The impairment of facial emotion recognition (FER) among patients with schizophrenia (SCZ) is a significant feature of the illness. Childhood trauma (CT) is reported with a high prevalence in SCZ and is considered one of its risk factors.

To investigate the relationship between FER and CT in SCZ.

Fifty-eight outpatients with stable SCZ completed the Childhood Trauma Questionnaire retrospectively assessing five types of childhood trauma (emotional, physical and sexual abuse, and emotional and physical neglect). They also completed a newly developed and validated FER task constructed from photographs of the face of a famous Tunisian actress and evaluating the ability to correctly identify Ekman's six basic facial emotions (happiness, sadness, anger, disgust, fear and surprise).

Patients with higher scores of CT performed significantly worse in FER task. Our results suggest that the presence of sexual abuse is specifically correlated to a poor identification of anger (P = 0.02) and disgust (P = 0.03) while the presence of emotional abuse and physical neglect are correlated to a poor identification of happiness and sadness.

CT may represent one of the causes of the FER deficits in schizophrenia. Further studies are necessary to confirm the link between specific kinds of childhood trauma and deficits in the recognition of discrete emotions.

The authors have not supplied their declaration of competing interest.

Neurocognition and social cognition are the core deficits influencing social outcomes in patients with schizophrenia. These deficits are present in prodromal phase and throughout the illness, in first-degree relatives and are considered in the framework of neurodevelopmental or neurodegenerative models.

Four clinical cases with patients reflecting different cognitive profiles were chosen to demonstrate heterogeneity of cognitive biases and their influence on the social function en vivo. The patients have undergone a number of neurocognitive and social cognitive measures.

In these four patients, we would like to highlight the dissociation of neurocognitive deficits, clinical manifestations and social functioning. Social cognitive measures revealed heterogeneity of biases in different domains. As a result of our observation, we can hypothesize that better social functioning was achieved by patients with better abilities to discriminate negative emotions and states of mind in others.

Despite certain limitations of case-report studies, it is hard not to point out heterogeneity and incoherence of social and neurocognition. We assume that intact domains of Processing of Emotions and Theory of Mind predispose to better social functioning, while it's hard to trace this connection to neurocognition. This result needs to be challenged on large samples in future research, concerning emotionality in Theory of Mind and capacity for empathy and its’ role in social functioning.

The authors have not supplied their declaration of competing interest.

The literature on the neurobiology of emotional processing in panic disorder (PD) remains inconsistent. Clinical heterogeneity could be causing this.

To investigate differences in brain activity between PD and healthy controls using the emotional faces fMRI paradigm.

To elucidate neurobiological mechanisms underlying emotional processing in PD and previously identified subtypes (Pattyn et al., 2015).

The main analysis compared the neural processing of different emotional facial expressions from a large group of PD patients (n = 73) versus healthy controls (n = 58) originating from the Netherlands Study of Depression and Anxiety (NESDA). A second analysis divided the PD group into the three previously identified subgroups: a cognitive-autonomic (n = 22), an autonomic (n = 16) and an aspecific subgroup (n = 35). The fusiform gyrus, the anterior cingulate cortex and the insula were used in a ROI approach.

Comparing PD patients with healthy controls, a decreased activity on angry faces was observed in the left fusiform gyrus. The subgroup analysis showed more activity in the anterior cingulate cortex on neutral faces in the cognitive-autonomic subgroup versus the autonomic subgroup and a decreased activity in the left fusiform gyrus on angry faces compared to the aspecific subgroup. Less activity was observed in the right insula on neutral faces in the autonomic subgroup versus the aspecific subgroup.

Reduced activity in the left fusiform gyrus was differentiating panic disorder patients from healthy controls. In accordance with clinical subtyping, between-subtype differences are an indication that a phenomenological approach could provide more insight in underlying neurobiological mechanisms in emotional processing in PD.

The authors have not supplied their declaration of competing interest.

Several studies have shown that evolutionary relevant fear stimuli hold a privileged access to the fear module, an independent behavioral, psychophysiological and neural system that is automatically and selectively activated, and is relatively encapsulated from more advanced human cognition. However, to the best of our knowledge no study has yet directly assessed whether such stimuli are granted a facilitated access to visual awareness, compared to stimuli without such evolutionary relevance.

In the present study we used an interocular suppression technique, the Continuous Flash Suppression, known to reduce the activity along the geniculostriate pathway and to strongly suppress processing in the visual cortex.

Our goal was to investigate whether ecologically relevant fear stimuli (snakes and spiders) overcame suppression and accessed awareness to a larger extent than non-evolutionary relevant animal stimuli (birds).

