Case Reports in Psychiatry最新文献_第6页

Managing Recurrent Postictal Worsening of Psychosis in Clozapine-Treated Schizophrenia: A Case Report. 氯氮平治疗的精神分裂症患者精神病复发后恶化的处理：一例报告。

Case Reports in Psychiatry Pub Date : 2026-02-23 eCollection Date: 2026-01-01 DOI: 10.1155/crps/8712049

Rafae Alam, Robert O Cotes, David R Goldsmith

{"title":"Managing Recurrent Postictal Worsening of Psychosis in Clozapine-Treated Schizophrenia: A Case Report.","authors":"Rafae Alam, Robert O Cotes, David R Goldsmith","doi":"10.1155/crps/8712049","DOIUrl":"10.1155/crps/8712049","url":null,"abstract":"Postictal worsening of psychosis can be described as the development or exacerbation of psychotic symptoms following a seizure. Patients on clozapine for treatment-resistant schizophrenia are at an increased risk for seizures and subsequent postictal worsening of psychosis. Because patients with schizophrenia may experience ongoing psychotic symptoms, it may be difficult to appreciate the development of postictal worsening of psychosis in these patients. We present the case of a 49-year-old woman with a longstanding history of schizophrenia treated with clozapine who presented to the emergency department (ED) after experiencing a seizure. In the following days, she and her mother reported an exacerbation of psychotic symptoms, which was ultimately attributed to a postictal worsening of psychosis. She was successfully treated after being prescribed an increased nightly dose of clozapine. This dose was eventually reduced to the usual dose she had been taking prior to the postictal exacerbation of psychosis. We also briefly describe a recurrent episode the patient experienced approximately 1 year later. This case contributes to the literature by offering one potential management strategy for postictal worsening of psychosis in a patient with a primary psychotic disorder.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"8712049"},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282372","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

Compulsory Psychiatric Treatment at Home in the Netherlands: A Case Report. 荷兰家庭强制精神病治疗：一个案例报告。

Case Reports in Psychiatry Pub Date : 2026-02-23 eCollection Date: 2026-01-01 DOI: 10.1155/crps/4088726

D A de Waardt, G A M Widdershoven, M H C M Laan, R Favie, C L Mulder

{"title":"Compulsory Psychiatric Treatment at Home in the Netherlands: A Case Report.","authors":"D A de Waardt, G A M Widdershoven, M H C M Laan, R Favie, C L Mulder","doi":"10.1155/crps/4088726","DOIUrl":"10.1155/crps/4088726","url":null,"abstract":"An important aim of the new mental health act implemented in the Netherlands in 2020 was to shift the focus from hospitalization to treatment. The act provides an option for patients' compulsory treatment at home (CTH). Unlike compulsory community treatment (CCT), which allows mental health workers to hospitalize patients involuntarily if they do not comply with treatment. CTH is not provided elsewhere in the world. This case report concerns a patient who, to avoid hospitalization, received CTH in the form of compulsory medication and was able to recover at home. Retrospectively, she and the mental health team both positively evaluated this use of CTH. The parties involved all concluded that CTH restricted the patient's autonomy less than hospitalization, it did not influence the therapeutic relationship, and the CTH could be delivered in a way that it did not compromise participants' safety. This case report shows that, in some situations, CTH can avoid hospitalization. Care should nonetheless be taken to assess its appropriateness, to discuss any preconditions, and to evaluate the use of compulsory treatment in dialog with the patient and significant others.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"4088726"},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282379","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

Correction to "Exploring Van Gogh Syndrome: A Case Report on Schizoaffective Disorder and Self-Harm". 更正“探索梵高综合症：精神分裂情感性障碍与自残个案报告”。

Case Reports in Psychiatry Pub Date : 2026-02-22 eCollection Date: 2026-01-01 DOI: 10.1155/crps/9865295

引用次数: 0

Autism and Its Lookalikes: A Case Report of a Child Whose Autism Diagnosis No Longer Fit Years Later. 自闭症及其相似之处：一个儿童的自闭症诊断多年后不再适合的病例报告。

Case Reports in Psychiatry Pub Date : 2026-02-09 eCollection Date: 2026-01-01 DOI: 10.1155/crps/8279416

