An example of the unification of the contrast between artistic creativity and discipline of science, Nikola Tesla engineer and physicist, was also a prolific inventor that contributed to the transformation of modern society. Having resurfaced in the mainstream culture as a mythical figure, he appears to be enjoying a renaissance of posthumous recognition and praise. Throughaccounts available directly from his autobiography and descriptions offered by those who worked with him, the existence of the inventor´s eccentricities appear to reveal the existence of mental health disorder.

The authors explore Tesla and the psychopathology that accompanied him throughout his periods of brilliance and as well as hardship.

The authors conducted a brief non-structured narrative literature review. The keywords used during the research, alone or in combination, included: Nikola Tesla, psychopathology and mental illness. The works consulted included: news articles, autobiographies and biographies. 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 popular image of the mad scientist, which describes a brilliant but solitary and eccentric individual focused on their work is one that could be applied to Tesla. Documents reveal that he suffered a nervous breakdown, as well as having symptoms that point to a probably presence of obsessive-compulsive disorder, of which included counting and cleanliness rituals, exacerbated by chronic insomnia.

There appears to be anecdotal evidence pointing to an eventual relationship between creative genius and mental pathology. Although not formally evidenced through the scientific literature, exploring the life and accomplishments of Tesla serve as a significant example of a spark of genius perhaps ignited by mental illness. Tesla demonstrated suffering associated with his symptoms especially when considering the end of his life. At the time, adequate mental health interventions and treatments were not widely available, with his diagnosis probably being considered the quirks of genius and not the symptoms of disease.

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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.

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A number of studies have demonstrated that hyperthyroidism increases the prevalence of psychiatric disorders and the likelihood of depressive symptoms, anxiety and hipomania. Apathetic hyperthyroidism is a syndrome, which presents with symptoms of depression, apathy, somnolence or pseudodementia in the absence of the usual symptoms and signs of hyperthyroidism. This condition is more common in the elderly although it has also been described in young adults and adolescents.

In the majority of cases, treatment of hyperthyroidism results in an improvement in neuropsychiatric manifestations in parallel with an improvement of psychical (somatic?) symptoms and psychotropic medication is deemed unnecessary.

Approximately one-third of patients with Graves’ hyperthyroidism are prescribed psychotropic drugs. Sometimes to treat mental symptoms like psychosis or severe agitation, sometimes to treat mental symptoms remaining after amelioration of hyperthyroidism, and sometimes when the diagnosis of Graves’ hyperthyroidism has been missed and the patient is treated as having a primary psychiatric disorder.

To present a case of a patient with neuropsychiatric symptoms caused by thyroid dysfunction.

Case presentation and non-systematic review of existing literature on Pubmed using the following keywords: hyperthyroidism, psychiatric disorders, psychiatric symptoms, depression, psychosis.

We report the case of a 21-year-old female without history of psychiatric illness who presented to the emergency department with somnolence, apathy, cognitive impairment (answering “I don’t know” to most questions), poverty of speech, abulia, perplexity and delusional belief of ruin, in addition to physical symptoms namely alopecia and weight loss. According to her father, she was very active and dynamic person until two days prior, when he started noticing growing apathy, leading to job absenteeism. Urine analysis for elicit drugs was negative.

Investigation for organic disease was undertaken and the blood analysis revealed overt hyperthyroidism.

She was initially treated with aripiprazol. After thyroid dysfunction was identified, she was evaluated by an endocrinologist and started treatment with tiamazol and propanolol, presenting gradual remission of the psychiatric changes. Aripiprazole was discontinued and she was reevaluated in psychiatry consultation after about a month, with complete remission of psychiatric manifestations and normalized thyroid function.

Neuropsychiatric manifestations of thyroid dysfunction are often misdiagnosed as a primary psychiatric disorder. It is necessary to optimize the medical management of these patients in whom the psychiatric symptoms masks a curable organic cause.

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The Covid-19 pandemic has generated an unprecedented impact on multiple levels (health, occupational, economic, and social) which affected the general population and has been an enormous stress factor for individuals with obsessive-compulsive disorder (OCD), particularly for those with contamination symptoms. Many patients, as well as healthy individuals, experienced new obsessive-compulsive-like symptoms centered on COVID-19 during the pandemic. However, data on this population are still scarce.

