Low-Dose Fluoxetine in Four Children with Autistic Spectrum Disorder Improves Self-Injurious Behavior, ADHD-Like Symptoms, and Irritability.
Authors: Lucchelli JP, Bertschy G Abstract 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 demons...
Source: Case Reports in Psychiatry - July 15, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Diagnostic, Treatment, and System Challenges in the Management of Recurrent Neuroleptic Malignant Syndrome on a General Medical Service.
Authors: Verma K, Jayadeva V, Serrano R, Sivashanker K Abstract 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 medic...
Source: Case Reports in Psychiatry - July 12, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Misinterpretation of Psychiatric Illness in Deaf Patients: Two Case Reports.
Authors: Anglemyer E, Crespi C Abstract The Deaf/hard of hearing population is growing rapidly and the medical community is facing a higher demand for this special needs group. The Deaf culture is unique in that spoken word is via sign language. What one person may see as mania or psychosis is actually a norm with Deaf individuals. The fear of the unknown language often creates immediate conclusions that are false. As such, being culturally sensitive becomes a large component of properly assessing a Deaf patient in any psychiatric situation. In the first case, the patient is a 26-year-old prelingually Deaf male, wh...
Source: Case Reports in Psychiatry - July 11, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Pervasive Refusal Syndrome in Autistic Spectrum Disorder.
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. We explore comorbidity and interaction of the two diagno...
Source: Case Reports in Psychiatry - July 11, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Camptocormia in an Adolescent: A Case Report and Review of the Literature.
Authors: Kaplan L, Aurigemma E, Sullivan T, Sidlow R Abstract Camptocormia, or bent-spine syndrome, is an entity with a long history and many etiologies. We discuss below both the history of this diagnosis in light of a rare case of psychogenic camptocormia and the recent changes in nosology regarding this disorder. PMID: 29971176 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - July 5, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Delayed-Onset Seizure in a Mild Quetiapine Overdose: Report of a Case and Review of the Literature.
Authors: Chen JA, Unverferth KM, Cheung EH Abstract Among atypical antipsychotics, quetiapine is commonly prescribed and considered to have a favorable side effect and safety profile. Here, we report the case of a patient who developed a generalized tonic-clonic seizure 28 hours following ingestion of 1,400 mg of quetiapine. Review of the literature identifies delayed-onset seizure as a potential complication of quetiapine overdose. Unique to this case, delayed-onset seizures occurred in a patient with a relatively low dose of quetiapine and no obvious toxidrome, suggesting that this reaction may be an impor...
Source: Case Reports in Psychiatry - June 12, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Salivary Alpha-Amylase Activity Levels in Catatonic Schizophrenia Decrease after Electroconvulsive Therapy.
Conclusions: sAA activity levels could be a potential biomarker of schizophrenia with catatonic state. PMID: 29862108 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - June 5, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Phenibut ( β-Phenyl-γ-aminobutyric Acid) Dependence and Management of Withdrawal: Emerging Nootropics of Abuse.
We report a case in which a patient experienced withdrawal symptoms from phenibut and was successfully treated with a baclofen taper. This case report highlights the development of phenibut use disorder with coingestion of alcohol and potential management for phenibut withdrawal. We believe clinicians must be aware of how phenibut dependence may present and how to manage the withdrawal syndrome. PMID: 29854531 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - June 2, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Treatment-Emergent Mania in a Prepubertal Boy.
We present the case of a prepubertal child presenting with an apparent depressive episode who developed treatment-emergent mania when commenced on sertraline. This case highlights the need for further research into the presentations and pharmacological management of prepubertal children with bipolar affective disorder. PMID: 29850349 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - June 1, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Olfactory Reference Syndrome with Suicidal Attempt Treated with Pimozide and Fluvoxamine.
Authors: Jegede O, Virk I, Cherukupally K, Germain W, Fouron P, Olupona T, Jolayemi A Abstract The core symptomatology of the Olfactory Reference Syndrome (ORS) is characterized by a preoccupation with the belief that one emits an offensive odor, albeit not perceived by others. The present case is that of a 75-year-old African American woman, with an unclear past psychiatric history, who was brought into our Emergency Room after a suicide attempt. The patient reported a three-year history of a "rotten" smell from her vagina. She adamantly believes that she smells despite being told otherwise by people. Th...
Source: Case Reports in Psychiatry - June 1, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

"Capgras" Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures.