Elizabeth Kim, Ji Su Hong

引用次数: 0

Persistent Tremor in Bipolar Disorder: A Case Report of Idiopathic Parkinson's Disease Superimposed on Lithium and Antipsychotic Effects. 双相情感障碍的持续性震颤：特发性帕金森病叠加锂和抗精神病药物的一例报告。

Case Reports in Psychiatry Pub Date : 2026-02-06 eCollection Date: 2026-01-01 DOI: 10.1155/crps/5580753

Ethan Jetter, Daisy Valle, Diego Nolasco, Brent Carr

{"title":"Persistent Tremor in Bipolar Disorder: A Case Report of Idiopathic Parkinson's Disease Superimposed on Lithium and Antipsychotic Effects.","authors":"Ethan Jetter, Daisy Valle, Diego Nolasco, Brent Carr","doi":"10.1155/crps/5580753","DOIUrl":"10.1155/crps/5580753","url":null,"abstract":"We report a 58-year-old woman with bipolar I disorder on long-term lithium and aripiprazole who developed a progressive asymmetric resting tremor and rigidity. Despite stopping both agents, the tremor persisted for more than a year. Dopamine transporter imaging showed reduced uptake in the left putamen, confirming idiopathic Parkinson's disease (PD) with superimposed drug-induced parkinsonism (DIP). Management included discontinuing lithium, switching aripiprazole to quetiapine to limit motor worsening, and starting carbidopa-levodopa. Motor symptoms improved, but hypomanic symptoms emerged and required psychiatric dose adjustments, while apathy remained prominent. The case illustrates diagnostic overshadowing in bipolar disorder (BD) and highlights two practical lessons. When parkinsonian signs are atypical or persist after medication changes, consider idiopathic PD rather than attributing symptoms to side effects. Care is best delivered through close collaboration between psychiatry and neurology to balance dopaminergic therapy with mood stabilization.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"5580753"},"PeriodicalIF":0.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12878793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140848","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

Clozapine as an Off-Label Treatment for Severe and Treatment-Resistant (Auto-)Aggressive Behavior in a 40-Year-Old Patient With Mild Intellecutal Disability and Borderline Personality Disorder. 氯氮平对40岁轻度智力障碍和边缘型人格障碍患者行为的非严重和治疗抵抗性（自动）攻击标签治疗

Case Reports in Psychiatry Pub Date : 2026-01-31 eCollection Date: 2026-01-01 DOI: 10.1155/crps/9991035

Lukas Zabel, Nathalie Ersek, Andreas B Hofmann, Lena Machetanz, Johannes Kirchebner, Susanne Stübner

{"title":"Clozapine as an Off-Label Treatment for Severe and Treatment-Resistant (Auto-)Aggressive Behavior in a 40-Year-Old Patient With Mild Intellecutal Disability and Borderline Personality Disorder.","authors":"Lukas Zabel, Nathalie Ersek, Andreas B Hofmann, Lena Machetanz, Johannes Kirchebner, Susanne Stübner","doi":"10.1155/crps/9991035","DOIUrl":"10.1155/crps/9991035","url":null,"abstract":"Background: Clozapine has shown to be effective as an off-label treatment for aggressive behavior in patients with borderline personality disorder (BPD) and mild intellectual disability (MID). However, there is a lack of empirical evidence for its efficacy in these patient populations and results are so far heterogeneous.Case presentation: A 40-year-old woman diagnosed with BPD and MID with severe and treatment-resistant aggressive behavior was treated off-label with clozapine. A carefully administered treatment with slow titration led to a significant reduction in self-aggressive behavior and termination of aggressive behavior towards others over a 26-week observation period.Conclusions: Our case highlights the potential efficacy of clozapine as an off-label treatment for severe and treatment-resistant aggressive behavior in patients with combined BPD and MID. Clozapine should be considered as a therapeutic option in severe and complex cases.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"9991035"},"PeriodicalIF":0.0,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12860392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103449","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

Effectiveness of Electroconvulsive Therapy in the Remission of Malignant Catatonia Associated With Schizophrenia: A Case Report. 电休克治疗缓解恶性精神分裂症紧张症的疗效：1例报告。

