Without awareness of what I am Casanova, T; Blanco Garrote, J.A; Isidro García, G ...
European psychiatry,
March 2016, Letnik:
33
Journal Article
Recenzirano
Introduction Fifty-year-old male. As a summary note that has a history of psychotic disorder from 25 years to coincide with the theological studies and your income as a priest. It has continued since ...then reviews and consultations in psychiatry, with two previous hospitalizations in private hospitals. It was stable with low doses of risperidone. Apparently, it makes a routine life linked to the activities of the church. Two months ago, he began to be irritable, suspicious, with discussions and problems at work, coinciding with the abandonment of treatment. Since the death of her mother a year ago has presented worsening. Objectives It presents the case of a patient who has no awareness of illness. Methods Psychopathological examination: conscious, oriented, scarcely manageable. Psychomotor restlessness. Expansive while maintaining distances, dysphoric and irritable. Verbiage. Ideas prejudice family-centered. There appears to be perceptual disturbances. Sleep-wake rhythms preserved. Results Treatment was initiated with injectable paliperidone administered dose of 150 mg and 100 mg, with 12 mg of oral paliperidone with good response progressively. At high partial remission of symptoms, it is factual. Conclusions The lack of awareness of the disease is non-pharmacological factors that can make it difficult to comply with neuroleptic treatment. These patients do not calibrate well how important that medication has on the evolution of his illness. Therefore, the therapeutic substance of such failure worsens the quality of life of patients and their families, as well as the prognosis of their disease presenting increasingly severe relapses.
Introduction Bupropion is a dual antidepressant, a norepinephrine and dopamine reuptake inhibitor. Its main use is in affective disorders as major depression. Antidepressants have been commonly ...associated with sexual side effects in the libido, sexual arousal, orgasm and erectile function. Bupropion has negative influence in sexual function, even it could increase the libido. Due to this, it could be a good option in patients with active sexual life and affective disorder. Clinical report A 58-year-old female with a long history of depression disorder for 5 years. History of lots of side effects with different treatments, sexual dysfunction with serotonin-antidepressants. Treated with bupropion SR 150 mg/day and alprazolam, she suffered a relapse. The bupropion was increased to 300 mg/day. Three days later she appeared in the consultation room, presented a sense of pre-orgasmic of 72 hours of evolution, high increased libido, tiredness, muscle tension and insomnia. This sense did not improve after the sexual act. It had never happened previously. The side effect improved when the bupropion was reduced to 150 mg/day and disappeared with its withdrawal. Conclusions The case made a relationship between the increased of bupropion's dose and the appearance of unusual sexual side effects (increased of libido and pre-orgasmic sense). Not only bupropion is one of the antidepressants that do not cause sexual dysfunction, if not it was reported in some trials that could be a treatment against this dysfunction due to its prosexual effects. The mechanism is unknown but could be related with norepinephrine or dopamine transmission.
Antidepressant-induced hyponatremia Rodríguez Andrés, L; Gómez Sánchez, S; Rodríguez Campos, A ...
European psychiatry,
March 2016, Letnik:
33, Številka:
S1
Journal Article
Recenzirano
Introduction Hyponatremia is one of the electrolytic disorders most comonly observed among general hospitalized populations (2% of hospitalized patients). A form of hyponatremia is the syndrome of ...inappropriate antidiuretic hormone secrection (SIADH). One of its diverse causes is medication. Selective serotonine reuptake inhibitors (ISRSs) can cause hyponatremia due to SIADH, particularly among elderly population. Clinical case report A 81-year-old female treated with paroxetine 20 mg/day because of depression. Two weeks later she starts feeling nausea, somnolence and motor inhibition. The sodium level previous to the onset of treatment was normal but after two weeks it has decreased to 121 mEq/L, pointing to SIADH induced by ISRSs. Discussion The incidence of hyponatremia among elderly patients treated with antidepressants of ISRSs class has increased. The prevalence varies between 0.5 and 25%. Although half of the patients are asymptomatic, the mortality is rate may reach 25%. It generally develops during the first month of treatment and is reversible between 2 and 28 days after the suspension of the ISRSs.
How strange is everything Casanova, T; Blanco Garrote, J.A; Hernández Antón, R ...
