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ARIPIPRAZOLE-INDUCED OCULOGYRIC CRISIS (ACUTE DYSTONIA)
- L. Rodriguez Andres, C. Vallecillo, L. Gallardo Borge, C. M. Capella Meseguer, G. Guerra Valera, C. Noval Canga
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1009-S1010
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Introduction
Aripiprazole is a third generation atypical antipsychotic and a dopamine serotonin system stabilizer, effective against positive and negative symptoms of schizophrenia. Within the group of atypical antipsychotics, aripiprazole shows a relatively benign safety profile (e.g. lower metabolic impact, mild effect on cardiovascular parameters), although the reported rate of extrapyramidal side effects is measurable.
Oculogyric crisis (OGC) is a rare movement disorder characterized by a prolongued involuntary upward deviation of the eyes, lasting minutes to hours. In most cases, OCG is a drug-induced adverse event with acute or tardive onset often attributable to a functional impairment of dopaminergic neurotransmission.
ObjectivesOGC is seldom reported in children and young adults during treatment with aripiprazole, althouh it is commonly used in youths.
MethodsWe report a case of an aripiprazole-induced oculogyric crisis in a 19 year old girl who diagnosed with schizophrenia (paranoid).
ResultsThere was a complete remission of the OGC’s following aripiprazole dose reduction, suggesting the clinical manifestation was a dose-dependent phenomenon.
ConclusionsThe present report should raise awarness among clinicians for this relevant possible adverse event, that can happen also with the use of aripiprazol, not only with typical or more antidopaminergic antipsychotics. Future research in the field should emphasize neurobiological dysfunctions as the basis of EPS/OGC in patients.
Disclosure of InterestNone Declared
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
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S767-S768
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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.
Covid 19, lockdown and brief psychotic disorders
- J. Gonçalves Cerejeira, I. Santos Carrasco, C. Capella Meseguer, E. Rodríguez Vázquez, M. Óscar, M. Queipo De Llano, G. Guerra Valera, A. Gonzaga Ramírez
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S543
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Introduction
Acute and transient psychotic disorders are a rare condition entity as the sudden appearance of affective, confusional symptoms and paranoia triggered by some psychological trauma. The current pandemic caused by COVID-19 is an important psychological stressor that could favor the appearance of acute psychotic disorders. Several studies have been recently published proposing that the multifactorial stress associated with lockdown could function as a catalyst for acute psychotic disorders.
ObjectivesTo present a case of a brief psychotic disorder during the national lockdown in Spain and to review the literature about the relationship between the current pandemic and psychosis.
MethodsWe will present a case report and a literature review.
ResultsWe report a case of a 27-year-old woman, with no previous psychiatric history. Three weeks after the start of Spain lockdown sudden symptoms appeared with psychomotor restlessness, confused speech, emotional lability, thought blocking and persecutory and referential delusions. Physical exam, blood analysis and cerebral CT scan with no alterations. Treatment was performed with aripiprazole 10 mg and lorazepam 1 mg daily with clinical improvement in one weeks. She was diagnosed of Acute transient psychotic disorder.
ConclusionsStressful life events that can trigger psychosis in vulnerable individuals and the current pandemic and lockdown context could favor the appearance of acute psychotic disorders. The case reported here is in line with other current studies that show a preliminary intuition of this trend.
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
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S474-S475
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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
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S650
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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.
Barking dogs seldom bite? a case of diagnostic overshadowing in emergency department
- J. Gonçalves Cerejeira, C. Burón, I. Santos Carrasco, C. Capella Meseguer, E. Rodríguez Vázquez, M. Queipo De Llano De La Viuda, A. Gonzaga Ramírez, G. Guerra Valera
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S654
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Introduction
Diagnostic overshadowing is one of the main consequences of stigma involving patients diagnosed with a psychiatric disorder. Some studies show that in emergency departments, being diagnosed with a psychiatric illness can lead to a poor evaluation of organic symptoms, delaying the diagnosis and putting the patient’s life at risk.
Objectives- To present the case of a patient diagnosed with factitious disorder who was misdiagnosed after attending the emergency department due to the stigma related to his psychiatric diagnosis. - To provide a reflection on stigma in mental health.
MethodsWe will present a case report and a literature review.