Case Reports in Psychiatry Pub Date : 2026-01-29 eCollection Date: 2026-01-01 DOI: 10.1155/crps/8478463

Lucas Reis Alves Mota, Joyce Dos Santos Neves, Carolina de Souza Baldin, Gustavo Barros da Silva, Gustavo Bigaton Lovadini, Silvia Cristina Mangini Bocchi

{"title":"Effectiveness of Electroconvulsive Therapy in the Remission of Malignant Catatonia Associated With Schizophrenia: A Case Report.","authors":"Lucas Reis Alves Mota, Joyce Dos Santos Neves, Carolina de Souza Baldin, Gustavo Barros da Silva, Gustavo Bigaton Lovadini, Silvia Cristina Mangini Bocchi","doi":"10.1155/crps/8478463","DOIUrl":"10.1155/crps/8478463","url":null,"abstract":"Despite the robust body of evidence supporting the efficacy and safety of electroconvulsive therapy (ECT) in the treatment of severe psychiatric disorders, this procedure remains at the center of social debate, often influenced by historical prejudice. Such misconceptions have contributed to restricted access, which typically occurs either through costly private practice or in large academic centers within the public health system. Among the clinical conditions for which ECT is considered a first-line treatment, malignant catatonia stands out-a rare and potentially fatal syndrome characterized by psychomotor disturbances and severe autonomic instability. If not treated promptly, its mortality rate may reach up to 50%. This case report describes the successful treatment of malignant catatonia in a patient with schizophrenia, in whom ECT sessions were administered intermittently and without a subsequent maintenance phase during inpatient care at a specialized psychiatric hospital affiliated with the Unified Health System in the state of São Paulo, Brazil. After 10 sessions, there was complete remission of the catatonic state, followed by hospital discharge for outpatient follow-up. After 16 months, the patient maintained psychiatric stability, medication adherence, and partial independence in daily activities, with no new episodes of psychiatric decompensation. The case underscores the effectiveness of ECT in achieving remission of a rare and potentially life-threatening disorder.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"8478463"},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103818","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

Successful Clozapine Rechallenge in a 40-Year-Old Male Patient With Paranoid Schizophrenia After Clozapine-Associated Myocarditis. 40岁男性氯氮平相关性心肌炎后偏执型精神分裂症患者氯氮平再注射成功。

Case Reports in Psychiatry Pub Date : 2026-01-20 eCollection Date: 2026-01-01 DOI: 10.1155/crps/3858403

Lukas Zabel, Nathalie Ersek, Andreas B Hofmann, Lena Machetanz, Johannes Kirchebner, Susanne Stübner

{"title":"Successful Clozapine Rechallenge in a 40-Year-Old Male Patient With Paranoid Schizophrenia After Clozapine-Associated Myocarditis.","authors":"Lukas Zabel, Nathalie Ersek, Andreas B Hofmann, Lena Machetanz, Johannes Kirchebner, Susanne Stübner","doi":"10.1155/crps/3858403","DOIUrl":"10.1155/crps/3858403","url":null,"abstract":"Background: Clozapine-associated myocarditis (CAM) is the most common inflammatory adverse effect under clozapine treatment. In the absence of equally effective therapeutic alternatives for treating treatment-resistant schizophrenia (TRS), clinicians are often faced with the question of whether to rechallenge clozapine in patients who have experienced CAM. However, there is a lack of standardized protocols and published case reports of successful clozapine rechallenge following CAM.Case presentation: A 40-year-old patient diagnosed with paranoid schizophrenia experienced CAM during his first clozapine treatment. Four years later, he was successfully rechallenged using a recently published standardized protocol involving a very slow titration schedule.Conclusions: Our case adds to the limited number of published cases of successful clozapine rechallenge following CAM. It is the first published case report to use the rechallenge protocol recently published by Qubad et al. (2024), thereby contributing to the development of standardized protocols for the safe and successful clozapine rechallenge following CAM.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"3858403"},"PeriodicalIF":0.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017386","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

"Dream Insertion": A Case Report of a Novel Psychotic Symptom in a Male Inpatient With Treatment Resistant Schizophrenia. “梦境插入”：一例难治性精神分裂症住院男性患者的新精神症状报告。

