Subject(s)
Authorship , Competency-Based Education , Internship and Residency , Education, Medical, Graduate , Female , Humans , Mentors , Publications , Sex DistributionABSTRACT
Bariatric patients may present for psychiatric evaluation due to exacerbation of preexisting psychiatric disorders, new onset psychiatric disorders and/or neuropsychiatric complications associated with abnormal nutritional and metabolic states following the surgical procedure. These neuropsychiatric complications can be insidious, and clinical manifestations may vary, possibly due to the individual central nervous system (CNS) vulnerability to nutritional decline. Lack of awareness of these complications and their symptoms can result in delays in diagnosis and treatment. Identifying and correcting underlying pathophysiologic processes that lead to such neuropsychiatric syndromes can be challenging. We report a case of a patient who developed a protracted course of mood and cognitive disorder after gastric bypass surgery, which illustrates some of the complexities encountered in diagnosing and managing these patients.
Subject(s)
Deficiency Diseases/etiology , Gastric Bypass/adverse effects , Gastric Bypass/psychology , Mental Disorders/psychology , Female , Humans , Middle AgedABSTRACT
Extreme neglect of one's living space and self-care is a perplexing condition termed Diogenes syndrome, where outcomes of intervention are often poor, with high relapse and mortality rates. Relatively little has been reported regarding management approaches. We present a case of Diogenes syndrome responsive to a structured behavioral paradigm during a hospital admission and speculate on the mechanism of neuroplasticity-based behavioral treatment in facilitating clinical improvement.