Late Onset Schizophrenia. A Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S530-S531
Author(s):  
J.M. Hernández Sánchez ◽  
M.C. Cancino Botello ◽  
M.F. Molina Lopez ◽  
M. Muñoz Carril ◽  
S. Arnés González ◽  
...  
Keyword(s):  
Late Onset ◽  
Clinical History ◽  
Developed Countries ◽  
Main Diagnosis ◽  
Medline Search ◽  
Wide Range ◽  
History Of ◽  
Competing Interest ◽  
Long Acting ◽  
Clinical Conditions

IntroductionThe presence of elderly people is more and more common in developed countries. Unlike other medical conditions, late onset psychosis includes organic and mental precipitants in its differential diagnosis.ObjectivesTo present a case of late onset schizophrenia.MethodsMedline search and review of the clinical history and the related literature.ResultsWe present the case of a 71-year-old woman with organic medical history of rectum adenocarcinoma in 2008 that underwent radiotherapy, chemotherapy and surgical resection with successful results. According to the psychiatric history, this patient has needed two admissions to the psychiatry ward, the first of them in 2012, (when the delusional symptoms started), due to deregulated behaviour in relation to persecutory delusions and auditory pseudo-hallucinations. In 2012, she was diagnosed with late onset schizophrenia. Blood tests (hemograme, biochemistry) and brain image were normal. Despite treatment with oral amisulpride and oral paliperidone and due to low compliance, delusional symptoms have remained. We started treatment with long-acting injectable papliperidone 75 mg/28 days having reached clinical stability.ConclusionsLate onset psychosis is due to a wide range of clinical conditions. In this case, our patient had no organic precipitants. The evolution and presentation of delusional symptoms in this patient made us think of late onset schizophrenia as main diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cycloid Psychosis: A Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S532-S532
Author(s):  
G. Martinez-Ales ◽  
I. Louzao ◽  
A. Irimia ◽  
M.F. Bravo ◽  
J. Marin
Keyword(s):  
Case Report ◽  
Psychotic Disorders ◽  
Clinical History ◽  
Diagnostic Systems ◽  
Cycloid Psychosis ◽  
History Of ◽  
Competing Interest ◽  
High Index Of Suspicion ◽  
Clinical Pictures ◽  
Restitutio Ad Integrum

IntroductionEpisodes of time-limited acute psychosis, with full recovery in between, are categorized as acute polymorphic psychotic or brief psychotic disorders. Leonhard described the three forms of cycloid psychosis (CP). Perry considers it a separate entity.Case reportWe report the case of a 54-year-old male, with a 9-year history of brief psychotic disorders. He was admitted to an inpatient unit after a 4-day episode of persecutory delusion, leading to high emotional repercussions and isolation at home. Euthymia was present. Previous admissions, 9 and 5 years before, presented similar clinical pictures. Treatment with low dose paliperidone during 6-month periods had led to the complete resolution of the episodes (restitutio ad integrum: no psychotic manifestations and the ability to run his business). In this episode, 8 days after the reintroduction of 12 mg of paliperidone per day, cessation of the symptoms took place. Careful reconstruction of the clinical history showed no stressors or drug consumption. And immediately previous 5-day phase of insomnia, hyperactivity and expenditure was described by the patient's wife.DiscussionThree inpatient admissions, a careful clinical history and a thorough review of the evidence regarding Perris criteria led to a diagnosis of CP.ConclusionCP, a classical nosological approach, is helpful in a clinical setting, as it might imply different prognosis and treatment. Recognition of CP, not included as an entity by the major diagnostic systems, requires a high index of suspicion.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Alcohol and substances acute intoxication in a population of suicide attempters

2016 ◽  
Vol 33 (S1) ◽  
pp. S599-S599
Author(s):  
S. Di Marco ◽  
I. Coppola ◽  
C. Delicato ◽  
E. Gattoni ◽  
A. Venesia ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Statistical Significance ◽  
Clinical History ◽  
Acute Intoxication ◽  
Suicide Attempters ◽  
Drugs And Alcohol ◽  
Alcohol And Drugs ◽  
History Of ◽  
Competing Interest ◽  
Demographic Features

