3 results
Autistic spectrum disorder masked by mental retardation and impulse control disorder
- L. Rodríguez Andrés, T. Ballesta Casanova, M.S. Hernández García, C. Noval Canga, L. Gallardo Borge, J.A. Espina Barrio
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S639
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Clinical case report
A 48-year-old male, diagnosed with impulsive control disorder, sex addiction disorder and mental retardation was followed-up by different psychiatrists for the last 20 years. He consults because of presenting depressive symptoms and behavioural disturbances related to the death of his mother two years before. The patient reports to experimenting depressed mood, irritability, insomnia and trends to cry. He has lost motivation for his job and hobbies (he used to show interest in topics such as physics, philosophy, maths, and medicine). He has feelings of loneliness, which make him look for social interaction and support through continuous calls to telephone sex lines. This act has made him spend large amounts of cash, thus, making him be in deep debts. He does not feel integrate in society.
Mental status examinationIntrovert, limited social skills, coherent language, echolalic, monotone, tangential speech, depressed mood, feelings of guilt and futility, dysphoria, partial anhedonia, ideas of hopelessness, structured death ideation, unconsciousness of his own acts, with trend to impulsiveness and compulsive behaviour and insomnia.
Complementary testWais test: no mental retardation found.
DiagnosisAutistic spectrum disorder (F84.0); major depressive disorder (F32.1); bereavement (V62.82).
DiscussionThe patient showed classic diagnostic criteria DSM 5 associated with autistic spectrum disorder (Asperger's disorder in DSM-IV); the permanent inability for social interactions and repetitive, restricted and stereotypic behavioural patterns.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Results of a smoking cessation program in primary care
- H. de la Red Gallego, Y. González Silva, T. Montero Carretero, Á. Delgado de Paz, M.F. Sánchez Añorga, E. Cañibano Maroto, G. Isidro García, A. Álvarez Astorga, A. Alonso Sánchez, M. Martín Fernández, A. Álvarez Hodel, I. Pérez González, S. Nieto Sánchez, S. Calvo Sardón, I. González Gurdiel, R. Hernández Antón, S. Gómez Sánchez, C. Noval Canga, M.S. Hernández García, L. Rodríguez Andrés
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S297-S298
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Introduction
Smoking is an addictive and chronic disease. Twenty-four percent of the Spanish population in 2012 smoked daily.
Aims and objectivesTo evaluate a smoking cessation program in a Primary Care Center.
MethodsObservational, prospective study. We describe an individualized smoking cessation in Plaza del Ejército Health Center (Valladolid). Inclusion criteria: active smoker, ≥ 18 years old and belonging to the Health Center. Exclusion: severe mental illness. Included patients from November 2013 until January2014. Ended in July 2014. Four Medical residents participated, we present the results of one of them. During the first consultation motivational interviewing was conducted, physical examination and treatment was prescribed (cognitive behavioral therapy or drug treatment: varenicline). In subsequent consultations interview and follow-up. Variables: age, gender, pack-years, nicotine dependence (Fagerstrom) and Prochaska and DiClemente phase, weight, treatment used, dropout rate and final withdrawal of snuff.
ResultsEleven patients, mean age 48.18 (13.61), 7 (63.6) women. Comorbidity: 6 (54.5) anxious-depressive pathology, 1 (9.1) dysthymia, 2 (18.2) endocrine pathology and 1 (9.1) respiratory disease. Four (36.4) showed high dependency and 2 (18.2) extreme. Media packages 20.50/year (19,20). Seven (63.6) were in action phase of Prochaska and DiClemente and 2 (18.2) in preparation. Visits range: 1-11. The average was 4.55 (3.64). Three (27.27) patients attended only the first visit. Four (36.4) achieved complete abstinence, 3 (27.27) met maintenance phase. One (9.1) reduced consumption in half. Patients gained average 0.5 kg (2.47).
ConclusionsThe results are similar to those reported in other series. Modest dropout rate. No pharmacological treatment was used due to high coexistence of comorbidities, the only patient who used varenicline suffered insomnia. Average age and media packages were superior to other series.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Immunity and eating disorders. Clinical description of a case
- M.D.H. Gallego, A. Álvarez Astorga, A. Alonso Sánchez, R. Hernández Antón, E. Mayor Toranzo, I. Sevillano Benito, M.S. Hernández García, M.S. Geijo Uribe, F. De Uribe Ladrón de Cegama
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, pp. S552-S553
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Introduction
Recently, there is an increasing interest in the link between anorexia nervosa and autoimmune diseases. Studies show significant association between anorexia nervosa, diabetes mellitus, autoimmune thyroid disease and Crohn's disease [1]. The findings of significantly elevated autoantibodies (anti α-MSH, anti ACTH) and cytokines (IL-1, IL-6, IFN-γ, TNF-α) support this relationship.
ObjectivesTo illustrate with a clinical case the connection between eating disorders and Crohn's disease.
MethodsFourteen years-old boy with moderate depression syndrome after his grandfather's decease. Since overweight diagnosis by his pediatrician, he begins to restrict food intake with an important weight loss (19 kg in 9 months) and over exercising. Blood test reveals microcytic and hypochromic anaemia, rest of the examination shows no other disorder. Psychometric assessment EDI-3 suggests Anorexia Nervosa restricting type.
ResultsTwo months after clinical stabilization, he is hospitalized due to abdominal pain. Exploration including blood test, serology, coproculture, sonography and colonoscopy reveals severe Crohn's disease.
ConclusionsThis case is about a patient diagnosed of moderate depressive syndrome, who develops anorexia nervosa and Crohn's disease during his follow up. It exemplifies the link between stress, immunity and eating disorders. Recent findings suggest that immune diseases are involved in onset and maintenance of eating disorders. More studies are required in order to inference its consequences in evaluation, prognostic, treatment and identification of subgroups of patients.
Disclosure of interestThe authors have not supplied their declaration of competing interest.