Case Reports in Psychiatry最新文献

{"title":"Substance Abuse, Depression, and Social Anxiety: Case Study and Application of Cognitive Psychotherapy.","authors":"Feda Abu Al-Khair","doi":"10.1155/2023/3430636","DOIUrl":"https://doi.org/10.1155/2023/3430636","url":null,"abstract":"<p><p>A 20-year-old male was referred by a psychiatrist to the clinic for treatment. He was diagnosed with social anxiety disorder (SAD), depression, and substances abuse. He complained of depressive mood and severe anxiety symptoms. These symptoms are triggered in social situations, as well as when talking to others, being in public areas, and going to malls or any crowded places. Because of his symptoms, he avoided getting into the situation, which affected his daily life. The patient was diagnosed with SAD, major depression, and substance abuse and underwent 20 separate sessions of cognitive behavioral therapy (CBT). The application of CBT led to a decrease in the number of anxiety attacks and angry outbursts that the patient suffers from. It also helped him learn some techniques to use in his interactions within the society, as well as other techniques, such as cognitive reorganization of dysfunctional thoughts, and gradually exposed him to the social situations. He also learned to practice some relaxation techniques, to teach him integration in social situations and confrontation instead of avoidance.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"3430636"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10020145","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":"Premature Ejaculation after Lithium Treatment in a Patient with Bipolar Disorder.","authors":"Pedro Amadeu Almeida,&nbsp;Filipa Caldas,&nbsp;Inês Homem de Melo,&nbsp;Ana Maria Moreira,&nbsp;Gustavo França Santos","doi":"10.1155/2023/6156023","DOIUrl":"https://doi.org/10.1155/2023/6156023","url":null,"abstract":"<p><p>Lithium has proven its efficacy in treating bipolar disorder. Severe side effects caused by lithium, including renal and endocrine outcomes, have already been amply documented. The impact of lithium on sexual function, however, is less well known. A 33-year-old man, with no past medical history, diagnosed with bipolar disorder, developed premature ejaculation after short-term use of lithium. The dose of lithium was reduced, leading to a rapid clinical resolution. Retrospectively, lithium-induced premature ejaculation was deemed the most likely diagnosis. Premature ejaculation is a rare side effect of lithium. Changing the time of medication administration and lowering dose could be considered as alternatives. Given lithium's pharmacological profile, it is likely that the pathophysiologic mechanism behind premature ejaculation is altered levels or altered serotonin receptor sensitivity in the ejaculatory modulating centers of the central nervous system. Given the reluctance to spontaneously report sexual adverse effects, clinicians should be aware of this possible side effect.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"6156023"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9114879","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":"Catatonia, Pregnancy, and Electroconvulsive Therapy (ECT).","authors":"Khushbu Gandhi,&nbsp;KieuHanh Nguyen,&nbsp;Maggie Driscoll,&nbsp;Zahid Islam,&nbsp;Siddhartha Maru","doi":"10.1155/2023/9601642","DOIUrl":"https://doi.org/10.1155/2023/9601642","url":null,"abstract":"<p><strong>Background: </strong>Catatonia is a neuropsychiatric syndrome, which typically occurs in the context of another psychiatric or medical condition, with a significant morbidity and mortality risk. Significant medical conditions resulting from catatonia include nutritional deficiencies, skin ulcerations, electrolyte disturbances, aspiration pneumonia, and venous thromboembolism. As a result, prompt treatment is required. Gold standard treatment consists of benzodiazepines, followed by electroconvulsive therapy (ECT) if pharmacotherapy alone is ineffective. With pregnancy and catatonia, there is a high risk of adverse maternal/fetal outcomes, and the risks/benefits of treatment must be carefully considered.</p><p><strong>Case: </strong>Here, we present a case of a young pregnant woman with schizoaffective disorder whose catatonic state was not successfully resolved with lorazepam, therefore requiring ECT. Patient presented to the emergency department at 20 weeks of pregnancy, displaying symptoms of catatonia and psychosis. She was admitted to the inpatient behavioral health unit, where she was treated with lorazepam for catatonia. Treatment occurred in close collaboration with the obstetrics team. While initially, the patient appeared to have a positive response to lorazepam, she became increasingly catatonic with minimal oral intake, mutism, and urinary retention. As a result, she was transferred to the medical floor, where ECT was initiated due to the ineffectiveness of lorazepam. Her catatonia was successfully resolved with 12 total treatments of ECT; there were no adverse effects to the fetus. Patient delivered her baby at 39 weeks with no complications. She continued to receive inpatient psychiatric care until she was stable for discharge to an extended acute care unit.</p><p><strong>Objectives: </strong>In this report, we will review relevant literature on catatonia in pregnancy, with focus on treatment with ECT.</p><p><strong>Conclusions: </strong>Though the literature on these topics is limited and typically presented in case reports format, there appears to be a favorable view toward the use of ECT for pregnant catatonic patients. This case could be considered a vital contribution to the literature, as it provides a successful example of treating catatonia in pregnancy with no known adverse effects to the mother or child.