• Title/Summary/Keyword: Psychosis

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At Risk State for Psychosis : Related Issues and Future Directions (정신병 위험상태 : 관련된 문제와 향후 전망)

  • Roh, Dae-Young;Kim, Chan-Hyung
    • Korean Journal of Biological Psychiatry
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    • v.18 no.4
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    • pp.203-209
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    • 2011
  • In medicine, general clinical practice moves in the direction of early detection and intervention for the prevention of progressive disease. In psychiatry, research in subjects with the risk syndrome for psychosis, has been conducted for the prevention of schizophrenia, known as a devastating chronic disease. The inclusion of 'attenuated psychosis syndrome', based on the results of early intervention studies, is one of the major issues in the upcoming DSM-V. Further investigations are needed to find biological markers and endophenotypes to supplement the diagnostic criteria. In the future, adoption of clinical staging is promising to overcome the shortcoming of current diagnosis of schizophrenia. In clinical practice, more concerns are needed about attenuated psychotic symptoms which might be risk signals for the transition to psychosis.

A Theoretical Structural Model for Caring Persons with Early Psychosis: A systematic review and qualitative meta-analysis (조기 정신증 돌봄 모형 개발: 질적 메타분석을 통한 이론적 접근)

  • Sung, Kyung Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.66-74
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    • 2017
  • This study was aimed to construct a theoretical model for managing persons with early psychosis. We systematically searched SCOPUS, PubMed, RISS, Web of Knowledge, and KoreaMed for related factors to manage persons with early psychosis. Significant terms or phrases for a preliminary structural model were obtained from 19 studies since 2000 regarding the management of persons with early psychosis. Moreover, the content validity for the model was evaluated by 22 professionals. The study results revealed 51 factors for managing persons with early psychosis extracted by meta-analysis, and all factors were divided into 21 medium classification and 8 categories. A theoretical model was constructed with 8 categories, by using the middle range theory of Peplau's Interpersonal Relationships in Nursing. The results suggest that the theoretical model for the management of persons with early psychosis provides a sound theoretical basis for future study.

Psychosis in Parkinson's Disease-Treatment with 5-HT Receptor Antagonist (5-HT 수용체 길항제를 이용한 파킨슨 환자의 정신 증상의 치료)

  • Koh, Seong-Beom;Park, Kun-Woo;Lee, Dae-Hie
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.132-135
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    • 1997
  • Current treatment strategies for levodopa-induced psychosis in advanced Parkinson's disease have had limited success. Reduction or discontinuation of levodopa and coadministration with dopamine-blocking neuroleptics may attenuate the psychotic symptoms, but these strategies are associated with worsening of parkinsonian symptoms. Administration of 5-HT3 receptor antagonist ; ondansetron, a newer strategy to attenuate psychosis of Parkinson'disease without motor deterioration was introduced. A 41-year-old young-onset male, who was diagnosed as Parkinson's disease 7 years ago, was treated with levodopa therapy, and had levodopa-induced psychosis(delusion, hallucination, paranoid, insomnia). After trial of ondansetron, he showed improvement in the Brief Psychiatric Rating Scale(from 21 points to 9 points) in spite of increasing the dosage of levodopa. With ondansetron, we could increase the dosage of levodopa without psychotic complications(esp, hallucination), and he showed improvement in the motor fluctuation.

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Steroid-induced Psychosis in Adolescent Patient with Crohn's Disease

  • Kim, Jin Woo;Kang, Ki Soo;Kang, Na Ri
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.3
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    • pp.161-164
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    • 2020
  • Crohn's disease is a chronic inflammatory disease that involves the upper and lower gastrointestinal tracts, including the oral cavity. For the conventional treatment of inflammatory bowel diseases, steroids are usually used as induction therapy, and azathioprine is used as maintenance therapy. Steroids are associated with various side effects. Under rare circumstances, they can even cause psychotic symptoms, and reports on steroid-induced psychosis in the pediatric population are few. Here, we report the first case of steroid-induced psychosis in a 16-year-old female with Crohn's disease administered with steroids as induction therapy in South Korea. She showed psychotic symptoms, including auditory hallucination, loosening of association, and idea of reference, after 2 weeks of administering prednisolone 60 mg/day. One week after steroid discontinuation, the patient gradually recovered and was treated with quetiapine. Therefore, pediatricians should be aware of serious psychiatric adverse effects when administering corticosteroids for various indications.

Clinical Usefulness of Aripiprazole Treatment in a Girl with Prader-Willi Syndrome and Psychosis

  • Briegel, Wolfgang
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.497-500
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    • 2018
  • Prader-Willi syndrome (PWS) is a quite rare multi-systemic genetic disorder strongly associated with psychiatric illness in adults, especially psychosis. This report presents a 16-year-old female with PWS and symptoms of brief psychotic disorder with a complete resolution of symptoms under aripiprazole medication. However, an exacerbation occurred after aripiprazole reduction. Apart from a weight gain of about 2 kg over the course of two years, no adverse effects could be found. This first report on the use of aripiprazole in a subject with PWS and psychosis suggests that aripiprazole might be a promising treatment approach in this distinct group of patients.

