The process of adjustment to disability and illness among people with chronic illness and disabilities (CID) impacts on motivation for rehabilitation illness self-management, and psychological well-being. It involves a complex interplay of biopsychosocial factors, and was seldom examined in the Chinese context.

Identify the predictors of mental well-being of people with from a set of variables including illness and social support, functional abilities, coping strategies, resilience. Examine how these factors interact in determining psychosocial adaptation and mental well-being by structural equations modelling (SEM).

We conducted a survey of people with CID, who were recruited from community-rehabilitation settings and self-help groups (N = 244). The research questionnaire collected basic demographic information, illness-related variables (e.g. pain, fatigue, functional limitations), and RIDI), social support, measures of resilience, coping, psychosocial ad as predictors, and mental well-being.

Of General Linear Model (GLM) revealed that males have better adaptation than females. Resilience, social coping, & active problem solving are significant predictors of adaptation (Table 1), while age, breathing, pain, resilience, avoidance coping, are predictors of maladaptation (Table 2). A SEM was tested to examine the interaction among the predictors and outcome of adaptation and mental well-being (Figure 1), and the model fit was fair (CFI = 0.89; RMSEA = 0.09)

The results indicated that there are gender differences in adaptation. While all the hypothesized groups of variables contributed to mental well-being of people with CID. Resilience, illness variables, and some forms of coping are closely linked to adaptation and maladaptation.

No significant relationships.

People with chronic illness and disabilities (CID) often need to adjust to changes in self-concept, cope with their grief from the loss of functional abilities, and to “live with the illness”. Emotional adjustment to disabilities is a major challenge in rehabilitation, but there is no validated Chinese instrument for assessing psychosocial adaptation of people with CID.

This study translated the Reaction to Impairment and Disability Inventory (RIDI) into Chinese and validated the Chinese version (C-RIDI), for assessing emotional adjustment in people with CID. We examined the factor structure, internal consistency, convergent validity, and criterion-related validity of the C-RIDI.

We conducted a survey of people with CID who were recruited from community-rehabilitation settings and self-help groups (n = 244). The research questionnaire collected demographic information, illness-related variables, the C-RIDI, and measures of resilience and well-being.

The C-RIDI has good content validity and no major changes to the translated items were needed for the use with Chinese population. For factor structure, we replicated the results of Livneh, Martz, & Boder (2006). The C-RIDI has two second-order factors of adaptive and non-adaptive scales, which interact with the two denial subscales. Internal consistency of the subscales is satisfactory except for the 3-item denial subscales. Correlations of the C-RIDI subscales with illness-related variables, resilience, and mental well-being are consistent with our hypotheses and provide support for the convergent and criterion-related validity of the scale.

The C-RIDI has satisfactory psychometric properties. The study results support its internal consistency, convergent validity, criterion-related validity, and factorial validity.

No significant relationships.

Administrative databases (AD) are repositories of administrative and clinical data related to patient contact episodes with all sorts of health facilities (primary care, hospitals, pharmacies,…).The large number of patients/contact episodes with pharmaceutical facilities available, the systematic and broad register and the fact that AD provides Real-world data are some of the pros in using AD data.

To perform a narrative review on the role of Big Data pharmaceutical registries in Mental Health research.

We conducted a narrative review using MEDLINE and Google Scholar databases in order to analyse current literature regarding the role of BigData pharmaceutical registries in Mental Health Research.

Administrative variables like drug names and prices may be used and linked to other clinical variables such as patients disease, in-hospital mortality, length of stay,(…). The use of electronic medical records may also contribute to systematic surveillance approaches like local or national pharmacovigilance strategies, identification of patients at risk of developing complications and software pop-up warnings related to medication dosage, duplication and lateral effects. The use of Big Data pharmaceutical registries allows to create predictive epidemiological models regarding drugs lateral effects or interactions and may help to perform pharmacovigilance phase 4 clinical trials. Its use may be applied to the optimization of clinical decision, monitoring of drug adverse events, drug cost and administrative monitoring and as surrogate measures of quality care indicators.

