Case Reports in Psychiatry最新文献

{"title":"Serotonin Syndrome with Monotherapy of Low-Dose Sertraline in an Adult Patient with Autism Spectrum Disorder.","authors":"Rohit Madan,&nbsp;Jody Platto,&nbsp;Senthil Rajaram Manoharan,&nbsp;Varun Monga","doi":"10.1155/2023/6610152","DOIUrl":"https://doi.org/10.1155/2023/6610152","url":null,"abstract":"<p><p>Serotonin syndrome, also known as serotonin toxicity, is associated with increased serotonergic activity in the central and the peripheral nervous system. The symptoms can range from mild to potentially life threatening. Given the widespread use of serotonergic agents, the number of cases is on the rise. It is seen with therapeutic medication use, inadvertent interactions between drugs, and intentional self-poisoning, but still known cases with monotherapy of selective serotonin reuptake inhibitors are uncommon. Another known fact is that elevated whole blood serotonin, or hyperserotonemia, is one of the first biomarkers identified in autism spectrum disorder and is present in more than 25% of affected children. We present a case of a 32-year-old male with a history of autism spectrum disorder and depressive disorder who presented to the emergency department with restless agitation, neuromuscular excitability, and autonomic instability. He had been prescribed sertraline 50 mg which he had taken daily as prescribed for 4 days. On the fourth day, he presented to the emergency department with diffuse muscle stiffness, upper extremity tremors, ocular clonus, and inducible ankle clonus. He was diagnosed with probable serotonin syndrome utilizing Hunter's criteria. Patient's symptoms resolved within 24 hours with intravenous fluids, lorazepam, and discontinuation of sertraline. This case highlights the importance of a high degree of clinical suspicion in patients even on monotherapy of selective serotonin reuptake inhibitors in therapeutic doses, especially in children and adults with autism spectrum disorder. Due to preexisting hyperserotonemia, they may be more susceptible to serotonin syndrome than the general population.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"6610152"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10264136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9659973","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":"Psychogenic Nonepileptic Seizures (PNES) in the Setting of Trauma and Schizophrenia.","authors":"Sikander Chohan,&nbsp;Ali Chohan,&nbsp;Muhamid Asif","doi":"10.1155/2023/6644876","DOIUrl":"https://doi.org/10.1155/2023/6644876","url":null,"abstract":"<p><p>Psychogenic nonepileptic seizures (PNES) are nonepileptic events characterized by seizure-like manifestations without abnormal electrical activity in the brain. Our case report illustrates the diagnostic journey of a young female with a history of schizophrenia and childhood trauma who had an initial misdiagnosis of epilepsy. The etiology of PNES is complex. Major depressive disorder and generalized anxiety disorder are common comorbid conditions in these patients. Additionally, previous trauma has been linked as a predisposing factor for the development of PNES. Psychotic disorders, specifically schizophrenia, have only recently been associated with PNES. We explore this relationship in depth, while also underscoring the diagnostic and treatment challenges of PNES that clinicians must remain aware of.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"6644876"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050015","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":"New-Onset Hyperreligiosity, Demonic Hallucinations, and Apocalyptic Delusions following COVID-19 Infection.","authors":"Joseph Ahearn,&nbsp;Maggie Driscoll,&nbsp;Sahiti Gilela","doi":"10.1155/2023/9792099","DOIUrl":"https://doi.org/10.1155/2023/9792099","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric sequelae of COVID-19 have been documented, including delusions, hallucinations, agitation, and disorganized behavior. Although the mechanisms for these symptoms remain unclear, there has been an increasing body of literature suggesting a correlation between COVID-19 infection and psychosis. Here, we illustrate the case of a 34-year-old female with no previous psychiatric history who contracted COVID-19 and subsequently developed severe symptoms of psychosis. After presenting to the emergency department with one month of worsening mood, auditory hallucinations, intrusive thoughts, and hyperreligiosity, she was admitted to the inpatient psychiatric unit. The patient was treated with multiple antipsychotic medications and was discharged in stable condition with resolution of her auditory hallucinations; however, her delusions, hyperreligiosity, and negative psychotic symptoms persisted, resulting in a second inpatient psychiatric admission eight days after discharge, during which she again did not reach full remission.