3 results
Psychopharmacological treatment in dissociative identity disorder (DID)
- R. Pinilla, C. Rodríguez Sabaté, B. Ordóñez Méndez, A. Sotillos, A. Hernández Mata
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S151
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Introduction
Patients with dissociative identity disorder (DID) present two or more identities. Although it is a widely questioned diagnosis, it is currently found in the main DSM-5 and ICD-10 diagnostic manuals. So far there is no standard psychopharmacological treatment for people with this pathology.
ObjectivesDescribe the pharmacological treatment associated with the clinical evolution of a patient with DID.
MethodsFollow-up was carried out in a mental health center for a year, undergoing psychopharmacological and psychotherapeutic treatment. The information is taken from the medical history.
ResultsThe patient presents with anxious and depressive symptoms. She was referred from primary care with 50mg sertraline without response. Dose was increased to 100mg without response. New management started with desvenlafaxine 100mg, associated with lorazepam, partially reducing the symptoms. Later, the patient presented self-referentiality, sounding of thought, began to describe frequent memory losses and a rebound in anxiety-depression symptoms, increasing the dose of desvenlafaxine to 200mg and introducing haloperidol to 1.5mg. Three months later, she presented showing another identity, active, aggressive, pythiatic, without evident anxious symptoms that she previously presented in a marked way. Desvenlafaxine was adjusted to 100mg and haloperidol to 0.5mg every 12 hours. The patient evolved favorably, decreasing anxiety, depressive symptoms and memory loss, in addition to disappearing psychotic symptoms. This treatment was sustained, keeping the patient psychopathological and functional stability and allowing a psychotherapeutic approach.
ConclusionsTreatment with desvenlafaxine and haloperidol was favorable to maintain clinical stability and allow other therapeutic approaches.High dose of antidepressant could favor the expression of another identity of the patient.
DisclosureNo significant relationships.
Keywordantidepresive antipsicotic disociative memory-loss
Historical path of paraphrenia
- A. Hernández Mata, A. Sotillos Gómez, P. Marco Coscujuela, B. Ordóñez Méndez
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S815
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- Article
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- You have access Access
- Open access
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Introduction
Paraphrenia is a psychotic disorder characterized by an insidious development of a vivid and exuberant delusional system, accompanied by hallucinations and confabulations, without a personality deterioration. It is considered to be an intermediate entity between the disorganization of schizophrenia and the systematization of a delusional disorder.
ObjectivesDevelop knowledge about paraphrenia as an individualized diagnostic entity and its historical path through the classical authors’ texts.
MethodsExtensive research on the historical path of the paraphrenia diagnostic entity was carried out, as well as the current situation of the term.
ResultsIn the German psychiatry it was Karl Kahlbaum who first introduced the term of paraphrenia. Later many authors of the German psychiatry delved into this diagnostic entity. Emil Kraepelin described four different subtypes of paraphrenia: paraphrenia systematica, expansiva, confabulans and phantastica. However, other authors such as Kleist or Bleuler, considered paraphrenia should not be judge as an individualized diagnostic entity as it should be considered inside schizophrenia, so the term disappeared in the German psychiatry. In the French psychiatry, unlike the German, the independence of chronic psychosis from schizophrenias was recognized, so the term had a longer path. Henry Ey recognized four important clinical features in this disorder: paralogical thought dominance, megalomania, confabulation and integrity of relation with reality.
ConclusionsCurrently the term paraphrenia is no longer considered an individualized diagnostic entity. In fact, in today’s textbooks of psychiatry paraphrenia is considered a psychotic disorder that has nothing in common with the one described by the classical authors, and it is part of the late-onset psychosis.
DisclosureNo significant relationships.
Historical path of paraphrenia
- A. Hernández Mata, A. Sotillos Gómez, P. Marco Coscujuela, B. Ordóñez Méndez
-
- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S517-S518
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Paraphrenia is a psychotic disorder characterized by an insidious development of a vivid and exuberant delusional system, accompanied by hallucinations and confabulations, without a personality deterioration. It is considered to be an intermediate entity between the disorganization of schizophrenia and the systematization of a delusional disorder.
ObjectivesDevelop knowledge about paraphrenia as an individualized diagnostic entity and its historical path through the classical authors’ texts.
MethodsExtensive research on the historical path of the paraphrenia diagnostic entity was carried out, as well as the current situation of the term.
ResultsIn the German psychiatry it was Karl Kahlbaum who first introduced the term of paraphrenia. Later many authors of the German psychiatry delved into this diagnostic entity. Emil Kraepelin described four different subtypes of paraphrenia: paraphrenia systematica, expansiva, confabulans and phantastica. However, other authors such as Kleist or Bleuler, considered paraphrenia should not be judge as an individualized diagnostic entity as it should be considered inside schizophrenia, so the term disappeared in the German psychiatry. In the French psychiatry, unlike the German, the independence of chronic psychosis from schizophrenias was recognized, so the term had a longer path. Henry Ey recognized four important clinical features in this disorder: paralogical thought dominance, megalomania, confabulation and integrity of relation with reality.
ConclusionsCurrently the term paraphrenia is no longer considered an individualized diagnostic entity. In fact, in today’s textbooks of psychiatry paraphrenia is considered a psychotic disorder that has nothing in common with the one described by the classical authors, and it is part of the late-onset psychosis.