Sleep disorders in meningoencephalitis with adjustment disorders

Sarah Endang S. Siahaan, N. Ariani, D. Utami
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Abstract

Many patients with medical disorders, such as meningoencephalitis are evaluated by psychiatrists complaining of sleep problems as one of the symptoms. A 65-years old married male patient who was currently unemployed was interviewed by a psychiatrist in an uncomfortable reclining position. The patient had been hospitalized for 8 days prior to the interview with a history of being unconscious. The patient showed disorganized speech, tried to pull the intravenous line, and hit his wife. The patient said that at this time, he was unable to sleep due to the throbbing headaches, nauseous, and frequent urination at night. Thus, the patient felt uncomfortable, tired, and drowsy in the morning. Those symptoms got worse in the last week.  The patient never had sleep problems before. The psychiatric status showed an appropriate appearance, uncomfortable looks, adequate verbal and visual contact, clear consciousness, dysphoric mood and affect which was congruent, logical realist coherent thought process, and a preoccupation of headache. There was no hallucination or illusion, but mixed type insomnia was found. The patient was diagnosed with adjustment disorder with predominant symptoms and sleep disturbances (F43.28). 
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伴有适应障碍的脑膜脑炎患者的睡眠障碍
许多患有医学疾病的病人,如脑膜脑炎,都是由精神科医生评估的,他们抱怨睡眠问题是症状之一。一位65岁的已婚男性病人,目前处于失业状态,精神病医生以一种不舒服的斜躺姿势对他进行了采访。患者在访视前住院8天,有昏迷史。病人言语混乱,试图拉静脉注射管,还打了他的妻子。病人说,此时,他无法入睡,因为悸动的头痛,恶心,晚上尿频。因此,患者在早晨感到不舒服、疲倦和昏昏欲睡。这些症状在上周加重了。这位病人以前从未有过睡眠问题。精神状态表现为:外表得体,外表不舒服,语言和视觉接触充足,意识清晰,情绪和情绪一致,逻辑现实连贯的思维过程,头痛的困扰。无幻觉或幻觉,但有混合型失眠。患者被诊断为适应障碍,主要症状为睡眠障碍(F43.28)。
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