To present a case exemplifying the association between the Covid-19 pandemic and the onset of OCD.

Case presentation and non-systematic review of existing literature on Pubmed using the keywords: Covid-19, OCD, pandemic, depression.

We report a case of a 30-year-old female who presented to the emergency department due to depressive mood and suicidal ideation associated with exacerbation of OCD symptoms, namely intense fear of being infected with Covid-19. These symptoms led to avoidance of touching objects, surfaces or even herself in addition to frequent and long rituals of hand-washing and showers. She was asymptomatic prior to being infected with Covid-19, when she started developing obsessive ideas of contamination. She sought psychiatric support and was medicated with fluoxetine, olanzapine and clonazepam. Due to insufficient symptom control, she was admitted to the psychiatry ward, where treatment was initiated with aripiprazol and fluvoxamine. After dose titration, gradual remission of OCD symptomatology and depressive mood was observed.

The present case illustrates the correlation between Covid-19 and the onset of OCD symptomatology. Existing studies demonstrate that the pandemic worsened the landscape of symptoms of OCD, both in diagnosed patients as well as in previously healthy individuals. However literature is still limited thus, multinational and cross-cultural, longitudinal studies are warranted to gain further insights on this topic.

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Schizophrenia is a complex psychiatric disorder in which biological sex differences, have been extensively documented and researched. What is less well described, is what motivates these differences. Of the various proposed and explored reasons, estrogen appears to be one that has maintained some interest and promise. An increase in symptoms of schizophrenia has been observed to correspond with decreasing levels of estrogen in menopausal women, this, allied to the later symptom onset, culminated in the interest in this hormone and its role in psychotic illness.

The authors aim to briefly explore the current evidence on the association between estrogen and schizophrenia. Its relevance in symptom onset, protective status and eventual therapeutic applications will also be discussed.

The authors conducted a brief non-structured narrative 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: sex hormones, estrogen, schizophrenia and psychiatry.The studies consulted in this work included: cross-sectional studies, cohort studies, literature reviews and clinical case reports.

The literature exploring the relationship between the sex hormone, estrogen, and schizophrenia is extensive. Various studies confirm that during periods of estrogen withdrawal, women appear more susceptible to psychotic episodes. Results also demonstred that those with low estrogen, respond poorly to anti-psychotic drugs, whereas estrogen increased the efficiency of antipsychotics. In regards to symptoms, estrogen has been demonstrated to reduce the positive and cognitive symptoms of schizophrenia in the short term, thus being proposed as an eventual complementary treatment in those suffering from the disorder. It is known that estrogen regulates important pathophysiological pathways in schizophrenia, including dopamine activity, mitochondrial function, and the stress system.One of the explanations for this beneficial effect has been proposed to be action on cerebral blood flow and glucoce metabilism, as well as sensitizing postsynaptic dopamine receptors, thus serving as a protective agent against schizophrenia.

The research appears to be pointing in the direction that estrogen appears to have an effect on psychosis in women, serving as a protective factor in these conditions as well as playing a significant part of the pathophysiology in schizophrenia. This influence on the pathophysiology, promises clinical pertinence, not only in a possible application so to attenuate positive and cognitive symptoms but also as a method to influence antipsychotic efficacy. Continued study in regards to the effects of sex hormones on the psychotic disorders is merited so as to further expand the tools in the mental health professional’s repertoire in the treatment of these serious mental illnesses.

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Shakespeare wrote that “We are such stuff as dreams are made on; and our little life is rounded with a sleep.” Sleep is a fundamental part of our being, so much so, humans tend to spend one third of their lives in this immobile and vulnerable state. Disorders of sleep have been the target of much scientific curiosity and investigation, with inumerous articles, reports and books dedicated to the theme. The bidirectional relationship between psychiatric disorders and those of sleep is also well described. Schizophrenia is a heterogenous psychiatric disorder which is often associated with sleep disturbances of various kinds.

The authors aim to briefly explore the relationship between schizophrenia and sleep disturbances. Potential underlying mechanisms and risk factors, as well as therapeutic interventions will be addressed.

