Abrus precatorius is an ornamental plant that belongs to the Leguminoceae family. It contains toxalbumin, named abrin, in all of its parts. However, the seeds are more toxic when consumed in crushed form. Deaths due to abrus seed poisoning are rare. We are reporting a case of suicidal ingestion of crushed abrus precatorius seeds by a 37-year-old female. She presented to the hospital with complaints of multiple episodes of vomiting and diarrhea. She was resuscitated with fluid boluses, followed by a stomach wash and activated charcoal, and referred to our tertiary hospital, where she presented with giddiness, abdominal pain, bloody diarrhea, and epigastric tenderness. On subsequent days, she developed altered sensorium, renal failure, and electrolyte imbalance. She was managed conservatively. Blood investigation revealed elevated leucocyte count, increased urea and creatinine levels, and elevated liver enzymes. She died five days after ingesting the seeds. On autopsy examination, the brain and lungs were congested and edematous. The peritoneal cavity contained around 500mL of straw-colored fluid. Petechial hemorrhages were present over the lungs, heart, and liver surfaces. The mucosa of the gastrointestinal tract was hemorrhagic, the liver showed steatosis, and the kidneys showed congestion and obscuration of the corticomedullary junction. Histopathologically, the lungs showed mild congestion with alveolar edema, the liver showed necrosis with steatosis, and the kidney showed acute tubular necrosis. The toxicology screening was positive for abrin. This case highlights not only the rare fatality following abrus precatorius poisoning but also the toxic nature of this plant.

BACKGROUND: Digital phenotyping has seen a broad increase in application across clinical research; however, little research has implemented passive assessment approaches for suicide risk detection. There is a significant potential for a novel form of digital phenotyping, termed screenomics, which captures smartphone activity via screenshots.
OBJECTIVE: This paper focuses on a comprehensive case review of 2 participants who reported past 1-month active suicidal ideation, detailing their passive (ie, obtained via screenomics screenshot capture) and active (ie, obtained via ecological momentary assessment [EMA]) risk profiles that culminated in suicidal crises and subsequent psychiatric hospitalizations. Through this analysis, we shed light on the timescale of risk processes as they unfold before hospitalization, as well as introduce the novel application of screenomics within the field of suicide research.
METHODS: To underscore the potential benefits of screenomics in comprehending suicide risk, the analysis concentrates on a specific type of data gleaned from screenshots-text-captured prior to hospitalization, alongside self-reported EMA responses. Following a comprehensive baseline assessment, participants completed an intensive time sampling period. During this period, screenshots were collected every 5 seconds while one\'s phone was in use for 35 days, and EMA data were collected 6 times a day for 28 days. In our analysis, we focus on the following: suicide-related content (obtained via screenshots and EMA), risk factors theoretically and empirically relevant to suicide risk (obtained via screenshots and EMA), and social content (obtained via screenshots).
RESULTS: Our analysis revealed several key findings. First, there was a notable decrease in EMA compliance during suicidal crises, with both participants completing fewer EMAs in the days prior to hospitalization. This contrasted with an overall increase in phone usage leading up to hospitalization, which was particularly marked by heightened social use. Screenomics also captured prominent precipitating factors in each instance of suicidal crisis that were not well detected via self-report, specifically physical pain and loneliness.
CONCLUSIONS: Our preliminary findings underscore the potential of passively collected data in understanding and predicting suicidal crises. The vast number of screenshots from each participant offers a granular look into their daily digital interactions, shedding light on novel risks not captured via self-report alone. When combined with EMA assessments, screenomics provides a more comprehensive view of an individual\'s psychological processes in the time leading up to a suicidal crisis.

