Psychiatry research case reports最新文献

{"title":"Bidirectional therapeutic sequencing of repetitive transcranial magnetic stimulation and intranasal esketamine for treatment-resistant depression: a real-world consecutive case series","authors":"M Isabel Martínez-Gras ,&nbsp;Juan de Dios Molina ,&nbsp;Luis Sánchez-Pastor ,&nbsp;Sara Llamas ,&nbsp;Juan Manuel Espejo-Saavedra ,&nbsp;Alejandro Compaired ,&nbsp;Juan Carlos Leza ,&nbsp;Gabriel Rubio","doi":"10.1016/j.psycr.2026.100332","DOIUrl":"10.1016/j.psycr.2026.100332","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment-resistant depression (TRD) is commonly managed through iterative, individualized therapeutic strategies. Although repetitive transcranial magnetic stimulation (rTMS) and intranasal esketamine are evidence-based interventions, many patients experience non-response, partial response, or early relapse. Evidence guiding the clinical sequencing of rTMS and intranasal esketamine in real-world practice remains limited.</div></div><div><h3>Case presentation</h3><div>We present a naturalistic case series of five consecutive patients with TRD treated in a specialized outpatient program, in whom rTMS and intranasal esketamine were used sequentially within bidirectional therapeutic trajectories (rTMS followed by intranasal esketamine or intranasal esketamine followed by rTMS) after non-response, partial response, or early relapse. The term “sequential” was used to indicate the order of treatment introduction and did not necessarily imply strict temporal separation, as partial overlap occurred in some cases.</div><div>Introduction of a second evidence-based intervention was temporally associated with improvement in depressive symptoms, anxiety, and functioning. Although all five patients met the predefined operational criterion for remission (MADRS ≤10) at some point during follow-up, the observational design does not permit causal attribution.</div></div><div><h3>Discussion</h3><div>These observations are descriptive and hypothesis-generating. Heterogeneity in therapeutic sequencing, stimulation protocols, and cumulative treatment exposure limits comparability between cases. The retrospective uncontrolled design precludes causal inference.</div></div><div><h3>Conclusion</h3><div>This naturalistic case series describes individualized bidirectional therapeutic trajectories in which sequential incorporation of rTMS and intranasal esketamine was temporally associated with clinical improvement in treatment-resistant depression. These findings should be considered hypothesis-generating. Prospective controlled studies are needed to define optimal sequencing strategies and identify predictors of response.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100332"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177876","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":"Guiding treatment in obsessive compulsive disorders by a pharmacogenetic approach","authors":"Avigaelle Amory ,&nbsp;Aurelie Casterman ,&nbsp;Philippe de Timary ,&nbsp;Vincent Haufroid","doi":"10.1016/j.psycr.2026.100310","DOIUrl":"10.1016/j.psycr.2026.100310","url":null,"abstract":"<div><div>Obsessive-compulsive disorder (OCD) is a common and often enduring neuropsychiatric disorder that results in significant impairments in quality of life. Mostly commonly, its pharmacological management entails a course of a selective serotonin reuptake inhibitors (SSRIs) for ten to twelve weeks, but at higher doses than are typical for treating major depression disorder (MDD). However, the relatively high SSRI doses bring a significant risk for dropout due to side effects in the highly anxious OCD population. We now illustrate through a clinical case study how the use of pharmacogenetics (PGx) in an OCD patient enabled a personalized pharmacological strategy giving better therapeutic response along with lesser risk of untoward side effects. In our case, the patient’s poor clinical responses to initial trials with fluoxetine and escitalopram led us to undertake her pharmacogenetic profiling, which correctly predicted that high dose sertraline would obtain effective management of OCD symptoms. This case report illustrates how PGx assessment can enable physicians to make a more confident and personalized choice of SSRI and dosage, leading to improved patient compliance and a stronger therapeutic response, along with lesser side effects. Pharmacogenetic testing presents an emerging tool for guiding SSRI prescription for OCD, considerably improving the management of these difficult-to-treat patients.