Sante Mentale au Quebec最新文献_第3页

Clozapine-Associated Myocarditis with Ventricular Fibrillation Revealing Brugada Syndrome: A Case Report. 氯氮平相关性心肌炎伴心室颤动显示Brugada综合征1例报告。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Shanya Maheu, Violaine Masson, Rafik Tadros, Arash Bahremand

{"title":"Clozapine-Associated Myocarditis with Ventricular Fibrillation Revealing Brugada Syndrome: A Case Report.","authors":"Shanya Maheu, Violaine Masson, Rafik Tadros, Arash Bahremand","doi":"","DOIUrl":"","url":null,"abstract":"Clozapine is the gold-standard treatment for refractory psychotic disorders but is associated with rare, potentially fatal cardiovascular complications. We report the case of a 72-year-old man with schizoaffective disorder and complex multimorbidity who developed acute cardiac decompensation compatible with Clozapine-associated myocarditis. Despite prompt Clozapine discontinuation and supportive management, he experienced ventricular fibrillation leading to cardiac arrest. Subsequent investigations revealed a spontaneous Type I Brugada electrocardiogram (ECG) pattern compatible with Brugada syndrome (BrS), a rare inherited cardiac channelopathy associated with sudden cardiac death. After full medical stabilization and recovery of cardiac function, antipsychotic treatment was cautiously reintroduced with Quetiapine, resulting in good psychiatric response without recurrence of cardiac abnormalities to date. This case highlights the diagnostic challenges at the intersection of psychopharmacology and inherited arrhythmogenic disorders in older psychiatric patients. Moreover, it underscores the importance of considering Brugada syndrome in unexplained cardiac arrest and malignant arrhythmias during Clozapine treatment, even when myocarditis is initially suspected.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"63-78"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Delusion of Fellatio and Multimodal Cenesthetic Hallucinations in Schizophrenia: Beyond the Incubus]. 精神分裂症患者的口交妄想和多模态感官幻觉：超越梦魇。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Emmanuel Stip, Thomas Chamard-Bergeron, David Caron, Alexandre Kilburg, Tu-Khue Nguyen, Saolie Dubois

{"title":"[Delusion of Fellatio and Multimodal Cenesthetic Hallucinations in Schizophrenia: Beyond the Incubus].","authors":"Emmanuel Stip, Thomas Chamard-Bergeron, David Caron, Alexandre Kilburg, Tu-Khue Nguyen, Saolie Dubois","doi":"","DOIUrl":"","url":null,"abstract":"Background Hallucinations with sexual content, particularly cenesthetic and oral hallucinations, are rarely reported in the psychiatric literature despite their significant potential for distress and impact on therapeutic engagement. Case presentation We describe a 51-year-old woman presenting with a complex psychotic picture, including cenesthetic hallucinations experienced as \"forced oral sexual acts,\" associated with multimodal hallucinations (gustatory, visual, auditory, and olfactory) and marked mistrust toward healthcare providers. Differential diagnosis A review of the literature using MEDLINE and Google Scholar found no recognized autonomous nosographic entity corresponding to a \"fellatio delusion,\" and neither the DSM-5-TR nor the ICD-11 describes a syndrome specifically centered on this content. Sexual-themed delusions in psychotic disorders are categorized by their general content rather than by specific sexual acts such as fellation. These manifestations are better conceptualized as a rare and severe subtype of sexual or somatic hallucinations within established psychotic disorders, most commonly schizophrenia spectrum disorders, and must be differentiated from the incubus phenomenon, a parasomnia occurring during sleep paralysis. Treatment Management required an integrated and adaptive therapeutic approach addressing psychotic symptoms, patient distress, and relational challenges within the clinical team. Outcome and follow-up Clinical follow-up highlighted the importance of tailoring care to ethical, relational, and gender-sensitive considerations in the therapeutic setting. Discussion This case underscores the need for careful phenomenological assessment, accurate differential diagnosis, and ethically informed clinical adaptation when managing rare and distressing sexual hallucinations in psychotic disorders.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"131-145"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Treatment of dissociation in borderline personality disorder with dissociative identity disorder and complex post-traumatic stress disorder: A clinical case]. [边缘型人格障碍伴分离性身份障碍和复杂创伤后应激障碍的分离治疗：1例临床病例]。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Barnabé Kiepura, Félix-Antoine Bérubé, Lionel Cailhol

