Introduction: The prevalence of alcohol abuse increased over 10% in the last decade, with special impact in women. It is not known how the characteristics of suicide attempts vary with different forms of alcohol involvement. The aim of this study is to clarify the role of alcohol use disorder and acute alcohol consumption in suicide attempts. Objectives: Perform a brief literature review on the alcohol use disorders and suicide behaviours in those patients. Methods: A PubMed database review, with 'alcoholism" and 'suicide attempts" as keywords. Results: Alcohol abuse and suicide may be intimately linked. This association is related to impulsivity, aggression, social norm transgression, poor judgment, abnormal speech, perceptual blunting and increased pain threshold, which may all contribute to the suicide attempt. Moreover, mental disorders (particularly depression) are often associated with suicide. The lifetime prevalence of suicide attempts in patients with alcohol dependence is about 40% and mortality for suicide is 7%. Thus, patients with alcohol abuse should be screened for psychiatric symptoms and suicidality. Clinicians should assess the severity of suicidal symptoms and other depressive signs and symptoms in patients with alcohol abuse. Conclusions: Suicide attempts are common in patients with alcohol use disorder. Future studies should contribute to a deeper knowledge of these events and respective treatment.

IntroductionLatest classifications led to an inflamed debate urging for change or validation in the way personality disorders are classified. The placement in psychiatric classifications of several personality disorders, particularly Borderline Personality Disorder (BPD), is also a matter of discussion.Objectives and aimsThe present work aims to question BPDs place in classification alongside with other personality disorders, rather than focusing on the algorithms used to classify it. The authors review updated literature on core features of the disorder collected from online scientific databases.ResultsStudies reveal that the stability of the diagnosis of BPD over the longer term is less than what standard general definitions of personality disorders would appear to require. It is a chronic and debilitating syndrome with severe functional and psychosocial impairment that remain relevant when comparing to other personality disorders. Additionally, these measures show further declines over time in spite of improvement in psychopathology, in contrast to what happens with other personality disorders. Several misconceptions may have led to the placement of BPD on former axis II, namely being a direct consequence of trauma and merely explained by environmental factors. However, recent research on heritability shows the contrary and several neurobiological markers suggest it has got a nature of its own.ConclusionBPD is probably the most studied and validated personality disorder and has substantially greater empirical basis, clinical significance and public health implications, being both enduring and distinct from other personality disorders. We suggest the placement of BPD as major psychiatric disorder in classifications.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Introduction: Choking phobia was described by Chorpita, Vitali and Barlow as a condition characterized by intense fear of choking along with avoidance of swallowing solid food, drinking and taking pills in the absence of anatomical or physiological abnormalities. Patients may present a significant weight loss, on which they usually feel uncomfortable Objectives: Report a patient with choking phobia who was admitted to the Neurology service of Santa Maria Hospital and conduct a brief literature review on the subject. Methods: Analyse the patient's clinical records and perform a PubMed database review, using 'chocking phobia" as keywords. Results: A 31 years old woman with no history of psychiatric care was admitted to the Neurology service after presenting progressive dysphagia with excessive weight loss. It was possible to determine the sudden onset with progressive worsening (initially the patient was fed only in the presence of other people-due to fear of choking-and lately refused solid food intake). Changes in diagnostic procedures (endoscopy, electromyography and barium meal) were not found. The patient was observed by the Psychiatry service and initiated a treatment with sertraline, supported with cognitive behavioural therapy, which revealed a clear improvement from the resistance to swallowing point of view (currently the patient is able to have lunch / dinner in less than 1 hour). Conclusions: Choking phobia is a rare and poorly understood disorder, whereby future studies should contribute to a deeper knowledge of these events and their treatment.

IntroductionAccording to some studies, deaf psychiatric inpatients have prevalence rates of psychotic disorders ranging from 20 to 54%. There are descriptions of the paradoxical finding that prelingually deaf patients with psychosis may hear voices.ObjectivesTo present a case report and conduct a database review in order to understand if deaf patients with psychosis can have auditory hallucinations.AimsThe authors’ aim is to describe a case, highlight the clinical and scientific relevance of auditory hallucinations in deaf patients and the difficulties and limitations of this process.MethodsA Pubmed database search using as keywords “auditory hallucinations”, “deaf” and “deafness” and retrieved papers were selected according to their relevance.ResultsThe authors report a case of a 47-year-old female patient apparently suffering from congenital deafness. The patient had no previous psychiatric history until 4 months prior to her admission at our institution, when she started having psychotic symptoms. The patient was admitted into a Neurology ward but because no neurological sign was found psychiatric liaison consultation was requested. Four months later, she had the same symptoms, describing a voice that said to “shut up” and was admitted to a psychiatric hospital. After medication, the symptoms relapsed and now she is followed in an outpatient setting.The presence and nature of auditory hallucinations in deaf patients is not fully elucidated and there are methodological problems in the investigation of this subject.ConclusionsCurrent evidence is still inconclusive and the fact that prelingually deaf patient hear voices needs further research.Disclosure of interestThe authors have not supplied their declaration of competing interest.