Psychiatry research case reports最新文献

{"title":"Recurrent clozapine-induced adynamic bowel obstruction requiring two laparotomies: A case report","authors":"Archana Poudel ,&nbsp;Sanjeev Kumar Mishra ,&nbsp;Diwakar Koirala ,&nbsp;Ramesh Sapkota ,&nbsp;Bivek Mishra ,&nbsp;Tek Nath Yogi","doi":"10.1016/j.psycr.2026.100309","DOIUrl":"10.1016/j.psycr.2026.100309","url":null,"abstract":"<div><h3>Introduction</h3><div>CIGH is a potentially life-threatening adverse effect that may progress from constipation to adynamic obstruction, ischemia, sepsis, and death. Its early recognition is often delayed due to impaired symptom reporting, polypharmacy, and clozapine’s anticholinergic and anti-serotonergic effects, making vigilance essential in clinical practice.</div></div><div><h3>Case Presentation</h3><div>We report a 35-year-old man with a chronic psychotic illness on long-term clozapine who presented with acute abdominal pain, distension, bilious vomiting, and five days of constipation. Emergency laparotomy revealed 110 cm of pregangrenous small bowel, necessitating resection and double-barrel ileostomy. Three months later, following ileostomy reversal, he developed recurrent ileus requiring a second laparotomy, which demonstrated adynamic obstruction without mechanical cause, consistent with CIGH. His postoperative course was complicated by severe manic–psychotic relapse requiring antipsychotic re-initiation and electroconvulsive therapy. Multidisciplinary care enabled stabilization, and he was discharged with plans for delayed re-anastomosis once psychiatric control is optimized.</div></div><div><h3>Discussion</h3><div>This case exemplifies the severe and recurrent nature of CIGH and parallels the broad clinical spectrum reported in the literature, ranging from reversible ileus to fatal gastrointestinal necrosis. Timeliness of diagnosis and intervention determines outcome, as seen in comparable cases where delayed recognition resulted in fulminant ischemia and mortality, whereas early management enabled full recovery.</div></div><div><h3>Conclusion</h3><div>CIGH should be considered a medical emergency. Routine bowel monitoring, proactive laxative protocols, and a low threshold for imaging or surgical consultation are crucial. Integrated medical–psychiatric management is essential to prevent catastrophic complications and ensure safe continuation of antipsychotic therapy.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100309"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977301","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}

{"title":"Retraction notice to “A Case of First-Episode Psychosis with Catatonic Features in an Adolescent Following THC Use” [Psychiatry Research Case Reports 4 (2025) 100248]","authors":"Lily Porsa Do","doi":"10.1016/j.psycr.2026.100316","DOIUrl":"10.1016/j.psycr.2026.100316","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100316"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241363","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}

{"title":"Ketamine-assisted psychotherapy for treatment of an Asian American patient with post-traumatic stress disorder (PTSD): a case study","authors":"Albert Yeung ,&nbsp;Huiqiong Deng ,&nbsp;Wendy Feng ,&nbsp;Yian Wu ,&nbsp;David Mischoulon","doi":"10.1016/j.psycr.2026.100331","DOIUrl":"10.1016/j.psycr.2026.100331","url":null,"abstract":"<div><h3>Background</h3><div>Posttraumatic stress disorder (PTSD) remains a challenging condition to treat. Nonpsychedelic pharmacotherapies have modest efficacy, and trauma-focused therapies such as Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) demonstrate higher response rates than medications, yet they suffer from high dropout rates (25–35%) and limited accessibility. Recent advances in psychedelic-assisted psychotherapy (PAP), including ketamine-assisted psychotherapy (KAP) are being investigated as an alternative treatment. However, cultural, legal, and structural barriers hinder both the accessibility and acceptance of KAP within many Asian communities. Their deep-rooted skepticism toward mental health treatment, alongside collectivist values like filial piety and the prioritization of family harmony, can further complicate the management of PTSD. KAP could be a viable, but understudied option for treatment of PTSD in this population.</div></div><div><h3>Case presentation</h3><div>This case study examines the use of KAP in a 26-year-old Asian American woman with chronic PTSD stemming from childhood abuse and neglect. Mary had undergone years of psychoanalytic psychotherapy and pharmacotherapy with minimal symptom relief. Over eight months, she received 11 intramuscular ketamine sessions (mean dose = 88.2 ± 12.5 mg) paired with integration therapy. Treatment progress was assessed via standardized measures (PCL-5, PHQ-9, GAD-7) and qualitative reports. The cultural aspects of how patient’s Asian heritage shaped her trauma experience (e.g., filial piety, stigma) and treatment process were discussed. Her choice of working with an Asian therapist supports the importance of cultural concordance in KAP.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100331"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177870","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}

