Objective: Cariprazine is a new atypical antipsychotic approved for the acute and maintenance treatment of schizophrenia (1, 2) and for the treatment of manic or mixed episodes associated with bipolar I disorder (1). Recently, cariprazine also got extended FDA-approval for the treatment of depressive episodes in adults with bipolar I disorder (3). The use of low doses of atypical antipsychotics is an essential component of early intervention in psychosis. For its particular performance and tolerability, cariprazine is becoming an important option for the treatment of first-episode psychosis.Method: Three patients experiencing first-episode psychosis (FEP) were successfully treated with cariprazine. Two patients were in their first months of the disease, and the third patient was in his third year after the FEP.Results: The three patients had a diagnosis of non-affective FEP, which includes schizophrenia, delusional disorder, and schizoaffective disorder. One of them was in their third year after the FEP with a predominance of negative symptoms at this stage of the disorder. All the patients were treated with cariprazine with a target dose of 3–4.5 mg/day. The three patients showed improvements in their psychosis, including a decrease in negative symptoms. No significant side effects were reported.Conclusion: Our three case reports indicate that cariprazine is an atypical antipsychotic beneficial in the treatment of early psychosis. Treatment with low doses of cariprazine could be effective and tolerable in this phase of the disorder. Future studies with longer follow-up of FEP patients are recommended to confirm these positive results of cariprazine in the early phases of psychosis.

Various diseases that impact different systems and organs in the body may trigger manic episodes. Strokes are often associated with psychiatric symptoms, particularly depressive and, more rarely, manic. We herein report a case of bipolar disorder secondary to cerebrovascular disease in a 67-year-old man with no personal or family history of psychiatric illness who, at the age of 64, had a bilateral ischemic stroke in the middle cerebral artery territory. About 20 days after this stroke, he experienced a manic episode. Three years later, he experienced a second manic episode, with another hospitalization in a psychiatric ward. With this case, we intend to emphasize that, although rare, the diagnosis of mania after stroke should not be forgotten, and most important, one should be aware of the recurrence of affective episodes just as in non-medical-caused bipolar disorder.

Introdução: Os sintomas psicóticos estão entre as manifestações psiquiátricas (MP) menos prevalentes e pouco investigadas da doença de Huntington (DH). Relado de caso: Relatamos o caso de um paciente do sexo masculino, 31 anos, que apresentou MP com predomínio de sintomas negativos, sem qualquer movimento anormal significativo. A DH foi diagnosticada com base em uma análise de DNA positiva e na história familiar. A DH impõe um acompanhamento longitudinal por meio de uma abordagem multidisciplinar, a fim de melhorar a qualidade de vida e o prognóstico. Conclusão: Este relato de caso destaca a importância da compreensão das MPs na apresentação inicial da DH, para que o diagnóstico não seja atrasado até ao aparecimento dos sintomas motores.

IntroductionThe mental health effects of Coronavirus2019(COVID-19) outbreak might be profound, including higher suicide rates.This phenomena is likely to become a more pressing concern as the pandemic spreads.While remarkable social distancing interventions have been implemented to reduce the rate of new infections,the potential for adverse outcomes on suicide risk is high, especially among vulnerable populations.ObjectivesThe aim is to do a review of the literature of suicide prevention during the COVID-19 outbreak.MethodsNon-systematic review of the literature with selection of scientific articles published in the last 7 months; by searching the Pubmed databases, the following MeSH terms were used: Suicide prevention; COVID-19ResultsIn order to prevent suicide, urgent consideration must be extend beyond general mental health approaches. A wide-ranging interdisciplinary response that recognises how the pandemic might heighten risk is needed. The application of knowledge about effective suicide prevention is the key. Mental health services should develop clear remote assessment and care pathways, and staff training to support new ways of dealing with. Publications on mental health and psychological effects of COVID-19 outbreak provide important information and recommendations for all three levels of suicide prevention: primary, secondary, and tertiary.ConclusionsThe challenge of the COVID-19 outbreak might bring with it an opportunity to advance the field of suicide prevention and, thus, to save lives, which also represent a public health priority. The mental health community, backed by active vigilance and international collaboration, should be prepared and can use this challenging period to advance suicide prevention.