Big Data use in pharmaceutical registries allows to collect large and important clinical and administrative data that may be later used in Mental Health care and research.

No significant relationships.

Previous studies have demonstrated that night-shift work is associated with adverse effects impacting physical and psychological health, including the Shift Work Disorder (SWD). SWD is a circadian rhythm disorder characterized by sleepiness and insomnia, resulting from working a shift other than the traditional daytime-shift. Armodafinil, a modafinil longer-lasting R-isomer, is approved for SWD treatment. Due to its pharmacodynamic profile, it may result in more sustained wakefulness during night-shifts than Modafinil.

To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the efficacy of Armodafinil vs Modafinil and/or placebo on reducing SWD excessive sleepiness.

Will follow PRISMA guidelines. A systematic search will be conducted on PubMed, Web of Science, Scopus and ClinicalTrials.gov databases. RCTs comparing Armodafinil with Modafinil and/or Placebo for SWD treatment will be included. No language nor date restrictions will be applied. Outcomes of interest are prespecified as follows: the primary endpoint will be objective sleepiness; secondary endpoints will include subjective sleepiness, adverse effects, awareness, reaction time, memory and cognition. Retrieved studies will be independently screened for eligibility by two reviewers. Disagreements will be solved by consensus or by a third reviewer. Primary studies methodological quality will be assessed and data extracted independently using a standardized extraction-form.

Data will be described and reported as narrative text and summary tables. Heterogeneity of the included studies will be assessed and, if possible, a meta-analysis will be conducted.

It is expected that this systematic review and meta-analysis favours Armodafinil over Modafinil and placebo in the treatment of SWD.

No significant relationships.

Paraphrenia is a classic diagnostic entity characterized by an insidious development of a vivid and exuberant delusional system, more or less systematized, hallucinations and confabulations.

Increase knowledge about paraphrenia, a classic diagnosis that no longer appears on international classifications.

Extensive research on the historical path of the paraphrenia diagnostic entity was carried out. Patient’s data is obtained from medical history and psychiatric interviews done during her hospitalizations.

68 year-old patient attended the hospital emergency service due to a demonic possession delusion that emerged when she was 44 year-old, when she first consulted a psychiatrist because she believed someone introduced the demon inside her body. She described kinesthetic hallucinations as “movements of her brain” and an intense headache, both originated by the demon; as well as other types of hallucinations and confabulations. However, there was no deterioration in her personaliy or her intellectual capacity, as it could have been seen in a case of schizophrenia. This clinical case is considered a paraphrenia phantastica as it presents the typical features raised by the classic authors (mainly Henry Ey): paralogical thought dominance, megalomania, confabulation and integrity of relation with reality.

Current internacional classifications do not consider paraphrenia as a differentiated diagnostic entity, as it also occurs with other classical entities. This causes a loss of important tools that would achieve a better approach to the patient’s condition.

No significant relationships.

Zoanthropy is a mental disorder in which a patient believes to be an animal. These patients believe they have morphed into another species and began to act like such. Several types of zoanthropy have been described. Mental disorders can be triggered by stressful life events in patients with certain vulnerability. Hearing impairment as a risk factor for psychosis has been suggested in Psychiatry research. The potential mechanisms underlying this association included loneliness, diminished theory of mind, disturbances of source monitoring and top-down processing and deafferentiation.

This case presents a patient, with no history of psychiatric diseases, who developed the delirious of being a dog during Codiv-19 quarantine.

Previously healthy, sixty-year-old woman, with poor hearing, was taken to the Hospital for altered behavior after the confinement was stated. A low back pain started which derived on walking difficulties. The transformation begun and she started walking on four legs, barked and even pooped like a dog. Physical examination was normal. Mental exam revealed presence of delusion. Blood tests and brain imaging revealed no abnormalities. A treatment based on long-acting injectable aripiprazole was started.

Within 4 months of treatment, her mental state improved by attenuation of psychotic symptoms.

