Cycloid Psychosis: Differential Diagnosis and case repot
P. Nava Garcia, M. Arevalo Gil, S. Orrego Molina, F. Pascual Pinazo, M. Sobredo VegaIntroduction
A 43-year-old woman is admitted to the Hospitalization Unit due to a psychotic episode characterized by marked behavioral disorganization , psychomotor agitation, irritability, suspiciousness, pressuring, verbose, rambling speech with loose associations, from which megalomaniacal and paranoid delusional content emerges. Global insomnia with a significant increase in anxiety. A family stressor is identified as a precipitant.
Two years prior, the patient presented with a similar episode requiring brief hospital admission, stemming from high work stress. She was treated with Olanzapine 10mg with a rapid response within the first 24-48 hours and complete symptomatic resolution ( ad integrum ). She discontinued neuroleptic treatment after one week and has maintained stability until now.
Objectives
To establish a differential diagnosis and according treatment.
Methods
There are no relevant medical history records. No toxic substance consumption. Laboratory and imaging tests are within normal limits.
A first-degree relative in the horizontal line has a Bipolar Disorder diagnosis, with sustained stability described without treatment.
Results
The first episode was classified as a psychogenic disorder . The current one initially appears as a maniform decompensation with psychotic symptoms: congruent and incongruent delusions, and hallucinatory phenomena. The response to antipsychotic treatment with Olanzapine 10mg is rapid (first 24-48h) and complete, although it is substituted with Aripiprazole due to excessive somnolence. Upon hospital discharge, the treatment is Aripiprazole 300mg IM (Intramuscular).
In this case, for which other diagnostic hypotheses were initially proposed, the differential diagnosis with Cycloid Psychosis is consideredTo e
Conclusions
Perris and Brockington establish the following diagnostic criteria for
Cycloid Psychosis:
Psychotic disorder
not related to toxic substance consumption or an organic disease.
Onset
between the ages of 15 and 50.
Sudden and rapidly progressive onset
.
Co-occurrence of at least 4
of the following: confusion, incongruent affect/mood, delusional ideation, sensory-perceptual disturbances, anxiety, feelings of euphoria, psychomotor alterations, death/suicidal ideation, or affective oscillations; and
frequent change in symptomatic manifestation
Disclosure of Interest
None Declared