Öz
Psychosis is a general psychiatric definition used in different psychiatric disorders with severe disruption in thought and perceptions. Patients with psychotic episodes may have hallucinations, delusional beliefs and disorientation. They may show changes in personality. Since onset of psychosis occurs rarely in old age, depression and dementia should be primarily considered especially in elderly patients presenting with hallucinations, delusional beliefs, personality changes and thought disorder. We present a case report of patient with dementia and late onset depression presenting with tactile hallucination. The aim of this case presentation is to focus on the hazards of symptom-based diagnosis and treatment that may cause misdiagnosis in elderly patients. An 85-year-old male patient was admitted to outpatient clinic with a complaint of tingling in his body and the feeling of insects crawling underneath your skin. After physical examination and comprehensive geriatric assessment, psychiatric consultant evaluated patient in Geriatric Medicine department. He was diagnosed with psychotic depression and dementia. Every patient should be examined for the cognitive impairment by the physician. It should also be considered that other psychiatric disorders may accompany by the dementia.
Anahtar Kelimeler
Kaynakça
- American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. Fifth ed. American Psychiatric Publishing, Arlington, 2013: 87-88.
- Lincoln TM, Mobius C, Huber MT, Nagel M, Moritz S. Frequency and correlates of maladaptive responses to paranoid thoughts in patients with psychosis compared to a population sample. Cogn Neuropsychiatry 2014; 19 (6): 509-26.
- Brendel RW, Stern TA. Psychotic symptoms in the elderly. Prim Care Companion J Clin Psychiatry 2005; 7 (5): 238-41.
- Cort E, Meehan J, Reeves S, Howard R. Very Late–Onset Schizophrenia-Like Psychosis: A Clinical Update. Journal of psychosocial nursing and mental health services 2017; 56 (1): 37-47.
- Palmer BW, Mcclure FS, Jeste DV. Schizophrenia in late life: findings challange traditional concepts. Harv Rev Psychiatry 2001; 9 (2): 51-8.
- Jeste DW, Finkel SI. Psychosis of alzheimer’s disease and related dementias. Diagnostic criteria for a distinct syndrome. Am J Geriatr Psychiatry 2000; 8 (1): 29-34.
- El Haj M, Roche J, Jardri R, Kapogiannis D, Gallouj K, Antoine P. Clinical and neurocognitive aspects of hallucinations in Alzheimer’s disease. Neurosci Biobehav Rev 2017; 83: 713–20.
- Moritz, S, Goritz, AS, Gallinat J et al. Subjective competence breeds overconfidence in errors in psychosis. A hubris account of paranoia. J Behav Ther Exp Psychiatry 2015; 48: 118-24.
- Rubin, R. Exploring the relationship between depression and dementia. Jama 2018; 320 (10): 961-2.
Öz
Psikoz, düşünce ve algının ağır oranda bozulduğu zihin durumunu tanımlamakta kullanılan genel bir psikiyatri terimidir. Psikotik epizot geçiren hastalar halüsinasyonlar görebilirler, delüzyonel inançlar taşıyabilirler, kişilik değişiklikleri ve düşünce bozukluğu gösterebilirler. Psikozun ileri yaşta başlaması daha nadir görüldüğünden; özellikle halüsinasyon, delüzyonel inançlar, kişilik değişiklikleri ve düşünce bozukluğu ile başvuran ileri yaştaki kişilerde ayırıcı tanıda psikoz tanısının yanı sıra depresyon ve demans tanıları da düşünülmelidir. Bu vakada, taktil halüsinasyonla başvuran, depresyonun eşlik ettiği 85 yaşında demans hastası sunulmuştur. Vücutta karıncalanma ve sürekli pirelerin ısırdığını hissetme şikâyeti ile başvuran erkek hastaya, fizik ve psikiyatrik muayene ile kapsamlı geriatrik değerlendirme sonrası psikotik bulgulu depresyon ve demans tanısı konmuştur. Hekim tarafından ileri yaştaki her hasta demansiyel süreç açısından değerlendirilmeli ve demansiyel duruma başka psikiyatrik hastalıkların eşlik edebileceği göz önünde bulundurulmalıdır.
Kaynakça
- American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. Fifth ed. American Psychiatric Publishing, Arlington, 2013: 87-88.
- Lincoln TM, Mobius C, Huber MT, Nagel M, Moritz S. Frequency and correlates of maladaptive responses to paranoid thoughts in patients with psychosis compared to a population sample. Cogn Neuropsychiatry 2014; 19 (6): 509-26.
- Brendel RW, Stern TA. Psychotic symptoms in the elderly. Prim Care Companion J Clin Psychiatry 2005; 7 (5): 238-41.
- Cort E, Meehan J, Reeves S, Howard R. Very Late–Onset Schizophrenia-Like Psychosis: A Clinical Update. Journal of psychosocial nursing and mental health services 2017; 56 (1): 37-47.
- Palmer BW, Mcclure FS, Jeste DV. Schizophrenia in late life: findings challange traditional concepts. Harv Rev Psychiatry 2001; 9 (2): 51-8.
- Jeste DW, Finkel SI. Psychosis of alzheimer’s disease and related dementias. Diagnostic criteria for a distinct syndrome. Am J Geriatr Psychiatry 2000; 8 (1): 29-34.
- El Haj M, Roche J, Jardri R, Kapogiannis D, Gallouj K, Antoine P. Clinical and neurocognitive aspects of hallucinations in Alzheimer’s disease. Neurosci Biobehav Rev 2017; 83: 713–20.
- Moritz, S, Goritz, AS, Gallinat J et al. Subjective competence breeds overconfidence in errors in psychosis. A hubris account of paranoia. J Behav Ther Exp Psychiatry 2015; 48: 118-24.
- Rubin, R. Exploring the relationship between depression and dementia. Jama 2018; 320 (10): 961-2.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2020 |
| Gönderilme Tarihi | 5 Temmuz 2019 |
| Yayımlandığı Sayı | Yıl 2020Cilt: 59 Sayı: 2 |