{"title":"A photo logbook against dissociative amnesias - a case report","authors":"C Lau ,&nbsp;K Seifert ,&nbsp;C McCormick ,&nbsp;J Taube ,&nbsp;A Philipsen ,&nbsp;MC Pensel","doi":"10.1016/j.psycr.2025.100307","DOIUrl":"10.1016/j.psycr.2025.100307","url":null,"abstract":"<div><div>We report on a 47-year-old female patient who was diagnosed with a complex dissociative disorder, including dissociative identity disorder (DID) and dissociative amnesias in everyday life. Dissociative amnesias represent a major challenge for patients, as they reduce coherence in everyday experience and are accompanied by an impaired sense of agency. The neurobiological background of dissociative amnesia has been little researched, and therapeutic options specifically targeting this symptom are rare. In a photo elicitation interview, the patient reports of amnesias regarding her past, but also of time gaps in everyday life. To structure her experience of time, she reports of taking up to 200 photos of her immediate surroundings with her phone every day, which she regularly reviews in the evening. As an outcome, reviewing these photos provides a structuring frame for her everyday memory, reduces symptoms of perceived time gaps, and thereby increases her reported sense of agency. In addition, the photographic motifs also provide insights into the processing of dissociative experiences, e.g., regarding feelings of fragmentation and disruption. Furthermore, MRI-data of the patient were analysed and results are compatible with overall volume increases of the hippocampus following pattern completion tasks (specifically in CA2/3 subfields), and reduced volumes in CA1 subfields, as previously reported in patients with dissociative amnesia. The case report stresses the usefulness of photographs in complex dissociative disorders, as a complementary diagnostic tool regarding dissociative states and as a therapeutic method against dissociative amnesias. An involvement of the hippocampus is suggested but needs further scientific exploration.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100307"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977271","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}

{"title":"New onset psychosis following cannabis discontinuation: A case report","authors":"Naing Bajaj ,&nbsp;David T. Lardier ,&nbsp;Stephen Lewis ,&nbsp;Snehal R Bhatt","doi":"10.1016/j.psycr.2025.100301","DOIUrl":"10.1016/j.psycr.2025.100301","url":null,"abstract":"<div><h3>Background</h3><div>Substance-induced psychoses are brief psychotic syndromes triggered by substance use that can persist for days to weeks after substance discontinuation. With the rising popularity of cannabis and cannabis-related products, including synthetic cannabinoids, the incidence of cannabis-related psychotic episodes may continue to rise, particularly among geriatric populations where less is known about cannabis effects on psychotic symptoms.</div></div><div><h3>Objective</h3><div>This case study examines the emergence of psychotic symptoms following abrupt cannabis cessation in a 67-year-old female with pre-existing anxiety and depression.</div></div><div><h3>Case presentation</h3><div>A 67-year-old Caucasian female developed new-onset paranoid delusions and suicidal ideation approximately four weeks after discontinuing six years of heavy cannabis use (3 grams daily). She required two hospitalizations with treatment including risperidone (Risperdal) and escitalopram. Complete resolution of psychotic symptoms occurred with short-term antipsychotic treatment, which was successfully discontinued after four months.</div></div><div><h3>Conclusions</h3><div>This case contributes to growing evidence suggesting a potential link between cannabis withdrawal and new-onset psychosis, among vulnerable populations with underlying mental health conditions. The successful resolution with short-term treatment and absence of recurrence after medication discontinuation highlights the temporary nature of this phenomenon.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100301"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798682","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}

