Based on this modeling exercise, it could be expected that LAR may be a cost-effective treatment with limited budget impact in Portugal. However, further studies are required to test the generalizability of the results of the present modeling study to the larger population of Portugal.

Introduction: Folie à deux or induced psychotic disorder is a rare psychiatric illness and was first described in the 19th century. The essential feature is a psychotic disorder shared by two emotionally close persons, usually a blood relative or spouse, while living in relative isolation. The disorder is characterized by a primary psychotic person, usually older, more intelligent and better educated who gradually imposes her delusional beliefs on the other person, who is often dependent on or submissive to the person with the psychotic disorder. The disorder usually resolves in the more passive person when the two are separated. Objectives/aims: To describe two case studies of two couples who shared psychotic illness and make a review of the literature. Methods: Search in the PubMed/MedLine and Medscape databases with the following key words: folie à deux; shared psychosis; shared delusion. Results/conclusions: Even though Folie a deux is rare to diagnose, clinicians should be aware of this condition, since it is tremendously important to treat properly both people involved.

Introduction: Popularly called erotomania, this syndrome was first described by G.G. De Clérambault in 1885, and is characterized by the delusional idea, usually in a young woman, that a man whom she considers to be of higher social and/or professional standing is in love with her. The patient develops an elaborate delusional process about this person, the love for her/him and the inability to escape his/her "affectionate clutches." This syndrome may persist for a period of a few weeks to a few months in the recurrent form and be replaced by a similar delusion about another person. In the fixed form it may persist for several years. Both primary and secondary types of erotomania have been identified, the latter being associated with evidence of an aetiologically significant organic or psychiatric condition. The aetiology of primary erotomania is not yet fully understood. Objectives / Aims: To describe two case studies of patients diagnosed with De Clérambault Syndrome and make a review of the literature. Methods: Search in the PubMed/MedLine and Medscape databases with the following key words: Clérambault; Erotomania. Results / Conclusions: The aetiology of primary erotomania is not yet fully understood, being the psychodynamic explanations the most accepted, but neuroimaging, genetic studies and findings from evolutionary psychopathology may help us in the near future to understand this condition.

Objectives: To determine the relationship between smoking and: 1) exacerbation of positive symptoms of schizophrenia; 2) reduction of negative symptoms of schizophrenia. Clinical case: 31-year old man, smoker of 30 units-pack-year, with the diagnosis of paranoid schizophrenia since 2009, when he was admitted to the Centro Hospitalar Psiquiátrico de Lisboa. He was treated with risperidone, clozapine, quetiapine and ciamemazine, with reduction of positive symptoms and improvements in functional and social skills. There was persistence, however, of affective incongruity, discrete auditory-verbal hallucinations, attenuated feelings of passivity and residual delusion. During ambulatory follow-up the patient stated, concerning his habits of smoking, that: "when I am not smoking voices are feeble" (sic). Discussion: Studies show that some ingredients of cigarette smoke (mainly polycyclic aromatic hydrocarbons) have an accelerating effect on the metabolism of several antipsychotics (i.e. clozapine, olanzapine, members of the phenotiazine group, and haloperidol). Other studies suggest that nicotinic receptor agonists (such as nicotine) may have a therapeutic role in the treatment of cognitive impairments (i.e. dfisturbances in attention and in verbal, visual and working memories) in schizophrenia, and in turn, abstinence from tobacco can lead to deterioration of cognitive and psychomotor performance in this patients population. Conclusions: 1) Exacerbations of positive symptoms may be related to decreased effectiveness of certain antipsychotics in result of an accelerated metabolism induced by cigarette smoking. 2) Nicotine may reduce some negative symptoms of schizophrenia, including cognitive impairment.