Family Psychiatric History Research Articles

Psychomotor Agitation Following Treatment with Hydroxychloroquine.

We describe the case of an elderly woman with elderly-onset rheumatoid arthritis, where the use of 4 mg/kg/day of hydroxychloroquine (HCQ) was followed by the onset of psychomotor agitation with marked physical and verbal violence towards her partner, including throwing objects at her partner. No disturbance in sleep and no anxiety, nervousness, or irritability had emerged before the onset of her psychomotor agitation. The disappearance of agitation following targeted pharmacologic intervention and HCQ interruption, its re-onset after reintroduction of the drug, and the high score (9) of Naranjo’s algorithm are surely linked to the existence of a causal relationship between HCQ and psychomotor agitation. HCQ may produce undesirable effects on the central nervous system, mainly irritability, nervousness, emotional changes, and nightmares. To the best of our knowledge, there are only a few case reports of psychosis due to HCQ. No favoring condition such as pharmacokinetic interactions or a personal and family psychiatric history was present in our patient. The neuropsychiatric manifestations we observed could be considered a bizarre-type adverse drug reaction linked to an individual’s hypersensitivity.

Pediatric Mania: The Controversy between Euphoria and Irritability.

: Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95–100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common.Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder.

Prevalence of borderline personality disorder and its risk factors in female prison inmates in China

High prevalence of borderline personality disorder (BPD) has been found in Western prisons but no such data exists in China. The objective of this study was to determine the lifetime prevalence of BPD in Chinese female prison inmates and its associated risk factors. This cross-sectional study was conducted in Hunan Provincial Female Prison. Data on consenting inmates’ socio-demographic and clinical characteristics were collected and the diagnosis of lifetime BPD was established using the Structural Clinical Interview for DSM-IV. The prevalence of BPD was 10.6% in the cohort of 2709 participating inmates. Multiple logistic regression analysis revealed that younger age, unmarried marital status, higher education level, fewer major medical conditions, more frequent personal and family members’ drug use, more frequent comorbid psychiatric disorders and family history of psychiatric disorders were positively and independently associated with BPD. BPD is common in Chinese female prison inmates. Considering its adverse social consequences and impact on physical and mental well-being, serious attempts should be made to diagnose BPD early and improve access to treatment in women prisons.

Abrupt Discontinuation of Champix in a Patient with Major Depressive Disorder, In Full Remission, Can Induce Serious Adverse Events: A Case Report

Objective: The smoking cessation drug, varenicline, has had effective results, but has also been linked with psychiatric side effects, particularly during treatment. Many cases of varenicline - induced psychosis have been reported, however, very few cases are seen with onset during withdrawal. This case report describes the development of a serious adverse event induced by the discontinuation of varenicline, in a patient with major depressive disorder in full remission. Methods and Results: A patient, with a psychiatric history of major depressive disorder, in full remission, discontinued the use of varenicline on two separate occasions. The first instance, the patient experienced out of character changes, including irritability, aggression, and inappropriate and bizarre public behaviour. The second attempt, the patient experienced the same symptoms, as well as a serious adverse event, where she stabbed herself 15 times in the abdomen. A psychiatric review was performed, and no underlying psychotic disorders were noted. Conclusion: Abrupt discontinuation of the varenicline treatment in patients with past, current, or family psychiatric history could trigger withdrawal-related serious adverse events. Physicians should carefully monitor these patients when terminating their treatment, as well as screen patients for any psychiatric history before prescribing the medication. Research should be conducted to further explore the topic of varenicline discontinuation in psychiatric patients.

M53 - Gene Expression Alterations Related To Mania And Psychotic Symptoms In Peripheral Blood of Patients with A First Episode of Psychosis

