Pub Date : 2025-01-22DOI: 10.1016/j.psycr.2025.100248
Lily Porsa DO
This paper presents a case study of a 14-year-old female admitted with first-episode psychosis and catatonic features following delta-9 tetrahydrocannabinol (THC) use. The rising prevalence of cannabis, especially among adolescents, underscores the need to distinguish between substance-induced and primary psychoses. The discussion explores the challenges in diagnosis, emphasizing predictors such as family history and trauma. Treatment strategies, including abstinence promotion, medical evaluation, and early psychosis intervention, are crucial for effective management. The case highlights the complexities of psychosis management, emphasizing a comprehensive approach for improved outcomes and prevention of future episodes.
{"title":"A case of first-episode psychosis with catatonic features in an adolescent following THC use","authors":"Lily Porsa DO","doi":"10.1016/j.psycr.2025.100248","DOIUrl":"10.1016/j.psycr.2025.100248","url":null,"abstract":"<div><div>This paper presents a case study of a 14-year-old female admitted with first-episode psychosis and catatonic features following delta-9 tetrahydrocannabinol (THC) use. The rising prevalence of cannabis, especially among adolescents, underscores the need to distinguish between substance-induced and primary psychoses. The discussion explores the challenges in diagnosis, emphasizing predictors such as family history and trauma. Treatment strategies, including abstinence promotion, medical evaluation, and early psychosis intervention, are crucial for effective management. The case highlights the complexities of psychosis management, emphasizing a comprehensive approach for improved outcomes and prevention of future episodes.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100248"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.1016/j.psycr.2025.100247
Megan S. Barker , Neil A. Shneider , Masood Manoochehri , Edward D. Huey , Elizabeth C. Lindenberger
Although amyotrophic lateral sclerosis (ALS) is defined as a neuromuscular disease, cognitive and/or behavioral symptoms are relatively common, and a portion of ALS patients will meet criteria for behavioral variant frontotemporal dementia (bvFTD). In this report, we describe the case of a man with ALS with bvFTD (ALS-FTD) presenting with excessive emotional reactivity, including severe anger, aggression, and obsessive thoughts. We contrast this case with the decreased emotional reactivity that is usually observed in patients with bvFTD without ALS. We discuss possible explanations including that: 1) the behavioral symptoms of bvFTD and ALS-FTD are the same, but the motor dysfunction influences the clinical manifestations of the behavioral symptoms in ALS-FTD; 2) the emotional and behavioral symptoms of bvFTD and ALS-FTD are the same, but ALS-FTD patients come to clinical attention earlier in the course of their FTD than bvFTD patients without ALS; and 3) the emotional and behavioral symptoms of bvFTD and ALS-FTD could differ.
{"title":"Excessive emotional reactivity in a case of behavioral variant frontotemporal dementia with amyotrophic lateral sclerosis","authors":"Megan S. Barker , Neil A. Shneider , Masood Manoochehri , Edward D. Huey , Elizabeth C. Lindenberger","doi":"10.1016/j.psycr.2025.100247","DOIUrl":"10.1016/j.psycr.2025.100247","url":null,"abstract":"<div><div>Although amyotrophic lateral sclerosis (ALS) is defined as a neuromuscular disease, cognitive and/or behavioral symptoms are relatively common, and a portion of ALS patients will meet criteria for behavioral variant frontotemporal dementia (bvFTD). In this report, we describe the case of a man with ALS with bvFTD (ALS-FTD) presenting with excessive emotional reactivity, including severe anger, aggression, and obsessive thoughts. We contrast this case with the decreased emotional reactivity that is usually observed in patients with bvFTD without ALS. We discuss possible explanations including that: 1) the behavioral symptoms of bvFTD and ALS-FTD are the same, but the motor dysfunction influences the clinical manifestations of the behavioral symptoms in ALS-FTD; 2) the emotional and behavioral symptoms of bvFTD and ALS-FTD are the same, but ALS-FTD patients come to clinical attention earlier in the course of their FTD than bvFTD patients without ALS; and 3) the emotional and behavioral symptoms of bvFTD and ALS-FTD could differ.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100247"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-12DOI: 10.1016/j.psycr.2025.100246
Jamie Torrance , Jessica Smith , Philip Newall
