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Organic psychosis: Much more than dopamine
- R. Martín Gutierrez, M. Juncal Ruiz, O. Porta Olivares, R. Landera Rodríguez, L. Sánchez Blanco, D. Abejas Díez, G. Pardo de Santayana Jenaro, M. Gómez Revuelta, C. Marín Requena, V. Gajardo Galán
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. s822
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Introduction
Most of elderly onset psychosis present as a consequence of one or more organic processes. We present the case of an 81-year-old patient with diagnosis of a posterior fossa meningioma. It emerged with abrupt positive symptoms of psychosis with important family and social disruption. The interest of the case lies in the low frequency of psychiatric symptoms associated to this type of tumor, given its location. Thus, these symptoms may be explained, by normal pressure hydrocephalus (NPH) secondary to the tumor.
ObjectivesTo highlight the importance of performing a complete organic screening in elderly onset psycotic patients.
Material and methodFrom the mentioned case, we performed a literature review of psychopathology associated with NPH.
ResultsPsychiatric examination demonstrated parasitization delusions and delusional misinterpretations; tactile and visual zoomorphic hallucinations were also present. They were compatible with Ekbom syndrome; anxiety and behavioral disorganization were prominent. We introduced treatment with risperidone 0.5 mg/12 h with important decrease of positive psychotic symptoms. Currently, the patient is waiting for a ventricular-peritoneal shunt.
ConclusionsThe NPH usually presents with memory failures, psychomotor slowing, problems in calculating and writing. It may progress to a neurological impairment so intense that may be indistinguishable from Alzheimer's disease. From a psychopathological point of view, affective or psychotic symptoms and/or behavioral disorganization may also appear. In few cases, HNT onset shows with prominent psychiatric symptoms instead of neurological impairment. These symptoms may improve with pharmacological and surgical treatment. Thus, it is important to get an accurate diagnosis.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Parasomnias and Panicattacks: a Case Report
- S. Benavente López, N. Salgado Borrego, C. Hernández Durán, E. Muro Fernández de Pinedo, a.P. García Marín, L. Pérez Ordoño, a. Sainz Herrero, a.M. Sanz Paloma, R. Barbosa Requena, L.T. Vázquez Rodríguez, G. Rodrigo Borja, J. Vila Santos, F. Jiménez Morillas, S. Bermejo Lorero, M.L. Castroarias
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S440
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Introduction
Parasomnias are a category of sleep disorders in which abnormal events occur during sleep, due to inappropriately timed activation of physiological systems.
Case reportwe report the case of a 41-year-old female who has no psychiatric history. The patient went to emergency department because when she was starting to sleep, in the first state of sleep, she felts a sensation of paralysis in all her body, with incapacity for breathing, chest oppression and tactile hallucinations like something or someone was touching her entire body. Due to that, the patient awoke frightened, with high levels of anxiety, with heart palpitations, shortness of breath, trembling, choking feeling, sweating, nausea and fear of dying. When the patient arrived to the emergency department, she was suffering a panic attack, thinking that she could have some kind of neurological disease or she was suffering a heart attack.after treating the panic attack with 1 mg of lorazepam, all the symptoms subsided gradually.
Discussionin this case report, we present a patient with a new-onset parasomnia, with hypnagogic hallucinations and a panic attack at the awakening. It is known that stress factors are closely associated with parasomnias, as we can see in this case because the patient was moving and she was sleeping in a new place.
ConclusionsParasomnias are very frequently present in general population and they can trigger intense anxiety status that can lead to panic attacks.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Hyperthyroidism and Psychotic Symptoms: a Case Report
- S. Benavente López, N. Salgado Borrego, L. arroyave Villa, C. Hernández Durán, E. Muro Fernández de Pinedo, a.P. García Marín, L. Pérez Ordoño, a.M. Sanz Paloma, R. Barbosa Requena, M. Gil Mosquera, N. Bermejo Cabanas, R. Franco Sánchez-Horneros, I. Fernández Marín, a. Rodríguez Miravalles, M.L. Castroarias
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S440-S441
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Introduction
Hyperthyroidism may lead to high anxiety status, emotional lability, irritability, overactivity, exaggerated sensitivity to noise, and fluctuating mood, insomnia and hyporexia.in extreme cases, they may appear delusions and hallucinations as psychiatric symptoms.
Case reportwe report the case of a 53-year-old female who was diagnosed of hyperthyroidism and generalized anxiety disorder. The patient went to emergency department because of high levels of anxiety, with heart palpitations, trembling, shortness of breath and nausea. She was presenting auditory hallucinations and delusions as psychiatric symptoms.an urgent thyroid profile was made and it was observed the next results: TSH < 0.005; T4:4; T3:21. Due to a severe thyroid malfunction, the patient was admitted and treated with antithyroid agent, improving the psychiatric and somatic symptoms.
Discussionin this case, a patient diagnosed of hyperthyroidism and generalized anxiety disorder presented very severe psychiatric symptoms, with hallucinations and delusions. These symptoms may be produced by primary psychiatric disorders, but is very important to look for thyroid alterations, because if they are the cause, the acute treatment of thyroid malfunction is the correct management of the patient.
ConclusionsHyperthyroidism is very common in general population, being infradiagnosed most of times.in patient with anxiety or other psychiatric symptoms, it is very important to make a thyroid function tests before the diagnosis of a psychiatric disorder.in extreme cases, hyperthyroidism status may lead to severe psychiatric and somatic complications.
Disclosure of interestThe authors have not supplied their declaration of competing interest.