European psychiatry,
March 2016, Letnik:
33
Journal Article
Recenzirano
Introduction Twenty-year-old woman. In summary, we noted that a year ago, she had an episode of psychotic features secondary to cannabis in London. She then presented a depressing picture. In the ...current episode, the patient is anxious to be in a kind of dream. She says it is able to communicate through thought, and says his mind thinks fast. Make interpretations, giving meaning to everything that is new. Refer to hear voices in his head of his children. It is told with great emotional impact. Absence of previous consumption. Objectives It presents the case of a patient with psychotic symptoms treated early. Methods Psychopathological examination: conscious, oriented, collaborative. Good looks and touch. Tachypsychia and tachylalia. Speech inconsistent with loose associations of ideas. Dysphoria with emotional lability and continuous crying, feelings of guilt. Great anxiety component. Phenomena of derealization and depersonalization. Delusional interpretations of objects. Alterations of the experience of self. Possible auditory hallucinations. Insomnia. Results During treatment with olanzapine, income starts to 20 mg and then proceeds to therapeutic change aripiprazole with good response, objectifying a partial remission of symptoms, quiet and adequate meeting, being aware of what happened. Conclusions Schizoaffective disorder describes a mental disorder characterized by recurrent episodes of mood changes underway in all cases with psychotic symptoms. People with schizoaffective disorder are more likely to return to their previous level of function than do people with other psychotic disorders.
Introduction Directed by Edward Zwick “Pawn Sacrifice” is a biographical film released on September 2015. The film stars Tobey Maguire as Bobby Fischer, the American World Chess Champion, considered ...one of greatest player of all time. His career's peak was in 1972 when he captured the World Chess Championship from Boris Spassky of the USSR. Aims We tried to dig a little in the biography of Bobby Fischer who many described as mentally ill. We tried to figure out what is reality and what is just legend about Fischer. Our goal is promote chess, and also honour the great Fischer. Moreover, we wanted to explore the scientific literature published about the benefits of playing chess, especially in childhood. Methods We made an exhaustive review of the author's life, and also testimonies of people who knew him. Moreover, we found some articles that review the relationship between chess and IQ trying to confirm or debunk some myths about this legendary game. Results It was incomprehensible to everyone that the top of the career of Bobby Fischer at the same time meant an abrupt and complete fall. One possible explanation for this attitude would be a mentally unbalance not specified disorder throughout his lifespan. Conclusions Not all geniuses are crazy, neither all crazy are geniuses. A genius is a person with extraordinary capabilities, that focused on a topic, has the ability to enlight new ways to explain this complex world, whether it is to create a symphony, paint masterpiece or the next move on the chessboard.
A bizarre love Noval Canga, C; Hernández Antón, R; Cepedello Pérez, S ...
European psychiatry,
March 2016, Letnik:
33, Številka:
S1
Journal Article
Recenzirano
Introduction Adoption constitutes a discontinuity in child care trajectory, that falls into a separation and a lost of reference figures, and therefore, the need to set up new attachment figures into ...a suitable familiar atmosphere. Objectives This case is a review of how a child adoption process, that can be something positive at first, can also produce many problems in the future, added to dificulties in order to regulate stressing situations and also solving problems. Methods The clinical case consists in a 25-year-old woman, who suffers from anxiety and self-injure behaviour. She has a diagnosis of non-specified personality disorder with limit characteristics. The patient was adopted a few months after her birth. At the moment she's living with her adoptive father, her adoptive mother passed away when she was 4. At the age of 21, the patient meets her biological mother and since that moment she spends most of the weekends with her. After a few medical appointments, she admits that she has allowed sexual relationships with her biological mother since six months ago. Results It's important to appreciate the value of familiar atmosphere, and in addition, the attachment between child and his parental figures. The quality of the attachment is going to have influence in emotional regulation. Conclusions Children who have suffered neglect from their biological parents and have been adopted develop attachment behaviours characterized by negative experiences. In spite of being in a good familiar environment, they feel vulnerable and insecure. Early and appropriate attachment experiences can improve relationships between children and their new family.
Belle de jour : A case of hysteria Noval Canga, C; Gómez Sánchez, S; Cepedello Pérez, S ...
European psychiatry,
March 2016, Letnik:
33, Številka:
S1
Journal Article
Recenzirano
Introduction Histrionic Personality Disorder is one of the most common personality disorders diagnosed in Psychiatry. This disorder has been known to be present in more than 40% of patients. There is ...also a high tendency for those diagnosed with this disorder to be female. Objectives The case is to show all the difficulties caused by this pathology, differencial diagnosis with other personality disorders, groups of characteristics from different clusters and also, complications produced in daily routine. Methods The purpose is to study a clinical case of a 27-year-old woman, with a degree in journalism, who began with a depressive episode after a failed relationship. After being diagnosed of infertility, she debuted with dissociative episodes and somatization symptoms. After that, she suffered several depressive episodes. At the moment, all the clinical symptoms support the diagnosis of histrionic personality disorder. Results Histrionic Personality Disorder can be found in the cluster B group of personality disorders. They often present in an overly dramatic, erratic or emotional manner. They may fulfil their need for attention through speech and behaviour that draws one's focus of attention toward themselves, and also demanding and manipulative in interpersonal relationships. There are high comorbidity rates in those who suffer from HPD with other diagnoses. Conclusions Histrionic Personality Disorder appears to be one of the least threatening diagnosis among personality disorders as those affected are high functioning and do not seek relief for the disorder itself. There is also very little research on HPD which makes treatment options limitless.