Thirty university students volunteered to participate. Participants were asked to identify the screen quadrant in which the stimulus was presented in order to ensure that there was indeed a conscious processing.

The results confirmed our hypothesis by showing an advantage of fear stimuli (snakes and spiders) over the control stimulus (birds) in emerging from suppression into awareness, which was evidenced by significantly shorter response times.

Our findings support the notion that evolutionary relevant stimuli hold a privileged access into awareness, most likely involving a direct brainstem-thalamic route to the amygdala. Importantly, they contribute to elucidate the functions and mechanisms of the fear system and may have important implications for understanding emotional disorders, since many of these involve the fear system.

The authors have not supplied their declaration of competing interest.

Cannabis is one of the most prevalent drugs used worldwide. However, the neural consequences of cannabis remain poorly understood. There is a need for a rapid improvement of the scientific knowledge on the cerebral impact of cannabis use. Since the retina is an easy-to-access part of the central nervous system, it can reflect the neurochemistry of the brain.

Considering the anatomical and functional distribution of the cannabinoid system in the retinal ganglion cells, the objective of this study was to assess whether the regular use of cannabis could affect the ganglion cells functioning.

Assessment of the ganglion cells function in regular cannabis users compared to healthy controls.

Recordings of pattern electroretinogram (PERG) were performed in regular cannabis users and healthy controls using standard of the International Society for Clinical Electrophysiology of Vision (ISCEV). The amplitude and implicit time of the PERG N95 were assessed.

The N95 implicit time of PERG was significantly decreased in regular cannabis users compared to healthy controls.

We found alterations in the ganglion cells function in regular cannabis users, as showed by the increase in N95 implicit time. The ganglion cells represent the ultimate retinal relay before the visual information is relayed to the brain and, according to these results, we suppose that the signal elicited by these cells and transferred through the visual pathways is altered in cannabis users. A direct action of exogenous cannabinoids in the retinal glutamatergic transmission is discussed.

The authors have not supplied their declaration of competing interest.

Cognitive dysfunction in patients with systemic lupus erythematosus affects 10–36% of them.

To determine a profile of selected cognitive functions in systemic lupus erythematosus.

To investigate and characterize selected cognitive parameters in patients with systemic lupus erythematosus (SLE) using a standardized, comparable and reproducible computer-based method.

The study included 25 patients with SLE. For neuropsychological assessment, the Cambridge Neuropsychological Test Automated Battery was used. Following parameters were investigated: mean latency and mean error in motor screening (MOTML, MOTME), big little circle (BLC), paired associated learning (PAL), problems solved in minimum moves in stockings of Cambridge (SOC PSMM) and graded naming test (GNT). Results were referred automatically to determined ranges of norms matched according to age and gender.

In patients with SLE results displayed by median and upper and lower quartiles were as follows: MOTML = 1.1 (0.9–1.34), MOTME = 0.41 (0.31–0.52), BLC = 0.16 (0.16–0.18), PAL = −0.43 (−1.28; −0.18), SOCPSMM = −0.62 (−1.19–0.04), and GNT = −0.8 (−1.6; −0.32).

MOTML correlated negatively with MOTME (r = −0.51), MOTME correlated with SOCPSMM (r = 0.41), and PAL correlated with GNT (r = 0.48) (P < 0.05).

In our study, predominant abnormalities were those related to lexical and semantic memory, revealed by the GNT, spatial planning and spatial working memory, assessed by the SOC, together with visual memory and new learning, assessed with the PAL.

The authors have not supplied their declaration of competing interest.

Impairment in cognitive performance is an important characteristic in many psychiatric illnesses, such as Bipolar Disorder and Major Depressive Disorder. Initially, cognitive dysfunctions were considered to be present only in acute depressive episodes and to improve after symptoms recovered. Reports have described persistent cognitive deficits even after significant improvement of depressive symptoms.

We wanted to understand the dimension of cognitive impairment in unipolar and bipolar depression and also to underline the differences between cognitive profiles of patients diagnosed within the two mentioned disorders.

This review examined recent literature about unipolar and bipolar depression.

Both depressed patients presented cognitive deficits in several cognitive domains. Different aspects of attention were altered in both patients but impairment in shifting attention appeared specific to unipolar disorder while impaired sustained attention was particular for bipolar disorder. Both types of patients showed memory deficits that were associated with poor global functioning. Two recent studies described that bipolar depressed subjects were more impaired across all cognitive domains than unipolar depressed subjects on tests assessing verbal memory, verbal fluency, attention and executive functions. The most consistently deficits were displayed on measures of executive functioning – such as tasks requiring problem solving, planning, decision making – suggesting that this cognitive domain is a trait-marker for depression.