</p><p><strong>Objectives: </strong>With this information, we hope to increase awareness of COVID-induced psychosis and further discuss the relationship between COVID-19 infection and neuropsychiatric symptoms.</p><p><strong>Conclusions: </strong>Although there has been increasing research about the COVID-19 pandemic, there is much to be elucidated regarding the neuropsychiatric symptoms related to these infections. Similar to previous studies, our case describes a patient with no previous psychiatric history who developed severe psychotic symptoms after COVID-19 infection and was admitted to the inpatient psychiatric unit. These symptoms resulting from infection can be severe or debilitating for the patient. Therefore, physicians should be aware of these potential neuropsychiatric sequelae when treating patients with active COVID-19 infections, and treatment with antipsychotics or acute inpatient psychiatric admission should be considered.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"9792099"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10826771","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":"Schizophrenia-Like Psychotic Symptoms Associated to Leigh Syndrome.","authors":"F Jaballah,&nbsp;R Ben Soussia Nouira,&nbsp;S Mallouli,&nbsp;H Boussaid,&nbsp;S Younes,&nbsp;L Zarrouk,&nbsp;S Younes","doi":"10.1155/2023/8886555","DOIUrl":"https://doi.org/10.1155/2023/8886555","url":null,"abstract":"<p><strong>Introduction: </strong>Leigh syndrome (LS) is a mitochondrial disease characterized by subacute necrotizing encephalomyelopathy with an estimated incidence of 1:40,000 births. The comorbidity of psychotic symptoms noted in mitochondrial and psychiatric diseases has spurred interest in the effects of DNA mutations and psychiatric disorders. <i>Case presentation</i>. We report the case of a Tunisian 28-year-old male diagnosed with maternally inherited Leigh syndrome. He presented anxiety and auditory hallucinations, and he reported a vague, unsystematized delusion evolving since 6 months. Significant remission was observed at risperidone 3 mg/day. <i>Discussion</i>. The normality of explorations in our case raised the issue of the link between the two diseases, supporting the hypothesis that mitochondrial dysfunction maybe the primary origin of psychotic disorders.</p><p><strong>Conclusion: </strong>The aim of our work is to study the relations between mitochondrial dysfunction and psychiatric symptoms. Further study of mitochondrial dysfunction in psychiatric disorders is expected to be useful for the development of cellular disease markers and new psychotropics.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"8886555"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213198","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":"Acute Psychotic Episode Induced by Antimicrobial Treatment.","authors":"Savera I Arain,&nbsp;Majed Al Shakhori,&nbsp;Shabeer A Thorakkattil,&nbsp;Omer Amin","doi":"10.1155/2023/9996763","DOIUrl":"https://doi.org/10.1155/2023/9996763","url":null,"abstract":"<p><p>Psychosis is an abnormal state of mind that leads to losing touch with reality. Symptoms may include delusions and hallucinations, amongst other features. Psychosis is known to increase the risk of other health conditions and may have serious adverse outcomes. This is a case report of a 26-year-old woman with no previous psychiatric history who presented with symptoms and signs suggestive of acute psychosis shortly after starting a postprocedural combination of antimicrobials. The patient's family decided to stop the antimicrobials as they observed an escalation of the psychotic symptoms with the ongoing use of antibiotics. The patient was subsequently brought to the emergency service (EMS) department, and she was admitted to the behavioral health unit. The treatment team managed to stabilize the patient with several interventions, including the administration of antianxiety and antipsychotic medications along with psychosocial intervention. The symptoms of psychosis resolved within 3-4 days, and she was discharged home. Even though transient psychotic episodes have been reported previously with antibiotics, this case emphasizes the increased need for vigilance and reporting in patients receiving antimicrobials.