Sensory impairment and social isolation, have been associated with late-onset psychosis, but appear to exert a nonspecific influence on vulnerability. Early assessment and treatment of hearing impairment in patients with high risk of psychosis may be essential in psychosis treatment and prevention.

No significant relationships.

Negative thought disorders are found in various diagnoses in clinical practice. These symptoms may show a possible psychosis continuum and may be taken into account when assessing schizophrenic risk. Neurocognitive functioning of patients with negative thought disorders need to be clarified.

Aim of the study is to identify and validate the differences of executive functions between patients with negative thought disorders and patients without thought disorders.

Used a standardized neuropsychological test battery. There were 15 patients with negative thought disorders (affective disorders, personality disorders, schizophrenic spectrum disorders) and 18 patients with depressive episode without thought disorders in the research. Patients aged 17-25 years. The Mann–Whitney U test and ANOVA were used for statistical analysis.

Significant results were obtained from The Verbal Fluency Test, The Design Fluency Test, The Digit span, The Rey-Osterrieth Complex Figure and Bidstrup’s drawings (All tests have p-values less than 0.05). In the methods listed above, the results in the group of patients with negative thought disorders are significantly lower than in the group of patients without thought disorders.

The data indicate a violation of Executive functions among patients with negative thought disorders: inhibitory control, planning and regulation, working memory, difficulty switching, which related to left frontal lobe dysfunction. A lack of simultaneity and understanding figurative language, which is associated with right hemisphere dysfunction.

The reported study was funded by RFBR, project number 20-013-00772

It reveals a case that occurred in a patient with no previous history whose first manifestation was kinesthetic allucinations, subsequently appearing other psychopathological alterations

24-year-old male. Truck driver by profession. No prior mental health story. Good operation prior to the consultation. He comes accompanied by his parents for having a sensation of having bugs under his skin. It has come to throw gasoline on top to eliminate the possible infection.

Exploration: He is concius, oriented, with scratching lesions. He wears a cap soaked in gasoline to ward off critters. He does not present in the foreground other psychopathological alterations. CT with normal results, thyroid hormones, and normal biochemistry are requested. Treatment with aripiprazole is initiated in ascending doses, as it presents in the beginning a torpid evolution with the appearance of delusions of injury to its boss.

After that, he is currently psychopathologically stable and has returned to work with his father in the field.

Although not the most common, psychotic disorders can occur at the beginning with cenesthetic alterations. Organic screening should be performed and results treated accordingly.

No significant relationships.

Delusion of pregnancy has been described as a false and fixed belief of being pregnant despite factual evidence to the contrary. Pseudocyesis is a condition in which the patient has all signs and symptoms of pregnancy except for the confirmation of the presence of a fetus. There has been described symptoms as abdominal distention, cessation of menses, morning sickness, etc.

The aim of this work was to distinguish between pseudocyesis and pseudopregnancy. This case presents a single 49-year-old woman, who developed the delusion of being pregnant after months of lonely confinement during Covid-19 quarantine.

She had missed her period for 10 months. She was convinced that she could feel the fetal movements. Her thought content revealed delusion of persecution, reference, and delusion of being pregnant. She did not reveal any hallucinations. Blood tests and brain imaging revealed no abnormalities. □The treatment was started with Paliperidone 100mg/month, and clonazepam 2mg/d.

The patient showed a substantial improvement within 10 weeks of treatment. Pseudocyesis and delusional pregnancy have been rarely described on scientific bibliography. A distinction has been demonstrated based on the consideration of the associated psychotic features that might be present in delusions of pregnancy, which were described in the current case. On the other hand, pseudocyesis clinical presentation is centered on the false signs and symptoms of pregnancy.

Antipsychotics played a key role in the delusion of pregnancy. Psychodynamic and supportive psychotherapy could play a pivotal role in the management of pseudocyesis.

No significant relationships.

Psychosis itself may be associated with an increased risk of atrial fibrillation. Moreover, antipscyhotic treatment increases this risk. Recently D’Urso et al. reported aripiprazole-induced atrial fibrillation in a patient with concomitant risk factors.

