Case Reports in Psychiatry最新文献_第7页

Self-Evisceration of Intestines as the Initial Presentation of Schizoaffective Disorder. 自我内脏切除是分裂情感性障碍的初始表现。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/4334552

Stephanie Hamlin, Dana L Sharma, Anita S Kablinger

{"title":"Self-Evisceration of Intestines as the Initial Presentation of Schizoaffective Disorder.","authors":"Stephanie Hamlin, Dana L Sharma, Anita S Kablinger","doi":"10.1155/2023/4334552","DOIUrl":"https://doi.org/10.1155/2023/4334552","url":null,"abstract":"Schizoaffective disorder is categorized by major mood episodes and symptoms of schizophrenia that include disorganized speech, delusions, paranoia, and hallucinations. It is associated with risk factors, including a history of abuse and cannabis use, and patients are typically diagnosed in adolescence and young adulthood. In this case report, we describe the unusual case of a 39-year-old male patient with undiagnosed schizoaffective disorder who self-eviscerated his intestines during an episode of psychosis. He received an emergent exploratory laparotomy with a partial colectomy. After medical stabilization and reorientation, the patient recalled a 10-year history of paranoia associated with significant cannabis use, despite otherwise functioning appropriately in society. During a two-week hospital course, his paranoia and hallucinations were remitted on olanzapine and valproic acid. In addition to discussing his presentation and recollection of the incident, we also discuss similar cases of self-mutilation in nonsuicidal patients and the relationship between cannabis use and schizophrenia spectrum disorders.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"4334552"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9164423","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

Oculogyric Crisis after Initiation of Aripiprazole: A Case Report of an Active Duty Service Member. 阿立哌唑开始使用后的眼科危机:一名现役军人的病例报告。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/9440028

Nicole L Hadler, Yevin A Roh, David A Nissan

{"title":"Oculogyric Crisis after Initiation of Aripiprazole: A Case Report of an Active Duty Service Member.","authors":"Nicole L Hadler, Yevin A Roh, David A Nissan","doi":"10.1155/2023/9440028","DOIUrl":"https://doi.org/10.1155/2023/9440028","url":null,"abstract":"Introduction: Oculogyric crisis is an acute dystonic reaction characterized by sustained, bilateral, and upward deviation of the eyes. It is a relatively uncommon extrapyramidal side effect of antipsychotic medications. Aripiprazole is an atypical antipsychotic that is FDA-approved for the treatment of schizophrenia, bipolar disorder, Tourette's disorder, and treatment resistant major depressive disorder. Compared to other antipsychotics, it is thought to have a lower propensity for causing dystonic side effects. Clinical Case. This case report is of a 19-year-old male who was psychiatrically hospitalized for first episode psychosis and initiated on low-dose oral aripiprazole. Three days after initiation of the medication, the patient was found to be markedly anxious and pacing around his room. Exam was notable for intermittent upward eye rolling, sustained upward conjugate gaze, and limited downward gaze. No other facial dyskinetic movements were observed. Treatment. The patient's oral aripiprazole was held, and he was administered 50 mg of oral diphenhydramine with improvement in symptoms within one hour. Ocular symptoms, dizziness, frontal headache, and pacing were resolved the following morning. He declined reinitiation of an antipsychotic medication.Conclusion: Aripiprazole-induced acute dystonia, specifically OGC, is a rare potential adverse effect of aripiprazole. Risk factors include male gender, young age, use of typical antipsychotics, and initiation or uptitration of an antipsychotic. Even though atypical antipsychotics including aripiprazole are associated with lower risk for extrapyramidal symptoms, the possibility of oculogyric dystonia merits close monitoring especially in young, male, and drug naive patients. Anticholinergic agents such as diphenhydramine can treat symptoms of acute dystonia.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"9440028"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10544815","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: 3

False-Positive Phencyclidine (PCP) Result on 11-Panel Urine Drug Screen (UDS) in a 17-Year-Old Adolescent with Long-Term Venlafaxine Use. 长期使用文拉法辛的17岁青少年11组尿药物筛查(UDS)假阳性苯环利定(PCP)结果。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/6666197

Hyun Sue Kim, Aakash Jain, Anita S Kablinger

引用次数: 0

Postictal Psychosis: Case Report and Literature Review. 后置精神病:个案报告及文献回顾。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/7960227

Joana Regala, João Lourenço, Francisco Moniz-Pereira, António Bento

引用次数: 0

Occurrence of Terrifying Nightmares after Few Days of Mirtazapine Use in Elderly Patients. 老年患者使用米氮平数日后恐怖噩梦的发生。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/8843206

