It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.

To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.

Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.

IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).

Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.

Borderline Personality Disorder (BPD) is a chronic personality disorder characterized by emotional and interpersonal instability, difficulty in mentalization, impulsivity with functional impairment and increased rates of comorbid mental disorders. Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in premenopausal women, with important impact on quality of life and mental health. Studies have begun to explore the eventual relationship between these two pathologies.

The authors aim to describe the existing evidence exploring the relationship between BPD and PCOS as well as explore eventual common causal pathways and the forms which one might influence the other.

The authors describe a clinical case of a 31 year old female patient with history of borderline personality disorder and polycystic ovary syndrome presenting with hyperandrogenism and hirsutism as well as menstrual irregularities. As a compliment to the case, the authors conducted a brief non-structured literature review using articles published in the Medline/Pubmed, ScienceDirect and Google Scholar databases. The keywords used during the research, alone or in combination, included: Polycystic ovary syndrome and Borderline Personality Disorder. The studies consulted in this work included: cross-sectional studies, cohort studies, literature reviews and clinical case reports. Of these, those that were written in the English language and deemed most pertinent to the explored theme were chosen for review in this work.

The results demonstrate a paucity in the literature with only 10 articles having been published between 2009 and 2023 having dedicated studies and research to the relationship between the pathologies. One study reports that those with PCOS show relevant psychiatric disorders in comparison to controls, including personality disorders, such as is demonstrated in the described clinical case. Of the few case studies available, these found that BPD was associated with PCOS with the latter having most frequently been diagnosed previously to the personality disorder. Altered androgen metabolism has been described in both these pathologies, thus further strengthening the relationship between these.

Hormonal fluctuation has been classically associated with psychopathological symptoms, including unstable mood and impulsivity. The alterations demonstrated in PCOS might serve as an exacerbating factor in the genesis of the emotional instability and other symptoms present in BPD. The literature on this topic is still in an embryonic phase with a clear lacuna existing which merits attention and further study so as to fully comprehend the potential of these comorbid states. Clinicians should remain attentive to this comorbidity and the influence that PCOS might have on the psychopathology of BPD so as to better quality of life and global functioning which is impacted in both.

None Declared

Craniofacial malformations have long been associated with a heightened risk of psychiatric disorders. Understanding this link is crucial, as it can inform early intervention and support for affected individuals, enhancing their overall well-being. Research in this area aims to shed light on the prevalence and nature of these disorders within the craniofacial population, ultimately improving healthcare and quality of life for affected individuals.

This study aims to establish a comprehensive understanding of the relationship between craniofacial malformations and psychiatric disorders. Specifically, our objectives include: assessing prevalence, identifying risk factors, evaluating impact and informing clinical practice. This research aims to improve the holistic care and mental well-being of individuals with craniofacial malformations, contributing to a more comprehensive approach in the field of psychiatry.

This cross-sectional study was conducted at a prominent referral hospital named Hospital de Clínicas de Porto Alegre during the month of August 2023.

Participant Selection: Patients with craniofacial malformations of all ages and both genders.

Data Collection: We conducted structured interviews with participants to gather demographic information, medical history, and details of their craniofacial conditions.

Medical Records Review: Medical records were reviewed to corroborate craniofacial diagnoses and identify any comorbid conditions.

Statistical Analysis: Data were analyzed using appropriate statistical techniques to assess the association between craniofacial malformations and psychiatric disorders.

Ethical Considerations: The study adhered to all ethical guidelines, with informed consent obtained from participants or their legal guardians. Ethical approval was obtained from the hospital’s Institutional Review Board.

Data Handling: Confidentiality and data security were ensured throughout the study, with all data anonymized to protect participant privacy.

In our study, we assessed 132 different patients, comprising 62 females and 70 males. The youngest patient was 2 months old, while the oldest was 56 years old. The mean age of the patients was 16.22 years, with a median of 9 years, a harmonic mean of 18 years, and a standard deviation of 15.23 years.

Among the patients, 24 exhibited psychiatric disorders, evenly split between 12 males and 12 females. Their average age was 16.21 years, with a median of 10 years, a harmonic mean of 6.13, and a standard deviation of 14.57. The youngest patient with evidence of a psychiatric disorder was 2 years old.

Image:

Image 2:

Our study underscores the prevalence of psychiatric disorders among craniofacial patients, which seems to be greater than the general population, emphasizing the need for integrated care that considers both medical and psychological aspects, thus enhancing the overall well-being of these individuals.