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100310"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977213","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 “Clozapine Discontinuation-Induced Catatonia: A Detailed Case Report and Exploration of Potential Underlying Mechanisms” [Psychiatry Research Case Reports 3(2024) 100230]","authors":"Lai Yu Tsang,&nbsp;Richard Gomez,&nbsp;Jaila Graham,&nbsp;Sukhraj Bains,&nbsp;Andrea Bulbena-Cabre","doi":"10.1016/j.psycr.2026.100317","DOIUrl":"10.1016/j.psycr.2026.100317","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100317"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241364","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 rare but debilitating disorder: A case report on olfactory reference syndrome","authors":"Mohammed Saud Almubaddil ,&nbsp;Faisal Saleh Alsalamah ,&nbsp;Reema Abdulaziz Alageel ,&nbsp;Nujud Mohammed Bin khunayn ,&nbsp;Reem Abdullah Alfulayj ,&nbsp;Sultan Alshahrani","doi":"10.1016/j.psycr.2025.100305","DOIUrl":"10.1016/j.psycr.2025.100305","url":null,"abstract":"<div><div>Olfactory reference syndrome (ORS) is a persistent and false belief that one emits a foul, unpleasant, or socially offensive body odor that leads to anxiety, depression, and significant functional impairment. Diagnosis remains challenging as it overlaps with multiple psychiatric conditions. Despite DSM-5 categorizing it as a part of “other specified obsessive-compulsive and related disorders,” its classification remains debated. We present a case of a 45-year-old male with persistent foul mouth odor, accompanied by significant anxiety and repetitive hygiene behaviors that impacted his social and occupational functioning. Upon admission, physical and neurological examinations are normal. Mental status examination with Yale-Brown Obsessive-Compulsive Scale reflecting severe obsessive-compulsive symptoms. The patient was started on Cognitive Behavioral Therapy (CBT), with multiple interruptions and restarts of various psychiatric medications. Currently, he is on Aripiprazole 5mg/day, Fluoxetine 20mg/day, and a gradual tapering of Olanzapine. We aimed here to discuss the place of ORS in the diagnostic systems with reference to this case. Our case supports the perspective that olfactory reference syndrome is related to other specified obsessive-compulsive and related disorders classification. Future research should seek to delineate ORS's place within psychiatric classification systems.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100305"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798683","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 “Primary or secondary? A case report of psychosis in the setting of an intracranial mass” [Psychiatry Research Case Reports 1(2022) 100031]","authors":"Zoe A. Karavolis ,&nbsp;Gilbert Pan","doi":"10.1016/j.psycr.2026.100318","DOIUrl":"10.1016/j.psycr.2026.100318","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"5 1","pages":"Article 100318"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241362","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":"Erratum regarding missing Statements in previously published articles","authors":"","doi":"10.1016/j.psycr.2025.100268","DOIUrl":"10.1016/j.psycr.2025.100268","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100268"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683662","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":"Erratum regarding missing Statements in previously published articles","authors":"","doi":"10.1016/j.psycr.2025.100267","DOIUrl":"10.1016/j.psycr.2025.100267","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100267"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683664","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 “Asymptomatic hepatitis as a late side effect of clozapine: A case report” [Psychiatry Research Case Reports Volume 2, Issue 1, June 2023, 100107]","authors":"Lucas Lopes ,&nbsp;Mariana Remelhe ,&nbsp;Maria Manuela Estevinho ,&nbsp;Ângela Venâncio ,&nbsp;Sara Pereira","doi":"10.1016/j.psycr.2025.100273","DOIUrl":"10.1016/j.psycr.2025.100273","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100273"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683666","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":"Delayed onset tacrolimus-induced neuropsychiatric symptoms in a pancreas-after-kidney transplant