{"title":"Remission of auditory verbal hallucinations following neuronavigated, personalized rTMS guided by EEG, MRI, and auditory evoked potentials: A case report","authors":"Barbora Provaznikova ,&nbsp;Anna Monn ,&nbsp;Aygün Ertuğrul ,&nbsp;Samantha Weber ,&nbsp;Erich Seifritz ,&nbsp;Johannes Jungwirth ,&nbsp;Golo Kronenberg ,&nbsp;Sebastian Olbrich ,&nbsp;Tobias Welt","doi":"10.1016/j.psycr.2025.100306","DOIUrl":"10.1016/j.psycr.2025.100306","url":null,"abstract":"<div><div>Auditory verbal hallucinations (AVH) are a particularly distressing symptom of schizophrenia and are associated with significant reductions in quality of life. Antipsychotic medications fail to produce adequate symptom relief in approximately 25–30 % of patients and are frequently accompanied by adverse side effects, underscoring the need for effective alternative treatment. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a non-invasive intervention for patients experiencing persistent AVH. While previous studies have explored the effects of rTMS on AVH, this is the first case report, to our knowledge, that combines individual localization of the primary auditory cortex using acoustic evoked potentials (AEP) and precise MRI-based neuronavigation for targeted rTMS application. The changes in auditory hallucinations were assessed through questionnaires and EEG (Electroencephalography), with standardized Low Resolution Brain Electromagnetic Tomography Analysis (sLORETA) used to investigate alterations in functional brain connectivity. We present the case of a 53-year-old male patient with schizoaffective disorder and persistent AVH, in whom AEP and MRI-based neuronavigation were combined to guide individualized rTMS targeting of the left primary auditory cortex. This personalized approach resulted in a rapid and complete remission of AVH after 5 days of rTMS treatment with 1 Hz Protocol. Notably, the clinical improvement was mirrored in source-localized EEG data using sLORETA, which showed reduced activity in the left parietal lobe (Brodmann area 40, postcentral gyrus) across higher frequency bands (Beta and Gamma). This could reflect a downstream or network-level modulation related to auditory processing and AVH symptoms. Further studies are needed to investigate the reproducibility of this approach.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100306"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746986","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}

{"title":"Palliative psychiatry in ultra-treatment resistant schizophrenia with refractory somatic hallucinations: A case report","authors":"Marian Taiwo ,&nbsp;Simrit K. Toor ,&nbsp;Myles Turkson ,&nbsp;Monique Du Boulay","doi":"10.1016/j.psycr.2025.100303","DOIUrl":"10.1016/j.psycr.2025.100303","url":null,"abstract":"<div><div>We report the case of a middle-aged male with ultra-treatment-resistant schizophrenia and severe multimodal hallucinations, including rare and difficult-to-manage somatic hallucinations. Conventional treatment strategies, including multiple antipsychotic regimens, clozapine, and electroconvulsive therapy, provided limited benefit. Care was reframed within a palliative psychiatric framework that prioritized symptom relief, dignity, and quality of life via integration of creative therapies, peer counselling, alongside supportive pharmacotherapy. Despite the persistence of psychotic symptoms, the framework contributed to meaningful improvement in the patient’s well-being and functionality by reducing distress, avoiding polypharmacy with adverse effects, enhancing engagement with treatment, and within the community. This case contributes to the limited clinical literature by demonstrating the structured application of palliative psychiatry in UTRS, highlighting its potential to enhance quality of life even when all evidence-based treatments have been exhausted. This framework offers palliative psychiatry as a humane and practical framework for clinicians to consider in cases of ultra-treatment-resistant schizophrenia when complete symptom remission is unattainable.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100303"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712503","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}

{"title":"Implementing a classification methodology for serial arson: a case report","authors":"Palix Julie ,&nbsp;Broillet Alain ,&nbsp;Abbiati Milena","doi":"10.1016/j.psycr.2025.100308","DOIUrl":"10.1016/j.psycr.2025.100308","url":null,"abstract":"<div><div>Early detection of serial arsonists can be challenging for forensic professionals. Serial arsonists account for nearly 20% of all fire setters, but only 1% of these individuals are diagnosed with pyromania and receive appropriate treatment. There is an urgent need for accurate identification to enable more effective management, thus preventing the significant ecological and economic damage caused by these criminal acts.</div><div>We present a case of a young serial arsonist responsible for setting 12 deliberate fires over a period of four weeks. The individual had been diagnosed with pyromania in pre-adolescence but was not diagnosed with it during the post-arrest assessment. Using psychiatric and forensic reports, we applied a validated 44-item classification methodology for incendiary acts. We performed multidimensional scaling analysis to examine the characteristics of serial fire setting.</div><div>In this case, alcohol abuse and episodes of arson without periods of emotional calm were recurrent. Advanced skills in arson were demonstrated, with a variety of scenarios targeting both objects and people.</div><div>The implementation of a classification methodology allowed us to identify additional features that distinguish this case beyond the diagnosis of pyromania. This approach paves the way for more appropriate and effective interventions, particularly those focused on controlling impulsivity.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100308"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926772","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}