None Declared

Psychiatry Pitstop is a role-play-based program for medical students aimed to improve communication skills in the framework of mental health. The workshop involved amateur actors who simulated different clinical scenarios and psychiatry residents, who facilitated the sessions and provided constructive feedback following the Pendleton method. Psychiatry Pitstop was originally developed in the United Kingdom and it was expanded to Lisbon, Portugal, in 2019. The authors adapted the course to the Portuguese context, adjusting the number of sessions and altering the scenarios to match common clinical situations faced by junior doctors in Portugal. By now, we conducted four courses.

Our study aims to describe the Portuguese adaptation of the program and to learn insights from the students feedback.

The course was assessed using satisfaction questionnaires, completed by the students after each session. These included a Likert scale ranging from 1 to 5, with items pertaining to Future Importance, Overall Quality, Theoretical Quality, and Practical Quality. Quantitative data was analyzed using Excel and standard descriptive statistics to summarize the results. The open questions invited students to articulate the main positive aspects, suggestions for improvement and future topics. A Natural Language Processing (NLP) software was used to evaluate open-ended responses and extract the main concepts.

We obtained a total of 39 single-answers from 4 different courses. Evaluation results yielded a mean score of 4.7 for Future Importance, 4.9 for Overall Quality, 4.3 for Theoretical Teaching, and 4.9 for Practical Teaching. Notable positive aspects included students’ appreciation of the immersive interview environment, the dedication exhibited by actors and doctors, well-prepared case scenarios, and engaging interactions with participants. Suggestions for improvement encompass enhanced theoretical introductions, comprehensive topic coverage, universal participation in simulations, and expanded workshop days. Future prospects for the program include practicing interviews with other psychiatric diagnosis, addressing difficult patients, delivering bad news and covering topics related to sexuality, grief and moral dilemmas.

Our study shows that Psychiatry Pitstop adaptation to the Portuguese context was successful. Overall, the feedback from medical students has been consistently positive. Subsequent editions will draw upon the findings of this study to enhance overall program quality.

None Declared

Craniofacial surgery is a specialized field that addresses congenital and acquired deformities of the head and face. While the physical outcomes of craniofacial surgery are well-documented, less attention has been given to the psychological well-being of adult patients. This abstract aims to explore self-esteem issues among adult patients treated at the Craniofacial Surgery Sector of HCPA (Hospital de Clínicas de Porto Alegre), where a substantial proportion of adult patients have reported self-esteem problems.

1. 1. To assess the prevalence of self-esteem issues among adult patients (≥18 years old) attending the HCPA Craniofacial Surgery Sector.

2. 2. To examine potential contributing factors to self-esteem problems in this specific patient population.

3. 3. To evaluate the impact of self-esteem on the mental health and psychosocial functioning of adult craniofacial surgery patients.

4. 4. To propose recommendations for psychosocial support and intervention strategies tailored to the needs of adult patients in this context.

This cross-sectional study involved 132 adult patients who had undergone or were scheduled for craniofacial surgery at HCPA. Participants reported self-esteem issues in their talk with the hospital’s physicians, and their medical records were reviewed to collect demographic and clinical data. Additionally, participants provided information about their mental health status and psychosocial functioning.

Among the 39 adult patients included in the study, 37 (94.9%) reported experiencing self-esteem issues, such as lack of confidence or feeling unattractive. The most commonly reported contributing factors were visible facial differences, social interactions, and prior surgical experiences. Patients with lower self-esteem had a higher likelihood of reporting symptoms of depression and anxiety and reported lower overall psychosocial functioning compared to those with higher self-esteem.

This reveals a strikingly high prevalence of self-esteem issues among adult patients attending the Craniofacial Surgery Sector at HCPA. These findings underscore the importance of recognizing and addressing the psychological well-being of adult craniofacial surgery patients. Comprehensive psychosocial support, including counseling, peer support, and interventions to enhance self-esteem, should be integrated into the care of these patients. By addressing self-esteem concerns, healthcare providers can improve the mental health and overall quality of life of adult craniofacial surgery patients.

None Declared

The Pierre-Robin sequence (PRS), characterized by micrognathia, glossoptosis, and cleft palate, has long been a subject of clinical interest. Recent research suggests a potential association between PRS and cognitive or psychiatric disorders. This study explores this intriguing connection, shedding light on the complex interplay between craniofacial anomalies and mental health.