recipient","authors":"Sara Briker ,&nbsp;Aria Vitale ,&nbsp;Sara Wierbowski ,&nbsp;Jonathan Galla ,&nbsp;Kelly Hamilton ,&nbsp;Steven Potter ,&nbsp;Jennifer F. Schreiber","doi":"10.1016/j.psycr.2025.100295","DOIUrl":"10.1016/j.psycr.2025.100295","url":null,"abstract":"<div><div>The introduction of tacrolimus as an anti-rejection medication has markedly improved the outcomes of patients receiving organ transplants. While the use of tacrolimus has been instrumental in preventing organ rejection, especially in the case of pancreas and multi-organ transplants, the neuropsychiatric side effects are less commonly reported. Here, we present the complicated psychiatric and behavioral presentation of a 38-year-old woman with a psychiatric history of treatment-resistant depression, anxiety, and an unspecified eating disorder, who had been maintained uneventfully on tacrolimus after receiving a living-donor kidney transplant two years earlier. The patient then underwent an isolated pancreas transplant. Psychiatry was consulted six days after transplant for hyperactivity, disruptive behaviors, physical agitation, impaired cognition, disorientation, disorganized speech, and occasional hallucinations; these symptoms were refractory to multiple trials of psychiatric medications. After extensive medical and neurological work-up, and several instances of critically elevated tacrolimus levels, the patient was transitioned to cyclosporine, with gradual improvement, and eventual return to cognitive baseline. In exploring the possible causes of this complicated psychiatric presentation, we highlight the correlation between tacrolimus use and psychiatric symptoms, even when levels are in the therapeutic range, and emphasize the need to consider switching to an alternate agent. To our knowledge, this is the first case of tacrolimus-induced psychotic symptoms in the setting of a second organ transplant, years after initiation of tacrolimus for an initial transplant. Considering this, clinicians should remain vigilant in monitoring patients with chronic tacrolimus use, while awaiting more research into the neurotoxic implications of its long-term use.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416110","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":"First-break psychosis and mycoplasma-associated encephalitis: a case series highlighting the role of cannabis use, immune-based interventions, and antipsychotic treatment","authors":"Emmanuel Annor,&nbsp;David Finch,&nbsp;Madeline Pollak,&nbsp;Dhanalakshmi Ramasamy,&nbsp;Elizabeth Mutter","doi":"10.1016/j.psycr.2025.100292","DOIUrl":"10.1016/j.psycr.2025.100292","url":null,"abstract":"<div><div>First-episode psychosis (FEP) in adolescents poses challenges when distinguishing between primary psychiatric disorders and organic causes like autoimmune encephalitis. Mycoplasma pneumoniae can lead to neuropsychiatric symptoms, including psychosis. However, its connection to first-break psychosis has not been fully studied. The diagnostic challenge grows with the use of substances, especially cannabis. In this study, we discuss two adolescent cases of first-break psychosis associated with Mycoplasma and cannabis use. In Case 1, a 15-year-old girl experienced treatment-resistant psychosis, with multiple antipsychotic medications failing to help. An evaluation showed cerebrospinal fluid (CSF) pleocytosis and high Mycoplasma IgM/IgG antibodies. She showed significant improvement 48 h after completing doxycycline. In Case 2, a 17-year-old boy displayed disorganized thoughts, hallucinations, and dystonic movements. Laboratory tests revealed CSF pleocytosis and positive Mycoplasma serology. He responded well to intravenous immunoglobulin and azithromycin, returning to his usual level of functioning. Both patients had used cannabis and were initially diagnosed with substance-induced psychosis before the organic causes were found. These cases emphasize the need to consider infectious and autoimmune factors in adolescents with sudden, treatment-resistant psychosis, even when there is a history of substance use. Their positive response to antimicrobial and immunomodulatory treatment suggests that early recognition and treatment of Mycoplasma-associated encephalitis may lead to better outcomes and help avoid long-term psychiatric issues.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100292"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265882","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}