Temporal tumor as a cause of bipolar-like disorder?

2017 ◽  
Vol 41 (S1) ◽  
pp. S471-S471
Author(s):  
S. Domingues ◽  
M. Cotter ◽  
I. Amado ◽  
R. Massano
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Symptoms ◽  
Sudden Onset ◽  
Psychomotor Agitation ◽  
Temporal Epilepsy ◽  
Co Morbidity ◽  
History Of ◽  
Competing Interest ◽  
History Of Epilepsy ◽  
Clinical Records

IntroductionThe relationship between brain tumours, temporal epilepsy and psychiatric symptoms are historically known.ObjectivesTo report a case of mania in a patient with previous diagnosis of bipolar disorder, temporal tumour and temporal epilepsy.MethodsClinical records. Research on PubMed, using “lateral temporal epilepsy” or “brain tumour” and “mania”.ResultsA 52 years old man was conducted to the emergency department by the police. He was found with psychomotor agitation at the Sanctuary of Fátima. He was apparently hyperthimic with flight of ideas. He had a history of epilepsy and temporal tumour and two previous manic episodes. It was assumed as a maniac episode.During inpatient evaluation, patient had memory for the occurrence. He described a sudden onset on the day before, after drinking wine. He described delirant atmosphere, persecutory and mystic delusional beliefs “this is the third secret of Fátima being revealed”, followed by ecstasy and psychomotor agitation. Remission was obtained in one week on psychotropics. MRI documented the lesion. Electroencephalography performed one month later revealed “slow waves.”ConclusionsOrganic causes should be excluded before consider a psychiatric disorder. The hypothesis of epilepsy-related psychosis or mania and other effects of a temporal tumour should be considered in etiology. However, co morbidity with bipolar disorder cannot be excluded.Disclosure of interestThe authors have not supplied their declaration of competing interest.

ADHD and bipolar disorder challenge in diagnosis in children and adolescents

2016 ◽  
Vol 33 (S1) ◽  
pp. S347-S347
Author(s):  
P. Cano Ruiz ◽  
A. Gómez Peinado ◽  
S. Cañas Fraile ◽  
P. Sanmartin Salinas
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Attention Deficit Disorder ◽  
Psychiatric Symptoms ◽  
Family Factors ◽  
Bipolar Spectrum ◽  
Hyperactivity Disorder ◽  
Bipolar Disease ◽  
History Of ◽  
Competing Interest

IntroductionThe professionals in charge of children and adolescents with attention deficit disorder and hyperactivity disorder (ADHD) should be prepared to treat a wide variety of psychiatric symptoms, as most have at least one comorbid psychiatric disorder.Sometimes the differential diagnosis between ADHD and bipolar disease is difficult because of overlapping symptoms between the two disorders (Geller et al., 1997; Biederman et al., 2000; Singh et al., 2006).MethodologyA literature review about the comorbidity between ADHD and bipolar disorder in children and adolescents was performed.ResultsAccording to different studies, between 60 and 90% of children and adolescents with ADHD have comorbid bipolar disorder. However, the percentage of children and adolescents with ADHD that has comorbid bipolar disorder varied from 10 to 22% (puedes poner from 60 to 90% si no quieres repetir el and).ConclusionsThe prevalence of bipolar disease, particularly among adolescents, is between 1 and 7%. This percentage is higher if all forms of bipolar spectrum are included. Some personal and family factors increase the probability of a patient having ADHD present bipolar disease: decreased IQ, delayed development, family history of ADHD or bipolar disease, and the combined subtype.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A case of neurosyphilis in a patient presenting with bipolar mixed episode suggestive symptoms

2017 ◽  
Vol 41 (S1) ◽  
pp. S347-S347
Author(s):  
M. Martins ◽  
R. Fernandes
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Psychiatric Symptoms ◽  
Transmitted Disease ◽  
Previous History ◽  
Clinical Manifestations ◽  
Presenting Symptoms ◽  
History Of ◽  
Clinical Records ◽  
First Admission

IntroductionSyphilis is a sexually transmitted disease caused by Treponema pallidum. Early invasion of the central nervous system might occur early in the course of the disease. Clinical manifestations may include acute meningeal syphilis, meningovascular syphilis, paretic neurosyphilis and tabetic neurosyphilis. Psychiatric symptoms are often the presenting symptoms of this illness and the correct diagnosis involves both a high degree of suspicion and adequate diagnostic tests.ObjectivesThe authors report a case of a patient, with no previous history of mental illness, initially admitted in a psychiatric unit with a clinical picture suggestive of a mixed bipolar disorder episode who has been diagnosed with neurosyphilis a year after.MethodsReview of clinical records and complementary exams.ResultsBy the first admission, the patient presented with depressed and irritable mood, emotional lability, aggressiveness, grandiose and racing thoughts. Upon discharge, he was diagnosed with bipolar disorder and referred to ambulatory unit. The following year he starts presenting cognitive deficits and a progressive loss of autonomy in daily living activities, being referred to neurology evaluation. A year after the first admission, he is admitted in a neurology unit and diagnosed with neurosyphilis.ConclusionsCurrent prevalence of symptomatic neurosyphilis in Western Europe is unknown. Atypical cases presenting with heterogeneous psychiatric and neurologic symptoms, with no previous history of mental illness, should raise a high index of clinical suspicion, since consequences for the patient's health might be severe if not properly diagnosed and treated.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comorbid depression and ulcerative colitis – is there a connection?