Background Psychotic disorders, such as schizophrenia and bipolar disorder, affect approximately 3% of the general population. The symptoms include hallucinations, delusional beliefs, severe mood variations, and cognitive impairment. However, these clinical aspects may be difficult to distinguish from one another, mainly during the early stages of psychosis. The first-episode psychosis (FEP) is a critical period given that brain abnormalities and cognitive deficits are already present and progress faster and more aggressively in the first years of the disorder. We investigated differences in the mRNA levels of 12 genes among individuals with FEP of schizophrenia spectrum disorder (FEP-S; N=53), FEP with mania (FEP-M; N=16), and healthy controls (N=73). We also verified whether gene expression is correlated to clinical features, including functional impairment and severity of psychotic, manic, and depressive symptoms. The study aims are to differentiate FEP-M and FEP-S, improving early diagnosis and adequate intervention. Methods Antipsychotic-naive FEP patients (N = 69) were recruited from a psychiatric emergency unit in Sao Paulo, Brazil. Trained psychiatrists established the diagnosis of a psychotic disorder and patients were assessed at baseline and followed up for at least two months. At the end of follow-up, patients with a schizophrenia or schizophreniform disorder diagnosis were classified as FEP-S (N = 53) and patients who met bipolar disorder (with psychotic symptoms) diagnostic criteria were classified as FEP-M (N = 16). Healthy controls were age- and gender-matched with no current or previous diagnosis of a psychiatric disease or family history of a psychotic disorder (N = 73). A total of 5 mL of whole blood was collected in PAXgene® RNA tubes and RNA was isolated with PAXgene Blood RNA kit. Approximately 400 ng of each RNA sample was reverse-transcribed. The expression of 12 psychotic-disorder-related genes was evaluated by quantitative PCR. Gene expression was quantified using the relative threshold method (Crt) with the geometric mean (GM) between ACTB and GAPDH as the endogenous control. Results AKT1 and DICER1 expression levels were higher in FEP-M patients compared to that in FEP-S patients and healthy controls, suggesting that expression of these genes is associated more specifically to manic features. DICER1 expression was positively correlated to the PANSS (positive and negative syndrome scale) excitement dimension and YMRS (young mania rating scale) total score. Furthermore, MBP and NDEL1 expression levels were higher in FEP-S and FEP-M patients than in healthy controls, indicating that these genes are psychosis-related (independent of diagnosis). Discussion To our knowledge, this is the first study that compares gene expression in antipsychotic-naive FEP-M and FEP-S, suggesting potential diagnostic specificities. Based on an integrated model, we propose that MBP and NDEL1 are upregulated in FEP-S and FEP-M patients, who all exhibit psychotic symptoms. Moreover, two other genes, AKT1 and DICER1, were upregulated in FEP-M patients only, indicating that these genes could be related to mania, independently of psychotic symptoms. Although further validation is needed, our findings suggest that genes related to neuronal development are altered in psychotic disorders, and some of them might support the differential diagnosis between schizophrenia and bipolar disorder in the near future, which in turn could have an impact on the treatment of these disorders.

Mood changes at very high altitudes in Pakistan.

Objective:To screen out psychiatric ‘cases’ and find the frequency of anxiety and depression symptoms in military volunteers performing duties at very high altitudes in the Karakoram ranges of Pakistan.Methods:This was a descriptive study lasting from Jan 2015 to June 2015, on volunteers serving at very high altitude, using General Health Questionnaire-12 (GHQ-12) and Hospital Anxiety and Depression Scale (HADS), Urdu versions. Analysis involved descriptive, inferential techniques and Bonferroni test. Demographic variables were compared to the scores.Results:A high percentage of the military volunteers screened positive for psychiatric ‘caseness’ and symptoms of anxiety and depression; mostly in the mild to moderate range, while very few of them reported severe symptoms. Demographic variables such as marital status, number of children, positive family psychiatric history, past medical history, duration at high altitude and educational levels were found to be significant risk factors for developing symptoms of anxiety and depression.Conclusions:Individuals performing duties at very high altitude, experience symptoms of anxiety and depression, their demographics are important in understanding their emotional problems.

A 10-year evaluation on adolescents with anxiety disorders: are they at risk of bipolarity?

Objective: Anxiety disorders are the most frequent disorders comorbid with bipolar disorder (BD) often preceding the BD onset. The presence of comorbid anxiety in patients diagnosed with BD is associated with worsening of their BD symptoms, increased risky behaviour, decreased response to pharmacological treatment and deterioration in their quality of life and global functioning. The aim of this study was to investigate if anxiety disorders in adolescence could be considered as predictors of BD.Methods: Adolescents with a primary anxiety disorder were recruited consecutively from the Mood and Anxiety Disorders Unit, Department of Neuroscience, University of Turin. Subjects were evaluated for Axis I psychiatric disorders, family history and global functioning, and followed up on average 10 years later.Results: A total of 29 patients (59.2%) were male and the mean age at the onset of anxiety disorder was 16.3 (±0.8). Ten years following recruitment, 11 (22.4%) patients fulfilled the criteria for BD. Of them, 10 (90.9%) had a family history of BD and four (36.4%) presented a comorbid substance use disorder.Conclusions: Our study shows that both family history of BD and substance use disorder, in adolescent patients with a primary anxiety disorder, should be considered as potential predictors of BD onset.