While most previous adolescent gambling research focuses on the illegal use of age-restricted products, adolescents can also often gamble legally using machines such as coin pushers (aka ‘penny falls’ machines). Using a qualitative case report design, we use an in-depth interview to complement previous findings, which have associated recollected adolescent use of coin pusher machines with levels of adult gambling-related harm. We recruited a 57-year-old male with a history of significant gambling-related harm, whose initiation into gambling involved the adolescent use of coin pusher machines. The interview was audio recorded, transcribed, and analyzed using interpretative phenomenological analysis. Three themes were identified: the structural similarities between coin pushers and traditional gambling formats, the role of proximity and normalization in facilitating progression to riskier gambling, and the participant's suggestions for population-level harm prevention measures. This novel case report highlights how a person's lifelong struggles with severe gambling-related harms began with adolescent exposure to coin pusher machines. Greater awareness of this case could encourage more gamblers to share similar experiences, alongside helping to educate parents and policymakers about the potential harmful consequences of using coin pusher machines.
{"title":"‘I wouldn't have become addicted to fruit machines if it wasn't for coin pushers’: A case report of adolescent coin pusher use leading to lifelong gambling-related harm","authors":"Jamie Torrance , Jessica Smith , Philip Newall","doi":"10.1016/j.psycr.2025.100246","DOIUrl":"10.1016/j.psycr.2025.100246","url":null,"abstract":"<div><div>While most previous adolescent gambling research focuses on the illegal use of age-restricted products, adolescents can also often gamble legally using machines such as coin pushers (aka ‘penny falls’ machines). Using a qualitative case report design, we use an in-depth interview to complement previous findings, which have associated recollected adolescent use of coin pusher machines with levels of adult gambling-related harm. We recruited a 57-year-old male with a history of significant gambling-related harm, whose initiation into gambling involved the adolescent use of coin pusher machines. The interview was audio recorded, transcribed, and analyzed using interpretative phenomenological analysis. Three themes were identified: the structural similarities between coin pushers and traditional gambling formats, the role of proximity and normalization in facilitating progression to riskier gambling, and the participant's suggestions for population-level harm prevention measures. This novel case report highlights how a person's lifelong struggles with severe gambling-related harms began with adolescent exposure to coin pusher machines. Greater awareness of this case could encourage more gamblers to share similar experiences, alongside helping to educate parents and policymakers about the potential harmful consequences of using coin pusher machines.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100246"},"PeriodicalIF":0.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1016/j.psycr.2025.100245
Martin Blay , Inès Benmakhlouf , Mario Speranza
Psychotherapy enhanced by psychedelics has recently been found to be helpful for the treatment of several psychiatric disorders, notably depressive disorders. However, it has only been considered scarcely in patients suffering from personality disorders. Here, we report the case of a 37 years-old woman suffering from severe mixed personality disorder and ADHD. Alongside the beginning of her GPM-based psychotherapeutic treatment, and despite our concerns, she started closely monitored psychedelic micro-dosing, using products bought online, punctuated by occasional macro-dosing After one-year of this psychotherapy associated with concomitant independent use of psychedelics, paranoid, narcissistic and borderline personality dimensions were largely improved, as well as emotion regulation, impulsivity, mentalization abilities, and social functioning. Given the actual evidence regarding the efficacy of psychedelics to improve the latter four dimensions, given the patient's reported experience, and despite important limits, we make the hypothesis that the concomitant use of psychedelics has enhanced psychotherapy efficacy. Overall, this case asks the question of the potential usefulness of psychedelics associated with psychotherapy in patients with PD. Further pilot studies should be conducted on this issue.
