9 results
Bed for three
- C. Vallecillo Adame, T. Jiménez Aparicio, C. De Andrés Lobo, M. Queipo De Llano De La Viuda, G. Guerra Valera, A. Gonzaga Ramírez, I. Santos Carrasco, J. Gonçalves Cerejeira, C. Capella Meseguer, E. Rodríguez Vázquez
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S767-S768
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Charles Bonnet syndrome (CBS) is characterized by the presence of visual hallucinations without other sensory-perceptual disturbances or evidence of organic mental disorder nor functional psychosis.
ObjectivesReview differential diagnosis of BCS, searching articles in Pubmed.
Methods62-year-old woman, undergoing treatment with Sertraline and psychotherapy for three months because of anxious-depressive synthoms. Pathological myopia and retinal detachment in 2012, blind left eye, retaining 33% vision in the right eye. She comes to the emergency room feeling really anxious, she says that for a year now she has had the feeling that her husband is cheating on her with another woman, and she claims with certainty that she sees a woman in her bed at night, as well as flashes of light evidencing her presence. She has also begun to hear voices through the telephone wires. She and her family deny memory loss or other cognitive impairments. We performed a Nuclear Magnetic Resonance with normal results. Family claims good conygal relation until these synthoms began and no signs of cognitive impairment.
ResultsThe patient lives as real these hallucinations which haven´t appeared during admission. We started treatment with an antipsychotic and a benzodiazepine, with great improvement of anxiety and development of some insight. Executive impairment was observed.
ConclusionsThe results obtained, make us think that, although our patient has an important visual loss, it is more a psychiatric pathology. Here lies the importance of a multidisciplinary approach among ophthalmologists, neurologists and psychiatrists in order to avoid misdiagnosis and that the patient can benefit from proper treatment.
DisclosureNo significant relationships.
Capgras syndrome. Where to find it?
- I.D.L.M. Santos Carrasco, J. Gonçalves Cerejeira, E. Rodríguez Vázquez, C. Capella Meseguer, M. Queipo De Llano De La Viuda, G. Guerra Valera, A. Gonzaga Ramírez, C. De Andrés Lobo, C. Vallecillo Adame, T. Jiménez Aparicio, A. Pérez Escudero
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S474-S475
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Capgras syndrome, where patients have the conviction that one or more close people have been replaced by a “double,” is the most prevalent delusional misidentification syndrome. It appears in psychiatric illness and organic brain damage. It seems to be due to damage of bifrontal and right limbic and temporal regions, mainly in the right hemisphere.
ObjectivesTo review the pathologies associated to Capgras Syndrome and the relevance of the differential diagnosis
Methods53-year-old female was admitted due to great sadness, crying, social withdrawal and severe paranoid concerns over the last month. Follow-up in Mental Health since 2014, because of anxious depression. After her mother’s death, she felt being followed because of old faults. Since then, low dosis of antipsychotics were used. Now she is afraid of being harmed in relation to petty thefts she committed over 15 years ago. In recent days, she has been noticing small details indicating that her family members have been impersonated by strangers, showing anguish regarding their whereabouts.
ResultsDuring her admission, high doses of antidepresants and paliperidone 6 mg/day were used with the complete disappearance of Capgras Syndrome and her anguish. Mild guilty thoughts were present after her discharge. That is why she was diagnosed with psychotic depression.
ConclusionsCapgras syndrome can be encountered in primary psychiatric diagnosis (particularly in schizophrenia and mood disorders) – where an organic element may exist in about a third of all cases – or secondary to organic disorders or medication-induced, through to overt organic brain damage, particularly in neurodegenerative disease.
Toothache
- E. Rodríguez Vázquez, C. Capella Meseguer, J. Gonçalves Cerejeira, I. Santos Carrasco, G. Guerra Valera, M. Queipo De Llano De La Viuda, A. Gonzaga Ramírez, C. Vallecillo Adame, T. Jiménez Aparicio, C. De Andrés Lobo, A. Pérez Escudero
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S650
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Mental retardation (RM) is defined as by a deficient intellectual capacity as well as by alterations of the adaptive capacity that are externalized in two or more functional areas (Personal autonomy, Communication, Orientation in the environment, Work and Free time).