We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology. PMID: 29707400 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - May 2, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Polysubstance and Behavioral Addictions in a Patient with Bipolar Disorder: Role of Lifetime Subthreshold Autism Spectrum.
Authors: Dell'Osso L, Conversano C, Corsi M, Bertelloni CA, Cremone IM, Carpita B, Carbone MG, Gesi C, Carmassi C Abstract This case report draws attention to the potential relevance of undetected autism spectrum symptoms in a bipolar patient with high work functioning showing a peculiar addictive profile with impulsive and antisocial behaviors. A 23-year-old man with a diagnosis of Bipolar Disorder (BD) and Substance Use Disorder (SUD) was hospitalized at the Psychiatric Clinic of the University of Pisa for diuretics and β-2 adrenergic agonist abuse in a remission phase of benzodiazepines and substance abuse....
Source: Case Reports in Psychiatry - April 25, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Corrigendum to "A Case of Sporadic Creutzfeldt-Jakob Disease Presenting as Conversion Disorder".
Corrigendum to "A Case of Sporadic Creutzfeldt-Jakob Disease Presenting as Conversion Disorder". Case Rep Psychiatry. 2018;2018:3826863 Authors: Yegya-Raman N, Aziz R, Schneider D, Tobia A, Leitch M, Nwobi O Abstract [This corrects the article DOI: 10.1155/2017/2735329.]. PMID: 29682384 [PubMed - in process] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - April 25, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

What Can Happen When Postpartum Anxiety Progresses to Psychosis? A Case Study.
Authors: Pirec V Abstract This case report describes a primipara without documented psychiatric history prior to complicated delivery. Onset of severe insomnia and anxiety was right after childbirth but not treated. Obsessive thinking pattern became more prominent. The patient became depressed and sought psychiatric help four months after delivery. Insomnia was then treated pharmacologically. Anxiety and depression persisted, suicidal ideation emerged, and the patient became confused, indecisive, overwhelmed, and delusional regarding her child's health. Medications for depression and anxiety were started six months...
Source: Case Reports in Psychiatry - April 22, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Huntington's Disease in a Patient Misdiagnosed as Conversion Disorder.
We present a clinical case of a 65-year-old woman admitted to our Psychiatric Acute Unit. During the 6 years preceding the admission, the patient had clinical assessments made several times by different specialties that focused only on isolated symptoms, disregarding the syndrome as a whole. In the course of her last admission, the patient was referred to our Neuropsychiatric Team, which made the provisional diagnosis of late-onset Huntington's disease, later confirmed by genetic testing. This clinical vignette highlights the importance of a multidisciplinary approach to atypical clinical presentations and raises awareness...
Source: Case Reports in Psychiatry - April 21, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Prosopagnosia as a Type of Conversion Disorder.
Conclusions: We propose that our patient's adverse childhood experiences led to the development of a particular personality and coping style that "primed" him for a later abnormal emotional and behavioural response when confronted with reminders of his traumatic background. Further interdisciplinary studies are required to further elucidate the neurobiological basis for this condition. PMID: 29666739 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - April 19, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Treatment of Acute Psychosis with Second-Generation Antipsychotics in a Patient with Left Temporal Lobe Lesion.
We present a case of rapid onset severe psychosis followed by suicide attempt in a United States Navy sailor. Investigation revealed a left temporal lobe brain mass suspicious for low-grade glioma. After hospitalization and medical management with olanzapine and lurasidone the patient's psychosis improved. The purpose of this paper is to add to the existing case reports that suggest a relationship between temporal lobe lesions and psychiatric illness, specifically psychosis. In addition, this case adds insight into the effectiveness of medical therapy for brain tumor patients that are not immediate candidates for neurosurg...
Source: Case Reports in Psychiatry - April 19, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder.
Authors: Grootendorst-van Mil NH, Huiskens ARM, Dieleman S, Birkenhäger TK Abstract The clinical management of patients with treatment-resistant psychotic disorders is still challenging despite years of extensive research. If first-line antipsychotic treatment proves ineffective, clozapine is considered golden standard. Herein, we report on a patient with schizoaffective disorder that initially showed no response to treatment with clozapine and ECT and therefore reached a therapeutic dead end. After an unintentional exposure to supratherapeutic clozapine levels, related to a pneumonia, a significant and persis...
Source: Case Reports in Psychiatry - April 8, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Pantoprazole-Induced Delirium: Review of a Case and Associated Literature.