Cognitive deficits are present in both disorders during a depressive episode but they display slightly different patterns of impairment.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The discovery of mirror neurons, considered to be responsible for empathy, intrigued researchers all over the world. Many studies have been developed associating mirror neurons to the incidence of Autism Spectrum Disorder (ASD).

Identifying a possible influence of mirror neuron in autism.

Reviewing the recent trajectory of neuroscience in relation to the connection of impaired mirror neurons in autism.

Bibliographical review of studies in English, published in SciELO and LILACS databases, between 2008 and 2013. The keywords used were: autism, brain, cortex and mirror neuron.

Different subjects explored the influence of mirror neurons in autism as shown below (Fig. 1). Among 17 studies, 12 were bibliographical reviews and 5 involved experiments. Seventy-six percent of the studies were favorable to the influence of these neurons, while 24% were not.

There was a balance in the distribution of themes explored in the articles and few studies exploring the role of mirror neurons in autism. Even though the current research may not be conclusive, it can be said that currently neuroscientists tend to agree that mirror neurons significantly influence ASD. Recent studies suggest that, if properly stimulated, ASD individuals can develop their social skill and, consequently, be socially inserted. According to most author studied, technological development is needed in order to enable scientific advances involving mirror-neurons and ASD.

The authors have not supplied their declaration of competing interest.

Tardive dyskinesia is a collection of symptoms related to the side effects of neuroleptic medications that can mimic other types of disorders. Accurate diagnosis can be challenging, as there is no single test for tardive dyskinesia.

Female patient, 64 years old, with personal history of Chronic Myeloid Leukaemia and psychosis since forth decade, currently medicated with quetiapine 350 mg/day, risperidone IM 50 mg 15/15 days and trazodone 150 mg/day (previously medicated with haloperidol, amisulpride and olanzapine). She started with involuntary movements interpreted as tardive dyskinesia after 2 years on neuroleptic treatment. The difficult control of involuntary movements motivated the reference to ambulatory Neurology department. The review of personal history suggested a family history of involuntary movements and psychiatric illness. Physical examination showed generalized choreic movements. The analytical and imagiologic study was unremarkable. The presence of family history and involuntary movements atypical to be classified as tardive dyskinesia supported a genetic test for Huntington's disease who detected a CAG expansion with 43 repetitions in HTT gene. Despite treatment with amantadine and riluzole she maintains disease progression and evident cognitive deterioration.

The diagnostic process of involuntary movements may involve more than one physician and requires the review of a detailed medical history, a physical examination and a neuropsychological evaluation in order to determine whether one is indeed suffering from tardive dyskinesia or a different neurological disorder.

The authors have not supplied their declaration of competing interest.

Several epidemiological studies describe the association between substance abuse and appearance of psychotic symptoms. There is a higher prevalence of psychotic symptoms among cannabis and cocaine consumers compared to the general population.

The cannabinoid receptors regulate the release of dopamine and cocaine has a strong inhibitory action on reuptake of the same. This may explain the greater proportion of subjects moderately or heavily dependent on cocaine or cannabis experience symptoms of psychotic sphere.

Describing the profile of drug consumption among a group of patients diagnosed with delusional disorder.

Our data come from a case register study of delusional disorder in Andalucía (Spanish largest region). By accessing digital health data, we selected 1927 cases who meet criteria DSM 5 for delusional disorder collecting different toxic consumption habits.

It was found that 1070 (93.4%) of patients diagnosed as delusional disorder according DSM 5 did not consume cannabis, compared to 75 (6.6%) who do so. Among patients diagnosed as “other psychoses”, 243 (85%) did not use drugs and 43 (15%) consume other drugs of different types of cannabis.

In our sample, we found that the use of drugs such as cannabis and cocaine is less common among patients diagnosed with delusional disorder compared with other individuals diagnosed as “other psychosis”.

The authors have not supplied their declaration of competing interest.

The use of psychostimulants, such as amphetamines and cocaine in psychotic patients is 4 times more frequent than non-psychotic ones. It is believed that people with psychosis may use substances as a self-treatment for negative symptoms. However, early onset of substance use disorder can develop psychotic and/or negative symptoms, leading to confusion between primary or secondary psychosis.

Systematic review of the literature in English (PubMed) and patient's clinical record. Keywords: “Substance use disorder”; “psychosis”.

to highlight the importance of an adequate characterization of psychotic symptoms in patients with substance use disorder.

