Objective: Cotard’s syndrome is a rare psychiatric syndrome. Its core symptom is nihilistic ideation or delusion.Case Report: A female patient with Cotard’s syndrome symptoms associated with out of body experience and depersonalization, and complicated grief was referred for evaluation. She believed that she was killed by a creature named "Aal" in the Persian folklore Conclusions: Cultural and superstitious beliefs could affect the forming of the complex constellation of the patient’s symptoms including Cotard’s syndrome symptoms. The resolution of symptoms might be achieved step by step. Declaration of interest: None.

Background: Drug non adherence is one of the major problems in treatment of psychiatric patients which could increase the risk of relapse and re-hospitalization. Objectives: The aim of this study is to determine factors associated with drug non adherence by patients with mood disorders after their discharge from hospital and assessment of relation between drug attitude and drug adherence. Patients and Methods:In this cohort, prospective, and descriptive study, 150 patients with mood disorders (major depressive disorder, bipolar mood disorder) at the time of discharge were assessed. For each patient, demographic information form and Drug Attitude Inventory (DAI-10) [persian translation] was completed at the time of discharge. Then all of the patients were monitored monthly until 6 months through telephone. In every follow up DAI-10 and drug use inventory (which consists of causes of drug non adherence) were completed. Finally relation between different variables and patient drug attitude with drug adherence were assessed. Results: From all studied variables such as demographic factors, diagnosis, treatment factors, and drug attitude, only drug attitude had a significant relation with drug adherence. Conclusions: Patients' attitude toward drugs has a major role in drug adherence.

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BackgroundSome study suggest that unipolar mania could be a separate subtype, while there is no unipolar mania listing in DSM. We compared sociodemographic and clinical data of unipolar and bipolar mania.MethodsIn an analytical-observation study,through 850 patients with bipolar I disorder, in 10 years of illness duration, 240 patients were included. We evaluated demographic and clinical information and interview with patients and their families consistent with DSM, then we assessment the comorbidities and other clinical conditions and analysed our data by using the mann-witney test, chi-squar test and fisher exact test.Results22.4% of 219 patients presented a course of illness characterized by unipolar manic episodes without history of major or mild depression. When this group was compared with 170 manic patients with a previous history of depressive episodes, we found significant similarities in most demographic, familial, and clinical characteristics. Just positive family history for MDD was higher in bipolar mania significantly (P< 0.005). Unipolar mania group reported more congruent psychotic symptoms (Pv= 0.005). Lastly in unipolar group total number of episodes is less than and manic episodes is more than bipolar. (Pv= 0.005).DiscussionThere is no prominent differences between two groups and inform clinical and psychopathological have common characteristics in unipolar and bipolar mania. So, biologic, physiologic and anatomical bases of unipolar and bipolar mania could be similar. Literature on this topic is still insufficient, and it is necessary to ongoing unipolar manic studies in future.

Dextroamphetamine is one of the main medications for treating ADHD. It may cause several psychiatric side effects including hallucinations. As far as we know there is no previous report of clear derealization. In this report we present a 6 years old female patient with proved impression of ADHD. Her symptoms subsided with 10 mg/day Dextroamphetamine. A few months later she refused taking medication. She complained of feeling objects and persons are different and horrible way. Symptoms disappeared when the drug shifted to Ritalin. We present her history, describing symptoms of derealization and reflections of drug side effect in her drawings. We also discusses the role of side effects of Dextroamphetamine in poor compliance.