Diabetes mellitus is one of the most frequent chronic diseases in Tunisia. Individuals with diabetes mellitus may have concurrent mental health disorders and are shown to have poorer disease outcomes.

The aim of this study was to determine the prevalence of depression and anxiety in diabetics attending the primary care setting.

This was a cross-sectional survey carried out over two months and including diabetic patients followed up at the consultation for chronic diseases at the primary care center of Hiboun, in Mahdia, Tunisia. The validated Hosiptal Anxiety and Depression scale (HAD) questionnaire was used as a screening tool for the symptoms of depression and anxiety.

A total of 64 patients (24 men and 40 women) was enrolled. The average age was 54.5 ± 7.2 years. The mean duration of diabetes was 8.2 ± 2.3 years. The average HbA1c level was 9.1%.Over 48% of patients were overweight. The prevalence of Depression and anxiety among patients with diabetes from our study was 29.6% and 40.6%, respectively. Depression was found to be significantly associated with marital status of widowed, HbA1c level of more than 8.5%, and a family history of psychiatric illness. anxiety was significantly associated with females, unmployement and HbA1c level of more than 8.5%.

Screening of high risk Type II diabetics for depression and anxiety symptoms in the primary care setting is recommended at regular intervals.

Diabetes is a major public health problem in Tunisia. Its prevalence increases with age. In addition, depression, at the top of mental disorders list, mainly remain undiagnosed, in particular in the elderly and consequently untreated.

The aim of this study was to estimate depressive symptoms and related factors in elderly diabetic patients.

This is a cross-sectional study, conducted among type 2 diabetic patients aged ≥ 60 years old, attending Mahdia’s primary health center, from January 2019 to March 2019. Depressive symptoms were assessed by using the Geriatric Depression Scale (GDS).

95 diabetic patients were recruited. The average age was 75 ± 7.4 years and the sex ratio was 0.9. In our sample, 68.4% of patients were categorized according to having depressive symptoms. The proportion of participants with mild and severe depression symptoms were 25.3% and 43.1%, respectively. Analytical results demonstrate many factors which were significantly associated with depressive symptoms: female gender, living alone, history of hypertension, presence of complication, and using insulin (p < 0.05).

Our study shows that depressive symptoms are common in elderly subjects with diabetes, and there have been many significant risk factors associated with it. So there is need for physicians to detect, confirm, and treat depression in elderly diabetic patients.

Schizophrenia is highly comorbid with substance use disorders (SUD) but large epidemiological cohorts exploring the prevalence and prognostic significance of SUD are lacking.

To investigate the prevalence of SUD in patients with schizophrenia in Finland and Sweden, and the effect of these co-occurring disorders on risks of psychiatric hospitalization and mortality.

45,476 individuals with schizophrenia from two independent national cohort studies, aged <46 years at cohort entry, were followed during 22 (1996-2017, Finland) and 11 years (2006-2016, Sweden). We first assessed SUD prevalence (excluding smoking). Then we performed Cox regression on risk of psychiatric hospitalization and mortality in patients with schizohrenia and SUD compared with those without SUD.

The prevalence of SUD in specialized healthcare ranged from 26% (Finland) to 31% (Sweden). Multiple drug use and alcohol use disorders were the most prevalent SUD, followed by cannabis use disorders. Any SUD comorbidity, and particularly multiple drug use and alcohol use, were associated with 50% to 100% increases in hospitalization and mortality compared to individuals without SUD. Elevated mortality risks were observed especially for deaths due to suicide and other external causes. All results were similar across countries.

Co-occurring SUD, and particularly alcohol and multiple drug use, are associated with high rates of hospitalization and mortality in patients with schizophrenia. Preventive interventions should prioritize detection and tailored treatments for these co-morbidities, which often remain underdiagnosed and untreated.