{"title":"[Treatment of dissociation in borderline personality disorder with dissociative identity disorder and complex post-traumatic stress disorder: A clinical case].","authors":"Barnabé Kiepura, Félix-Antoine Bérubé, Lionel Cailhol","doi":"","DOIUrl":"","url":null,"abstract":"We describe the trajectory of a 24-year-old woman with a history of borderline personality disorder (BPD) and complex trauma who presented with significant dissociative episodes. The initial assessment-including a psychiatric interview, the use of standardized measures (PCL-5, CAPS-5), and collateral information gathering-identified complex post-traumatic-stress disorder (PTSD) comorbid with dissociative identity disorder (DIID) and incomplete diagnostic criteria for BPD. Treatment consisted of an integrated psychiatric and psychotherapeutic approach based on the DBT-PTSD model. After just over one year of follow-up and 45 therapy sessions, the patient was in clinical remission from PTSD, while dissociative episodes attributable to DID persisted at a lower intensity. This case illustrates that response to DBT-PTSD may be favorable in patients with comorbid DID. The one-year follow-up highlights the persistence of dissociative episodes alongside sustained clinical remission of PTSD. The patient also shares her perspective on her therapeutic experience. This is, to our knowledge, the first reported case of the results of DBT-PTSD on a person with both complex PTSD and DID, at one year of follow-up after finishing therapy.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"233-243"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Antibiomania: A Novel Presentation of a Case of Metronidazole-Induced Neurotoxicity]. [抗生素狂热：甲硝唑引起的神经毒性的新表现]。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Marie Vincent-Tremblay, Isabelle Paquette, David Caron

{"title":"[Antibiomania: A Novel Presentation of a Case of Metronidazole-Induced Neurotoxicity].","authors":"Marie Vincent-Tremblay, Isabelle Paquette, David Caron","doi":"","DOIUrl":"","url":null,"abstract":"Metronidazole is known to induce a characteristic encephalopathy, marked by neurological manifestations and typical MRI abnormalities, whereas psychiatric presentations remain rarely described. To date, no description of a frank manic symptomatology occurring concomitantly with metronidazole-induced encephalopathy has been reported in the literature. Antibiomania is a rare adverse effect defined by the onset of a manic or hypomanic episode in close temporal association with antibiotic exposure. We report the case of a 67-year-old man hospitalized for complex hepatobiliary complications and intermittently and cumulatively exposed to metronidazole and ciprofloxacin. He developed an acute behavioral change characterized by disinhibition, psychomotor agitation, logorrhea with pressured speech, irritability, hallucinatory phenomena, as well as dysarthria and falls. Brain MRI revealed T2 hyperintensities involving the dentate nuclei, red nuclei, tectal plate, and splenium of the corpus callosum, findings consistent with metronidazole-induced encephalopathy. Discontinuation of antibiotics was followed by rapid clinical improvement, with no recurrence after reintroduction of ciprofloxacin alone. This case highlights a previously undescribed clinical presentation combining typical metronidazole-induced encephalopathy with a frank manic syndrome. It underscores the importance of considering antibiomania in the differential diagnosis of a first acute manic episode in order to enable early discontinuation of the causative antibiotic.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"39-52"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[The Treatment of Long-Standing Obsessive-Compulsive Disorder in an Intensive Specialized Program: A Case Study]. [长期强迫症的强化专业治疗：个案研究]。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Catherine Ouellet-Courtois, Rosanne Villemaire-Krajden

