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Case Reports in Psychiatry

Louise Todorov, Amel Ait Boudaoud, Rachel Pascal de Raykeer, Alina Radu, Khadija Lahlou-Laforêt, Frédéric Limosin, Cédric Lemogne, Sébastien Czernichow
Introduction: Hypothyroidism has been associated with mood disorders but some cases of acute psychosis have also been reported. However, less attention has been paid to suicidal behavior in these patients. Case Report: We report a case of suicide attempt by self-stabbing in a 43-year-old woman without past psychiatric history, four months after radioiodine therapy for Graves' disease. On clinical examination remarkable signs of myxedema were found and blood investigations showed hypothyroidism with an extremely high thyroid stimulating hormone (TSH) level (152 mUI/L; reference range 0...
2019: Case Reports in Psychiatry
Kenichi Asano
Emotion processing is an important factor for successful psychotherapy. Clients tend to suffer from maladaptive emotions, which contribute to states of confusion, rumination, and stagnation. The therapist should demonstrate adequate empathy and understanding of the client's complaints to help the client to recognize and respect their own emotions and desires. In most cases, there is more than one desire, and each desire should be confronted. The compassionate self exercises are helpful to distinguish and integrate confused states...
2019: Case Reports in Psychiatry
Vinod Sharma, Aditi Sharma
With increasing trend of polypharmacy, there are higher chances of drug-drug interactions leading to adverse effects, especially in psychiatric patients with co-morbid chronic medical problems. This case demonstrates a schizoaffective 30-year-old male on highly active antiretroviral therapy (HAART) who reported an incident of priapism potentially caused by an interaction between previously prescribed atypical antipsychotic, trazodone, norepinephrine dopamine reuptake inhibitor (NDRI), HAART, and newly added selective serotonin reuptake inhibitor (SSRI)...
2019: Case Reports in Psychiatry
Ori-Michael J Benhamou, Mohammad Tavakkoli, Hande Okan, Mitchell Nobler
Here we report a case of a 55-year-old male who had presented with recent falls and behavioral changes, including a heightened religious preoccupation, hypergraphia, and paranoid ideations. He was initially treated for psychosis but soon exhibited absence-like seizures, which were consistent with faciobrachial dystonic seizures. Workup for underlying infectious, immunodeficiency, and autoimmune causes revealed antibodies towards the leucine-rich glioma inactivated subunit of the voltage-gated potassium complex...
2018: Case Reports in Psychiatry
Reem M A Shafi, Laura Suarez, Maria I Lapid
Behavioral and psychological symptoms of dementia (BPSD) have varied presentations and frequently occur throughout the trajectory of dementia. Hypersexuality and general disinhibition of societal and cultural norms are commonly documented in all types of dementia. However, sparse literature exists on polyembolokoilamania (insertion of foreign objects in bodily orifices) without a sexual component as a dementia-related symptom. We review an unusual case of a 94-year-old man who presented with urethral polyembolokoilamania without hypersexuality or other behavioral disinhibition...
2018: Case Reports in Psychiatry
Heela Azizi, Tasmia Khan, Cecilia Canale, Jisha Kallikkadan, Ivan Leung, Alexa Kahn, Dina Rimawi, Shantale Williams, Chidubem Matthew Obegolu, Sharon Paul, Shazia Chaudhry, Chiedozie Ojimba, Kodjovi Kodjo, Olaniyi Olayinka, Oluwole Jegede, Ayodeji Jolayemi
Coprophagia is a rare and distressing disorder characterized by symptoms of compulsive consumption of feces. Several attempts have been made in literature to explore the pathophysiology, management, and outcomes of this disorder. However, critical questions remain, related to characterizing effective management, features of associated comorbidities, time to recovery of symptoms, sustainability of recovery, and the determinants of outcomes. Unfortunately, there is a dearth of available literature addressing these questions...