2017 ◽  
Vol 41 (S1) ◽  
pp. S534-S534
Author(s):  
A. Melada ◽  
I. Krišto-Mađura ◽  
A. Vidović
Keyword(s):  
Ulcerative Colitis ◽  
Psychiatric Treatment ◽  
Psychiatric Symptoms ◽  
Specific Treatment ◽  
Unknown Etiology ◽  
Suicidal Thoughts ◽  
Symptoms Of Depression ◽  
Bidirectional Communication ◽  
History Of ◽  
Competing Interest

Ulcerative colitis (UC) is a subset disorder of inflammatory bowel disease (IBD) with chronic course and symptoms such as fatigue, gastrointestinal pain, fever, etc. IBD is associated with psychological manifestations including depression and anxiety. There is an increased number of studies trying to link these comorbidities. The gut-brain axis is regulated by intestinal microbiota and this bidirectional communication including immune, neural, endocrine and metabolic mechanisms may bring us closer to the answer. The following case concerns a 56-year-old patient with history of major depressive disorder who was in continuous psychiatric care and treated with antidepressants. Several years after the beginning of psychiatric treatment, he was hospitalized for diagnostic examination due to subfebrility of unknown etiology, but with no final somatic diagnosis. After two years he was referred to our department and at administration the patient showed symptoms of depression, anxiety, lack of motivation and suicidal thoughts and tendencies. Subfebrility was still present at that time. His psychopharmacotherapy was revised and there was a slight improvement in mood and behaviour. During outpatient follow-ups the symptoms of depression were still prominent and remission was not achieved even with modulation of antidepressant pharmacotherapy. The following year the patient was diagnosed with UC and started specific treatment after he presented with diarrhea in addition to subfebrility. Subsequently his mood improved, suicidal thoughts were diminished and ultimately remission was achieved. This case suggests that only after UC was being treated the psychiatric symptoms also withdrew which implicates that inflammatory mediators were involved in pathogenesis of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cognitive reserve in neuropsychiatry

2006 ◽  
Vol 36 (8) ◽  
pp. 1053-1064 ◽  
Author(s):  
J. H. BARNETT ◽  
C. H. SALMOND ◽  
P. B. JONES ◽  
B. J. SAHAKIAN
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Function ◽  
Head Injury ◽  
Cognitive Reserve ◽  
Protective Factor ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Disorders ◽  
Future Studies ◽  
Cognitive Failure ◽  
History Of

Background. The idea that superior cognitive function acts as a protective factor against dementia and the consequences of head injury is well established. Here we suggest the hypothesis that cognitive reserve is also important in neuropsychiatric disorders including schizophrenia, bipolar disorder and depression.Method. We review the history of passive and active models of reserve, and apply the concept to neuropsychiatric disorders. Schizophrenia is used as an exemplar because the effects of premorbid IQ and cognitive function in this disorder have been extensively studied.Results. Cognitive reserve may impact on neuropsychiatric disorders in three ways: by affecting the risk for developing the disorder, in the expression of symptoms within disorders, and in patients' functional outcome. Cognitive failure below a certain threshold may alone, or in combination with common psychiatric symptoms, produce neuropsychiatric syndromes.Conclusions. Consideration of cognitive reserve may considerably improve our understanding of individual differences in the causes and consequences of neuropsychiatric disorders. For these reasons, the concept of cognitive reserve should be incorporated in future studies of neuropsychiatric disorder. It may be possible to enhance cognitive reserve through pharmacological or non-pharmacological means, such as education, neurocognitive activation or other treatment programmes.