A 29-year-old man, with psychostimulants and cannabis abuse since adolescence and very short abstinence episodes. Later on, he developed paranoia symptoms that slightly improved once he decreased drugs dosage, but they were still present even on complete abstinence. Over the last year he has showed negative and psychotic symptoms that have been worsening with aggressive behavior during the last months, so he had to be hospitalized. During this period, he has been treated successfully with aripiprazol depot once monthly. His evolution has been positive, it has disappeared psychotic symptoms and paranoia, and after discharge he has managed to remain abstinent to psychostimulants.

Adequate characterization of patients with psychotic symptoms and substance abuse is essential to determine whether the psychotic disorder is associated with primary or induced TUS. Therefore, it is essential a thorough clinical evaluation to make an accurate diagnosis and to draw an individualized treatment plan.

The authors have not supplied their declaration of competing interest.

Asthma is a major public health problem and its prevalence has increased in both developed and developing countries during the last few years. Once it is a chronic illness, it has also revealed psychological consequences. Moreover, recent studies have suggested an association between asthma (especially of severe grade) and mental disorders.

The authors pretend to make a brief review concerning psychiatric disorders among asthmatic patients.

To understand and to be able to deal with the psychiatric disorders among chronic asthmatic patients.

The review was based on scientific documentation published in PubMed database, using the following terms as keywords: “asthma”, “depression”, “anxiety” and “panic disorder”.

Compared to the general population, both anxiety and mood disorders rates are at least two times those observed in asthmatic patients. Moreover, certain psychiatric disorders rates, including panic disorder (PD) and major depressive disorder, are as much as six times more prevalent among asthmatics when compared to the general population. The association between psychiatric disorders and poor asthma control and asthma-related quality of life could occur through several pathways, such as behavioural pathways; cognitive or perceptual pathways; or through the direct physiological effects of depression and anxiety on the autonomic nervous system (ANS) and immune systems which increase asthma symptomatology.

There is a close correlation between anxiety, PD and depression, and a poor controlled asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.

The authors have not supplied their declaration of competing interest.

Opioids are the most powerful drugs commercialised for acute and chronic pain relief. The main emerging problem in our midst is the abuse and addiction to synthetic opioids iatrogenically established in general population.

We report the case of a female patient aged 48 admitted to the Acute Psychiatric Unit after a suicide attempt. She refers she finds herself more irritable and depressed since she began a treatment with oxycodone after she was diagnosed with fibromyalgia. She has lost a lot of weight, is not able to get to sleep and has become socially isolated.

During the first few days, the patient is uncooperative and shows a marked self-referentiality and verbalises delusional ideation related to her immediate surroundings. Once the treatment with opioids was withdrawn and we had prescribed paliperidone ER, she seemed more cooperative and calmed. She was discharged from the Psychiatric Day Hospital showing a good evolution.

Paranoid personality disorder (F60); mental and behavioural disorders due to use of opioids (F11); recurrent depressive disorder, current episode moderate (F33.1); fibromyalgia (M79.7).

The use of synthetic opioids (tramadol, fentanyl, oxycodone) in easy-to-use formats (patches, pills, dispersible tablets, lollipops) and their dissemination in pain treatment, is leading to an increase of problems related to it, both their side effects (psychotic symptoms) and the generation of misuse and addiction. We should pay greater attention to the prescription of opioids to patients with dysfunctional personality traits.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Quality of life (QoL) is a complex concept that depends on many factors such as life style, past experiences, expectations, future plans and ambitions. It may be altered in patients suffering from chronic disease.

Assess QoL in patients with asthma as well as associated factors.

We conducted a cross-sectional, descriptive and analytic study, including 30 patients followed for asthma at pulmonary outpatient department, Hedi Chaker Hospital, Sfax, Tunisia. Asthma control level was evaluated by the Asthma Control Test (ACT). QoL was assessed using the 36-item Short Form Health Survey (SF-36), that contains 36 questions grouped into 8 domains (D1: Physical Functioning, D2: Role limitations due to physical problems, D3: Bodily Pain, D4: General Health, D5: Vitality, D6: Social Functioning, D7: Role limitations due to emotional problems and D8: Mental Health).

The mean age was 51 ans. The mean duration of disease was 11 years. The average ACT score was 16.8 points. Asthma was uncontrolled in 1/3 of patients. The mean of average overall scores SF-36 was 46.22. QoL was altered in 83.3% of patients. The most altered domains were D8 followed by D7then D4 and D2. The average overall score SF-36 was correlated to ACT score (P < 0.001), early age of onset of the disease (P = 0.049) and poor asthma control (P < 0.001). Altered QoL was associated to advanced age (P = 0.016), long duration of disease (P < 0.001) and low ACT score (P = 0.034).

