Atypical anti-psychotics have been found to be associated with hyperuricemia. The aims of this study were to determine the prevalence of hyperuricemia and metabolic adverse events in children and adolescents with ASD treated with risperidone.

In this cross-sectional study, we recruited 127 Thai ASD children and adolescents aged 3–20 years receiving risperidone for more than 4 weeks. The clinical data and laboratory data were obtained and analyzed. Hyperuricemia was defined as serum uric acid > 5.5 mg/dL.

Hyperuricemia was present in 57.48% of total ASD patients treated with risperidone. Uric acid levels were significantly higher in adolescents as compared to children. Uric acid levels correlated with risperidone dose (P = 0.01), duration of treatment (P < 0.0001), BMI (P < 0.0001), waist circumference (P = 0.003), triglyceride (TG; P < 0.0001), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-C; P < 0.0001), insulin (P = 0.04), homeostatic model assessment index (HOMA-IR; P = 0.03), high-sensitivity CRP (hs-CRP; P < 0.0001), and leptin levels (P < 0.0001). HDL-C and adiponectin levels were negatively correlated with uric acid levels (P < 0.0001). In multiple regressions analysis, age, BMI, TG/HDL-C, and adiponectin level remained significantly associated with uric acid levels (P < 0.0001).

Hyperuricemia may play a role in metabolic adverse effects in children and adolescents with ASD receiving high dose and/or long-term treatment with risperidone.

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

The authors have not supplied their declaration of competing interest.

Anxiety-phobic disorders are caused both by environmental and hereditary factors. The study was designed to determine the level of chromosomal aberrations in the peripheral blood lymphocytes (PBL) of children and adolescents of both sexes with phobic-anxiety disorders (PAD).

Cytogenetic analysis was performed in 27 children and adolescents of both sexes with PAD, aged 9–15 years; the control group consisted of 50 healthy peers of both genders. Statistical analysis-Excel and SPSS statistics 17.0.

Cytogenetic analysis of patients with PAD and in healthy age-matched individuals has established normal female (46,XX) and male (46,XY) karyotypes. The frequency of the chromosomal aberrations (CA) spontaneous level in the PBL is 4.6 times higher than the CA frequency in healthy persons. In children and adolescents with the disease, the spontaneous frequency of aberrations of chromatid and chromosome types is also significantly higher than the same in healthy children and adolescents. Single acentric fragments and exchanges prevail among the chromatid–type aberrations; pair acentric fragments prevail among the chromosome–type aberrations. An increase in the frequency of the chromosome-type aberrations has been revealed in boys with PAD (1.72 vs.0.55 per100 cells in healthy boys, P < 0.001 by pair acentric fragments), in comparison with healthy boys; and the chromatid–type aberrations have been observed in girls with PAD (3.22 vs.0.94 per 100 cells in healthy girls, P < 0.001 by single acentric fragments), in comparison with healthy girls. A pronounced individual variability of CA frequency, which ranges in our patients from 2.0 to18.0 per 100 metaphase plates, has been found along with an increase in the CA level in patients with PAD.

Children and adolescents with PAD require a careful cytogenetic analysis and the consequent therapeutic measures for genome stabilization.

The authors have not supplied their declaration of competing interest.

To date, limited data has been available regarding the impact of adenotonsillectomy (AT) on the psychosocial well-being of chronic adenotonsillar hypertrophy (CAH) subjects.

In the present study, we examined the impacts of AT on attention-deficit/hyperactivity disorder symptoms (ADHD) and sleep disturbance symptoms and quality of life of children with chronic adenotonsillar hypertrophy.

Parents of children with CAH filled in Conners Parent Rating Scale-Revised Short (CPRS-RS), children's sleep habits questionnaire (CSHQ), and the pediatric quality of life inventory, parent versions (PedsQL-P) before and six months after AT.

