It is known that antipsychotic drugs can increase prolactinaemia, we report a case in which the use of aripiprazole after treatment with paliperidone helped regaining normality levels.

During treatment with PALiperidone12 mg/day the patient, a 27-year-old female diagnosed with borderline personality disorder, developed hyperprolactinaemia with galactorrhea and menstrual disorders. During hospitalization, aripiprazole is introduced while paliperidone is progressively decreased. Antipsychotic were prescribed because delusions of reference and auditory pseudo-hallucinations arose suddenly in a woman without history of previous psychotic breaks. Before treatment with aripiprazole, prolactinaemia was 156,96 ng/mL (pregnancy test was negative) and after stopping, paliperidone was 23,60 ng/mL.

If hyperprolactinaemia symptoms appeared (galactorrhea…), aripiprazole is a good option if antipsychotic treatment is required. In this case, paliperidone was decreased slowly, while aripiprazole was increased, until minimum effective dose was reached.

Hyperprolactinaemia is a common side effect in antipsychotic treatments and if symptoms appeared aripiprazole is a good option.

The authors have not supplied their declaration of competing interest.

Delirium is a clinical entity consisting of acute loss of consciousness, with attention deficit and fluctuating evolution. Antidepressive medication can cause these symptoms or worsen them.

We report the case of a 84-year-old blind female who was diagnosed of delirium in relation to intoxication with sertraline. The patient was admitted into a short-stay psychiatric unit for three days. She presented behavioural disturbances consisting in auto and heteroaggressive behaviour, altered consciousness and visual hallucinations (rocks, turtles). When dosage of sertraline was doubled from 50 mg/day to 100 mg/day visual hallucinations started. There were not other medical causes found, so sertraline was suspended, achieving clinical improvement.

This case report shows how a patient with antidepressive treatment can display delirium. The three main causes of delirium that are infections, side effects and methabolic syndrome.

In the case of treating a patient with delirium, the presence of previous illness has to be investigated. It is indispensable to describe the presence of previous illness, medication and recent changes of the dosages in the medical history in a patient with Sertraline.

The authors have not supplied their declaration of competing interest.

We present a clinical case of eruption caused by the use of bupropion. Bupropion is known to cause hypersensitivity reactions.

We report the case of a 48-year-old female who was diagnosed of depressive disorder. She went to emergency because a few days after prescribing bupropion (150 mg/24 h) scaly skin eruptions were found distributed along the skin. In the present case, after its introduction, bupropion was found to be a probable etiological agent. The patient was successfully treated with corticosteroids. Because of that, bupropion dosage was stopped and replaced with fluoxetine. No remissions and exacerbations were noticed in a month's follow up.

In this case report, we present a patient with an eruption related to bupropion. The aetiological spectrum of eruption include drugs, infectious agents and food additives. Drugs attributing eruption include nonsteroidal anti-inflammatory drugs, antibiotics, and anti-epileptic drugs, antidepressive medication amongst others.

No specific diagnostic criterion exists for eruption and the diagnosis is purely based on clinical presentation. Diagnostic features, which suggest eruption, are the acute onset (or recurrent nature) and skin lesions.

The authors have not supplied their declaration of competing interest.

Intramuscular paliperidone palmitate is a long-acting atypical antipsychotic, which has only been marketed in Romania from march 2015 as a free of charge medication/subsidized for the acute and maintenance treatment of schizophrenia in adults.

To determine the efficacy and tolerability of paliperidone palmitate in 12 patients with schizophrenia in an outpatient care unit, taking into account the limited clinical experience with this product in Romania.

The study was performed in an outpatient care unit. Data was collected from medical records of patients started on paliperidone palmitate between March and June 2015. This time period was selected because we wanted to have at least a 6-month period of evaluating these patients. Some of the patients were previously on risperidone long-acting injection (in Romania the advantages of a 1-month injection instead of 2 and the fact that the medication does not need to be held in a refrigerator are 2 important factors that can increase the compliance of the patients). Others were treated with other long-acting antipsychotics (flupentixol). The rest were patients treated before with risperidone, with good response, but with problems of non-compliance.

None of the patients treated with paliperidone palmitate relapsed. Some of them had, at maximum dose, minor extrapyramidal symptoms that disappeared when we lowered the dose. Taking into account the lack of insight and the non-compliance of patients with schizophrenia, this treatment seems to be extremely valuable, maybe more in this kind of cases, in outpatient care units.