The authors conducted a brief non-structured narrative 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: sleep disturbance, sleep disorder and schizophrenia.The studies consulted in this work included: cross-sectional studies, cohort studies, literature reviews and clinical case reports. Works that were included, were written in the English language and deemed as pertinent to the explored theme.

Although sleep disturbances do not make up part of the criteria formal diagnosis of schizophrenia, they are present in approximately 80% of those with the condition and have been identified as a common symptom in prodromic clinical pictures. The problems in sleep are as heterogenous as the presentations in schizophrenia, ranging from insomnia, restless legs syndrome, obstructuve sleep apnea, circadian rhythm disfunctions to hypersomnia. Sleep has been identified as fundamental for the reparation and restoration of various bodily systems, it is no surprise that sleep irregularities, especially in schizophrenia, can significantly reduce quality of life and promote deterioration. Some studies have stated the role that D2 receptors have in the classic symptoms of schizophrenia as well as on sleep disturbances. Second-generations antipsychotics have not only demonstrated much promise on psychotic symptoms, but they appear to aid in sleep regulation and quality.

Sleep is fundamental for mental health. Various sleep disturbances have been identified in those suffering with schizophrenia. Slepe disturbances have been associated with worse outcomes, more florid clinical pictures and significant deterioration. Thus, bettering sleep quality in these patients, would permit better health outcomes which are fundamental in those who live with schizophrenia.

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Questions regarding death have generated debates and art since the dawn of civilization. These themes permeate through various areas of study, including religion, philosophy, ethics, medicine and humanities. Various countries have been revising their laws regarding the end of life, especially on the right to aid and choice in the end in the context of medical and phychological suffering. Physician-Assisted Suicide (PAS) and euthanasia are methods by which people, mostly terminal patients, seek to end their lives with the help of medical professionals. PAS and euthanasia have been the target of heated debates in politics and in medicine, with the question of ethics centering most of these.

The authors aim to explore PAS and euthanasia in the context of the ethical debate. Based on the pillars of ethics, based on the principal of do no harm and beneficence, the authors explore the role of the Psychiatrist, if any, in these end of life issues.

The authors performed a brief narrative review of the available literature, with recourse to various databases such as PubMed and Scopus. The search terms utilized in isolation or combination included: physician assisted suicide, euthanasia, psychiatry, mental illness and ethical issues. Taking into consideration the widespread discussion of these themes in the public forum, news articles were included based on their merit and relevance to the explored topic.

The ethical debate appears to rest between the pillars of first, do no harm, the principles of beneficence and nonmaleficence and aut. Here, the conflict between the first and last appear, where the killing of any patient, whether directly or indirectly is clearly contrary to the principle of primum non nocere. However, the prolonging of suffering in a terminal patient, appears to contradict the principles of nonmaleficence. The Psychiatrist is called to evaluate competence to choose, which is allied to autonomy. Other sources explore the role of the Psychiatrist in permitting a suicide to occur, when the profession is dedicated to the prevention of suicide. From the literature, the psychiatric evaluation is rarely regularly carried out, usually being solicited in cases where mental illness which might compromise the capacity to choose is suspected.

In ethical debates, clear cut answers are rarely every developed, with the nuance and greyscale of difficult topics usually dividing those that ferverantly champion each cause. Psychiatric evaluation is usually invoked when patient autonomy, especially in terms of capacity, is called into question. Questions remain as to whether the presence of the psychiatrist should be a regular one in these procedures or if it should be carried out in a selective manner. There is little consensus in regards to this role, which merits further conversation in the various forums of medical and ethical communication.

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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.

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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.

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Existing as an emerging topic in the field and undergoing constant evolution, Transcultural Psychiatry addresses how social and cultural factors influence mental illness. During the second half of the twentieth century, phenomena such as globalization, massive migrations and immigration, occurring in ever increasing frequency, continue to bring this topic to the forefront of discussion as challenges in the treatment of patients from varying cultural backgrounds emerge. Viewed from the biopsychosocial perspective, culture delineates a framework for the evaluation of various expressions of emotion and behaviour as well as defining the limits of what counts as disorder. As border restrictions are lifted, cases which present with these particularities are bound to increase, necessitating an increased attention to the influence that cultural and social factors play in the psychopathological clinical pictures which may present to the practitioner.