ML: Genomi Solutions Ltd, Nursie Health Ltd, Sunovion, Orion Pharma, Janssen-Cilag, Finnish Medical Foundation, Emil Aaltonen Foundation. HT, EMR, AT: Eli Lilly, Janssen–Cilag. JT: Eli Lilly, Janssen-Cilag, Lundbeck, Otsuka.

Neurofibromatosis type 2 (NF2) is a rare disorder associated with significant morbidity such as hearing loss that can lead to many psychiatric disorders.

Describe the psychiatric symptoms associated to NF2.

We report the case of a patient admitted to the locked unit of the psychiatric ward for agitation and persecutory delusion and diagnosed with NF2. The data was collected from the patient’s medical file. A review of the literature was performed by selecting articles from PubMed using ‘Psychosis acoustic neuromas’ and ‘Psychosis neurofibromatosis 2’ as key words.

This is the case of a 21-year-old patient who was admitted for behavioral disorders. Our patient had a medical history of a one-sided deafness treated with a hearing prosthesis. He was also followed irregularly by a free-lance psychiatrist. The start of trouble dated back to 3 years marked by behavioral disorders such as fugue, agitation, irritability and sleep disorder. The symptoms worsen in the last 3 months with appearance of hostility and delusion of persecution towards his mother. The patient declines to eat the food that his mother cooked for him and threatened her with a knife. The clinical overview includes delirium, clastic agitation strikes, emotional lability, cerebral ataxia and conjunctival hyperemia. Brain scanner showed an association of bilateral acoustic neuromas, cavernous and intraventricular meningioma. These clinical and radiological signs met the diagnosis for NF2 according to the consensus conference of the National Institute of Health in Bethesda (USA 1988).

The psychiatric symptoms reported in acoustic neuroma patients are usually described as transient.

Attention-Deficit/Hyperactivity Disorder (ADHD) and Obesity are frequently comorbid. The prevalence of ADHD rises from around 2.8% in the general population (adults) to about 27% among those with obesity. Although neurobiological mechanisms explaining the strong association between ADHD and obesity are still unclear, several hypotheses have been proposed to explain the high comorbidity, including common genes, dopaminergic neurotransmission, deficits in executive functions (planning, adherence to weight loss programs or protocols after bariatric surgery) and circadian rhythm dysregulation.

Review on the relationship between ADHD and Obesity, focusing on possible biological mechanisms driving their high comorbidity.

We conducted a search in PubMed and ClinicalKey with the terms: “Attention-Deficit/Hyperactivity Disorder”, “Obesity”, “Dopamine”.

Altered reward processing and impaired inhibitory control are key features of ADHD and are also related to obesity. The ability to resist the impulse to eat and an appropriate reward response require normal function of these dopamine circuits. Both ADHD and obesity are usually associated with reduced volume of putamen, known to be a fundamental player in inhibitory control functioning. Human and animal studies have also demonstrated that obese individuals have decreased dopamine D2 receptor availability in the striatum. Recently genetic analyses implicated specifically Dopamine-DARPP32 Feedback in cAMP Signaling in both ADHD and Obesity.

ADHD and obesity are often comorbid. Dysregulated dopaminergic neurotransmission seems to be a fundamental factor underlying the overlap between ADHD and obesity, probably involving DARPP-32 signaling and possibly through neurobiological features of putamen, namely inhibitory control. Further studies are necessary to explain the neurobiological correlation between these entities.

The burden of depression and anxiety is poorly documented in Central African populations.

To present the epidemiology of depressive and anxiety disorders among older people in two Central African countries.

A cross-sectional population-based study was carried out in Republic of Congo (ROC) and Central African Republic (CAR) between 2011 - 2012 among people aged ≥ 65 years (EPIDEMCA study). Data were collected using a standardized questionnaire and participants underwent a brief physical examination. Depression and anxiety symptoms were ascertained using a community version of the Geriatric Mental State (GMS-B3). Probable cases were defined as having a GMS-AGECAT score ≥ 3. Logistic regression models were used to investigate the association between potential risk factors collected and presence of at least one of both symptoms.

