There is a high comorbidity between psychiatric disorders and juvenile myoclonic epilepsy (JME), observed in up to 58% of these patients; specifically, mood disorders, anxiety and personality disorders (PD). In some patients with PD there are nonspecific alterations in the EEG, which nevertheless sometimes involve pathology. The presence of personality disorders along with JME has been repeatedly described. Previous studies have emphasized the difficulties in treating patients with JME, which have been attributed to some specific psychiatric, psychological and psychosocial characteristics.

Describing distinctive personality traits in JME

Review of scientific literature based on a relevant clinical case.

19-year-old woman, single. Psychiatric history since she was 12 due to anxiety-depressive symptoms, after being diagnosed with JME. 4 admissions in Psychiatry, with a variety of diagnoses: eating disorder, attention deficit hyperactivity disorder and borderline personality disorder. The evolution of both disorders has been parallel, presenting epileptic seizures due to irregular therapeutic adherence together with pseudo-seizures, which made difficult their differential diagnosis. In addition, he has had frequent visits to the emergency room for suicide attempts and impulsive behaviors.

In 1957, for the first time, distinctive personality traits were described in patients with JME: lack of control and perseverance, emotional instability, variable self-concept and reactive mood, which have been confirmed in subsequent studies. It is believed as epilepsy progresses, patients tend to develop symptoms of depression, anxiety, social problems, and attention deficit. Therefore, these patients have difficulty in following medical recommendations, especially precautions regarding precipitating factors for seizures.

No significant relationships.

A debate regarding the comparative efficacy and tolerability of oral and long-acting injectable antipsychotics (LAIs) in patients diagnosed with schizophrenia is still open in the mind of clinicians. While the adherence is intuitively improved by the LAIs, the acceptance of this treatment is not always good.

To conduct a literature review in order to find the data about the comparative efficacy of oral and LAI antipsychotics in schizophrenia, during the maintenance phase.

A literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE) using the search paradigm “schizophrenia” AND “maintenance treatment” AND “oral antipsychotics” OR “long-acting injectable antipsychotics”. All papers published between January 2000 and August 2021 were included.

Based on the reviewed clinical trials (n=37), LAI antipsychotics are associated with an efficacy and tolerability profile similar to or slightly superior to the oral formulation. This is confirmed for both typical and atypical antipsychotics that have been detected by this review. The main advantage of the LAIs is their superior therapeutic compliance and the possibility of early detection for non-adherent patients. However, not all data are unanimously supporting this perspective: while observational trials favor LAI antipsychotics, randomized trials included in the meta-analyses do not detect significant differences between the two types of formulations.

LAIs are associated with superior adherence, but their overall efficacy and tolerability are only slightly superior to those of the oral equivalents. Moreover, there are differences in the results related to the methodology of the trials, therefore data should be interpreted with care.

No significant relationships.

The Diabetes Mellitus is a chronic disease whose treatment requires strict clinical care and continuing education such as medication, nutrition and physical activity. Education is a decisive factor in preventing complications that may arise from the failure of therapy. Therefore, the therapeutic adherence must include a psycho-social approach.

To study the degree of adherence to the pharmacologic treatment and dietary habits in patients with type I and type II diabetes mellitus and to evaluate the influence of the level of education, sex and type of diabetes.

A cross-sectional study was conducted of the descriptive-correlational type. The sample consisted of 100 diabetic type I and type II individuals and was obtained by convenience at the health center of S. Martinho do Bispo, in Coimbra - Portugal, during the period from May till June 2009.

The results indicate a high adherence to therapy, reflected trhough the diet and also the pharmacological treatment. However, the higher adherence found was related to prescription of medication. The demographic variables such as sex and level of education of patients, seem to positively influence the adherence to treatment.