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Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)

Published online by Cambridge University Press:  13 August 2021

A. Sarafopoulos ,
D. Antoniadis  and
V. Karpouza
A. Sarafopoulos*
Affiliation:
4th Picu, Psychiatric Hospital of Thessaliniki, Thessaloniki, Greece
D. Antoniadis
Affiliation:
4th Picu, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
V. Karpouza
Affiliation:
4th Picu, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
*
*Corresponding author.

Abstract

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Introduction

A 47 y.o. female patient was admitted to the female PICU with a manic episode. Upon admission she presented with mood elation, psychosis, pressured speech, lack of sleep and agitation.

Objectives

To investigate negative prognostic factors such as the co-morbidity with a personality disorder in patients presenting with severe mania.

Methods

The patient was assessed regularly by the psychiatric team consisting of a CT doctor and one General Adult Consultant. Appropriate psychological assessments for mania and laboratory investigations took place.

Results

The patient initially scored above 45 in the Young Mania Rating Scale (YMRS), establishing a diagnosis of severe mania. She was treated with Olanzapine titrated up to 20mg OD and augmentation with Lithium treatment. Lithium plasma levels were at 0,6. Due to the treatment resistant manic presentation a second antipsychotic agent was administered and the patient was also treated with Zuclopenthixol depot 400mg every two weeks. Clinical improvement was observed after 16 days from admission.

Conclusions

The clinical team wondered about the clinical challenges of the case. According to the literature having a Personality Disorder diagnosis is a negative prognostic factor for patients with mania and this is relevant to this case as well.

Disclosure

No significant relationships.

Keywords

maníaBPD
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S625
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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