IntroductionThe effects of psychotropic drugs and alcohol acute intoxication are important risk factors for attempted suicide among individuals with and without substance use disorder (SUD).AimsThe first aim of this study is describing the socio-demographic features and clinical history of subjects who were acutely intoxicated when attempting suicide. The second aim is to compare their features with those of subjects without acute alcohol and substances intoxication at suicide attempt time.MethodsDeterminants of ER psychiatric consultations were studied prospectively during the period 2008–2014 at the “Maggiore della Carità” Hospital in Novara, Italy. For each patient, a data sheet was filled in by experienced psychiatrists, in order to gather demographic features, psychiatric history and present clinical issues like blood and urine dosage of amphetamine and methamphetamine, cannabinoid, cocaine and alcohol. Comparison of qualitative data was performed by means of the Chi2 test. Statistical significance was set at P ≤ 0.05.ResultsWe collected a sample of 495 suicide attempters who referred to our ER. Statistical analysis of demographic and clinical data is still ongoing.ConclusionsPreliminary results point out that acute alcohol and drugs intoxication at suicide attempt time is much more frequent in subjects without a SUD. Implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Treatment with intramuscular paliperidone palmitate in schizoaffective disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S581-S581
Author(s):  
L. Maroto Martin ◽  
P. Hervías Higueras
Keyword(s):  
Schizoaffective Disorder ◽  
Complex Disease ◽  
Psychotic Disorders ◽  
Paliperidone Palmitate ◽  
Valuable Treatment ◽  
History Of ◽  
Competing Interest ◽  
One Year ◽  
Long Acting ◽  
Monthly Dose

IntroductionInjectable formulations of long acting antipsychotic are a valuable treatment option for patients with psychotic disorders. Schizoaffective Disorder (SAD) is a complex disease; the optimal treatment is not well established yet.ObjectiveAnswer the question about the effectiveness offered by intramuscular Paliperidone Palmitate in SAD versus other injectable antipsychotics. Keywords: schizoaffective disorder; paliperidone palmitate injection.MethodsA case report of a 35-year-old male diagnosed with Schizoaffective Disorder six years ago and with personal history of multiple manic decompensation after treatment discontinuation. Throughout his life he has been treated with intramuscular Risperidone 87.5 mg (50 + 37.5) every 14 days, Olanzapine flas 20 mg/day, Risperidone flas 3 mg, Amisulpride 600 mg/day, Valproic acid 1500 mg/day Clonazepam 2 mg/day and Lormetazepam 1 mg. In the last admission one year ago, he started treatment with intramuscular paliperidone palmitate up to 200 mg a month. Currently he receives a monthly dose of 100 mg and concomitant lithium 800 mg/day.DiscussionThe use of intramuscular paliperidone palmitate in SAD and its effectiveness against other injectable antipsychotic is discussed.ConclusionsThe use of intramuscular paliperidone palmitate appears to constitute an employment opportunity in the treatment of intramuscular maintenance in SAD. It could be effective in stabilizing episodes of acute exacerbation and remissions of psychotic, manic and depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Electroconvulsive therapy (ECT) treatments in late-onset schizophrenia: Report of a case

2016 ◽  
Vol 33 (S1) ◽  
pp. S556-S556
Author(s):  
M. Valverde Barea ◽  
F. Cartas Moreno ◽  
M.E. Ortigosa Luque
Keyword(s):  
Behavioral Disorders ◽  
Electroconvulsive Therapy ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Personal History ◽  
Psychotic Symptoms ◽  
Sexual Content ◽  
History Of ◽  
Competing Interest ◽  
Effective Result

Female patient, 66 years old, who goes to the doctor because of behavioral disorders and delusional injury 8 months of evolution. She showed no personal history of psychiatric disorders. In the psychopathological examination some relevant symptoms are seen delusions of prejudice with their immediate surroundings, self-referential regarding neighbors and walls. Delusional interpretations of sexual content. Punitive pseudo hallucinations hearing which are identifies with her daughters and sex with her son-in-law. Behavioral disorders consisting of going out naked into the street overnight and rebuking pedestrians; furthermore, she showed heteroaggressivity towards objects. Logical psychotropic treatment is initiated as indicated by the guidelines having no effect. Electroconvulsive therapy being tested an effective result. The late-onset schizophrenia symptoms should be taken into account in people with psychotic symptoms start at an advanced age, but is most prevalent at younger ages. Electroconvulsive therapy (ECT) may be used as an adjunct to drug therapy or as second-line treatment in patients with affective or psychotic disorders resistant to treatment with psychotropic drugs. It is essential a differential diagnosis with dementia symptoms previously established, given that part of the late-onset schizophrenia evolves to dementia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals (Doctor…My child keeps falling over) unexpected MRI findings in children with history of frequent falls and dizziness: a case series