Case Reports in Psychiatry Pub Date : 2026-01-16 eCollection Date: 2026-01-01 DOI: 10.1155/crps/3048932

David Clayton, Sandeep Grover

{"title":"\"Dream Insertion\": A Case Report of a Novel Psychotic Symptom in a Male Inpatient With Treatment Resistant Schizophrenia.","authors":"David Clayton, Sandeep Grover","doi":"10.1155/crps/3048932","DOIUrl":"10.1155/crps/3048932","url":null,"abstract":"Background: Individuals with schizophrenia appear to experience differences in dreaming compared to control populations-the small amounts of research that does exist demonstrates abnormalities such as simpler dreams that are more bizarre and with greater negative content than those of controls. Dream-related psychopathology remains insufficiently described however-particularly experiences in which patients believe their dreams are externally generated or controlled. Such phenomena extend classically described first rank symptoms-such as thought insertion and passivity phenomena-into the domain of sleep mentation. This case presents a patient who describes a delusional belief that an external agent can directly infiltrate his nocturnal state to insert dreams themselves.Case presentation: A 34-year-old male patient with schizophrenia was admitted to the inpatient unit for commencement of clozapine following poor response to multiple antipsychotic agents. While admitted, he described a new delusional belief that a Central Intelligence Agency (CIA) agent was infiltrating his dreams at night and inserting externally created dreams. This symptom did not respond to ongoing clozapine uptitration and community follow-up suggests an ongoing limited response.Conclusions: This patient describes a novel symptom not previously described in the literature to the best of the authors knowledge and neither appears consistent with other commonly described sleep related phenomenon nor first rank symptoms. As such, we use the term \"dream insertion\" to describe the phenomenon noted in the case report and suggest an expanded inquiry into the oneiric effects of schizophrenia to enhance understanding and management of such symptoms.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"3048932"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997565","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

Nuances of Gender Identity for a Transgender Patient Receiving Inpatient Treatment for Paranoid Schizophrenia: A Case Study. 偏执型精神分裂症住院治疗的跨性别患者性别认同的细微差别：个案研究。

Case Reports in Psychiatry Pub Date : 2026-01-11 eCollection Date: 2026-01-01 DOI: 10.1155/crps/5529934

Ravleen Kaur Suri, Kathleen P Heslin, Susan Sperry, Luba Leontieva

{"title":"Nuances of Gender Identity for a Transgender Patient Receiving Inpatient Treatment for Paranoid Schizophrenia: A Case Study.","authors":"Ravleen Kaur Suri, Kathleen P Heslin, Susan Sperry, Luba Leontieva","doi":"10.1155/crps/5529934","DOIUrl":"10.1155/crps/5529934","url":null,"abstract":"Introduction: Nearly one-fourth of individuals diagnosed with schizophrenia may experience symptoms of gender dysphoria. Patients may identify with a gender other than the gender assigned at birth before or after psychotic disorder onset. In either case, the presence of both psychosis and gender dysphoria may complicate evaluation and treatment.Case: We present the case of a 45-year-old patient with a past psychiatric history of paranoid schizophrenia who was assigned male at birth and began to identify as a woman in her youth around the age when her psychosis first developed. During the admission discussed in this report, the patient identified as a man during a period with frank psychotic symptoms but preferred feminine clothing and structured the clothes to create the appearance of female anatomy. Later in admission, as psychosis resolved with pharmacologic treatment, the patient began to identify as a woman and adopted a traditionally feminine name and female-coded dress. Psychiatric assessment, record-gathering, and psychological assessment were completed to better understand her perspective on self and others and the historical context of her symptoms and gender identity.Conclusion: This case highlights the risk of assessing gender identity in patients with active thought disorders. Patients' perspectives on gender and presentation may shift during periods of psychosis compared to periods of remission. Assessment and treatment of gender dysphoria is possible and beneficial in patients with psychotic disorders, but physicians must be cautious about diagnosing and treating gender dysphoria during active psychosis.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2026 ","pages":"5529934"},"PeriodicalIF":0.0,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12791158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145964972","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