scholarly journals Psychiatric Symptomatology in Early-Onset Binswanger’s Disease: Two Case Reports

1995 ◽  
Vol 8 (1) ◽  
pp. 43-46 ◽  
Author(s):  
R. M. Lawrence ◽  
J. C. Hillam
Keyword(s):  
Early Identification ◽  
Psychiatric Illness ◽  
Case Reports ◽  
Accurate Diagnosis ◽  
Psychotic Symptoms ◽  
Psychiatric Symptomatology ◽  
Neurological Signs ◽  
Binswanger’S Disease ◽  
History Of ◽  
Binswanger's Disease

We describe two cases of Binswanger's disease of pre-senile onset which presented with affective and psychotic symptoms well before the appearance of cognitive deterioration and neurological signs, initially evading an accurate diagnosis. Psychiatrists should be aware of white matter disease and its role in the pathogenesis of psychiatric illness. Particular attention should be given to a history of hypertension as a risk factor in the early identification of these cases.

Psychotic symptoms in pediatric bipolar disorder and family history of psychiatric illness

2006 ◽  
Vol 96 (1-2) ◽  
pp. 127-131 ◽  
Author(s):  
Richard Rende ◽  
Boris Birmaher ◽  
David Axelson ◽  
Michael Strober ◽  
Mary Kay Gill ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Psychiatric Illness ◽  
Psychotic Symptoms ◽  
Pediatric Bipolar Disorder ◽  
History Of

scholarly journals A Case of Psychosis Due to Acute Hypocalcemia From Hypoparathyroidism

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A172-A173
Author(s):  
Joseph Theressa Nehu Parimi ◽  
John Chen Liu ◽  
Rajani Gundluru ◽  
Sowjanya Naha ◽  
Timur Gusov ◽  
...  
Keyword(s):  
Psychiatric Symptoms ◽  
Case Reports ◽  
Severe Depression ◽  
Altered Mental Status ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Organic Psychosis ◽  
Neuropsychiatric Manifestations ◽  
History Of ◽  
Gait Abnormalities

Abstract A 61-year-old female with past medical history of depression, hypoparathyroidism (hypoPtH), and hypothyroidism had disappeared from her home and was found wandering a few hours away with persecutory delusions, visual and auditory hallucinations. Serum calcium (Ca) was 6.3 mg/dL (range 8.6–10.2), albumin 3.7 g/dL (range 3.5–5.2) and ionized Ca 0.89 mmol/L (range 1.12–1.30). She was admitted and treated with Ca and calcitriol. Work-up for altered mental status was negative except for hypocalcemia (hypoCa) and scattered bilateral basal ganglia calcifications (BGC) with cortical and subcortical frontal lobe calcifications on CT. Psychiatry diagnosed delirium due to hypoCa. Acute psychosis resolved once Ca levels improved. Diagnosis of idiopathic hypoPtH was in 1997. Her regimen included Ca citrate 1500mg daily and 10 mcg of Forteo twice daily. She had skipped her medications for at least 2 days prior to presentation. Her medical records revealed that she was seen for severe depression, progressive gait abnormalities, slowed movements, and imbalance, in 2015. CT scan and MRI brain showed BGC. Her son gave a history of multiple admissions for psychosis, violence, delusions with agitation, and wandering at times when the patient was hypoCa, which was diagnosed as schizophrenia. Neuropsychiatric disturbances are commonly associated with hypercalcemia. Review of literature found a few case reports of psychosis and hypoPtH 1,2 BGC is common in hypoPtH. Psychotic symptoms due to BGC include auditory hallucinations, delusions of influence, paranoid states, and complex perceptual distortions.3,5 HypoCa is associated with cognitive impairment. Neurological manifestations tend to improve with Ca correction, but psychiatric symptoms do not improve substantially.4,5 Further studies are needed in hypoPtH with BGC to appropriately diagnose organic psychosis. This is important in management of the vicious cycle of psychiatric illness leading to noncompliance resulting in psychosis. Prevention of BGC will play a key role. References: 1. Finan M, Axelband J. This is your brain on calcium: psychosis as the presentation of isolated hypoparathyroidism. Am J Emerg Med. 2014;32:945.e1-4. 2. Ang AW, Ko SM, Tan CH. Calcium, magnesium, and psychotic symptoms in a girl with idiopathic hypoparathyroidism. Psychosom Med. 1995;57:299–302. 3. Burns K, Brodaty H. Fahr’s disease and psychosis. In: Sachdev PS, Keshavan MS, editors. Secondary schizophrenia. Cambridge: Cambridge University; 2010. p. 358–66. 4. Maiti A, Chatterjee S. Neuropsychiatric manifestations and their outcomes in chronic hypocalcaemia. J Indian Med Assoc. 2013;111:174–7. 5. Amara A, Novais C, Coelho M, Silva A, Curral R, Brandao I, Torres A. Organic psychosis due to hypoparathyroidism in an older adult: a case report. Braz. J. Psychiatry; 2016; 38(4)