ObjectivesPresent a patient with a severe behavioural disturbance with an associated intellectual deficit, who remained hospitalized for 2 months and after observing an oral alteration her symptoms improved.
MethodsA descriptive study of a clinical case
Results54-year-old woman, single. You have a moderate intellectual disability. In January 2019, she began mental health consultations with a diagnosis of adjustment disorder, on treatment with aripiprazole 5 mg/day, mirtazapine 15 mg/day, lorazepam 0.5 mg/day and dipotassium clorazepate 10 mg/day. Went to the emergency room with mutism, hyporesponsiveness and refuse to intake, having lost 25 kg in 6 months. Abdominal and thoracic CT and upper gastrointestinal endoscopy without significant findings. Consultation with otorhinolaryngology, dermatology, traumatology without significant findings. Odontostomatology consultation: Deep cavities are observed, so it is necessary to carry out extractions of the pieces in poor condition. After this intervention, the patient returns to accept oral intake.
ConclusionsPeople with intellectual disabilities have a wide range of medical problems that in many cases are directly associated with the underlying disease or syndrome and, in others, with poor physical health due to problems in basic self-care skills or the ability to express verbally. Usually, the first manifestation of pain is an alteration in behaviour, which must be taken into account when making a differential diagnosis.
DisclosureNo significant relationships.
¡ I see presenters in my house !
- M. Queipo De Llano, E. Rodríguez Vázquez, C. Capella Meseguer, J. Gonçalves Cerejeira, I. Santos Carrasco, G. Guerra Valera, A. Gonzaga Ramírez, C. Vallecillo Adame, C. De Andrés Lobo, T. Jiménez Aparicio
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S412
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Charles Bonnet syndrome (CBS) is characterized by the presence of visual hallucinations, generally complex, which occurs in patients with alterations in the visual pathway. The majority of affected patients are elderly. It appears in 15% of people with visual loss, predominantly in the 80-year-old female gender.
ObjectivesTo present a clinical case of a patient with visual hallucinations and a possible diagnosis of Charles Bonnet syndrome. Highlight the importance of an adequate differential diagnosis.
MethodsBibliographic review of the treatment and diagnosis of CBS, from articles published in the last 5 years in Pubmed.
ResultsWoman, 80 years old. No ophthalmological history except those associated with advanced age. She goes to the emergency room due to the presence of visual hallucinosis, in the form of “television presenters” of whom she makes partial criticism, being aware most of the time of their unreality. Hallucinations are not accompanied by anxiety or significant affective repercussions. Discarded delirium, intoxication by substances or drugs that cause the condition. Currently under follow-up to rule out other causes.
ConclusionsThe diagnosis of SCB requires a multidisciplinary approach between neurologists, psychiatrists and ophthalmologists in order to avoid erroneous diagnoses. The differential diagnosis should be made with pathologies such as Lewy body dementia, Parkinson’s disease, delirium, substance intoxication, migraine aura, and metabolic encephalopathy, among others. It is important to involve the family in the treatment of the syndrome to reinforce the recognition of the unreality of these hallucinations in the patients. Antipsychotic treatment can be effective only if the condition is extremely distressing.
Comorbid anorexia nervosa and schizophrenia
- C. De Andrés Lobo, C. Vallecillo Adame, T. Jiménez Aparicio, M. Queipo De Llano De La Viuda, A. Gonzaga Ramírez, G. Guerra Valera, I. Santos Carrasco, J. Gonçalves Cerejeira, C. Capella Meseguer, E. Rodríguez Vázquez
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S243-S244
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Although schizophrenia and anorexia nervosa are very different disorders, when they occur in the same patient it can be difficult to distinguish whether the alterations in body image are due to psychotic symptoms or correspond to a comorbid eating disorder. It is also relevant to know how they can interact with each other.
ObjectivesPresentation of a clinical case of anorexia nervosa in the context of a patient with a previous diagnosis of paranoid schizophrenia.
MethodsBibliographic review of the relationship between schizophrenia and alterations in the perception of body image by searching for articles in Pubmed.