The authors have not supplied their declaration of competing interest.

Nutrition interventions are critical for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). As mental health teams evolve to incorporate nutrition interventions, evidence needs to guide clinical practice.

A systematic review and meta-analysis was performed to assess whether nutrition interventions improve:

• – anthropometric and biochemical measures,

• – nutritional intake of people experiencing SMI.

To evaluate the effectiveness of a dietician-led nutrition intervention, as part of a broader lifestyle intervention, in the early stages of antipsychotic prescription.

An electronic database search was conducted to identify all trials with nutritional components. Included trials were pooled for meta-analysis. Meta-regression analyses were run on potential anthropometric moderators. Weekly individualised dietetic consultations plus group cooking classes were then offered to clients attending a Community Early Psychosis Programme, who had recently commenced antipsychotics for a 12-week period.

From pooled trials, nutrition interventions resulted in significant weight loss (19 studies, g = –0.39, P < 0.001), reduced BMI (17 studies, g = –0.40, P < 0.001), decreased waist circumference (10 studies, g = –0.27, P < 0.001) and lower blood glucose levels (5 studies, g = –0.37, P = 0.02). Dietician-led interventions (g = –0.90) and trials focussing on preventing weight gain (g = –0.61) were the most effective. The 12-week nutrition intervention resulted in a 47% reduction in discretionary (junk) food intake (P < 0.001) and reductions in daily energy (–24%, P < 0.001) and sodium intakes (–26%, P < 0.001), while improving diet quality (P < 0.05).

Evidence supports the inclusion of nutrition interventions as part of standard care for preventing weight gain and metabolic deterioration among people with SMI.

The authors have not supplied their declaration of competing interest.

In this article, a case who was prescribed duloxetine (30 mg capsule) upon the fibromyalgia diagnosis by a physical therapist and had acute dystonia and dyskinesia after approximately 1.5 hours from duloxetine intake shall be presented.

It was learnt that a married female patient aged 38 consulted a physical therapist with the complaint of back pain and duloxetine (30 mg capsule) was prescribed. It was reported that, the patient applied to our hospital with the compliant of involuntary movements around the mouth, on the lips and neck, spasm, inability to open the mouth completely, spasm in jaw, gritting teeth, mumbling and aphasia after approximately 1.5 hours from her duloxetine intake. The patient was conscious. Her psychomotor activity was natural. As a result of cranial MR, EEG, BT examinations hemogram and the routine biochemistry examinations, any abnormality in zinc and iron levels was not detected. Complaints of the patient regressed after 1 hour from the discontinuance of duloxetine and the administration of biperiden 5 mg/mL ampoule 1000 cm3 in SF. After 72 hours, any symptoms were not found.

Dopamine neurotransmission can be inhibited through the increase in serotonin and norepinephrine. Additionally, dystonia may originate from the prevailing of noradrenaline as a result of the failure of dopaminergic–noradrenergic balance.

The author has not supplied his/her declaration of competing interest.

To evaluate the clinical curative effect of risperdal merger An Nao Wan for schizophrenia.

Screening a mental health center in the first half of 2012 hospitalized patients with schizophrenia, which alone give risperdal or merger An Nao Wan give risperdal with 28 days treatment cycle, were as a clinical observation objects. Efficacy was assessed using symptoms scale (PANSS), evaluation of adverse reactions was with side effects scale (TESS). And through collecting the clinical data, related testing results, the daily detailed medical records to record adverse reactions.

Fifty cases of screened 427 patients meet the conditions, including 11 cases with risperdal merger An Nao Wan, and 39 cases only used risperdal. All of 50 cases after two weeks treatment, the symptoms were down significantly (P < 0.01). The adverse reactions rate of patients only with risperdal was 53.8%, of patients with risperidone merger An Nao Wan was only 27.3%.

Risperdal merger An Nao Wan can improve the therapeutic effect of risperidone, short the recovery time of schizophrenia, prevent the adverse reaction of psychotic drug, also improve the safety and patient drug compliance.

The author has not supplied his/her declaration of competing interest.

Hospitalization is fundamental in the treatment of severe psychiatric disorders, at present and in the past. The Psychiatric Hospital “Ntra. Sra. Del Pilar de Zaragoza”, established in 1425, is one of the most ancient hospitals and with longest history of the country, one of the first centers to start considering as demented persons as another sick patient. This paper describes the sociodemographic and clinical characteristics of the patients admitted to the psychiatric hospital between 1912 and 1915.

