Psychiatry research case reports最新文献

{"title":"Diagnostic and management challenges of a patient with schizophrenia and comorbid anorexia nervosa","authors":"Ho Teck Tan ,&nbsp;Cecilia Sze Nga Kwok ,&nbsp;Huei Yen Lee ,&nbsp;Giles Ming Yee Tan","doi":"10.1016/j.psycr.2024.100240","DOIUrl":"10.1016/j.psycr.2024.100240","url":null,"abstract":"<div><div>The prevalence of comorbid schizophrenia in patients with eating disorders is between 3 and 10% while symptoms of anorexia nervosa has been observed in 1–4% of patients with schizophrenia. However, there is a lack of comprehensive studies available to better understand and manage this complex dual diagnosis at present.</div><div>Here, we present a case of treatment-resistant schizophrenia and comorbid anorexia nervosa in a young woman in a long-stay ward of a tertiary psychiatric hospital requiring 1-1 nursing care. She exhibited disordered eating behaviors, a distorted body image, and persistent food refusal. A diagnostic dilemma presented due to the overlap in symptomatology between her eating disorder-related restrictive behaviors and psychosis-driven food refusal. Efforts to engage her in various therapies for her anorexia nervosa has been hampered by her regressed and disorganized behavior, with concerns of the metabolic side effects of anti-psychotics potentially worsening her eating disorder cognitions. She required constant monitoring of her bloods and vitals due to her severely low body mass index (BMI). Different combinations of psychotropics, neurostimulation and psychotherapies were trialed with limited efficacy. The diagnostic overlap and treatment challenges highlights the need for interdisciplinary approaches and tailored management strategies for complex comorbid cases of schizophrenia and anorexia nervosa.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100240"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of eye movement desensitization and reprocessing in a person with dementia and post-traumatic stress disorder: A case report","authors":"J.E. Ruisch ,&nbsp;M. van Kordenoordt ,&nbsp;C. Steins ,&nbsp;M.A.M.J. Daamen ,&nbsp;K.R.J. Schruers ,&nbsp;S. Sobczak ,&nbsp;E.M.J. Gielkens","doi":"10.1016/j.psycr.2024.100239","DOIUrl":"10.1016/j.psycr.2024.100239","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-traumatic stress disorder (PTSD) is an independent risk factor for dementia. Case reports of poor-moderate quality indicate the feasibility of Eye Movement Desensitization and Reprocessing (EMDR) sessions in this population but lack a detailed description of the treatment and its challenges.</div></div><div><h3>Goal</h3><div>This report aimed to provide a detailed description of the feasibility and challenges of EMDR for a person with dementia to assist in the first step toward recognizing and treating PTSD in people with dementia.</div></div><div><h3>Methods</h3><div>In this case study, we describe an 89-year-old nursing home resident with mild–moderate dementia and trauma related symptoms. EMDR treatment was indicated, and four sessions, according to a standard child/youth protocol, were applied. Debriefing questionnaires were completed by a psychologist after each EMDR session. To monitor the effect of the EMDR therapy, a structured interview exploring PTSD symptoms (TRADE- TRAuma and DEmentia interview) was conducted between the treatment sessions.</div></div><div><h3>Results</h3><div>The debriefing questionnaires showed that EMDR was well tolerated and experienced as pleasant, but some challenges occurred; During the EMDR sessions she was easily distracted, requested multiple breaks, and required the use of shorter sentences, with a more directive approach. PTSD symptoms of recurring memories and negative thoughts were reduced.</div></div><div><h3>Conclusions</h3><div>This case report provides a detailed description showing the feasibility of EMDR therapy for a person with PTSD and dementia. It appeared necessary to adjust the EMDR standard child/youth protocol to a further simplified form, due to the reduced concentration and endurance.