IntroductionRecent studies point for an increased incidence of psychotic disorders among immigrants when compared to nom-immigrant population, with a substantial risk variation being observed among different ethnic minority groups and diverse host countries/societies.ObjectiveThis communication explores the relation between immigration and the onset of psychosis disease, namely the individual and socio-environmental factors implicated in this association.AimsAccessing the implications of immigration in the establishment of psychotic disorders.MethodsThe authors conducted a literary search on Medline and PsychInfo databases regarding the subject immigration and psychotic disorders, elaborating a bibliographic review of the topic.ResultsA greater incidence of psychotic disorders in immigrants (in comparison to nom-immigrant population) has been established. In actuality a range of studies carried out in different socio demographic contexts and with different ethnic groups (of immigrants) identify ethnicity, neighbourhood characteristics (namely level ethnic density), discrimination and refugee status, as some of the probable factors that modulate the rate of psychotic disorder and influence its incidence in immigrants.ConclusionsWith regard to the relationship between immigration and the development of psychosis, much is still to be understood. Future studies with focuses on different individual, social, cultural and demographic aspects need to be developed in order to better understand and addressed this phenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionReligion/spirituality and medicine have been related in one way or another sense the beginning of our know History. Patients’ beliefs, values and practices influence the way disease is perceived and managed. In order to provide adequate care the physician must have proper knowledge of the patients’ spiritual/religious context, otherwise it may fall prey to errors of diagnostic, inappropriate management and subsequent poor compliance.ObjectivesTo present the case of an adult male (a preacher whose beliefs include mediunity) with delusional ideation of mystical content and mood elation, identified during a religious ceremony.AimsQuestioning the frontier between spiritual/religious beliefs and psychopathology.MethodsA case report is presented and a literature review of the theme is shortly surveyed.ResultsThe case reports to a 53 years old man, who during a religious ceremony presented himself with agitation and disinhibition, removing all his cloths and living the church naked. Additionally it was identified the presence of insomnia, heteroaggressiveness, accelerated speech, mood elation and delusional ideation of mystical and megalomaniac content. Several studies demonstrate the importance of acknowledging the religious/spiritual beliefs of patients. This knowledge allows the psychiatry to correctly identify the existing psychopathology and organize an appropriate intervention plan for the patient.ConclusionsSpiritual and religious beliefs’ influence the way disease is perceiver and managed. Physician should collect a brief spiritual story of the patient and learn about the different religious/spiritual beliefs and practices of their community, in order to understand the full dimension of the individual illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionFor the most part, central nervous system (CNS) tumors present themselves with focal neurologic sing or manifestations resulting from increased intracranial pressure. However, in particular cases, these tumors may present exclusively psychiatric symptoms.ObjectiveThis communication explores importance of CNS tumors as differential diagnosis of various psychiatric disorders.AimsHighlight the need of acknowledging this important differential diagnosis (CNS tumors) in current psychiatry practice, while presenting a clinical case as an example of the subject.MethodsIt is exposed a bibliographic review of the topic, followed by the description of a clinical case regarding a patient with pituitary adenoma and simultaneous installation of psychotic symptoms namely delusional paranoid ideation.ResultsThe authors present a case report of a 66-year-old patient admitted compulsively in a Psychiatric ward in the context of behavioral changes associated with delusional ideation of paranoid content. Multidisciplinary assessed by specialties of Psychiatry, Neurology, Neurosurgery, Endocrinology and Psychology, concluded by the presence of nonfunctioning pituitary adenoma associated with cognitive major disturbance.ConclusionsThe tumors of the CNS can be associated with a whole variety of psychiatric symptoms such as psychosis, anxiety, depression or cognitive impairment, even in the absence of organic/neurological symptoms. Its role in the genesis of psychiatric symptomatology makes these neoplasias an important differential diagnosis, whose clinical approach should include different medical specialties integrated as a multidisciplinary team.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introdução: A par dos modelos nacionais e internacionais de intervenção na fase inicial das perturbações psicóticas, teve início, em 2010, um Programa de Intervenção Precoce em Psicose (PIPP) na instituição dos autores. Este proporciona um acompanhamento multidisciplinar intensivo, a doentes nos primeiros cinco anos de apresentação de sintomas psicóticos, visando otimizar a abordagem para que alcancem uma melhor recuperação e evolução. Foi objetivo do presente trabalho avaliar o impacto dessa intervenção especializada sobre a evolução dos doentes em fase inicial de uma perturbação psicótica. Metodologia: Foi efetuado um estudo retrospetivo de um conjunto de variáveis clínicas e sociais de uma amostra de doentes admitidos consecutivamente no PIPP, desde 2010, por um diagnóstico de psicose com menos de cinco anos de evolução, e acompanhados durante os cinco anos seguintes no programa. Comparativamente, analisámos o comportamento das mesmas variáveis numa amostra histórica de doentes com psicose inicial tratados de forma genérica (N-PIPP), previamente à criação do programa. A análise estatística fez-se com recurso ao programa informático SPSS 22. Resultados: Comparativamente ao grupo N-PIPP, os doentes do grupo PIPP apresentaram, ao fim de cinco anos, um risco significativamente menor de reinternamento (RR=0,33, p=0,043) e de abandono definitivo do tratamento (RR=0,21, p=0,011); e uma maior probabilidade de ocupação social ou profissional (RR= 1,83, p=0,048). Apresentaram também maior remissão sintomática apesar de não se ter apurado significância estatística nessa associação (RR= 1,33, p=0,184).  Conclusões: O acompanhamento dos doentes em fase de psicose inicial num programa especializado tem um efeito favorável na sua evolução clínica e social.