We present a case report of PPI-induced delirium, regarding which not much has been written in the literature. Case Report: We present a case of a 93-year-old woman with no known past psychiatric history, who was hospitalized for syncope workup and who developed delirium after a double dose of pantoprazole. Discussion: Very few reports of PPI-induced delirium exist in the literature. In this case report, we attempt to highlight the mechanism of PPI induced delirium which in our case was most likely due to the primary effects of PPI and drug-drug interactions. Given the paucity of literature on this topic, we encour...
Source: Case Reports in Psychiatry - March 17, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Reversible Thrombocytopenia after Gabapentin in an HIV-Positive Patient.
Authors: Basith M, Francis A, Bellon A Abstract Gabapentin has become increasingly used in psychiatric practice specifically for anxiety disorders. Even though gabapentin is not approved by the US Food and Drug Administration to treat anxiety, physicians sometimes use it as an alternative to benzodiazepines in patients with a history of substance abuse. Gabapentin is also prescribed when individuals are at risk of thrombocytopenia which is not considered a side effect. Among patients at risk of thrombocytopenia are those positive for human immunodeficiency virus (HIV). Here we present a case of an HIV-positive man ...
Source: Case Reports in Psychiatry - March 17, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Pharmacological Hypotension as a Cause of Delirious Mania in a Patient with Bipolar Disorder.
Authors: Carbone MG, Miniati M, Simoncini M, Tripodi B, Tagliarini C, Carmassi C, Dell'Osso L Abstract Delirious mania is a severe but often underrecognized syndrome characterized by rapid onset of delirium, mania, and psychosis, not associated with a prior toxicity, physical illness, or mental disorder. We discuss the case of a delirious mania potentially triggered and maintained by a systemic hypotension induced by antihypertensive drugs. Symptoms recovered completely after the discontinuation of antihypertensive medications and the normalization of blood pressure levels. PMID: 29410928 [PubMed] (Source: Case...
Source: Case Reports in Psychiatry - February 8, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Treatment of Generalized Anxiety Disorder with Gabapentin.
We present a case of a 59-year-old female with a psychiatric history of GAD. The patient discontinued benzodiazepines after more than 7 years of daily treatment which led to rebound anxiety, benzodiazepine withdrawal symptoms, and suicidal ideation. She was psychiatrically hospitalized and started on gabapentin. Over the next 10 months of outpatient follow-up, she attempted to taper off gabapentin due to personal preference to limit medications. During this time, we observed a clear dose-response pattern of gabapentin on GAD symptoms. In the absence of controlled studies, these findings may offer important information abou...
Source: Case Reports in Psychiatry - February 3, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Autoamputation of Genitalia in Bipolar Patient.
This report will highlight various factors responsible for self-mutilation in nonpsychotic and nondelusional person. PMID: 29375923 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - January 31, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Hemiataxia: A Novel Presentation of Anti-NMDA Receptor Antibody Mediated Encephalitis in an Adolescent.
We report a case of isolated hemiataxia in a young adult with mild initial psychiatric manifestations. A personal and family history of preceding neuropsychiatric symptoms produced diagnostic confusion and resulted in a significant diagnostic and therapeutic delay. Our case confirms the unilateral movement manifestations that have been emphasized in recent reports. Additionally, it confirms the need for involvement of neurologic as well as psychiatric services in the evaluation of such cases and emphasizes the importance of the neurologic examination in presentations with an initial psychiatric predominance. PMID: 2933...
Source: Case Reports in Psychiatry - January 17, 2018 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Coprophagia in an 8-Year-Old Hospitalized Patient: A Case Report and Review of the Literature.
We present a pediatric case of presumptive coprophagia. After a negative medical work-up, the pediatrics team asked psychiatry to assist them in managing this relatively rare disorder in the hospital setting. Little is known about the etiology and treatment of coprophagia in the pediatric population. Using the case as a catalyst, we discuss what is known about this disorder as well as treatment strategies in the hospital setting. PMID: 29279783 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - December 29, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

The Treatment of Clozapine-Withdrawal Delirium with Electroconvulsive Therapy.
In this report, we describe a case of delirium with catatonic features emerging after the immediate cessation of clozapine subsequent to concerns of developing neuroleptic malignant syndrome. After multiple treatments were found to be inefficacious, electroconvulsive therapy (ECT) was initiated, resulting in significant improvement. A literature search revealed six previous cases of clozapine-withdrawal syndromes of varied symptomatology treated with ECT. To our knowledge, the present case represents the first reported clozapine-withdrawal delirium treated successfully with ECT. PMID: 29230342 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - December 13, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Use of Interpersonal Counseling for Modern Type Depression.
