Deep Brain Stimulation represents a therapeutic option for PD patients. In this paper, we present and discuss a case of acute delirium and psychosis manifesting after DBS in a 58-years-old man affected by Parkinson's Disease. We highlight the importance of an exhaustive psychiatric evaluation in candidates for DBS and we underline the severity and non-reversibility of some adverse events associated with the implantation, suggesting the use of Quetiapine in the management of these effects. Acute psychosis may be listed as a potential severe adverse event associated with DBS, even in patients without a clear cut previous history of psychiatric disorders.

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BackgroundPatients with cerebral palsy (CP) have an increased risk of developing mental health disorders.AimsThis paper is aimed to investigate the occurrence of psychiatric symptoms in adults with CP and to explore the relation between clinical and psychosocial variables.Methods and proceduresWe included 199 adults with a diagnosis of CP. The chi-square and the Mann-Whitney U tests were used to compare clinical and psychosocial variables, the level of perceived disability, and the type of observed parental style in patients with and without psychiatric symptoms. Logistic regression analysis was used to identify variables that could predict the occurrence of mental health disorders.Outcome and resultsAnxiety and psychosis were the most represented disorders. Age, living status, assumption of drugs, motor, manual, and global impairment were significantly different between patients with and without psychiatric symptoms. Similarly, a different parental style was observed between the two groups. Logistic regression indicated that living status, prescribed drugs, parental style, and the perceived disability in getting along with others predicted the occurrence of psychiatric symptoms.Conclusions and implicationsResults suggest that patients with and without psychiatric symptoms have different clinical and psychosocial characteristics. Some variables should be considered as potentially affecting the mental health of patients with CP.

Parkinson's Disease is a progressive disorder of the nervous system which frequently starts before the sixth decade of life. This is a preliminary overview concerning the effect of a training on cooking with four women with Parkinson's Disease. Cooking is a complex activity that requires functions as attention, memory and task organization; fine motor skills and bimanual coordination are also involved. Moreover, this kind of activity is important for women to maintain their social role as housewives. The assessment was done before and after the training and included: The Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Quality of Life questionnaire (PDQL), Schwab & England Scale, Functional Independence Measure (FIM) and a cooking test. The training consisted of 10 group sessions of 90 minutes each one. At the end of the cooking training, the level of disability, measured by the UPDRS, decreased for all participants as well as the time required to perform a cooking test. Scores on other test were unvaried. A cooking training may be useful to improve the course of the Parkinson's disease and should be included in a comprehensive rehabilitation program.

Substance abuse and drug dependence are frequently observed among inmates. Clonazepam is a benzodiazepine approved only for treatment of epilepsy. Despite this, often correctional health care professionals inappropriately prescribed high doses of Clonazepam for the treatment of anxiety and insomnia in prison. It has therefore emerged as a drug of abuse in prison.In this study we describe the pathway of removal of Clonazepam in an Italian prison.First, all correctional health care professionals, together with psychiatrist, met to discuss the opportunity and the way to remove this drug from the formulary, considering the clinical and environmental impact on doing this. Psychiatrist recommended guidelines for substitution with others benzodiazepines if necessary.During the next year (2012) we observed differences in the prescription of benzodiazepines and modifications in inmates behavior (as self-injury, aggressiveness or suicidal behavior), if any. Moreover, we registered if antipsychotics and antidepressant medications were necessary to manage the patients during the removal. We considered the mean number of the inmates in 2011 (n=348) and in 2012 (n=342). Drug doses are reported in number of tablets.In 2012, the use of Clonazepam, limited to the treatment of epilepsy, reduced (from about 47.000 to 140 tablets) whereas the use of Delorazepam and Triazolam increased. The consumption of other benzodiazepines, antipsychotics and antidepressant medications remained substantially unchanged. Also frequency of suicidal and self-injurious behaviors did not change.These conclusions support the decision to remove clonazepam for the treatment of anxiety or sleep disorders in prison.