{"title":"Could psychedelics be useful in the treatment of patients with personality disorder? A case report of psychotherapy with concomitant use of psychedelics","authors":"Martin Blay , Inès Benmakhlouf , Mario Speranza","doi":"10.1016/j.psycr.2025.100245","DOIUrl":"10.1016/j.psycr.2025.100245","url":null,"abstract":"<div><div>Psychotherapy enhanced by psychedelics has recently been found to be helpful for the treatment of several psychiatric disorders, notably depressive disorders. However, it has only been considered scarcely in patients suffering from personality disorders. Here, we report the case of a 37 years-old woman suffering from severe mixed personality disorder and ADHD. Alongside the beginning of her GPM-based psychotherapeutic treatment, and despite our concerns, she started closely monitored psychedelic micro-dosing, using products bought online, punctuated by occasional macro-dosing After one-year of this psychotherapy associated with concomitant independent use of psychedelics, paranoid, narcissistic and borderline personality dimensions were largely improved, as well as emotion regulation, impulsivity, mentalization abilities, and social functioning. Given the actual evidence regarding the efficacy of psychedelics to improve the latter four dimensions, given the patient's reported experience, and despite important limits, we make the hypothesis that the concomitant use of psychedelics has enhanced psychotherapy efficacy. Overall, this case asks the question of the potential usefulness of psychedelics associated with psychotherapy in patients with PD. Further pilot studies should be conducted on this issue.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-04DOI: 10.1016/j.psycr.2025.100244
Annabelle M. Mournet, Allison K. Ruork, Evan M. Kleiman, Shireen L. Rizvi
Introduction
Sleep disturbances are a well-established suicide risk factor. This case series represents an investigation into the individual-level associations between objectively measured sleep using actigraphy and fatigue on next-day suicidal ideation, self-harm urges, and desire to be alive.
Methods
This case series utilizes data from seven adults with borderline personality disorder receiving dialectical behavioral therapy (DBT). Participants wore a Phillips HealthBand wearable device to collect actigraphy data and completed ecological momentary assessment (EMA). Data was collected for one week per month for each of the six months of treatment. We conducted a series of individual linear regressions.
Results
For participant 1, fatigue was associated with self-injury urges. Sleep duration and time in bed were predictive of desire to be alive. For participant 3, fatigue was associated with suicidal ideation. Sleep efficiency was predictive of desire to be alive. Participant 5′s WASO was predictive of suicidal ideation and desire to be alive. For participant 6, WASO predicted desire to be alive. For participant 7, fatigue was predictive of desire to be alive.
Discussion
This case series provides evidence that certain aspects of sleep, as measured by actigraphy, is predictive of SI, self-harm urges, and desire to be alive among certain DBT patients. Results points to the importance of examining actigraphy findings on an individual level. Future research should continue to utilize multimodal data to advance understanding of the associations between sleep metrics with STBs, as well as how to continue to best leverage actigraphy data in combination with other methodologies.
{"title":"An actigraphy case series: Sleep disturbance associations with suicidal ideation, self-harm and desire to live","authors":"Annabelle M. Mournet, Allison K. Ruork, Evan M. Kleiman, Shireen L. Rizvi","doi":"10.1016/j.psycr.2025.100244","DOIUrl":"10.1016/j.psycr.2025.100244","url":null,"abstract":"<div><h3>Introduction</h3><div>Sleep disturbances are a well-established suicide risk factor. This case series represents an investigation into the individual-level associations between objectively measured sleep using actigraphy and fatigue on next-day suicidal ideation, self-harm urges, and desire to be alive.</div></div><div><h3>Methods</h3><div>This case series utilizes data from seven adults with borderline personality disorder receiving dialectical behavioral therapy (DBT). Participants wore a Phillips HealthBand wearable device to collect actigraphy data and completed ecological momentary assessment (EMA). Data was collected for one week per month for each of the six months of treatment. We conducted a series of individual linear regressions.</div></div><div><h3>Results</h3><div>For participant 1, fatigue was associated with self-injury urges. Sleep duration and time in bed were predictive of desire to be alive. For participant 3, fatigue was associated with suicidal ideation. Sleep efficiency was predictive of desire to be alive. Participant 5′s WASO was predictive of suicidal ideation and desire to be alive. For participant 6, WASO predicted desire to be alive. For participant 7, fatigue was predictive of desire to be alive.</div></div><div><h3>Discussion</h3><div>This case series provides evidence that certain aspects of sleep, as measured by actigraphy, is predictive of SI, self-harm urges, and desire to be alive among certain DBT patients. Results points to the importance of examining actigraphy findings on an individual level. Future research should continue to utilize multimodal data to advance understanding of the associations between sleep metrics with STBs, as well as how to continue to best leverage actigraphy data in combination with other methodologies.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100244"},"PeriodicalIF":0.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-07DOI: 10.1016/j.psycr.2024.100243
Yumin Kim , Rachel Bigley , Aubrey DeVinney , Paul S. Nestadt
Background
Psilocybin use has been increasingly popular in the United States, and its use as a novel therapeutic treatment for psychiatric conditions has led to greater public acceptance as a recreational substance. Consequently, clinicians are faced with managing complications and adverse effects associated with psilocybin use.