A total of 64 children were included the study (mean age: 6.8 ± 2.4 years; 50% boys). Mean ADHD Index (11.98 ± 6.94 versus 10.35 ± 6.44) (before AT versus after AT) and oppositional scores (6.73 ± 3.72 versus 5.87 ± 3.52) improved statistically significantly after AT (P < 0.05). All of the CSHQ subdomain scores, except sleep duration, significantly reduced after AT (P < 0.05). Regarding to quality of life, both PedsQL-P physical health (64.20 ± 19.81 versus 69.84 ± 18.63) and psychosocial health subdomain scores (67.83 ± 12.89 versus 75.57 ± 13.16), and PedsQL-P total score (66.57 ± 12.94 versus 73.58 ± 12.46) of the patients were significantly higher six months after AT (P < 0.001).

It is necessary for child and adolescent psychiatrists to query the symptoms of CAH to identify children with chronic adenotonsillar hypertrophy who suffer from ADHD symptoms, oppositionality, and sleep disturbance. To carry out AT seems to be beneficial for coexisting ADHD and sleep disorder symptoms and quality of life in these children.

The authors have not supplied their declaration of competing interest.

Cerebral palsy (CP) is described as a primary disorder of posture and movement; however, intellectual impairment is prevalent in children with CP.

The aim of the present study was to examine the association with intellectual level and gross motor function, hand function, type of CP, and the presence of co-morbid disorders in these children.

A total of 107 children with CP were included in the study. Intellectual functions of the children were determined by clinical assessment, adaptive function of daily life, and individualized standardized intelligence testing. Gross motor function and hand function of the patients were classified using the gross motor function classification system and the bimanual fine motor function measurements.

The mean age of the patients were 8.10 ± 3.43 years (age: 2–16 years). During clinical typing, we observed that 80.4% of the patients were spastic, 11.2% were mixed, 4.7% were dyskinetic, and 3.7% were ataxic. No significant relationship was determined between the type of CP and intellectual functioning (P > 0.05). Intellectual functioning was found to be significantly correlated negatively with both gross motor function and hand functions level (P < 0.001). The factors related to intellectual functioning were neonatal convulsion (x2 = 12.97, P = 0.002), epilepsy (x2 = 29.221, P < 0.001), and speech disorders (x2 = 23.29, P < 0.001).

There is an association between intellectual functioning in children with CP and the degree of motor impairment, neonatal convulsion, epilepsy, and speech disorders. Intelligence assessment should be an essential part of CP evaluation.

The authors have not supplied their declaration of competing interest.

Adolescents’ well being is affected by their parenting situation and can influence their well being over time. We present an exploratory study with an Illumina 450 k array, comparing methylation in adolescents, based on perceived parenting at T0, and how methylation can interact with parenting in explaining depressive symptoms two years later (T2).

Identify differentially methylated regions (DMRs) associated with perceived parenting at T0 and investigate their association with depressive symptoms two years later.

An exploratory analysis evaluating the association between methylation and depressive symptoms longitudinally.

From two extreme parenting clusters: perceived supportive, and punishing neglecting, we randomly selected 44 adolescents (MAge = 14 at T0; 48%boys). The CES-D scale (Center for Epidemiologic Studies Depression Scale) assessed depressive symptoms. DMRs were identified based on the parenting clusters (DMRcate and comb-p) using llumina Infinium HumanMethylation 450 BeadChip data. Associations between the most significant CpG for each DMR and the depression score at T2, were calculated using linear regression analysis.

We identified 17 DMRs, but only cg13306335 in PEX10 was associated with depressive symptoms at T2 (P = 0.0014, Bonferroni (17 tests): P < 0.0029). Additionally, an interaction between parenting at T0 and PEX10 methylation (T0) in explaining depressive symptoms (T2) can be suggested (P = 0.014).

We show that methylation at PEX10's most significant CpG is correlated with depressive symptoms at T2, these exploratory results also suggest a possible interaction between parenting and PEX10 methylation at T0 in association with depressive symptoms at T2. Validation in a larger sample is needed to support the role of methylation and its interactions in depression over time.