Asenapine in the treatment of trichotillomania with comorbid bipolar disorder: A case report

2017 ◽  
Vol 41 (S1) ◽  
pp. S683-S683
Author(s):  
B. Francis ◽  
S.T. Jambunathan ◽  
J.S. Gill
Keyword(s):  
Bipolar Disorder ◽  
Poor Sleep ◽  
Hair Pulling ◽  
The Past ◽  
Co Morbidity ◽  
Receptor Profile ◽  
Mood Lability ◽  
Competing Interest ◽  
Disorder Type

Trichotillomania has been found to be associated with mood disorders, particularly bipolar disorder. Trichotillomania has shared similarities with bipolar disorder by virtue of phenomenology, co-morbidity, and psychopharmacologic observations. In the past, trichotillomania with comorbid bipolar disorder was treated with lithium and sodium valproate. There has been little, if any, literature on using asenapine to augment treatment in patients with trichotillomania with comorbid bipolar disorder. A patient presented with hair-pulling episodes for a year, resulting in bald scalp patches. She had no mood symptoms prior to this. She developed low mood, anhedonia, poor sleep and poor appetite subsequently as she could not stop pulling her hair. She was started on escitalopram 10 mg daily for he depressive symptoms. Three years later, she developed hypomanic symptoms such as irritability and spending sprees. Her hair pulling behaviour worsened at this time. At this point, a diagnosis of bipolar disorder type 2 was considered and she was started on lithium 300 mg daily. Her escitalopram was discontinued. As her mood was still labile 10 months later, asenapine was added to augment lithium in the treatment of the bipolar disorder. With asenapine, her hair pulling frequency started to decrease rapidly. Asenapine was increased to 10 mg daily and her hair pulling ceased. Her mood also stabilized and she no longer had erratic periods of mood lability. In conclusion, asenapine augmentation of lithium has potential to be used in patients who have trichotillomania with comorbid bipolar disorder due to its unique receptor profile.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Selective Mutism and Abnormal Electroencephalography (EEG) Tracings

2011 ◽  
Vol 26 (11) ◽  
pp. 1377-1382 ◽  
Author(s):  
Keren Politi ◽  
Sara Kivity ◽  
Hadassa Goldberg-Stern ◽  
Ayelet Halevi ◽  
Avinoam Shuper
Keyword(s):  
Clinical Picture ◽  
Selective Mutism ◽  
Brain Disorder ◽  
Co Morbidity ◽  
Epileptic Discharges ◽  
History Of ◽  
Organic Brain ◽  
History Of Epilepsy ◽  
Work Up ◽  
Benign Epilepsy

Epileptic discharges are not considered a part of the clinical picture of selective mutism, and electroencephalography is generally not recommended in its work-up. This report describes 6 children with selective mutism who were found to have a history of epilepsy and abnormal interictal or subclinical electroencephalography recordings. Two of them had benign epilepsy of childhood with centro-temporal spikes. The mutism was not related in time to the presence of active seizures. While seizures could be controlled in all children by medications, the mutism resolved only in 1. Although the discharges could be coincidental, they might represent a co-morbidity of selective mutism or even play a role in its pathogenesis. Selective mutism should be listed among the psychiatric disorders that may be associated with electroencephalographic abnormalities. It can probably be regarded as a symptom of a more complicated organic brain disorder.

Pediatric Autoimmune Neuropsychiatric Syndrome (PANS), Developmental Regression and Autism

2017 ◽  
Vol 41 (S1) ◽  
pp. S122-S122
Author(s):  
S. Bejerot ◽  
E. Hesselmark
Keyword(s):  
Diagnostic Test ◽  
Clinical Picture ◽  
Psychiatric Symptoms ◽  
Clinical Phenotype ◽  
Somatic Symptoms ◽  
Sudden Onset ◽  
Test Results ◽  
Developmental Regression ◽  
Competing Interest ◽  
Positive Effect

IntroductionPediatric autoimmune neuropsychiatric syndrome (PANS) is a term used to describe a clinical picture which includes sudden onset of psychiatric symptoms and a possible autoimmune genesis. The sudden decline in neuropsychiatric functioning as well as the multiple combinations of symptoms may lead to a clinical phenotype similar to that in infantile autism (IA) with regressive features. We are conducting a study with the aim to evaluate a diagnostic test for PANS currently marketed by Moleculera Labs. All patients in Sweden who had taken the test (n = 154) were invited to the study.ObjectivesThe aim of the study is to characterize a subgroup of patients with IA within the PANS diagnosis study.MethodsParticipants (n = 53) were examined for psychiatric and somatic symptoms and evaluated for PANS caseness by an experienced psychiatrist. Because the criteria for entering the study was having taken the diagnostic test for PANS, the participants in the study comprise a group with mixed symptoms.ResultsTwelve participants had IA. Eleven of these reported a developmental regression with loss of abilities. Two of the IA patients also fulfill criteria for PANS. Eight of the IA patients had been treated with antibiotics for psychiatric symptoms and 4 reported a positive effect of this treatment. Nine of the patients had elevated test results suggesting possible PANS according to Moleculera Labs.ConclusionsVery early onset on PANS may be phenotypically similar to IA with regressive features. Further analysis of the immunological attributes of patients with autism with regressive features is warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Association Between School Achievement and Subsequent Development of Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S208-S209
Author(s):  
S.D. Pedersen ◽  
L. Petersen ◽  
O. Mors ◽  
S.D. Østergaard
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Mental Disorder ◽  
Cox Model ◽  
School Achievement ◽  
Subsequent Development ◽  
Positive Association ◽  
History Of ◽  
Competing Interest ◽  
Rate Ratios