Authors: Ono H, Yamamoto A, Taketani R, Tsujimoto E Abstract A novel form of depression, called "modern type depression" (MTD), has been increasing in prevalence in Japan. Patients with MTD present with an overt appeal of depressive mood and a desire to be excused from their work duties; as such, this can cause considerable trouble in the workplace. Psychosocial interventions should be primarily considered for the treatment of MTD. Interpersonal counseling (IPC), which has proven effective for treating subthreshold depression, may be effective for MTD. However, IPC is rarely done in Japan. Herein, we repo...
Source: Case Reports in Psychiatry - December 8, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Deletion Involving the 7q31-32 Band at the CADPS2 Gene Locus in a Patient with Autism Spectrum Disorder and Recurrent Psychotic Syndrome Triggered by Stress.
Authors: Grabowski PAP, Bello AF, Rodrigues DL, Forbeci MJ, Motter V, Raskin S Abstract Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by impairments in social functioning, language, communication, and behavior. Recent genome-wide association studies show some microdeletions on the 7q31-32 region, including the CADPS2 locus in autistic patients. This paper reports the case of a patient with ASD and recurrent psychotic syndrome, in which a deletion on the 7q31-32 band at the CADPS2 gene locus was evidenced, as well as a brief review of the literature on the CADPS2 gene and its association wit...
Source: Case Reports in Psychiatry - December 6, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Electroconvulsive Therapy in Functional Hallucination: Scope and Challenges.
We report on a female patient with paranoid schizophrenia who experienced functional hallucinations continuously despite the use of adequate risperidone, which controlled other symptoms. She was treated with ECT which resolved the functional hallucinations. The case highlights the need to ponder on the significance of the phenomenon as well as treatment of this psychopathology by ECT. It also underscores ECT as a treatment option for this kind of hallucination. PMID: 29181215 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - November 29, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

A Case of Probable Amisulpride Induced Mania after Eight Months of Therapy.
Authors: Thapa P, Sharma R Abstract Development of manic symptoms during treatment with atypical antipsychotics can be a troublesome side effect that has been described with most atypical antipsychotics. However, reports of amisulpride induced mania have been rare. Here, we report the case of an 18-year-old male patient diagnosed with schizophrenia, who developed manic symptoms while on treatment with amisulpride. While previous reports have described occurrence of mania within days to three months of treatment with amisulpride, we report a case where manic symptoms occurred after around eight months of therapy. We...
Source: Case Reports in Psychiatry - November 15, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts.
This report describes the case of a 28-year-old male, who works as a first responder, who presented with new onset symptoms characteristic of MDD and PTSD, with no past history of OCD or suicidality who developed OCD with suicidal obsessions. Differentiating between suicidal ideation in the context of other psychiatric illnesses and suicidal obsessions in OCD is critical to ensuring accurate diagnosis and timely provision of most appropriate treatment. The combination of exposure and response prevention therapy and pharmacotherapy with sertraline and olanzapine was effective in helping the patient manage the anxiety and di...
Source: Case Reports in Psychiatry - November 5, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Adapting Lymphedema Treatment in Patients with a Mental Disability.
CONCLUSION: The use of a single treatment strategy in the form of a low-stretch stocking in such cases together with the involvement of a multidisciplinary team can lead to good treatment outcomes for chronic lymphedema. PMID: 29085696 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - November 2, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Trichloroacetic Acid Ingestion: Self-Harm Attempt.
CONCLUSION: Awareness among physicians, particularly psychiatrists, regarding this relatively obscure chemical compound (TCAA) and its use by suicidal patients mistakenly believing it to be a substance that can be significantly more lethal (TCA), is imperative. PMID: 29082058 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - October 31, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Jitteriness/Anxiety Syndrome Developing Immediately following Initiation of Oral Administration of Sertraline.
Authors: Nakamura T, Sugiyama N, Sasayama D, Hagiwara T, Washizuka S Abstract Here, we report our experience with patients in whom jitteriness/anxiety syndrome developed immediately following the start of oral sertraline administration. Administration was discontinued in these patients on day 2, and the jitteriness/anxiety syndrome improved the following day. Jitteriness/anxiety syndrome may develop immediately following oral administration of even low doses of sertraline, and improvement can be expected if sertraline is promptly discontinued. PMID: 28912994 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - September 17, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Coprophagia and Entomophagia in a Patient with Alcohol Related Dementia.