The phenomenology and diagnosis of psychiatric illness in people with Prader–Willi syndrome

2008 ◽  
Vol 38 (10) ◽  
pp. 1505-1514 ◽  
Author(s):  
S. Soni ◽  
J. Whittington ◽  
A. J. Holland ◽  
T. Webb ◽  
E. N. Maina ◽  
...  
Keyword(s):  
Family History ◽  
Affective Disorder ◽  
Psychiatric Illness ◽  
Uniparental Disomy ◽  
Psychotic Symptoms ◽  
Chromosome 15 ◽  
Prader Willi Syndrome ◽  
Psychotic Illness ◽  
Genetic Subtype ◽  
History Of

BackgroundPsychotic illness is strongly associated with the maternal uniparental disomy (mUPD) genetic subtype of Prader–Willi syndrome (PWS), but not the deletion subtype (delPWS). This study investigates the clinical features of psychiatric illness associated with PWS. We consider possible genetic and other mechanisms that may be responsible for the development of psychotic illness, predominantly in those with mUPD.MethodThe study sample comprised 119 individuals with genetically confirmed PWS, of whom 46 had a history of psychiatric illness. A detailed clinical and family psychiatric history was obtained from these 46 using the PAS-ADD, OPCRIT, Family History and Life Events Questionnaires.ResultsIndividuals with mUPD had a higher rate of psychiatric illness than those with delPWS (22/34 v. 24/85, p<0.001). The profile of psychiatric illness in both genetic subtypes resembled an atypical affective disorder with or without psychotic symptoms. Those with delPWS were more likely to have developed a non-psychotic depressive illness (p=0.005) and those with mUPD a bipolar disorder with psychotic symptoms (p=0.00005). Individuals with delPWS and psychotic illness had an increased family history of affective disorder. This was confined exclusively to their mothers.ConclusionsPsychiatric illness in PWS is predominately affective with atypical features. The prevalence and possibly the severity of illness are greater in those with mUPD. We present a ‘two-hit’ hypothesis, involving imprinted genes on chromosome 15, for the development of affective psychosis in people with PWS, regardless of genetic subtype.

Meditation-induced psychosis: a narrative review and individual patient data analysis

2019 ◽  
pp. 1-7 ◽  
Author(s):  
Pawan Sharma ◽  
Ananya Mahapatra ◽  
Rishab Gupta
Keyword(s):  
English Language ◽  
Psychotic Disorders ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Clinical Settings ◽  
Equal Distribution ◽  
Meditative Practice ◽  
History Of ◽  
Age Range ◽  
The Relationship

