Case Reports in Psychiatry最新文献_第3页

Agitated Depression Associated With Flurazepam Discontinuation. 与停用氟西泮有关的躁动抑郁症。

Case Reports in Psychiatry Pub Date : 2024-09-20 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8845349

Mohamed Salih, Reem Mohamed Osman, Wala Alim, Leena Khalid, Wafa Sosal, Danya Ibrahim, Yassir Mahgoub

{"title":"Agitated Depression Associated With Flurazepam Discontinuation.","authors":"Mohamed Salih, Reem Mohamed Osman, Wala Alim, Leena Khalid, Wafa Sosal, Danya Ibrahim, Yassir Mahgoub","doi":"10.1155/2024/8845349","DOIUrl":"https://doi.org/10.1155/2024/8845349","url":null,"abstract":"Agitated depression, also known as melancholia agitata, is a variant of depression characterized by severe symptoms of psychomotor agitation, inner unrest, anxiety, restlessness, prominent vegetative symptoms, and a high risk of suicide. This form of depression is reported to worsen with antidepressants and potentially improve with the use of ECT, lithium, antiepileptics, antipsychotics, and benzodiazepines. We describe a case of a 73-year-old female with a prior history of depression and generalized anxiety disorder who was maintained on flurazepam for 44 years and was admitted for severe depression with psychomotor agitation, prominent vegetative symptoms, thought perseveration, indecisiveness, and psychotic features that emerged following the discontinuation of flurazepam. Symptoms did not resolve with the use of alternative benzodiazepines such as nitrazepam and temazepam and further worsened with the use of several antidepressants. She finally had a complete resolution of these symptoms with a combination of alprazolam, zopiclone, and olanzapine. This case provides insight into this unique variant of depression and the role of GABA agonists in its pathology and management.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2024 ","pages":"8845349"},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342266","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}

引用次数: 0

Conquering Phagophobia: A Journey to Overcoming the Fear of Choking. 战胜窒息恐惧症：克服窒息恐惧的旅程》（Conquering Phagophobia: A Journey to Overcoming the Fear of Choking）。

Case Reports in Psychiatry Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8827460

R Rijal, P Pokhrel

{"title":"Conquering Phagophobia: A Journey to Overcoming the Fear of Choking.","authors":"R Rijal, P Pokhrel","doi":"10.1155/2024/8827460","DOIUrl":"10.1155/2024/8827460","url":null,"abstract":"Phagophobia is a rare and debilitating mental health condition characterized by an intense fear of choking solid food or liquids. Usually there is no underlying anatomical or physiological abnormalities. Choking phobia can lead to the avoidance of solid foods and liquids. This can give rise to other psychiatric disorders like major depressive disorder and anxiety disorder. Only few case reports of choking phobia are available in the literature. Here we present the case of a middle-aged man, with a 10-year history of fear of choking, starting after an aspiration episode and later maintained by a similar episode. The patient felt that food would be stuck in the windpipe, and he could not breathe while swallowing solid food and liquids. This eventually led to reduced eating and drinking causing significant weight loss. He also isolated himself and became depressed. After several searches for help in somatic healthcare, including surgery for deviated nasal septum, the patient was finally investigated in a psychiatric clinic and treated with pharmacological measures and behavioral therapy with considerable improvement within a few months. Choking phobia can mimic different physical conditions and is often misdiagnosed. Early recognition and timely referral to mental health professionals are vital for effective management.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2024 ","pages":"8827460"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119080","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}

引用次数: 0

An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT. 一名接受电痉挛疗法的患者意外出现羟色胺综合征。

Case Reports in Psychiatry Pub Date : 2024-08-23 eCollection Date: 2024-01-01 DOI: 10.1155/2024/6938553

Shahzaib Khan, Breanna Wennberg, Malgorzata Witkowska, Jacob Rattin, Raunak Khisty

{"title":"An Unexpected Presentation of Serotonin Syndrome in a Patient Receiving ECT.","authors":"Shahzaib Khan, Breanna Wennberg, Malgorzata Witkowska, Jacob Rattin, Raunak Khisty","doi":"10.1155/2024/6938553","DOIUrl":"10.1155/2024/6938553","url":null,"abstract":"Serotonin syndrome is a toxidrome consisting of autonomic instability, altered mentation, hyperreflexia, clonus, and seizures. It is suspected to be due to either elevated serotonin concentrations or overstimulation of 5-hydroxytryptamine (5-HT) receptors. There are at least seven families of serotonin or 5-HT receptors along with multiple subtypes. The 5-HT1A and 5-HT2A serotonin receptor subtypes are heavily suspected to cause the broad spectrum of symptoms seen in serotonin syndrome. We present the case of a young woman treated with multiple psychotropic medications who developed serotonin syndrome (SS) after receiving electroconvulsive therapy (ECT). She had multiple psychiatric hospitalizations, and ECT was determined to be the appropriate course of treatment due to her treatment-resistant symptoms and catatonia. The case was unique as she tolerated multiple ECT treatments over a few weeks before the acute onset of serotonin syndrome following her eighth treatment, and she did not have any medication changes after the second ECT treatment. The patient's acute presentation of rigidity, elevated temperature, hyperreflexia, diaphoresis, confusion, and psychomotor agitation led to a diagnosis of serotonin syndrome. ECT is a neuromodulatory procedure approved for treatment-resistant depression and schizophrenia that involves electrically stimulating the brain with electrodes on the scalp to induce a seizure. The mechanism by which ECT confers therapeutic benefit for patients with neuropsychiatric conditions is not entirely understood. We discuss some of the literature on SS and ECT to better understand the potential for a causal relationship.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2024 ","pages":"6938553"},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104723","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}

