ABSTRACT
Dysphagia is a symptom shared by many medical and psychiatric conditions. A thorough Psychiatric evaluation could rule in a functional or psychological etiology. If a Psychological etiology is identified, a psychodynamic formulation could help the consultation psychiatrist clarify the origin of the symptom and provide a better explanation to the patient and medical team, resulting in improved care by prevention of unnecessary medical interventions, improvement of symptoms and individualization of the treatment.
Subject(s)
Conversion Disorder/diagnosis , Deglutition Disorders/etiology , Anxiety/etiology , Conversion Disorder/therapy , Deglutition Disorders/psychology , Deglutition Disorders/therapy , Female , Humans , Mother-Child Relations , Object Attachment , Psychosomatic Medicine/trends , Psychotherapy , Stress, Psychological/etiology , Young AdultABSTRACT
Rarely screened in psychiatric patients, primary and/or secondary Carnitine deficiency could be influencing and/or mimicking the mood symptoms of our patient population. The brain and specifically neurons are highly vulnerable to impairments in oxidative metabolism, which can lead to neuronal cell death and disorders of neurotransmitters causing changes in cognition and behavior. For this reason, identification of this disorder is important since its treatment could result in symptom improvement and better quality of life of our patients. We present a case where exacerbation of mood symptoms was associated to primary and secondary Carnitine deficiency.
Subject(s)
Antimanic Agents/adverse effects , Attention Deficit Disorder with Hyperactivity/complications , Carnitine/deficiency , Hyperammonemia/psychology , Ketoglutarate Dehydrogenase Complex/antagonists & inhibitors , Mood Disorders/complications , Organic Cation Transport Proteins/deficiency , Valproic Acid/adverse effects , Adult , Antidepressive Agents/therapeutic use , Attention Deficit Disorder with Hyperactivity/blood , Benzodiazepines/therapeutic use , Carnitine/therapeutic use , Citalopram/therapeutic use , Depressive Disorder/complications , Depressive Disorder/drug therapy , Disruptive, Impulse Control, and Conduct Disorders/complications , Drug Substitution , Drug Therapy, Combination , Humans , Hyperammonemia/chemically induced , Hyperammonemia/genetics , Lorazepam/therapeutic use , Male , Mood Disorders/blood , Olanzapine , Organic Cation Transport Proteins/genetics , Solute Carrier Family 22 Member 5 , Valproic Acid/pharmacology , Valproic Acid/therapeutic useABSTRACT
Exacerbation of symptoms in mood disorders such as bipolar disorders, major depressive disorders and premenstrual dysphoric disorders could be influenced by the hormonal changes of the menstrual cycles in female patients. Menarche has been related to onset of mood symptoms, which at times have been described as menstrual psychoses and could represent an early presentation of Pediatric bipolar disorders. Pediatric bipolar disorders appear to be characterized by less clearly defined mood episodes, shorter duration of these episodes, and different hallmark symptoms than in adults. This report describes a pediatric patient who had no previous psychiatric symptoms and for whom menstrual psychosis was the presenting symptom of bipolar disorder not otherwise specified.