BACKGROUND: The coronavirus pandemic is associated with significant morbidity and mortality. While physical recovery has been made a priority, the psychological wellbeing of recovered patients is not receiving the attention it deserves.
METHODS: We present the case of a 27-year-old male who developed severe depression associated with anxiety and suicidal ideations two weeks after full recovery from COVID- 19 infection. Significant somatization was also present at the onset which he misattributed to a recurrence of the infection. He was admitted for in-patient psychiatric care and fully recovered after six weeks of medication and psychotherapy.
CONCLUSIONS: Infection with the virus is a psychologically distressing experience that can trigger mental disorders in vulnerable individuals. Our report highlights the mental health needs of all COVID-19 patients and the need for psychological evaluation in the post-recovery period.
BACKGROUND: La pandémie de coronavirus est associée àmorbidité et mortalité importantes. Pendant la récupération physiquea été fait une priorité, le bien-être psychologique deles patients rétablis ne reçoivent pas l’attention qu’ils méritent.
UNASSIGNED: Nous présentons le cas d’un jeune homme de 27 anshomme qui a développé une dépression sévère associée à l’anxiétéet les idées suicidaires deux semaines après le rétablissement complet de la COVID-19 infection. Une somatisation importante était également présente à l’apparition qu’il a attribuée à tort à une récurrence de l’infection.Il a été admis pour des soins psychiatriques hospitaliers et completsrécupéré après six semaines de médicaments et de psychothérapie.
CONCLUSIONS: L’infection par le virus est une atteinte psychologiqueexpérience pénible qui peut déclencher des troubles mentaux dansles personnes vulnérables. Notre rapport met en lumière la santé mentaleles besoins de tous les patients atteints de la COVID-19 et le besoin deévaluation dans la période post-rétablissement.
UNASSIGNED: Anxiété, Dépression, Suicidaire, COVID-19, Nigéria.

Papillon-Lefèvre syndrome (PLS) is an autosomal recessive disorder that presents with palmoplantar hyperkeratosis and childhood-onset progressive loss of all dentition. Mental retardation is the only neurodevelopmental disorder reported with this condition till date. We report the first ever case in the literature of PLS presenting with psychotic depression and suicidal intention. A 40-year-old, never married, unemployed woman presented for psychiatric consultation and was given an International Classification of Diseases version 10 diagnosis of severe depression with psychotic symptoms. Physical examination warranted dermatological and dental evaluation before electroconvulsive therapy (ECT) could be administered. She was diagnosed with PLS and pseudoainhum by the skin and dental specialists. Karyotyping study was normal, and histopathology of the palmar tissue showed hyperkeratinization. She was treated with ECT, duloxetine and olanzapine, and she achieved full remission of her depression. She was prescribed oral retinoids and emollients for the skin disorder, and there was a good improvement. The dental prosthesis was fixed, and she was able to eat and feel better than before. Early diagnosis of this condition and rehabilitation would be important in improving wellbeing.

Suicide prevention in psychiatric care is arguably complex and incompletely understood as a patient safety issue. A resilient healthcare approach provides perspectives through which to understand this complexity by understanding everyday clinical practice. By including suicidal patients and healthcare professionals as sources of knowledge, a deeper understanding of what constitutes safe clinical practice can be achieved.
This planned study aims to adopt the perspective of resilient healthcare to provide a deeper understanding of safe clinical practice for suicidal patients in psychiatric inpatient care. It will describe the experienced components and conditions of safe clinical practice and the experienced practice of patient safety. The study will apply a descriptive case study approach consisting of qualitative semistructured interviews and focus groups. The data sources are hospitalised patients in a suicidal crisis and healthcare professionals in clinical practice.
This study was approved by the Regional Ethics Committee (2016/34). The results will be disseminated through scientific articles, a PhD dissertation, and national and international conferences. These findings can generate knowledge to be integrated into the practice of safety for suicidal inpatients in Norway and to improve the feasibility of patient safety measures. Theoretical generalisations can be drawn regarding safe clinical practice by taking into account the experiences of patients and healthcare professionals. Thus, this study can inform the conceptual development of safe clinical practice for suicidal patients.

Suicidal insulin overdoses are an under-recognized and uncommon cause of death, often relying on scene and nonspecific autopsy findings. Here, we present a case report of a fatal exogenous insulin overdose in a patient with type 1 diabetes. In our case, there were no contributory autopsy findings; however, serum analog aspart insulin levels were c. 10× the predicted therapeutic upper limit (4000, reference 6.6-55 uU/mL), which correlated with scene findings. This was specifically determined by a newly developed immunocapture liquid chromatography-tandem mass spectrometry assay, able to discriminate between various synthetic insulin analogs. Total insulin levels by immunoassay were highly elevated on the Siemens Advia Centaur, but not the Roche platforms (4741 vs. 5.2 uU/mL, respectively), showing variable sensitivity of detection within the same analog depending on assay. We discuss the prevalence and features to look for at autopsy in these types of cases. Additionally, analytical options for testing insulin levels, including new methodologies, guidance on collection of samples, as well as an outline of available historical reference range data are discussed.