Folie à deux or induced psychotic disorder is a rare psychiatric illness and was first described in the 19th century. The essential feature is a psychotic disorder shared by two emotionally close persons, usually a blood relative or spouse, while living in relative isolation. The disorder is characterized by a primary psychotic person, usually older, more intelligent and better educated who gradually imposes her delusional beliefs on the other person, who is often dependent on or submissive to the person with the psychotic disorder. The disorder usually resolves in the more passive person when the two are separated.

To describe two case studies of two couples who shared psychotic illness and make a review of the literature.

Search in the PubMed/MedLine and Medscape databases with the following key words: folie à deux; shared psychosis; shared delusion.

Even though Folie a deux is rare to diagnose, clinicians should be aware of this condition, since it is tremendously important to treat properly both people involved.

Toxic psychoses are growing problem in every-day clinical psychiatric practice. Well-known is fact that use of psychoactive substances, particularly stimulants and cannabis, is associated with psychotic mental disorders.

Differences between psychopathology of schizophrenia and toxic psychotic states are not clear.

To compare psychopathology of patients treated with schizophrenia and toxic psychosis.

Patients with schizophrenia who only temporally used psychoactive substances and patients with non-alcoholic toxic psychoses treated at Psychiatric Clinic of FMUC and UHB in interval of years 2006–2010 were enrolled in present study. Retrospective analysis of demographic and clinical characteristic, especially psychopathological symptoms was conducted.

The authors collected data from medical records of 93 patients treated with non-alcoholic toxic psychoses (TP; 86,0% males, 14,0% females) and 80 patients treated with schizophrenia who only temporally used psychoactive substances (SCH; 93,7% males, 6,3% females) (Tab. 1). Toxic psychotic state was induced mostly by more substances, stimulants and cannabis.

The most frequently observed clinical picture in toxic psychoses was paranoid-hallucinatory syndrome. In schizophrenia group was most prominent paranoid form. The authors found and discussed differences between psychopathology in both groups. It seems to that a more specific description and classification of toxic psychoses could be possible.

Brief Psychiatric Rating Scale (BPRS) is a widely used outcome measure to assess 24 different psychiatric symptoms. For several reasons it is important to study psychiatric subsyndromes instead of investigating separate symptoms because these subsyndromes may point to a common neurobiological pathogenesis or may have similar treatment.

The focus of the present study was to determine the factor structure of the BPRS for psychiatric inpatients with different diagnostics. The aim of this study was to detect subscales of the 24-item BPRS that could bring some relevant information to sustain the daily practice.

Factor analysis of symptom ratings recorded on the BPRS for a sample of 139 inpatients, during the first week of hospitalization at the department of Psychiatry of HUC between April 2010 and September 2011. Principal component analysis (with Varimax rotation) was used for factor analysis.

The results of the exploratory factor analyses obtained eight factors, which explained 73,225% of the variance in the data. The first factor represents 19.511% of the total variance, and the other seven factors represents, respectively, 13.069%, 10.938%, 7.995%, 6,491%, 5,524%, 5,094% and 4,603%.

Results showed the presence of eight subscales. This study provides additional evidence of the existence of subsyndromes in psychiatric disorders which can give insight into possible relationships between individual symptoms and their underlying pathogenesis.

Traditional classifications confuse etiologic factors with symptomatic ones, making it difficult to treat psychosis.

Traditional and Henri Ey's classifications of mental illness are discussed. And the theory of neo-organo-dynamism is proposed.

The acute phase of disease may only be a temporary modification of the basic mental illness and the nature of the latter can be expressed in terms of the depth of the organic degeneration. The psychotic state consists of the basic disorder and its acute aggregative phase that is in proportion to the degree of abnormal neuronal excitations. In my classification, mental illness is classified from a normal stage N or N+ to a stage X and the degree of acute aggravation is staged from 0 to 7. By applying this classification to diagnosis, we can accurately represent the conditions of psychiatric patients that change organo-dynamically over time. At the same time, clinical comparative research, such as the effects of medicine and of biochemical changes becomes possible. The principle of the accessory pathway is also proposed. Mental pressures or ritual acts promote construction and the reorganization of neural network, and it is fixed by repeating itself. Coding to the subconsciousness of a new neural network namely bypass will be made, and it is immobilized as an accessory pathway like the bundle of Kent of the Wolff-Parkinson-White syndrome.

