A case report of brief psychotic disorder with catalepsy associated with sequential life-threatening events in a patient with advanced cancer.
A case report of brief psychotic disorder with catalepsy associated with sequential life-threatening events in a patient with advanced cancer.
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DOI：
10.1186/s13030-017-0095-7
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发表时间：
2017
影响因子：
2.1
通讯作者：
Onishi H
中科院分区：
文献类型：
--
作者：
Ishida M;Kawada S;Onishi H
癌症通常被认为是威胁生命和普遍存在的压力；然而，对极端压力事件的反应而发生的短暂精神障碍尚未见报道。一位63岁的女性，被诊断为胰腺癌合并肝转移，在一系列危及生命的事件，如双肺动脉血栓形成和十二指肠第三部分狭窄后，由于疾病从肿瘤紧急入院开始的3周多的进展，对言语接触几乎没有反应。实验室结果和脑电检查结果并不明显。当心理肿瘤学家举起她的手(昏厥)时，她保持了这个姿势。她没有精神疾病、酒精或药物滥用的病史。根据这些发现，她被怀疑患有短暂的精神障碍，并伴有昏迷和亚昏迷，并接受了2.5毫克氟哌啶醇的治疗。她的精神症状在4天内消失，确诊为短暂精神障碍。癌症患者可能会出现短暂的精神障碍。需要进行仔细的临床评估，以正确诊断患有简单精神障碍的癌症患者，并确定哪些患者将从正确的治疗中受益。
Cancer is commonly perceived as life-threatening and universally stressful; however, brief psychotic disorder, which occurs in response to extremely stressful events, has not been reported. A 63-year-old woman, who was diagnosed as having pancreatic cancer with liver metastasis, became unresponsive with very little reaction to verbal contact after sequential life-threatening events, such as thrombosis of both pulmonary arteries and stenosis of the third portion of the duodenum, due to disease progression over 3 weeks beginning with oncological emergency hospital admission. Laboratory findings and electroencephalography were unremarkable. She maintained the position when the psycho-oncologist raised her hand (catalepsy). She had no medical history of psychiatric illness, or alcohol or drug abuse. From these findings, she was suspected of having a brief psychotic disorder with catalepsy and substupor, and 2.5 mg of haloperidol was administered. Her psychiatric symptoms disappeared in 4 days and the diagnosis of brief psychotic disorder was confirmed. Brief psychotic disorders can manifest in patients with cancer. Careful clinical assessment is needed to correctly diagnose patients with cancer who develop brief psychotic disorders and to identify those who will benefit from correct treatment.