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Introduction: Reviewing the histories of patients with childhood and adolescent schizophrenia, on numerous occasions, traumatic factors with great emotional and social impact are observed, such as situations of mistreatment, abuse and emotional deprivation, where help is requested but resources are scarce and the approach is limited without work in network. Objectives: 1. Analysis of the consultation pathways in adolescents with severe psychiatric and socio-familial symptoms and the time delay in optimal guidance. 2. Evaluate the services involved. 3. Evaluate the clinical control of treatment with aripiprazole. Methods: Retrospective observational analysis, 5 months, of prodromal symptoms of childhood psychosis and help-seeking pathways in a 13-year-old adolescent, as well as a description of the pharmacological approach and professional teams involved. Results: A 13-year-old adolescent who went to the emergency room with her mother for ingesting anti-cockroaches with self-inflicted intent. Reviewing his medical history, 4 serious autolytic gestures were detected in the last 2 months. Referred to Mental Health who did not attend. On clinical examination, florid psychotic, with perplexity, self-reference, ideation of harm, language and behavioral disorganization. Auditory and kinesthetic hallucinations. A situation of neglect of the minor and abuse by the parents is detected; the risk had not been previously reported. Oral aripiprazole (up to 15 mg/day) was prescribed with good tolerance and progressive improvement in symptoms. We worked jointly with Social Services, the Juvenile Prosecutor's Office, Education and the hospital Psychiatry unit. In some of the resources the situation was already evident, the scope of their action was limited and delaying attention for months. Conclusions: Based on cases like this, we ask ourselves if psychiatrists are sensitized to the comorbidity of serious mental pathology and the existence of risk situations in minors and if they are oriented toward multiprofessional management. Networking provides us with an early diagnosis, improving the therapeutic approach. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction Many neurological, oncological and autoimmune diseases may have psychiatric symptoms; these diseases sometimes start with these symptoms, so the diagnosis may be confused and the treatment is delayed. Objective Review the relationship between the secondary immune deficiency and increased predisposition to infectious processes and the psychopathological conditions which manifest themselves in some cases in these situations. Methods A 17-year-old male patient, who began psychiatry consultations when he was 3 years old due to psychomotor delay and behavior disorders. He was diagnosed with ADHD and mild mental retardation. Medical history: Viral encephalitis; Perthes disease; recurrent urinary tract infections; intestinal giardiasis; Alport syndrome. He's being treated with aripiprazole 5 mg (1/2-0-0). The patient presents an episode of perplexity, psychotic anguish, auditory hallucinations and paranoid delusion. The patient presented an infectious process with general malaise, diarrhea and vomiting during previous days. Results The patient was assessed by the Departments of internal medicine, neurology and psychiatry. A cerebral TAC, lumbar puncture, EEG and urine porphyrins were requested. The secondary immune deficiency makes the patient more vulnerable in an infectious process. Discussion The diagnosis of psychotic disorder due to medical condition may be transient or recurrent. Treating of the medical condition often gets resolution of psychosis, although the symptoms can persist in some cases. There is often a prodomo of viral syndrome weeks before the rest of symptoms appear. The differential diagnosis should be made with primary psychotic disorders, affective disorders, confusional syndromes, impulse control disorder or sleep disorders, neuroleptic malignant syndrome, serotonin syndrome and substance-induced psychotic disorders. [ABSTRACT FROM AUTHOR]

Aboriginal and Torres Strait Islander culture is the oldest living culture in the world, dating over 60,000 years. An understanding of the complexity and richness of Aboriginal and Torres Strait Islander cultures, including the relationship between land and health, is still yet to be fully realised and as a result this people suffer ongoing social and health inequalities. These inequalities contribute to higher rates of ill health and a 17-year life expectancy gap between Aboriginal and Torres Strait Islander and non-Aboriginal and Torres Strait Islander Australians. Aboriginal and Torres Strait Islander Australians report higher levels of psychological distress compared with other Australians, with 77 percent reporting experiencing at least one major stressor in the past 12 months, the most common stressor being the death of a family member or close friend (42%). Particularly in rural and remote Australia, have higher rates of depression, substance abuse, co-morbidity and post-traumatic stress disorder. However, Aboriginal and Torres Strait Islander Australians do not access community and outpatient mental health services at a level that is commensurate with their need. In contrast, hospitalisation rates for mental health-related causes involving specialised psychiatric care are almost twice the rate, and for mental health-related causes without specialised psychiatric care are around three times higher, compared with non-Aboriginal and Torres Strait Islander Australians and death rates from ‘mental and behavioural disorders’ are much higher for Aboriginal and Torres Strait Islander Australians than for non-Aboriginal and Torres Strait Islander people. [ABSTRACT FROM AUTHOR]

Introduction Fifty-year-old male. As a summary note that has a history of psychotic disorder from 25 years to coincide with the theological studies and your income as a priest. It has continued since then reviews and consultations in psychiatry, with two previous hospitalizations in private hospitals. It was stable with low doses of risperidone. Apparently, it makes a routine life linked to the activities of the church. Two months ago, he began to be irritable, suspicious, with discussions and problems at work, coinciding with the abandonment of treatment. Since the death of her mother a year ago has presented worsening. Objectives It presents the case of a patient who has no awareness of illness. Methods Psychopathological examination: conscious, oriented, scarcely manageable. Psychomotor restlessness. Expansive while maintaining distances, dysphoric and irritable. Verbiage. Ideas prejudice family-centered. There appears to be perceptual disturbances. Sleep-wake rhythms preserved. Results Treatment was initiated with injectable paliperidone administered dose of 150 mg and 100 mg, with 12 mg of oral paliperidone with good response progressively. At high partial remission of symptoms, it is factual. Conclusions The lack of awareness of the disease is non-pharmacological factors that can make it difficult to comply with neuroleptic treatment. These patients do not calibrate well how important that medication has on the evolution of his illness. Therefore, the therapeutic substance of such failure worsens the quality of life of patients and their families, as well as the prognosis of their disease presenting increasingly severe relapses. [ABSTRACT FROM AUTHOR]