Optimum asthma and associated comorbidities support would improve control and therefore the patient's quality of life.

The authors have not supplied their declaration of competing interest.

Alcohol consumption associated with other psychiatric disorders in outpatient psychiatric comorbidity is a common, yet often underdiagnosed and undertreated, resulting in a worse prognosis of both diseases.

To evaluate the prevalence of alcohol consumption in psychiatric outpatient consultations and compared to drug addiction consultations.

A total of 25 outpatient psychiatrists of Extremadura and 10 doctors of substance abuse centers of Extremadura (CEDEX) participated in the study. They were included in the study a total of 373 patients, 244 who were in treatment at mental health center and 129 as a center of drugs.

The mean age of patients in psychiatric consultations was 50.05 years and 42.60 years of CEDEX. The percentage of women was 54% of cases in psychiatric consultations and 18.6% in the CEDEX. Diagnoses included in psychiatric consultations were: anxiety disorders (17.2%), depressive disorders (46.3%); personality disorders (7.8%); mild mental retardation (2.5%); psychotic disorders (12.3%); dementia (2.5%); bipolar disorder (6.1%); and ADHD (1.2%). In the consultations of drugs they were: 45.4% alcohol dependent; 15.7% to cannabis; 13.3% cocaine; 10.9% heroin; 8.1% more heroin to cocaine; and 6.6% to other addictions. A total of 18.9% of patients in psychiatric consultations had a score of 2 or more in the CAGE and 62.8% of the CEDEX.

We found nearly a fifth of the patients attending psychiatric outpatient clinics which have a hazardous drinking, harmful or alcohol dependence, for almost two thirds of drug queries.

The authors have not supplied their declaration of competing interest.

Depression and alcohol problems are common in psychiatric outpatients, but there are few studies including patients with anxiety disorders.

To study the prevalence of problematic alcohol consumption in a sample of patients diagnosed of anxiety or depressive disorder and treated in a mental health clinic and to analyze clinical and sociodemographic variables associated to alcohol consumption.

The sample studied included 194 outpatients (31.9% men and 68.1% women) treated in an outpatient clinic and diagnosed of any anxiety or depressive disorder included in DSM-IVTR as main diagnose. Instruments used were Beck Depression Inventory (BDI), and the Alcohol Use Identification Test (AUDIT). Other variables studied included age, civil status, level of studies, and specific psychiatric diagnoses.

A total of 64.9% were diagnosed of anxiety disorder and 35.1% were diagnosed of depressive disorder. The prevalence of problematic alcohol consumption was 7.8%, being more frequent in men, especially in men and in middle ages. Problematic alcohol consumption was found with more frequency in patients with generalized anxiety disorder and major depression, in this order. Patients with other comorbidity disorders in Axis II presented the highest prevalences of problematic alcohol consumption.

Problematic alcohol consumption presents high prevalence in patients with anxiety or depressive disorders and dual diagnose usually is associated with poor prognosis. It is necessary to make efforts to detect alcohol problematic consumption in psychiatric patients and develop specific treatment programs directed to this group of patients in both primary and specialized care units.

The authors have not supplied their declaration of competing interest.

Previous studies inform that psychiatric patients often report problems with their sleep and alcohol increase sleep disturbances.

To analyze the prevalence of sleep disturbances in patients diagnosed of Alcohol Abuse or Dependence and to study clinical and sociodemographic variables associated with sleep disorders.

The sample is composed of a randomized sample of patients diagnosed of Alcohol Abuse or Dependence following DSM-IV-TR criteria and treated in a Mental Health Clinic in a period of 3 years. Medical records were reviewed. Quality and patterns of sleep were evaluated using the Pittsburg Sleep Quality Index (PSQI) with a cut-off point 5-6.

A total of 102 patients were included in the study, 69% were male and 31% were female. Mean age 39.4 years (SD 9.26).

Sleep disorders were found in 91.6% of patients. The most altered subscales in the overall sample were the Use of Sleeping Medication and Sleep Disturbances. Women presented worse sleep quality compared to men (P < 0.01) with higher number of altered subscales. The most altered subscales in women were Subjective Sleep Quality (P < 0.005) and Sleep Disturbances (P < 0.02).

Comorbidity with other psychiatric disorders and other clinical and sociodemographic variables are analyzed.

Sleep disorders have high prevalence in patients with alcohol abuse of dependence, especially in women and patients with other psychiatric comorbidity. Poor quality sleep may have a powerful impact on the global functioning and prognosis of these groups of psychiatric patients.

The authors have not supplied their declaration of competing interest.