Background: Meditation is associated with health benefits; however, there are reports that it may trigger or exacerbate psychotic states. In this review, we aim to collate case reports of psychotic disorders occurring in association with meditative practice and to discuss the relationship between psychosis and meditation. Methodology: We performed case-based analysis of all the existing studies published in English language using PubMed, PsycINFO, Cochrane, Scopus, EMBASE, CINAHL and Google Scholar with the search terms; ‘Psychosis’ OR ‘Psychotic Symptoms’ OR ‘Schizophrenia’ AND ‘Meditation.’ Results: A total of 19 studies and 28 cases were included in the review. The patients described had an age range of 18–57 years; there was equal distribution of males and females. The diagnoses included acute psychosis in 14 cases, schizophrenia in 7 cases, mania with psychotic symptoms in 3 cases, and schizoaffective disorder in 1 case. The types of meditation described were Transcendent, Mindfulness, Buddhist Meditation like Qigong, Zen, and Theraveda, and others like Bikram yoga, Pranic Healing, and Hindustan Type meditation. Of the 28 cases reported, 14 patients had certain precipitating factors like insomnia, lack of food intake, history of mental illness, stress, and psychoactive substance use. Conclusion: There are case reports of psychotic disorder arising in association with meditative practice; however, it is difficult to attribute a causal relationship between the two. At the same time, there is a body of research describing the beneficial effect of meditative practice in clinical settings for patients with psychotic disorders. Appropriately designed studies are needed to further investigate the relationship between meditative practice and psychosis.

scholarly journals A Case of Psychosis in Disulfiram Treatment for Alcoholism

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Raquel Calvão de Melo ◽  
Rui Lopes ◽  
José Carlos Alves
Keyword(s):  
Psychiatric Illness ◽  
Past History ◽  
Rare Complication ◽  
Chronic Alcoholism ◽  
Physical Symptoms ◽  
Psychotic Symptoms ◽  
Alcohol Dependency ◽  
Mesolimbic System ◽  
History Of

Background. Disulfiram, a drug used in the treatment of alcohol dependence, is an inhibitor of dopamine-β-hydroxylase causing an increase in the concentration of dopamine in the mesolimbic system. In addition to the physical symptoms associated with concomitant use of alcohol, disulfiram may lead to adverse events, when used alone, including psychosis.Aims. To report a case of a rare complication when using disulfiram for alcoholism treatment in a patient in alcoholic abstinence.Case Report. We describe the case of a 42-year-old male patient, who developed psychotic symptoms 3 weeks after initiating treatment with disulfiram for alcohol dependency. The patient had a history of chronic alcoholism for 12 years and was under disulfiram treatment (250 mg/day) for 1 month, with no other past history of psychiatric illness. The symptoms worsened after he initiated alcohol consumption, while taking disulfiram. The patient was hospitalized and disulfiram was suspended. After 4 days he was asymptomatic and at 6-week follow-up remained asymptomatic.Conclusion. Treatment with disulfiram can lead to the appearance of psychosis in patients with increased vulnerability. In clinical practice, psychosis in the context of alcoholism with disulfiram therapy is often neglected and should be taken into account.

scholarly journals A Subset of Primary Polydipsia, “Dipsogneic Diabetes Insipidus”, in Apparently Healthy People Due to Excessive Water Intake: Not Enough Light to Illuminate the Dark Tunnel

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 406
Author(s):  
Krishnaraju Venkatesan ◽  
Kumarappan Chidambaram ◽  
Premalatha Paulsamy ◽  
Ramasubbamma Ramaiah ◽  
Ali Al-Qahtani ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Psychiatric Illness ◽  
Case Reports ◽  
Treatment Options ◽  
Urine Osmolality ◽  
Healthy People ◽  
Psychiatric Disease ◽  
Primary Polydipsia ◽  
History Of ◽  
Excessive Intake