Liliana Dell'Osso, Primo Lorenzi, Benedetta Nardi, Barbara Carpita, Francesca Benedetti, Ivan Mirko Cremone

{"title":"Occurrence of Terrifying Nightmares after Few Days of Mirtazapine Use in Elderly Patients.","authors":"Liliana Dell'Osso, Primo Lorenzi, Benedetta Nardi, Barbara Carpita, Francesca Benedetti, Ivan Mirko Cremone","doi":"10.1155/2023/8843206","DOIUrl":"https://doi.org/10.1155/2023/8843206","url":null,"abstract":"Introduction. Sleep disturbance and insomnia are some of the most frequent complaints in patients suffering from depression. Some common antidepressant with excitatory effects may worsen sleep qualities, whereas others (like mirtazapine), thanks to their antihistaminergic action, are associated with sedative properties and can quickly improve sleep quality. In the case of mirtazapine, even if its mechanisms of action on sleep remain controversial, beneficial changes in sleep pattern may be observable since the first dose and are associated with a faster onset of the antidepressive action. Case Presentation. Despite these documented beneficial effects, we reported five cases of elderly patients (age ranging from 69 to 79) with various diagnoses and comorbidities (severe or recurrent depression, general anxiety disorder, borderline personality disorder, and Parkinson's disease) assessed during clinical daily routine for whom the use of mirtazapine was linked to the onset of nightmares so impressive and dramatic that made it necessary to interrupt the treatment. Discussion. This peculiar side effect is still scarcely documented, and the literature on this topic remains conflicting; however, considering that the cases were collected in a short range of time, the exacerbation of nightmares caused by mirtazapine may be more frequent than previously believed. Furthermore, some common features shared by all the cases reported have been highlighted such as the onset of the nightmares being chronologically associated with the initiation of the therapy with mirtazapine, the disappearance with the interruption, the similar age range of all, and the occurrence of the episodes described during fall season.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"8843206"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9305495","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: 1

Loxapine in the Treatment of Manic and Psychotic Symptoms in an Individual Intolerant to Multiple Mood-Stabilizing and Antipsychotic Medications. 洛沙平治疗对多种情绪稳定和抗精神病药物不耐受的个体躁狂和精神病症状

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/8887553

David S Im, Marina Capitanov, Amy M VandenBerg

{"title":"Loxapine in the Treatment of Manic and Psychotic Symptoms in an Individual Intolerant to Multiple Mood-Stabilizing and Antipsychotic Medications.","authors":"David S Im, Marina Capitanov, Amy M VandenBerg","doi":"10.1155/2023/8887553","DOIUrl":"https://doi.org/10.1155/2023/8887553","url":null,"abstract":"First-line treatments for schizophrenia and schizoaffective disorder include antipsychotics and mood stabilizers, but their use may at times be limited due to severe adverse events. This case describes a 41-year-old male with a history of schizoaffective disorder and polysubstance use who was admitted to an inpatient psychiatry unit for acute manic and psychotic symptoms in the setting of absconding from his residential home and noncompliance with prescribed psychiatric medications. During his inpatient psychiatric hospitalization, he experienced DRESS (drug reaction with eosinophilia and systemic symptoms) with valproate, nephrogenic diabetes insipidus with lithium, potential neuroleptic malignant syndrome with risperidone, and orthostasis/tachycardia with clozapine. He ultimately achieved stabilization of manic and psychotic symptoms with loxapine without experiencing adverse events. This report highlights the potential utility of loxapine in individuals with schizoaffective disorder intolerant to standard mood-stabilizing and antipsychotic medications.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"8887553"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018420","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: 1

Misdiagnosis of Psychosis and Obsessive-Compulsive Disorder in a Young Patient with Autism Spectrum Disorder. 年轻自闭症谱系障碍患者精神病和强迫症的误诊。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/7705913

Jiangbo Ying, Melvyn Weibin Zhang, Sreedharan Geetha Sajith, Giles Ming-Yee Tan, Ker-Chiah Wei