Overall 2002 participants were included in the EPIDEMCA study. Median age of the participants was 72 years [interquartile range: 68 – 78 years] and 61.8% were females. Prevalence was 38.1% (95% Confidence Interval: 35.9% - 40.2%) for depression, 7.7% (95% CI: 6.5% - 8.9%) for anxiety. In total 40.1% had least one of both symptoms. In multivariable models, the following factors were associated with the presence of at least one of both symptoms: female sex, residence area, frailty, cognitive disorders, a high happiness score (protective) and hypertension (adjusted Odds Ratios from 1.3 to 1.7; p<0.01).

In light of the high prevalence of both psychiatric symptoms among Central African older people, evidence on their epidemiology is important for better management and policy planning.

Multiple sclerosis (MS) is an inflammatory demyelinating illness characterized not only by severe neurological symptoms and somatic signs but also by psychiatric symptoms. Psychiatric comorbidity is common in MS. However, the incidence of psychiatric comorbidity remains understudied.

To discuss the relationship of psychiatric disorder to neurologic dysfunction in MS through a clinical case.

Presentation of a clinical case of bipolar disorder in a 45-year-old woman with MS, followed by a literature review.

We reported a case of a 45-year-old woman, who was followed in neurology for MS since the age of twenty-five. She was stable under monthly treatment. She was referred by her neurologist for psychomotor excitement, insomnia, feeling of well being, and sexual disinhibition. The symptoms were present for three weeks. At the interview, she was euphoric, disinhibited, she had logorrhea and did not verbalize delirium. An attack of multiple sclerosis was ruled out. The patient did not report any history of psychiatric illness, epilepsy, head trauma, or use of psychoactive substances. We retained the diagnosis of bipolar disorder (manic episode). Divalproex sodium and olanzapine were prescribed with significant improvement of symptoms.

This reported case is interesting since it highlights the possible association between multiple sclerosis and bipolar disorder. Further investigations are needed to identify potential shared risk factors between these pathologies to improve patients’ outcomes.

Elevated prevalence of somatic disorders (SD) in patients with mental diseases is well recognized and studied since latest years. However, their detection remains too late, which darken the prognosis of both diseases, and complicate the therapeutic management.

We aimed to determine the prevalence of SD in psychiatric inpatients, and to assess relationships between the two diseases.

We analyzed retrospectively the medical records of 94 male patients hospitalized for the first time in psychiatry “B” department, Hedi Chaker hospital (Sfax, Tunisia), in the period from January 1st until December 31st, 2019.

The mean age of patients was 36.88 years. Among them, 22.3% used cannabis and 37.2% consumed alcohol. Schizophrenia (41,5%) and bipolar disorders (20.2%) were the most common psychiatric diagnoses. During their hospitalization, at list one SD was noted in 53.2%: cardiovascular diseases 21.3% (electrocardiographic anomalies 19,1%); infections 9.6% and hepatic pathologies 8.5 %. The SD was comorbid with psychiatric disease in 90%, and represented a side effect of psychotropics in 10% of patients with SD. Older Patients were more likely to present SD during hospitalization, without a significant association. Patients with schizophrenia were significantly more likely to present infections (p=0.031). Repolarization disorders are more common in patients with cannabis use (p = 0.006).

Our study pointed the high prevalence of SD in patients with mental illnesses, especially in those with schizophrenia and cannabis use. Thus, the somatic assessment should be a systematic practice to identify patients at risk for somatic complications and ensure timely their transfer to a specialized setting.

Studies on psychiatric patients have shown that the presence of autistic traits affects the effectiveness of the treatment, decreasing the likelihood of positive clinical outcomes.

The aim of the present study is to investigate which are the areas of overlap between psychiatric symptoms and the traits of the autism spectrum using a bayesian approach.

