IntroductionGlucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme deficiency worldwide. In this condition acute hemolysis is caused by exposure to an oxidative stressor in the form of an oxidative drug, an infection or aliments. G6PD deficiency can be associated to different psychiatric conditions, but little is known about the risk of acute hemolysis in G6PD deficient patients that are treated with antipsychotics and mood stabilizers.AimsA clinical description is presented in order to illustrate the possible risk of acute hemolysis with Lithium therapy in a G6PD patient.MethodsA 33 years old male of hispanic origin and a G6PD enzyme deficiency was admitted presenting a first episode of mania. Lithium treatment was initiated.The patient was clinically examined daily. Extensive laboratory evaluation was performed, including complete blood cell count, liver, renal and thyroid function tests, serum electrolytes and glucose levels, urinalysis, lithium blood dosage. Neuroimaging studies were also performed excluding secondary causes of mania.ResultsAt J7 of lithium therapy the patient presented with jaundice and a blood count revealed a drop in the number of red blood cell (from 3,42 T/L to 2,42 T/L) with an increase of bilirubin (87,2 umol/l) which revealed an episode of acute hemolysis. Lithium therapy was discontinued immediately. Red blood cell count continued to drop for another 7 days and returned to normal after 2 weeks of discontinuation of Lihium therapy.ConclusionsLithium might be a trigger of acute hemolysis in bipolar patients with G6PD deficiency associated.

IntroductionEkbom syndrome is a delusional parasitosis in which the patient has the delusion of infestation by parasites. This condition might occur in concordance with senile dementia or cerebrovascular disease, but it is also present in mood disorders or schizophrenia.ObjectivesTo present a clinical description of a delusional parasitosis that appeared in a young nigerian women after she immigrated in France.AimsOur case is suggestive for showing that delusional parasitosis might develop in circumstances of social vulnerability such as the immigration and might have different cultural aspects.MethodsWe present the case of a 29 years old nigerian women that developed a delusional parasitosis 3 years after her arrival in France. The diagnosis was based on a carefully detailed clinical history, an MMSE was also applied. In order to exclude secondary causes an extensive laboratory evaluation was performed including: complete blood cell count, liver, renal and thyroid function tests, serum electrolytes and glucose levels, vitamin B12, folate, iron studies, coproanalysis, neuroimaging.ResultsThe patient had all laboratory and neuroimaging tests normal. She presented a delusional parasitosis and she described an infestation with multiple intestinal worms. She was capable of describing them and their movements under the skin and also in all the organs. She described dracunculiasis and three more different species that are commonly present in Nigeria, she never mentioned lice or mites.ConclusionsEkbom syndrome is a delusion of hallucinatory mechanism that might have different cultural presentations and could be favored by social vulnerability such as immigration.

IntroductionPeople with major mental disorders are more likely to be violent than other members of the general population. What is contoversial is the influence of the patients’ environnemental violence as regards their aggressive behaviors.The aim of the study was to assess the violence of patients with psychotic disorders regarding the crime rate in the patients’ community.MethodWe have led a prospective multicentre study in 9 French cities-each of them having different crime rates. Eligible patients were psychotic involuntary patients hospitalized in the cities’acute admission psychiatric wards. During their treatments, any kind of the patients’aggressive behavior has been reported by the OAS (Overt Aggresion Scale).ResultsFrom June 2010 to May 2011, 95 patients have been included. Seventy-nine per cent of the patients were violent during their hospitalizations. The patients’violence was mostly verbal (65%). In a bivariate analysis, the patients’violence was significantly associated to different factors: male gender, the patients's violence history, substance abuse, manic or mixed disorder, the symptoms severity measured by the BPRS, the insight degree and the crime rate in the city. In a multivariate analysis, the only significant factors associated with the patients’violence were substance abuse, the symptoms severity and the patients’cities’crime rates.DiscussionThe results are in accordance with the literature on the risk factors of violent behaviors.The environnemental factor-wich was until now not so much studied-also appears highly associated to this risk.ConclusionThese results suggest that the violence within the psychotic patients’environnement could represent a risk of violence during the treatment.