The authors have not supplied their declaration of competing interest.

Under contemporary social circumstances, there is a tendency to increasing of amount of persons disposed to addictive behavior (AB) as a mean to remove psychoemotional tension and to solve their significant problems. This tendency raises in patients with neurotic disorders (ND) that influences on clinical manifestations of the pathology and impedes diagnosis and timely care for this category of patients.

To investigate AB in the structure of neurotic disorders (F44.7, F40.8, F48.0).

Assessment of personal addictive status with AUDIT-like tests to detect disorders related to substance and non-substance abuse; 109 patients with ND (main group) and 52 persons without ND (control group) were examined.

It was revealed that patients with ND had significantly higher risk of AB formation (59.73% compared with 21.15% in healthy persons; P < 0.0001). According to the group comparison, in patients with ND levels of AB expression on parameters of “Job” (12.06 points), “Food” (11.98 points), “Internet” (11.10 points), “TV” (8.82 points), “Shopping” (6.59 points) were significantly higher than in healthy persons (9.73; 9.23; 9.00; 7.38; 4.25 points, respectively; P < 0.05). However, levels of keenness on computer were significantly higher in healthy persons (3.48 points) than in patients with ND (2.34 points; P < 0.05). AB connected with substance abuse was not registered in the groups.

The results suggest that the patients use AB in forms of food, Internet, job, TV, shopping dependencies as a subconscious mechanism substituting unsatisfied needs and decreasing motivation-emotional tension under conditions of a frustration conflict.

The authors have not supplied their declaration of competing interest.

The endogenous opiate system (EOS) has been linked to social attachment in classical animal experiments, to addictive disorders (AD) and, more recently, to specific traits of personality through research in genetic polymorphisms and neuroimaging techniques.

To expose the relation between social bonding and AD, via the latest neurobiological findings in the EOS. To propose a theoretical framework which may allow a clinical approach based upon respect and no stigmatization.

Literature review in MEDLINE database with the keywords “opioid”, “polymorphism”, “object attachment”, “addictive behavior”, “personality”.

Polymorphisms in the mu-opioid receptor gene lead to different attachment behaviors in primates. The EOS in humans has been related to pain and placebo effect and recently, to social rejection and acceptance. Thus, some authors talk about “social pain”. Interestingly, the EOS has a role in harm avoidance and in the reward system. These traits of personality (harm avoidance and reward dependence) predispose to AD, and likely, pathological models of social bonding may drive to a need of palliating excessive discomfort originated by an altered opioid function through addictive behaviors. The origin of AD must be focused on the individual vulnerability rather than in the addictive substance/behavior.

The latest findings in the EOS yield concrete evidences that support the classical hypothesis of an opioid nexus between social attachment and AD, and shift the spotlight from the addictive object to the vulnerable subject. This theoretical framework may ease a clinical approach based upon respect and no stigmatization.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Older adults with adrenocortical insufficiency, including Addison's disease (AD), are at an increased risk for developing late-life depression. Treatment of AD with glucocorticoid replacement therapy may exacerbate depressive symptoms and may complicate treatment of late-life depression.

To present a case with algorithm of decision-making in a particular case of glucocorticoid induced depression in patient with syndrome of Addison.

To report a case-study, describing treatment of Addison's disease in LLD.

A case report is presented and discussed, followed by a literature review.

A 77-year-old female, diagnosed with Addison's disease, was referred with persistent fatigue, weakness, weight loss, sleep disturbances, and depressive symptoms over the previous 6 months. She was taken losartan 100 mg/day, zolpidem 10 mg/day, fludrocortisone 100 μg/day, and hydrocortisone 35 mg/day. There was no personal or family history of psychiatric problems. Clinical examination was normal aside from skin hyperpigmentation. After initial minimal dose reduction of glucocorticoids, Addison's disease remained under control. One week later, her depressive symptoms disappeared without administration of antidepressants.

The association between glucocorticoid replacement therapy and late-life depression is not well understood. The current case shows that treatment of glucocorticoid-induced depression in subjects with Addison's disease is achievable by minimal adjustments in glucocorticoid regiment. However, collaboration with endocrinology is of vital importance to prevent an Addison's crisis. Pharmacokinetic dose-finding studies are required to find optimal glucocorticoid adjustment strategy.

The authors have not supplied their declaration of competing interest.

The links between ADHD and SUD are demonstrated in the scientific literature. The existence of dual diagnosis affects both prognosis and clinical-therapeutic assessment.

Describe the general characteristics of a sample of patients with SUD (n = 162) who seek treatment for their addiction, based on the presence of symptomatic contamination by ADHD, compared to a sample of adults (n = 246) without addictive pathology (parents of children with different risk for ADHD).