The authors have not supplied their declaration of competing interest.

Receiving an autism spectrum disorder (ASD) diagnosis often is daunting for individuals and families because of the life-long difficulties with functioning, health and quality of life [1]. “Casa del Giardiniere” is the reference facility for ASD at the Local health authority. The multidisciplinary team is composed by child psychiatrist, psychiatrist, psychologist, behavior analyst, educator, speech therapists, neuropsychomotor therapist, and social worker. Following the international guidelines for the neurodevelopmental disorders, patients’ age changed from 0–18-year-old to lifespan.

This work aims to illustrate our model, resulting from the integration of family, social and health services, and school.

Data on demographic, family, and clinical factors were gathered among subjects admitted to our ASD unit along 2015. All participants underwent to the following process: diagnostic assessment, Functional assessment of speech, communication, cognitive and adjustment skills, treatment, and parent training.

Data showed a general improvement of skills. The best results were achieved when a full sharing of methods and strategies in all areas of life were possible. Results will be discussed in details.

This model allows to realize efficient individualized treatment programs and to benefit of specific training both on intervention programs and approach with families. Furthermore, parents learn to “see” their child not only within its limits.

The authors have not supplied their declaration of competing interest.

Despite fragmented evidence on individual interventions, good practice and child welfare programmes in low and middle-income countries (LMIC), there is no comprehensive model for early interventions, particularly for children who experience complex trauma.

The objective of the World Awareness for Children in Trauma (WACIT: www.wacit.org) is to develop an evidence-based psychosocial model for vulnerable children in low and middle-income countries with limited or no access to specialist resources.

The aim of the preliminary evaluation was to establish stakeholders’ views on the extent of need, socio-cultural context, service gaps, and recommendations for improvement and creation of working partnerships. This consisted of four studies:

– 1. Participatory workshops in six countries (Turkey, Pakistan, Indonesia, Kenya, Rwanda, Brazil) with a total 250 strategic and operational stakeholders;

– 2. Quantitative evaluation in two of these countries (Turkey, 32 participants; and Brazil, 80 participants);

– 3. Interviews with 17 stakeholders from the six countries;

– 4. Focus groups with 7 children, 7 parents, 9 teachers and 11 other professionals in one country (Kenya).

Findings indicated that lack of resources (funding, facilities, training and personnel), poor collaboration (between church, families, government, schools and community), impaired parenting, socio-economic challenges and limited knowledge on child mental health as key factors that impede interventions.

The findings have informed the next phase of the WACIT programme in developing sustainable networks, training, and culturally appropriate interventions in the participating LMIC.

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

Schizophrenia is associated with cannabis use and deficits in selective attention.

This study investigated these relationships using habituation of the startle reflex in schizophrenia patients relative to cannabis users during selective attentional tasks.

Participants included 12 healthy controls (CON), 16 healthy cannabis users in the last 12 months (THC), and eight schizophrenia patients (SCZ). Auditory startle reflex was recorded from orbicularis oculi muscle while participants were attending to (Attend Task) or ignoring (Ignore Task) 100 dB startling pulses. Startle habituation was measured as the absolute reduction in startle magnitude on block 2 (last nine trials) vs. block 1 (first nine trials) on each attentional task and in each group.

All three groups were matched on demographics, alcohol, and caffeine consumption. ANCOVA with two within-subject factors (attention and habituation with 2 levels each), one between-subject factor (group with 3 levels), and one covariate (nicotine use which was higher in SCZ vs. CON or THC) showed a significant startle habituation with moderate to large effect sizes in all three groups on the Ignore Task (Cohen's d = 0.67 in CON, d = 0.59 in THC, d = 0.90 in SCZ) but not on the Attend Task. Attentional modulation of the startle reflex occurred only in CON (d = 1.33) and THC (d = 1.17), but not in SCZ.