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"9996763"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10082676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9284179","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":"Charles Bonnet Syndrome Related to a Pituitary Adenoma: A Case Study in a Tunisian Woman.","authors":"Haifa Ghabi,&nbsp;Amira Maamri,&nbsp;Ahlem Hajri,&nbsp;Haifa Zalila","doi":"10.1155/2023/9979128","DOIUrl":"https://doi.org/10.1155/2023/9979128","url":null,"abstract":"<p><p>According to the International Statistical Classification of Diseases and Related Health Problems 11th Revision (ICD-11) definition, \"Charles Bonnet Syndrome\" (CBS) refers to the experience of complex visual hallucinations in a person who has experienced a partial or complete loss of vision. Pituitary adenoma is a rare situation that may be associated with CBS. We report a case of CBS in a Tunisian 44-year-old female with pituitary macroadenoma. The patient reported visual hallucinations which persisted after transsphenoidal adenomectomy. She had no prior psychiatric history. She did not take any medication that could produce hallucinations. After Olanzapine initiation, hallucinations were completely resolved. It is the first Tunisian case of CBS reported in English language. This peculiar condition seems to be under-recognized in our country. Clinicians should be aware that visual hallucinations may concern patients without psychiatric disorders.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"9979128"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10085657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9297844","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":"Giant Cell Arteritis Presenting with Mania, Psychosis, and Cognitive Dysfunction: A Case Report.","authors":"Heidi Madeleine Latvala,&nbsp;Solveig Klæbo Reitan,&nbsp;Arne Einar Vaaler","doi":"10.1155/2023/7989712","DOIUrl":"https://doi.org/10.1155/2023/7989712","url":null,"abstract":"<p><strong>Background: </strong>Giant cell arteritis (GCA) is an autoimmune vasculitis affecting medium- and large-sized arteries. Vascular inflammation may lead to narrowing of the arterial lumen, and acute occlusion may result in vision loss and stroke. The classical symptoms include headache, fever, and jaw claudication. However, there is an increasing recognition of atypical presentations. <i>Case Presentation</i>. We report a case of a 70-year-old woman presenting with fluctuating manic symptoms and confusion, in addition to headache and musculoskeletal pain. After diagnosis of GCA, treatment with corticosteroids gradually improved the somatic symptoms.</p><p><strong>Conclusion: </strong>Corticosteroids led to a temporary exacerbation of manic symptoms, which improved after 3 to 4 weeks of continuous treatment, indicating that the symptoms were most likely associated with GCA. The patient manifested with clinical features and a clinical course that has, to our knowledge, not been described or published before. Therefore, GCA may be an underdiagnosed disease in psychiatric populations and should be considered in case of atypical, new-onset psychiatric disorders in the elderly.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"7989712"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9317025","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 New-Onset Obsessive-Compulsive Disorder and Schizophrenia in a 14-Year-Old Male following the COVID-19 Pandemic.","authors":"Daniel Bibawy,&nbsp;Jennyferd Barco,&nbsp;Yeghia Sounboolian,&nbsp;Priya Atodaria","doi":"10.1155/2023/1789546","DOIUrl":"https://doi.org/10.1155/2023/1789546","url":null,"abstract":"<p><p>The post-COVID-19 era has introduced novel cases of psychiatric complications that are either organic or purely psychological in nature due to social isolation. This report details a case of new-onset obsessive-compulsive disorder (OCD) and schizophrenia following the COVID-19 pandemic. The novelty of this case lies in the onset of the patient's symptoms in the context of the COVID-19 pandemic, without prior predisposing risks in the environmental, social, or biological aspects. We provided therapeutic treatment to the patient in an inpatient setting, while examining the patient to decipher the root cause of his symptoms. While there is substantial data suggesting exacerbations of OCD during the COVID-19 pandemic in the general population and a new onset of schizophrenia due to the virus itself, very little is known about the prevalence of either OCD or schizophrenia after the pandemic. With this in mind, we hope to provide more information regarding new-onset psychosis and OCD within the adolescent population. A considerable amount of studies and data are needed in this subset of the population.</p>","PeriodicalId":9631,"journal":{"name":"Case Reports in Psychiatry","volume":"2023 ","pages":"1789546"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018421","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":"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}