We assessed using different scales the properties of the sample (visual analogical [general state of health, sadness, anxiety, irritability, suspiciousness], WURS, BDI and Exploratory List of ADHD symptoms).

The average age in the group of parents was 40.59 versus 35.88 on the SUD group, with 42% and 87% males respectively. SUD group presented worse general state, with higher average of sadness, anxiety, irritability and suspicioness, as well as WURS and exploratory symptoms of ADHD, as shown in Fig. 1 and 2.

The SUD group had higher ADHD symptomatic contamination respect to Parents group. These results are preliminary and are pending more thorough analysis as part of a more extensive and complex study, requiring further confirmation in future studies.

The authors have not supplied their declaration of competing interest.

The general data of this sample were presented in “ADHD symptomatic contamination in a Dual Pathology (I): General Analysis of the Sym_Con Sample”. We evaluated the presence of symptomatic contamination by ADHD in a SUD group compared with a group of non-consumers adults (parents of children treated in a CAP unit).

Describe more specifically the peculiarities of the sample Sym_Con according to the type of substance consumption (Alcohol [n = 65], Cocaine [n = 48], Cannabis [n = 49] assessing the presence of ADHD symptomatic contamination.

We use differents Visual Analogical Scales plus the WURS, BDI, and Exploratory Lists of symptoms of ADHD.

As can be seen in Fig. 1 and 2, the subgroup of Alcohol has a poorer “scalar” status with worse general state, more sadness and anxiety, being the subgroup of cocaine the most “suspicious”. The presence of ADHD-symptomatic contamination is more noticeable in the Cannabis subgroup.

ADHD symptomatic contamination in our Sym_Con sample is frequent, being the cannabis subgroup the more contaminated one. More studies that corroborate the results obtained in this sample are required.

The authors have not supplied their declaration of competing interest.

Comorbidity between two or more mental disorders is highly frequent. Depression is one of the diseases that more often accompanies other conditions.

The objective of this study is to establish the prevalence of depression in patients with delusional disorder and describe the treatment used in these cases.

The aim is to provide useful information regarding this frequent, often disregarded, comorbidity.

Our results proceed from the Andalusian delusional disorder case register. We reviewed 1927 clinical histories of patients diagnosed of delusional disorder. Upon having verified the diagnosis, following DSM-V criteria, we recollected several data, including sociodemographic factors, depression comorbidity and antidepressive treatment.

One thousand four hundred and fifty-two patients matched DSM-V delusional disorder criteria. 49,8% of our sample were women. Average following period was 9 years and 1 month, with an average of 0,84 hospitalizations. The prevalence of depression in patients with delusional disorders was 31,9%. 67,5% of them received some kind of antidepressive treatment. The antidepressive drugs most frequently used were selective serotonin reuptake inhibitors.

Depression is a highly prevalent condition among patients with delusional disorder. Most of them are on antidepressive treatment, the most employed of which is based on selective serotonin reuptake inhibitors. Comorbid depression can have an important impact on the course of delusional disorder. A correct diagnosis and treatment should be made to help improve the prognosis and life quality of these patients.

The authors have not supplied their declaration of competing interest.

Patients with anxiety disorders are more vulnerable to develop other comorbid conditions. In particular, large epidemiological studies show a strong association between different anxiety disorders and substance use disorders.

To show the prevalence of major anxiety disorders and the consumption of different substances. As well as the particular characteristics of this dual diagnosis and treatments that have proven more effective.

Exhaustive review of all the material published on this topic in the recent years.

Nearly 24% of patients with anxiety disorder suffer from a comorbid substance disorder use in their lifetime (17.9% diagnosis of alcohol abuse or dependence diagnosis and 11.9% of abuse or dependence on other drugs). Dual patients show a number of distinctive features, such as more frequency in males, family history of alcohol or other substances abuse and behavioral problems, early parental loss among others.

The authors have not supplied their declaration of competing interest.

Dual diagnosis is a growing problem in Western society, despite which there are no large studies examining this issue, nor specific protocols to address them.

To raise awareness of the importance of dual diagnosis both its prevalence and special features that presents need a different performance plan from them separately.

Comprehensive literature review of all published in the last 2 years, as well as the specific features.

Dual diagnosis has very specific characteristics that we must know in order to develop therapeutic strategies adapted to the present conditions.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Epilepsy is a public health problem that often affects personal and social patients’ life. Self-esteem, an important factor contributing to psychosocial well-being, is generally disrupted in epilepsy.

The aim of our study was to assess self-esteem and factors associated in patients suffering from epilepsy.

We conducted a cross-sectional, descriptive and analytic study, including 20 patients followed for epilepsy at neurology outpatient department, Habib Bourguiba hospital, Sfax, Tunisia. We collected socio-demographic and clinical characteristics, and used the Rosenberg Self-Esteem Scale (RSES).