2018: Case Reports in Psychiatry
Kenichi Asano, Eiji Shimizu
Major depressive disorder is a common mental health problem around the world. To treat depression, cognitive behavioural therapy is highly recommended by some guidelines. However, there are reports pointing out the existence of patients who do not respond to cognitive behavioural therapy because of dissociation between thoughts and experiences. To treat such patients, compassion focused therapy was developed, but there are no reports of compassion focused therapy for Japanese patients. This report presents a case of compassion focused therapy for a Japanese female with major depressive disorder and suicidal feelings...
2018: Case Reports in Psychiatry
Alexander A DiSciullo, Clayton D English, William T Horn
Modafinil has been used as an adjunctive medication in the treatment of bipolar 1 depression with reported success. Case reports have been published demonstrating modafinil induced mania in bipolar patients and modafinil induced psychosis in schizophrenic patients. To our knowledge, we report the only case of modafinil induced psychosis in a patient with bipolar depression treated with both mood stabilizers and antipsychotics. In addition, it is the quickest onset to psychosis (2 days) at the lowest dosage of modafinil (100 mg/day) reported in the literature...
2018: Case Reports in Psychiatry
Mugtaba Osman, Mashael Mustafa
Tramadol is a powerful analgesic medication with antidepressant effects like venlafaxine. Hypomanic features were reported in patients with psychiatric history of mood disturbance when tramadol was prescribed for them. However, it is extremely rare to notice such mood-elevating effect in patients who have no previous psychiatric history. We report on the observation of a distressing mood-elevating effect for tramadol in a patient with no previous psychiatric history. We present the case of a 26-year-old female patient who developed accelerated flow of speech, overactivity, and difficulty in sleeping following intake of tramadol 50 mg dose...
2018: Case Reports in Psychiatry
Michael S Scheeringa, Lauren C Burns
Generalized anxiety disorder (GAD) is purported to start in early childhood but concerns about attenuation of anxiety symptoms over time and the development of emerging cognitive and emotional processing capabilities pose multiple challenges for accurate detection. This paper presents the first known case reports of very young children with GAD to examine these developmental challenges at the item level. Three children, five-to-six years of age, were assessed with the Diagnostic Infant and Preschool Assessment twice in a test-retest reliability study...
2018: Case Reports in Psychiatry
Karin E P Carter, Adrian Wells
A 41-year-old female with schizo-affective disorder presenting with an eight-year history of auditory hallucinations participated in a single case treatment study (A-B-A-B-A-C-B) of the effects of the Attention Training Technique (ATT). No antipsychotic medication was prescribed in this case following a serious adverse reaction in the past. The aim of the study was to test the impact of ATT on the frequency and duration of hallucinations using a repeated return to baseline followed by an alternating treatment design...
2018: Case Reports in Psychiatry
A Bahji, S Khalid-Khan
22q11.2 duplication syndrome is a recently discovered genetic syndrome with unclear neuropsychiatric sequelae. While its connection to 22q11.2 deletion syndrome is actively investigated, case reports on the neuropsychiatric sequelae of affected individuals have been previously described, largely focusing on comorbid autism spectrum disorder. Here, we present the case of an 8-year-old female experiencing episodes of severe behavioural regression following medical illness. We analyze the case and relate it to the available literature and identify potential risk factors...
2018: Case Reports in Psychiatry
Kamal Patel, Brandon Lilly, Oluwadamilare Ajayi, Kelly Melvin
Neuroleptic Malignant Syndrome (NMS) is a rare condition clinically characterized by muscle rigidity, hyperthermia, autonomic instability, and acute mental status change. NMS is most often associated with use of high-potency first-generation antipsychotic medications; though, other neuroleptics have been implicated as well. NMS can be fatal with estimated mortality rates as high as 20%. Patients experiencing certain severe complications, including renal failure, have been associated with mortality as high as 50%, stressing the need for early recognition and treatment...
2018: Case Reports in Psychiatry
Samantha Zwiebel, Alejandro G Villasante-Tejanos, Jose de Leon
Kahlbaum first described catatonia; later Kraepelin, Gjessing, and Leonhard each defined periodic catatonia differently. A 48-year-old female with catatonia, whose grandmother probably died from it, was prospectively followed for >4 years in a US psychiatric state hospital. Through 4 catatonic episodes (one lasting 17 months) there were menstrual exacerbations of catatonia and increases in 4 biological variables: (1) creatine kinase (CK) up to 4,920 U/L, (2) lactate dehydrogenase (LDH) up to 424 U/L, (3) late afternoon cortisol levels up to 28...