ResultsWe report a case of a 57-year-old man diagnosed with a factitious disorder. He attended the emergency department of our tertiary care center with confused speech, desorientation and disruptive behavior at home. Although the clinical picture was compatible with a confusional state, he was ordered to be admitted to the psychiatric service. No blood test was previously requested. Three hours after being admitted, he suffered an episode of seizures. A blood test was requested and severe hypomagnesemia (0.2 mg / dl) was found. Because of this episode the patient was admitted to the Intensive Care Unit for three days.
ConclusionsFactitious disorder is a serious mental disorder with a significant stigmatizing burden. Giving a patient this diagnostic label should be the subject of careful thought in order to protect him from future diagnostic neglect.
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
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S412
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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
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S243-S244
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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
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S611
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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
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S651
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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
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S688
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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.
Compartment syndrome and suicide attempt
- E. Rodríguez Vázquez, C. Capella Meseguer, J. Gonçalves Cerejeira, I. Santos Carrasco, M. Queipo De Llano De La Viuda, A. Gonzaga Ramírez, G. Guerra Valera
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S647
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Introduction
The compartment syndrome is a pathological condition characterized by a decrease, or even interruption, of the microcirculation within a soft tissue compartment. There have been a few cases reported about compartment syndrome due to a suicide attempt.
ObjectivesTo present an unusual complication of an autolytic attempt
MethodsA descriptive study of a clinical case and literature review
ResultsA 49-year-old woman, divorced. With no psychiatric history and no somatic antecedents. Comes to the hospital after been found lying face down on the bathroom’s floor for 48 hours, next to her two empty blister packs of lorazepam and naproxen. Her partner says they argued two days ago. Brain CT: with no abnormalities. Blood analysis: metabolic acidosis with rhabdomyolysis and kidney failure. She presents ischemic injuries in both inferior extremities with right food ischemia and with no pedal pulses. Compartment syndrome is diagnosed, being necessary a bilateral fasciotomy and later a right lower extremity amputation. Initiates referral from Vascular Surgery for self-poisoning. She refers to low mood and mild anxiety due to work and relationship issues/problems. She accepts that she self-poisoning only to attract her partner’s attention after the argument. The examination shows logical thought, emotional lability, good judgement, future-oriented without suicidal ideation. Clinical judgement: acute stress reaction.
ConclusionsThe compartment syndrome is a rare complication of the suicide attempt. Our patient suffered a compartment syndrome lying on the bathroom’s floor for 48 consecutive hours without apparent trauma and no somatic antecedents. This syndrome could be developed by high naproxen and lorazepam intake.
DisclosureNo significant relationships.
A first manic episode in an elderly patient
- E. Rodríguez Vázquez, C. Capella Meseguer, G. Guerra Valera, A. Gonzaga Ramírez, M. Queipo De Llano De La Viuda, I. Santos Carrasco, J. Gonçalves Cerejeira
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S618-S619
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Introduction
The bipolar disorder is characterized by instability mood. It normally happens in the middle-aged. In elderly patients with a first manic episode, you have to dismiss organic pathology.
ObjectivesTo present an elderly patient with a first manic episode
MethodsA descriptive study of a clinical case and literature review
ResultsA 67-year-old man, married. Consulted Mental Health 5 years ago, about low mood after his early retirement. With no psychiatric treatment. Somatic antecedents: Acute myocardial infarction, hypertension and dyslipidemia. Came to the hospital accompanied by his son-in-law presenting rapid speech and thinking, bright clothing, risky behaviour, irritability, grandiosity deliration ideas and less sleep; being necessary a hospital admission. Blood and urine analysis: with no abnormalities. No toxics in the urine. Asenapine 20mg and Lorazepam 3mg were prescribed with clinical improvement. Brain CT: with no abnormalities. After that, Lithium 400mg per day was prescribed to avoid the induction of depression. Clinical judgement: manic episode. Bipolar disorder Type I
ConclusionsAfter dismissing somatic causes, the symptomatic treatment of a manic episode in older patients is on the same lines as the treatment for mania in young adults. 8-10% of psychiatric inpatients over age 55-60 years are diagnosed with bipolar disorder. Since there is an increase in the number of individuals living longer, an expected increase in the number of older adults who will be diagnosed with bipolar disorder. Older adults with bipolar disorder will increase in absolute numbers as well as the proportion of the general populations.