Basic Procedures/Main Findings
We present three cases seen in a dual diagnosis inpatient psychiatry unit during a four-week period in 2023: Case 1: the case of intermittent psilocybin use associated with a particularly prolonged psychosis requiring treatment with higher doses and a longer course of neuroleptic medication; Case 2: the case of a short period of frequent psilocybin use culminating into increasing paranoia and a medically serious suicide attempt treated with neuroleptics; and Case 3: the case of long-term “microdosing” followed by mania-like symptoms including grandiosity, irritability, and physical aggression towards others, but with resolution of symptoms after discontinuing psilocybin use.
Conclusions
Amidst psilocybin's increasing prevalence and acceptance, clinicians are faced with managing the complications and adverse effects of psilocybin use with minimal guidelines or evidence. This case series aims to highlight varied presentations, management strategies, and treatment responses to contribute some insight into this unknown territory.
{"title":"The many faces of psilocybin-related psychosis: A case series","authors":"Yumin Kim , Rachel Bigley , Aubrey DeVinney , Paul S. Nestadt","doi":"10.1016/j.psycr.2024.100243","DOIUrl":"10.1016/j.psycr.2024.100243","url":null,"abstract":"<div><h3>Background</h3><div>Psilocybin use has been increasingly popular in the United States, and its use as a novel therapeutic treatment for psychiatric conditions has led to greater public acceptance as a recreational substance. Consequently, clinicians are faced with managing complications and adverse effects associated with psilocybin use.</div></div><div><h3>Basic Procedures/Main Findings</h3><div>We present three cases seen in a dual diagnosis inpatient psychiatry unit during a four-week period in 2023: Case 1: the case of intermittent psilocybin use associated with a particularly prolonged psychosis requiring treatment with higher doses and a longer course of neuroleptic medication; Case 2: the case of a short period of frequent psilocybin use culminating into increasing paranoia and a medically serious suicide attempt treated with neuroleptics; and Case 3: the case of long-term “microdosing” followed by mania-like symptoms including grandiosity, irritability, and physical aggression towards others, but with resolution of symptoms after discontinuing psilocybin use.</div></div><div><h3>Conclusions</h3><div>Amidst psilocybin's increasing prevalence and acceptance, clinicians are faced with managing the complications and adverse effects of psilocybin use with minimal guidelines or evidence. This case series aims to highlight varied presentations, management strategies, and treatment responses to contribute some insight into this unknown territory.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100243"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.psycr.2024.100241
Nancy Peeters , Boris van Passel , Gert-Jan Hendriks , Eni Becker , Julie Krans
Exposure is effective for patients with anxiety disorders or obsessive-compulsive disorders (OCD). Yet, a significant minority does not recover with current guideline treatments due to comorbid personality disorder symptoms. For these patients, no further guideline treatments exist. Schema therapy (ST) is an evidence-based treatment for personality disorders and integrating ST and exposure could provide a solution. We tested a new schema-therapeutic exposure treatment in patients with treatment-resistant anxiety or OCD. Using the latest methodological and statistical insights in a well-powered single-case experimental design (SCED; N = 6), we administered weekly measures of psychological malfunctioning, anxiety/OCD symptoms, and schema modes over the course of treatment (29–32 weeks). Schema-therapeutic exposure was effective for 33.33 % of our sample, with improvement on all or most outcome measures. Another 33.33 % demonstrated partial improvements, and 33.33 % remained stable. Given the historical chronicity of symptoms in our sample, these effects are highly encouraging. Secondary findings showed that changes in schema modes did not precede changes in anxiety/OCD symptoms or psychological malfunctioning, and that 66.66 % of the sample continued to improve in the second half of the treatment. Future research is wanted to unravel the interactive and additive effects of schema-therapeutic exposure to further optimize treatment.