A sample of 190 adult psychiatric patients, diagnosed with schizophrenia, bipolar disorder, major depression, and personality disorder participated in the study. The RAADS-R questionnaire was used to assess the presence of autistic traits. The severity of psychiatric symptoms was measured with the BPRS and PANSS scales, the perceived well-being and disability using the Whodas and Whoqol scales, the TOL and STROOP for the measurement of executive functions, the attentional matrices for visual-spatial attention, the Raven for general cognitive skills.

No difference emerged between the diagnoses regarding the presence of symptoms of the autism spectrum, which affects 64% of subjects. Logistic regression showed that the severity of symptoms measured as BPRS and PANSS predicted the probability of having autistic traits. Bayesian regression showed that specific autistic traits are indicative of executive functions deficits. Namely, motor impairment severity measured at RAADS is strongly predicted by rule violation with number of correct moves measured at TOL. The other executive functions seemed to be only moderately linked to autistic traits.

These results provide new information about the expression of comorbidity with autism in psychiatric patients.

Parkinson’s disease has long been considered as a neurodegenerative disorder of pure motor expression. Motor dysfunction in Parkinson’s disease and other parkinsonian disorders is frequently accompanied by nonmotor signs and symptoms, including cognitive impairment, apathy, anxiety, and depression. Among psychiatric disorders comorbid with Parkinson’s disease, depression is probably the most important in terms of frequency and impact.

The aim of this presentation was to illustrate the importance of considering depressive symptoms in patients with Parkinson’s disease.

A case report describing a patient with depressive symptoms in a patient with Parkinson’s disease and literature review.

We report a case of a 57-year-old woman who presented symptoms of Parkinson’s disease for two years. She was treated with Benserazide (Madopar). She was referred to our department for depressive symptomatology. The patient suffered from fatigue, insomnia, loss of sexual desire, sadness, anhedonia, and social withdrawal during the last three months. The diagnosis of depression was not immediately retained. Finally, a major depressive episode was diagnosed. Fluoxetine (20mg per day) was prescribed with clinical improvement.

The diagnosis of a depressive episode is most often complex, due to an overlap symptomatic of both disorders. The depression comorbid to Parkinson’s disease because of its frequency and impact, requires specific identification and management early.

People followed at the department of psychiatry have a high prevalence of somatic pathologies that are generally not taken optimal care of in time, which implies excess mortality rate among these patients.

To study somatic comorbidities in patients followed at the department of psychiatry of the regional hospital of Gabes (Tunisia).

We conducted a retrospective, descriptive and analytical study carried out on a clinical population who consult for the first time at the psychiatry department at the Gabes regional hospital during the period from January 1st, 2010 to December 31, 2013. Sociodemographic, clinical and therapeutic data of the patients were assessed. Data were analysed using the software SPSS (20th edition).

The number of patients consulting for the first time at the psychiatry department during the study’s period was 1601 patients, with a mean age of 34 years and a sex ratio (M / F) of 0.96. Among these patients, 399 (24.9%) had somatic comorbidity. The most common somatic comorbidity was arterial hypertension (8.1% of patients, n=129 patients). Diabetes mellitus was ranked second with 99 patients (6.2%). The analytical study showed that depressive disorders were significantly more frequent in patients with hypertension (p<0.001), diabetes mellitus (p<0.001) and asthma (p=0.026).

Somatic comorbidities were frequent in patients followed by the department of psychiatry. Paying attention to somatic comorbidities must be part of the evaluation of these patients in order to coordinate effectively with the somatic doctors.

The dual diagnosis among patients with primary psychotic disorders is frequent and causes diagnostic and treatment challenges. In clinical practice, differentiating between substance-induced psychoses and independent (primary) psychoses when the patient is actively using drugs of addiction, is difficult, especially in the acute phase of the psychosis.

The aim of the study is to identify clinical data relevant for differentiating between primary psychoses triggered by addictive drug misuse and substance-induced psychoses, using psychometric scales.

