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IntroductionIn the past six decades, extensive research has been done on family therapy from different areas of knowledge such as psychology, psychiatry and social work. Leading to development of different intervention techniques and optimal clinical evaluation with families.AimsThe systemic perspective focus on the study of the dimensions that contribute to the stability and consistency of the members of the family system. The family is an interrelated system, dependent on each other, where there is an influence of the group over the individual, which is why each of its members plays a pivotal role in family therapy. Throughout all these years of evolution of systemic family therapy, many different concepts and techniques have been used, including the ones currently used today.MethodsKnowing the evolution of the different techniques allows us to understand the functioning of families, for example, their links and the elements that constitute it: their roles, the functions performed by each member in the family, communication, standards and power relations.ConclusionsThe descriptive diagnosis of family ties, help us implement intervention strategies that could improve clinical care and diagnostic approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionEncopresis is a not very common disorder. The prevalence of this disorder is about 1.5% after the age of 5 years old and decreased even more as age increased, being very rare in adolescence.AimHere we present a clinical case of an 11-year-old girl, with a diagnosis of functional encopresis with constipation and overflow incontinence for 4 years.MethodIn this case, we followed a program consisted of 12 sessions combining different techniques that are on experimental phase. The program we designed consist of toilet training, stablishment-token economy- of a diet high in fiber with a progressive remove of laxative medication and a family intervention with both parents that got divorced 4 years ago.ResultsHaving both parents the same frame the patient's problem easily started to decrease. In follow-up (6 and 12 months), we observed good toilet habits and not constipations episodes.ConclusionsEven though all the techniques used were in experimental phase, we considered that because of the chronicity of this problem a multidisciplinary approach was the best option.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionDue to constant flow of people in and out of Europe several drugs are now days appearing in European markets that were previously unknown. There is a need to gain awareness and knowledge about these new substances and to recognize their use and learn about their effects and management.Aims/objectivesAyahuascais commonly called yagé is a traditional spiritual medicine in ceremonies among the Indigenous peoples of Amazonian Peru. It is undetected in urine or blood and therefore it is important to understand and ask about its usage during clinical assessment.Methods/resultsThirty-six years old woman immigrant from South America came to us with auditory hallucinations. About three years ago she was introduced who introduced her to a community of Euto poeple that performed daily rituals of spiritual awareness involving the use of Ayahuasca. She became a part of it and started consuming Ayahuasca daily. She started becoming socially isolated accompanied by delusional and mystical religious ideations. She later began having persecutory delusions and auditory hallucinations that Archangels speak to her about how to create music. Patient was involuntary admitted in a mental health unit and started on risperidone. Gradually her condition improved and she stopped having auditory hallucinations. After being discharged from the hospital, patient was followed on an outpatient basis with injectable risperidone.ConclusionsDue to the blend of different cultures in Europe, it is necessary to have a better understanding about the cultures, rituals and the substances that are relatively new and are currently been used.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionPublished rates of HIV infection among psychiatric patients are 3.1% to 23.9%, at least eight times higher than general population. (Nebhinan et al., 2013)AimsDefects in judgment and insight in patients with psychosis is often associated with lot of anger and impulsiveness, risky behavior and lower treatment adherence. This often led to worsening of clinical status and prognosis. (Uruchurtu, 2013)MethodsA 31-year-old man diagnosed with schizophrenia and HIV four years ago. At the beginning of last year, the patient was hospitalized in the Acute Psychiatry Hospital Unit because of decompensation. Two years after diagnosis of HIV, he stopped taking his medications and was arrested several times because misdemeanours. Furthermore, patient was highly sexually active in the form of unprotected sex with multiple partners, as he had no concept of his disease. In addition to this, he made a delusional interpretation about HIV (known as VIH in Spanish) as Immortal human life (Vida Immortal Humana). He was admitted in the hospital for a month and was treated with medications and psychotherapy, which led to good stabilization, and he gained insight of both of his illnesses. At the moment, one year after this episode, the patient is stable, taking both medications regularly and followed up by his psychiatrist in the Mental Health team.ConclusionIt is of extreme importance that psychotic patients with HIV receive a good follow-up during life, as decompensation can affect the patients’ health and health of others, with the implicit consequences that it carries. (Uruchurtu, 2013)Disclosure of interestThe authors have not supplied their declaration of competing interest.

Diagnosis plays a key role in identification of a disease, learn about its course, management and predicting prognosis. In mental health, diseases are often complex and coalesce of different symptoms. Diagnosing a mental health condition requires careful evaluation of the symptoms and excluding other differential disorders that may share common symptoms. Diagnose hastily can lead to misdiagnosis. A premature diagnosis or misdiagnosis has clear negative consequences. This is one of the problems related to mental health and one needs to optimize the diagnostic process to achieve a balance between sensitivity and specificity. Currently, the diagnosis of bipolar disorder (BD) is one of the major mental health conditions that is often misdiagnosed.To differentiate BD from unipolar depression with recurrent episodes or with personality disorder (PD), especially type Cluster B – with features shared with mania/hypomania like mental instability or impulsivity, it is important to differentiate between a diagnosis and its comorbidity. BD is often misdiagnosed as personality disorder and vice versa specially when both are coexisting (almost 20% of patients with bipolar disorder type II are misdiagnosed as personality disorders). This is common especially with borderline PD, although in some cases the histrionic PD may also be misdiagnosed as mania.Due to the inconsistency in patient care involving different psychiatrists combined with difficulty in obtaining a precise patient history and family history leads to loss of key information which in turn leads to misdiagnosis of the condition. The time delay in making the correct diagnosis cause by such inconsistencies may worsen the prognosis of the disease in the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.