scholarly journals A case report of late-onset schizophrenia differentiated from a dementing disorder

2021 ◽  
Author(s):  
Takamitsu Shimada ◽  
Takashi Uehara ◽  
Tatsuya Nagasawa ◽  
Mitsuru Hasegawa ◽  
Yoshiki Maeda ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Dopamine Transporter ◽  
Psychiatric Symptoms ◽  
Late Onset ◽  
Clinical Importance ◽  
Auditory Hallucinations ◽  
Elevated Concentration ◽  
Subsequent Increase ◽  
Total Tau ◽  
Dementing Disorders

Abstract Background With the increase in life expectancy and the subsequent increase in the older population, the clinical importance of late-onset psychosis also increases. Neuropathological findings play an important role in the differential diagnosis of dementing disorders in older adults. Herein, we report a case of late-onset schizophrenia that required differentiation from a dementing disorder. Case presentation: The patient was an 83-year-old woman who had experienced auditory hallucinations since she was 67 years old. She was hospitalized for treatment of her psychosis. Initially, various examinations were performed to consider the possibility that she had a dementing disorder such as dementia with Lewy bodies. 123I-meta-iodobenzylguanidine myocardial scintigraphy revealed no decrease in iodine accumulation in the myocardium, and 123I-ioflupane dopamine transporter imaging revealed no decrease in dopamine transporter accumulation in the striatum. The patient had an elevated concentration of total tau (488 pg/mL), a cerebrospinal fluid biomarker. After comprehensive testing, the patient was diagnosed with late-onset schizophrenia. Her psychiatric symptoms such as auditory hallucinations diminished after the administration of the recommended first-line drug risperidone (3 mg/day), and she was discharged on day 90. Conclusions This case was identified as late-onset schizophrenia. However, an elevated total tau concentration was observed, indicating that neurofibrillary tangles and neuronal death, which are characteristic of Alzheimer 's disease, may also have been present. Late-onset schizophrenia should be treated based on an appropriate differential diagnosis, including neuropathological consideration of dementing disorders.

Late-onset schizophrenia

2020 ◽  
pp. 671-694
Author(s):  
Ellen E. Lee ◽  
Baichun Hou ◽  
Ipsit V. Vahia ◽  
Dilip V. Jeste
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Life Events ◽  
Genetic Risk ◽  
Psychiatric Symptoms ◽  
Late Onset ◽  
Sociodemographic Factors ◽  
Sensory Loss ◽  
Adverse Life Events

Late-onset schizophrenia remains an understudied subtype of schizophrenia, despite growing recognition of its impact and distinction from early-onset schizophrenia. This chapter reviews the existing literature on late-onset schizophrenia including beginning with the nomenclature and epidemiology. Then we provide a review of key risk factors and correlates—including genetic risk, sex differences, comorbid sensory loss and physical illness, cognitive and psychiatric symptoms, sociodemographic factors, adverse life events, neuropathology, and inflammation. The chapter ends with clinical issues, including symptoms, differential diagnosis, treatments, and prognosis. Recent studies have examined the role of oestrogen treatments and a new therapy for tardive dyskinesia therapy as well as inflammatory mechanisms in schizophrenia.

Late-onset mononeuritis multiplex: the importance of differential diagnosis

2020 ◽  
Vol 179 (10) ◽  
Author(s):  
Sofia F. Tavares ◽  
Vanessa M. Chaves ◽  
Verónica B. Guiomar ◽  
Pedro M. Rodrigues ◽  
Ana O. Monteiro ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Late Onset ◽  
Mononeuritis Multiplex

Cotard syndrome in a young man?

2016 ◽  
Vol 33 (S1) ◽  
pp. S348-S348
Author(s):  
A. Cercos López ◽  
M.C. Cancino Botello ◽  
V. Chavarria Romero ◽  
G. Sugranyes Ernest
Keyword(s):  
Differential Diagnosis ◽  
Suicide Ideation ◽  
Psychiatric Symptoms ◽  
Past History ◽  
Gastrointestinal Symptoms ◽  
Autoimmune Encephalitis ◽  
Psychomotor Retardation ◽  
Stressful Events ◽  
Psychotic Episode ◽  
Degree Relative

IntroductionAnti-NMDA encephalitis normally appears as a characteristic syndrome with typical symptoms that undergoes with multiphase evolution. However, it sometimes develops atypical symptoms so we must perform a careful differential diagnosis.ObjectivesTo conduct a current review of detection and management of anti-NMDAr encephalitis, and psychiatric manifestations.MethodSystematic review of the literature in English (PubMed), with the following keywords: “Autoimmune encephalitis”, “psychosis”, and “NMDA receptor”.ResultsWe present the case of a 15-year-old boy referred to evaluation for a first psychotic episode. He had no past history of psychiatric illness or substance abuse. The only relevant antecedent is multiple sclerosis in a first degree relative. For the last months, he presented high levels of anxiety symptoms apparently related to college stressful events and fluctuating hypoesthesia of left cranial side. Days later, it appeared autolimited gastrointestinal symptoms, headache and fever. During the next days it appeared psychomotor retardation, choreic movements, suicide ideation and mood-congruent paranoid and nihilistic ideation, auditory and visual hallucinations, perplexity and catatonic symptoms so he was hospitalized. We observed cognitive functions impairment, unsteady gait, dysartria, dysphasia, clonus and left babinsky sign. EEG showed slow waves on right frontal area. CFS showed protein elevation and immunologic study revealed positive anti-NMDA antibodies. Treatment with methylprednisolone and gammaglobuline was started with partial response, needing addition of rituximab.ConclusionsIn this case, we highlight the importance of early detection and a detailed differential diagnosis, to determine whether the etiology of psychiatric symptoms in order to achieve an accurate and early treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals C-06 Differential and Dual Diagnosis of Alzheimer’s Disease and Personality Disorders: Performance on WAIS-IV Subtests