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100239"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the role of metoclopramide in Tardive Dyskinesia: A case report","authors":"Evaristus Chino Ezema ,&nbsp;Ngozi Akueme ,&nbsp;Precious Okpechi ,&nbsp;Omotola Emmanuel ,&nbsp;Omosumwen Ede ,&nbsp;Sanmi Michael Obe ,&nbsp;Ndukaku Ogbonna ,&nbsp;Maureen Obi ,&nbsp;Nnenna Bessie Emejuru ,&nbsp;Ogochukwu Agazie ,&nbsp;Vivien Obitulata Ugwu ,&nbsp;John Mmaduabuchi ,&nbsp;Emmanuel Chiebuka ,&nbsp;Valentine Keke ,&nbsp;Chinenye Loveth Aleke","doi":"10.1016/j.psycr.2024.100238","DOIUrl":"10.1016/j.psycr.2024.100238","url":null,"abstract":"<div><div>Tardive dyskinesia is a medication-induced movement disorder commonly caused by the blockade or depletion of dopamine in the basal ganglia, seen mostly in the psychiatric setting following prolonged use of antipsychotic medications. It is also reported in other settings where patients receive non-antipsychotic medications. The prevalence of tardive dyskinesia varies across age, gender, and race, with women of middle age being more prone to develop tardive dyskinesia more than men. Therefore, we report a case of tardive dyskinesia, post-delivery, in an African woman, who received metoclopramide as part of premedication for spinal anesthesia for an emergency cesarean delivery. The debriefing period following the resolution of the symptoms offered a clue to prior utilization of metoclopramide for the treatment of hyperemesis gravidarum as provided by the patient's family. Hence, fulfilling the diagnostic criteria of prolong usage of the implicating agent.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100238"},"PeriodicalIF":0.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A unique case of iatrogenic hebephiliac behavior emerging late in life in a patient with Gordon Holmes Syndrome","authors":"Riccardo Loconte ,&nbsp;Gianluca Sesso ,&nbsp;Cristina Scarpazza ,&nbsp;Pietro Pietrini","doi":"10.1016/j.psycr.2024.100237","DOIUrl":"10.1016/j.psycr.2024.100237","url":null,"abstract":"<div><h3>Background</h3><div>Pedophilic or hebephiliac behavior is defined iatrogenic when emerging for the first time as a side effect of medications. To date, pedophilic or hebephiliac behavior emerging after testosterone replacement therapy (TRT) has never been described.</div></div><div><h3>Case presentation</h3><div>a patient diagnosed with Gordon-Holmes syndrome (GHS), a genetic condition characterized by cerebellar ataxia and hypogonadotropic hypogonadism (HH), at the age of 55 developed hebephiliac attitudes after starting TRT. A multidisciplinary approach integrating psychiatric evaluation, general (IQ) and specific (social cognition) neuropsychological assessment, and structural brain MRI was important to characterize the patient's clinical and functional profile.</div></div><div><h3>Discussion</h3><div>We discuss how the co-occurrence of HH, requiring hormone replacement therapy, combined with the patient's borderline IQ explains the sexual offenses against pre-adolescents in light of the Insufficient but Non-Redundant Parts of Unnecessary but Sufficient Conditions (INUS) model of causation. In other words, both the administration of TRT and the borderline IQ are configured as INUS causes for understanding the illegal behavior.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100237"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esketamine-Induced acute transient psychotic episode in treatment-resistant depression: A case report","authors":"Özgür Değirmenci ,&nbsp;Ezgi Key ,&nbsp;Defne Dakota ,&nbsp;Ali Saffet Gonul","doi":"10.1016/j.psycr.2024.100236","DOIUrl":"10.1016/j.psycr.2024.100236","url":null,"abstract":"<div><div>The approval of intranasal esketamine offers a novel therapeutic avenue for managing treatment-resistant depression (TRD), albeit concerns regarding its potential side effects persist. We present a case of esketamine-induced acute transient psychotic episode in a 55-year-old male with TRD who had no history of psychosis or substance abuse. The patient had a long history of depression with relapses after initial response to antidepressants or ECT (Electroconvulsive Therapy). In the recent treatment, esketamine was added to ongoing treatment with venlafaxine 300 mg/day and olanzapine 10 mg/day. Forty-eight hours after esketamine administration, he exhibited acute psychotic symptoms requiring emergency intervention. Subsequent treatment adjustments and electroconvulsive therapy led to partial remission. This case underscores the potential risk of psychosis associated with esketamine and highlights the need for further research into its short- and long-term adverse effects. Factors such as patient history, monitoring protocols, and optimal treatment duration remain uncertain, emphasizing the importance of careful patient selection and monitoring when using esketamine for TRD management.