Migrations are a source of stress for patients, which can have repercussions on their Mental Health. We present the case of a native Senegalese patient who presented a first psychotic episode.

Presentation of a clinical case of an immigrant patient with a psychotic disorder.

Bibliographic review on migration and psychosis by searching for articles in Pubmed.

We present the case of a patient of 20 years, a native of Senegal, who has been living in Spain for 3 months in a shelter home. He has no family or relations in Spain, and only speaks Wolof, presenting serious difficulties in communication with healthcare workers. He came to Hospital with his social worker because strange behaviors had been observed. He presented delusional ideation of self-referential and mystical-religious content, related to “the prophet” and “the need to fulfill a mission”. He also presented auditory hallucinations that he identified as of divine origin, and ordered him to perform behaviors such as picking hairs from the ground and various rituals. He acknowledges cannabis and alcohol use in the previous days. Paliperidone treatment was started. Throughout the admission, he begins to show concern for the state of his relatives in Senegal and the need to send them money.

Multiple studies indicate that migrants are at higher risk of psychosis, specially those from countries where the majority of population was black, according to some series. The challenge lies in understanding the mechanisms underlying this increased incidence, taking into account psychosocial factors such as social isolation and trauma.

No significant relationships.

The detection of the initial prodrome of schizophrenia (SK) before the first episode psychosis remains a major concern in current psychiatric research.

In this paper we aimed to analyse clinical and psychopathological aspects of prodromes leading to first-lifetime psychotic episodes and to highlight the high-risk features in order to establish preventive strategies and to provide early intervention in SK.

This is a retrospective observational descriptive study conducted in the ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry in Bucharest, Romania. We collected data from the medical records of 139 patients previously diagnosed with SK who were admitted to our clinic. For all included patients, diagnoses were recorded according to the DSM-IV TR and ICD-10 classification criteria. Data collected included patient demographics and clinical information. All analyses were conducted using SPSS package.

Of the 139 patients included in this study, 130 patients (93,5%) presented prodromal symptoms. 73 of these patients (52,5%) presented with negative symptoms that were more common in our study in single male patients that had low academic performance and a family history of mental illness, findings consistent with the literature. A decline in social functioning decline was observed in 64 patients (46%) prior to their first admission. 87 patients (62,6%) had a prodromal phase which lasted more than one year.

These findings support the value of early psychopathology in predicting the diagnosis of SK, but clinical guidelines are needed for a more systematic evaluation of the SK prodrome.

No significant relationships.

To examine the relationship between self-esteem and psychiatric disorders in adolescents.

Seventy-six adolescents (mean age: 16.02 years; range: 12-20) treated in an inpatient unit and presenting with DSM-IV psychotic disorder, depressive disorder, anxious disorder, anorexia nervosa, personality disorder, or conduct disorder were compared with a control group of 119 adolescents drawn from a normal population. All the subjects were assessed with the French translation of the Coopersmith self-esteem inventory (SEI).

Self-esteem was significantly higher in the control than in the clinical population (P = 0.0001). Female patients showed significantly lower SEI scores than male patients. Self-esteem increased significantly after 12 weeks in patients with a first psychotic episode who responded successfully to antipsychotic drug treatment. In the clinical group, a history of suicide attempts and sexual abuse was associated with significantly lower SEI scores. Lack of boy- or girlfriend, dropping out of school, and social withdrawal were also associated with lower self-esteem.

The presence of a psychiatric disorder in adolescents is associated with decreased self-esteem. This decrease in self-esteem varies according to the psychiatric disorder. Appropriate treatment can enhance self-esteem in adolescent patients.