The theory of the neo-organo-dynamism is proposed as a minimum clinical classification of mental illness for psychiatrists.

Highly structured interviews have become the gold standard of diagnostic interviewing, primarily in research but are also increasingly used in the context of routine clinical assessment. Discussions of the foundations of psychiatric interview usually deal with efficacies (sensitivities, specificities) and reliabilities of particular interview approaches. They fail to address more overarching theoretical concerns such as; the adequate manner of obtaining the psycho-diagnostic information. There is an important gap in the psychiatric literature concerning the being and nature of symptoms/signs in psychiatry, and a lack of an adequate epistemiological approach to psycho-diagnostic interviewing that is both theoretically coherent and reflecting practical-clinical reality.

The aim of this presentation is to address the main theoretical and clinical aspects of diagnostic psychopathological interviewing.

For the sake of illustration, we will contrast two types of interviewing: 1) a fully-structured psychiatric interview, conducted by a “for-the-purpose” trained non-clinician and 2) a conversational, phenomenologically oriented, semi-structured interview conducted by an experienced, reliability-trained clinician. Various aspects of the psycho-diagnostic interview such as; individualizing the interview approach to the patient, the characterization of symptom/sign in psychiatry, the knowledge and experience of the interviewer and the implications of converting subjective experiences into words.

The theoretical and clinical aspects of the diagnostic psychopathological interview addressed here, imply that the fully-structured interview is not a suitable and theoretically coherent way of obtaining psycho-diagnostic information, and could result in misdiagnosing.

The contemporary methodology in obtaining psychopathological information relies almost exclusively on the use of structured questionnaires and interview schedules. These interviews yield high interrater reliability and reduce cost. The assessments of anomalous self-experience and of mental status (disorders of experience and expression) are often considered as “soft”, “subjective” and hence unreliable. In spite of the advantages of the structured interviews, concerns have been raised about the epistemiological coherence and the validity of the structured interviews.

To examine the interrater reliability between experienced clinicians with a semistructured, phenomenologically-oriented psychopathological interview assessing anomalous self-experience and mental status.

Seventeen inpatients were interviewed by one of the raters, with both raters were present. The interview comprised of a thorough psycho-social history and the EASE-scale.

The interater-reliability for the total EASE-scale showed nearly perfect agreement with kappa = 0.94. The interrater agreement for the MSE assessment showed substantial to complete agreement with kappas above 0.81, except for four items: “Withdrawn/shy” (kappa = 0.77), “Suspicious, guarded and hostile” (kappa = 0.77), “Raport insecure and anxious” (kappa = 0.76), “Restless” (kappa = 0.64).

High interrater-reliability can be achieved for the asssessment of anomalous self-experience and mental status in the context of conversational, phenomenological-oriented, semi-structured interview. This is an important finding because these dimensions of descriptive psychopathology are often considered unreliable, and therefore rarely studied.

Non-schizophrenic delusional pathology although it is known and accepted in current nosologies(persistent delusional disorders), it is yet considered by many authors as a part of paranoid schizophrenia.

The assessment of clinical status of a sample of subjects with paranoid schizophrenia compared with a sample of subjects with persistent delusional disorder after an average of 10 years of evolution using BPRS scale.

To highlight the differences between symptoms in the two types of pathologies after long-term development.

The application of BPRS scale on a sample of 60 subjects with a diagnosis of persistent delusional disorders and a group of 40 subjects with a paranoid schizophrenia diagnosis - these diagnoses were maintained during the last 5 years of evolution - and the comparison between the scale items mean values of the two samples.

Significant differences were observed in social withdrawal items, emotional bluntness, mannierisms, postural attitudes, as well as hallucinatory behavior that were more intense in the paranoid schizophrenia group and in depressed mood items and guilt feeling were more pronounced in the group with persistent delusional disorder.

Although paranoid schizophrenia can be defined only by the presence of a delusional hallucinatory constellation, a careful analysis of the cases reveals after a long evolution period the presence of negative and disorganized symptoms that should not be found in the delusional non-schizophrenic symptomatology.

