The aims of this study were to know the frequency and clinical characteristics of insomnia, and related variables to insomnia in patients diagnosed with type 2 diabetes.

IntroductionGiven the profound life changing event that having a child represents, women are at an increased risk of developing psychiatric illness during the postpartum period. Although postpartum depression and psychosis have been widely studied, postpartum onset obsessive compulsive-disorder (OCD) seems to be an overlooked condition, remaining many times undiagnosed and untreated.Objectives/AimsThis work aims to review the prevalence, clinical features and characteristics of postpartum onset OCD.MethodsA review of relevant literature was conducted alongside online database research (PubMed and Medscape).ResultsIn postpartum onset OCD obsessions are typically related to the baby and include: fear of intentionally or accidentally harm the newborn, fear of contamination, obsessions of symmetry/exactness, aggression and religiousness. These intrusive and obsessional thoughts, especially aggressive obsessions, create great distress and fear on acting on them.To relieve the anxiety common compulsions include: avoiding taking care of the baby, repetitive and ritualistic washing, checking, ordering, counting, reassurance seeking, and praying.The lifetime prevalence of OCD in general population is about 2 – 3%, however the prevalence of postpartum onset OCD is not known.ConclusionsFurther investigation is necessary to clarify the epidemiology, risk factors, and clinical course of postpartum OCD. Is it crucial to reassure parents that these intrusive thoughts are frequent, and do not translate any unconscious desires.These symptoms should be screened appropriately and identified in the early postpartum period, in order to reduce the associated distress, family dysfunction, and the negative impact in the mother-infant bonding.

IntroductionPsychopaths are incapable of feeling empathy and guilt, being responsible for most violent crimes. To date, confinement has been the option of choice to minimize the harm they inflict. However, a deeper understanding of the neurobiology of psychopathy may lead to new insight on possible treatment approaches.AimsThis work aims to review the current knowledge in psychopathy treatment.MethodsA literature search of MEDLINE (2000-present) was conducted using the search terms “psychopathy” + “treatment” and “drug therapy”.ResultsDefects in the amygdala and the prefrontal cortex have been implicated in the pathological basis of psychopathy. The most affected areas are the ventromedial prefrontal cortex (VMPC) and the associated anterior cingulated cortex. Alterations in connectivity between the amygdala and the VMPC with other areas of the brain have been demonstrated and seem to be responsible for the non-empathetic, unemotional, and amoral features of psychopaths. Also, they present an increase in dopamine turnover and metabolism and a serotonin dysregulation.As not all individuals with the biological substrate for psychopathy become violent, it seems that plasticity in forebrain circuits may allow the development of more prosocial responses, especially in youth. Some authors emphasize the need to address other behaviours that can be responsible for violent actions, namely, impulsive aggression. Some drugs have shown efficacy in controlling impulsive aggression.ConclusionsPharmacological approaches to treating psychopathy have been disappointing. A more reasonable goal would be to focus on impulsive aggression, for which treatment effectiveness has been demonstrated. Additional research is needed if we hope to design rational therapeutic strategies for this disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionSuicide behaviors (suicide acts and suicide attempts) are a major concern for clinicians treating patients with psychiatric disorders. Among them, patients with bipolar disorder (BD) have the highest prevalence of suicide behaviors, accounting for up to one-quarter of all completed suicides. Additionally, suicide remains the leading cause of avoidable death in patients with BD.AimsThis work aims to review the main risk factors for suicide behaviors in patients with BD.MethodsThe MEDLINE/Pubmed database was searched using the keywords “bipolar disorder” with: “suicide”; “suicide attempt”; and “suicide risk factors”. Articles published in the last 10 years were considered.ResultsIt is estimated that 25% to 50% of patients with BD will attempt suicide at least once in their lifetime and, that 10% to 15% will die. The risk factors for suicide behaviors in patients with BD have been widely studied and their knowledge is crucial for identifying patients at risk.The main risk factors include previous suicide attempts, family history of suicide and hopelessness. Other risk factors have also been identified: depressive polarity of first mood episode; rapid cycling; increasing severity of affective episodes; depressive polarity of the latest mood episode; mixed affective states; early age of onset; and comorbid anxiety disorders, substance use disorders and cluster B personality disorders.ConclusionsPrevention of suicide behaviors is crucial when treating patients with BD. Therefore, the knowledge of these risk factors is of extreme importance in order to promptly identify patients at risk and adopt the proper preventive therapeutic interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.