A case of delusional disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s828-s828
Author(s):  
O. Porta Olivares ◽  
M. Juncal Ruiz ◽  
B. Fernández Abascal Puente ◽  
M. Gómez Revuelta ◽  
M. Pérez Herrera ◽  
...  
Keyword(s):  
Therapeutic Relationship ◽  
Psychiatric Treatment ◽  
Delusional Disorder ◽  
Psychotic Symptoms ◽  
First Line ◽  
Behavioral Disturbances ◽  
Competing Interest ◽  
Long Acting ◽  
The Right ◽  
First Line Treatment

IntroductionFunctioning of patients with delusional disorder may be impaired, particularly if the delusional thinking is chronic rather than episodic. They refuse to characterize their beliefs as false and view opposing views with surprise, if not hostility and disdain, dismissing or ignoring them, and continuing their struggle to find resolution or restitution for the wrongs they have endured or the illnesses from which they suffer. They typically reject and often resent the suggestion that they are mentally compromised. They are a difficult group to engage clinically, often refusing to meet with a clinician about their delusions and/or to take medication. The first-line treatment of delusional disorder is antipsychotic medication rather than other clinical interventions. Patients with the disorder often reject psychiatric treatment, it is particularly important that medication be prescribed in the context of a therapeutic relationship that includes support, education, encouragement of healthier pursuits, and discouragement of damaging, delusion-inspired actions.MethodsWe describe a case of a 55-year-old woman with a delusional disorder that was diagnosed 4 years before. The supervision of the right take of the treatment was not possible and the intensity of behavioral disturbances increased. Then we started the treatment with long-acting injectable aripiprazole.ResultsWithin the 4 months following the start of treatment, her mental state improved by attenuation of psychotic symptoms.ConclusionsLong-acting aripiprazole could be an effective tool for treatment of psychotic symptoms in patients with no insight and difficulties to check the proper treatment take.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Care for Women with Delusional Disorder: Towards a Specialized Approach

Women ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 46-59
Author(s):  
Alexandre González-Rodríguez ◽  
Mary V. Seeman ◽  
Aida Álvarez ◽  
Armand Guàrdia ◽  
Nadia Sanz ◽  
...  
Keyword(s):  
Psychological Health ◽  
Psychiatric Treatment ◽  
Adult Life ◽  
Delusional Disorder ◽  
Health Needs ◽  
Psychotic Symptoms ◽  
High Functioning ◽  
Service Programs ◽  
Prevalence Of Depression ◽  
Specific Health

Delusional disorder is a difficult-to-treat clinical condition with health needs that are often undertreated. Although individuals with delusional disorder may be high functioning in daily life, they suffer from serious health complaints that may be sex-specific. The main aim of this narrative review is to address these sex-specific health needs and to find ways of integrating their management into service programs. Age is an important issue. Delusional disorder most often first occurs in middle to late adult life, a time that corresponds to menopause in women, and menopausal age correlates with increased development of both somatic and psychological health problems in women. It is associated with a rise in the prevalence of depression and a worsening of prior psychotic symptoms. Importantly, women with delusional disorder show low compliance rates with both psychiatric treatment and with medical/surgical referrals. Intervention at the patient, provider, and systems levels are needed to address these ongoing problems.

Frontotemporal dementia and psychosis: Literature review

2016 ◽  
Vol 33 (S1) ◽  
pp. S367-S367
Author(s):  
D. Brandão ◽  
J. Massano
Keyword(s):  
Literature Review ◽  
Frontotemporal Dementia ◽  
Positive Family History ◽  
Genetic Mutation ◽  
Conclusive Evidence ◽  
Psychotic Symptoms ◽  
Initial Symptom ◽  
Clinical Criteria ◽  
Competing Interest ◽  
The Right

IntroductionFrontotemporal dementia (FTD) is a progressive neurodegenerative disease especially sporadic. About 30–40% have positive family history, with an identifiable genetic mutation in a percentage of cases increasing. Although the FTD psychosis has been recognized for many years, it is not included in the clinical criteria.ObjectivesTo assess the prevalence and characteristics of psychotic symptoms in FTD, compare the presence of psychosis in FTD C9+ versus C9− and analyze the occurrence of wrong diagnoses in FTD with psychosis.MethodsLiterature review, using computerized databases (Pubmed®). Articles were selected based on the content of their abstract and their relevance.ResultsIt is frequently the presence of psychotic symptoms in FTD associated with C9+ versus C9−. These may arise as initial symptom often leading to a psychiatric diagnosis years before obtaining diagnosis of FTD. There is no conclusive evidence about the anatomical correlation of psychotic features in the FTD, although there is the possible association with the right brain degeneration.ConclusionsThe existence of psychotic symptoms do not argues against the diagnosis of FTD verifying a high frequency of psychosis in FTD – C9+. As can be the first symptom in FTD is critical to differentiate psychiatric disorders. Further studies are needed in order to obtain a better characterization of psychotic symptoms in FTD – C9+.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychiatrists’ opinion on treatment adherence in Delusional Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S570-S570
Author(s):  
B. Girela Serrano ◽  
L. Aguado Bailón ◽  
P. Calvo ◽  
J.E. Muñoz Negro ◽  
J. Cervilla Ballesteros
Keyword(s):  
Treatment Adherence ◽  
Health Care Services ◽  
Delusional Disorder ◽  
Poor Adherence ◽  
Adherence To Treatment ◽  
Care Services ◽  
Active Compliance ◽  
Competing Interest ◽  
Long Acting ◽  
High Level