Forward psychiatry – early intervention for mental health problems among UK armed forces in Afghanistan

BackgroundThis observational study examined return to duty (RTD) rates following receipt of early mental health interventions delivered by deployed mental health practitioners. MethodIn-depth clinical interviews were conducted among 975 UK military personnel referred for mental health assessment whilst deployed in Afghanistan. Socio-demographic, military, operational, clinical and therapy outcomes were recorded in an electronic health record database. Rates and predictors of EVAC were the main outcomes examined using adjusted binary logistic regression analyses. ResultsOverall 74.8% (n=729) of personnel RTD on completion of care. Of those that underwent evacuation home (n=246), 69.1% (n=170) returned by aeromedical evacuation; the remainder returned home using routine air transport. Predictors of evacuation included; inability to adjust to the operational environment, family psychiatric history, previously experiencing trauma and thinking about or carrying out acts of deliberate self-harm. ConclusionDeployed mental health practitioners helped to facilitate RTD for three quarters of mental health casualties who consulted with them during deployment; psychological rather than combat-related factors predicted evacuation home.

First-episode psychosis: Ongoing mental health service utilization during the stable period for adolescents.

The timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. Ongoing treatment after stabilization is also essential in the years following a first-episode psychosis (FEP), but has received less research attention. In this study, variables that could impact continued psychiatric service utilization by adolescents following their FEP and temporal patterns in service utilization are examined. Families of 52 adolescents (aged 14.4 ± 2.5 years) discharged following a hospitalization for FEP were contacted two or more years following the adolescents' discharge. A chart review (Time 1) of hospital records provided clinical data on each adolescent's psychiatric diagnosis, symptoms, illness course, medications and family history. Follow-up (Time 2) data were collected from parents/caregivers using a questionnaire enquiring about post-discharge treatment history and service utilization. Bivariate analyses were conducted to identify Time 1 variables associated with psychiatric service utilization at Time 2. Significant variables were included in a logistic regression model and three variables were independently associated with continued service utilization: having a primary diagnosis of schizophrenia (odds ratio (OR) = 24.0; P = 0.02), not having a first-degree relative with depression (OR = 0.12; P = 0.05) and fewer months since the last inpatient discharge (OR = 0.92; P = 0.02). Findings suggest: (1) the importance of early diagnosis, (2) that a relative with depression may negatively influence the adolescent's ongoing service utilization, and (3) that 18 months post-discharge may be a critical time to review treatment strategies and collaborate with youth and families to ensure appropriateness of services.

Is My Son Autistic?

Is My Son Autistic?

Suicidal thoughts and behaviors in psychiatrically referred young children.

Despite increased awareness of the prevalence and seriousness of mental health problems in early childhood, there have been few empirical studies of suicidal thoughts and behaviors in this age group. This study examined suicidal thoughts and behaviors in 360 preschool-aged children (ages 3 to 7 years) presenting to a psychiatric day treatment program. A semi-structured diagnostic interview (conducted with primary caregivers) was used to assess for child suicidal thoughts and behaviors and psychiatric disorders. Participating mothers also reported on their own psychological distress and family psychiatric history. Forty-eight children (13%) were reported to have suicidal thoughts and behaviors, with suicidal plans or attempts endorsed for 2-3% of the sample. Suicidal thinking and behavior was associated with older child age and with higher rates of concurrent depression, oppositional defiant disorder, and posttraumatic stress disorder in univariate analyses, with age and depression remaining as significant predictors in a multivariate logistic regression model. Findings suggest that suicidal thoughts and behaviors are a significant clinical concern for young children presenting with early psychopathology, particularly depression, with implications for early childhood psychiatric assessment and treatment.