{"title":"Schema-therapeutic exposure for treatment resistant anxiety and obsessive-compulsive disorders: A multiple baseline case series design study","authors":"Nancy Peeters , Boris van Passel , Gert-Jan Hendriks , Eni Becker , Julie Krans","doi":"10.1016/j.psycr.2024.100241","DOIUrl":"10.1016/j.psycr.2024.100241","url":null,"abstract":"<div><div>Exposure is effective for patients with anxiety disorders or obsessive-compulsive disorders (OCD). Yet, a significant minority does not recover with current guideline treatments due to comorbid personality disorder symptoms. For these patients, no further guideline treatments exist. Schema therapy (ST) is an evidence-based treatment for personality disorders and integrating ST and exposure could provide a solution. We tested a new schema-therapeutic exposure treatment in patients with treatment-resistant anxiety or OCD. Using the latest methodological and statistical insights in a well-powered single-case experimental design (SCED; <em>N</em> = 6), we administered weekly measures of psychological malfunctioning, anxiety/OCD symptoms, and schema modes over the course of treatment (29–32 weeks). Schema-therapeutic exposure was effective for 33.33 % of our sample, with improvement on all or most outcome measures. Another 33.33 % demonstrated partial improvements, and 33.33 % remained stable. Given the historical chronicity of symptoms in our sample, these effects are highly encouraging. Secondary findings showed that changes in schema modes did not precede changes in anxiety/OCD symptoms or psychological malfunctioning, and that 66.66 % of the sample continued to improve in the second half of the treatment. Future research is wanted to unravel the interactive and additive effects of schema-therapeutic exposure to further optimize treatment.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100241"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.psycr.2024.100240
Ho Teck Tan , Cecilia Sze Nga Kwok , Huei Yen Lee , Giles Ming Yee Tan
The prevalence of comorbid schizophrenia in patients with eating disorders is between 3 and 10% while symptoms of anorexia nervosa has been observed in 1–4% of patients with schizophrenia. However, there is a lack of comprehensive studies available to better understand and manage this complex dual diagnosis at present.
Here, we present a case of treatment-resistant schizophrenia and comorbid anorexia nervosa in a young woman in a long-stay ward of a tertiary psychiatric hospital requiring 1-1 nursing care. She exhibited disordered eating behaviors, a distorted body image, and persistent food refusal. A diagnostic dilemma presented due to the overlap in symptomatology between her eating disorder-related restrictive behaviors and psychosis-driven food refusal. Efforts to engage her in various therapies for her anorexia nervosa has been hampered by her regressed and disorganized behavior, with concerns of the metabolic side effects of anti-psychotics potentially worsening her eating disorder cognitions. She required constant monitoring of her bloods and vitals due to her severely low body mass index (BMI). Different combinations of psychotropics, neurostimulation and psychotherapies were trialed with limited efficacy. The diagnostic overlap and treatment challenges highlights the need for interdisciplinary approaches and tailored management strategies for complex comorbid cases of schizophrenia and anorexia nervosa.