The study was conducted on 111 patients divided in four samples: 28 dual diagnosis psychotic patients (DD), 27 bipolar patients (BD), 25 schizoaffective patients (SCA) and 31 patients with schizophrenia (SCZ). The subjects were assessed using scales for the severity of psychiatric symptoms, cognitive functions and social acuity (theory of mind): BPRS-E (Brief Psychiatric Rating Scale – Expanded), MoCA (Montreal Cognitive Assessment), CBS (Cambridge Behavioral Scale), and RMET (Reading the Mind in the Eyes Test). The tests were performed when patients were in the remission phase of the psychosis.

BPRS-E scores showed significant differences between DD subjects and patients from the other three samples (primary psychoses). CBS revealed significant differences between the DD subjects and patients with schizophrenia spectrum psychoses (SCA and SCZ). RMET identified significant differences between DD and BD patients.

Although differentiating between substance-induced and primary psychoses remains a difficult task, social acuity assessment performed in remitted patients may be helpful in guiding the clinician to establish a more accurate diagnosis.

Acute traumatic injuries in children are diverse: skeletal trauma, traumatic brain injury (TBI), spinal injury (SCI), amputations, combined trauma and others. Severe injuries lead to severe disability and desadaptation of the child. It is known that children tolerate hard the awareness and acceptance of their new state.

To study emotional disorders after traumatic injuries in children at early stages of rehabilitation.

159 children up to 18 y.o.: 80 (TBI), 60 (SCI), 19 (amputation, skeletal injury, electro-trauma). Methods: psychopathological, psychological; scales, questionnaires.

In children after severe and moderately severe TBI, depression was detected in 43% as a consequence of injury and recovery of mental activity. In children with SCI, depression was detected in 48% as a reaction to stressful situation. In children with amputation, severe skeletal injury, electro-trauma depression was in 60%, both as a consequence of organic recovery of mental activity and as a reaction to psycho-traumatic situation. In the acute period, children had comprehensive interdisciplinary rehabilitation. Neuropsychiatrist recommended neuropharmacotherapy with antidepressants from the group of serotonin reuptake inhibitors (sertraline), GABA preparations. For psychological support, gestalt correction techniques were used.

After acute trauma, depression in children occupies a significant place in clinical picture. Genesis of depressive disorders can be caused both by organic damage to brain structures and by reaction to psychotraumatic situation. In order to improve rehabilitation effectiveness, to make patient’s returning to usual living environment easier as well as to improve the quality of life, interdisciplinary approach is needed since early stages of rehabilitation and after.

Anhedonia is an important transdiagnostic phenotypic characteristic of schizophrenia, mood disorders (MD), alcohol use disorder (AUD) and other mental diseases. This Symptom could reflect the neurochemical abnormalities in addictive and affective disorders when the function of reward system is dysregulated (Koob G.F., 2017).

To compare the severity of Anhedonia in clinic of MD and AUD in dynamic of antidepressant therapy

The study enrolled 93 patients under treatment in MHRI Clinics: 45 AUD (F10.2; ICD-10) and 48 MD patients (F31-F34; ICD-10). The evaluation of Anhedonia was provided with the SHAPS modified for clinician administration (SHAPS-C) (Rezvan A., 2014).

Due to statistical analysis, we found the level of anhedonia in the MD group was higher than in the AUD group before the treatment. After four weeks of antidepressant therapy the scrutiny of score difference shows less changes in severity of the Symptom in the AUD group (Table 1) Table 1. Dynamics of Anhedonia in MD and AUD groups by SHAPS-C

Anhedonia in the structure of AUD is less pronounced than in MD, but responds less to antidepressant therapy. The study is supported by RSF Grant no. 19-15-00023 “Clinical features and search of potential biomarkers of comorbidity of alcoholism and affective disorders”.

This article will focus on the case of patient whose disease manifested after episode of dehydration at 16 years of age and within 8 years led to his death. During the eight years of illness, the patient suffered from polymorfic psychotic states accompanied by various types of epileptic seizures, including absence and grand-mal seizures, resistant to drug therapy. In addition, he suffered from multiple motor disorders, skeletal and mimiс muscle atrophy, as well as progressive cognitive decline from very high level of cognitive functions to level of moderate deterioration. Despite repeated evaluations, there was no unequivocal diagnosis of his disorder.