Auditory startle habituation depends on selective attention but is not affected by schizophrenia or cannabis use. Deficient attentional modulation of the startle reflex suggests that a more severe deficit in selective attention occurs in schizophrenia relative to cannabis use.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The objective of this family-based whole exome sequencing (WES) is to examine genetic variants of autism spectrum disorder (ASD) in Korean population.

The probands with ASD and their biological parents were recruited in this study. We ascertained diagnosis based on DSM-5™ criteria, using Autism Diagnostic Observation Schedule and Autism Diagnostic Interview–Revised. We selected probands with typical phenotypes of ASD both in social interaction/communication and repetitive behaviour/limited interest domains, with intellectual disability (IQ < 70), for attaining homogeneity of the phenotypes. First, we performed WES minimum 50× for 13 probands and high-coverage pooled sequencing for their parents. We performed additional WES for 38 trio families, at least 100× depth. De novo mutations were confirmed by Sanger sequencing. All the sequence reads were mapped onto the human reference genome (hg19 without Y chromosome). Bioinformatics analyses were performed by BWA-MEM, Picard, GATK, and snpEff for variant annotation. We selected de novo mutation candidates from probands, which are neither detected in two pooled samples nor both parents.

Fifty-one subjects with ASD (5 females, 40∼175 months, mean IQ 42) and their families were included in this study. We discovered 109 de novo variants from 46 families. Twenty-nine variants are expected to be amino acid changing, potentially causing deleterious effects. We assume CELSR3, MYH1, ATXN1, IDUA, NFKB1, and C4A/C4B may have adverse effect on central nerve system.

We observed novel de novo variants which are assumed to contribute to development of ASD with typical phenotypes and low intelligence in WES study.

This work has been supported by Healthcare Technology R&D project (No: A120029) by Ministry of Health and Welfare, Republic of Korea.

The work was developed with the people hospitalized in the period of 1 year in a psychiatric clinic in Rio de Janeiro city, Brazil. 175 patients who presented dual diagnosis were evaluated.

The research aims to know the distribution of the most frequent psychiatric diagnosis associated with the disorders for the use of psychoactive substances. The work also has as objective to assess the treatment of patients carrying these disorders so that there is a better efficiency of the individual treatment plan.

The work consisted of the evaluation of all patients who were admitted to the clinic in the period of 1 year, using the ICD-10 for the diagnosis of dual pathologies. All the patients were assessed by the multiprofessional team, composed by general practicioner, psychiatrist, psychologist, pharmaceutic, therapist in chemical dependence, family therapist and physiotherapist. The patients were treated with the use of psychopharms, cognitive behavioral psychotherapy, 12-step program, art therapy and moderate physical activity. Family members of all patients were also interviewed.

In the evaluation conducted by the team, it was found the following distribution of the most frequent diagnosis associated to disorder for the use of psychoactive substances: depression (26.3%), personality disorder (22.9%), bipolar disorder (22.3%), non-schizophrenic psychosis (12.6%), schizophrenia (9.1%), and other diagnosis (6.8%).

The formulation of the dual diagnosis provided a better approach of the patients on the part of the team, promoting the strengthening of the therapeutic bond and causing positive impact on the evolution of these disorders.

The authors have not supplied their declaration of competing interest.

Previous studies have reported depressive symptoms in patients with persistent delusional disorder (PDD). Patients with PDD and depression may need antidepressants for treatment.

The aim of the study was to compare the sociodemographic profile, clinical presentation and treatment response in patients with PDD with and without comorbid depressive symptoms.

We conducted a retrospective chart review of patients diagnosed with PDD (ICD-10) from 2000 to 2014 (n = 455). We divided the patients into PDD + depression (n = 187) and PDD only (n = 268) for analysis.