2019 ◽  
Vol 12 (7) ◽  
pp. e229849 ◽  
Author(s):  
Ashraf Nabeel Mahmood ◽  
Osama Abulaban ◽  
Arshad Janjua
Keyword(s):  
Physical Examination ◽  
Case Series ◽  
Clinical History ◽  
Brain Stem Glioma ◽  
Mri Findings ◽  
Group Management ◽  
Wide Range ◽  
Detailed Clinical History ◽  
History Of ◽  
Low Threshold

Frequent falls and dizziness are common complaints in children. These symptoms can be caused by wide range of underlying pathologies including peripheral vestibular deficits, cardiac disease, central lesions, motor skills delay and psychogenic disorders. We report three paediatric cases who presented with complaints of repeated falls and imbalance. MRI scan revealed underlying brain lesions (frontal lobe arteriovenous malformation, exophytic brain stem glioma and cerebellomedullary angle arachnoid cyst with cerebellar tonsillar ectopia). By reporting these cases, we would like to emphasise the importance of a thorough assessment of children with similar symptoms by detailed clinical history, physical examination and maintaining low threshold for investigations, including radiological imaging. Taking in consideration, the wide range of differential diagnosis, the challenge of obtaining detailed history and difficulty of performing reliable physical examination in this age group. Management of underlying disorders can be medical, surgical or just observational.

Comparative Study and Enlightenment of Barrier-Free Laws and Regulations of America, Britain and China

2014 ◽  
Vol 584-586 ◽  
pp. 790-795
Author(s):  
Wei Yang Jia
Keyword(s):  
Development Trend ◽  
Developed Countries ◽  
Vulnerable Groups ◽  
Design Stage ◽  
Wide Range ◽  
The Disabled ◽  
History Of ◽  
The Developed Countries ◽  
Free Environment ◽  
Barrier Free

The barrier-free environment is the guarantee for the vulnerable groups such as the senior citizens and the disabled, which reflects the civilization level of the society. And America and Britain are the most advanced countries which have longer history of barrier-free design. Their barrier-free design laws, regulations and standard system are complete, covering a wide range of security objects and having developed into the universal design or inclusive design stage with their own features. The barrier-free design of China was carried out late and yet within 30 years’ development, China still has made many achievements. However, in terms of scientific research and civil consciousness, the gap to the developed countries is still big. Summarizing the development trend of American and British barrier-free design features, comparison can provide the working direction for the barrier-free design cause of China, namely, the improvement of the researches on barrier-free design, the functions of organizations for the disabled, public participation and regulations enforcement.

Psychosis In A Blindness Patient: A Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S532-S532
Author(s):  
M. Marinho ◽  
C. Moreira ◽  
F. Catarina
Keyword(s):  
Clinical Case ◽  
Historical Record ◽  
Psychiatric Ward ◽  
Behavioural Disorders ◽  
Medline Search ◽  
History Of ◽  
Hcv Antibody ◽  
Competing Interest ◽  
Scientific Documentation ◽  
Positive Results

IntroductionUsing a clinical case as illustration, the present work engages the different psychopathologic alterations that blindness patients could present.MethodsThe presentation and discussion of a clinical case of psychosis in a blind patient are addressed. The scientific documentation used as support was obtained from PubMed/Medline search engines using as keywords blindness and psychosis.ResultsA 43-years-old male patient, with a medical history of arterial hypertension, heroine dependence (presently with methadone schema) and bilateral blindness caused by a bilateral retinal detachment 20 years ago, was admitted in the psychiatric ward. The patient's historical record includes a previous personality with paranoid characteristics, as well as a hospitalization due to persecutory and auto-reference ideas and kinaesthetic hallucinations with 1 month of evolution, coincident with address changes. Lab tests revealed the following results: haemoglobin 13.8; Leucocytosis 13,400; CRP: 6.2; ALT > AST. Positive results were obtained in the drug tests for cannabinoids, as well as for the anti-HCV antibody (IgG). Finally, the patient was medicated with an antipsychotic and humour stabilizer, achieving a significant improvement after 10 days of hospitalization.ConclusionsAlthough studies reveal that mental and behavioural disorders, especially those with symptoms of psychosis and mental retardation, are common among people with congenital blindness, more knowledge of the prevalence and aetiology of mental and behavioural disorders among people suffering from blindness is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Long-acting injectable aripiprazole. Clinical experience in a case series