DisclosureNo significant relationships.
“This is not me”; an overview
- A. Gonzaga Ramírez, C. Capella Meseguer, E. Rodríguez Vázquez, M. Queipo De Llano De La Viuda, G. Guerra Valera
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S228
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Introduction
APA describes Gender dysphoria (GD) as the conflict between a person’s physical or assigned gender and the gender with which he/she/they identify. Recently DSM-V renamed gender identity disorder as “gender dysphoria”. This change in terminology removes the ‘pathology’ from being transgender, which is not a mental health condition.
ObjectivesTo systematically summarise available evidence in this important but less researched field.
MethodsA comprehensive review was carried using the PubMed/ Medline database.
ResultsFormal epidemiological studies of gender dysphoria in children and adolescents have not been conducted. The true prevalence os gender dysphoria is unknown around the world because of the varying definitions, different cultural norms and lack of data. Individuals who identify as transgender are vulnerable, and have higher rates of psychiatric comorbility compared with the general population. Gender dysphoria, gender identity disorder or transsexualism is a psychological condition that requires care and multiple health professionals.
ConclusionsThe natural history of gender identity for children who express gender nonconforming or transgender identities is an area of active research. In addition, there is a lack of guidelines to approach these patients.
“Covid madness”
- C. Capella Meseguer, E. Rodríguez Vázquez, J. Gonçalves Cerejeira, I. Santos Carrasco, L. García García
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S297
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Introduction
We present the case of a man who, after receiving treatment for Covid-19 pneumonia, suffers a manic episode induced by medication.
ObjectivesThis case is chosen to present as an example of a psychiatric illness derived from Covid-19, in this case secondary to its treatment.
MethodsWe present a manic episode induced by covid medication.
ResultsComplementary examinations are carried out in which organic pathology is ruled out, being diagnosed of a manifest episode in probable relation to the treatments used and hospital admission is decided due to the impossibility of home management. Neuroleptic and anxiolytic treatment was started at low doses with a good response, and he was discharged with complete recovery and critiqued of the episode.
ConclusionsIt is estimated that between 20-40% of patients with COVID infection have presented neuropsychiatric symptoms. Mania secondary to treatment was reported in 13 (0 · 7%) of 1744 patients with coranavirus included in a study (1). The Spanish Pharmacivigilance System of Medicines for Human Use (SEFV-H) closely monitors the suspected adverse reactions reported with drugs considered potential therapeutic strategies for SARS-CoV-2 infection. 327 cases of adverse reactions have been reported, of which 18 cases include 28 thermal cases of suspected psychiatric adverse reactions. The interest of this case lies in the fact that it illustrates a psychiatric disorder derived from Covid-19, in this case secondary to the treatment used, which causes a manifest episode with a typical evolution in this type of case with rapid improvement at low doses of antipsychotics.
“Anorexia in a patient with piscosis”
- C. Capella Meseguer, E. Rodríguez Vázquez, J. Gonçalves Cerejeira, I. Santos Carrasco, A. Gonzaga Ramírez, G. Guerra Valera, M. Queipo De Llano De La Viuda, Ó. Martín
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S358
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Introduction
We present the case of a patient with schizophrenia who presents with restriction of intake, fear of gaining weight and alteration in the way of perceiving herself in which we ask ourselves if these behavioral alterations are secondary to her diagnosis of schizophrenia to an anorexia nervosa independent of previous diagnosis.
ObjectivesWe propose to carry out a differential diagnosis of alterations in the perception of self-image in a patient with a diagnosis of schizophrenia. We suggest that these alterations may be secondary to alterations in the experience of the self present due to their psychosis.
MethodsIn the differential diagnosis of the cause of alterations in self-image and fear of gaining weight, we rely on the psychiatric interview, the study of previous history and different scales: - Eating Disorders Inventory (EDI) - Gardner Body Image Assessment - Weight, body image and self-esteem scale E-PICA - IPASE scale
ResultsIn this patient in whom the differential diagnosis of the cause of her dietary restrictions and weight loss is proposed, there does not seem to be any psychotic symptoms that produce these alterations.
ConclusionsIn the alterations in self-image in those psychotic patients, there is a doubt as to whether these could be secondary to alterations in the perception of the self typical of psychotic diseases or, on the contrary, be secondary to the spectrum of Eating Disorders.