Of the 187 patients with PDD + D, only eighteen (3.9%) were diagnosed with syndromal depression. There were no significant differences in sociodemographic profile including sex, marital and socioeconomic status (all P > 0.05). PDD + D group had a significantly younger age at onset ([PDD + D: 30.6 9.2 years vs. PDD: 33.5 11.1 years]; t = 2.9, P < 0.05). There was no significant difference between the clinical presentation including mode of onset, the main theme of their delusion and secondary delusions (all P > 0.3). However, comorbid substance dependence was significantly higher in patients with PDD only. (χ2 = 5.3, P = 0.02). In terms of treatment, response to antipsychotics was also comparable ([> 75% response: PDD + D = 77/142 vs. PDD = 106/179); χ2 = 1.9, P = 0.3). There was a significant difference between the two groups in terms of antidepressant treatment ([PDD + D = 32/187; 17% vs PDD: 17/268; 6%), χ2 = 12.9, P = 0.001).

Patients with PDD + D had significantly earlier onset of illness. These patients may require antidepressants for treatment.

The authors have not supplied their declaration of competing interest.

Internet addiction has become a harmful behavioral problem found to be highly prevalent in high school and college students. Many studies demonstrated significantly association between Internet addiction and depression.

To study the prevalence of Internet addiction and the association between internet addiction and depression in medical students, faculty of medicine, Ramathibodi hospital.

A cross-sectional study was conducted. Participants were the first to fifth-year medical students who agreed to participate in this study. Demographic characteristics were derived from self-rated questionnaire and were analyzed by descriptive statistics. Thai version of Young's Internet Addiction Diagnostic Questionnaire and Thai version of Patient Health Questionnaire (PHQ-9) were used to assess internet addiction and depression, then Chi2 test and logistic regression were used to analyze the associations between internet addiction, depression and associated factors.

From 705 participants, 24.5% had internet addiction and 29.0% had depression. There was statistically significant association between Internet addiction and depression (odd ratio: 1.92; 95% confidence interval [CI]: 1.34–2.77, P-value < 0.000). Logistic regression analysis illustrated that the Internet addiction group had risk of depression 1.58 times higher than the group without Internet addiction (95% CI: 1.04-2.38; P-value < 0.031). Academic problem was found to be a significant predictor of both Internet addiction and depression. Furthermore, Internet addiction, relationship problems with friend and lover, and health problem were also significant predictors of depression.

Internet addiction was common psychiatric problem which associated with depression among medical students. We suggest that surveillance of Internet addiction should be considered in medical schools.

The authors have not supplied their declaration of competing interest.

The first phase following the diagnosis of a first psychotic episode (FEP), is crucial to determine clinical and functional long-term outcome. Cannabis exerts a mediating action on the debut of the disease and determines a poor prognosis.

The description of a specific population profile of increased vulnerability to maintain cannabis use after a FEP could help to identify this high risk subtype of patients and speed up the implementation of specific interventions.

One hundred and seventy-eight patients were recruited from PAFIP (early intervention program on FEP), obtaining detailed socio-demographic assessment. They were followed-up for a year during which cannabis consumption was assessed by Drake scale every three months. We divided the sample into two groups:

– those patients who neither smoked cannabis before the FEP nor during follow-up period (nn);

– consumers group: cannabis users before the FEP who kept on smoking during the follow-up period (ss) and those who smoked before the FEP and gave up consumption during follow-up (sn).

Statistically significant differences between groups were observed. The consumers group (ss + sn) had an earlier age of onset, most were male, unemployed, single, prone to loneliness and they were concomitant users of alcohol and tobacco.

The use of cannabis has a detrimental effect on the outcome of schizophrenia. A specific and early intervention could contribute to prognostic improvements. Identifying cannabis consumption subtypes could be useful for this purpose.

The authors have not supplied their declaration of competing interest.

ADHD is associated with psychopathic traits, both in the general population and in perpetrators, due to the impulsivity, but not the affective component of psychopathy.