Dipsogenic diabetes insipidus (DDI) is a subtype of primary polydipsia (PP), which occurs mostly in healthy people without psychiatric disease. In contrast, PP is characterized by a polyuria polydipsia syndrome (PPS) associated with psychiatric illness. However, the pathogenesis of DDI is not well established and remains unexplored. In order to diagnose DDI, the patient should exhibit excessive thirst as the main symptom, in addition to no history of psychiatric illness, polyuria with low urine osmolality, and intact urine concentrating ability. Treatment options for DDI remain scarce. On this front, there have been two published case reports with successful attempts at treating DDI patients. The noteworthy commonalities in these reports are that the patient was diagnosed with frequent excessive intake of water due to a belief that drinking excess water would have pathologic benefits. It could therefore be hypothesized that the increasing trend of excessive fluid intake in people who are health conscious could also contribute to DDI. Hence, this review provides an overview of the pathophysiology, diagnosis, and treatment, with a special emphasis on habitual polydipsia and DDI.

Ambulatory Patients with Medical and Psychiatric Illness: Care in a Special Medical Clinic

1978 ◽  
Vol 8 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Claire M. Hossenlopp ◽  
Jimmie Holland
Keyword(s):  
Psychiatric Illness ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Medical Clinic ◽  
Patient Relationship ◽  
Traditional Role ◽  
Psychiatric Symptomatology ◽  
Psychiatric Illnesses ◽  
Ambulatory Patients ◽  
Total Care

Patients who have both medical and psychiatric illnesses often present very difficult diagnostic and treatment problems. Cross referrals by the two or more specialties necessarily involved in their management are often perceived by these patients as rejection and not only may induce in them feelings of frustration, helplessness and anger, but may also lead to a worsening of their medical and psychiatric symptomatology. This paper describes the organization and operation of a comprehensive clinic, staffed by both internists and psychiatrists, designed to provide total care for these patients. The patient population comprises patients with independent or unrelated medical and psychiatric illnesses, patients with interdependent medical and psychiatric symptoms, patients with reactive psychological problems and patients with somatizations as an expression of psychological conflicts. Case reports illustrate the approach used in patient management and some of the encouraging results that can be achieved at such a clinic. The special nature of the clinic presented a challenge to the physician's traditional role and required careful attention to specific aspects of the doctor-patient relationship, which are briefly discussed.

scholarly journals Levetiracetam induced hypomania: a case report

2019 ◽  
Vol 10 ◽  
pp. 204209861987675 ◽  
Author(s):  
Ali Ercan Altınöz ◽  
Şengül Tosun Altınöz ◽  
Başak Güzel Biltekin ◽  
Murat Can Kaya
Keyword(s):  
Case Report ◽  
Psychiatric Disorder ◽  
Psychological Symptoms ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Drug Reactions ◽  
Manic Symptoms ◽  
Epilepsy Treatment ◽  
History Of ◽  
Clonic Seizures

Levetiracetam (LEV) is a newer second-generation antiepileptic drug that is found to be effective in tonic-clonic seizures, partial onset seizures, and myoclonic seizures. Among antiepileptic drugs, LEV is usually known for fewer adverse drug reactions. Psychiatric disorders after the administration of LEV have been reported in the literature. There are many case reports on LEV-induced psychosis, but there are only three case reports of mania induced by LEV use. In this report, we present a case with no history of psychiatric disorder who had a hypomania episode after receiving LEV for epilepsy treatment. The development of manic symptoms with LEV therapy is unusual. Clinicians should consider monitoring patients closely for treatment-related psychological symptoms and psychotic symptoms, including the possibility of mania.

scholarly journals Acute mania with psychotic symptom in post COVID-19 patient

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S50-S51
Author(s):  
Sridevi Shanmugam ◽  
Praveen Kumar ◽  
Blaga Carr
Keyword(s):  
Mental Health ◽  
Psychiatric Illness ◽  
Neuropsychiatric Symptoms ◽  
Previous History ◽  
Acute Mania ◽  
Medical Attention ◽  
Psychotic Symptoms ◽  
High Dose ◽  
Neuropsychiatric Complications ◽  
History Of

