El Síndrome de Deleción 22q11.2 o Síndrome de DiGeorge es una entidad genética caracterizada por la triada clínica de anomalías cardiacas conotruncales, hipoplasia tímica e hipocalcemia. No obstante, el fenotipo 22q11.2 es bastante variable, incluyendo anomalías físicas, metabólicas, endocrinológicas y a nivel conductual y del desarrollo. Incluye asociación piscopatológica con distintos síndromes psiquiátricos. Describimos el caso de un varón de 16 años con criterios diagnósticos de Trastorno del Espectro Autista enmarcado en un Síndrome de Deleción 22q11.2.
IntroductionWe expose a woman diagnosed with schizoaffective disorder 2 years ago, before she received several diagnostics. She was admitted to the psychiatry unit with hyperactivity, pressured speech without taking an appropriate turn, flight-of-ideas, irritability, expansiveness, emotional liability, ideas of reference and insomnia without diurnal tiredness. In addition, she admitted having abandoned the medication one month ago. She was diagnosed with maniac episode with psychotic symptoms and the medication was reintroduced. After two weeks, no response was observed so we decided to introduce ability depot 600 mg/3 weeks.ObjectivesWe want to show that is possible the use of ability depot off-label in patients with a special difficulty in handling. Also, we want to show that higher doses are not dangerous and it's possible to study new treatment guidelines for ability depot.MethodsWe use the Positive and Negative Syndrome Scale (PANSS) pre (the day of the introduction) and post (at two weeks) treatment with aripiprazol depot; the Clinical Global Impression rating scale (CGI), also pre and post.ResultsWe have obtained a punctuation of 180 in PANSS the day of the introduction of the aripiprazol depot and 45 at two weeks. In addition, we obtained 6 in CGI the day of the introduction and 3 at two weeks.ConclusionsIn this case, aripiprazol depot has shown good tolerability and efficacy for the acute phase of schizoaffective disorder at higher doses than recommended in clinical guidelines. The efficacy and safety data are consistent with short-term, placebo-controlled studies of aripiprazol depot conducted in similar populations.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionSteroid psychosis still presents many unsettled clinical aspects. Despite several reviews and case reports are available, modes of onset and recovery need a more accurate description. We will focus on a 53-year-old woman who was hospitalized against her will because of her agitated psychotic state. Her symptoms were indicative of an acute psychotic disorder resulting from the use of corticosteroids. We considered it important to report this case because corticosteroids have been widely prescribed since about 1950 to treat a broad spectrum of somatic illnesses and to emphasize the relevance of the dose of steroids in this case.ObjectivesWe describe a case of substance-induced psychotic disorder resulting from corticosteroids administration and we review the scientific literature about this topic.AimsTo obtain more information about the incidence of steroid-induced psychotic symptoms, the relation between the type of steroids, its dose and the clinical presentation, the most important risk factors and how to prevent psychotic episodes during steroids-treatment.MethodsAfter discussing the case, we studied the literature systematically using official medical browsers.ResultsVery little reliable evidence has been available relating to steroid-induced psychosis.ConclusionsThere is much to learn about adverse psychiatric reactions to corticosteroid treatment. It should be improved awareness of the limited available knowledge and to stimulate research aimed at improved methods of prevention, recognition and treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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