ResultsWe present a 48-year-old woman who resides with her mother and a sister. Diagnosed with paranoid schizophrenia and eating disorder. She had previously been admitted to hospital twice. Since 2004, she has been followed up in mental health consultations. The patient reports constant weight changes. A year ago she began to feel overweight and began to restrict her intake and to exercise, having lost 20 kg. She reports psychotic symptoms in the past, that she now denies. Various scales show moderate impact of weight on personal perception of psychosocial adjustment, an impulse to thinness and a significant distortion of body image, perceiving herself as heavier than she is and wishing she was lighter.
ConclusionsIn schizophrenia, confusion in bodily experiences and states is not uncommon. The possible interactions between the symptoms of schizophrenia and anorexia nervosa complicate the adequate care of these patients. Further research on comorbidity of these two disorders is necessary.
The ugliest woman un the world
- M. Queipo De Llano, C. Capella Meseguer, E. Rodríguez Vázquez, I. Santos Carrasco, J. Gonçalves Cerejeira, G. Guerra Valera, A. Gonzaga Ramírez, C. Vallecillo Adame, C. De Andrés Lobo, T. Jiménez Aparicio
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S611
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
The main feature of body dysmorphic disorder (BDD) is impairing preoccupation with a physical defect that appears slight or non-existent to others.
ObjectivesTo draw an overview of BDD through a clinical case of a patient with BDD and autolytic ideation, which improved after an adequate diagnosis and an early pharmacological and psychotherapeutic approach.
MethodsBibliographic review of the treatment and diagnosis of BDD, from articles published in the last 5 years in Pubmed.
Results18-year-old woman diagnosed with depression and obsessive ideation, which started at the age of 11, after a comment at school. The patient believes that she has intenseunder-eye bags or dark circles, this has caused her to abandon all activity and self-isolate at home. Symptoms included recurring obsessive and intruding thoughts related to the supposed defect, ritualized behaviors of hours of duration aiming toit through makeup, and autolytic ideation. Therapeutic approach combined psychopharmacological and psychotherapeutic treatments, obtaining gradual improvement of symptomatology and disappearance of the autolytic ideation.
ConclusionsThe disorder is severe, which is reflected in high rates of suicide attempts. Differential diagnosis between obsessive and delirious dysmorphophobia is essential for improving outcomes; the egodystonic nature of the symptom, awareness of illness and obsessive personality traits facilitate the diagnosis. A multidisciplinary approach involving psychiatrists and clinical psychologists is necessary for a correct diagnosis and early treatment of this pathology, as well as recognition by dermatologists, surgeons and medical aesthetic professionals, where these patients go with the aim of finding solutions to their problem.
DisclosureNo significant relationships.
Lithium toxicity. A case report
- E. Rodríguez Vázquez, C. Capella Meseguer, I. Santos Carrasco, J. Gonçalves Cerejeira, A. Gonzaga Ramírez, M. Queipo De Llano De La Viuda, G. Guerra Valera, C. De Andrés Lobo, T. Jiménez Aparicio, C. Vallecillo Adame
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S651
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Lithium is widely used in the treatment of the bipolar disorder. Once introduced, it is necessary to carry out an adequate control of the therapeutic range, since it is potentially toxic, and can affect various organs.
ObjectivesTo present the case of a patient suffering from lithium poisoning and to review the symptoms of lithium poisoning.
MethodsA descriptive study of a clinical case and review of the literature
Results49-year-old woman, married. Diagnosed with bipolar disorder. She went to the emergency room due to a low level of consciousness, kidney failure, trembling of the limbs, hyperthermia and leukocytosis. In the last two weeks, the patient has reduced her intake of food, not water, finding herself more and more shaky and less reactive. Lithium in blood at admission 1.71, so conventional dialysis was performed with a progressive decrease into 0.65. On examination, he is practically mutist, bradypsychia with a significant response latency. Clinical judgment: Accidental lithium poisoning.
ConclusionsThe primary site of toxicity is the central nervous system and clinical manifestations vary from asymptomatic supratherapeutic drug concentrations to clinical toxicity such as confusion, ataxia, or seizures. Severe lithium neurotoxicity occurs almost exclusively in the context of chronic therapeutic administration of lithium and rarely results from acute ingestion of lithium, even in patients currently taking lithium. As such it is an iatrogenic illness, occurring in patients who have identifiable clinical risk factors: nephrogenic diabetes insipidus, older age, abnormal thyroid function and impaired renal function.