Analysis of clinical features and its influencing factors of depression patients with and without psychotic symptoms

Objective To analyze the clinical features and its influencing factors of depression patients with and without psychotic symptoms. Methods According to the presence of psychotic symptoms, 374 patients with major depression were divided into psychotic major depression (PMD group, 79 case) and nonpsychotic major depression (NMD group, 268 case). All patients completed social demographic questionnaire (including gender, age, marital status, educational level, family history, positive family history of psychiatric disorder, disease onset age, frequency of attack, times of hospitalization, etc.) and Hamilton's depression scale (HAMD-24). Results Positive family history(PMD group 47/79, NMD group 104/268, P<0.01), psychiatric disorder positive family history(PMD group 19/79, NMD group 26/268, P<0.01) and times of hospitalization(PMD group(2.52±1.29), NMD group(1.39±1.31), P<0.01) in the PMD group were significantly higher than the NMD group.HAMD total scores(PMD total score(47.85±8.69), NMD total score(43.44±8.51), P<0.01), the factor score of anxiety/somatization(PMD group(11.40±3.28), NMD group(9.19±3.54), P<0.01) and cognitive impairment(PMD group(12.24±3.77), NMD group(9.45±3.68), P<0.01) in the PMD group were significantly higher than the NMD group.Disease onset age(PMD group(30.09±5.17), NMD group(35.95±9.06), P<0.01), the course of the disease(PMD group(1.58±0.76), NMD group(3.02±2.87), P<0.01), the factor score of day and night change(PMD group(0.76±0.46), NMD group(1.01±0.51), P<0.01) in PMD group were significantly lower than the NMD. Logistic regression analysis showed the major depression with positive family history of mental disorders(β=3.278), attack in early age(β=-2.524), seriously cognitive dysfunction in patients(β=3.836) may indicate the psychotic symptoms(P<0.05). Conclusion PMD patients more positive family history, psychiatric disorder positive family history, likely to be hospitalization, severe symptoms and attack in early age compared with NMD. With positive family history of mental disorders, attack in early age, seriously cognitive dysfunction in patients with major depression may indicate the psychotic symptoms. Key words: Depression; Psychotic symptoms; Clinical features

SUICIDE INTENT

Objectives: To see the Socio demographic profile of depressive patients whohas current suicide intent coming to the Psychiatry Departments of LUMS, SCJIP, Hyderabadand DHQ Hospital/ PMC Faisalabad. Design: Cross Sectional Study. Place &amp; Duration ofStudy: The study was conducted in six months from 1st April 2014 to 30th September 2014 atLiaquat University of Medical &amp; Health Sciences (LUMHS) &amp; Sir Cowasjee institute of Psychiatryand Department of Psychiatry and Behavioral Sciences, Faisalabad. Subjects and Methods:A total of 117 depressive patients were included in this study having moderate to high SuicidalIntent. Results: Out of 117 depressed patients with suicidal intent, predominantly females (59%)approached psychiatry ward as compared with males (41%). Mean age of the participants wasbetween 31 -40 years. Among patients 56% were married, 28% were housewives and 28% werestudent. Most of them were educated. Suicide intent was found more in middle socioeconomicgroup and more in nuclear family system. 96 patients (82.1%) were taking treatment forDepression or Anxiety at the time of interview. Conclusion: Prevalence of depressed populationwith suicidal intent predominates in students, married females especially housewives belongingfrom middle socioeconomic background and nuclear family system. Most of patients useddrugs of abuse. Past psychiatric history, family psychiatric history, past history of suicide, familyhistory of suicide and suicidal Ideations were present in patients with current suicide Intent.

English

.. Objectives: To see the Socio demographic profile of depressive patients who has current suicide intent coming to the Psychiatry Departments of LUMS, SCJIP, Hyderabad and DHQ Hospital/ PMC Faisalabad. Design: Cross Sectional Study. Place & Duration of Study: The study was conducted in six months from 1st April 2014 to 30th September 2014 at Liaquat University of Medical & Health Sciences (LUMHS) & Sir Cowasjee institute of Psychiatry and Department of Psychiatry and Behavioral Sciences, Faisalabad. Subjects and Methods: A total of 117 depressive patients were included in this study having moderate to high Suicidal Intent. Results: Out of 117 depressed patients with suicidal intent, predominantly females (59%) approached psychiatry ward as compared with males (41%). Mean age of the participants was between 31 -40 years. Among patients 56% were married, 28% were housewives and 28% were student. Most of them were educated. Suicide intent was found more in middle socioeconomic group and more in nuclear family system. 96 patients (82.1%) were taking treatment for Depression or Anxiety at the time of interview. Conclusion: Prevalence of depressed population with suicidal intent predominates in students, married females especially housewives belonging from middle socioeconomic background and nuclear family system. Most of patients used drugs of abuse. Past psychiatric history, family psychiatric history, past history of suicide, family history of suicide and suicidal Ideations were present in patients with current suicide Intent.