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100236"},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onset and exacerbation of first episode psychosis associated with cannabis withdrawal: A case series","authors":"Rachel B. Church ,&nbsp;Candice E. Crocker ,&nbsp;Philip G. Tibbo","doi":"10.1016/j.psycr.2024.100235","DOIUrl":"10.1016/j.psycr.2024.100235","url":null,"abstract":"<div><p>High levels of cannabis use have been established as a risk factor for the development of psychotic disorders and may exacerbate existing mental illness. Despite extensive research on the adverse effects of cannabis, less attention has been given to a concerning phenomenon: the onset and exacerbation of acute psychotic symptoms following abrupt cessation of cannabis use. This case series presents three individuals who developed their first episode of psychosis shortly after discontinuing heavy cannabis use (several grams daily). These cases underscore the potential link between cannabis withdrawal and the emergence or exacerbation of psychotic symptoms which may led to a psychotic episode, highlighting the need for greater public health awareness of safe cannabis use practices. The discussion explores potential mechanisms such as dysregulation of the endocannabinoid and dopamine systems following long-term cannabis use, which may predispose individuals to psychosis during withdrawal. The findings advocate for safer cannabis discontinuation guidelines, suggesting gradual reduction in cannabis use and potency of product consumed as preventive measures. Further research is essential to explore predictive risk factors and refine approaches to mitigate the risk of psychosis associated with cannabis withdrawal in vulnerable populations.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021224000312/pdfft?md5=5c972d97389e38f15230ade39339da73&pid=1-s2.0-S2773021224000312-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clozapine induced globus pharyngeus: A case report","authors":"Evaristus Ezema,&nbsp;Johnson Bamidele,&nbsp;Amir Meftah,&nbsp;Stanley Nkemjika,&nbsp;Bashir Aribisala,&nbsp;Tania Sultana,&nbsp;Esther Ezenagu,&nbsp;Singh Satwant,&nbsp;Thant Htet,&nbsp;Jude Beauchamp,&nbsp;Rabel Peterson,&nbsp;Patrice Fouron,&nbsp;Tolu Olupona","doi":"10.1016/j.psycr.2024.100234","DOIUrl":"10.1016/j.psycr.2024.100234","url":null,"abstract":"<div><p>Clozapine is an atypical antipsychotic agent often recommended after the failure of two or more antipsychotics for treatment-resistant schizophrenia. Clozapine has proven efficacy in reducing morbidity and suicide in schizophrenic patients. However, it is generally underutilized for eligible patients, primarily because of the associated side effects. Notably, clozapine's side effects on the gut include hypomotility, constipation, and dysphagia, which are secondary to the anticholinergic properties of the medication. Thus far, there remains a dearth in the literature regarding reported foreign body sensations on the throat. Therefore, we report a case of foreign body sensation on the throat in a patient receiving clozapine. Foreign body sensation on the throat is an alarming concern, given the role of the oropharynx in the airway. Hence, it is imperative to evaluate unfamiliar body sensation on the throat as part of comprehensive assessment of the gut side effects of clozapine therapy.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021224000300/pdfft?md5=e1f65ca493f21657a44dab484a7f83f3&pid=1-s2.0-S2773021224000300-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the enigma: Déjà vu in dementia—A case study","authors":"Su Yin Seow ,&nbsp;Sing Qin Ting ,&nbsp;Xinni Cheah ,&nbsp;Yao Cheng ,&nbsp;Ming Chua ,&nbsp;Sheena Kai Xin Lim ,&nbsp;Iris Rawtaer","doi":"10.1016/j.psycr.2024.100233","DOIUrl":"10.1016/j.psycr.2024.100233","url":null,"abstract":"<div><p>Déjà vu experiences in dementia are notably underreported and remain an area of limited research within the literature. Despite the prevalence of dementia, the phenomenon of déjà vu has received relatively little attention in clinical settings. Consequently, healthcare workers may overlook this symptom, potentially leading to delayed diagnosis and management of dementia-related issues. Our manuscript addresses this gap by presenting a case study of déjà vu experiences in a patient with dementia. By documenting and analysing such occurrences, we aim to raise awareness among healthcare professionals about the diverse symptoms that may manifest in dementia, including those less commonly recognised. Future studies investigating the prevalence, mechanisms, and clinical implications of déjà vu in dementia patients are warranted to deepen our understanding and improve the quality of care provided to individuals affected by this debilitating condition.