RESUMO
Neuroleptic Malignant Syndrome (NMS) is a rare but a potential lethal condition therefore it always represents a neurological emergency. Although NMS is considered mainly as idiosyncratic complication of antipsychotic medication, isolated reports show that the syndrome can rarely occur due to other causes such as, after abrupt withdrawal of anticholinergics and this was the case that is presented here. The syndrome continious to carry a high mortality rate and its basic management remains risk reduction, early diagnosis and supportive care. Thus, familiarity and vigilance to all known risk factors is considered essential for early diagnosis and intervention, and concequently for the reduction of morbidity and mortality of NMS.
RESUMO
BACKGROUND: Psychotic (delusional) major depression (PMD) in the elderly is a common condition in inpatient settings. There is evidence that late age onset depressives are more likely to be psychotic. OBJECTIVES: The aim of this study was to investigate the frequency, sociodemographic, and clinical characteristics of PMD in hospitalized elderly depressives. METHODS: The sample consisted of 118 elderly patients consecutively admitted at three different clinics. All patients fulfilled DSM-IV criteria for major depression disorder and were diagnosed on the basis of Structured Clinical Interview for DSM-IV (SCID). The subjects were also assessed using the Hamilton Rating Scale for Depression, the Mini Mental State Examination (MMSE) and a physical health rating scale. RESULTS: PMD was positively associated with age of depression onset over 60 [corrected]. The PMD patients were also more severely depressed, more psychomotorically retarded and referred more past psychotic depressive episodes. Furthermore, age at onset influenced the type of delusions, so that PMD patients with age [corrected] over 60 at onset expressed delusions of hypochondriacal and nihilistic content more frequently. CONCLUSIONS: The results of our study demonstrated that PMD in the elderly has a later age at onset.