This study aims to establish a comprehensive understanding of the relationship between Pierre-Robin Sequence and psychiatric disorders. Specifically, our objectives include: assessing prevalence, evaluating impact and informing clinical practice. This research aims to improve the holistic care and mental well-being of individuals with craniofacial malformations, contributing to a more comprehensive approach in the field of psychiatry.

This cross-sectional study was conducted at a prominent referral hospital named Hospital de Clínicas de Porto Alegre, an international reference in Pierre-Robin Sequence, during the month of August 2023.

Participant Selection: Patients with PRS. Inclusion criteria encompassed individuals of all ages and both genders.

Data Collection: Trained medical personnel conducted structured interviews with participants to gather demographic information, medical history, and details of their craniofacial conditions.

Medical Records Review: Medical records were reviewed to corroborate craniofacial diagnoses and identify any comorbid conditions.

Statistical Analysis: Data were analyzed using appropriate statistical techniques to assess the association between PRS and psychiatric disorders.

Ethical Considerations: The study adhered to all ethical guidelines, with informed consent obtained from participants or their legal guardians. Ethical approval was obtained from the hospital’s Institutional Review Board.

Data Handling: Confidentiality and data security were ensured throughout the study, with all data anonymized to protect participant privacy.

In our study, we assessed 28 different patients with Pierre-Robin Sequence, comprising 13 females and 15 males. The youngest patient was 2 months old, while the oldest was 22 years old. The mean age of the patients was 4.75 years, with a median of 3 years and a standard deviation of 5.36 years.

Among the patients, 6 exhibited psychiatric disorders, split between 4 males and 2 females. Their average age was 10 years, with a median of 9 years and a standard deviation of 4.2. The youngest patient with evidence of a psychiatric disorder was 5 years old.

This study underscores a concerning reality within the Pierre-Robin population, pointing to a high prevalence of psychiatric disorders. These findings highlight the urgent need for integrated care, emphasizing the importance of early psychiatric assessment and tailored interventions to enhance the overall well-being of individuals facing the challenges of PRS.

None Declared

Electroconvulsive therapy (ECT) is a psychiatric intervention that has proven effectiveness and safety in various psychiatric conditions, such as major depressive disorder, prolonged or severe manic episodes and catatonia. Despite positive scientific evidence, ECT was always seen as controversial by patients, caregivers, and even some psychiatrists, which lead to a decrease in its use over the years.

To investigate the way young psychiatrists view the place of ECT in modern psychiatry by assessing their knowledge, attitude and access to training opportunities in ECT.

An anonymous survey was disseminated online among early career psychiatrists and psychiatric trainees. The questionnaire consisted of 36 multiple-choice and Likert scale questions.

Most of our respondents consider ECT both an effective and a safe treatment option and would recommend ECT to their patients when indicated. Early career psychiatrists who had access to ECT training are more knowledgeable about the indications, precautions and side effects of this method, but more than half of the participants mentioned ECT training was unavailable during their residency programme. Almost all respondents stated that they are interested in enhancing their theoretical and practical competencies in ECT.

Early career psychiatrists have a positive attitude towards ECT but express the need of targeted education aimed at improving levels of knowledge about ECT.

None Declared

Despite their documented efficacy, substantial proportions of patients discontinue antidepressant medication (ADM) without a doctor's recommendation. The current report integrates data on patient-reported reasons into an investigation of patterns and predictors of ADM discontinuation.

Face-to-face interviews with community samples from 13 countries (n = 30 697) in the World Mental Health (WMH) Surveys included n = 1890 respondents who used ADMs within the past 12 months.

10.9% of 12-month ADM users reported discontinuation-based on recommendation of the prescriber while 15.7% discontinued in the absence of prescriber recommendation. The main patient-reported reason for discontinuation was feeling better (46.6%), which was reported by a higher proportion of patients who discontinued within the first 2 weeks of treatment than later. Perceived ineffectiveness (18.5%), predisposing factors (e.g. fear of dependence) (20.0%), and enabling factors (e.g. inability to afford treatment cost) (5.0%) were much less commonly reported reasons. Discontinuation in the absence of prescriber recommendation was associated with low country income level, being employed, and having above average personal income. Age, prior history of psychotropic medication use, and being prescribed treatment from a psychiatrist rather than from a general medical practitioner, in comparison, were associated with a lower probability of this type of discontinuation. However, these predictors varied substantially depending on patient-reported reasons for discontinuation.

