Treatment of Comorbid Schizophrenia in an Adolescent with Osteogenesis Imperfecta: A Case Report.

Ayşe Eylül Özel Gümüş, Merve Onat
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Abstract

Osteogenesis imperfecta (OI) is a rare connective tissue disorder characterized by bone fragility, growth retardation, hearing loss, and short stature. Literature on the comorbidity of OI and psychotic disorders is limited. Antipsychotic side effects such as hyperprolactinemia, sedation, and orthostatic hypotension may increase fracture risk, presenting challenges in comorbid cases. Here, we describe a 14-year-old male with OI and schizophrenia. The patient presented with a three-month history of irritability, self-harm, auditory hallucinations, and referential delusions. His history included multiple fractures, leading to OI diagnosis at age 8. He was admitted with acute psychotic disorder and treated with aripiprazole 20 mg/day, resulting in significant symptom improvement. No new bone fractures were observed during one year of follow-up. This case highlights the management of comorbid OI and schizophrenia. Fracture risk is a critical concern in OI patients. Clinicians should carefully select antipsychotics in the presence of psychosis and closely monitor patients to minimize adverse effects. Keywords: Adolescent, antipsychotics, osteogenesis imperfecta, schizophrenia, side effects.

青少年成骨不全患者共病性精神分裂症的治疗:1例报告。
成骨不全症(Osteogenesis imperfecta, OI)是一种罕见的结缔组织疾病,其特征是骨骼脆弱、生长迟缓、听力丧失和身材矮小。关于成骨不全和精神障碍合并症的文献是有限的。抗精神病药物的副作用,如高催乳素血症、镇静和体位性低血压可能增加骨折的风险,在合并症病例中提出挑战。在这里,我们描述了一个14岁的男性OI和精神分裂症。患者有三个月的易怒、自残、幻听和参照妄想史。他的病史包括多处骨折,导致8岁时被诊断为成骨不全。患者以急性精神障碍入院,给予阿立哌唑20mg /d治疗,症状明显改善。在一年的随访中没有观察到新的骨折。本病例强调了OI和精神分裂症合并症的管理。骨折风险是成骨不全患者的一个关键问题。临床医生应仔细选择存在精神病的抗精神病药物,并密切监测患者,以尽量减少不良反应。关键词:青少年,抗精神病药物,成骨不全,精神分裂症,副作用
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