Styliani Spyridi

Delusional disorder and alcohol abuse in a patient with Wilson's disease

OBJECTIVE Wilsons disease (WD) or hepatolenticular degeneration is a rare disorder of copper metabolism that results in copper deposition in brain, liver, kidneys and the cornea. Due to the copper deposits in the brain, neurological and psychiatric symptoms may appear. The psychiatric manifestations may vary from mood disorders, behavioral and personality disorders to cognitive impairment, while psychotic symptoms are rarely reported. The objective of this report was to present an unusual case of WD presenting with nonpersecutory delusional disorder and alcohol abuse in the absence of neurological signs. CASE SUMMARY A 34-year-old male patient, without any previous psychiatric or alcohol abuse history, presented with delusions of jealousy and alcohol abuse when he discontinued his treatment for WD. Although the patient had no previous symptoms or neurological signs, he was receiving treatment for WD for 3 years, after being diagnosed with the disease during family precautionary examination, since his brother developed symptomatic WD. The patient started combined pharmacotherapy, and after 3 months of follow-up the psychiatric manifestations were controlled sufficiently. CONCLUSIONS Although WD is rarely associated with alcohol abuse and delusions of jealousy, this disease should be taken into account in the differential diagnosis of these psychiatric manifestations.

Congenital cystic eye with multiple dermal appendages and intracranial congenital anomalies.

Congenital cystic eye (anophthalmia with cyst) is an extremely rare anomaly discovered at birth with few reported cases in the literature, resulting from partial or complete failure during invagination of the primary optic vesicle during fetal development. Herein we present the radiographic, ultrasound, and magnetic resonance imaging findings of a unique case of congenital cystic eye associated with dermal appendages and advanced intracranial congenital anomalies in a 3-month-old boy.

Status epilepticus in a patient treated with olanzapine and mirtazapine.

OBJECTIVE Few cases of seizures associated with olanzapine therapy and even fewer with mirtazapine have been published, most of them in patients with confounding risk factors. Our objective was to report a case of Status epilepticus in a patient receiving olanzapine and mirtazapine, with no previous history of seizure and no confirmed underlying cause for seizure. CASE SUMMARY A 48-year-old white, psychotic woman developed generalized tonic-clonic seizures that progressed to Status epilepticus during hospitalization. 4 days before the incident, mirtazapine (30 mg) was added to the treatment, while 2 days before the incident, the treatment switched from quetiapine to olanzapine, and mirtazapine was increased to 60 mg. No other toxic, metabolic, electrolyte or anatomic abnormality was identified. After discontinuation of olanzapine, the patient remained seizure-free. CONCLUSION To our knowledge, this is the second reported case of Status epilepticus that has been associated with the use of olanzapine, while only one report of seizures, but none of Status epilepticus connected to mirtazapine is found in the literature. Although olanzapine has infrequently been associated with epileptogenic risk, it should be used cautiously especially when concomitant medication or other predisposing factors exist.

Advances in the treatment of geriatric depression

Late-life depression is a rather difficult and complicated issue. Although there have been significant advances in our knowledge in this area, a large number of questions still remain unanswered. The aim of this review is a critical presentation of the current evidence for treatment of depression in the elderly. We summarize the evidence for the effectiveness and safety of a range of proposed treatments, including pharmacological, psychological and alternative therapies and lifestyle changes. The treatments with best evidence of effectiveness are antidepressant pharmacotherapy, electroconvulsive therapy, cognitive–behavioral therapy, psychodynamic psychotherapy, reminiscence therapy, problem-solving therapy and exercise. Implications for future research are discussed.

Hashimoto encephalopathy: a case report of a mixed type

Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here .

Location Learning Test: a new tool for the assessment of visuospatial learning and memory in patients with schizophrenia. Preliminary results

Background The Location Learning Test (LLT) is a brief, nonverbal measure of the ability to learn the spatial location of a series of everyday objects. Initially it was developed by Bucks and Willison (1997) for use in Alzheimers disease patients. However, it could also detect visuospatial memory deficits in other disorders associated with damage to hippocampus and to parahippocampal gyrus, such as schizophrenia. The aim of this study was to examine the applicability of LLT in patients with schizophrenia.