Melanie Marcille , Michael Jayson , Kevin Putinta , Brent Carr
{"title":"Durable response to electroconvulsive therapy with atypical electrode placement in a post-middle cerebral artery stroke patient","authors":"Melanie Marcille , Michael Jayson , Kevin Putinta , Brent Carr","doi":"10.1016/j.psycr.2023.100185","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100185","url":null,"abstract":"<div><p>Electroconvulsive Therapy (ECT) is a highly efficacious treatment for severe and often refractory affective and psychotic illnesses. Case reports also describe effective and durable responses in patients with neurologic disorders complicated by psychiatric syndromes. Recommendations on ECT technique include avoiding electrical stimulation over areas of known skull or brain abnormalities. We present a patient with a perinatal, large right middle cerebral artery (MCA) infarct affecting the entirety of the MCA distribution who safely underwent a full series of ECT using an alternative placement. ECT was well tolerated with rapid resolution of symptoms. With subsequent maintenance ECT, response was durable at eighteen months.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49814926","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":"Augmentation of risperidone with low dose clozapine in a patient with schizophrenia, a case report","authors":"Yiu-Chung Chan","doi":"10.1016/j.psycr.2023.100181","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100181","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49814928","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":"Demons of the past—Signs of childhood trauma reflected in psychosis due to vascular cognitive disorder?","authors":"Stefan Frisch , Fabian Fußer","doi":"10.1016/j.psycr.2023.100184","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100184","url":null,"abstract":"<div><p>Behavioral and psychological syndromes such as depression and psychosis often occur along with cognitive (esp. executive) deficits in vascular cognitive disorder (VCD) in the elderly. We present the case of an 85-year-old woman with deficits in executive functions as well as a persistent and clearly circumscribed paranoid hallucinatory syndrome (most probably due to VCD) which could not be adequately treated with antipsychotic medication. The patient also suffered from severe depression (independent of psychotic symptoms). Both psychosis and depression were successfully managed in a home treatment based on <em>Flexible Assertive Community Treatment</em> (FACT). Interestingly, a thematic association between the delusional contents and early childhood traumata could be reconstructed, and late-onset trauma-related symptoms could be successfully treated with cognitive-behavioral therapy (CBT) as well. In sum, behavioral management of psychotic syndromes is possible in the absence of adequate pharmacological treatment options, and multiprofessional and person-centered home treatment may be successful in the elderly, even in severe and complex disorders.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861375","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":"Pseudocyesis in a deployed military member","authors":"Ezie Nguyen , Allison Watkins , Lauren Wells","doi":"10.1016/j.psycr.2023.100183","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100183","url":null,"abstract":"<div><h3>Introduction</h3><p>Pseudocyesis is defined by the false and fixed belief of being pregnant with associated symptoms of pregnancy. This diagnosis is contrasted with delusion of pregnancy, which differs by lack of physical symptoms. Cases of pseudocyesis in high-income countries are rare and are typically associated with low socioeconomic status, history of infertility, and psychosocial stress.</p></div><div><h3>Case report</h3><p>A 35-year-old active-duty female Service member with three previous deployments and no history of psychiatric disorders presented for prenatal care of her reported 35-week gestation. She reported conception after return from deployment and validated pregnancy status with symptoms of increased breast and abdominal size as well as frequent nausea and vomiting. The patient also endorsed fetal movement. She endorsed regular monthly menses but noted that they had gotten lighter since she conceived this pregnancy. Obstetric history was notable for previous termination. Her social history was complicated by childhood sexual trauma and spousal emotional abuse. Physical exam and ultrasound showed a healthy weight woman with a non-distended abdomen and nongravid uterus. Qualitative and quantitative b-HCG laboratory findings were negative, and all other laboratory findings including urine drug screen were within normal limits. Psychiatric assessment and mental status exam were unremarkable. After diagnosis of pseudocyesis, indicated treatment involved supportive therapy.</p></div><div><h3>Discussion</h3><p>This case illustrates a rare incidence of pseudocyesis in a high-income setting. Pathophysiologic etiologies of pseudocyesis suggest neuroendocrine pathway dysregulation associated with underlying mood disorders and psychosocial stressors. Recognition and discernment of pseudocyesis is critical for appropriate intervention and prevention of recurrent episodes.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861373","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}
Tyler Wheeler, David Weinstein, Mohammed Molla, Sarayu Vasan
{"title":"Case report: Alcohol use disorder and noncompliance as factors in a case of probable Korsakoff syndrome diagnosed 10 years after gastric bypass","authors":"Tyler Wheeler, David Weinstein, Mohammed Molla, Sarayu Vasan","doi":"10.1016/j.psycr.2023.100182","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100182","url":null,"abstract":"<div><h3>Background</h3><p>Wernicke-Korsakoff syndrome (WKS) is a neuropsychiatric condition caused by thiamine deficiency, often associated with chronic alcohol use. We report a case of probable Korsakoff syndrome 10 years after bariatric weight loss surgery in a patient with alcohol use disorder.</p></div><div><h3>Case presentation</h3><p>A 53-year-old male with a history of alcohol use disorder and Roux-en-Y gastric bypass surgery presented with severe memory impairment, confabulation, nystagmus, and ataxia. He had discontinued his vitamin supplements and increased his alcohol consumption after the surgery. MRI of the brain showed significant atrophy of the mammillary bodies and mild to moderate cerebral volume loss. He was diagnosed with probable Korsakoff syndrome and treated with parenteral and intramuscular thiamine, with minor improvement.</p></div><div><h3>Discussion</h3><p>This case illustrates the risk of developing WKS following bariatric surgery, especially in patients with alcohol use disorder. Thiamine deficiency can result from malabsorption, malnutrition, or excessive vomiting after the surgery. Alcohol use can exacerbate the deficiency by impairing thiamine absorption and utilization. The diagnosis of WKS is often delayed or missed due to its variable presentation and low clinical suspicion.</p></div><div><h3>Conclusions</h3><p>WKS is a potentially preventable and treatable condition that can have devastating consequences if left untreated. Patients undergoing bariatric surgery should be screened for alcohol use disorder and counseled on the importance of adhering to vitamin supplementation and avoiding alcohol. Clinicians should be aware of the possibility of WKS in patients with bariatric surgery and alcohol use disorder who present with cognitive or neurological symptoms. Early diagnosis and treatment with thiamine can improve outcomes and prevent irreversible brain damage.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861374","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}