IntroductionPrior studies have indicated that both high and low school achievement are associated with development of bipolar disorder (BD). We believe that the latter association may be due to the confounding effect of family history of mental disorder.ObjectiveTo further investigate the association between school achievement and subsequent development of BD by adding adjustment for family history of mental disorder.MethodsWe are conducting a historical prospective cohort study based on data from nationwide Danish registers. The cohort consists of all individuals born in Denmark 1986–97 of Danish-born parents, who were alive and living in Denmark at age 16 years, and who have completed final examinations in 9th grade between 2002 and 2014 (n = 578,247). The cohort members will be followed until death, emigration, development of bipolar disorder, or end of study, whichever comes first. Hazard rate ratios for bipolar disorder will be calculated in a Cox model using the z-score for examination grades as unit of exposure. The regression analyses will be adjusted for a series of potential confounders including family history of mental disorder.ResultsWe expect to find a positive association between high school achievement and development of BD. In contrast, we expect to demonstrate that the association between low school achievement and BD detected in prior studies is due to confounding by family history of mental disorder. The results will be shown at the conference.ConclusionsBy further testing the potential link between eminence and BD, we hope to contribute to a more balanced perception of BD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Association Between HbA1c and Number of Episodes in Individuals with Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S115-S115
Author(s):  
F. Fellendorf
Keyword(s):  
Bipolar Disorder ◽  
Glucose Metabolism ◽  
Psychiatric Symptoms ◽  
Type Ii ◽  
Impaired Glucose Metabolism ◽  
Course Of Illness ◽  
Diabetes Mellitus Type Ii ◽  
Somatic Comorbidities ◽  
Competing Interest ◽  
Hba1c Levels

IntroductionBipolar disorder (BD) is associated with an impaired glucose metabolism (IGM) leading to diabetes mellitus Type II (DM). DM influences the medical state of BD individuals and leads to increased mortality. However, there is evidence that IGM is associated with psychiatric symptoms, as well.AimThe study aimed to investigate the association between IGM and number of episodes and their ratio in individuals with BD, separated for gender.MethodsHbA1c levels from fasting blood were measured of 162 individuals (46% females) with BD. Furthermore, clinical parameters e.g. number of depressive and (hypo)manic episodes were gathered.ResultsAfter adjustment for illness duration and BMI there was a positive correlation in male individuals between HbA1c and number of depressive (M = 13.86, SD = 14.67; r = .308, P < 0.05) as well as (hypo)manic episodes (M = 17.23, SD = 24.24; r = 0.263, P < 0.05). There was no association in females as well as between HbA1c levels and ratio of episodes.ConclusionAssociations between HbA1c and number of episodes in male individuals with BD were found. As there are correlations between IGM and somatic comorbidities as well as the course of illness the treatment of glucose metabolism is important in BD. However, number of episodes might have an impact on the glucose metabolism due to inflammation processes, but further investigations have to focus on the direction of the found correlation. As gender differences are known in different pathways, they should be considered in research, diagnosis and therapy.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Case Report: Unprovoked venous thromboembolism in a young adult

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 182
Author(s):  
Jeyhan Dhabhar ◽  
Varshil Mehta ◽  
Nimit Desai ◽  
Sameer Dawoodi ◽  
Sojib Bin Zaman
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Trauma Surgery ◽  
Sudden Onset ◽  
Vein Thrombosis ◽  
Doppler Study ◽  
Pulmonary Angiogram ◽  
Co Morbidity ◽  
History Of ◽  
Prolonged Immobilization

A 24-year-old male was presented to us with sudden onset of chest pain and dyspnea for the past one hour. There was no history of calf pain, trauma, surgery, prolonged immobilization, long-haul air travel, bleeding diathesis or any other co-morbidity. The patient denied any addiction history. The Electrocardiogram showed tachycardia with S1Q3T3 pattern. The left arterio-venous Doppler study was suggestive of a thrombus in popliteal vein and sapheno-popliteal junction. The CT-Pulmonary Angiogram scan was suggestive of a massive pulmonary thromboembolism. The patient was thrombolysed with Intravenous Alteplase immediately and was put on tab Rivaroxaban for maintenance. He was later discharged after being stable. Unprovoked venous thromboembolism (VTE) is very rare and has the potential to lead to pulmonary embolism which could be disastrous, especially in young adults. We present such a case where unprovoked VTE was diagnosed and treated. This case suggests that high clinical suspicion is the key for the diagnosis of acute pulmonary embolism, especially in the absence of history suggestive of deep vein thrombosis.

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