The authors aim to briefly explore the concept of transcultural psychiatry and its importance in clinical presentation and practice with recourse to various clinical cases of international patients hospitalized in a Portuguese Psychiatry ward during a two-year period.

A brief non-systematized literature review was performed based on works most pertinent to the topic discussed. As compliment to the topic, a discussion of various clinical cases of hospitalized international patients is presented.

Culture has been demonstrated to contribute to psychopathological presentations in a variety of forms, solidifying the old adage that ‘no man is an island’ and giving reason to the biopsychosocial approach applied in clinical practice. The impact of sociocultural factors is such that the DSM-5-TR includes in its classification culture-specific syndromes. The cases discussed demonstrate the various nuances necessary not only in exploring psychopathology, but also in implementing appropriate standards of care.

Transcultural psychiatry rises as a relatively recent topic as well as raising important philosophical, theoretical and technical challenges for mental health practitioners. Although existing as a subspecialty, each mental health practitioner should strive to be transcultural, taking into consideration the influence that these factors exert on mental illness. The patient should be evaluated with consideration to their cultural background, as well as not neglecting how the culture of the practitioner may influence the interpretation of psychopathological presentation.

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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.

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Delusion of pregnancy (DP) is a heterogeneous symptom that can emerge from different neuropsychiatric syndromes, including schizophrenia, bipolar disorders, but also major neurocognitive disorder (MND). According to the Diagnostic and Statistical Manuel of Mental Disorders-5 (DSM-5), DP is an unspecified type of delusional disorder present in the spectrum of schizophrenia and other psychotic disorders This type of delusion, which can affect both sexes, may have numerous determinants to its genesis and may last decades to resolve.

We aim to present a case and review of DP and its association with dementia/MND, hyperprolactinemia and galactorrhea.

Non-systematic literature review and case report, based on the search for titles and/or abstracts of articles that address both DP and dementia, and DP and hyperprolactinemia/galactorrhea, including articles published between 2010 and 2022 in English.

A 71-year-old female patient was admitted to the Psychiatric unit due to a change in usual behavior in the past 6 months: insomnia, anterograde amnesia, delusions of ruin and persecutory and, for the past month, the belief of being pregnant with twins, supported by the galactorrhea she presented after starting Risperidone prescribed by her Family Doctor weeks prior. Shortly after admission, the patient also revealed hearing her fetuses’ voices. DP vanished briefly after admission due to the combination between the change of Risperidone to Aripiprazole (a prolactin-sparing antipsychotic) and psychotherapy to help deconstruct the patient’s cognitive misinterpretations. She was furthermore diagnosed with Alzheimer’s disease and Memantine was started.

This patient, according to Bera et al. (Bera et.al. Indian J Psychol Med 2015;37:131-7) is part of the 28.6% of patients more than 50 years of age who present DP, 6.0% that report having twins and 8.3% that report hearing voices of their fetuses. No data was found correlating DP and MND directly. Hyperprolactinemia and its consequent galactorrhea represent one of the many explanations behind DP, especially in suggestible demented patients that easily misinterpret somatic sensations, in which delusional thoughts are frequent and contribute to the morbidity.

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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.

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Although evidence of cannibalism in humans dates back millennia, for most civilized societies, it is an unthinkable act of violence and strictly taboo. It is commonly relegated to the domain of horror films and literature, often associated with the likes of Jeffrey Dahmer or Hannibal Lecter. However, for some, this theme encompasses a pathological or sexual realm. Vorarephilia or sexual cannibalism is, at its simplest level, a psychosexual disorder characterized by the erotic desire to be consumed by, or to personally consume, another human being´s flesh.

The authors aim to review human sexual cannibalism as a concept and its eventual relationship to mental illness with recourse to the description of cases of human cannibalism documented in the literature.

A brief non-systematized literature review utilizing various databases including Pubmed and Google Scholar, as well as complimentary literature and case reports when pertinent to the theme was performed.

Although cannibalism is a common phenomenon in the animal kingdom, its expression in humans is assumed to be a minority occurrence and relegated to stories of a more primal past. Pathological cannibalism is an extremely rare occurrence and has been described in association with severe psychotic mental illness and extreme forms of significant paraphilia. Sexual cannibalism appears as a rarity in humans and although the majority with this paraphilia do not partake in actual human consumption, remaining a fantasy-based desire, cases of cannibalism have been reported and tried.