Anil K. Bachu , Sushma Srinivas , Vijaya P. Kotapati , Hansini Kochhar , Ozge C. Amuk Williams , Garima Yadav , Tejasvi Kainth , Zeeshan Mansuri
{"title":"Posterior reversible encephalopathy syndrome in a chronic alcoholic patient with alcohol withdrawal: A case report","authors":"Anil K. Bachu , Sushma Srinivas , Vijaya P. Kotapati , Hansini Kochhar , Ozge C. Amuk Williams , Garima Yadav , Tejasvi Kainth , Zeeshan Mansuri","doi":"10.1016/j.psycr.2023.100180","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100180","url":null,"abstract":"<div><p>Posterior reversible encephalopathy syndrome (PRES) is a critical neurological condition characterized by symptoms such as altered mental state, seizures, and visual disturbances. Essential hypertension is the most commonly associated risk factor. PRES has also been linked to alcohol intoxication. In this case report, we present the case of a 60-year-old male with a history of chronic alcoholism who developed PRES during an episode of acute hypertensive crisis. The patient's alcohol withdrawal delirium, exacerbated by alcohol use, was managed with benzodiazepines. Treatment of PRES typically involves addressing the underlying cause and providing symptomatic care. Prompt management is crucial in suspected PRES cases to prevent complications.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861372","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":"White–Sutton syndrome: A case report with intellectual disability and obsessive-compulsive symptoms","authors":"Isabela Faria , Sofia Morais , Nuno Madeira","doi":"10.1016/j.psycr.2023.100161","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100161","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100161"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861370","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}
Laura Orsolini , Silvia Bellagamba , Giulio Longo , Umberto Volpe , Takahiro A. Kato
{"title":"Youth hikikomori-like social withdrawal in Italy: Two clinical cases","authors":"Laura Orsolini , Silvia Bellagamba , Giulio Longo , Umberto Volpe , Takahiro A. Kato","doi":"10.1016/j.psycr.2023.100179","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100179","url":null,"abstract":"<div><p>Hikikomori, firstly described in Japan, is a psychosocial condition characterized by severe and prolonged social withdrawal. Hereby we describe two case vignettes of youth Hikikomori-like severe social withdrawal in a young 29-years-old girl with 7-years prolonged and severe social withdrawal condition and in a 18-years-old boy with 4-years prolonged social withdrawal and concomitant secondary Internet Gaming Disorder.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861369","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":"Transient eosinophilic colitis in clozapine use","authors":"Aderonke Oyetunji , Val Bellman , Jianwei Jiao","doi":"10.1016/j.psycr.2023.100178","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100178","url":null,"abstract":"<div><p>The conventional approach for initiating clozapine treatment involves gradual titration of the dosage over a period of several weeks in order to minimize adverse reactions. However, some patients are unable to tolerate the standard titration regimen and develop multiple side effects. This case report describes a 59-year-old Caucasian man who experienced eosinophilic colitis, potentially attributable to excessively rapid titration schedule. Through examination of the relative risks and benefits of various clozapine titration protocols, this case illuminates the feasibility, safety, and efficacy of these strategies in actual clinical practice. Individualized titration approaches are imperative in order to optimize clozapine initiation for each patient. Formal monitoring and documentation of outcomes can inform development of evidence-based standards for this complex process.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861371","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":"Clozapine–treatment–resistant schizophrenia successfully managed with brexpiprazole combination therapy and online meta-cognitive training: A case report","authors":"Laura Orsolini, Brodinela Marpepa, Umberto Volpe","doi":"10.1016/j.psycr.2023.100177","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100177","url":null,"abstract":"<div><p>Clozapine is considered one of the best effective strategies in treatment-resistant schizophrenia (TRS), despite up to 60 % of clozapine-treated patients not adequately and/or fully achieving a clinical response either partial remission (clozapine-resistant treatment, CRT). Hence, several combination strategies to clozapine have been investigated in CRT. Hereby, we describe a 50-year-old CRT male patient successfully managed with brexpiprazole augmentation strategy. The patient was assessed at the baseline, weekly up to week 4 and monthly after that up to week 16, with the following psychopathological rating scales: Clinical Global Impression - Improvement (CGI-I), Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS) Calgary Depression Scale for Schizophrenia (CDSS), Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Anxiety (HRS-A), Barnes Akathisia Scale (BARS), and Abnormal Involuntary Movement Scale (AIMS). At 1-month follow-up, he already showed a considerable improvement at the psychopathological assessment (63 % total PANSS reduction). At 4-month follow-up, a further 50 % PANSS total reduction was observed from the baseline. After 1-year of clozapine-brexpiprazole treatment, the patient was also administered an online metacognitive training (MCT) as adjunctive intervention, by reporting a further clinical improvement.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861368","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}