{"title":"Diagnostic and management challenges of a patient with schizophrenia and comorbid anorexia nervosa","authors":"Ho Teck Tan , Cecilia Sze Nga Kwok , Huei Yen Lee , Giles Ming Yee Tan","doi":"10.1016/j.psycr.2024.100240","DOIUrl":"10.1016/j.psycr.2024.100240","url":null,"abstract":"<div><div>The prevalence of comorbid schizophrenia in patients with eating disorders is between 3 and 10% while symptoms of anorexia nervosa has been observed in 1–4% of patients with schizophrenia. However, there is a lack of comprehensive studies available to better understand and manage this complex dual diagnosis at present.</div><div>Here, we present a case of treatment-resistant schizophrenia and comorbid anorexia nervosa in a young woman in a long-stay ward of a tertiary psychiatric hospital requiring 1-1 nursing care. She exhibited disordered eating behaviors, a distorted body image, and persistent food refusal. A diagnostic dilemma presented due to the overlap in symptomatology between her eating disorder-related restrictive behaviors and psychosis-driven food refusal. Efforts to engage her in various therapies for her anorexia nervosa has been hampered by her regressed and disorganized behavior, with concerns of the metabolic side effects of anti-psychotics potentially worsening her eating disorder cognitions. She required constant monitoring of her bloods and vitals due to her severely low body mass index (BMI). Different combinations of psychotropics, neurostimulation and psychotherapies were trialed with limited efficacy. The diagnostic overlap and treatment challenges highlights the need for interdisciplinary approaches and tailored management strategies for complex comorbid cases of schizophrenia and anorexia nervosa.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100240"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-13DOI: 10.1016/j.psycr.2024.100239
J.E. Ruisch , M. van Kordenoordt , C. Steins , M.A.M.J. Daamen , K.R.J. Schruers , S. Sobczak , E.M.J. Gielkens
Introduction
Post-traumatic stress disorder (PTSD) is an independent risk factor for dementia. Case reports of poor-moderate quality indicate the feasibility of Eye Movement Desensitization and Reprocessing (EMDR) sessions in this population but lack a detailed description of the treatment and its challenges.
Goal
This report aimed to provide a detailed description of the feasibility and challenges of EMDR for a person with dementia to assist in the first step toward recognizing and treating PTSD in people with dementia.
Methods
In this case study, we describe an 89-year-old nursing home resident with mild–moderate dementia and trauma related symptoms. EMDR treatment was indicated, and four sessions, according to a standard child/youth protocol, were applied. Debriefing questionnaires were completed by a psychologist after each EMDR session. To monitor the effect of the EMDR therapy, a structured interview exploring PTSD symptoms (TRADE- TRAuma and DEmentia interview) was conducted between the treatment sessions.
Results
The debriefing questionnaires showed that EMDR was well tolerated and experienced as pleasant, but some challenges occurred; During the EMDR sessions she was easily distracted, requested multiple breaks, and required the use of shorter sentences, with a more directive approach. PTSD symptoms of recurring memories and negative thoughts were reduced.
Conclusions
This case report provides a detailed description showing the feasibility of EMDR therapy for a person with PTSD and dementia. It appeared necessary to adjust the EMDR standard child/youth protocol to a further simplified form, due to the reduced concentration and endurance.
