scholarly journals What Can Happen When Postpartum Anxiety Progresses to Psychosis? A Case Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Vesna Pirec

This case report describes a primipara without documented psychiatric history prior to complicated delivery. Onset of severe insomnia and anxiety was right after childbirth but not treated. Obsessive thinking pattern became more prominent. The patient became depressed and sought psychiatric help four months after delivery. Insomnia was then treated pharmacologically. Anxiety and depression persisted, suicidal ideation emerged, and the patient became confused, indecisive, overwhelmed, and delusional regarding her child’s health. Medications for depression and anxiety were started six months postpartum yet were ineffective. The patient’s obsessions gradually became fully psychotic and she committed an altruistic infanticide eight months postpartum. Psychiatric hospitalization occurred, followed by a long course of mental, physical, legal, and social rehabilitation. She was minimally responsive to psychopharmacological treatment, which appeared to be partly related to her hormonal dysregulation. Several months into the treatment she gradually started improving and returned to baseline two years later. The Illinois court found the patient not guilty to murder by reason of Insanity.

2019 ◽  
Vol 3 (1) ◽  
pp. 27-32
Author(s):  
Scott Simpson

Presentations for anxiety and depression constitute the fastest growing category of mental health diagnoses seen in emergency departments (EDs). Even non-psychiatric clinicians must be prepared to provide psychotherapeutic interventions for these patients, just as they might provide motivational interviewing for a patient with substance use disorders. This case report of an 18-year-old woman with suicidal ideation illustrates the practicality and utility of a brief, single-session, crisis intervention model that facilitated discharge from the ED. This report will help practitioners to apply this model in their own practice and identify patients who may require psychiatric hospitalization.


2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
Kakali Pal ◽  
Abigail Smith ◽  
Joseph Hayes ◽  
Apu Chakraborty

This case report describes a forty-two-year-old man with no previous psychiatric history who developed delusional jealousy (Othello Syndrome) associated with ropinirole treatment. Ropinirole is a commonly used dopamine receptor agonist, which was being used to treat his Parkinson’s disease, and his delusional symptoms resolved entirely with ropinirole dose reduction.


2020 ◽  
Vol 15 ◽  
Author(s):  
Anangamanjari Pedapudi ◽  
Jonathan Stewart ◽  
Ankita Patel

: Quinacrine is an older antimalarial drug that remains in use for a variety of illnesses including treatment resistant giardiasis. We report a patient with no prior psychiatric history who developed mild, prodromal psychiatric symptoms when treated with quinacrine for treatment resistant giardiasis. Symptoms resolved when the drug was stopped, recurred with greater severity (requiring involuntary psychiatric hospitalization) when restarted and promptly resolved again when finally stopped. Although quinacrine remains in use today, providers may be unaware of its potential for serious neuropsychiatric toxicity.


2021 ◽  
Author(s):  
Olga Anatolevna Karpenko ◽  
Oleg Gennadyevich Melikhov ◽  
Andrej Alexandrovich Tyazhelnikov ◽  
Georgiy Petrovich Kostyuk

INTRODUCTION. Common mental disorders - anxiety and depression - are prevalent among patients with cardiovascular disease (CVD) and diabetes mellitus type 2 (DM) and can negatively influence treatment outcomes and healthcare expenses. Despite the importance of management of depression and anxiety in primary care facilities, the diagnostics and treatment of these disorders remain insufficient in the Russian Federation. OBJECTIVE. To explore whether the rates of referrals to psychiatrist and indicated pharmacological treatment received due to depression or anxiety among patients with CVD and DM will significantly change in the primary healthcare facility after the training of primary care physicians (PCPhs) to deal with comorbid depression and anxiety (including the algorithm for referral to a psychiatrist). METHODS. Patients in primary care outpatient settings with diagnoses of CVD and DM passed screening on anxiety and depression using the Hospital Anxiety and Depression Scale (HADS), and information about the indicated treatment for anxiety or depression was collected when present (Sample 1: n = 400). The educational programme for PCPhs on diagnostics of anxiety and depression was then performed, and PCPhs were instructed to refer patients with HADS 7 to a psychiatrist. After the training, the second sample was collected (Sample 2: n = 178) using the same assessments as for Sample 1. The independent expert (psychiatrist) evaluated whether the patients had received the indicated pharmacological treatment, according to the screening criteria used in the study for anxiety and depression for both samples. RESULTS. The proportions of patients with borderline abnormal and abnormal HADS scores ( 7) were 365 (91.2%) and 164 (92.1%) in Sample 1 and Sample 2, respectively. In Sample 1, among patients with HADS 7, 119 (29.8%) received psychopharmacological treatment, but in only 46 (38.7%) cases it was indicated in compliance with the screening criteria. In Sample 2, among patients with HADS 7, 59 (33.1%) received psychopharmacological treatment, and in only 14 (23.7%) cases was it indicated in compliance with the screening criteria. The differences in the indicated pharmacological treatment were not statistically significant, and no one from Sample 2 with HADS 7 met a psychiatrist through PCPh referral. CONCLUSIONS. Anxiety and depression are prevalent in patients with CVD and DM treated in primary care facilities, but these patients may not be receiving the indicated pharmacological treatment. Barriers to referral and the use of psychiatric consultation exist despite the focused training of PCPhs and the straightforward referral protocol provided.