IntroductionDelusional Disorder (DD) F22 is a disease with low prevalence, probably underdiagnosed by clinical specialists due to the high level of functionality, low awareness of disease, low deterioration of patients and poor adherence to prescribed treatment. Adherence to treatment is considered to be one of the major difficulties that stand in the way of the treatment of DD. The present paper assessed psychiatrists’ opinion of the adherence to treatment of patients with DD.Material and methodsA self-administered survey was conducted on a sample of psychiatrists proceeding on a wide array of mental health care services. Participants provided their opinions regarding adherence to treatment. Descriptive statistics were subsequently calculated with SPSS.ResultsIn the opinion of our participants none of the patients have an active compliance of the treatment, 36% consider that the participation is partial or passive. It is also estimated that 57.5% reject the treatment but not totally and 6.5% believe that rejection is absolute.ConclusionsLiterature informs of the association of poor adherence to treatment and little or no improvement of patients, suggesting the need to address the lack of compliance and adherence to treatment as a crucial aspect to improve the prognosis of DD. To address this problem Long Acting Injections (LAIs) of Atypical Antipsychotics are postulated to be a plausible solution as a good treatment strategy. In order to improve the clinical practice in DD and obtain information for further effectiveness we emphasize the need of implementing clinical studies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Toxic consumption among patients suffering delusional disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S375-S376
Author(s):  
C.M. Carrillo de Albornoz Calahorro ◽  
A. Porras ◽  
M. Guerrero ◽  
J. Cervilla Ballesteros
Keyword(s):  
Cannabinoid Receptors ◽  
Digital Health ◽  
Epidemiological Studies ◽  
Delusional Disorder ◽  
Psychotic Symptoms ◽  
Case Register ◽  
Dsm 5 ◽  
Different Types ◽  
Competing Interest ◽  
Do So

IntroductionSeveral epidemiological studies describe the association between substance abuse and appearance of psychotic symptoms. There is a higher prevalence of psychotic symptoms among cannabis and cocaine consumers compared to the general population.The cannabinoid receptors regulate the release of dopamine and cocaine has a strong inhibitory action on reuptake of the same. This may explain the greater proportion of subjects moderately or heavily dependent on cocaine or cannabis experience symptoms of psychotic sphere.Objectives/AimsDescribing the profile of drug consumption among a group of patients diagnosed with delusional disorder.MethodsOur data come from a case register study of delusional disorder in Andalucía (Spanish largest region). By accessing digital health data, we selected 1927 cases who meet criteria DSM 5 for delusional disorder collecting different toxic consumption habits.ResultsIt was found that 1070 (93.4%) of patients diagnosed as delusional disorder according DSM 5 did not consume cannabis, compared to 75 (6.6%) who do so. Among patients diagnosed as “other psychoses”, 243 (85%) did not use drugs and 43 (15%) consume other drugs of different types of cannabis.ConclusionIn our sample, we found that the use of drugs such as cannabis and cocaine is less common among patients diagnosed with delusional disorder compared with other individuals diagnosed as “other psychosis”.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Pychiatrists and Legal Issues in Dementia Care

2017 ◽  
Vol 41 (S1) ◽  
pp. S37-S37
Author(s):  
M.M. Carrasco
Keyword(s):  
Mental Disorders ◽  
Social Problems ◽  
Point Of View ◽  
Psychotic Symptoms ◽  
Theoretical Point ◽  
Behavioral Disturbances ◽  
The Family ◽  
Competing Interest ◽  
The Many

During more than half a century, Psychiatry has extensively accepted a biomedical model studying mental disorders (including schizophrenia, affective disorders and the large group of stress-related disorders, including anxiety disorder. Thus, the classical dichotomy between functional and organic psychiatric disorders is obsolete and from a theoretical point of view there should be no obstacle for Psychiatry to deal with the study of dementias from gene to clinical levels using empirical methods, including neurotransmitters and scanning techniques. However, in many European countries, the dementias have been claimed as belonging primarily to Neurology, leaving the role of psychiatrists to treat psychotic symptoms and bizarre behavioral disturbances.However, psychiatrists have a long tradition of detailed psychopathological description and great skill in coping with the many psychological, ethical and social problems that are such important features of mental disorders and particularly the dementias, and so, the specific skills of psychiatrists will certainly be warranted in managing the many significant psychological and social problems of the patient both within the family and in society. The discussion must overcome the sterile debate between specialties to focus on the skills needed to adequately address the needs of patients with dementia and their caregivers.Disclosure of interestThe author has not supplied his declaration of competing interest.