{"title":"Feasibility of eye movement desensitization and reprocessing in a person with dementia and post-traumatic stress disorder: A case report","authors":"J.E. Ruisch , M. van Kordenoordt , C. Steins , M.A.M.J. Daamen , K.R.J. Schruers , S. Sobczak , E.M.J. Gielkens","doi":"10.1016/j.psycr.2024.100239","DOIUrl":"10.1016/j.psycr.2024.100239","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-traumatic stress disorder (PTSD) is an independent risk factor for dementia. Case reports of poor-moderate quality indicate the feasibility of Eye Movement Desensitization and Reprocessing (EMDR) sessions in this population but lack a detailed description of the treatment and its challenges.</div></div><div><h3>Goal</h3><div>This report aimed to provide a detailed description of the feasibility and challenges of EMDR for a person with dementia to assist in the first step toward recognizing and treating PTSD in people with dementia.</div></div><div><h3>Methods</h3><div>In this case study, we describe an 89-year-old nursing home resident with mild–moderate dementia and trauma related symptoms. EMDR treatment was indicated, and four sessions, according to a standard child/youth protocol, were applied. Debriefing questionnaires were completed by a psychologist after each EMDR session. To monitor the effect of the EMDR therapy, a structured interview exploring PTSD symptoms (TRADE- TRAuma and DEmentia interview) was conducted between the treatment sessions.</div></div><div><h3>Results</h3><div>The debriefing questionnaires showed that EMDR was well tolerated and experienced as pleasant, but some challenges occurred; During the EMDR sessions she was easily distracted, requested multiple breaks, and required the use of shorter sentences, with a more directive approach. PTSD symptoms of recurring memories and negative thoughts were reduced.</div></div><div><h3>Conclusions</h3><div>This case report provides a detailed description showing the feasibility of EMDR therapy for a person with PTSD and dementia. It appeared necessary to adjust the EMDR standard child/youth protocol to a further simplified form, due to the reduced concentration and endurance.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100239"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-03DOI: 10.1016/j.psycr.2024.100238
Evaristus Chino Ezema , Ngozi Akueme , Precious Okpechi , Omotola Emmanuel , Omosumwen Ede , Sanmi Michael Obe , Ndukaku Ogbonna , Maureen Obi , Nnenna Bessie Emejuru , Ogochukwu Agazie , Vivien Obitulata Ugwu , John Mmaduabuchi , Emmanuel Chiebuka , Valentine Keke , Chinenye Loveth Aleke
Tardive dyskinesia is a medication-induced movement disorder commonly caused by the blockade or depletion of dopamine in the basal ganglia, seen mostly in the psychiatric setting following prolonged use of antipsychotic medications. It is also reported in other settings where patients receive non-antipsychotic medications. The prevalence of tardive dyskinesia varies across age, gender, and race, with women of middle age being more prone to develop tardive dyskinesia more than men. Therefore, we report a case of tardive dyskinesia, post-delivery, in an African woman, who received metoclopramide as part of premedication for spinal anesthesia for an emergency cesarean delivery. The debriefing period following the resolution of the symptoms offered a clue to prior utilization of metoclopramide for the treatment of hyperemesis gravidarum as provided by the patient's family. Hence, fulfilling the diagnostic criteria of prolong usage of the implicating agent.
{"title":"Expanding the role of metoclopramide in Tardive Dyskinesia: A case report","authors":"Evaristus Chino Ezema , Ngozi Akueme , Precious Okpechi , Omotola Emmanuel , Omosumwen Ede , Sanmi Michael Obe , Ndukaku Ogbonna , Maureen Obi , Nnenna Bessie Emejuru , Ogochukwu Agazie , Vivien Obitulata Ugwu , John Mmaduabuchi , Emmanuel Chiebuka , Valentine Keke , Chinenye Loveth Aleke","doi":"10.1016/j.psycr.2024.100238","DOIUrl":"10.1016/j.psycr.2024.100238","url":null,"abstract":"<div><div>Tardive dyskinesia is a medication-induced movement disorder commonly caused by the blockade or depletion of dopamine in the basal ganglia, seen mostly in the psychiatric setting following prolonged use of antipsychotic medications. It is also reported in other settings where patients receive non-antipsychotic medications. The prevalence of tardive dyskinesia varies across age, gender, and race, with women of middle age being more prone to develop tardive dyskinesia more than men. Therefore, we report a case of tardive dyskinesia, post-delivery, in an African woman, who received metoclopramide as part of premedication for spinal anesthesia for an emergency cesarean delivery. The debriefing period following the resolution of the symptoms offered a clue to prior utilization of metoclopramide for the treatment of hyperemesis gravidarum as provided by the patient's family. Hence, fulfilling the diagnostic criteria of prolong usage of the implicating agent.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"3 2","pages":"Article 100238"},"PeriodicalIF":0.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号