2019 ◽  
Vol 34 (6) ◽  
pp. 1033-1033
Author(s):  
R Berger ◽  
C Marker ◽  
C Burger
Keyword(s):  
Differential Diagnosis ◽  
Block Design ◽  
Past Research ◽  
Diagnostic Process ◽  
Adhd Assessment ◽  
Personality Functioning ◽  
Cognitive Patterns ◽  
Extensive Test ◽  
Matrix Reasoning ◽  
Dementing Disorders

Abstract Objective Certain personality disorder (PD) diagnoses are related to the development of dementing disorders. There is a higher rate of comorbidity of PD in samples of patients with dementing disorders compared to healthy controls, which can lead to difficulties during the diagnostic process. The present study seeks to identify the neurocognitive correlates of those diagnosed with Alzheimer’s dementia (AD) compared to PD, potentially aiding in differential diagnosis. Method Data was collected as part of a large assessment outpatient clinical practice. The data contained 580 participants who came to the clinic with a variety of referral questions (e.g., neurological diagnosis, personality functioning, ADHD assessment). To measure cognitive functioning, participants were administered the WAIS-IV. Participants included 43 people diagnosed with AD and 18 with PD. Results Subtest scores for participants diagnosed with AD were lower than participants with PD. We adjusted the mean level difference using vocabulary. Using regression, we pulled out the variance associated with vocabulary as it is not susceptible to cognitive decline. Block design was significantly different for the two groups even after controlling for vocabulary (r-square = .06; p = .017). Matrix reasoning was significantly different for the two groups even after controlling for vocabulary (r-square = .09; p = .005). Conclusions The differential diagnosis of PD and dementing disorders is important, and thus these findings are important in beginning to understand the cognitive patterns in those with AD and PD. Past research has not controlled for intellectual functioning. However, additional research utilizing larger sample sizes and an extensive test battery is necessary.

scholarly journals Maternal Serum Angiogenic Factor sFlt-1 to PlGF Ratio in Preeclampsia: A Useful Marker for Differential Diagnosis and Prognosis Evaluation in Chinese Women

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Wei-zhen Lou ◽  
Fang Jiang ◽  
Jing Hu ◽  
Xiao-xu Chen ◽  
Ying-na Song ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Early Onset ◽  
Late Onset ◽  
Gestational Hypertension ◽  
Angiogenic Factor ◽  
Chronic Hypertension ◽  
Control Groups ◽  
Roc Curve Analysis ◽  
And Control ◽  
Plgf Ratio

The ratio of soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) is elevated and proved to be useful in preeclampsia (PE) diagnosis. Its value in differential diagnosis with other pregnancy complications and prediction of pregnancy duration has yet to be clarified in Chinese population. We retrospectively analyzed 118 singleton pregnancies with suspected or diagnosed PE at the Peking Union Medical College Hospital (PUMCH) in China. Among these, 62 pregnancies were diagnosed as PE (48 early onsets and 14 late onsets, with 39 and 5 severe PE, respectively), 12 gestational hypertension (GH), 15 chronic hypertension (chrHTN), 16 autoimmune diseases, and 13 pregnancies with uncomplicated proteinuria. And 76 normal pregnancies were included as control. The results showed (1) the sFlt-1/PlGF ratio in early onset PE subgroup was significantly higher than that in GH, chrHTN, and control groups; the sFlt-1/PlGF ratio in late onset PE subgroup was significantly higher than that in chrHTN and control groups, but similar as GH group; the sFlt-1/PlGF ratio was similar among GH, chrHTN, and control groups. (2) The sFlt-1/PlGF ratio was significantly increased in the PE group compared with autoimmune disease and uncomplicated proteinuria pregnancies. (3) By ROC curve analysis, the cutoff value of the sFlt-1/PlGF ratio was less than 21.5 to rule out PE and higher than 97.2 to confirm the diagnosis of PE. (4) The sFlt-1/PlGF ratio was higher in PE pregnancies delivering within 7 days than those more than 7 days, either in early onset PE or severe PE. In conclusion, we show that maternal sFlt-1/PlGF ratio is an efficient biomarker in the diagnosis and differential diagnosis of PE. This ratio can be used to predict the timing of delivery for PE pregnancies.

Sign in / Sign up

Export Citation Format

Share Document