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Introduction: 25-year-old woman originary from China. Moved to Barcelona 2 years ago for her master studies. Not known personal or familiar psychiatric record. Admitted to the psychiatric ward due to a 3-month psychotic episode with delusional features including transportation delusions "people can travel into other dimensions"; megalomaniac delusions, "I communicate with a Buddhist divinity called Guan Yin", "I have the mission of rejuvenating the population"; nihilistic and Cotard-like delusions "people around is old and dead"; denial of lineage syndrome, intermetamorphosis syndrome and doppelgänger syndrome. Nohallucinatory featureswere present. Severe emotional and behavioural implications were associated. Objectives: To analyse the transcultural component of bizarre delusions in a Chinese patient. Methods: Somatic causes for psychosis were ruled out. Risperidone up to 6 mg was started and afterwards intramuscular paliperidone palmitate 150+100 mg was administered, suspending risperidone. Results: Psychotic symptoms remitted progressively during hospitalization, so that the patient was discharged after 1-month. Conclusions: 1. This patient presented polymorphous bizarre delusions, some of them related to the Chinese culture. 2. Psychotic contents are influenced by the cultural beliefs. In this case, Guan Yin divinity (from Chinese religion) acquires psychotic implications being part of the cultural background of the patient. 3. The denial of lineage syndrome, which can be misinterpreted as a Capgras syndrome, is one of the most common delusions in China. 4. Due to the one-child policy, Chinese population aging will be a forecasted problem. The patient expressed this concert in a megalomaniac delusional manner. [ABSTRACT FROM AUTHOR]

Introduction: Clinical lycanthropy is an uncommon delusion of turning into a wolf. A systematic review in 2016 found only 13 case descriptions, only one not secondary to a psychiatric disorder. Objectives: To identify and describe an unusual symptom based on a clinical case. Methods: The present study is a case report of a patient admitted for clinical lycanthropy to our hospital. Wealso searched previously case reports, series and systematic reviews of clinical lycanthropy using a pubmed query ("lycanthropy", "cerebellum", "hydrocephalus", "psychosis"). Results: Mr. CJ. is a 38-year-old Mexican male, with no prior psychiatric history or substance use. He was admitted for bizarre behaviors and delusions. He had been living in the forest for the last weeks with the belief that he was a werewolf, and on full moon he behaved like a wolf (naked and howling). He also presented multimodal hallucinations, headache, ataxia and visual blur. The mental evaluation did not suggest a delirium. A CT scan revealed a left cerebellar lesion and hydrocephalus (Image 1,2,3). He experienced full remission of psychotic symptoms after external ventricular drain and antipsychotic treatment (risperidone, olanzapine). After surgical r emoval the histology revealed a cerebellar hemangioblastoma. Conclusions: The clinical presentation suggested the diagnosis of a psychotic disorder due to cerebellar hemangioblastoma with consequent hydrocephalus. Cerebellum abnormalities and hydrocephalus have been associated to psychotic symptoms. Furthermore, other case reports showed rapid recovery of psychosis due to hydrocephalus after neurosurgical intervention. To our knowledge, this is the first report about clinical lycanthropy due to a tumor of the central nervous system. [ABSTRACT FROM AUTHOR]

Patients with schizophrenia exhibit a reduced life expectancy. Although unhealthy lifestyle or suicide risk plays a role, the main causes are diverse medical conditions such as cardiovascular diseases, type 2 diabetes mellitus and metabolic syndrome. Albeit pharmacological secondary side effects might also trigger previous conditions, studies in naïve patients reflect diverse anomalies at the onset. Patients with a first episode of psychosis, display a wide scope of metabolic abnormalities, ranging from normality till pathological values depending on the parameters studied. We attempted to evaluate the metabolic syndrome and glycemic homeostasis in a subset of antipsychotic-naïve patients with a first episode of non-affective psychosis. Patients ( n = 84) showed a similar prevalence of metabolic syndrome compared with a matched control sample ( n = 98) (6% vs 4%, P = 0.562), while glucose homeostasis values differed significantly (14% vs. 5%, P = 0.034). Our results suggest that metabolic syndrome is not a useful clinical condition to be evaluated in patients before pharmacological treatment. Abnormal glycemic homeostasis at the onset of the disease requires specific diagnostic tools and preventive measures in order to avoid future cardiovascular events. New strategies must be implemented in order to evaluate the cardiovascular risk and subsequent morbidity in patients at the onset of the disease. [ABSTRACT FROM AUTHOR]