We developed a descriptive research, using secondary information sources (clinical histories) of patients hospitalized between 1912 and 1915. For data analysis was used software SPSS 10.

We reviewed 110 files and the most common diagnoses were senile dementia and manic-depressive psychosis. The mean of age was 42 years, and the predominant marital status was the single status (47%). We documented that in more than 60% of the cases, the precedence of the patients was from rural zone. El 75% of the patients had remained hospitalized during several years until their death. Only the 10% were discharged for improvement.

It is important to understand the socio-economic variables of the female patients from a century ago to be aware of the evolution of psychiatry and psychiatric treatment and consequently of the profile of current patients.

The authors have not supplied their declaration of competing interest.

Perinatal mental illness is one of the most frequent complications of pregnancy and the postpartum period. During the puerperium, the risk of developing a mental disease, such as a psychotic episode, is higher than in any other time in a woman's life.

The two main objectives are to describe a case series of 4 patients diagnosed with pospartum psychosis, and to synthesize the most important facets of this mental illness based on a literature review.

The aim is to provide an overview of the clinical and epidemiological aspects of postpartum psychosis.

The four clinical cases are presented by describing the similar as opposed to the differential aspects between all patients, using the information obtained through successive clinical interviews and the case file. Research was accomplished through Clinical Key and PubMed (2005-2015) using the keywords: postpartum psychosis.

In all four cases, the patients developed symptoms of sleep disturbance, mood fluctuation, altered thinking process with delusions or obsessions, and bizarre behaviours. This occurred within the first four weeks after labour, which was in all cases an obstrutced labour. The data suggests that postpartum psychosis is a presentation of bipolar disorder. Clinical aspects and risk factors related to this perinatal complication all coincide with the cases presented.

Postpartum psychosis is a rare presentation of perinatal mental illness. However, it presents itself, as a psychiatric emergency, and the early and correct assessment are crucial to reset the development of the mother–child bond.

The authors have not supplied their declaration of competing interest.

This study is designed to investigate the relationship between first-time-mother postpartum parenting education and its effectiveness on the quality of mother–infant interaction and in turn, sense changes of parenting competence.

Eighty-one healthy first-time-mother infant dyads were recruited. The control group (n = 40) received normal postpartum care, being the medical and cultural norms practiced in Taiwan. The experimental group (n = 41) received extra education by way of a 40-minute videotape on infant states, behaviors, communication cues, and a handout about play practices. Data was collected at five time periods: around first week, followed by the first, second, third and sixth month after birth. Assessment scales used for this study were the Chinese Version of the Parenting Sense of Competence Scale (C-PSOC), the Edinburgh Perinatal Depression Scale (EPDS), and the Nursing Child Assessment Teaching Scale (NCATS), in order to score videotaped mother-infant interactions.

The results of the study between these two groups showed that there was an increase in the quality of mother–infant interaction within the experiential group. In addition, it was found that at the five points of assessment, there were no significant sense changes of parenting competency and no significant differences in postpartum depression. For all subjects, there was a correlation between postpartum depressions, competency in parenting, and quality of mother–infant interaction.

Study results prove that first-time-mothers in Taiwan who are provided extra educations about infant abilities, as well as how to effectively play with babies, are likely to witness an improvement in interactional quality.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The hormonal imbalance produced by antipsychotics can be detected by symptoms, such as: infertility, acne, hirsutism, sexual dysfunction and galactorrhea. We consider especially important the study of women's diseases, which may develop due to hyperprolactinemia, specifically: breast cancer, endometrial cancer and osteoporosis.

To undertake a systematic review about the relationship between hyperprolactinemia as a result of the treatment with antipsychoticsand endometrial and breast cancer.

An exhaustive search was performed on PUBMED and COCHRANE (from 2006 to 2015).

Fifteen papers were selected including comparative studies, clinical trials and clinical reviews.

With respect to endometrial carcinoma, there is no direct relationship with the use of antipsychotics. However, most papers have suggested that the blood prolactin elevation is a risk factor in the development of endometrial engrossment, which could lead to endometrial hyperplasia, polyps and endometrial cancer. Related to the use of antipsychotics as a treatment for schizophrenic women and breast carcinoma, a significant association was found and this association is strengthened through the interaction of other factors like the fact that women with schizophrenia are less worried about going to the clinical screening reviews in their health centre, smoking, and lower physical activity than healthy women.