This report shows a rare association of these two conditions in a patient with dementia. PMID: 28912995 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - September 17, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Clozapine-Induced Microseizures, Orofacial Dyskinesia, and Speech Dysfluency in an Adolescent with Treatment Resistant Early Onset Schizophrenia on Concurrent Lithium Therapy.
Authors: Rachamallu V, Haq A, Song MM, Aligeti M Abstract Clozapine is an atypical antipsychotic used in the treatment of refractory schizophrenia. It has a well-known side effect profile, including agranulocytosis, decreased seizure threshold, and tardive dyskinesia. In addition, numerous case reports have described clozapine-induced stuttering in adults. However, there has been only one previous case report describing it in the adolescent population. In addition, concurrent lithium therapy has been shown to enhance the neurotoxic effects of antipsychotics and lower the seizure threshold. Here, we report on the de...
Source: Case Reports in Psychiatry - August 25, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Autoscopic Hallucination in Alcohol Dependence Syndrome: A Rare or Missed Phenomenon?
We present a case of a 40-year-old man who experienced autoscopic hallucination during the withdrawal state of alcohol. He was successfully treated with detoxification and an antipsychotic medication and was doing well. The case highlights the need for strong suspicion and exploration of the autoscopic hallucination and autoscopic phenomenon in general in cases of alcohol dependence syndrome. PMID: 28811950 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - August 18, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Misdiagnoses of Epilepsy as Ekbom Syndrome, Mood Instability, and Nocturnal Visual Hallucinations.
We report three female patients with no preexisting history of epilepsy that were unsuccessfully treated as primary psychiatric disorder: one patient was initially diagnosed with somatization and Ekbom syndrome; the second was referred to psychiatrist due to mood instability and visual hallucinations; and the third one was referred for anxiety and hallucinations related to sleep. A carefully taken medical history clarified diagnoses of epilepsy. None of the patients responded to medications aimed at treating psychiatric symptoms, and all the patients had favorable response to antiepileptic treatment. These cases illustrate...
Source: Case Reports in Psychiatry - August 10, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Distressing Visual Hallucinations after Treatment with Trazodone.
We describe a case of a 60-year-old man who received trazodone for primary insomnia. He returned, to the emergency department, two days later with distressing visual hallucinations, which prompted inpatient treatment. Trazodone was discontinued, leading to a complete resolution of his visual hallucinations, and he was treated with mirtazapine for 6 months. There has been no relapse in a follow-up period of two years. Patients presenting with visual hallucinations without significant psychiatry history can be a challenging situation. We highlight the importance of careful anamnesis with an accurate medication history. Given...
Source: Case Reports in Psychiatry - July 15, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Adult ADHD: Questioning Diagnosis and Treatment in a Patient with Multiple Psychiatric Comorbidities.
This report presents a detailed account of a clinical case involving a middle-aged man with a history of recurrent depressive episodes and an unsubstantiated diagnosis of ADHD, treated with stimulants. There is persistent debate around the use of psychostimulants both in adult ADHD and in the treatment of depression. Despite promising activating properties, psychostimulants carry significant risks of misuse and substance use disorder. In this report, we consider the potential benefits and adverse effects of stimulants in the treatment of adult ADHD and mood disorders and review the learning points of this complicated, but ...
Source: Case Reports in Psychiatry - July 12, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Psychosis Crisis Associated with Thyrotoxicosis due to Graves' Disease.
We present the case of a patient with previous psychiatric illness, acutely exacerbated by thyroid storm due to Graves' disease, in whom treatment with antipsychotics induced catatonia. These associations are extremely rare and may be confused with Hashimoto's encephalopathy, especially in the presence of anti-thyroid antibodies in cerebrospinal fluid. The treatment consists in the control of the triggering disease (in this case the resolution of the thyrotoxicosis) and the use of benzodiazepines. However, in some cases, the resolution of psychiatric symptoms is partial and may require the use of electroconvulsive therapy....
Source: Case Reports in Psychiatry - July 12, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

A Case Report of Mania and Psychosis Five Months after Traumatic Brain Injury Successfully Treated Using Olanzapine.
CONCLUSION: Olanzapine was effective and well tolerated for the treatment of mania following TBI. PMID: 28695036 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - July 12, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Obsessive-Compulsive Disorder Associated with Posterior Cranial Fossa Meningioma.