To the best of author’s knowledge no data has been published about the safety and the efficacy of lurasidone treatment in psychotic patient with comorbid atrial fibrillation.

A 68 years old patient with persistent atrial fibrillation and hypertension in treatment with amiodarone 100 mg/day, lurasidone 25 mg/day, rivaroxaban 15 mg/day, clopidogrel 75 mg/day, bisoprolol 1,25 mg/day, tamsulosin 0,4 mg/day presented delusional ideas of jealousy for not real betrayal by his wife, social withdrawal, reduced sleep. Blood pressure 130/80 mmHg, heart rate 70 bpm, Qtc 420 msec. The patient was drug-naïve for any psychotropic treatment. The authors decided to start lurasidone treatment at the dosage of 18,5 mg/day.

After the first administration of lurasidone treatment sleep was resolved. After two weeks delusional ideas and social withdrawal were markedly improved. After one month of treatment, blood pressure, heart rate and Qtc remained almost stable. The authors decided not to increase the dosage of lurasidone because of the age of the patient and the comorbid cardiovascular pathologies.

Lurasidone has showed safety and efficacy in the treatment of this patient with delusional disorder and comorbid atrial fibrillation. This is a preliminary data that requires follow up and further studies to confirm the usefulness of lurasidone in psychotic patients with atrial fibrillation and cardiovascular risks.

No significant relationships.

Spirituality and religious commitment have a “protector” function among mental health patients who abuse psychoactive substances. The main task of spiritually-oriented therapy is not only to reactivate the internal control of a person, but to actualize their experience of communication with God before everything else.

Studying the influence of spiritual life-related factors on efficiency of therapy of psychiatric co-morbidities.

Clinical and psychopathological, clinical follow-up, pathopsychological and statistic.

The research covered 26 patients (the main group) diagnosed with paroxysmal schizophrenia and schizo-affective psychosis in the prospective follow-up with alcohol addiction. All patients practiced Orthodox worldviews though to a different extent, and have been participating in the spiritually-oriented rehabilitation with a family-oriented module for two years. During psychosocial rehabilitation the patients took group and individual training with a multidisciplinary team of experts: psychiatrists, clinical psychologists, specialists in sociotherapy and members of the clergy. The rehabilitation employed the principles of therapeutic community, systematic family approach [Zoricic Z., 2019], notions of coping behavior or coping strategies [Verhagen P., 2019, Pargament, K.I. et al, 2014] as well as spiritually-oriented models of assistance to patients (for example, the religion-oriented strategy of forgiveness based on REACH model [Worthington E. L. et al, 2016]).

Development of a lengthy remission is dependent on changing lifestyle and patterns, and spiritual labor of penance and forgiveness is just as important.

No significant relationships.

In the late XIXth century Kraepelin described a new nosologic division for the psycothic disorders – Paranoia and Dementia Praecox. He emphasized that dementia praecox is a central nervous system disease, involving permanent lesions on cerebral cortex. Besides biological deterioration, it appears as the result of psychic degenerative process. From the mid-20th century onward, antipsychotic drugs had been robustly generalized, and in parallel to the current classifications, residual symptoms in schizophrenia tend to be rare but still prevail in our patients.

The aim of our work is to report a clinical case of residual schizophrenia in parallel with the classic classification of Dementia Praecox and also do an overview of this disorder and its historical perspective.

We conducted clinical interviews with the patient and family members, reviewed clinical records and conducted a query in the MEDLINE database using the terms " Dementia Praecox ", “Psychosis”, “Paranoia”, “Kraepelin”, “History”.

We present the clinical case of a 74-year-old man with onset of psychotic symptoms on his twenties and diagnosed with Schizophrenia. In the past years, after acute psychotic episodes it was increasingly difficult to return to prior levels of functioning. Currently, he was brought to psychiatric emergency ward presenting bizarre behavior, stereotyped movements and speech disturbances, which reveal disorganized thinking and inability to express his emotions.