Two-year prospective study of characteristics and outcome of adolescents referred to an adolescent urgent psychiatric clinic.

(a) To describe the clinical characteristics and outcome of adolescents referred for urgent psychiatric consultation, and (b) compare suicidal with non-suicidal referrals. This was a 2-year prospective study. Data was gathered on demographic, historical and clinical variables. Comparison of suicidal and non-suicidal patients was conducted using χ2. A hospital database was used for referral and wait times. Of 805 assessments, 55% were referred by emergency physicians and 28% by primary care physicians. Sixty-four percent of referrals were referred for suicidal behavior and depression and 19.6% for aggression. Eighty percent had a positive family psychiatric history and 59% were bullied. The most frequent psychiatrist assigned diagnosis was attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD). Almost a quarter did not require psychiatric follow-up. Referrals to an outpatient clinic and admission were reduced significantly. Greater suicidality was associated with being female, presence of bullying-victimization and substance abuse [χ2(1)=9.33, p=0.002]. Suicidal behavior is the most common reason for urgent psychiatric consults. ADHD was the most frequent psychiatrist assigned diagnosis. Urgent psychiatric services can reduce admissions, referrals and wait times for hospital based clinics for low lethality, low intent suicidal behaviors and facilitate triage to community services.

Why Are Children in Urban Neighborhoods at Increased Risk for Psychotic Symptoms? Findings From a UK Longitudinal Cohort Study

Background:Urban upbringing is associated with a 2-fold adulthood psychosis risk, and this association replicates for childhood psychotic symptoms. No study has investigated whether specific features of urban neighborhoods increase children’s risk for psychotic symptoms, despite these early psychotic phenomena elevating risk for schizophrenia and other psychiatric disorders in adulthood.Methods:Analyses were conducted on over 2000 children from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of UK-born twins. Neighborhood-level characteristics were assessed for each family via: a geodemographic discriminator indexing neighborhood-level deprivation, postal surveys of over 5000 residents living alongside the children, and in-home interviews with the children’s mothers. Children were interviewed about psychotic symptoms at age 12. Analyses were adjusted for important family-level confounders including socioeconomic status (SES), psychiatric history, and maternal psychosis.Results:Urban residency at age-5 (OR = 1.80, 95% CI = 1.16–2.77) and age-12 (OR = 1.76, 95% CI = 1.15–2.69) were both significantly associated with childhood psychotic symptoms, but not with age-12 anxiety, depression, or antisocial behavior. The association was not attributable to family SES, family psychiatric history, or maternal psychosis, each implicated in childhood mental health. Low social cohesion, together with crime victimization in the neighborhood explained nearly a quarter of the association between urbanicity and childhood psychotic symptoms after considering family-level confounders.Conclusions:Low social cohesion and crime victimization in the neighborhood partly explain why children in cities have an elevated risk of developing psychotic symptoms. Greater understanding of the mechanisms leading from neighborhood-level exposures to psychotic symptoms could help target interventions for emerging childhood psychotic symptoms.

Phenotypes in patients with monopolar and bipolar depression

Introduction Recurrent depressive disorder is heterogeneous in respect to its etiology (predominantly exogenous or endogenous). Patients with recurrent depressive disorder (RDD) may change diagnosis to bipolar disorder (BD). Regarding the true RDD there is the possibility that in most cases it is exogenous, and the prevalence of endogenous RDD might be similar to BD. There is still debate regarding useful criteria for distinguishing between bipolar and monopolar depression especially at the first episode. Objectives The purpose of the study is to identify useful phenotypes that could help distinguishing between endogenous monopolar and bipolar depression. Methods The study was carried out on patients diagnosed with RDD and BD according to ICD 10 criteria. The following data was analyzed: socio-demographic parameters, family psychiatric history, seasonality, suicidal attempts, and behavioral phenotypes such as nicotine, alcohol, or illicit drug use. Results The study included 105 RDD and 74 BD patients. In the RDD sample the mean age at disorder onset was 45.93 years, while in the BD sample, was 32.45 years. Significant differences between the samples were found in: family psychiatric history (BD patients having more relatives with schizophrenia, P =0.01), smoking habits (BD patients smoking more cigarettes than RDD patients, P =0.001), and seasonal depression (mainly summer and winter in RDD, and mainly summer and autumn in BD). No differences were found regarding suicidal attempts, alcohol or illicit drug use. Conclusions Onset age, family psychiatric history, smoking habits, and seasonality may reflect endogenous depression (BD or RDD) or different subtypes of BD or RDD.