Aripiprazolis associated with a low prevalence of hyperprolactinemia. Menopausal women, the obese, and women who smoke receiving antipsychotics that produce hyperprolactinemia have the greatest risk of developing endometrial pathology. Schizophrenic women with hyperprolactinemia due to antipsychotics and loss of motivation to go to screening activities have a greater risk of breast cancer. Sexual dysfunction could be a non-adherence treatment factor.

The authors have not supplied their declaration of competing interest.

The people who maintain close relationships with relatives suffering from addiction to psychoactive substances may become more sensitive to develop a physical, mental and emotional state, similar to an emotional addiction.

The aim of this study is to give a cross-cultural perspective to codependence and reveal the profile of female relatives of addicted persons in Greece and Bulgaria.

Thirty-nine Greek mothers of addicted persons from Greece (Mage = 43.97, SDage = 18.34, all high school graduates), a similar group of forty Greek female participants (32 mothers of non-addicted persons, Mage = 40.97, SDage = 17.22, all high school graduates), and thirty Bulgarian women (all mothers of addicted persons, Mage = 53.55, SDage = 5.58, all high school graduates) were examined with the STAI-state questionnaire, the ZUNG Self Rating Depression Scale and the Questionnaire of Establishment of Codependency.

Results indicated that there are statistically significant differences between the Greek and the Bulgarian female relatives of addicted persons on the scores ofZUNG (MGreek = 51.64, SDGreek = 2.07, MBulgarian = 73.63, SDBulgarian = 4.04) and STAI (MGreek = 53.89, SDGreek = 2.68, MBulgarian = 74.16, SDBulgarian = 4.84), but not for the Questionnaire of Establishment of Codependency. Statistically significant differences in all three questionnaires were found for the groups of Greek mothers of dependent and non-dependent persons (P < .005).

This research suggests that although there is more anxiety and depression reported by the Bulgarian mothers of addicted persons, no cross-cultural difference was found for codependence in mothers of addicted persons.

The authors have not supplied their declaration of competing interest.

Co-dependent relationships are characterized as a type of dysfunctional helping relationship in which there is an excessive reliance on other people for approval and identity. This is very common for female relatives who support/enable another person's addiction, poor mental health, immaturity, and/or irresponsibility.

The aim of the present study is to reveal the co-dependence profile of mothers of addicted persons in Bulgaria.

Four hundred Bulgarian women coming from Blagoevgrad, Sofia and Stara Zagora (Mage = 53.55, SDage = 5.58; level of education: 71% with high school degree, 29%with university degree; all mothers of addicted persons) were examined at the Municipal Council on Drug Addiction Blagoevgrad with the STAI-state questionnaire, the ZUNG Self Rating Depression Scale and the Questionnaire of Establishment of Codependency.

Results indicated that in a scale of scores ranging from 2 = minimum to 4 = maximum of co-dependence, this group of women had high self-reported levels of co-dependence (M = 3.6375, SD = .52610), a high depressive profile (M = 49.07, SD = 3.23, and high state anxiety (M = 66.60, SD = 5.58).

The present research suggests that mothers of dependent individuals in Bulgaria show a high level of co-dependency, anxiety and depression. Future research should clarify the reasons of this overall negative emotional profile.

The authors have not supplied their declaration of competing interest.

There is an evidence indicating that women experiencing intimate partner violence (IPV) quite common suffer from anxiety and depression, but predictors and protective factors are not well known in this group of patients.

The aim of the study was to try to find factor that are connected with higher rates of anxiety and depressive symptoms in the group of female patients experiencing IPV.

The study was conducted in six randomly selected centers of primary health care (PHCs) in Lublin province. One hundred and two female patients experiencing IPV were administered a structured questionnaire and the Hospital Anxiety and Depression Scale (HADS). The sequential models were created with using backward stepwise multiple regression to investigate potential risk and protective factors connected with higher rates of anxiety and depression symptom in the group.

