A Case of Comorbid PTSD and Posttraumatic OCD Treated with Sertraline-Aripiprazole AugmentationRead the full article
Case Reports in Psychiatry publishes case reports and case series in all areas of psychiatry.
Case Reports in Psychiatry maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.
Abstracting and Indexing
Latest ArticlesMore articles
A Case of Septum Pellucidum Agenesis in a Patient with Psychotic Symptoms
Agenesis of the septum pellucidum is a rare congenital defect that has been associated with psychiatric disorders, cognitive deficits, learning disabilities, seizures, and neuropsychiatric disturbances. We present the case of a patient with partial agenesis of the septum pellucidum who exhibits disorganized behavior and paranoid and persecutory delusions. We add to the literature of incidental neuropsychiatric symptoms in patients with partial agenesis of the septum pellucidum which is an area that requires further exploration and study. We discuss the implications of these findings in light of previous literature findings.
Comorbid Depressive and Anxiety Symptoms in a Patient with Myasthenia Gravis
Introduction. Myasthenia gravis (MG) is a chronic illness most commonly found in women under 40 years. The most common psychiatric comorbidities found in MG include depressive and anxiety disorders. Clinical Presentation. We describe a case of a 43-year-old African American female with MG who was brought in for shortness of breath. History included MG diagnosed twelve years prior to the current presentation and a history of seven intubations. The patient was admitted to the ICU and intubated. She endorsed poor sleep, easy fatigability, and feeling hopeless in the context of psychosocial stressors—being single, homeless, and unemployed. The patient was started on Zoloft 50 mg per oral daily for depression and Atarax 50 mg per oral three times a day for anxiety. The patient responded well to the treatment and was discharged on day 10 after the resolution of her symptoms with appropriate aftercare in place. Discussion. Depressive and anxiety symptoms usually develop as comorbidity during MG disease. Depressive and anxiety symptoms, besides motor symptoms, have a negative impact on the quality of life. Mental health must be a clinical focus during the treatment of somatic symptoms during MG.
Clinical Management of Children and Adolescents with Neurofibromatosis Type 1 Like Phenotypes and Complex Behavioural Manifestations: A Multidisciplinary and Dimensional Approach
Introduction. Cognitive and behavioural problems associated with Neurofibromatosis type 1 (NF1) are common sources of distress and the reasons behind seeking help. Here we describe patients with NF1 or NF1-like phenotypes referred to a Tier 3 Child and Adolescent Psychiatry Department and highlight the benefits of a multidisciplinary assessment. Methods. Prospective data were gathered from NF1 patients aged 7–15 years, referred by the NF1 Referral Centre due to additional difficulties either in management or diagnosis. For the selected cases, we performed a psychiatric assessment, a tailored neuropsychological evaluation based on clinical demands and history, broad speech and motor skills evaluations if there were concerns regarding language, motor abilities and/or learning difficulties and autism specific evaluations, if clinically relevant. No exclusion criteria were applied. Results. Complex NF1 cases represented only 5% of the patients (11/224). Assessments revealed the complexity of NF1 phenotype and a variety of problems including learning difficulties, emotional problems and autism spectrum disorders. Specific evaluations of language, motor, attentional and neurovisual domains were essential to guide tailored intervention strategies. Conclusions. In terms of clinical implications, the heterogeneity of NF1 phenotypical manifestations needs to be considered when developing assessment and remediation approaches for children with complex NF1.
Acceptance of Anxiety through Art Therapy: A Case Report Exploring How Anthroposophic Art Therapy Addresses Emotion Regulation and Executive Functioning
Anxiety is a major problem for many individuals, causing impairment in daily life. Art therapy is often deployed and although positive results are communicated in clinical practice, its effectiveness and working mechanisms have hardly been studied. Therefore, it is important to systematically describe the intervention process and to detect the working mechanisms to be able to evaluate them. Narrative case studies help to understand the intervention in more depth. A typical case file was selected for case reporting according to scientific (CARE & CARE-AAT) guidelines, with the aim to explore the therapeutic elements that contributed to the reduction of anxiety. The report describes the intervention process of a 54-year-old female, suffering from anxiety since childhood and diagnosed with panic disorder, agoraphobia, claustrophobia and hypochondria. After 14 sessions of anthroposophic art therapy, reduction of anxiety was shown, as well as improvements of emotion regulation and executive functioning. The client indicated that she became more tolerant and accepting towards her anxiety. She noted a softened attitude towards herself and her complaints, even one year after art therapy. The course of treatment suggests that aspects of emotion regulation and executive functioning were addressed through implicit learning processes in different art therapy assignments.
A Case of Cognitive Decline Resulting from Aging, Temporal Lobe Epilepsy, and Environmental Factors
Cognitive functioning is imperative in our daily lives. It allows us to understand, process, and react appropriately to different situations. Aging has been linked to cognitive decline. The degree and rate of cognitive decline are crucial as they differentiate normal aging from dementia or memory loss secondary to medical conditions. A 63-year-old Caucasian woman with a 50-year history of temporal lobe epilepsy experienced memory difficulties in recent years. She was admitted voluntarily to the neuropsychiatry ward for a 3-day ambulatory electroencephalogram (EEG), which reported mild bitemporal structural or functional abnormality. The patient reported subjective seizure experiences that were not reflective of seizure activity on the EEG. Possible causes included panic attacks or other anxiety experiences. Routine laboratory test and magnetic resonance imaging results were unremarkable. During her hospital stay she showed improvement in cognitive functioning. However, anxiety continued to negatively impact her memory. We hypothesized that the memory impairments could have resulted from age, psychological factors, the patient’s own expectations, pressure from the environment and history of TLE. We diagnosed the patient with mild cognitive impairment and adjustment disorder with anxiety. She was discharged with seizure and anxiety medication. This report highlights the importance of both age-related and disease-related variables when diagnosing patients with cognitive decline.
A Case Series: Adjunctive Treatment of Major Depressive Disorder in the Geriatric Population with the Methylphenidate Patch
Major depressive disorder can affect anyone regardless of age. In geriatric populations depression is often overlooked and untreated, which subsequently may lead to serious consequences. Almost one third of elderly patients with depression fail to respond to initial treatment and require adjunctive treatment. Methylphenidate is one such option, which is seldom used in the geriatric population to treat depression despite reports of improvement in symptoms of mood within a brief period of time. Methylphenidate is also available in a patch formulation that can be used in patient’s nonadherent to the medication, which is reported to be an issue in as many as 75% of the geriatric population. Here we present three geriatric patients who were diagnosed with recurrent severe major depressive disorder without psychotic features. The three patients responded well with methylphenidate as adjunctive treatment to conventional antidepressants.