Obsessive symptoms in schizophrenia: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S573-S574 ◽  
Author(s):  
S. Benavente López ◽  
N. Salgado Borrego ◽  
M.I. de la Hera Cabero ◽  
I. Oñoro Carrascal ◽  
L. Flores ◽  
...  
Keyword(s):  
Case Report ◽  
Effective Dose ◽  
Mood State ◽  
Physical Restraint ◽  
Psychotic Symptoms ◽  
Minimum Effective Dose ◽  
Obsessive Compulsive ◽  
Behavioral Disturbances ◽  
Compulsive Disorder ◽  
Competing Interest

IntroductionSchizophrenia could be presented with obsessive thoughts or an obsessive-compulsive disorder. It is known that some antipsychotics like clozapine could cause obsessive symptoms or worsen them.Case ReportWe report the case of a 53-year-old male who was diagnosed of schizophrenia. The patient was admitted into a long-stay psychiatric unit due to the impossibility of outpatient treatment. He presented a chronic psychosis consisted in delusions of reference, grandiose religious delusions, and auditory pseudohallucinations. He often presented behavioral disturbances consisted in auto and heteroaggressive behavior, being needed the physical restraint. Various treatments were used, including clozapine, but obsessive and ruminative thoughts went worse. Because of that, clozapine dose was lowed, and it was prescribed sertraline and clomipramine. With this treatment the patient presented a considerable improvement of his symptoms, ceasing the auto and heteroaggressive behavior, presenting a better mood state, and being possible the coexistence with other patients. Psychotic symptoms did not disappeared, but the emotional and behavioral impact caused by them was lower.DiscussionThis case report shows how a patient with schizophrenia could present severe behavioral disturbances due to obsessive symptoms. If obsessive symptoms are presented, clozapine must be at the minimum effective dose and antidepressants with a good antiobsessive profile.ConclusionsObsessive symptoms could be presented as a part of schizophrenia. Clozapine could worsen this symptoms and it is necessary to adjust its dose to the minimum effective dose.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Pegaspargase-induced hypertriglyceridemia in a patient with acute lymphoblastic leukemia

2019 ◽  
Vol 26 (1) ◽  
pp. 193-199 ◽  
Author(s):  
Kimberly M Lau ◽  
Ila M Saunders ◽  
Aaron Goodman
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Leukemic Cells ◽  
Hypersensitivity Reactions ◽  
Specific Enzyme ◽  
First Line ◽  
Severe Hypertriglyceridemia ◽  
Adult Acute Lymphoblastic Leukemia ◽  
Long Acting ◽  
First Line Treatment

Pegaspargase, a long acting formulation of L-asparaginase, is an asparagine specific enzyme that selectively kills leukemic cells by depleting plasma asparagine. Pegaspargase is FDA approved for the first-line treatment of adult acute lymphoblastic leukemia and is a critical component of numerous multi-chemotherapeutic regimens. Pegaspargase is associated with well-described toxicities including hypersensitivity reactions, hepatotoxicity, and thrombosis. However, hypertriglyceridemia is a much rarer complication of pegaspargase and has only been described in a limited number of reports. We present a case of severe hypertriglyceridemia after a single dose of pegaspargase. The patient was re-challenged with pegaspargase and again developed hypertriglyceridemia which was complicated by pancreatitis. Here, we summarize published reports and a literature review describing the incidence of pegaspargase-induced hypertriglyceridemia in common acute lymphoblastic leukemia protocols.

“…I Just Wanted to Report Me, I Went Into the Subway Without Paying 9 Times…”

2016 ◽  
Vol 33 (S1) ◽  
pp. S528-S528
Author(s):  
M. Canseco Navarro ◽  
M.M. Machado Vera ◽  
A. Peña Serrano ◽  
S. Alonso Guitiérrez ◽  
F. Molina López ◽  
...  
Keyword(s):  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Tolerability Profile ◽  
Behavioral Disturbances ◽  
Good Tolerability ◽  
Grammatical Errors ◽  
Competing Interest ◽  
Progressive Scan ◽  
Reason For Admission ◽  
Objective Improvement

A clinical case is presented. The reason for admission was for behavioral disturbances and agitation piscomotriz episode in the street: she had gone to a library to “denounce” the police for entering the subway without paying several times. The patient was very distraught because she was heavily guarded (someone had tapped her phone, entered her house, changed objects place, she was chased down the street…). In the psychopathological examination revealed the sphere of language, her speech was fluid, with pressured speech, full of details, with loss of thread and highlighted the presence of neologisms and grammatical errors (changes of subject and predicate…) and changes some letters by others in the same word. She often used sayings incorrectly and, when you are exploring about this fact, objectively presenting alteration in abstract thinking. In addition, it presents self-references on television. The diagnostic impression was chronic psychotic process of years of evolution. In this case, it was decided to administer intramuscular antipsychotic treatment because she was not aware of the disease but presenting good tolerability profile because, otherwise, leave the track and also a good social functioning was sought. Currently, she continues in mental health, she has not reported new crisis and a progressive scan objective improvement in the organization of thought and speech, leaving the psychotic symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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