THERAPEUTIC APPROACH IN COEXISTENCE OF AVOIDANT PERSONALITY DISORDER AND PSYCHOTIC STRUCTURE IN ITS EARLY MANIFESTATIONS: A CASE REPORT

Alice Izabel Costa Silva, Sílvia Goulart Curi, Edmundo Araújo Neto
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Abstract

Introduction: The first manifestations of a psychotic structure, generally in adolescence or early adulthood, are an important milestone in an individual's life. But, considering the concomitant signs and symptoms of an avoidant personality disorder can appear since childhood, there is a demand for more targeted and delicate attention from the team of healthcare professionals. Case summary: During the monitoring of the patient, a series of clinical signs and symptoms appeared that met the criteria of two simultaneous psychic conditions, one of them structural and the other personality related. With the aforementioned diagnoses, specific new pharmacological treatment tests were carried out, carrying positive effects and improving the patient's quality of life (introduction of antipsychotics instead of antidepressants as the pivot of therapy). Discussion: the onset of a psychotic condition in the trema phase associated with pre-existing avoidant/avoidant personality disorder demands balanced management between both conditions, using the strategies offered by both pharmacotherapies and psychotherapies. Conclusion: in order to adopt an appropriate treatment and management of the case, due to the complexity of diagnostic simultaneity, constant attention is required from the assistant team, so that continuous reassessments of hypotheses are made and, therefore, adjustments whenever necessary.
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回避型人格障碍与精神病早期表现并存时的治疗方法:病例报告
前言精神病结构的最初表现一般出现在青春期或成年早期,是一个人生命中的重要里程碑。但是,考虑到回避型人格障碍的伴随症状和体征可能从小就出现,因此需要医护人员团队给予更有针对性的细致关注。病例摘要:在对患者进行监测期间,出现了一系列临床症状和体征,这些症状和体征符合同时出现两种精神疾病的标准,其中一种是结构性的,另一种则与人格有关。根据上述诊断,对患者进行了新的药物治疗试验,取得了积极的效果,改善了患者的生活质量(以抗精神病药物取代抗抑郁药物作为治疗的关键)。讨论:如果患者在三期出现精神病症状,并伴有原有的回避型/回避型人格障碍,则需要利用药物疗法和心理疗法提供的策略,对这两种病症进行平衡管理。结论:由于同时诊断的复杂性,为了对病例采取适当的治疗和管理,助理团队需要持续关注,以便对假设进行不断的重新评估,从而在必要时做出调整。
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