Dropping out early is not necessarily negative with almost half of individuals noting they felt better. The study underscores the diverse reasons given for dropping out and the need to evaluate how and whether dropping out influences short- or long-term functioning.

Depressive symptoms occur in different phases of psychosis, including prodromal, acute and post-psychotic. Post-psychotic depression (PPD) is a phenomenon that presents as a diagnostic and therapeutic challenge. Having been ascribed various descriptions in the past, PPD has been used in a broad manner to describe depressive symptoms that appear in patients with history of psychosis. PPD unveils itself as a separate nosological entity, differing from the adverse effects typically associated with antipsychotics, the negative symptoms of psychosis, and other psychiatric disorders that present with both psychotic and depressive symptoms (e.g. bipolar disorder, schizoaffective disorder, or psychotic depression).

The authors present a case of a 64 year-old man hospitalized due to inaugural psychosis with persecutory and grandiose delusions as well as auditory hallucinatory activity, who began to develop a depressive clinical picture whilst under treatment. A brief discussion on post-psychotic depression, from its clinical presentation to its treatment and implications in prognosis is also presented.

A brief non-systematized literature review using the Pubmed platform as well as presentation of a clinical case.

Depressive complaints are a common complication of psychotic episodes, with the literature estimating that approximately a quarter of psychotic patients present with PPD. Although typically described in association with schizophrenia, recent literature describes PPD occurring alongside other psychotic presentations, including first-episode psychosis. A division between affect and psychosis has been attempted in terms of psychiatric classification, however, the blurred lines between the two continue to contribute to difficulties in differential diagnosis. This becomes a challenge when distinguishing between extrapyramidal symptoms associated with antipsychotics, negative symptoms (i.e apathy, abulia and alogia) and psychiatric disorders with affective-psychotic overlap. Having only recently been considered a distinct clinical entity in psychiatric classification systems, research on its etiology, course, treatment and prognosis are scarce. In regards to the previously described patient, a depressive disorder whilst in treatment for psychosis was identified, and through early recognition of the symptoms treatment with an antidepressant was initiated with favourable response.

PPD is a relatively common phenomenon which is gaining more attention in recent literature. As classifications have begun to consider PPD as a distinct clinical entity, as well as unifying defining criteria, further studies can be developed so as to clarify aspects which remain to be defined. The clinician should be aware of this entity as well as the potentially confounding symptom presentations, so as to provide adequate early treatment thus contributing to improved patient outcomes.

None Declared

Brief psychotic disorder according to the DSM-5 is a condition of sudden onset lasting less than 1 month followed by complete remission with possible future relapses, characterized by the development of psychotic conditions. The duration of the illness is a differentiating factor from other disorders such as schizophreniform psychosis or schizophrenia. When there is a stressful event at the origin of the psychotic symptomatology, it is also called brief reactive psychosis. The pathophysiology of BPD is not known, especially given the extremely low incidence of the disorder. This condition most often affects people in their 20s, 30s, and 40s, and its higher prevalence among patients with personality or mood disorders may suggest an underlying biological or psychological susceptibility that may have some genetic influence.

To describe the main diagnostic considerations, clinical manifestations, treatment, prognosis and prevention of brief reactive psychosis through the description of a clinical case that developed two episodes of brief reactive psychosis in a period of 1 year and to emphasize the importance of maintaining treatment for a period of suitable time.

Case report and literature search with the terms: brief reactive psychosis, psychosis, neuroleptic, stressor event.

We describe the clinical case of a 29-year-old woman, born in S. Tomé and Príncipe, previously healthy, with no personal or family history of mental illness, who had her first brief reactive episode after coming to Portugal. With the introduction of the 2nd generation antipsychotic, paliperidone, there was a substantial improvement in the condition, however, with the development of side effects having subsequently abandoned the treatment. About 1 year after starting work in Portugal, she develops a new event, a new psychotic episode, with characteristics of a brief psychotic disorder.

It is extremely important to alert patients to the possible side effects of drugs, as well as those who experience a brief psychotic episode, which are the risk factors and the need to comply with treatment in order to avoid a new relapse.

