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Introduction: Carboplatin-liposomal doxorubicin is a widely used chemotherapy combination against ovarian cancer. Very few cases of new-onset psychosis have been reported during treatment with platinum-containing antineoplastic drugs. Anxiety, depression and insomnia have been reported with doxorubicin; but there are no reports of acute psychosis so far. Objectives: The aim is to expose a clinical case in order to provide further evidence on this topic. Methods: We present a 67-year-old woman without previous psychiatric history, diagnosed with ovarian high-grade serous carcinoma stage IIIB. She received three cycles of carboplatinpaclitaxel, which was later changed to carboplatin-liposomal doxorubicin due to peripheral neurotoxicity associated to paclitaxel. Behavioural disturbances, persecutory delusions, insomnia and aggressiveness appeared two weeks after receiving the second cycle of the new antineoplastic combination. She was hospitalized and assessed for organic etiologies, although no evidence of metastasis in Central Nervous System was found. Results: She was diagnosed with brief psychotic disorder and started on paliperidone up to 12 mg per day and quetiapine 50 mg per day. The following days she recovered to her basal mental state and one week after she was discharged. No psychotic relapse occurred after two more cycles of chemotherapy. Conclusions: This case reports the possible association between chemotherapy and the development of a psychotic episode. The timing of symptomatology onset suggests doxorubicin was responsible for the psychiatric complication. Behavioural disturbances in patients receiving chemotherapy should lead to psychiatric evaluation, as long as organic pathology has been discarded. [ABSTRACT FROM AUTHOR]

Introduction: Facing extreme life experiences can impoverish the ability to narrate experience and self. Descriptive psychiatry's model of psychoeducation focusing insight in psychosis may fail its purpose and threaten the already damaged patient's identity. Through the process of accepting illness, a value-bearing individual can end up being considered dysfunctional and worthless and experience guilt, shame, hopelessness, demoralization and helplessness. Elseway, denying illness would be considered proof of anosognosia. Both situations may lead to illness narratives introjection, agency loss, own beliefs and competency mistrust and stagnation. Objectives: The aim is to show narrative therapy as an advantageous complement or alternative to objective psychiatry psychoeducation in psychosis clinical practice. Reintegrate one's life narratives and retrieve recovery agency is one of the most powerful, adaptative and healing a person can accomplish. Methods: Narrative model encourages the patient to build and tell coherent and desirable stories in which recovery is promoted, from a personal point of view, and validates these. A non-pathologizing speech, normalization, externalization, empathy, respect and kindness are recomended. It is fostered to embrace different truths and alternative versions of self, promoting dialogue and cooperation between selves to dynamize identity narratives and allow choosing a preferred self in each situation. Exploiting personal resources is encouraged. Results: The person feels reauthorized in the direction of life and recovery, starts narrating personal life stories and recover the possibility of social interaction. Conclusions: Through recovery process, the person regain an integrated sense of identity, separated from illness and develop an author-narrator-protagonist role in his own life story and the recovery process. [ABSTRACT FROM AUTHOR]

Strict adherence to antiretroviral treatment (ART) is needed to ensure the effectiveness of HIV treatment. The adverse effects of substance abuse and neurocognitive impairment on medication adherence have both been suggested by several studies. Therefore, the aim of this research is to study the relationship among adherence to ART, cognitive dysfunction, and abuse of certain substances (alcohol, heroin, cocaine, other stimulants, cannabis and benzodiazepines) and/or methadone treatment in our social environment. We performed an observational case-control study with a sample of 125 HIV+ patients, who were classified as patients with poor adherence (cases) and subjects with adequate compliance (controls). Adherence was defined by the Hospital Pharmacy and verified with the Simplified Medication Adherence Questionnaire (SMAQ) and the reference physician's clinical impression. Cognitive functioning was measured with the Zoo Map Test and Trail Making Test (TMT). Substance abuse was collected through a semi-structured clinical interview protocol. Statistical analysis was made using a binary logistic regression model. The results indicate that both alcohol abuse and neurocognitive impairment measured by Zoo Map Test were significantly associated with poorer adherence to ART. No significant association was found between adherence and other substance use, or between adherence and TMT score. Screening of cognitive impairment measured by the Zoo Map Test and alcohol abuse may lead to the development of strategies to improve de adherence to ART in HIV+ patients.