2018: Case Reports in Psychiatry
Yasira Doluweera, Chathurie Suraweera
Musical hallucination carries no diagnostic significance on its own. However, it is an interesting phenomenon which can occur in various organic and psychiatric disorders. We report three patients who presented with musical hallucinations due to different aetiologies, namely, due to hearing impairment, intracerebral haemorrhage, and schizophrenia. The case series also highlights the fact that different aetiologies should be managed differently for the patients to be benefited.
2018: Case Reports in Psychiatry
Drew H Barzman, Hannah Jackson, Umesh Singh, Marcus Griffey, Michael Sorter, Jonathan A Bernstein
Here we report a case of a 15-year-old female who had originally been diagnosed and treated unsuccessfully for schizophrenia, psychosis, severe anxiety, and depression. More in-depth history revealed an abrupt onset of her symptoms with remote acute infections and many exhibited characteristics of obsessive compulsive disorder with rituals. Work-up for underlying infectious, immunodeficiency, and autoimmune causes was unrevealing except for very high levels of anti-neuronal antibodies which have been linked to Pediatric Acute-onset Neuropsychiatric Syndrome (PANS)...
2018: Case Reports in Psychiatry
Maggie Wang, Joseph I Sison
Dopa-responsive dystonia is a rare childhood neurological disorder characterized by asymmetric dystonia, predominantly of the lower limb, that responds excellently to levodopa replacement therapy. Although it is known that behavioral changes, such as depression, anxiety disorders, and sleep disturbances, typically follow onset of motor symptoms, there is limited literature on the psychiatric symptoms of this disorder. This report describes a novel case of a 20-year-old male with a history of dopa-responsive dystonia and schizoaffective disorder who presented with both dystonia and psychosis after a period of medication noncompliance...
2018: Case Reports in Psychiatry
Juan Pablo Lucchelli, Gilles Bertschy
Autism Spectrum Disorder (ASD) is defined by the copresence of two core symptoms: alteration in social communication and repetitive behaviors and/or restricted interests. In ASD children and adults, irritability, self-injurious behavior (SIB), and Attention Deficit and Hyperactivity Disorders- (ADHD-) like symptoms are regularly observed. In these situations, pharmacological treatments are sometimes used. Selective Serotonin Reuptake Inhibitors- (SSRI-) based treatments have been the subject of several publications: case reports and controlled studies, both of which demonstrate efficacy on the symptoms mentioned above, even if no consensus has been reached concerning their usage...
2018: Case Reports in Psychiatry
Karan Verma, Vivek Jayadeva, Raymond Serrano, Karthik Sivashanker
Neuroleptic malignant syndrome (NMS), an iatrogenic form of malignant catatonia, carries high morbidity and mortality rates especially in the context of delayed recognition and standard intervention protocol of lorazepam trial. However, there is limited guidance available through literature for further management if benzodiazepine treatment is ineffective and electroconvulsive therapy (ECT) is not readily accessible. This case report describes a multimodal approach to address the diagnostic, treatment, and logistical system challenges in an acute medical hospital through the case of a 69-year-old man with schizophrenia who represented from a psychiatric ward with neuroleptic malignant syndrome...
2018: Case Reports in Psychiatry
Emily Claire Bond, Rosalind Yvonne Kirton Oliphant
Pervasive Refusal Syndrome (PRS) is a rare child psychiatric condition. We describe a case of PRS in a 9-year-old boy with a diagnosis of Autism Spectrum Disorder (ASD) presenting with severe weight loss due to extreme restriction of food and fluids. Other prominent symptoms included total mutism, school refusal, and self-neglect. He was admitted to a specialist Child and Adolescent Mental Health Unit. We discuss the symptoms present in this case and the differential diagnosis of ASD in PRS. Although this differential has briefly been considered one in previous case, there have been no reported cases of PRS with a prior diagnosis of ASD...
2018: Case Reports in Psychiatry
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