Schizophrenia and delusional disorders are diagnosed at 231 (77%) by patiennts, affective disorders with psychotic symptoms -at 19 (6,3%), psychotic organic mental disorders - at 31 (10,4%), psychotic disorders connected with the use of alcohol - at 19 (6,3%). The mystical delusion came to light in 74 (24,7%) supervision, mesianic delusion - in 65 (21,7%), delusion of religious reforms - in 14 (4,7%), delusion of sin - in 34 (11,3%), delusion of witchcraft - in 64 (21,3%) and delusion of possession - in 49 (16,3%). It is established, that specificity of a RADC is determined by presence in structure of syndromes reflecting deep disorder of mental activity (hallucinatory-paranoid syndrome, paraphrenic syndrome, syndromes of aberration of consciousness), the delusional behavior, and representing social danger.

A debate of differential diagnosis and possible presentations of anorexia nervosa, autistic spectrum disorder, simple schizophrenia, obsessional slowness, catatonia in an adolescent patient.

Study case, close and thorough observation and monitor of the patient while an inpatient on a CAMHS ward, being involved a multidisciplinary team and literature search. Description of symptoms and management plan.

A multiple and very rare psychopathology in adolescents.

Only four similar cases have been described in the literature.

The case is based on a study case of a 14 year old patient from a CAMHS ward. The patient has a 5 year history of deterioration of mental state, initially presenting with anorexic symptoms, which gradually developed into a full picture of obsessive - compulsive disorder, simple schizophrenia with right sided body neglect, catatonia, psychomotor retardation, bizarre behaviour (walking in circle, smearing of faeces).

The patient was closely monitored and assessed by psychologists, speech and language therapists, neurologists, endocrinologists.

The catatonic symptoms had a very good response to Lorazepam, but unfortunately on discharge patient had residual obssessional slowness and obssessive compulsive disorder like symptoms, which gives a dilemma to the diagnosis and treatment.

Penn State Worry Questionnaire (PSWQ) is an appropriate instrument for assessing of worry. Worry is the cognitive component of anxiety. It has a positive correlation with severity of the anxiety disorders. Preparing PWSQ and its psychometric index was necessary for Iranian students.

The aim of this study was to assess factorial structures, validity and reliability of Pennsylvania State Worry Questionnaire.

The English version of the questionnaire was translated into Persian with the standard procedures done for translating Psychological tests. 272 second grade high school students were selected by cluster sampling from different educational regions of City of Tehran. They completed PSWQ and principal components procedure by the Varimax rotation used for data analysis.

Exploratory factor analysis showed that PSWQ is a one-dimensional instrument for worry. Validity according to internal consistency coefficients was 0.83. Correlation with metacognition 30 question questionnaire was 0.63 indicating convergence reliability. Correlation with the Spiel Berger Anxiety scale was 0.67, with trait anxiety scale 0.70, with state anxiety scale 0.58. This finding shows that the predictive reliability of the Questionnaire is acceptable.

According to the findings of this study PSWQ have good Psychometrics properties in Iranian population and can be used as a valid measurement in Psychological research.

Kraepelin's nosology found difficulties on diagnosing some psychotic pictures. Leonhard defined them as cycloid psychosis. Despite its clinical relevance, the diagnosis of cycloid psychosis has been neglected in the psychiatric literature and in the current nosological systems.

To present a case study describing a cycloid psychosis and to examine the clinical validity and nosological status of the concept.

The concept, nosological status, diagnostic features, associated clinical characteristics and the etiopathological variables involved in cycloid psychosis are reviewed.

A case report is presented in detail and a literature review is shortly surveyed.

We report a case of a 44-year-old man with no background until 2005 when he went to work in Holland and developed a sudden onset of behavior disturbance with aggressiveness, sexual disinhibition, coprolalia and persecutory delusions concerning his colleagues. He returned to Portugal and was admitted to our department, sleepy and dysarthric. He was treated with low doses of antipsychotic with quick remission of the symptoms. On 2007 he went to work in Spain and developed a clinical picture of behavior disturbance with psychomotor restlessness and sexual disinhibition. As he was admitted to our department, he showed himself perplexed, almost in mutism. Low doses of antipsychotic overtook the symptoms.

Cycloid psychosis is a valid clinical construct that can be differentiated from the boundary disorders on clinical grounds. It's heterogeneous from the etiopathological point of view, in that many factors seem to be involved to a different degree in most of the patients.