gender, race, language, and educational level were not significant predictors of parkinsonism.

Parkinsonism and behavioral health disorders co-exist among Latino immigrants in the United States and Spain. This may be related in part to exposure to dopamine-blocking medications. Future studies should focus on early detection of mental health co-morbidities among Parkinson's disease patients as well as on prevention of “secondary” parkinsonism among people living with mental health disorders.

The authors have not supplied their declaration of competing interest.

Being hospitalized in a psychiatric clinic, patients present, in addition to the diseases that determine the hospitalization, clinic comorbidities, generally decompensated.

To present the most frequent clinic pathologies in a population of hospitalized patients having diverse mental disorders and establish a protocol for investigation and their early treatment.

To know the most frequent pathologies in a population of hospitalized psychiatric patients and establish a protocol for their assesment, in a way that contributes to the global improvement of the patient health condition.

For its mission realization, the clinic counts on a multidisciplinary team. The participants were 762 patients, seen in the referred clinic, which presented a minimum period of hospitalization of 10 days and that were submitted to thorough clinic exam and complementary routine exams. The time frame referred to the period of March of 2012 to February of 2014, totalizing 24 months.

In the patients that had medical release after periods of hospitalization of, 90-day average, were obtained, in the totality of the cases, excellent evolution, evidenced by the improvement of the laboratory parameters.

The results were achieved in the hospitalization system with careful medicament administration, differentiated diets established in agreement with the patients, supervised physical activities and psychological and psychiatric support.

The authors have not supplied their declaration of competing interest.

The simultaneous presence of temporal epilepsy and psychosis includes a careful approach to diagnosis and titration of medication.

To achieve remission of comorbid diseases resistant to therapy.

Psychotherapy interview and support, laboratory measurements, EEG, cerebral CT and MRI scan, psychological testing.

The patient was a girl 16 years of age. In 2011, she started experiencing auditory hallucinations of disturbing content, ideas of persecution, and she feared that people were going to kill her, all of which were bothering her deeply. In the family anamnesis, her grandmother and aunt both suffer from schizophrenia. In the first neurological assessment, there were no abberations. The patient was treated with high doses of various antipsychotics, but the hallucinations became unbearable to the extent that she was about to commit suicide. Anticonvulsive therapy was planned, and in the meantime, a second neurological assessment was performed, which confirmed the coexistence of temporal epilepsy. Combined therapy consisting of anticonvulsive and antipsychotic medication markedly abated the hallucinations. However, the patient began to feel cramping of the right arm, as well as experiencing the negative symptoms of psychosis. She wasn’t functioning normally anymore, she was distinctly adynamic, depressive, with a lack of initiative, and poor memory and concentration. Psychological testing confirmed significant cognitive, emotional and personality disorders (of organic source).

Treatment of the overlapping symptoms of temporal epilepsy and psychosis is complex, along with the presence of intellectual deterioration.

The authors have not supplied their declaration of competing interest.

Parkinson's disease is the most common neurodegenerative movement disorder in the elderly population. The disease is clinically characterized by major motor symptoms that include bradykinesia, rigidity, tremor and postural instability. In addition to the motor symptoms, Parkinson‘s disease is characterized by emotional and cognitive deficits, which reduce quality of life independently from motor manifestations.

To discuss the clinical manifestations of depression in Parkinson's disease according to the most recent scientific literature.

Online search/review of the literature has been carried out, using Medline/Pubmed, concerning, “Parkinson's disease” and “depression”.

Depression is the most frequent psychiatric disorder in Parkinson's disease. In up to 30% of the cases, the depressive symptoms precede the development of motor symptoms. Independently of the age of appearance, duration and severity of the motor symptoms, depression is generally an integral part of the disease. Depression in Parkinson's disease is generally mild or moderate, with premature loss of self-esteem and volition. Although the high rates of suicidal ideation, suicide is rare. There is also a high prevalence of panic attacks and anxiety.

It is difficult to correctly identify depression in Parkinson's disease as some symptoms assigned to Parkinson's disease itself can in fact be the clinical manifestation of a depressive disorder. On the other hand, depressive symptoms may not be recognized as such, but considered manifestations of Parkinson's disease.

The authors have not supplied their declaration of competing interest.