Psychiatry research case reports最新文献

{"title":"Ketamine overdose: A case series from a referral poison center in Iran","authors":"Iman Bhia ,&nbsp;Mitra Rahimi ,&nbsp;Mohammad Poursalehian ,&nbsp;Babak Mostafazadeh ,&nbsp;Peyman Erfan Talab Evini ,&nbsp;Shahin Shadnia","doi":"10.1016/j.psycr.2023.100191","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100191","url":null,"abstract":"<div><p>Ketamine, primarily utilized as an analgesic agent, has gained attention for its diverse applications, including its use as an antidepressant. However, there has been a concerning rise in ketamine misuse in Asia particularly Southeast Asian countries, as a recreational drug. This study aims to analyze the emergence of ketamine abuse in Tehran, Iran, specifically focusing on cases reported at Loghman Hakim Hospital Poison Center (LHHPC). Over the past five years, LHHPC recorded a total of 13 patients admitted with the final diagnosis of ketamine toxicity. We evaluated various parameters including age, dosage, history of habitual abuse, prior addiction issues, time from ingestion to admission, and the duration of hospitalization. Notably, there was a higher prevalence of smoking (p-value: 0.1) and alcohol consumption (p-value: 0.75) in females compared to males. Furthermore, a notable prevalence of a prior history of depression was observed among patients admitted due to ketamine misuse, with a more pronounced occurrence in females (71.4 %) compared to males (50 %). This is the first retrospective case series shedding light on ketamine abuse in Iran. Our study offered valuable insights into the correlation between a history of depression and ketamine misuse and additionally supported findings from existing reviews and case series. This research emphasizes the importance of reporting ketamine abuse cases by various centers to obtain a more comprehensive understanding of the prevalence of ketamine abuse in Iran.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021223000895/pdfft?md5=56349b1181804fd06238ed1c9d039bb8&pid=1-s2.0-S2773021223000895-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92019530","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":"Treatment of delirious mania with catatonia in a community teaching hospital: A case series","authors":"Tyler Wheeler,&nbsp;Sarayu Vasan","doi":"10.1016/j.psycr.2023.100190","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100190","url":null,"abstract":"<div><h3>Background</h3><p>Delirious mania (DM) is a serious and poorly understood neuropsychiatric syndrome with features of mania, delirium, catatonia, and psychosis. Although it was first described in the 1800s, there is no consensus on nosology or diagnostic criteria, exacerbating challenges in detection and treatment. DM is sometimes viewed as a subtype of mania, while others consider it to be a separate entity. There appears to also be a relationship between DM and catatonia, and DM has similarly been responsive to treatment with benzodiazepines and electroconvulsive therapy (ECT). The literature surrounding DM is limited largely to case studies.</p></div><div><h3>Objective</h3><p>We present two cases of DM observed and treated in a community-based inpatient psychiatric unit to further add to the available literature on this challenging and severe neuropsychiatric syndrome.</p></div><div><h3>Discussion</h3><p>Diagnosis of DM was complicated by lack of consensus diagnostic criteria; however, both patients displayed symptomatology consistent with the descriptions of DM put forward in the literature. Given the extensive differential diagnosis for DM, consideration was given to a variety of etiologies, including medical, neurological, and toxicological. Clinical severity throughout each patient's hospital course was assessed using Confusion Assessment Method Severity (CAM-S) and Clinical Global Impressions Severity (CGI-S) scales for each day of admission. Signs and symptoms consistent with delirium and catatonia were also displayed by each patient during their hospital course. In each case, the patients were treated with a combination of antipsychotics, mood stabilizers, and benzodiazepines. We posit that this is an effective treatment regimen in cases of DM with catatonia in which ECT is not accessible.</p></div><div><h3>Conclusion</h3><p>DM is a serious and likely under-recognized clinical phenomenon. A combination of antipsychotics, mood stabilizers, and benzodiazepines may be an effective treatment regimen in DM cases with catatonia where administration of ECT is not possible. Development of a consensus diagnostic criteria is needed to expand research into the management of DM.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021223000883/pdfft?md5=199b226ea6d393ddbdf947970f3bea70&pid=1-s2.0-S2773021223000883-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91956906","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":"Twins with psychiatric features and a nonsense HRAS variant affecting transcript processing","authors":"Andrea Accogli ,&nbsp;Meagan L. Collins Hutchinson ,&nbsp;Eric Krochmalnek ,&nbsp;Judith St-Onge ,&nbsp;Nassima Boudrahem-Addour ,&nbsp;Jean-Baptiste Rivière ,&nbsp;Ridha Joober ,&nbsp;Myriam Srour ,&nbsp;Yannis Trakadis","doi":"10.1016/j.psycr.2023.100189","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100189","url":null,"abstract":"<div><h3>Background</h3><p>Heterozygous germline variants in <em>HRAS</em> can lead to RASopathies, a group of disorders caused by gain-of-function variants in several components and modulators of the Ras-MAPK pathway. Recently, different missense variants, indels and a frameshift variant, have been associated with attenuated or distinctive phenotypes, suggesting a wider clinical spectrum.</p></div><div><h3>Case presentation</h3><p>We report a pair of twins with shared distinctive features, including mild intellectual disability, anxiety, psychosis, dysmorphism, short stature, early hair loss, vitamin D deficiency, osteopenia and hematuria, harboring a novel <em>de novo</em> nonsense variant in <em>HRAS</em>. Targeted RNA-sequencing demonstrates that this variant affects splicing.