Introduction:Auditory hallucinations in deaf people are known since the XIX century. However, research in this area is scarce.Objectives:Auditory hallucinations can be caused by alterations in receptors, stimulus carrying routes or cerebral centres. Therefore, they can take place in persons without mental illness.Methods:Bibliographical review in literature and pub med using as key words: “Auditory hallucinations, Auditory deficit,ACBS”Results:There is always chronic hearing loss caused by an auditory injury.Higher prevalence in females with acute or gradual onset.Usually unilateral.Most common phenomena are musical hallucinations.Not associated with other types of hallucinations.Can be modified by attention and will.It is a hallucinosis.Not accompanied by disturbances of consciousness, memory or judgment.Treatment of hearing impairment leads to healing. Results are unsatisfactory with psychotropic drugs. Psychoeducation may lead to improvements.Conclusions:The existence of auditory hallucinations with consciousness of unreality rules out an organic pathology. It is important to assess hearing, because an entity has been defined by musical auditory hallucinations with unreality conscious and with preserved judgment, memory and consciousness, in patients with acquired hearing loss, mainly women and elderly, called by many professionals ACBS. Awareness of this entity by specialists in otolaryngology and psychiatry is essential.

Introduction: Mentally ill patients have rates of medical comorbidity and mortality higher than the rest of the population. They require adequate medical care that isn´t usually. Objectives: Emphasis on physical health problems affecting the mentally ill patients, analyze situations that may motivate and possible solutions. Methods: Bibliographical review in the literature and pub med using key words: "medical comorbidity, severe mental illness, psychopharmacological treatments" Results: Mentally ill patients have greater medical comorbidity and higher mortality rate than the general population. In patients with schizophrenia life expectancy is 20% lower and mortality risk of 1.5-3 times higher than the rest of population. Affective disorders are associated with a standardized mortality ratio for medical reasons also high. Studies show that excess mortality in patients with severe mental illness is 60% due to natural causes and 40% to unnatural causes (28% suicide and 12% accidents). This increased mortality is mainly due to cardio-respiratory and infectious disease. Low socioeconomic class, lack of social care, poor medical care, bad habits (poor diet, sedentary, toxics) and adverse effects of psychopharmacological treatments are the main factors. Despite this, detection and treatment of physical illness is low. It is estimated that between 30 % and 47% of these patients are untreated. Conclusions: Improved medical care of these patients would improve their performance and quality of life. A system for each type of mental health to screening, assessment, diagnosis and treatment of somatic diseases, and a protocol for referral to appropiate medical / surgical centers are required.

IntroductionPegylated-interferon (pegIFN) plus ribavirin (RBV) is for the moment the licensed therapy for chronic hepatitis C. Neuropsychiatric symptoms are frequent side effects due to the treatment with pegIFN, registered in 30 to 80% of instances, with mood rather than psychotic disorders usually observed.ObjectiveA manic profile with psychotic symptoms in a HCV infected patient receiving pegIFN-RBV is presented to discuss management strategies and outcome.MethodsA 47 year-old male patient, former IDU and alcohol abuser, without past psychiatric history, was under therapy for chronic hepatitis C (genotype 1a, HCV-RNA 6.2 log IU/mL, Child A5). After 14 weeks of pegIFN-RBV treatment the patient attends ER with insomnia, uneasiness, expansive mood, irritability, extravagant and disinhibited behaviour, and detrimental and self-referential delusion.ResultsThe patient was admitted at the Psychiatric Unit to receive amisulpride (400 mg/12h) plus lorazepam (1 mg/8h), with psychotic symptoms regressing over following days. It was agreed that psychotropic drugs would be maintained at the same doses until the end pegIFN-RBV therapy, intended for 48 weeks.ConclusionAntipsychotic therapy may be effective and allows VHC infected patients with manic symptoms related to pegIFN-RBV therapy to continue their treatment.

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IntroductionDelusional disorder, also known as paranoia, is a low prevalence psychotic disorder in our environement. Usually, patients who have this disorder are very difficult to treat adequately besides its poor adherence to medical treatment, and the ineffectiveness of some therapies are well documented.ObjectivesThe aims of this study were to describe clinical, socio-demographic and pharmacological variables among a large stable sample in the community, and quantify the association between these variables and mental health care adherence.MethodsHospital Clinico San Carlos Hospital covers three local health areas; the sample was taken from one of them, wich provides health care to 268,000 people, approximately.We identified 130 out-patients with delusional disorder, but only 90 of these fulfilled DSM IV criteria. We recorded socio-demographic, clinical, pharmacological and legal data from 71 medical history patients. We also included number of visits and number of times patients didn't attend to an appointment among the total in one year. We defined mental health care adherence as good, irregular, or abandoned, in relation to missed appointments.ResultsDelusional disorder incidence was 1,6 per 100,000 habitants, with a prevalence of 36 per 100,000 habitants, according to other studies results. Among all treatments, risperidone was the most prescribes neuroleptic. We found association almost significant between tratment with benzodiacepinesn and good adherence (x2 = 0,059).ConclusionsThese results give as a more realistic view of delusional disorder in our enviroment, and let us to reconsider aspects of mental health care adherence and a posible association with benzodiazepine treatment.