We report here a patient in whom the effects of a cerebellum mass may have led to development of obsessive-compulsive disorder (OCD). A 33-year-old woman showed symptoms of OCD, including obsessive worry about infection from tainted blood and repetitive confirmation, which worsened during pregnancy. She had comprehension in regard to her illness and no evidence of cognitive dysfunction and did not meet other DSM-5 criteria such as depression. One month after giving childbirth, the symptoms worsened, while headache and dizziness also developed. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score was 34. The patient was...
Source: Case Reports in Psychiatry - June 29, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Treatment of Hypochondriasis in Two Schizophrenia Patients Using Clozapine.
Authors: Tundo A, Proietti L, de Filippis R Abstract Hypochondriasis (HYPO), an obsessive-compulsive spectrum disorder, is frequent in patients with schizophrenia (SCH) (20%), especially among those treated with clozapine (36.7%). Treatment options for OCS/OCD in patients under clozapine (CLZ) include combining clozapine with amisulpride/aripiprazole or a mood stabilizer, augmenting clozapine with a serotoninergic reuptake inhibitor, adding cognitive behavioural therapy, and gradually reducing dosage. No treatments have been proposed for HYPO in patients using clozapine so we examine these options in 2 cases and re...
Source: Case Reports in Psychiatry - June 25, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Home-Based Telepsychiatry in US Urban Area.
Authors: Amirsadri A, Burns J, Pizzuti A, Arfken CL Abstract Telepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if the patient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized for schizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practice with social worker traveling to the home with electronic tablet for connection with psychiatrist). The intervention resulted in detecting unrecognized depression and complex t...
Source: Case Reports in Psychiatry - June 22, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Management of Severe Developmental Regression in an Autistic Child with a 1q21.3 Microdeletion and Self-Injurious Blindness.
We report the case of a young boy with nonverbal autism and intellectual disability, with a rare de novo 1q21.3 microdeletion. The patient had early and extreme self-injurious behaviours that led to blindness, complicated by severe developmental regression. A significant reduction in the self-injurious behaviours and the recovery of developmental dynamics were attained in a multidisciplinary neurodevelopmental inpatient unit. Improvement was obtained after managing all causes of somatic pains, using opiate blockers and stabilizing the patient's mood. We offered both sensorimotor developmental approach with therapeutic body...
Source: Case Reports in Psychiatry - June 21, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Pseudologia Fantastica in the Emergency Department: A Case Report and Review of the Literature.
This article presents the case of a patient who presents to the emergency department with an unusual and elaborate web of deceptions along multiple themes including feigning medical illness, multiple losses, and grandiose academic and athletic achievements. We review the clinical characteristics of pseudologia fantastica and discuss how this patient's constellation of malingering, factitious disorder, and personality disorder suggests this diagnosis. PMID: 28573061 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - June 4, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Neuropsychiatric Manifestations in a Patient with Panhypopituitarism.
We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admission, the patient's clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations. A head CT scan and a pituitary MRI revealed a near total resection of the pituitary while laboratory investigations revealed hyponatremia and a grossly low hormone ...
Source: Case Reports in Psychiatry - June 2, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

A Case of Sporadic Creutzfeldt-Jakob Disease Presenting as Conversion Disorder.
Discussion. This case highlights the central role of psychiatric symptoms in early presentations of Creutzfeldt-Jakob disease. Still, few other cases in the literature report functional neurological symptoms as an initial sign. The consultation psychiatrist must remain alert to changing clinical symptoms, especially with uncharacteristic disease presentations. PMID: 28553554 [PubMed] (Source: Case Reports in Psychiatry)
Source: Case Reports in Psychiatry - May 30, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Catatonia Secondary to Sudden Clozapine Withdrawal: A Case with Three Repeated Episodes and a Literature Review.
Authors: Bilbily J, McCollum B, de Leon J Abstract A literature search identified 9 previously published cases that were considered as possible cases of catatonia secondary to sudden clozapine withdrawal. Two of these 9 cases did not provide enough information to make a diagnosis of catatonia according to the Diagnostic and Statistical Manual, 5th Edition (DSM-5). The Liverpool Adverse Drug Reaction (ADR) Causality Scale was modified to assess ADRs secondary to drug withdrawal. From the 7 published cases which met DSM-5 catatonia criteria, using the modified scale, we established that 3 were definitive and 4 were p...
Source: Case Reports in Psychiatry - April 13, 2017 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research