To analyze this relationship among a sample of inmates from a high-security male prison, using an instrument that further divides the callous-unemotional factor of psychopathy into boldness and cruelty, and see if they relate to ADHD independently from the impulsivity/disinhibition.

One hundred and one subjects aged 18–65, with at least 4 years of formal education, were interviewed for socio-demographic data and completed the ASRS-v1.1 (Adult ADHD Self-Report Scale) and the TriPM (Triarchic Psychopathy Measure). Subjects were divided into ADHD positive or negative according to their score in the ASRS-v1.1, and then compared regarding TriPM score (total, disinhibition, boldness and cruelty) using Student's t-test. Linear regression was used to assess independency between the subscales of TriPM.

Seventeen subjects scored positive for ADHD. They significantly differed from the non-ADHD group regarding all psychopathy scores (total, t = −5.03, P < 0.0001; disinhibition, t = −3.53, P = 0.0006; and cruelty, t = −4.96, P < 0.0001), except for boldness (t = 1.97, P = 0.005). The cruelty score is independent from boldness (R2 = 0.03) but not from the disinhibition score (R2 = 0.24). Disinhibition and boldness are also unrelated (R2 = 0.01).

In line with previous work, our study shows a strong association between ADHD and psychopathy, with both conditions sharing the disinhibition/impulsivity factor. Although ADHD subjects score higher for cruelty, this isn’t independent from disinhibition, and may be a result of them being more prone to admit to cruel behaviours, due to deficient response inhibition.

The authors have not supplied their declaration of competing interest.

Comorbidities between psychiatric diseases and consumption of traditional substances of abuse are common. Nevertheless, there is no data regarding the use of novel psychoactive substances (NPS) in the psychiatric population.

The purpose of this multicentre survey is to investigate the consumption of a wide variety of psychoactive substances in a young psychiatric sample.

Between September 2013 and November 2015, a questionnaire has been administered, in ten Italian psychiatric care facilities, to a sample of 671 psychiatric patients (48.5% men; 51.5% women), aged between 18 and 26 years (mean age: 22.24).

8.2% of the sample declared use of NPS at least once in a lifetime and 2.2% have assumed NPS in the last three months. The NPS more used were synthetic cannabinoids (4.5%), followed by methamphetamine (3.6%). The three psychiatric diagnosis with more frequent NPS consumption were bipolar disorder (23.1%), personality disorders (11.8%) and schizophrenia and related disorders (11.6%). Bipolar disorder was associated with NPS consumption (P < .001). Among the illicit drugs investigated, 31.4% of the sample was cannabis smoker and 10.7% cocaine user. Moreover, 70.6% of the sample declared alcohol use and 47.7% had binge drinking conducts. In univariate regression analysis, bipolar disorder was positive associated with binge drinking while obsessive compulsive disorder resulted negative associated.

The use of novel psychoactive substances in a young psychiatric population appears to be a frequent phenomenon, probably still underestimated. Bipolar disorder shows an association with NPS use. Therefore, careful and constant monitoring and accurate evaluations of possible clinical effects related to their use are necessary.

The authors have not supplied their declaration of competing interest.

After alcohol withdrawal, secondary depression may persists and might be a risk factor for relapse among primary alcoholics.

The differences between male alcoholics with secondary depression (D) and without depression (wD) regarding the personality dimensions and tobacco smoking were explored.

The aim was to investigate risk factors for secondary depression.

One hundred male primary alcoholics were recruited during inpatient treatment, and 86 completed the study. The assessment of depression by Hamilton Depression Rating Scale - HAMD (Hamilton, 1960), the pattern of cigarette use and personality dimensions assessment by Eysenck personality questionnaire – EPQ (Eysenck & Eysenck, 1975) were performed for all participants on admission. After four weeks according HDRS cut off score, they were divided into D group (n = 43) and wD (n = 43) group. The differences between groups were tested by Student t-test and Pearson's correlation test was applied.