In a study group, 68% in Anxiety Subscale(A) and 56% in Depression Subscale of HADS (D) had positive scores. Living in the country (P = 0.003) was connected with higher scores in HADS-A (P = 0.003) but not in HADS-D. Experiencing physical violence was connected with higher score in HADS-D (P = 0.005), but not in HADS-A. Chronic physical illness (A P = 0.013; D P = 0.015), being unemployed (A P = 0.024; B P = 0.008), and experiencing economic violence (A P < 0.001; D P = 0.001) were connected with higher stores in both Subscales of HADS. Taking financial support (A P = 0.002, D P = 0.003) was the protective factor for both kinds of symptoms.

Socio-economic factors have stronger influence on anxiety and depressive symptoms in women experiencing IPV than demographic factors.

The authors have not supplied their declaration of competing interest.

This research aimed to identify the effects of depressive mood of female high school students on dysmenorrhea and sleep quality.

This research was conducted for 2 months from September 2015 to October 2015. A total of 3 types of self-reported questionnaire were adopted for the research. Control group was separated by Zung Self-rating Depression Scale (ZSDS). Each group adopted a self-made questionnaire for research on menstruation and Pittsburgh Sleep Quality Index (PSQI) for research on sleep. Chi2 test and AVOVA analysis through SPSS-21 were used as statistics methods.

Analysis was made on 72 female students who submitted clear answers to the questionnaire. There were 34 students from normal mood group and 38 from depressive mood group. Depressive group presented meaningful results on regularity, pain severity, and drug treatment history of menstruation. Particularly, depressive group had 51.4% among subjects having severe menstrual pain of grade 3 by VMS (verbal multidimensional scoring system), way higher than 27.6% among subjects in the normal group. PSQI for sleep showed a meaningful result that 20.8% of those in the normal group were diagnosed with sleep disorder compared to 86.8% for the depressive group. A meaningful difference was seen in sleep latency, sleep duration, sleep disturbance, use of sleep medication, daytime functional disturbance among 7 items of PSQI.

This research showed that female high school students with depressive mood had high frequency and severity in dysmenorrhea and sleep quality disturbance.

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.

Although the influence of trait internalization and state body satisfaction on appearance comparisons has been well documented, their interactive influence on comparison behaviours is unknown. Therefore, the present study thus tested a person X situation model in which both mood state and trait internalization interacted to predict engagement in upward comparisons.

One hundred and forty-eight women aged 18 to 40 completed baseline measures of trait internalization, and then completed via iPhone app an experience sampling phase in which they reported momentary experiences of mood and comparison behaviours at up to 6 random times daily for 7 days.

Multilevel analyses revealed that although upward comparisons were more likely for individuals who internalized the thin ideal (t = 3.27, P < .001), this effect was minimized in instances when a participant was satisfied with her appearance (t = –1.90, P = .031). Further exploratory analyses showed that state body satisfaction was a stronger predictor than trait internalization of comparison behaviours (R2 = .14 vs. R2 = .11) when the time lag between state body satisfaction and comparison event was less than 2 hours, but this pattern reversed as the time lag between state level predictor and outcome increased beyond 2 hours (R2 = .09 vs. R2 = .12).

Present findings suggest that bolstering one's body satisfaction in the moment may be as clinically important as reducing a client's interest in the thin ideal for alleviating occurrence of unhealthy body comparisons.

The authors have not supplied their declaration of competing interest.

Postpartum psychosis (or puerperal psychosis) is a term that covers a group of mental illnesses with the sudden onset of psychotic symptoms following childbirth. A typical example occurs when after childbirth, a woman becomes irritable, has extreme mood swings and hallucinations with the possibility of needing psychiatric hospitalization. Often, out of fear of stigma or misunderstanding, women hide their condition.

To review the evidence regarding prophylactic treatment and acute management of postpartum psychosis and affective disorders in the puerperium.

Online search/review of the literature has been carried out, using Medline/Pubmed, concerning “postpartum psychosis”, “postpartum”, “mental disorders”, “mania” and “depression”.

Postpartum psychosis is a rare and severe psychiatric condition requiring rapid restoration of health in view of significant risks to both mother and the infant. The known risk factors and negative consequences of postpartum psychosis point to the importance of preventive and acute treatment measures. The majority of patients who develop psychosis immediately following childbirth suffer from bipolar disorder.

Understanding the relationship between postpartum psychosis and affective disorders has implications for perinatal and long-term treatment. The rapid and accurate diagnosis of postpartum psychosis is essential to expedite appropriate treatment.

The authors have not supplied their declaration of competing interest.