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"9601642"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9828934","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":"Delirium with Concurrent Use of Lithium and ECT and the Safety Implications: Case Reports and Review of the Literature.","authors":"Mustafa Ali,&nbsp;Barikar C Malathesh,&nbsp;Seshadri Sekhar Chatterjee,&nbsp;Soumitra Das,&nbsp;Prakriti Pokhrel,&nbsp;Mary Elizabeth Trejo Hernandez,&nbsp;John C Murnin","doi":"10.1155/2023/9117292","DOIUrl":"https://doi.org/10.1155/2023/9117292","url":null,"abstract":"<p><p>Using electroconvulsive treatment and lithium together to treat acute manic episodes is common, but the effects of combining these therapies vary according to the literature. Some studies have found severe adverse side effects, while others have found the combination of both medications safe and helpful. To investigate potential adverse side effects, this study reports on two cases where bipolar affective disorder patients developed delirium after receiving electroconvulsive therapy and lithium concurrently. The delirium was attributed only to the combined administration of these medicines after ruling out other potential causes. Additionally, alterations in blood-brain barrier permeability, such as those caused by electroconvulsive therapy and age, increased the likelihood of delirium. As a result, caution should be taken when using this combination of medicines, especially in those predisposed to delirium. This study established links between these medications and adverse effects, such as delirium. Further research is necessary to determine the efficacy and risks of combining these medications, establish causality, and develop prevention strategies.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"9117292"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10188255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9484347","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":"Recurrent Catatonia due to Episodic Obsessive-Compulsive Disorder.","authors":"Soumitra Das, Sakshi Prasad, Palak Atul Fichadia, Abhigan Babu Shrestha, Ozge C Amuk Williams, Anil Bachu","doi":"10.1155/2022/2022474","DOIUrl":"10.1155/2022/2022474","url":null,"abstract":"<p><strong>Background: </strong>Catatonia is regarded as a diverse type of motor dysregulation syndrome that includes mutism, immobility, catalepsy, negativism, stereotypies, and echo phenomena. Catatonia is known to coexist with a wide range of physical and mental health conditions, including mood disorders, schizophrenia, autoimmune disorders, and metabolic abnormalities. Albeit, the association between obsessive-compulsive disorder (OCD) and catatonia is underreported, and mechanisms are not well elucidated. <i>Study</i>. In this study, we present a case of a 36-year-old woman who developed episodes of catatonia during the course of her obsessive-compulsive disorder (OCD). Success rates have been recorded with both benzodiazepines and electroconvulsive therapy (ECT). Gauging the severity of her symptoms and poor drug compliance, the patient was opted for and successfully treated with ECT. She was also educated about OCD through a series of therapy sessions and exposure and response prevention (ERP) principles. She was maintained on ERP and adjunctive clonazepam upon discharge. On subsequent follow-ups, the patient seemed to be doing well and was eager to begin her job again.</p><p><strong>Conclusion: </strong>Our study shows a possible link between OCD and catatonia. Additionally, robust studies are needed in order to determine the pathophysiology of catatonia and the mechanism of ECT so that more beneficial therapeutics can be developed. A combination of ECT and antidepressants with ERP therapy for recurrent catatonia with OCD could be effective as a therapeutic modality.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":" ","pages":"2022474"},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9681564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40722276","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":"Comorbid Major Depressive Disorder and Obstructive Sleep Apnea.","authors":"Chotiman Chinvararak,&nbsp;Diego Garcia-Borreguero","doi":"10.1155/2022/2943059","DOIUrl":"https://doi.org/10.1155/2022/2943059","url":null,"abstract":"<p><strong>Introduction: </strong>Major depressive disorder (MDD) and obstructive sleep apnoea (OSA) are prevalent in the general population. Moreover, early studies found that the two conditions are associated bidirectionally and lead to poor health outcomes. The prevalence of comorbid MDD in OSA patients could be as high as two-thirds. A sedentary lifestyle and psychological stress in the globalisation age may increase the risk of MDD and OSA.</p><p><strong>Method: </strong>We reported a case of an MDD patient with OSA as well as discussed the assessment method and also reviewed the treatment of both conditions. We aimed to raise awareness for psychiatrists to differentiate other medical conditions when the symptomatology of MDD is atypical and unresponsive to standard psychiatric treatment.</p><p><strong>Conclusion: </strong>Early detection and effective treatment for MDD and OSA are essential to achieve patient outcomes. Furthermore, it can reduce complications from both conditions. Therefore, a comprehensive evaluation should be made to determine the diagnoses when physicians suspect overlapping MDD and OSA.