In daily clinical practice we use to make diagnoses in first consultations, but sometimes it is more complicated, requiring a cross-sectional study of the evolution of the case.In daily clinical practice we use to make diagnoses in first consultations, but sometimes it is more complicated, requiring a cross-sectional study of the evolution of the case.

44-year-old woman. Married and mother of one child. She has an hospitalization for alcohol dependence in the context of depressive syndrome. The patient attends the consultation regularly, presenting in the foreground alcohol consumption with evasive characteristics due to hypothymic mood. Many pharmacological approaches are tried with poor tolerance, as well as referral to an alcohol cessation unit. After that, it requires new income where partial disorientation is observed.

A CT scan is performed and is reported as normal.

In admissions, family-type interventions are performed to reduce accompanying family dysfunction. The evolution is torpid, with the appearance of dysfunctional hysteromorphic personality traits, with childish demands and refusal to go to prescribed consultations. Tendency to confabulation and demonstrative attitudes in the family context, which yield with hospitalization, presenting an absence of disruptive behaviors in the hospital context, but it does seem to present brain alterations due to alcoholism. It is sent home with appropriate indications.

Sometimes, a detailed investigation and follow-up of a case, in this case by way of admission, may result in a different diagnosis than the previous one, which entails a different management.

No significant relationships.

It reveals a case that occurred in a patient with no previous history whose first manifestation was kinesthetic allucinations, subsequently appearing other psychopathological alterations

24-year-old male. Truck driver by profession. No prior mental health story. Good operation prior to the consultation. He comes accompanied by his parents for having a sensation of having bugs under his skin. It has come to throw gasoline on top to eliminate the possible infection.

Exploration: He is concius, oriented, with scratching lesions. He wears a cap soaked in gasoline to ward off critters. He does not present in the foreground other psychopathological alterations. CT with normal results, thyroid hormones, and normal biochemistry are requested. Treatment with aripiprazole is initiated in ascending doses, as it presents in the beginning a torpid evolution with the appearance of delusions of injury to its boss.

After that, he is currently psychopathologically stable and has returned to work with his father in the field.

Although not the most common, psychotic disorders can occur at the beginning with cenesthetic alterations. Organic screening should be performed and results treated accordingly.

No significant relationships.

Prader-Willi syndrome is a congenital disease caused by a genetic alteration of chromosome 15, described by doctors Prader, Labhart and Willi in 1956. It’s a rare disease (prevalence 2.8/100,000) and it occurs equally in both sexes and in all races. This disorder produces changes in hypothalamic function that can lead to muscle hypotonia, short stature, a compulsion to eat, and a lack of satiety. At the psychopathological level, the clinic is very varied, being mainly important the psychomotor retardation in different degrees and behavioral problems;especially in the behavioral phenotype. Affective and psychotic symptoms are also frequent.

Psychopathology and treatment analysis through a clinical case.

40-year-old patient undergoing mental health follow-up since adolescence with a diagnosis of paranoid personality disorder. No medical history of interest. He was admitted to the hospitalization unit for serious behavioral alterations in a context of probable paranoid ideation towards the neighborhood. In the psychopathological examination, marked cognitive rigidity, high impulsivity and very low tolerance to frustration stand out, showing a hostile and defiant attitude. Poorly structured paranoid ideation. Presents obsessive-compulsive behaviors (scratching). Hyperphagia and obesity.

Psychometric assessment (Waiss-IV): total IQ 61 (mild mental retardation). Genetics:deletion 15 q11-q13 of chromosome 15), confirms Prader-Willi diagnosis. Remission of behavioral disorders, suspiciousness and heteroaggressive behaviors with treatment with monthly depot paliperidone (150 mg).

Knowledge of the clinical and morphological characteristics of this syndrome would allow an early diagnosis and treat its possible complications as soon as possible. Antipsychotic treatment is effective in the management of behavioral and psychotic symptoms.

No significant relationships.

Maternal age and related factors, such as social vulnerability, are associated with neurodevelopmental and behavioral disorders in offspring.

To examine the influence of maternal age and its related factors on the appearance of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), alterations in executive functions and behavioral syndromes of the offspring.

A prospective study was conducted, consisting of 131 healthy pregnant women aged 20 to 41 years, recruited at 38 weeks’ gestation. Their offspring were followed up to 2 years after birth, when psychopatology was assessed. Maternal age and possible related factors were considered predictors. Bayesian ordinal regression models were performed for each outcome variable.

Symptoms of ASD in children were associated with an older maternal age (OR = 0.188; 95% CI[1.062, 1.401]) and a lower educational level of the parents (OR = -0.879; 95% CI[0.202, 0.832]), meanwhile poor social support predicted most ADHD symptoms OR = -0.086; 95% CI[0.838, 1]) and executive dysfunctions OR = -0.661; 95% CI[0.313, 0.845]. Lower parental education predicted both externalizing and internalizing behavior.

Maternal age-related factors were the main predictors of neurodevelopmental disorders in offspring, rather than maternal age. The performance of prenatal interventions in pregnant women with advanced age and anxious depressive symptoms or adverse social situation, is crucial to reduce the risk of neurodevelopmental disorders in the offspring. Likewise, being able to carry out an early detection of childhood psychopathology would allow the implementation of resources that improve their long-term prognosis.

No significant relationships.