The personality traits showed difference between D and wD alcoholics’ subgroups for neuroticism 15.07 ± 4.89 vs. 10.37 ± 4.40 (P < 0.01) and for extraversion 11.74 ± 5.05 vs. 14.30 ± 4.24 (P < 0.05) respectively. The positive correlation between the mean HDRS score and neuroticism (r = 0.487, P < 0.001), without significant correlation between other EPQ dimensions and depression was recorded. The D group started smoking earlier, but without differences of cigarettes daily.

The group of alcoholics with depression started smoking earlier. They were characterized by higher neuroticism and lower extraversion on admission, which could predict persistent secondary depression. Screening on personality traits among alcoholics on admission could improve prevention of secondary depression after alcohol withdrawal.

The authors have not supplied their declaration of competing interest.

At the present stage of psychiatry development, the problem of co-morbidity, which is an important factor determining the effectiveness of treatment. One of such tendencies is the combination of neurotic pathology and addictive behavior (AB).

To research AB features in neurotic disorders.

One hundred and forty-eight patients with neurotic disorders: neurasthenia (F48.0), dissociative disorder (F44.7), anxiety-phobic disorder (F40.8), according to ICD-10 criteria. Clinical-psychopathological, psychodiagnostic (AUDIT-like tests), statistical methods were used.

It was found out that the patients with neurotic disorders had a high risk of AB formation (59.73%). The most prominent among AB were: the use of psychoactive substances (tea/coffee [11,682], tobacco [8,091], sedatives [6,964], food addiction [14,036]), as well as socio-acceptable AB, such as Internet (13,527), watching television (9,982), computer games (2,909), shopping (7,264), workaholism (15,018). Socio-demographic characteristics of the generation of neurotic disorders with AB were determined: young age (50.46%), AB presence among the surrounding people (91.64%), a short interval of time between the psychogenic factor exposure and the first signs of neurotic disorder (50.46%). The clinical pattern of neurotic disorders with AB was characterized by a predominance of anxiety-obsessive (35.78%), as well as anxiety-phobic (45.95%) syndromes associated with AB: “Shopping” (−0.32; −0.51, respectively), “Sleeping pills, sedatives” (−0.37; −0.42), “Sex” (−0.41; −0.37) and “Tea/coffee” (−0.34; −0.39).

The data obtained determine AB specificity and should be taken into account in pharmaco – and psychotherapy.

The authors have not supplied their declaration of competing interest.

Addiction is often underdiagnosed in bipolar disorder (BD), although it is frequent and known to complicate its clinical course.

The aim of our study was to study socio-demographic and clinical factors associated with addiction in BD patients.

This is a retrospective, cross-sectional, descriptive and comparative study on 100 patients followed in our department and diagnosed with BD type I according to DSM 5. Demographic and clinical data was compared across the groups: Addiction + (A + ) and Addiction–(A − ).

Nighteen patients had an addiction co-morbidity (A + ), whereas 81 had not (A − ). The mean age of the (A + ) group was 39.47 years whereas it was 42.52 years in the (A − ) group. Males represented 68.4% of the (A + ) group and 48.1% of the (A − ) group. Age of illness onset was lower in the (A + ) group (mean = 23.16, median = 21) compared to the (A − ) group (mean = 26.04, median = 27). Addiction co-morbidity was significantly associated with predominant manic polarity (P = 0.03). All (A + ) patients presented mood episodes with psychotic features, whereas psychotic features were only found in 86.6% of (A − ) patients. Co-morbid addiction was significantly associated with a higher number of mood episodes (P = 0.04), a higher number and duration of hospitalisations (P = 0.02, P = 0.015), and a poorer compliance (P = 0.07). All A+ subjects received antipsychotics, and they were significantly more to receive long-acting antipsychotics (P = 0.06).

Addictions worsen the prognosis of bipolar disorder and require specific therapeutic strategies. They deserve therefore the particular attention of clinicians.

The authors have not supplied their declaration of competing interest.