</p></div><div><h3>Conclusion</h3><p>Our report provides evidence that variants affecting transcript processing in <em>HRAS</em> may lead to an attenuated phenotype associated with neuropsychiatric features. Further studies are needed to fully understand the mechanism and phenotypic variability.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021223000871/pdfft?md5=6653b87fab6b8d7bb766adfb2686d174&pid=1-s2.0-S2773021223000871-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92019528","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":"Intranasal esketamine as tool for rapid cycling bipolar disorder: A case report of successful mood stabilization","authors":"Giacomo d'Andrea ,&nbsp;Ornella di Marco ,&nbsp;Francesco Maria Semeraro ,&nbsp;Rosalba Carullo ,&nbsp;Stefano L. Sensi ,&nbsp;Mauro Pettorruso ,&nbsp;Giovanni Martinotti","doi":"10.1016/j.psycr.2023.100188","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100188","url":null,"abstract":"<div><p>Rapid Cyclic Bipolar Disorder (RCBD) is a debilitating condition that manifests as four or more episodes of depression, mania, or hypomania in a span of one year, with depression being the predominant event. RCBD is prevalent among individuals diagnosed with bipolar disorder and is associated with elevated suicide risk, prolonged disease duration, unfavorable clinical outcomes, and cognitive decline. The treatment of RCBD is challenging, owing to the poor response to lithium and other conventional treatments for bipolar disorder and the possibility of exacerbating rapid-cycling oscillations during depressive phases with the use of antidepressant therapies. Esketamine Nasal Spray (ESK-NS) has been approved for the treatment of Treatment-Resistant Depression but its application in the context of RCBD is limited and unknown. This study presents the case of a 56-year-old male diagnosed with RCBD who received ESK-NS treatment during a depressive episode and was followed up for 18 months. During the observation period, the subject exhibited a significant mood stabilization, with only a transient depressive episode observed during a three-month period of cessation of ESK-NS treatment, which promptly resolved upon reinstating ESK-NS therapy. Mild dissociative symptoms were observed during the initial doses of ESK-NS administration, but no other significant adverse events were reported. This case report provides initial evidence for the potential utilization of ESK-NS in the treatment of RCBD, supporting the hypothesis of an additional mood-stabilizing effect.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49814929","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 case series of manic delirium: Life saving treatment for patients in rural areas","authors":"Benjamin Kopec ,&nbsp;Kelly Ridley","doi":"10.1016/j.psycr.2023.100187","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100187","url":null,"abstract":"<div><h3>Introduction</h3><p>Manic delirium is an ill-defined, but serious diagnosis. It is a complex neuropsychiatric syndrome outlined by acute mania with features of delirium not caused by other illness. Research suggests electroconvulsive therapy (ECT) is the gold standard treatment, however this proves difficult in rural locations.</p></div><div><h3>Methods</h3><p>We describe the cases of four patients with manic delirium admitted to a rural inpatient psychiatric unit between October 2020 and May 2022.</p></div><div><h3>Results</h3><p>All four patients experienced symptoms of mania and delirium, complicated by urinary retention and reduced oral intake requiring ECT. Symptoms of delirium resolved faster than mania with full resolution of manic delirium occurring within twelve sessions of ECT.</p></div><div><h3>Conclusion</h3><p>ECT was the definitive treatment in all cases following poor response to medication. Access to ECT should be a priority for rural health services to improve the care of patients with severe mental illness.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773021223000858/pdfft?md5=8cdd6611020544a7e651c1516e6aeb39&pid=1-s2.0-S2773021223000858-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92019529","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 of possible stiff person syndrome (SPS) / Progressive encephalomyelitis with rigidity and myoclonus (PERM) misclassified as catatonia","authors":"Mallory Kane ,&nbsp;Anika Makol ,&nbsp;Gregory Gerety ,&nbsp;Alicia Lipscomb ,&nbsp;Bharat Narapareddy","doi":"10.1016/j.psycr.2023.100186","DOIUrl":"https://doi.org/10.1016/j.psycr.2023.100186","url":null,"abstract":"<div><p>Stiff person syndrome (SPS) is a rare neurological disorder manifesting as profound stiffness and rigidity. It is believed to be caused by autoantibodies against antigens involved in the synthesis and release of Gamma-aminobutyric acid (GABA) – a major inhibitory neurotransmitter of the central nervous system (CNS). Progressive encephalomyelitis with rigidity and myoclonus (PERM), also known as SPS-plus syndrome, has more extensive involvement of the CNS and autonomic nervous system. Diagnosis of SPS has become largely reliant on the detection of antibodies in the serum and CSF. However, existing literature suggests that up to one third of cases of SPS have no known antibody positivity. This case report describes a presentation of presumed antibody negative SPS which was initially misclassified as catatonia. It aims to highlight the need for improved diagnostic criteria and increased recognition of SPS, as many patients with this syndrome live disabled for years before they are diagnosed and treated.</p></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"2 2","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49814927","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":"Durable response to electroconvulsive therapy with atypical electrode placement in a post-middle cerebral artery stroke patient","authors":"Melanie Marcille ,&nbsp;Michael Jayson ,&nbsp;Kevin Putinta ,&nbsp;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 ,&nbsp;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 ,&nbsp;Allison Watkins ,&nbsp;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}