None Declared

A feeling as ancient as humankind, having been documented in the Bible, represented by mythological figures and appearing as a recurrent theme in art and literature, jealousy is a complex emotion that is non-discriminatory and often associated with negative feelings ranging from insecurity, suspicion, rage, fear to humiliation. Commonly associated with romantic relationships, it typically arises when one perceives a threat, either real or imagined, from a third party in regards to possession or perceived security. Jealousy, like other aspects of the human experience, varies in its expression and intensity, ranging from an adaptive response to a potentially dangerous psychopathological symptom.

The authors aim to describe jealousy and discuss the spectrum on which it appears, ranging from an adaptive response to a psychopathological manifestation.

A brief non-structured literature review was carried out with recourse to various databases such as Pubmed as well as complimentary literary sources when deemed pertinent.

Described as a defensive reaction that is expressed as a cognitive, emotional and behavioural response to a perceived threat, jealousy has been discussed in various arenas of thought ranging from evolutionary psychology to philosophy to psychiatry to representation in the arts. It is a difficult term to define as it is a feeling expressed through diverse emotions and behaviours originating from various contexts as well as varying in its intensity. The literature demonstrates that jealousy can exist as an adaptive response, with evolutionary explanations, to a psychopathological expression either as obsessive jealousy or morbid jealousy, also known as Othello’s Syndrome. Each carries its own particularities in terms of expression, clinical significance and intervention. The more often described delusional jealousy, is characterized by the presence of strong, false beliefs that the partner is unfaithful, whereas obsessive jealousy, less commonly described, presents with unpleasant, ego-dystonic and irrational jealous ruminations that the partner could be unfaithful. These thoughts are often accompanied by compulsive verification of the partners’ behaviour. Treatment interventions in these cases are varied and present implications in prognosis.

Jealousy is a complex emotional state and has been described as part of the universal human experience, with research indicating its existence across various cultures. The expression of this emotional experience as well as its potential manifestation types should be taken into consideration by the mental health practitioner when carrying out an evaluation, as treatment interventions and prognosis may vary depending on the presentation.

None Declared

With a history of several decades, electroconvulsive therapy (ECT) has been carefully investigated and data supports its use as a safe and effective treatment for patients with severe depression, prolonged or severe manic episodes and catatonia. However, ECT is still regarded with reluctance by patients and caregivers, and its acceptance and use seem to be controversial even for psychiatrists.

To investigate the access to opportunities of training in ECT among early career psychiatrists and their views regarding the place of ECT in modern psychiatry.

A cross-sectional study was conducted between July and December 2022 utilizing an anonymous online survey consisting of 36 multiple-choice and Likert scale questions.

These preliminary findings show a great discrepancy regarding the availability of ECT training in European countries, as access to specialized ECT centers is unavailable in some areas. Early career psychiatrists who had access to ECT training are more knowledgeable about the indications, precautions and side effects of this method. Most of our respondents consider ECT both an effective and a safe treatment option and have expressed their wish to improve their theoretical and practical competencies in ECT.

ECT is a standard treatment and a therapeutic mainstay in psychiatry but is being less performed in some countries. Early career psychiatrists lack experience with ECT but are interested in training opportunities. Future actions are needed for the improvement of education and training in ECT.

None Declared

Mood disorders have been reported in the literature as a risk factor for developing cognitive deficits. Bipolar disorder (BD) and Frontotemporal Dementia (FTD) share many common features, often presenting as a differential diagnostic challenge to the clinician. The clinical features of mania, such as euphoria, hyper-sexuality and difficulties in impulse control can mimic the impaired judgment and loss of inhibition seen in FTD. Depressive features such as anhedonia and social isolation can mimic apathy associated with FTD. Of the various subtypes, the behavioural-variant of FTD (bvFTD) is most similar to a manic episode.

The authors aim to explore the relationship between BD and FTD, and the implications in differential diagnosis, treatment and prognosis with recourse to a clinical case example.

A non-systematized review of pertinent literature on the topic with focus on that which is most relevant to the theme was included. The authors present a clinical case of 55 year-old female with history of BD who was hospitalized in the context of a depressive episode with suicidal ideation and disorganized behaviour.

It is not uncommon for patients with bvFTD to be initially diagnosed with BD, whereas on the other hand, patients presenting in late with an inaugural manic episode are considered to have dementia. The literature also reports that patients with BD appear to be at increased risk of a later FTD diagnosis, further contributing the diagnostic difficulties. Core symptoms that present in mood disorders, also make-up the clinical picture of FTD, and vice versa. Correct diagnosis is imperative as early-intervention may have significant impact on prognosis of the clinical pictures. The patient underwent complementary diagnostic imaging testing with magnetic resonance imaging, which documented atrophy in the fronto-temporal regions which were not detected on previous exams, thus strongly suggesting a FTD diagnosis in a patient with history of BD.