Although these syndromes are nowadays relatively rare, it is important to keep them in mind, in order to understand the natural progression of psychotic diseases, improve their rehabilitative treatment and prognosis.

No significant relationships.

The relation between obsessive-compulsive symptoms and psychosis presents in different ways. While obsessive-compulsive symptoms can present as prodromes of schizophrenia, or in overlap with psychotic phenomenology, a new clinical entity as been proposed as a subgroup of schizophrenia: the schizo-obsessive disorder.

The present review aims to emphasize the comorbility between schizophrenia and obsessive-compulsive disorder, bringing to light the importance of early detection and adequate treatment approaches.

The authors describe the patient’s disease progression and discuss the longitudinal dynamics between obsessive-compulsive disorder and schizophrenia, providing a brief and updated literature overview.

The illustrated case addresses a 31-year-old male patient diagnosed with obsessive-compulsive disorder at the age of 16, who later developed delusional ideation compatible with a schizophrenia diagnosis. At the onset of disease, the patient developed obsessive-compulsive symptoms such counting and repetitive hand-washing rituals that later turned into sexual obsessions concerning homossexuality. Following his 25th birthday, the patient became increasingly disorganized with frequent agressive outbursts toward his family and the obsessive egodystonic ideation turned into delusional egosyntonic ideation. Over the years, the patient shows intermittent obsessive-compulsive behavior while sustaining schizophrenia symptoms, particularly the negative symptoms.

Despite the controversy associated with the recently proposed new subgroup of schizophrenia, the schizo-obsessive disorder, we believe the patient described fits the diagnosis. Clinicians managing patients of schizophrenia should evaluate the patients thoroughly for presence of comorbid obsessive-compulsive symptoms/disorder and must take the same into account while managing the patients.

No significant relationships.

The only FDA approval therapeutic for schizoaffective disorder is paliperidone. Hiperprolactinemia is one of the most frequent side effects induced by first generation antipsychotics (FGA) or by second generation antipsychotic (SGA), such as risperidone and paliperidone. Prolactin related symptoms (PRS) include amenorrhea, galactorrhea, gynecomastia and fluctuations in psychotic symptoms.

To report the case of a patient with schizoaffective disorder difficult to manage due to symptom resistance and PRS, that improved symptomatology when prolactin serum levels were reduced.

Clinical-demographic data collected by clinical interview and clinical process consultation. Non-systematic literature review, searching “psychosis”; “prolactin”; “antipsychotic”; “schizoaffective disorder” on Pubmed database.

We report the case of 33 years-old female, admitted to our psychiatry inpatient unit for persecutory delusions, loosening of association, auditory hallucinations, and irritability with functional impairment. Symptoms began 13 years before. She was medicated with paliperidone 100mg IM monthly, lithium 800mg daily and clozapine 225mg daily. When admitted she wasn’t adhering to oral medication. On physical examination presented some PRS. The serum presented hyperprolactinemia and lithium in non-therapeutic levels. Initially was re-introduced the previous therapeutic without improval. It was made a therapeutic switch to associate aripiprazole 400mg IM monthly and clozapine 225mg daily, and lithium 800mg daily resulting in prolactine normalization and subsequent improval of psychotic symptoms previously presented.

This case reports challenges in management of patients diagnosed with Schizoaffetive Disorder due to therapeutic refractoriness and side effects. PRS can be ruling, therefore impacting therapeutic choices. We propose a possible role of combination of clozapine and aripiprazole in this scenario.

No significant relationships.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving the production of autoantibodies with consequent involvement of multiple organ systems. Although not an uncommon condition, its pleomorphic neuropsychiatric manifestations imply consideration of SLE as a relevant differential diagnosis. As many as 50% of patients with SLE have neurological involvement throughout their disease course and it is associated with impaired quality of life, high morbidity and mortality rates.

Case report study and discussion.

