原发性肾上腺功能不全背景下的急性躁狂和精神病:文献的系统回顾。

IF 1.3 4区 医学 Q4 BEHAVIORAL SCIENCES Cognitive and Behavioral Neurology Pub Date : 2023-06-01 DOI:10.1097/WNN.0000000000000340
Andrew Ovakimyan, Neal A Patel, Nolan J Brown, Taylor Reardon, Gianna Fote, Julian Gendreau
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引用次数: 0

摘要

背景:考虑到原发性肾上腺功能不全(PAI)中急性躁狂或精神病的稀疏性,医生可能不知道这两种疾病之间的联系。目的:对文献进行系统综述,以确定所有报告PAI患者躁狂和/或精神病的研究,目的是确定所有报告与PAI相关的躁狂或精神病病例的研究。结果:我们确定了9份病例报告,其中9名患者(M年龄=43.3岁,男性=44.4%)来自8个国家,符合我们的纳入/排除标准。8名(89%)患者曾经历过精神病。躁狂和/或精神病症状100%得到缓解,其中类固醇替代疗法在7例(78%)中有效,在6例(67%)中足够。结论:PAI背景下的急性躁狂和精神病是一种非常罕见的疾病。通过纠正潜在的肾上腺功能不全,可以可靠地解决急性精神病变化。
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Acute Mania and Psychosis in the Context of Primary Adrenal Insufficiency: A Systematic Review of the Literature.

Background: Given the sparse nature of acute mania or psychosis in primary adrenal insufficiency (PAI), physicians may not be aware of the association of these two entities.

Objective: To conduct a systematic review of the literature for the purpose of identifying all studies reporting mania and/or psychosis in individuals with PAI.

Method: We conducted a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the PubMed, Embase, and Web of Science databases from June 22, 1970 to June 22, 2021, for the purpose of identifying all studies reporting instances of mania or psychosis associated with PAI.

Results: We identified nine case reports featuring nine patients (M age = 43.3 years, male = 44.4%) over eight countries that fit our inclusion/exclusion criteria. Eight (89%) of the patients had experienced psychosis. Manic and/or psychotic symptom resolution was achieved in 100% of the cases, of which steroid replacement therapy was efficacious in seven (78%) cases and was sufficient in six (67%).

Conclusion: Acute mania and psychosis in the context of PAI is a very rare presentation of an already uncommon disease. Resolution of acute psychiatric change is reliably achieved with the correction of underlying adrenal insufficiency.

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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
68
审稿时长
>12 weeks
期刊介绍: Cognitive and Behavioral Neurology (CBN) is a forum for advances in the neurologic understanding and possible treatment of human disorders that affect thinking, learning, memory, communication, and behavior. As an incubator for innovations in these fields, CBN helps transform theory into practice. The journal serves clinical research, patient care, education, and professional advancement. The journal welcomes contributions from neurology, cognitive neuroscience, neuropsychology, neuropsychiatry, and other relevant fields. The editors particularly encourage review articles (including reviews of clinical practice), experimental and observational case reports, instructional articles for interested students and professionals in other fields, and innovative articles that do not fit neatly into any category. Also welcome are therapeutic trials and other experimental and observational studies, brief reports, first-person accounts of neurologic experiences, position papers, hypotheses, opinion papers, commentaries, historical perspectives, and book reviews.
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