IntroductionInvoluntary admission of mentally ill patients tends to be related to clinical severity and worst therapeutic response.ObjectivesTo evaluate whether there is a relationship between involuntary admission and prescription of two or more antipsychotics (that is, polytherapy) among patients with schizophrenia and other psychosis.MethodsA total of 241 patients (40.2% females, mean age 39.7+/−13.0 years) consecutively admitted during 2009 to a psychiatric inpatient ward with diagnosis of schizophrenia and other psychoses were assessed.ResultsOut of the total sample, 150 (62.2%) patients were on polytherapy, and of the 241 patients 134 (55.6%) were involuntarily admitted. Involuntary admission was unrelated to age (p = 0.335), specific diagnosis (p = 0.452), or length of psychosis (p = 0.234). On the contrary, it was related to gender (61.8% of males vs. 46.4% of females were involuntary, p = 0.018) and to polytherapy/monotherapy prescription (62.0% of patients on polytherapy vs. 45.1% of patients on monotherapy were involuntarily admitted; and 53.3% of voluntary patients vs. 69.4% of involuntary were on polytherapy p = 0.010). After controlling for age, gender, specific diagnosis and length of psychosis the association between involuntary admission and being in polytherapy remained significant (p = 0.047).ConclusionsPatients involuntarily admitted are more prone to be on antipsychotic polytherapy.

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Kleine-Levin syndrome is a rare disorder whose diagnosis is clinical, today there is no clinical test or pathognomonic symptoms feature that facilitates diagnosis. It is necessary to rule out any organic cause etiology to make the diagnosis.We report a case of a 13 year old patient presented multiple hospitalizations (up to 12) in pediatrics because of behavior and cognitive disturbances: hypersexuality, compulsive eating behavior, hypersomnia, amnesia, and confusion, with the initial diagnosis suspected anti NMDA encephalitis. Throughout its evolution is also studied by psychiatry service. Through this case we explain how finally through the clinical characteristics, the medical test totally normal and the characteristics of the disease patterns (in the form of episodes, absence of symptoms between them …) who our patient is diagnosed with this rare disorder that usually occurs in the second period of life and especially in males.it is very important to learn about it and be able to identify the characteristics in our work place because in spite of is a rare disorder can have repercussions on a personal (school, family, friends…) environment.

Objectives:Demostrate that clozapine decrease the number of hospitalizations, and improve the adherence to treatment.The sample consisted of 36 schizophrenia patients who were in treatment with a typical and atypical neuroleptic and then had their medication changed to clozapine. We ascertained the number of inpatient hospitalizations before starting clozapine and compared this with the number of hospitalizations after starting clozapine. We also followed an age- and gender-matched comparison group of other schizophrenia patients who were at treatment approximately the same time. Results indicate that the mean number of rehospitalizations while on other neuroleptic was bigger than after the commencement of clozapine treatment. The decrease in hospitalization rate for the comparison group was also statistically significant. The pre-post change was much greater for the clozapine patients than comparison patients. A 2 x 2 repeated measures analysis of variance (ANOVA) contrasting the comparison group to the clozapine patients both before and after the index date indicates a significant time by group interaction, thus documenting the greater relative decrease in rehospitalization rate in the clozapine gr.We also used a compliance scale pre and post-begining of treatment with clozapine for evaluate the adherence to treatment. Clozapine improve the compliance of treatment, in comparison to the neuroleptics that patient has taken before.Conclusions:the clozapine seems to be more effective than other antipsychotics in decrease the risk of hospitalizations, and improve the adherence to treatment