{"title":"Excited catatonia masking tardive dyskinesia in schizoaffective disorder: an illustrative case and mechanistic considerations","authors":"Andrew Muran,&nbsp;William Schwartz,&nbsp;Isabelle Kaplan,&nbsp;Giselle Appel,&nbsp;Anshuman Srivastava","doi":"10.1016/j.psycr.2026.100330","DOIUrl":"10.1016/j.psycr.2026.100330","url":null,"abstract":"<div><h3>Background</h3><div>Catatonia can obscure co-occurring movement disorders, but published masking phenomena to date have only involved catatonic stupor. Two prior case reports describe the disappearance of tardive dyskinesia (TD) during catatonic stupor with re-emergence as catatonia resolves. Whether excited catatonia can similarly mask TD has not been documented. We describe an illustrative case of excited catatonia masking TD and discuss mechanistic parallels across catatonia subtypes despite distinct clinical presentations.</div></div><div><h3>Methods</h3><div>We report a single inpatient case observed during treatment of decompensated schizoaffective disorder and contextualize the clinical findings within the existing literature on catatonia and TD.</div></div><div><h3>Results</h3><div>A 37-year-old patient with schizoaffective disorder, bipolar type and established TD treated with valbenazine presented after medication nonadherence with agitation, disorganization, and prominent motor excitement. On evaluation, the patient exhibited multiple catatonic signs most consistent with the excited subtype, with an initial Bush–Francis Catatonia Rating Scale (BFCRS) score of 17. Catatonia improved over two weeks with benzodiazepines, with BFCRS decreasing to 1. During peak excited catatonia, baseline tardive movements were less clinically apparent; as catatonia improved, tardive movements became progressively more conspicuous and subjectively distressing despite continued valbenazine, prompting addition of amantadine.</div></div><div><h3>Conclusions</h3><div>This case suggests that excited catatonia, like catatonic stupor, can mask co-occurring TD. We propose two non-mutually exclusive mechanisms: state-dependent hypodopaminergic effects during catatonia and competition between catatonic and tardive motor programs. Clinically, serial structured movement assessments may be necessary to avoid underrecognition of TD when catatonia is present.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100330"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184361","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}

{"title":"Neuroleptic malignant syndrome following alcohol withdrawal: A case report","authors":"Takeshi Okuda ,&nbsp;Shogo Miyashita ,&nbsp;Ryota Takeuchi ,&nbsp;Yoshiaki Miyagishi ,&nbsp;Mitsuru Kikuchi","doi":"10.1016/j.psycr.2025.100304","DOIUrl":"10.1016/j.psycr.2025.100304","url":null,"abstract":"<div><h3>Background</h3><div>Neuroleptic malignant syndrome (NMS) is a rare but life-threatening emergency precipitated by the use or withdrawal of dopamine-receptor antagonists or dopaminergic agents. It classically presents with lead-pipe rigidity, hyperthermia, autonomic dysregulation, and altered mental status. Delayed recognition still carries considerable mortality. Alcohol-withdrawal syndrome (AWS) ranges from mild tremor to delirium tremens and overlaps with NMS in fever, agitation, and autonomic instability, making early distinction difficult.</div></div><div><h3>Case</h3><div>We describe a middle-aged man with alcohol-use disorder who developed NMS during treatment of AWS after intramuscular haloperidol. Given significant hepatic dysfunction, dantrolene was avoided; ICU-level supportive care with continuous intravenous midazolam was provided. He improved clinically and biochemically; lorazepam was tapered off and he was discharged.</div></div><div><h3>Conclusion</h3><div>Overlapping pathophysiology—particularly reduced central dopaminergic tone in withdrawal states—may lower the threshold for NMS. A high index of suspicion for NMS is warranted in patients with AWS after antipsychotics administration. In the presence of hepatic impairment, drug choice and dosing should be tailored to liver function.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100304"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798681","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}