Suicide attempts in area II of Valladolid Gómez Sánchez, S; Domínguez Álvarez, E; Hernández Antón, R ...
European psychiatry,
March 2016, Letnik:
33
Journal Article
Recenzirano
Introduction Suicide is among the ten leading causes of death in the world. According to WHO, the annual suicide mortality rate is 16:100,000. Suicide rate has increased by 45% globally and by 60% in ...Spain in the last 50 years. Objective It will be explained: – scale of the problem; – suicidal behaviour characteristics; – risk factors due to Werther effect; – protective factors; – presenting the study on autolytic attempts at HCUV from July to December 2013. Materials and method Data about autolytic attempts treated at the HCUV in the last 6 months were collected. A structured history was compiled for each patient collecting information about age, personal circumstances, cohabitation, studies, employment status, residence (urban, semi-urban or rural), religious beliefs, day of the week, family background, personal organic and psychiatric background, previous autolytic attempts, last three month's events, last week's events, method and medical practice undertaken. Conclusion The study shows that the average age is 43 years old, 42.2% are married, 41.3% live with their family, 33% have primary studies, 27.3% are unemployed and other data, which will be exposed through diagrams. Compared to a study from 1996/1997, there has been a 27% increase in the suicide attempts rate.
The psychotic patient at the General Hospital Monforte Porto, J.Á; San Román Uría, A; Llanes Álvarez, C ...
European psychiatry,
March 2016, Letnik:
33, Številka:
S1
Journal Article
Recenzirano
Background Patients with schizophrenia have a higher prevalence of physical illness and a higher mortality from natural causes than the general population, which is a reason why they can be ...hospitalized for medical and surgical pathologies. Aims To determine the demand, the reason for consultation and the sociodemographic characteristics of the psychotic patient admitted at the general hospital. Methods Sociodemographic variables (age, sex, marital status, education, place of residence, residential housing, with who they live, work status) and health care (service of origin, type of request and its relevance, complaints, days of delay between the request and assistance, number of visits, average length of stay). Study design Prospective epidemiological study of 80 psychotic patients (F.2 ICD-10), from the total of 906 consults solicited from 1 January 2012 until 31 December 2014. Bioethical considerations: compliance with these principles justice, non-maleficence, autonomy and beneficence. Results The average age is 58.34 years old, 60% were male, 73.8% single, 81.3% with primary education, 52.5% living in urban areas; and the 88.8% of cases were pensioners. The Departments that generate a greater demand are Internal Medicine (53.8%), Orthopaedic Surgery (10%), Pneumology (8.8%) and ICU (8.8%). The most frequent reasons for consultation are assessment/treatment setting (77.5%), abnormal behavior (30%), disorientation (18.8%) and psychotic symptoms (18.8%). Conclusions The typical profile of psychotic patients hospitalized for medical-surgical diseases is a male, middle-aged, single, with primary education and pensioner; from whom it's sued consultation for adjusting of treatment, and secondly for abnormal behavior.
Introduction Smoking is an addictive and chronic disease. Twenty-four percent of the Spanish population in 2012 smoked daily. Aims and objectives To evaluate a smoking cessation program in a Primary ...Care Center. Methods Observational, prospective study. We describe an individualized smoking cessation in Plaza del Ejército Health Center (Valladolid). Inclusion criteria: active smoker, ≥ 18 years old and belonging to the Health Center. Exclusion: severe mental illness. Included patients from November 2013 until January2014. Ended in July 2014. Four Medical residents participated, we present the results of one of them. During the first consultation motivational interviewing was conducted, physical examination and treatment was prescribed (cognitive behavioral therapy or drug treatment: varenicline). In subsequent consultations interview and follow-up. Variables: age, gender, pack-years, nicotine dependence (Fagerstrom) and Prochaska and DiClemente phase, weight, treatment used, dropout rate and final withdrawal of snuff. Results Eleven patients, mean age 48.18 (13.61), 7 (63.6) women. Comorbidity: 6 (54.5) anxious-depressive pathology, 1 (9.1) dysthymia, 2 (18.2) endocrine pathology and 1 (9.1) respiratory disease. Four (36.4) showed high dependency and 2 (18.2) extreme. Media packages 20.50/year (19,20). Seven (63.6) were in action phase of Prochaska and DiClemente and 2 (18.2) in preparation. Visits range: 1-11. The average was 4.55 (3.64). Three (27.27) patients attended only the first visit. Four (36.4) achieved complete abstinence, 3 (27.27) met maintenance phase. One (9.1) reduced consumption in half. Patients gained average 0.5 kg (2.47). Conclusions The results are similar to those reported in other series. Modest dropout rate. No pharmacological treatment was used due to high coexistence of comorbidities, the only patient who used varenicline suffered insomnia. Average age and media packages were superior to other series.