The authors present a case of a 50-year old woman without previous psychiatric history presenting to the psychiatric department with suicidal ideation in association with psychotic symptoms of rapid onset. She presented with various somatic symptoms including butterfly rash, alopecia, nail dystrophy and generalized myalgia and arthralgia. After conducting a thorough clinical investigation with subsequent unveiling of various alterations including those in the antibody panels and abnormal magnetic resonance imaging results, a diagnosis of neuropsychiatric lupus was established.

Improvements in initial psychiatric symptoms were noted after completing pulse corticoid therapy for SLE with adjunct antipsychotic medication. On follow-up, the patient demonstrated a complete return to previous mental functioning with no reported relapses.

This case demonstrates the heterogeneous presentations that neuropsychiatric lupus can assume. The vast array of psychopathological signs and symptoms in SLE continue to exist as a significant diagnostic and therapeutic challenge. Timely identification resulting from a proactive approach in maintaining lupus as part of our differentials may prevent the significant morbidity and mortality commonly associated with the resultant central nervous system involvement in SLE.

No significant relationships.

Schizophrenia is a chronic and debilitating psychiatric disorder. Affecting social, emotional, perceptive, and cognitive domains, its clinical phenotype can be subdivided into positive and negative symptoms, and those of cognitive impairment. As the knowledge base behind the social and environmental origins accumulates, the etiological and neuropathophysiological mechanisms behind them remain elusive.

To review the latest developments in potential etiological hypotheses linked to schizophrenia.

A non-systematic review was performed, searching Pubmed for articles published between the years of 2019 and 2020.

(1) Common genetic variants alter brain glycosylation and may play a fundamental role in the development of schizophrenia. The strongest coding variant in schizophrenia is a missense mutation in the manganese transporter SLC39A8, which is associated with altered glycosylation patterns in humans, resulting in modification of a subset of schizophrenia-associated proteins. (2) Failure of oligodendrocytes and astrocytes to differentiate contributes to several of the key characteristics of schizophrenia, including hypomyelination and abnormalities in glutamate and potassium homoeostasis. (3) Diglossia was hypothesized as a risk factor, as it could constitute a neurodevelopmental insult. This relationship may be mediated by the reduced lateralization of language in the brain. (4) The first brain-wide resting state effective-connectivity neuroimaging analysis proposed going beyond the disconnectivity hypothesis, drawing attention to differences between back projections and forward connections, with the backward connections from the precuneus and posterior cingulate cortex implicated in memory stronger in schizophrenia.

These novel insights may be a promising step in the right direction, presenting not only new approaches towards the complex pathogenesis of schizophrenia, but also eventual early interventions.

No significant relationships.

Violence and crime committed by individuals with mental disorders has been the focus of growing interest among mental health professionals.Added to psychopathological disorders, individual, socio familial and therapeutic factors can be involved in the criminogenic risk.

To assess the characteristics of homicide in Tunisian patients with psychosis and to establish their sociodemographic, clinical and therapeutic characteristics.

We reported7cases of patients who attended Psychiatric department“A”at the Hedi Chaker university hospital in Sfax,Tunisia,between January2014 and September2019.They were hospitalized for committing homicide and penal irresponsibility was recognized.

The homicide acts were matricide in 3cases, parricide in one case and conjugal homicide in one case.The homicide was not premeditated, committed by using knife weapon in 3cases and a blunt object in 4cases.The crime was done in the family home in the majority of cases(71.42%). The average age of patients was 34years. They were in almost cases(85.71%) male. Six patients (85.71%) had very low educational and income levels. They were mostly unmarried(71.42%)and unemployed(71.42%).Alcohol consumption was observed in3patients.However, we did not found any substance use. According to DSM-5,six patients were diagnosed with schizophrenia and one case with schizoaffective disorder.The majority(85.71%) had previous psychiatric folow-up. Furthermore, interruption of treatment was the rule.Five patients had a previous record of violent behavior towards the victim.Judicial history was notified among one patient.The persecution and influence delusion were found among 6cases.

Homicidal behavior is extremely rare.Evaluation of different variables of homicide’s act and offender is a fundamental issue for developing preventive and therapeutic strategies to deal with such criminal behavior.