Male, born in 1994, without a known hereditary pathology in the field of neurology or psychiatry. Pregnancy and childbirth proceeded without features and the early stages of cognitive-motor development were marked as normative, with the exception of a single epileptic seizure at the age of 3 years (according to the description of the parents). Until the age of 16, the patient was not under the supervision of a neurologist or psychiatrist, developed on a par with his peers, successfully attended school with high marks in the exact sciences, and went in for sports.

Case report

Case report

A patient is considered with a non-standard course of psychosis and epilepsy, which was accompanied by multiple neurological and psychiatric symptoms.In Israel there are only 13 patients with a resemble clinical picture and there is no diagnosis or group of diagnoses in ICD, DSM or any neulogical classificatin tha can describe his disease.

Depression and anxiety are recognized as common psychiatric complications of stroke, yet little is known about their clinical correlates and their impact on functional outcome.

To assess the prevalence of anxiety and depression during the first year post-stroke; To determine their relationships with clinical and functional variables.

We conducted a cross-sectional study, which included 147 patients, followed for stroke that had occurred over the past year. We used the HAD scale in its Arabic version for screening for anxiety and depression and the modified Rankin scale to assess the degree of disability due to stroke.

Anxiety was detected in 55.1% of patients and depression in 67.3% of them. These emotional disturbances were more common during the first six months post-stroke. Depression was more common among male gender (p=0.003). Older age and more than secondary educational attainment correlated with post-stroke anxiety (p respectively 0.013 and 0.002). Post-stroke anxiety and depression were significantly more common in case of infarcts involving the territory of the Sylvian and the anterior cerebral artery (p respectively 0.01 and 0.001). Depression was significantly associated with the presence of motor deficit on the initial neurological examination (p<0.001) and subsequent neurological sequelae (p<0.001). Anxiety and depression were significant predictors of functional disability during the 12 months post-stroke (p=0.007).

Anxiety and depression impair functional ability after stroke. These data may help identify the patients at greatest risk of poor emotional outcomes and thus help in planning appropriate interventions.

Psoriasis is a chronic skin disease, affecting up to 2-4% of population. The majority of investigations agree that this disease appears to be a result of confluence of genetic, allergenic and emotional factors. There is usually more than one trigger that leads to the manifestation or exacerbation of symptoms. Psychogenic factors are clearly in a pattern here. Some personality traits may lead to instability of the emotional sphere that can act alternately as a cause, then as an aftereffect of exacerbation of the chronic process, forming a so called “vicious circle” of psychosomatic disease.

To discover the impact of escitalopram on the symptoms of psoriasis.

14 patients were diagnosed with psoriasis. All patients underwent psychiatric interviewing and psychological testing (STAI and HADS). The results revealed increased trait anxiety levels among 8 of them with moderate severity of the process according to SCORAD index. 3 cases demonstrated symptoms of clinically expressed and 4 subclinical levels of depression. Escitalopram (10 to 20 mg. daily) was administered along with common dermatologic therapy in these patients.

Patients treated with escitalopram showed a reduction of anxiety and depression tests scores as well as the values some dermatological symptoms such as pruritus.

These preliminary results of 3 months study gives us a hope of successful psychopharmacological treatment of psoriasis in cooperation with dermatologists. Finding intercommunications in pathogenesis of skin and emotional disorders could optimize the treatment and improve patient’s quality of life. The publication was prepared with the support of the “RUDN University Program 5-100”.

In Russia, the prevalence of GERD is 18-46% [Ivashkin V. T., Maev I. V., Trukhmanov A. S., 2011]. GERD leads to a significant decrease in the quality of life of patients, especially with nocturnal symptoms, extraesophageal symptoms (chest pain, persistent cough), and increases the risk of complications such as bleeding from ulcers and erosions, peptic strictures and, which causes the greatest caution, Barrett’s esophagus and esophageal adenocarcinomas

The medical and social significance of the pathology of the thyroid gland and gastrointestinal tract problem is determined by their high prevalence regardless of age, the annual increase in morbidity and the decrease in the quality of life (QOL).