The mean age was 35.9 ans. Sex-ratio (M/F) was 3. Hobby practice was noted in 45% of cases. The disease evolves since 19.9 years on average. A worsening of health in the last year was felt in 30% of cases. The stigma was reported in 30% of patients. Self-esteem was: very low 5%, low 40%, average 40%, and high 15%. It was better among married patients, living in family and those with disease evolving since more than 10 years, but without a significant correlation. The factors correlated with good self-esteem were: practicing a hobby (P = 0.006) and absence of stigma (P = 0.001). Poor self-esteem was significantly correlated with perceived health worsened during the last 12 months (P = 0.02). It was poor in unstable patients professionally, but without significant correlation.

Our study confirms the decline of self-esteem in patients with epilepsy. A better education of these patients to accept their illness, as well as raising public awareness on this affection could facilitate social insertion and improve self-esteem.

The authors have not supplied their declaration of competing interest.

Somatic comorbidities in patients with mental disorders have become an important issue. They complicate therapeutic management and aggravate the prognosis.

Outline the nature of somatic disorders observed in psychiatry and assess the different interactions between psychiatric pathologies and organic diseases.

We conducted a descriptive retrospective study including 60 patients hospitalized in a psychiatry department during 2 years (2013 and 2014). We included patients having presented a somatic disorder at their admission. Data collection was based on psychiatric and clinical observations.

At the admission, somatic examination was abnormal in 53.3% of cases: skin abnormalities 28.3%; blood pressure abnormalities 8.3%. An abnormality of the initial biological tests has been reported in 51.7% of patients: leukocytosis 18.3%; liver test abnormalities 13.3%; hematologic abnormalities 8.3%. The electro-cardiograph was pathologic in 35% of cases. These anomalies have required advices from medical and surgical services: cardiology 33.3%; endocrinology 10%, orthopedics 10%. The relationship between somatic and psychiatric pathology was: a comorbidity: 55%; a side effect of psychotropic drug: 5%; an organic origin of the psychiatric disorder: 6.6% and a somatic disorder secondary to the psychiatric pathology: 10%. In the course of this investigation, 6.6% of patients were transferred urgently to a specialist department, the psychotropic treatment was stopped in 10% of cases, and a therapeutic adjustment was necessary in 6.6% of cases.

Our study confirms the importance of somatic assessment of patients with mental illnesses. This must be a systematic practice in order to detect in time patients at risk of somatic complications.

The authors have not supplied their declaration of competing interest.

Data-driven techniques are frequently applied to identify subtypes of depression and anxiety. Although they are highly comorbid and often grouped under a single internalizing banner, most subtyping studies have focused on either depression or anxiety. Furthermore, most previous subtyping studies have not taken into account experienced disability.

To incorporate disability into a data-driven cross-diagnostic subtyping model.

To capture heterogeneity of depression and anxiety symptomatology and investigate the importance of domain-specific disability-levels to distinguish between homogeneous subtypes.

Sixteen symptoms were assessed without skips using the MINI-interview in a population sample (LifeLines; n = 73403). Disability was measured with the RAND-36. To identify the best-fitting subtyping model, different nested latent variable models (latent class analysis, factor analysis and mixed-measurement item response theory [MM-IRT]) with and without disability covariates were compared. External variables were compared between the best model's classes.

A five-class MM-IRT model incorporating disability showed the best fit (Fig. 1). Accounting for disability improved the differentiation between classes reporting isolated non-specific symptoms (“Somatic” [13.0%], and “Worried” [14.0%]) and those reporting more psychopathological symptoms (“Subclinical” [8.8%], and “Clinical” [3.3%]). A “Subclinical” class reported symptomatology at subthreshold levels. No pure depression or anxiety, but only mixed classes were observed.

An overarching subtyping model incorporating both symptoms and disability identified distinct cross-diagnostic subtypes. Diagnostic nets should be cast wider than current phenomenology-based categorical systems.

Figure not available.

The authors have not supplied their declaration of competing interest.

Pediatric bronchial asthma as a chronic airway inflammatory disorder has a significant impact on asthmatic children both biologically and psychologically. On the other hand, parental stress and depression has been linked to pediatric asthma and claimed to play an important role in its morbidity.

Assessment of pediatric asthma biomarkers as parameters of disease severity in relation to mental disorders of an Egyptian sample of asthmatic children and their caregivers.

The current cross-sectional study comprised 60 Egyptian asthmatic children as Group I and 35 clinically healthy children of comparable age and sex as Group II. Thorough clinical evaluation and psychometric assessment were carried out for all enrolled children and their caregivers. In addition, pulmonary function testing and measurement of esinophilic count, IL-5, and total IgE were carried out for children of both studied groups.