{"title":"[The Treatment of Long-Standing Obsessive-Compulsive Disorder in an Intensive Specialized Program: A Case Study].","authors":"Catherine Ouellet-Courtois, Rosanne Villemaire-Krajden","doi":"","DOIUrl":"","url":null,"abstract":"Obsessive-compulsive disorder (OCD) is a disabling condition for which exposure and response prevention (ERP) is the first-line psychotherapeutic treatment. Despite strong evidence supporting its efficacy, many individuals with OCD do not receive specialized care, resulting in lengthy, costly, and often ineffective treatment trajectories. This case report describes a 66-year-old woman with a more than 40-year history of OCD who participated in an intensive, specialized ERP program delivered within a university hospital setting. Assessments conducted at pretreatment, post-treatment, and at a 2-month follow-up examined symptom severity, functional impairment, treatment acceptability, expectations for improvement, and willingness to tolerate discomfort associated with exposure-based work. Following two weeks of intensive intervention, the patient demonstrated a substantial reduction in OCD symptom severity, marked improvements in daily functioning, and a significant decrease in ritualistic behaviors. These clinical gains were maintained and further consolidated at the 2-month follow-up, alongside sustained confidence in the treatment approach and continued engagement in exposure-based strategies. These findings are consistent with evidence supporting the effectiveness of intensive ERP programs, including for individuals with longstanding OCD. This case underscores the critical need to expand access to specialized OCD services and to enhance clinician training in evidence-based interventions in Québec. More broadly, it illustrates that chronicity should not be equated with therapeutic resistance, but often reflects limited access to appropriate, specialized care.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"203-217"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Art as a Living Process: Creativity and Mental Health depicted by An Artificial Intelligence-Assisted Analysis of the Creative Process: A Case Report]. [艺术作为一种生活过程：人工智能辅助创作过程分析所描绘的创造力和心理健康：一个案例报告]。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Myriam Lemire, Alexandre Hudon

{"title":"[Art as a Living Process: Creativity and Mental Health depicted by An Artificial Intelligence-Assisted Analysis of the Creative Process: A Case Report].","authors":"Myriam Lemire, Alexandre Hudon","doi":"","DOIUrl":"","url":null,"abstract":"Artistic creativity maintains complex and bidirectional relationships with mental health, simultaneously reflecting psychological vulnerability and serving as a powerful vehicle for emotional regulation, symbolization, and resilience. In parallel, large language models (LLMs) are emerging as innovative tools to support the qualitative analysis of complex subjective processes. This case study presents the longitudinal trajectory of an emerging artist who is also a psychiatrist and lives with a chronic autoimmune disease, documenting her creative process throughout the development of a series of mixed-media artworks. The objective was to explore the creative process as a transformational space within the context of chronic illness, in which art functions both as a lever for resilience and as a means of identity reconfiguration. Twenty-six reflective audio recordings were collected over a six-month period, transcribed, and analyzed using a hybrid qualitative approach combining inductive thematic analysis with artificial intelligence-assisted analysis (GPT-4.0) within a secure local environment. Seven central themes emerged, conceptualizing art as an existential, dialogical, and embodied process mobilized in response to illness, invisibility, mortality, and identity-related challenges. The analysis highlights a progressive cognitive, affective, and metacognitive transformation, suggesting a trajectory of post-traumatic growth. This study illustrates the integrative potential of artistic practice supported by reflective narration and AI-assisted analysis, while also underscoring both the contributions and the limitations of LLMs as complementary tools in qualitative.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"293-307"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Cooccurrence of catatonia, delirium and dementia in an elderly woman: A case report]. 老年妇女紧张症、谵妄和痴呆同时发生1例报告

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Sante Mentale au Quebec Pub Date : 2026-01-01