引用次数: 0

A Case of Personality and Behavioral Changes with Frontotemporal and Cerebellar Atrophy on MRI with Corresponding Hypometabolism on FDG-PET. 一例在核磁共振成像上表现为人格和行为改变，同时伴有额颞叶和小脑萎缩，并在 FDG-PET 上表现为相应的代谢减低。

Case Reports in Psychiatry Pub Date : 2024-08-19 eCollection Date: 2024-01-01 DOI: 10.1155/2024/2863662

Megan Selig, Gloria Lee, Brian Lebowitz, Dinko Franceschi, Nicole Absar

{"title":"A Case of Personality and Behavioral Changes with Frontotemporal and Cerebellar Atrophy on MRI with Corresponding Hypometabolism on FDG-PET.","authors":"Megan Selig, Gloria Lee, Brian Lebowitz, Dinko Franceschi, Nicole Absar","doi":"10.1155/2024/2863662","DOIUrl":"10.1155/2024/2863662","url":null,"abstract":"Background: The differential diagnosis of a patient with cognitive, behavioral, and motor symptoms is broad. There is much overlap between neurocognitive disorders due to frontotemporal dementia and other subcortical dementia. A less known diagnosis, cerebellar cognitive affective syndrome (CCAS), should also be considered. Case History. A 29-year-old female presented with ataxia and left-sided weakness. CSF showed oligoclonal bands, and MRI showed multiple white matter lesions with some atrophy. She was diagnosed with multiple sclerosis (MS). At age 35, she developed frontal lobe symptoms and executive dysfunction; she was diagnosed with MS with bipolar disorder. Neuropsychological evaluation at that time showed significant deficits in multiple cognitive domains. Subsequent MRI showed progressive frontotemporal atrophy, and FDG-PET uncovered hypometabolism in the frontotemporal lobes and cerebellum. At age 38, her behavior worsened with aggression, and she was started on olanzapine. She responded well with decreased agitation and improved motivation and attention. Compared with previous scans, most recent MRI and FDG-PET showed interval increase in cerebellar atrophy with increase in hypometabolism in the cerebellum, respectively.Conclusion: Based on cerebellar, affective, and subcortical cognitive examination findings, our diagnosis is probable CCAS. The cerebellum should be considered as a possible etiology of frontal subcortical cognitive impairment.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2024 ","pages":"2863662"},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072070","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}

引用次数: 0

An Unusual Presentation with Facial Hyperpigmentation on Escalation of the Dose of Sertraline. 增加舍曲林剂量时面部色素沉着的异常表现

Case Reports in Psychiatry Pub Date : 2024-08-07 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7416277

Omkar Dhungel, Indra Prasad Amatya, Pawan Sharma

{"title":"An Unusual Presentation with Facial Hyperpigmentation on Escalation of the Dose of Sertraline.","authors":"Omkar Dhungel, Indra Prasad Amatya, Pawan Sharma","doi":"10.1155/2024/7416277","DOIUrl":"10.1155/2024/7416277","url":null,"abstract":"Background: Hyperpigmentation is a common side effect of different drugs with many of these having a well-explained mechanism and some even having a characteristic distribution. However, it is a rare side effect of sertraline, a selective serotonin reuptake inhibitor (SSRI), with only a few reported cases. In addition, there are no specific characteristics of the lesions or the risk factors. Case Summary. This is a case report of a 24-year-old male with panic disorder, who developed hyperpigmentation over the face after 5 days of increasing the dosage of sertraline to 100 mg/day. There were no other significant findings from the physical examination or investigations. The patient was treated as a case of sertraline-induced hyperpigmentation, and the dose was reduced to 75 mg/day and maintained at 50 mg/day after 1 week along with tablet propranolol 20 mg/day. He was also prescribed tablet tranexamic acid 500 mg/day and sunscreen with sun protection factor 50. The hyperpigmentation disappeared within 2 months, and the medication was gradually tapered after 7 months of treatment.Conclusion: Hyperpigmentation is a rare but distressing side effect of sertraline. It is a potentially curable side effect if recognized early. Early recognition and intervention can decrease unnecessary investigations and treatment. There are limited studies highlighting this unusual adverse effect of this commonly used SSRI. Hence, further studies are needed to better understand various aspects of this condition including the characteristics, patients at risk, and possible management. The development of diagnostic and treatment guidelines would decrease the dilemma of identification and management.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2024 ","pages":"7416277"},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987500","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}

引用次数: 0

Management Challenges and Potential Malabsorption of Valproic Acid in a Patient with Bipolar Disorder and Gastrointestinal History. 双相情感障碍和胃肠道病史患者丙戊酸的管理挑战和潜在吸收不良。

Case Reports in Psychiatry Pub Date : 2024-07-25 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1426930

James Kwok, Janeline Wong, Kye Kim

引用次数: 0

A Case of Phenibut Withdrawal Management and Detoxification Using Baclofen in the Outpatient Setting. 一例在门诊使用巴氯芬进行非尼布汀戒断管理和解毒的病例。

Case Reports in Psychiatry Pub Date : 2024-07-04 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8824770

Emma DiFiore, Julie Pittman

引用次数: 0

Parathyroid Paranoia: Unveiling Psychosis in Hyperparathyroidism. 甲状旁腺妄想症：揭开甲状旁腺功能亢进症的精神病面纱

Case Reports in Psychiatry Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8126125

Rachael J Murphy, Subin Paul, Ralph Primelo