{"title":"Misdiagnosis of Psychosis and Obsessive-Compulsive Disorder in a Young Patient with Autism Spectrum Disorder.","authors":"Jiangbo Ying, Melvyn Weibin Zhang, Sreedharan Geetha Sajith, Giles Ming-Yee Tan, Ker-Chiah Wei","doi":"10.1155/2023/7705913","DOIUrl":"https://doi.org/10.1155/2023/7705913","url":null,"abstract":"Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction and the presence of restricted and repetitive patterns of behavior. Making a first diagnosis of ASD in adults has certain difficulties, including inaccurate recall of developmental history and overlapping behaviors with other psychiatric conditions. This case study presents a young man who was assessed to have no major mental illness during his first visit to emergency services in a psychiatric hospital. During his second visit, he was initially assessed to have first episode psychosis, due to his possible delusional beliefs related to the insurance payout, social withdrawal, and strange behaviors, and then later he was assessed to have obsessive-compulsive disorder (OCD) instead of psychosis, because of his recurrent and intrusive thoughts. Eventually, his diagnosis was revised to ASD during outpatient follow-up after more comprehensive assessment. It is not easy to differentiate ASD from psychosis among some adult patients, even for expert psychiatrists. Cognitive rigidity in ASD may be similar to delusions in psychosis. Unusual behaviors in ASD can be confused with disorganized behaviors in psychosis. Differentiating ASD from OCD can be a complicated task as well, due to similarities between ASD and OCD. Restricted interests and repetitive behaviors in ASD may be perceived as obsessions and compulsions in OCD. Overall, diagnosis of ASD in adults requires comprehensive evaluation. Distinguishing symptoms of OCD and psychosis from autistic traits is critical for accurate diagnosis and optimal treatment. Although research in adult ASD has expanded alongside increased prevalence statistics over the past few years, more efforts to enhance the diagnostic processes in adult ASD are needed to reduce the challenges in this field.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"7705913"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9943599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769507","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: 1

The Use of Lisdexamfetamine to Treat ADHD in a Patient with Stimulant (Methamphetamine) Use Disorder. 利地安非他明治疗兴奋剂(甲基苯丙胺)使用障碍患者的ADHD。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/5574677

J Levine, H Swanson

{"title":"The Use of Lisdexamfetamine to Treat ADHD in a Patient with Stimulant (Methamphetamine) Use Disorder.","authors":"J Levine, H Swanson","doi":"10.1155/2023/5574677","DOIUrl":"https://doi.org/10.1155/2023/5574677","url":null,"abstract":"Introduction: The treatment of attention deficit hyperactivity disorder (ADHD) with stimulants among patients with stimulant use disorder carries concern for efficacy and exacerbation of addictive behaviors. Lisdexamfetamine is a unique stimulant used to treat ADHD with a lower abuse potential compared to other stimulants, as the medication is the only prodrug in its class. To our knowledge, there are no reports in the literature of the use of lisdexamfetamine to treat ADHD in patients with stimulant use disorder.Methods: We present a 33-year-old male with a history of stimulant (methamphetamine) use disorder, who was found to have long-standing ADHD. The patient was treated with lisdexamfetamine 30 mg, which was increased and sustained at 40 mg.Results: The patient reported significant improvement in focus, concentration, calmness, organization of thoughts, and less of a tendency to procrastinate. Additionally, he denied exacerbation of anxiety or sleep disturbances. He reported his cravings for stimulants were significantly decreased. After 2 months of treatment, he had moved out from his sober living facility, started a new job, and gained a promotion. He had no use of illicit substances, which was proven by routine urine drug screens.Conclusion: Our patient's ADHD was successfully treated with lisdexamfetamine. Not only did the patient's ADHD symptoms improve, but his cravings for stimulants were relieved. ADHD is common among patients with stimulant use disorder. Patients with ADHD and stimulant use disorder should not necessarily forgo pharmacologic treatment with stimulants for concerns of abuse. Due to its unique pharmacokinetic profile, lisdexamfetamine is a feasible treatment for patients with ADHD and a history of stimulant use disorder.","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"5574677"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10442178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10414377","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: 1

A Manualized Behavioral Therapy Intervention for Youth with Autism Spectrum Disorder and Substance Use Disorder. 青少年自闭症谱系障碍和物质使用障碍的行为干预。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/8998160

James McKowen, Amy Berger, Joshua Towbin, Amy M Yule, Diana Woodward, Lisa Nowinski, Gina Forchelli, Robert J Meyers, Gagan Joshi, Timothy E Wilens

引用次数: 1

Cushing's Disease Presenting with Functional Neurological (Conversion) Disorder. 库欣氏病表现为功能性神经(转换)障碍。

Case Reports in Psychiatry Pub Date : 2023-01-01 DOI: 10.1155/2023/1662271

Sahar Ashrafzadeh, Maria Theresa Mariano, Saba Syed

引用次数: 2