Maude Cossette-Lefebvre, Nicolas Bergeron

{"title":"[Cooccurrence of catatonia, delirium and dementia in an elderly woman: A case report].","authors":"Maude Cossette-Lefebvre, Nicolas Bergeron","doi":"","DOIUrl":"","url":null,"abstract":"Catatonia is a severe but underrecognized neuropsychiatric syndrome that is frequently misdiagnosed as delirium or dementia in older adults, resulting in delayed and potentially inappropriate treatment. A 79-year-old woman was admitted for rapid cognitive decline, significant weight loss, and social withdrawal. Initial evaluations suggested major depressive disorder or dementia. Neurological investigations were inconclusive. Following the initiation of psychotropic medication, psychiatric assessment revealed mutism, posturing, and marked psychomotor retardation, fulfilling DSM-5 criteria for catatonia. A lorazepam challenge test confirmed the diagnosis. Psychotropic medications were discontinued, and lorazepam was titrated to 2 mg 4 times daily, resulting in significant clinical improvement. Subsequent brain positron emission tomography (PET) imaging along with clinical evidence supported the presence of an underlying Alzheimer's disease. However, the emergence of superimposed delirium required gradual benzodiazepine tapering. Memantine was subsequently introduced, allowing lorazepam withdrawal and full symptomatic remission. The patient was discharged home. During outpatient follow-up, recurrence of partial symptoms prompted consideration of alternative therapeutic strategies. This case underscores the importance of recognizing catatonia in older adults presenting with cognitive impairment. It highlights the diagnostic and therapeutic challenges posed by the coexistence of catatonia, delirium, and neurodegenerative disease, and emphasizes the need for early identification and a multidisciplinary approach to optimize outcomes.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"95-104"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Beyond words: The complexity of differential diagnosis and treatment of severe ritualized behaviors in an autistic adolescent without functional language and with an intellectual disability: A case report]. [言语之外：一个没有功能性语言和智力残疾的自闭症青少年的严重仪式化行为的鉴别诊断和治疗的复杂性：一个病例报告]。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Audrey Côté, Pascale Grégoire, Valérie Courchesne

{"title":"[Beyond words: The complexity of differential diagnosis and treatment of severe ritualized behaviors in an autistic adolescent without functional language and with an intellectual disability: A case report].","authors":"Audrey Côté, Pascale Grégoire, Valérie Courchesne","doi":"","DOIUrl":"","url":null,"abstract":"Autistic youth diagnosed with an associated intellectual disability (ID) represent nearly one third of the autistic population. However, the majority of studies on mental health and autism focus on autistic individuals without ID. Therefore, the mental health needs of autistic youth with an ID are still poorly understood. This case report focuses on the psychiatry follow-up of Nabil (fictitious name), an autistic adolescent with ID who has been treated for nearly 10 years for various symptoms, including ritualized behaviors that are part of a complex and rare diagnostic profile. In terms of neurodevelopmental disorders, in addition to symptoms associated with autism and ID, a diagnosis of attention deficit/hyperactivity disorder (ADHD) and Tourette syndrome was made, but the ADHD diagnosis was not maintained. Catatonia associated with autism has also emerged and is currently in remission. In terms of mental health, a diagnosis of obsessive-compulsive disorder (OCD) was made and behavioral problems were noted, without being attributed to the previous diagnoses. The presented case has three specific objectives: 1-to illustrate the challenges inherent in assessing the intellectual potential of autistic individuals with very low adaptive functioning and the impact on the treatment; 2- to provide avenues for the differential diagnosis of autistic rituals, compulsions, tics, stereotypies, and ADHD within this population and 3- to raise awareness about the underdiagnosis of catatonia in autistic youth.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"245-256"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[When psychiatric symptoms mask a neurological cause: A case report of epilepsy in geriatric psychiatry]. [当精神病学症状掩盖神经学原因：老年精神病学癫痫病例报告]。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Patrycja Mysak, Mylène Soucy, Sarah Brunelle