2016 ◽  
Vol 33 (S1) ◽  
pp. S614-S614
Author(s):  
J.M. Hernández Sánchez ◽  
M.C. Cancino Botello ◽  
M.F. Molina López ◽  
D. Peña Serrano ◽  
M. Machado Vera
Keyword(s):  
Mental Health ◽  
Health Center ◽  
Mental Health Center ◽  
Case Series ◽  
Antipsychotic Agent ◽  
Clinical History ◽  
Concomitant Treatment ◽  
Patient Profile ◽  
Competing Interest ◽  
Long Acting

IntroductionThe use of long-acting injectable antipsychotics is useful in patients with low therapeutic compliance.ObjectiveTo present the demographic and clinical data of a case series in which long-acting injectable aripiprazole has been prescribed in an ambulatory Mental Health Center.MethodsSystematic review of the related literature and clinical history of patients in which long-acting injectable aripiprazole had been prescribed from January to March 2015 in a Mental Health Center.ResultsWe found 10 patients, whose diagnosis were schizophrenia (4), non-specified psychosis (2), personality disorder (1), bipolar disorder (1), schizoaffective disorder (2), of whom 7 were men and 3 women, with a mean age of 43.8 years old. The mean of years since diagnosis was 15.1 years. In 7 patients, we found concomitant treatment with another antipsychotic agent (low dose quetiapine in all of them); antidepressants in 1 patient, benzodiazepines in 6; mood stabiliser in 5 and biperidene in 1. In relation to previous antipsychotic drugs, we found: aripiprazole 15 mg/day oral (4); long-acting injectable paliperdidone 150 mg/28 days (2) paliperdone 6 mg/day oral (1); combination of paliperidone 6 mg/day oral plus olanzapine 5 mg/day oral (1). Only 4 patients had used long-acting injectable drugs previously in their lifetime. The reason of having initiated treatment with long-acting injectable aripiprazole was sexual disturbance (3); lack of compliance (4); clinical inestability (2) and motor side effects (1).ConclusionsIn our series, we can observe a chronic patient profile, predominantly men with diagnosis of psychotic spectrum.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Toxic role in schizophrenia: A review by a clinical case

2016 ◽  
Vol 33 (S1) ◽  
pp. S292-S292
Author(s):  
M. Canseco Navarro ◽  
A. Peña Serrano ◽  
J.M. Hernández Sánchez ◽  
M. Canccino Botello ◽  
F. Molina López ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Negative Symptoms ◽  
Clinical Case ◽  
Paranoid Schizophrenia ◽  
Clinical History ◽  
Positive Symptoms ◽  
History Of ◽  
Competing Interest ◽  
Hospital General

IntroductionOften find it difficult diagnostic approach to patients with symptoms that could correspond to several clinical entities. This requires making a correct differential diagnosis to enable a better understanding and addressing the disease in an individualized way.ObjectiveDescribe pathogenetic factors of paranoid schizophrenia highlighting their relationship with drug consumption.MethodsReview of the clinical history of a patient admitted to acute ward of the Hospital General Universitario of Valencia.ResultsA case of a 30-year-old man, whose income is motivated by persistent and structured autolytic ideation occurs. It presents positive symptoms for several years and amotivational syndrome ago. It has a history of cannabis, cocaine and alcohol since he was thirteen and remains abstinent for more than six months ago. Differential diagnosis arises between amotivational toxic syndrome, reactive depressive symptoms to the disease and negative symptoms for chronic psychotic process. Finally diagnosed with paranoid schizophrenia and is included in the program of first psychotic episodes.Today the productive symptoms disappeared and remain negative though with less intensity achieving an improvement in overall activity.ConclusionsConsumption of toxic influences the development of a chronic psychotic process that may appear years later, becoming a etiological and maintainer factor, not only if its consumption continue, but other effects that occur long term amotivational syndrome and worsening prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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