Acne vulgaris, a condition that can affect people at any age, is the most common cause of referral to a dermatologist. Isotretinoin (ITT) is the most effective treatment available, but serious adverse effects, including a possible association with depression and suicide, limit its use. We review the current literature regarding the association of ITT with depression and suicide. Case reports and database studies show a clear association, and this association is biologically plausible. Although prospective studies have opposite results, limitations make them unsuitable to identify a subgroup of patients who may be at risk of developing depression or suicidal ideation with ITT. Overall, it seems some people might be at risk, particularly those with a personal or family history of mental disorder, but further studies are needed to identify those patients who would benefit from an early referral to a mental health professional when ITT is initiated. Currently, no conclusions can be drawn, and it seems appropriate to regularly screen all patients on ITT for depressive symptoms and suicidal ideation and promptly refer them to a mental health professional if any are found.

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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.

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IntroductionHuntington's Disease is an autosomal dominant neurodegenerative disease characterized by motor, psychiatric and cognitive symptoms. Irritability, affective disorders, apathy and psychosis are among the most frequent psychiatric symptoms and can predate the pre-clinical period.ObjectiveThe authors’ goal is to understand the complexity of Huntington's disease clinical presentation. Additionally, we present an illustrative clinical case.AimsTo convey the importance of collecting reliable information in order to make a proper diagnosis.MethodsA PubMed database review was performed using “Psychiatry”, “Psychiatric”, “Symptoms” and “Huntington's Disease” as keywords; retrieved papers were selected according to their relevance. The patient clinical record was reviewed.ResultsThe authors report a case of a 39-year-old woman, who was referred in 2014, to a psychiatrist because of depressive mood and suicidal ideation with two suicidal attempts in the past 5 years. However, she did not disclose her family history of Huntington's disease neither to her GP nor her psychiatrist. She never complied with the treatment plan and was admitted, in November, into a psychiatric unit because of subtle motor changes and apathy, which had resulted in personal neglect. The diagnosis could only be made after a family interview was held and the family medical history was revealed.ConclusionsCorroborative history from caregivers is of extreme importance in psychiatry. Early detection of symptoms can help mitigate the disease social impact. In our patient's case, by the time of proper diagnosis, she was estranged from her family and had endured distressing psychiatric symptoms without adequate treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.