No significant relationships.

Treatment-resistant schizophrenia (TRS) affects 30% of people with a diagnosis of schizophrenia, and is defined as nonresponse to at least two trials of antipsychotic medication of adequate dose and duration. Clozapine is the only evidence-based treatment for TRS. Cariprazine may be considered significantly more efficacious than risperidone in improving negative symptoms of schizophrenia.

To describe the experience of using cariprazine in combination with clozapine in patients with refractory schizophrenia and negative symptoms.

Qualitative design. We present a case report study of a 47-year-old male with a diagnosis of TRS, treated in our outpatient mental health clinic for twenty years. The patient experiences crystallized delusional ideas of harm, self-referential, paranoid and mystical-messianic content, phenomena of theft and thought reading, egodistonic auditory hallucinations. No substance use disorder was observed. He made several suicide attempts in the context of intense suffering and psychotic anguish. Clozapine 400mg/day was instituted after no response to treatment with amisulpride, paliperidone, olanzapine or aripiprazole. The intensity of positive symptoms was reduced (experiences of damage, commenting and insulting auditory hallucinations, self-referentiality), as well as the emotional and behavioral repercussions. Persistent negative symptoms appeared such as apathy, abulia, clinophilia, anergy, social isolation, affective flattening, impairing his functionality.

Neuroimaging and periodic blood tests results were normal. Oral cariprazine was added in ascending doses up to 4.5mg with good tolerance. The patient showed remission of apathy, enhancement of behavioral activation, socialization and motivation to perform occupational activities.

Combinations of clozapine with partial agonists may improve the quality of life in refractory schizophrenia.

No significant relationships.

Leukopenia and agranulocytosis are reported and dangerous haematological side-effects associated with the use of antipsychotics, mostly reported for clozapine administration. However, increased case reports about severe abnormalities even during treatment with second generation antipsychotics other than clozapine.

This review aims to compare haematological abnormalities associated with clozapine vs non-clozapine antipsychotic treatment, regarding aspects such as safety levels or the need for regular blood samples monitoring.

Pubmed and Google Scholar were searched for eligible articles, through keyword search and cross-referencing.

Neutropenia is common both in patients with schizophrenia on clozapine treatment and in those never on clozapine. Cases of agranulocytosis has been described with the use of olanzapine, risperidone or paliperidone, that do not have the same monitoring regulatory process as clozapine.

These results highlight the challenges in identifying and managing non-clozapine antipsychotic-induced leukopenia in susceptible patients. Continued research in this domain for evidence based management of antipsychotic-induced blood dyscrasias

No significant relationships.

Treatment of accompanying somatic disorders in patients with schizophrenia is a crucial issue, as those people die about 25 years earlier, compared with the general population. Moreover, premature death in this group of patients is more often caused by comorbidities than by suicide. It is worth emphasizing that cardiovascular disease itself in people with schizophrenia accounts for as much as 23% of causes of death, followed by suicides and drug toxicity. The paper presents a description of a 65-year-old patient diagnosed with schizophrenia, alcohol addiction, metabolic syndrome, and cardiac arrhythmia.

To determine the impact of cooperation between medical specialists and a psychiatric patient on the treatment effect.

A case of a patient treated in a day ward is described. A literature search was made in the PubMed database.

A patient after exacerbations of mental illness, often preceded by a return to alcohol use, tends to discontinue both psychiatric drugs and those prescribed for somatic diseases. Due to the diagnosed atrial fibrillation, sudden discontinuation of cardiac medications significantly increases the risk of life-threatening somatic complications, including stroke.

Diagnostic and therapeutic management in the treatment of psychiatric and somatic diseases with concurrent addiction to psychoactive substances requires interdisciplinary cooperation of medical specialists with the patient to achieve a successful outcome. Summarizing, in treatment, we must always look at the patient as a whole. Aside from caring for the mental state, the physical condition along with the possibility of cooperation on the part of the patient remains essential.

No significant relationships.