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021224000294/pdfft?md5=b83c8b24afbe3997c7d26c95aec7d572&pid=1-s2.0-S2773021224000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of a probable drug-induced liver injury after therapy remodulation with lamotrigine, quetiapine and sertraline in an adult female with recurrent major depression using the updated RUCAM score","authors":"Chiara Pistolesi ,&nbsp;Riccardo Spaggiari ,&nbsp;Veronica Finello ,&nbsp;Valeria Fortunato ,&nbsp;Michele Polastri ,&nbsp;Alba Gaban ,&nbsp;Laura Palagini ,&nbsp;Luigi Grassi ,&nbsp;Valeria Raparelli ,&nbsp;Angelina Passaro ,&nbsp;Michele Simonato ,&nbsp;Giovanni Zuliani ,&nbsp;Andrea D'Amuri","doi":"10.1016/j.psycr.2024.100232","DOIUrl":"10.1016/j.psycr.2024.100232","url":null,"abstract":"<div><h3>Background</h3><p>Drug-induced Liver Injury (DILI) is a common cause of acute liver injury and can be induced by several drugs. Lamotrigine, an antiepileptic drug, and quetiapine are used also as mood stabilizer medications and both have been reported to induce liver toxicity. The prescription of lamotrigine in association with other antidepressants can occur frequently in clinical practice, especially when depressive symptoms are resistant to monotherapy or are long-standing. The case we report highlights the likelihood of DILI with secondary liver damage due to the association between lamotrigine, quetiapine and sertraline through dose-dependent and not immune-mediated mechanisms.</p></div><div><h3>Case presentation</h3><p>We present the case of a young adult female with recurrent major depression that, after dose remodulation of antidepressant therapy with lamotrigine, quetiapine and sertraline, experienced abdominal pain with evidence of acute liver injury. Liver damage went into remission after antidepressant therapy was discontinued. DILI appears as a probable explanation for these findings (6 points in items for hepatocellular injury in the updated RUCAM score) caused by the interaction between these drugs.</p></div><div><h3>Conclusions</h3><p>This harmful effect is not yet well documented in the literature, and it seems to be due to a non-immune dose-dependent toxic effect. Caution is therefore warranted when prescribing the association of lamotrigine, quetiapine and sertraline.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021224000282/pdfft?md5=4e53d53062424faa8596fa15cc5e600d&pid=1-s2.0-S2773021224000282-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of GLP-1 receptor agonists on obesity in patients with severe mental illness: A state hospital case series of clozapine-treated patients","authors":"Syed Ali ,&nbsp;Narges Ghodsimaab ,&nbsp;Matthew Rusling ,&nbsp;Navid Rashid","doi":"10.1016/j.psycr.2024.100231","DOIUrl":"https://doi.org/10.1016/j.psycr.2024.100231","url":null,"abstract":"<div><p>Patients with severe mental illness (SMI) are ∼3 times more likely to live with obesity and experience a 2 - 3 fold higher mortality rate from cardiovascular disease compared to the non-psychiatric general population. Antipsychotic drugs (APDs), though effective in ameliorating symptoms of SMI, directly contribute to adverse metabolic effects including weight gain. Counteracting antipsychotic induced weight gain (AIWG) with pharmacological strategies and lifestyle modifications has demonstrated limited effects in previous studies. The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has recently become widespread in medicine. GLP-1 RAs offer a relatively novel and potentially effective approach to counteract weight gain and improve cardiometabolic abnormalities associated with commonly prescribed APDs in individuals with SMI.</p><p>In this retrospective case series, two chronic state mental health hospital patients living with obesity in the context of past medical issues and currently receiving clozapine, an APD with high metabolic risks, had also been receiving dulaglutide (supplemented with diet and weight management counsel) as an off-label intervention to promote weight loss. Retrospective review of patient data revealed encouraging results on weight and glyco-metabolic parameters in each of the two cases. In particular, in weight, Patient 1 achieved a 22 % reduction and Patient 2 achieved a 16 % reduction. In HbA1c levels, both patients achieved a 5 % reduction. In triglyceride levels, Patient 1 achieved a 46 % reduction and Patient 2 achieved a 68 % reduction. These results provide a compelling argument for the adoption of GLP-1 RAs in treatment plans for such oft-forgotten and stigmatized state mental health hospital patients, who often: have chronic lengths of stay, are on clozapine and/or polypharmacy medication regimens, are sedentary, and have AIWG, metabolic syndrome, or other significant comorbidities.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021224000270/pdfft?md5=552b8dbf4023b5a24f68d15d06f4d561&pid=1-s2.0-S2773021224000270-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}