Patients were divided in two groups: patients with GERD; patients with GERD and hypothyroidism. Quality of life was studied using the non-specific (general) SF 36 questionnaire.

The lowest indicators were shown by patients with GERD and hypothyroidism (PF scale - Me 75.00 and 45.00 (p=0.005470), RF scale - 75,00 and 25.00 (p=0.043046), BP scale - 74.00 and 52.00 (p=0.036493), GH scale - 58.00 and 15.00 (p=0.009959)). The second group was more disadvantaged (VT scale - IU 52.50 and 32.50 (p=0.098125), SF scale - 75 00 and 50.00 (p=0.019016), RE scale - 33.30 and 0.00 (p=0.028841), GH scale - 48.00 and 36.00 (p=0.025919).

According to the results, the presence of combined pathology of the thyroid gland and gastrointestinal tract significantly affected the physical and psychological component of health in the studied patients.

Executives functions (EF) are cognitive processes mediating the ability to successfully regulate thoughts and behaviours in order to fulfil a goal. EF impairment has been found both in the Attention Deficit Hyperactivity Disorder (ADHD) and in the Alcohol Use Disorder (AUD). Deficits in EF may have a major impact on patients’ everyday life.

The aim of this study was to evaluate EF in a population with a dual diagnosis of Adult ADHD et AUD. We also evaluated the correlation between EF and the dimensions of quality of life.

For this observational multicentric study, we included patients with AUD starting long-term residential treatment. We used ASRS v.1.1 to screen for Adult ADHD and DIVA to confirm the diagnosis. We assess EF with BRIEF-A. WHOQoL-BREF was used to evaluate quality of life.

Our population consists of 49 patients. Adult ADHD prevalence was 24,49%. Impairment score of all EF explored (Inhibition, Shifting, Emotional Control, Self-Monitoring, Initiative, Working Memory, Planning/Organizing, Organization of materials, Task Monitoring) was higher in patients with co-occuring Adult ADHD and AUD than in patients without Adult ADHD (p<0,001). We found strong negative correlation between Psychological Health and impairment score of Inhibition (p<0,001), Emotion Control (p<0,001), Self-Monitoring (p<0,001) and planning/Organizing (p<0,001). The other dimensions of quality of life were poorly correlated to EF impairment.

The prevalence of Adult ADHD in AUD patients is high. When AUD and Adult ADHD coexist, EF impairment is stronger and quality of life is poorer. Psychological health and EF impairment are strongly associated.

Although schizophrenia and anorexia nervosa are very different disorders, when they occur in the same patient it can be difficult to distinguish whether the alterations in body image are due to psychotic symptoms or correspond to a comorbid eating disorder. It is also relevant to know how they can interact with each other.

Presentation of a clinical case of anorexia nervosa in the context of a patient with a previous diagnosis of paranoid schizophrenia.

Bibliographic review of the relationship between schizophrenia and alterations in the perception of body image by searching for articles in Pubmed.

We present a 48-year-old woman who resides with her mother and a sister. Diagnosed with paranoid schizophrenia and eating disorder. She had previously been admitted to hospital twice. Since 2004, she has been followed up in mental health consultations. The patient reports constant weight changes. A year ago she began to feel overweight and began to restrict her intake and to exercise, having lost 20 kg. She reports psychotic symptoms in the past, that she now denies. Various scales show moderate impact of weight on personal perception of psychosocial adjustment, an impulse to thinness and a significant distortion of body image, perceiving herself as heavier than she is and wishing she was lighter.

In schizophrenia, confusion in bodily experiences and states is not uncommon. The possible interactions between the symptoms of schizophrenia and anorexia nervosa complicate the adequate care of these patients. Further research on comorbidity of these two disorders is necessary.