De la schizophrénie à la maladie de Wilson^*

Abstract

An 18 year-old male first presented a clinical picture of acute psychosis with two recurrences at ages 22 and 23. The diagnosis made at that time was paranoid schizophrenia. Twelve years after his first psychiatric hospitalization, it was discovered that he was suffering from Wilson's disease. In retrospect, the clinical picture was atypical, notably with an important neurologic involvement mainly parkinsonism almost uncontrollable and aggravated with neuroleptics. The chelating treatment with d-penicillamine resulted in partial improvement of the neurological involvement because the extrapyramidal and neurovegetative symptoms persisted. The psychiatric symptoms improved with fewer neuroleptics than during the 12 previous years. However, neuroleptics had to be continued because of the delay in diagnosing the illness, which diminished the efficiency of the single chelating treatment. The clinical presentation and therapeutic response of this patient strongly suggest a link between the cerebral intoxication by copper and the psychiatric symptoms.

Mismanagement of Wilson′s disease as psychotic disorder

“…Twelve years after his first psychiatric hospitalization, it was discovered that he was suffering from WD. [7] Another case was a 26-year-old woman with clinical picture of acute psychosis, as the first and main manifestation of WD, is presented. She developed abnormal involuntary choreoathetoid limb movements, few days after initiation of neuroleptic therapy.…”

Quality of Life and Psychiatric Symptoms in Wilson’s Disease: the Relevance of Bipolar Disorders

“…A wide set of psychiatric, psychological and psychosocial impairments have been reported; these include: mental retardation [39], confusional states [40], cognitive impairment [41], dementia [42], poor school performance [43], anxiety [44], depression [45], emotional lability [46], mania, abnormalities of behavior and personality disorders [47], schizophrenia-like states [48, 49], suicide [25]. The frequency and relative clinical significance of different psychiatric manifestations are difficult to determine from the literature; while the possible association with schizophrenia-like states has attracted much interest, debate such states are infrequent, the exact lifetime prevalence of psychiatric symptoms in patients with WD is unclear but the estimates range is from 30 to 100% of symptomatic patient [49].…”

“…Other psychiatric disorders have been associated with WD, such as anxiety disorders, substance abuse, catatonia and anorexia; their prevalence in WD patients compared with general population is difficult to determine from the literature [48]. …”

Psychosis in an adolescent with Wilson′s disease: A case report and review of the literature

“…[ 17 18 19 20 ] However, over the last two decades, there is the proliferation of case reports/series describing psychosis in patients with Wilson's disease. [ 2 4 7 8 10 11 12 15 16 21 22 23 24 25 26 27 ]…”