AimsCOVID-19 is an on-going pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent evidence suggests that SARS-CoV-2 may be associated with various neuropsychiatric symptoms, including mania. We present a case of a middle aged man presenting with acute mania with psychotic symptoms 20 days post COVID infection in the absence of prior psychiatric illness. This report highlights the need for rigorous neuropsychiatric assessment in patient with symptoms of SARS-CoV-2 infection.MethodA 52-year-old man of West African origin with past history of hypertension and no previous history of mental health illness presented with acute manic symptoms on background of two weeks of high fever, diarrhoea, mild headache, dry cough and anosmia. He was tested positive for SARS-CoV-2 infection on COVID PCR test. He was under self-isolation along with his family members who exhibited mild symptoms of SARS-CoV-2, none of them required hospital admission. He was initially fearful to seek medical attention but was brought in by family after exhibiting behaviour changes, obsession with toilet cleaning, reckless spending and getting aggressive approximately two weeks after the onset of acute upper respiratory symptoms. He presented elated in mood with pressure of speech and grandiose ideas. Investigations like neuroimaging and bloods were unremarkable. Initial psychiatric assessment found symptoms consistent with acute mania and he was detained under the Mental Health Act. During admission, he was sexually disinhibited and agitated on the ward requiring IM antipsychotics. He was treated with high dose of Olanzapine and Sodium valproate and his symptoms subsided within two weeks.ResultThis case emphasises the manifestation of neuropsychiatric illness post COVID-19 without a background of psychiatric illness, hypoxemia and cerebral infarction.Based on the CORONERVE Programme and latest retrospective Lancet cohort studies, the period between 14 and 90 days after diagnosis, 5.8% COVID-19 survivors had their first recorded diagnosis of psychiatric illness.It is also important to consider other organic disease given the simultaneous diagnosis of COVID-19. Although it is not yet possible to confirm here due to the lack of a validated CSF-PCR assay, previous reports have implicated SARS-CoV-2 in the development of viral encephalitis, and this remains an important differential.ConclusionClinicians should be alert to the possibility of patients with COVID-19 developing neuropsychiatric complications post SARS-CoV-2 infection, mandating the need for vigilant initial neuropsychiatric assessment and possibly follow-up care in 3 months.

Herpetic Whitlow of the Hand in Infants

2020 ◽  
Author(s):  
Mohammad M. Al-Qattan ◽  
Nada G. AlQadri ◽  
Ghada AlHayaza
Keyword(s):  
Bacterial Infection ◽  
Case Reports ◽  
Case Series ◽  
Individual Case ◽  
Senior Author ◽  
Secondary Bacterial Infection ◽  
Clinical Appearance ◽  
History Of ◽  
Mode Of Transmission ◽  
Time Of Presentation

Abstract Introduction Herpetic whitlows in infants are rare. Previous authors only reported individual case reports. We present a case series of six infants. Materials and Methods This is a retrospective study of six cases of herpetic whitlows in infants seen by the senior author (MMA) over the past 23 years (1995–2017 inclusive). The following data were collected: age, sex, digit involved in the hand, mode of transmission, time of presentation to the author, clinical appearance, presence of secondary bacterial infection, presence of other lesions outside the hand, method of diagnosis, treatment, and outcome. Results All six infants initially presented with classic multiple vesicles of the digital pulp. In all cases, there was a history of active herpes labialis in the mother. Incision and drainage or deroofing of the vesicles (for diagnostic purposes) resulted in secondary bacterial infection. Conclusion The current report is the first series in the literature on herpetic whitlows in infants. We stress on the mode of transmission (from the mother) and establishing the diagnosis clinically. In these cases, no need for obtaining viral cultures or polymerase chain reaction; and no medications are required. Once the vesicles are disrupted, secondary bacterial infection is frequent and a combination of oral acyclovir and intravenous antibiotics will be required.

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