Psychiatric family history in patients with eating disorders in a sample of hospital Day

The intensive care unit of eating disorders (UTCA) at Santa Cristina University Hospital (Madrid), covers on one hand hospital care Day with an allocation of 50 seats (25 in the morning shift and afternoon shift 25); outpatient and where the valuation of new patients, motivational work towards their inclusion in hospital Consultation Day and relapse prevention (and in coordination with the drifting device). The day hospital care is done as included full program and partial programs. The team consists of morning shift for 1 psychiatrist, one clinical psychologist and an occupational therapist shared with the evening shift. The day hospital treatment group is mainly with individual attention psychiatry, psychology, occupational therapy, nursing, nutrition interconsultor endocrinologist and weekly basis. We present a descriptive study of distribution in different diagnostic groups of eating disorders, psychiatric family history, patients treated in the Unit.

The late-onset bipolar disease: A case report

The prevalence of bipolar disorder after 65 years is 0.1 to 0.4%. Mania represents 4.6% to 18.5% of all psychiatric admissions in geriatrics in the USA. It has some specificity in terms of clinical presentation, evolution, prognosis and treatment.We report the case of a patient who presented a first manic episode after 65 years. E.H, AP, 67 years old, single, without personal and familial psychiatric history, addressed to psychiatric emergencies for psychomotor agitation and euphoric mood. He presented two months ago a manic access with almost total insomnia, euphoria, psychomotor agitation and delusions of grandeur. The balance sheet reveals no incorrections (blood count, thyroid balance, serology: TPHA, VDRL, hepatitis B and C, HIV). The cerebral CT was normal. The patient has been received a quetiapine 200 mg/day, olanxapine 10 mg/day and valproate 1000 mg/day. The evolution after three weeks was favorable.The late-onset bipolar disorder is characterized by: a less intense euphoria, replaced by anger and irritability, a more elements of persecution, disinhibiting and impulsivity. Respecting to that, this case is an exception. The most common confounding symptoms and behavioral disorders. A higher frequency of neurological diseases is noted in elderly subjects with a bipolar disorder and, so, a neuropsychiatric rigorous evaluation is fundamental to exclude the possibility of an organic pathology for the manic access. The prescription of psychotropic drugs in the elderly must be under monitoring.Disclosure of interest The authors have not supplied their declaration of competing interest.

Socio-demographic factors among delusional disorder: A case series register

IntroductionDelusional disorder has reached an entity of growing interest with a prevalence in developed countries between 1 and 4% of the psychiatric consultations.ObjectiveTo describe various socio-demographic and clinical variables that characterize patients diagnosed with delusional disorder in Andalucía according to DSM-5 criteria.MethodsReviewing common medical history digital records. First, it has been proved whether it complies DSM-5 criteria for the diagnosis of delusional disorder. Then, there have been different epidemiological variables collected: age, sex, family psychiatric history, and marital status, and employment status, age of onset of illness, number of years of follow-up by specialized care, the number of visits to your computer, and number of hospitalizations in a psychiatric inpatient unit among others.of the 1927 patients studied, 1452 met the criteria for diagnosis of delusional disorder. These patients live in Andalusia and come to different mental health care units, with an average follow-up period of 9 years and 1 month.ResultsAbout half of the sample were women and half men (49% versus 51%).Forty-seven percent of the sample are married or have a couple, and 19% are in active employment.Thirty-two percent have a family history of psychiatric mental disorder written in his digital clinical record.Seventy-five percent of the sample meets criteria F22, while 25% are diagnosed as other psychoses.ConclusionThis is the largest record of cases registered with delusional disorder to date, in which we describe the biopsychosocial characteristics of this group of patients in the largest Spanish region.Disclosure of interestThe authors have not supplied their declaration of competing interest.