Eating the flesh of one’s own species is probably one of the few remaining taboos in modern human societies. In humans, cannibalism is a rare occurrence and has been associated with mental illness. Due to the rarity of this phenomenon, with few cases documented in the literature, the underlying etiology, as well as potential environmental and individual risk factors are still to be defined, indicating a potential for further study.

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The diagnosis of the main psychiatric syndromes is still almost exclusively phenotypic and depends essentially of the recognition of characteristic signs and symptoms. The clinical evalution allows the formulation of a set of differential diagnoses, according to the pathological meaning of certain symptomatic patterns and combinations. Aside from the entire dependence on the clinical interview, there are still no complementary psychiatric diagnostic exams and it is also worth noting the absence of pathognomonic symptoms.

Through the presentation of the case of a patient with Bipolar Affective Disorder who manifests, during a manic episode, a Capgras delusion, we intend to approach the heterogeneity of the manifestation of some symptoms that tend to be specific of concrete psychiatric syndromes.

Clinical case presentation and non-systematic literature review using Pubmed plataform.

AB, female, 49 years old, diagnosed with Bipolar Affective Disorder. Hospitalized for a manic episode with dysphoric mood, increased energy levels and delusional activity of grandiose and persecutory content. During hospitalization, a Capgras delusion centered on the husband emerged: he was replaced by a stranger, I was able to detect him by smell.

Capgras delusion is a delusional misidentification syndrome characterized by the belief that someone close has been replaced by an imposter. Despite being a rare syndrome, vastly more common in schizophrenia, affecting about 73% of cases, it can also occur in other psychiatric conditions such as dementia syndromes and, less often, mood disorders (16.7%).

Additionally, there are several examples that demonstrate the versatility of psychiatric symptom occurrence in different diagnoses, with first-rank symptoms serving as an example. Described in 1959 by Kurt Schneider, they were considered specific symptoms of schizophrenia, assuming this diagnosis based on the recognition of only one symptom. Over time, its pathognomonic character has become extinct, and its detection in mood disorders and acute psychotic disorder is relatively common.

Another example is the overlap between depressive and anxious symptoms. In fact, anxiety symptoms occur in about 85% of patients diagnosed with depressive disorder and, in turn, the presence of depressive symptoms in about 90% of patients diagnosed with anxiety disorder. This evidence has allowed, over time, a review of the diagnostic criteria for these disorders, leading to a progressive blurring of the threshold between them.

Psychiatric diagnosis is still a delicate task, totally dependent on the clinical interview. The lack of analytical and imaging tests, as well as the absence of pathognomonic symptoms, constitute a particular challenge in diagnosis. For this reason, we highlight the importance of recognizing combinations and patterns of symptoms rather than the specificity of just one symptom.

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Frontotemporal dementia (FTD) is a devastating neurodegenerative condition with several clinical presentations for which there is currently no effective treatment. Although much less common than Alzheimer’s disease, the impact of FTD is high thanks to its relatively early onset and high heritability. This subtype of brain atrophy production decided the frontal and temporal lobes.

Clinical heterogeneity and overlap with other neurodegenerative and psychiatric syndromes complicate diagnosis. Three different subtypes are recognized: behavioral variant, non-fluent aphasia, and progressive semantic dementia.

Clinical review of frontotemporal dementia including the clinics, determination of diagnosis, treatment, and prognosis with a clinical case report.

Bibliographic research with the terms dementia, frontotemporal dementia.

The current clinical case follows a patient in her fifties, born in Brazil, who has a child and a poor social support network. No significant history, celebrating at least two years marked by an evolution framework of progressive change in verbal memory, increase in verbal influence, change in executive functions, namely, and definition of verbal decision.

In general terms, behavioral and language alterations are the dominant aspects of this type of dementia and as characteristics common to the various subgroups of FTD.

FTD is a catastrophic clinical entity thanks to its beginning, the exuberance of the clinical picture, and mainly the lack of treatment with guidance aimed at relieving symptoms and improving the patient’s quality of life.

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