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The impact of cocaine on diagnosis stability in psychosis, based on a case report
- M. Pérez Machado, L. Cano Roch, E. Mur Mila
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S665-S666
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Introduction
Substance-induced psychosis (SIP) is the name given to a psychosis that starts in the context of substance abuse, but persists for days and weeks with no substance use. There is growing recognition that individuals with substance-induced psychosis are more likely to develop a schizophrenia spectrum disorder. Early onset of substance-induced psychosis and cannabis use are predictors of conversion. Nevertheless, more evidence is needed to identify other factors.
ObjectivesThe objective of this study was to analyze the progression of substance-induced psychosis to several mental disorders, by reporting a case of a cocaine user, and identifying the factors that promote the progression.
MethodsWe report the case of a 55 years old male, with long-term consumption of endovenous cocaine and heroin, who has experienced various episodes of substance-induced psychosis in the past.
In 2017, he presented haptic and visual hallucinations oriented as parasite delusion during rehab hospitalization. The symptoms disappear after a few days of risperidone treatment and absence of consumption. Consuming cocaine and heroin ev in previous days.In October 2018 and July 2021 the patient was hospitalized in Dual Pathology for similar episodes oriented as substance-induced psychosis.
In the current episode, the patient was hospitalized in the Dual Pathology Unit due to a psychotic episode described as parasite infestation delusion and prejudice delusion against his family. The last consumption of heroin and cocaine was 3 months ago.
ResultsDATE OF HOSPITALIZATION LAST CONSUME BEFORE HOSPITALIZATION HABITUAL COMPSUPTION BEFORE HOSPITALIZATION INICIAL SYMTOMS DURING HOSPITALIZATION TREATMENT DURING HOSPITALIZATION 04/12/17 - 19/12/17 - 1 DAY COCAINE AND HEROIN: 1/8g/24h ev -PARASITE DELUSION -Haptic Hallucinations Risperidone 2mg/day 25/09/18 08/10/18 1 DAY -COCAINE AND HEROINE: O,5g, 2-3 times a week,ev -PARASITE DELUSION - Haptic and Visual Hallucinations Risperidona hasta 4mg/day 15/06/21 - 28/06/21 ? -COCAINE AND HEROINE: O,5g, 2-3 times a week,ev -PARASITE DELUSION - Behavioral impact Risperidone 3mg/day 15/09/2022- 17/10/2022 3 MONTHS - - PARASITE DELUSION -Behavioural impact - Prejudice delusion Paliperidone 3mg/day ConclusionsThis case report exemplifies the temporal relationship between substance use and the development of psychotic illness. Suggesting substance-induced psychosis as an indicator for the future development of a severe mental disorder. For this reason, more evidence is needed to identify other factors that promote the progression to severe mental disorders and stablish a higher risk group
Disclosure of InterestNone Declared
Descriptive study of patients with intellectual disability attended in a community mental health care center
- S. Oller Canet, E. Pérez Sánchez, L. Alba Pale, E. Mur Mila, B. Samsó Buixareu, C. Mizrahi Recasens, S. Gasque Llopis, S. Castillo Magaña
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, pp. S599-S600
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Introduction
The rate of mental illness among people with intellectual disability is at least 2.5 times higher than in the general population [1].
ObjectiveTo describe the clinical and sociodemographic characteristics of all patients with intellectual disability treated in a community mental health care center (CMH) located in a city of 120,000 inhabitants on the outskirts of Barcelona with a high poverty index.
MethodsDocuments and patient records were reviewed. Clinical, sociodemographic and other treatment data of patients with intellectual disability treated at the CMH were collected.
ResultsThe sample consisted of 118 patients. Mean age: 39.5 (SD: 15), 54% men. 92% single and 23.7% legally incapacitated. 46.6% never completed basic education and 44.1% completed primary school. Employment status: 14.4% unemployed, 14.4% currently active, and 50% pensioned. Patients living mainly with their family (parents:) 86%. 68.6% of patients showed aggressive behavior, but the rate of hospital psychiatric admissions was low (mean: 1.1 (SD: 2.3)). Organic comorbidity: 44.9%. Functionality measured with GAF mean: 45 (SD: 12). Level of intellectual disability was mostly mild (62%). Psychiatric diagnoses were: psychotic disorders: 49.25%, affective disorders: 6.8%, personality disorder: 3.4%, Obsessive-compulsive disorder: 3.4%, autism: 11.9% and other diagnoses: 37.3%. Patients treated with anti-psychotics: 78.8%, anti-depressants: 40.7%, and mood stabilizers: 70.5%.
ConclusionsIntellectually disabled patients from our sample showed high comorbidity with psychotic disorders, were highly medicated and often exhibited aggressive behavior.
Disclosure of interestThe authors have not supplied their declaration of competing interest.