Improved Treatment Acceptance and Adherence Following the Diagnosis of Multiple Malformations of Cortical Development in a Patient with Psychosis

Abstract

The increased use of neuroimaging has revealed a variety of malformations of cortical development (MCDs) presenting with a range of neuropsychiatric disorders, including psychotic illnesses. Non-adherence with antipsychotic medication is a common barrier to the effective treatment for psychosis. This case illustrates improved treatment acceptance and adherence following the diagnosis of two separate MCDs (bilateral periventricular heterotopia and focal cortical dysplasia) in a 48-year-old Caucasian male with psychosis. By incorporating the neuroimaging findings into a cognitive behavioral therapy approach, the patient was more amenable to accepting psychotropic medications including long-acting risperidone injection. This in turn led to an improvement in his overall functioning. Furthermore, this case adds to the literature by describing the first instance of psychotic symptoms occurring in the setting of both bilateral periventricular heterotopia and focal cortical dysplasia.