{"title":"[When psychiatric symptoms mask a neurological cause: A case report of epilepsy in geriatric psychiatry].","authors":"Patrycja Mysak, Mylène Soucy, Sarah Brunelle","doi":"","DOIUrl":"","url":null,"abstract":"Atypical neuropsychiatric presentations in older adults pose significant diagnostic challenges, particularly when psychiatric symptoms predominate early in the clinical course. We report the case of a 68-year-old woman referred to geriatric psychiatry for depressive symptoms associated with fluctuating cognitive complaints, brief paroxysmal episodes of confusion and language disturbance, and atypical somatic and motor manifestations. Initial investigations, including brain imaging and laboratory testing, were unremarkable, leading to preliminary consideration of primary psychiatric or functional etiologies. However, the longitudinal evolution, stereotyped episodic phenomena, and some clinical findings prompted further neurological assessment. Video-EEG monitoring ultimately documented epileptic activity consistent with temporal lobe seizure, providing a unifying explanation for the patient's symptoms. Introduction of anticonvulsant therapy resulted in marked improvement in mood, anxiety, somatic complaints, and motor manifestations, supporting an underlying neurological cause. This case highlights the diagnostic complexity of conditions at the interface of psychiatry and neurology and illustrates the risk of premature psychogenic attribution when standard investigations are normal. It underscores the importance of longitudinal diagnostic reasoning, vigilance for atypical features, and close interdisciplinary collaboration to minimize diagnostic delay and inappropriate treatment. Improved characterization of diagnostic trajectories in complex neuropsychiatric presentations among older adults may enhance diagnostic accuracy, optimize care pathways, and ultimately improve clinical outcomes.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"27-38"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Managing Severe Post-Stroke Catatonia in a Medically Complex Patient: Electroconvulsive Therapy During Thromboembolic Disease and Intracerebral Hemorrhage. 治疗医学复杂患者的严重中风后紧张症：血栓栓塞性疾病和脑出血期间的电痉挛治疗。

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Sante Mentale au Quebec Pub Date : 2026-01-01

Daniel-Jiajun Yu, Violaine Masson, Bruno Riverin-Deschênes

{"title":"Managing Severe Post-Stroke Catatonia in a Medically Complex Patient: Electroconvulsive Therapy During Thromboembolic Disease and Intracerebral Hemorrhage.","authors":"Daniel-Jiajun Yu, Violaine Masson, Bruno Riverin-Deschênes","doi":"","DOIUrl":"","url":null,"abstract":"Catatonia is a neuropsychiatric syndrome with diverse etiologies and substantial morbidity in older adults, particularly when thromboembolic complications occur. While affective disorders are frequent precipitants, catatonia following cerebrovascular events remains under-recognized. A 71-year-old woman with recent multifocal ischemic stroke, vascular neurocognitive disorder and prior depression presented with a subacute syndrome of immobility and mutism. At initial outpatient evaluation, she exhibited marked catatonic signs (Bush-Francis Catatonia Rating Scale [BFCRS] 31/69). Lorazepam produced only partial improvement and was limited by sedation and dysarthria. Given pharmacological resistance and tolerability issues, electroconvulsive therapy (ECT) was initiated, with clinical improvement after 2 sessions. ECT was interrupted due to COVID-19 infection, accompanied by proximal deep vein thrombosis and pulmonary embolism managed with apixaban. Within 1 month of ECT interruption, catatonia symptoms reemerged. After multidisciplinary consultations, ECT was cautiously restarted. Eleven consecutive ECT sessions were then performed, with varying frequency due to confusional states emerging at 3 sessions per week. A subsequent mechanical fall, along with neuroimaging findings consistent with a subacute intracerebral hemorrhage, prompted early discontinuation of ECT. Catatonia relapsed 2 months after discontinuation. Repetitive transcranial magnetic stimulation (rTMS) was tried without effect, and ECT was restarted with success and maintained. Adjunctive memantine and mirtazapine were trialed without clear benefit, while suspected underlying post-stroke depression was treated with high-dose venlafaxine, which was continued throughout the entire clinical follow-up. This case highlights the challenges of managing severe, post-stroke catatonia in the context of venous thromboembolism, intracerebral hematoma as well as the benefits of a multidisciplinary approach.","PeriodicalId":44148,"journal":{"name":"Sante Mentale au Quebec","volume":"51 1","pages":"79-93"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0