A case of Hashimoto's encephalopathy presenting with seizures and psychosis

  • Lee, Min-Joo;Lee, Hae-Sang;Hwang, Jin-Soon;Jung, Da-Eun
    • Clinical and Experimental Pediatrics
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    • v.55 no.3
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    • pp.111-113
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    • 2012
  • Hashimoto's encephalopathy (HE) is a rare, poorly understood, autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. Here, we report a case of a 14-year-old girl with HE and briefly review the literature. The patient presented with acute mental changes and seizures, but no evidence of infectious encephalitis. In the acute stage, the seizures did not respond to conventional antiepileptic drugs, including valproic acid, phenytoin, and topiramate. The clinical course was complicated by the development of acute psychosis, including bipolar mood, insomnia, agitation, and hallucinations. The diagnosis of HE was supported by positive results for antithyroperoxidase and antithyroglobulin antibodies. Treatment with methylprednisolone was effective; her psychosis improved and the number of seizures decreased. HE is a serious but curable, condition, which might be underdiagnosed if not suspected. Anti-thyroid antibodies must be measured for the diagnosis. HE should be considered in patients with diverse neuropsychiatric manifestations.

A case with Alcoholic Korsakoff's psychosis (알코올성 Korsakoff병(Alcoholic Korsakoff's psychosis) 환자 1례에 대한 증례보고)

  • Choi, En-Young;Kim, Ju-Ho;Gong, Dae-Jong;Koo, Byung-Soo;Kim, Kyeong-Ok
    • Journal of Oriental Neuropsychiatry
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    • v.15 no.1
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    • pp.155-165
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    • 2004
  • Alcoholic Korsakoff's psychosis is a clonic amnestic syndrome caused by alcohol abuse. It is characteristic of hypomnesis, disorientation and confabulation. We experienced a 53 year-old man who had a alcoholic korsakoff's syndrome, DM and general weakness and whose condition was improved through Oriental medical treatment. This case study illustrates what the manifestation of alcoholic korsakoff's syndrome is and how alcoholic korsakoff's syndrome improved.

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A Case of Acute Psychosis after Sibutramine Ingestion (시부트라민(sibutramine) 음독 후 발생된 급성 정신병증 1례)

  • Kim, Hyung-Min;Woo, Seon-Hee;Choi, Se-Min;So, Byung-Hak
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.2
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    • pp.176-179
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    • 2009
  • A 38-year-old woman was admitted to our hospital due to agitation, nausea, chest discomfort, tachycardia and hypertension 6h after ingesting approximately 60 capsules of sibutramine. The woman developed the clinical features of acute psychosis, including auditory hallucination, agitation and paranoid ideation, on day 2. No relevant changes were detected on the laboratory examinations or on the electrocardiogram throughout the period of hospitalization. She was treated with risperidone and benzodiazepine. The symptoms subsequently resolved completely with cessation of the provoking agent. The patient was discharged on day 7 and the follow-up revealed no sequelae for 5 months.

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A case of steroid-induced psychosis in a child having nephrotic syndrome with toxic epidermal necrolysis (신증후군 환아에서 발생한 독성표피괴사용해 치료를 위해 사용된 고용량 스테로이드로 인한 정신질환 1례)

  • Kim, Sae Yoon;Lee, Jae Min;Park, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.437-441
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    • 2010
  • Toxic epidermal necrolysis (TEN) and Stevens Johnson syndrome (SJS) are rare, life-threatening mucocutaneous -diseases, usually attributable to drugs and infections. Corticosteroids have been used in the management of TEN for the last 30 years. This remains controversial and is still much debated. TEN can occur despite administration of high doses of systemic corticosteroids. The psychiatric side effects of corticosteroids can include headache, insomnia, depression, and mood disorders with or without psychotic episodes. Steroid-induced psychosis is dealt with by tapering or discontinuing the steroid; antipsychotics are also sometimes used. We report a case of an 11-year-old boy who was admitted with TEN. He had also been diagnosed as having nephrotic syndrome in the past. Remission was achieved through induction therapy and by maintaining the use of steroids. After a full-dose intravenous dexamethasone for TEN, he showed psychotic symptoms. We diagnosed him as having steroid-induced psychosis. We tapered the steroid use and initiated an atypical antipsychotic medication, olazapine and intravenous immunoglobulin (IV-IG). His symptoms dramatically improved and he was discharged.

Factors Affecting the Duration of Untreated Psychosis in Community-Dwelling Patients with Schizophrenia Spectrum Disorder (지역사회 거주 조현병 범주 장애 환자의 정신증 미치료 기간 관련 요인)

  • Kim, Mina;Kim, Jae-Kyeong;Jhon, Min;Kim, Ju-Wan;Lee, Ju-Yeon;Kim, Jae-Min;Shin, IL-Seon;Yoon, Jin-Sang;Lee, Myung-Soo;Kim, Sung-Wan
    • Korean Journal of Schizophrenia Research
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    • v.23 no.1
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    • pp.1-7
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    • 2020
  • Objectives: This study aimed to identify factors affecting the duration of untreated psychosis (DUP) in patients with schizophrenia spectrum disorder. Methods: Six-hundred patients with schizophrenia spectrum disorder were recruited from mental health welfare centers in Gwangju Metropolitan City and Gyeonggi-do. Subjects were categorized into two groups according to median DUP. Demographic and clinical characteristics were compared between the two groups. Results: The mean DUP was 80.8 weeks, and the median DUP was 15.9 weeks. Patients with Medicaid, higher age, and longer duration of the schizophrenia prodrome were more likely to have a longer DUP. The DUP was shorter in patients who were consulted by family/relatives prior to treatment. Patients visiting university hospitals were more likely to have a shorter DUP compared with those visiting psychiatric clinics or small-sized mental hospitals, i.e., with less than 100 beds. A multivariate regression analysis showed that the duration of the prodrome was a factor that significantly affected DUP. Conclusion: The vulnerable group of patients with schizophrenia with a long DUP should be monitored closely. Moreover, it is necessary to develop a strategy to identify patients who have an insidious course of psychosis to reduce the DUP.