2020 ◽  
Vol 13 ◽  
Author(s):  
Charlotte Slaughter ◽  
Chris Allen

Abstract Heart failure increases the likelihood of an individual experiencing co-morbid anxiety and depression, which can affect their physical as well as mental health. There is a need to develop non-pharmacological interventions for the psychological consequences of heart failure. Evidence shows that cognitive behavioural therapy (CBT) can be helpful, but there is less clarity about CBT’s effectiveness for people with heart failure who have complex multi-morbid difficulties. This paper presents a case report of a man with heart failure. He was part of a research trial for cardiac resynchronisation therapy with defibrillation (CRT-D), after other physical procedures had been unsuccessful, and was experiencing severe anxiety and moderately severe depression. The intervention used was based on transdiagnostic CBT, provided at home over six sessions. Self-report measures were completed at each session and at 3-month follow-up. A measure of his use of clinical services was also carried out at pre-, post- and 3-month follow up. Post-intervention, the client showed non-clinical levels of depression and anxiety and these improvements were maintained at 3 months. Use of clinical services also reduced, with fewer admissions to hospital and fewer visits by specialist nurses and GPs. This case suggests that CBT, and particularly transdiagnostic CBT, can be helpful in reducing anxiety and depression in people with heart failure. Further work evaluating the impact on quality of life and the utility of this approach with a wider group of people with heart failure and psychological distress would be advantageous. Key learning aims (1) Depression and anxiety are prevalent in people with heart failure. (2) Cognitive behavioural therapy can be an effective intervention for reducing depression and anxiety in people living with heart failure. (3) There are benefits to integrating care with this population because they present with interlinked physical and psychological needs.


2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.


2011 ◽  
Vol 21 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Farzan Irani ◽  
Rodney Gabel

This case report describes the positive outcome of a therapeutic intervention that integrated an intensive, residential component with follow-up telepractice for a 21 year old male who stutters. This therapy utilized an eclectic approach to intensive therapy in conjunction with a 12-month follow-up via video telepractice. The results indicated that the client benefited from the program as demonstrated by a reduction in percent stuttered syllables, a reduction in stuttering severity, and a change in attitudes and feelings related to stuttering and speaking.


2014 ◽  
Vol 68 (2) ◽  
pp. 104-106
Author(s):  
Aleksandra Pivkova Veljanovska ◽  
Sonja Genadieva Stavrik ◽  
Zlate Stojanoski ◽  
Lazar Cadievski ◽  
Adela Stefanija ◽  
...  

Abstract The article presents a case with diagnosed Hodgkin disease (HD) during pregnancy. The aim of this case study was to present diagnostic possibilities in determining HD stage during pregnancy and therapeutic dilemmas. The incidence of HD during pregnancy is 3.2% of all cases with this malignant hematological disorder. The treatment of this disease during pregnancy depends on disease-related factors, pregnancy-related factors, as well as possible implications for fetal morbidity and mortality. The need of analysis of the nature of the disease during pregnancy indicates examination of a larger series of pregnant women with HD and the drawn conclusions affect the decision whether chemotherapy treatment should start immediately or it should be postponed for after delivery.


2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Meena Jain ◽  
Saloni Chandalia

This research paper deals with the Family Environment and its Correlation with Anxiety and Depression level among persons with Heart Disease. There had been a number of researches that investigated that ischemic heart disease patients who suffer significant anxiety have close to a 5-fold increased risk of experiencing frequent angina and those with depression have more than a 3-fold increased risk for these episodes. This observed link between psychiatric symptoms and angina underlines the importance of treating anxiety and depression in cardiac patients, according to study co author Dr Mark D Sullivan (University of Washington School of Medicine, Seattle). To gather the needed data, Hamilton Anxiety Scale and Becks Depression Inventory were used. As stated from literatures, for people with heart dysfunction, depression and anxiety can increase the risk of an adverse cardiac event such as a heart attack or blood clots. For people who do not have heart disease, depression and anxiety can also increase the risk of a heart attack and development of coronary artery disease. Researchers have also emphasized on the role of family psychosocial environment and its positive association with the Coronary Heart Disease risk.


Author(s):  
Ganapathi Rao ◽  
Vijay Kumar ◽  
Ashok Naikar ◽  
Chandrakanth Halli

A standard Ksharasutra is practiced in treatment of Bhagandara (fistula-in-ano) with high success rate and minimum recurrence rate. In previous research it was noted that Pittaja Prakruti patients sometime might cause more perianal irritation due to Apamarga Ksharasutra. So in this study Palasha Ksharasutra prepared in Arkaksheera was prepared by Palasha Kshara (Ash of Butea monosperma), Arka Ksheera (Calotropis gigantic) and turmeric powder (Curcuma longa). This Ksharasutra was prepared as per the API guidelines and preserved in air tight tube. A patient of Pittaja predominant Prakruti with fistula-in ano having two external opening at 6 and 7 O’ clock position of anus was treated with application of Ksharasutra. The Palasha Ksharasutra prepared in Arkaksheera was applied in these two opening under spinal anesthesia. Then Ksharasutra was changed by weekly interval under local xylocaine jelly 2%. The length of thread was measured weekly and noted in the case to assess the unit cutting time (UCT). The unit cutting time (UCT) of first thread was 7.5 days/cm and second one had UCT 6.8 days/cm. During the treatment patient was doing his job regularly without hampering the quality of life. After 2 months patient was free from all symptoms of fistula with normal scar and without any complications. This case study demonstrated the utility of Palasha Ksharasutra prepared in Arkaksheera in multiple fistula-in ano.


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