The literature establishes, especially through various case reports, an apparent clinical overlap between FTD and mood disorders. A multifaceted connection between BD and FTD appears to exist, with clinical and genetic similarities having been described, although further studies are merited demonstrating this relationship. The clinical case highlights the challenges in FTD diagnosis in a patient with prior history of a mood disorder, especially BD, as well as demonstrating the difficult task in establishing a differential diagnosis between the two conditions when the mood disorder presents late in life. The clinician is alerted to the mimicry between the two conditions, taking into account the possibility of a FTD diagnosis in patients with history of BD presenting with unexpected cognitive and behavioural decline.

None Declared

Recent evidences suggest that situations of abandonment, neglect and abuse are risks factores for onset of psychopatology in adulthood. This association occus in that traumatic events in the early stages of development and may trigger severe and disabling psychiatric disorders in adults.

The presente study aimed to evaluate the associations between the occurence and severity of chidhood trauma and the development of psychiatric disorders in hospitalized teenagers of the Hospital Psychiatric Vida Londrina/Pr.

The sample was consisted of 14 psychiatric patients, evaluated for severity of psychiatric symtoms by the Back Scale for Suicid Ideation (BSI); Beck Depression Inventory (BDI); Beck Anxiety Inventory (BAI); Back Hopelessness Scale (HAD) and the Barratt Impulsiveness Scale (BIS-11).

In the sample studie, 84% of the teenegers reports that they had some type of childhood trauma. The results indicate that traumas are associated mainly with the development of mood disorders and also with increasin severity of psychiatric symptoms, specially the depressive symptoms, hopelessness, suicidal ideation and impulsivity. Teenagers with emocional neglect, emocional abuse and physical neglect demonstrated having five times more risk of personality disorder. Individuals who suffered physical abuse; sexual abuse and physical neglect presentes at three times more risk of commiting suicid attemps.

These data demonstrate the relevance of trauma childhood as a trigger for psychiatric symptoms.

None Declared

Folie à deux is a clinical condition that was first described in 19th century. It is a psychotic disorder in which two closely associated individuals share a similar delusional system. However, folie à deux is still a matter of study and debate today as it remains a challenge for psychiatrists.

The aim of this article is to report a clinical case of folie à deux, between na inducer son and an induced mother. Review the nosological significance of folie à deux and to explore the disorder among patients with psychosis.

Search in the PubMed/MedLine and Medscape databases with the following key words: folie à deux; shared psychosis; shared delusion.

We presente a case of folie à deux between na inducer son 28 years old and the induced, his mother. They were found to be sharing similiar delusional beliefs. The patient has assumed the role of “man of the house” since his father’s death.

Many years after it was first described, folie à deux is still an interesting and challenging disorder to psychiatrists. Its recognition and correct referral for a rare diagnosis, such as folie a deux, are extremely important.

No significant relationships.

The capacity for lying is a common human phenomenon with evolutionary explanations, in which one seeks to deceive usually to avoid harmful or undesired consequences. The spectrum of lies is vast and varies from the content to the motivation. Pathological lying has the potential to affect mental evaluations thus motivating an important discussion regarding this behaviour.

The authors aim to explore the psychopathological concept and spectrum of pathological lies, from their underlying motives to their implications and challenges in psychiatric diagnosis with recourse to a clinical case example.

A review of pertinent literature on the topic with focus on that which is most relevant to the theme was included. The authors present the clinical case of a middle-aged female who presented with mythomania which included the fabrication of having attempted murder.

The literature demonstrates a relationship between compulsive lying and personality disorders. Head trauma and other central nervous system issues may also play a role. Some traits may facilitate the detection of deception, such as dramatic and unmotivated constructs with a positive self-portrayal. The clinical case description correlates the personality factors associated with mythomania, namely antisocial personality disorder, differing from the typical presentation as her fabrications portrayed her negatively.

The implication of pathological lying is that it may interfere with mental assessment thus altering, by way of deception, the psychiatric evaluation as lies may be difficult to detect upon a first evaluation. The psychiatrist should be alerted to the possibility of fabrication when dealing with a patient with predisposing factors.

No significant relationships.