Enrolled asthmatics had significant elevation of all studied asthma biomarkers with significant reduction of measured pulmonary functions compared to controls. Furthermore, asthmatics had significantly more encountered poor self-esteem, clinically manifest anxiety, and psychosocial impairment compared to controls. Meanwhile, parents of studied asthmatics had higher frequency of severer grades of clinically manifest isolation, anxiety, depression, and stress. Strikingly, the severer the asthma, the more the elevation of studied asthma biomarkers, the severer the asthmatic child's and caregivers’ anxiety and depression, and the more the caregivers’ isolation and stress.

Pediatric asthma biomarkers as parameters of disease severity has been proven to be linked to mental health impairment of asthmatic children and their caregivers.

The authors have not supplied their declaration of competing interest.

It's not easy to choose between different antipsychotics in the treatment of patients with schizophrenia that use drugs of abuse both legal (alcohol, benzodiazepine, anticholinergics) and illicit (heroin, cannabis, cocaine). The use of substances is a powerful risk factor for poor outcome. From CATIE study, we know that the discontinuity is lower with Olanzapine but psychotic patients continue to take drugs of abuse despite medication. Probably, an important aspect is the anhedonia secondarily produced by neuroleptics.

We want to evaluate if Paliperidone Palmitate reduces addictive behaviors in a small group of psychotic patient who have agreed to recived injection after the switch from other antipsychotics.

We have identified four individual with chronic use of drugs of abuse in a Mental Health Center. These subjects were abusing alcohol, cannabis, spice and benzodiazepine. We administered before new treatment and after 2 months the Snaith-Hamilton Pleasure Scale of Snaith et al. (1995) and the Leeds Dependence Questionaire of Raistrick et al. (1994).

The hedonic tone tends to improve and the addictive behavior decreased.

The therapy with Paliperidone Palmitato is associated with a reduction of the addictive behaviors but we need studies with a larger number of patients.

The authors have not supplied their declaration of competing interest.

Only few international studies have focused on mental diseases among the hearing-impaired population. However, Fellinger et al. (2012) underline the high discrepancy between the current and future demand of mental treatment and the simultaneous impeded access to health care.

The aim of this multicenter project is to conduct the first analysis of mental diseases among the hearing-impaired population in Germany in order to quantify and qualify the specific demands of treatment.

In order to achieve this aim, we compiled an extensive questionnaire battery.

This questionnaire battery measured sociodemographic data, non-verbal intelligence, quality of life, perception and suffering from stress, psychosomatic symptoms as well as personality traits.

Our three samples consisted of 21 hearing-impaired patients with a history of mental diseases (EG-HI), 21 hearing-impaired subjects without mental diseases (CG-HI) and 21 hearing participants without any psychological disease (CG-H). Compared to the two control groups, the EG-HI shows significantly higher rates in different fields, i.e. participants perceive a lower quality of life, suffer from more psychosomatic symptoms and show more pronounced personality traits. The two control groups did not differ significantly from each other.

Certain psychological characteristics among hearing-impaired patients can be detected which need to be accounted for in treatment. Furthermore, a hearing impairment is not inevitably linked to a reduced quality of life or even mental disorders. Therefore, future research should focus on risk factors and protective factors which could prevent mental diseases among the hearing-impaired population.

The authors have not supplied their declaration of competing interest.

Stuttering is a speech disorder characterized by involuntary repetition, prolongation or cessation of a sound. This dysfluency may be developmental or acquired. Acquired dysfluency can be classified as neurogenic or psychogenic.

This case report aims to describe and discuss a case of psychogenic stuttering, providing an updated review on this disorder.

In and outpatient interviews were performed by Neurology and Psychiatry. Investigation to exclude organic causes included lab exams, electrocardiogram, electroencephalography, computed tomography scan and magnetic resonance imaging. A literature review in Science Direct database, with the keywords “psychogenic stuttering”, was also conducted.

A 63-year-old man was admitted to the Beatriz Ângelo Hospital with an acute stuttering. Speech was characterized by the repetition of initial or stressed syllables, little affected by reading out loud or singing. Comprehension, syntaxes and semantic were not compromised, as weren’t sensory and motor abilities. During admission, stuttering characteristics changed. Multiple somatic complaints and stress prior to the onset and bizarre secondary behaviors were also detected. Work-up didn’t show an organic etiology for that sudden change. An iatrogenic etiology was considered, as sertraline and topiramate were started for depression 1 month before. However, the stuttering pattern, the negative results, the psychological and the social life events suggested a psychogenic etiology.

Psychogenic stuttering finds its origin in psychological or emotional problems. It is best classified as a conversion reaction. The differential diagnosis between psychogenic and neurological stuttering can be challenging.

The authors have not supplied their declaration of competing interest.