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":" ","pages":"2943059"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9643066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478925","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":"Secondary Psychosis Following Neoadjuvant AC-T Chemotherapy for Triple-Negative Breast Cancer: Case Report and Literature Review of Psychosis Postchemotherapy.","authors":"Sultan Alshehri,&nbsp;Hatem Assiri,&nbsp;Moayyad Alsalem,&nbsp;Majed A Alharbi","doi":"10.1155/2022/4939219","DOIUrl":"https://doi.org/10.1155/2022/4939219","url":null,"abstract":"<p><p>Triple-negative breast cancer is a unique subtype among breast cancers. Management includes a neoadjuvant chemotherapy regimen. Psychiatric complications of the regimen have not been reported before. We present a case of acute psychosis after the second cycle of chemotherapy in a 42-year-old woman with triple-negative breast cancer. The patient presented with sudden irritability, agitation, disorganization in speech and behavior, and paranoia involving her coworkers conspiring against her and causing her trouble with the law for 4 days. She was in her usual state of health until after her second cycle of chemotherapy. This was the first presentation of psychotic symptoms in her life. She was conscious and oriented. There were no neurologic deficits. She denied any change in her mood and any features of hallucinations. She was uncooperative, restless, had flight of ideas, and persecutory delusions. The remainder of the examination was normal. An autoimmune process, nervous system infection, or psychosis secondary to the chemotherapy were suspected. Serum electrolytes and other biochemical parameters were normal. Imaging of the brain showed no signs of acute brain insults or intracranial metastasis. Cerebrospinal fluid analysis and culture showed no abnormality or growth. The work-up revealed that neurologic, infectious, or autoimmune causes of her psychotic symptoms were less likely. Thus, a diagnosis of psychosis secondary to chemotherapy was considered. Treatment was with paliperidone, risperidone, clonazepam, and sertraline. Over the course of treatment, she showed substantial improvement and completed all of the chemotherapy sessions without adverse effects. In summary, we report a case of a patient whose initial chemotherapy course was complicated by psychosis. Since the neurotoxic and psychiatric effects of chemotherapeutics are not yet sufficiently elucidated, our case emphasizes that early signs of behavioral changes in patients receiving chemotherapy should trigger comprehensive psychiatric evaluation and monitoring of the patient's mental state.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":" ","pages":"4939219"},"PeriodicalIF":0.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40449665","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":"Meditation: A Double-Edged Sword-A Case Report of Psychosis Associated with Excessive Unguided Meditation.","authors":"Sripathi Santhosh Goud","doi":"10.1155/2022/2661824","DOIUrl":"10.1155/2022/2661824","url":null,"abstract":"<p><p>Meditation is gaining a lot of popularity nowadays because of the associated benefits on both mental and physical health. There is ample literature available on the benefits of meditation. However, there are cases of psychosis reported sporadically in individuals who indulge in excessive unguided meditation. Herein, we report a patient who presented with schizophrenia after doing excessive meditation.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":" ","pages":"2661824"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9617715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40460026","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 Medical Resident with a History of Alcohol Abuse and Suicidal Ideation: A Challenge for Both Psychiatry and Occupational Medicine in the Context of the First Wave of the COVID-19 Pandemic.","authors":"Martina Corsi,&nbsp;Antonello Veltri,&nbsp;Salvio Perretta,&nbsp;Riccardo Marino,&nbsp;Gabriele Necciari,&nbsp;Fabrizio Caldi,&nbsp;Rudy Foddis,&nbsp;Alfonso Cristaudo,&nbsp;Rodolfo Buselli,&nbsp;Giovanni Guglielmi","doi":"10.1155/2022/7396453","DOIUrl":"https://doi.org/10.1155/2022/7396453","url":null,"abstract":"<p><p>This case study draws attention to the hazards of physicians with a history of alcohol addiction and a particular psychopathology framework in the context of occupational health surveillance, particularly during the challenging working conditions brought about by the COVID-19 pandemic. The case involves a hospital resident in her thirties, with a previous history of addiction and attempts at suicide, who was assigned to a COVID-19 unit of an Italian hospital. In this case study, we discuss the preventive intervention put in place in order to protect physicians' health and work. What emerges is the key role that rapid substantive communications between specialists play in formulating an effective strategy for dealing with these conditions. We believe this case is noteworthy for the lessons that can be learned for tailoring prevention and treatment pathways for health care workers with addiction.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":" ","pages":"7396453"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40650243","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 Misophonia with Risperidone in a Patient with Autism Spectrum Disorder.","authors":"Eric J Pan,&nbsp;Jeremy Weleff,&nbsp;Akhil Anand,&nbsp;Brian S Barnett","doi":"10.1155/2022/3169834","DOIUrl":"https://doi.org/10.1155/2022/3169834","url":null,"abstract":"<p><p>We report the case of a 32-year-old male with autism spectrum disorder (ASD) suffering from severe misophonia. After titrating risperidone to 2 mg twice a day, the patient reported a significant reduction in his symptoms and his Amsterdam misophonia scale-revised (AMISOS-R) score dropped by from 31 to 5. Upon discharge, the patient was noted to have decreased irritability and overall improved behavior and effect. This significant symptomatic improvement was likely not explained by inpatient admission alone or other simultaneous pharmacologic treatments, as the effect was seen during an isolated titration of risperidone with other treatments remaining constant. Although, unfortunately, follow-up findings indicated that the treatment was not curative for the patient, risperidone's potential for treating misophonia may warrant systematic investigation.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":" ","pages":"3169834"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33514346","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}