DisclosureNo significant relationships.
They are not real patients
- T. Jiménez Aparicio, C. De Andrés Lobo, C. Vallecillo Adame, M. Queipo De Llano De La Viuda, G. Guerra Valera, A. Gonzaga Ramírez, J. Gonçalves Cerejeira, I. Santos Carrasco, C. Capella Meseguer, E. Rodríguez Vázquez
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S688
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Cognitive depressive disorder (or depressive pseudodementia) is a condition defined by functional impairment, similar to dementias or other neurodegenerative disorders, in the context of psychiatric patients. It is important to consider a differential diagnosis in patients with cognitive impairment.
ObjectivesPresentation of a clinical case of a patient with depression with psychotic symptoms who presents cognitive impairment.
MethodsBibliographic review of the differential diagnosis between cognitive depressive disorder and real dementia by searching for articles in PubMed.
ResultsWe present a 51-year-old woman, previously diagnosed with adjustment disorder (with mixed anxiety and depressed mood) and unspecific anxiety disorder, who was admitted to the hospital due to delusional ideation of harm and Capgras syndrome, ensuring that her relatives had been replaced and the rest of the patients were not real patients, but actors who conspired against her. The MRI (Magnetic Resonance Imaging) was strictly normal (tumors or acute injuries as stroke or hemorrhage were discarded), and a MoCA (Montreal Cognitive Assesment) test was performed to screen any cognitive impairments (obtaining a score of 19/30, with language fluency and abstraction particularly affected). It would be convenient to repeat the test when this episode and the psychotic symptoms are resolved or improved.
Conclusions1. Some patients may have cognitive impairment in the context of a mood disorder. 2. A differential diagnosis and follow-up of these patients should be performed to assess prognosis, reversibility and treatment. 3. Depressive cognitive impairment may precede the development and establishment of a dementia or neurodegenerative picture.
DisclosureNo significant relationships.
3 - You Build the Roads, We Are the Intersections
-
- By Adam Vázquez
- Edited by Barbara Bordalejo, Roopika Risam
-
- Book:
- Intersectionality in Digital Humanities
- Published by:
- Amsterdam University Press
- Published online:
- 20 November 2020
- Print publication:
- 30 November 2019, pp 35-44
-
- Chapter
- Export citation
-
Summary
IN HER ARTICLE “Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics,” Kimberlé Crenshaw uses the word “intersectionality” to describe how black women were not taken into account by either “feminist theory and in antiracist politics” or as she describes them: single-axis frameworks. In her 2016 Ted Talk, she talks about Emma, an African American woman who suspected she was not hired because of her race and gender. She filed a suit that was dismissed because she could not have two courses of action: according to the judge, that would give her an advantage over African American men and white women. Crenshaw explains:
It occurred to me maybe a simple analogy to an intersection might allow judges to better see Emma's dilemma. So, we think about this intersection, the roads to this intersection would be the way that the workforce was structured by race and by gender, and then the traffic in those roads would be the hiring policies and the other practices that ran through those roads. Now, because Emma was both black and female, she was positioned precisely where those roads overlapped, experiencing the simultaneous impact of the company's gender and race traffic.
In another article, “Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color,” she offers, among many others, an example that illustrates how rigid criteria often fail to anticipate reality and, therefore, actively deny assistance to the most vulnerable people. Crenshaw writes about a non-English-speaking woman who fled her home with her son because her husband threatened both their lives. They had to live on the streets because most shelters deny assistance to people who are not fluent in English. Diana Campos, Director of Human Services for Programas de Ocupaciones y Desarrollo Económico Real, Inc (PODER), helped her be accepted in a shelter that initially refused to take her in, their justification being that her poor English could make her “feel isolated” because the house had “rules that the woman must agree to follow” which included “to attend a support group and they would not be able to have her in the group if she could not communicate.”
![](/core/cambridge-core/public/images/lazy-loader.gif)