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Article contents

Organic psychosis: Much more than dopamine

Published online by Cambridge University Press:  23 March 2020

R. Martín Gutierrez
Affiliation:
Hospital Universitario Marques De Valdecilla, Psychiatry, Santander, Spain
M. Juncal Ruiz
Affiliation:
Hospital Universitario Marques De Valdecilla, Psychiatry, Santander, Spain
O. Porta Olivares
Affiliation:
Hospital Universitario Marques De Valdecilla, Psychiatry, Santander, Spain
R. Landera Rodríguez
Affiliation:
Hospital Universitario Marques De Valdecilla, Psychiatry, Santander, Spain
L. Sánchez Blanco
Affiliation:
Hospital Universitario Marques De Valdecilla, Psychiatry, Santander, Spain
D. Abejas Díez
Affiliation:
Hospital Universitario Marques De Valdecilla, Psychiatry, Santander, Spain
G. Pardo de Santayana Jenaro
Affiliation:
Hospital Universitario Marques De Valdecilla, Psychiatry, Santander, Spain
M. Gómez Revuelta
Affiliation:
Hospital Universitario de Álava-Sede Santiago, Psychiatry, Vitoria-Gasteiz, Spain
C. Marín Requena
Affiliation:
Hospital Universitario de Álava-Sede Santiago, Psychiatry, Vitoria-Gasteiz, Spain
V. Gajardo Galán
Affiliation:
Hospital Clínic, Psychiatry, Barcelona, Spain

Abstract

Introduction

Most of elderly onset psychosis present as a consequence of one or more organic processes. We present the case of an 81-year-old patient with diagnosis of a posterior fossa meningioma. It emerged with abrupt positive symptoms of psychosis with important family and social disruption. The interest of the case lies in the low frequency of psychiatric symptoms associated to this type of tumor, given its location. Thus, these symptoms may be explained, by normal pressure hydrocephalus (NPH) secondary to the tumor.

Objectives

To highlight the importance of performing a complete organic screening in elderly onset psycotic patients.

Material and method

From the mentioned case, we performed a literature review of psychopathology associated with NPH.

Results

Psychiatric examination demonstrated parasitization delusions and delusional misinterpretations; tactile and visual zoomorphic hallucinations were also present. They were compatible with Ekbom syndrome; anxiety and behavioral disorganization were prominent. We introduced treatment with risperidone 0.5 mg/12 h with important decrease of positive psychotic symptoms. Currently, the patient is waiting for a ventricular-peritoneal shunt.

Conclusions

The NPH usually presents with memory failures, psychomotor slowing, problems in calculating and writing. It may progress to a neurological impairment so intense that may be indistinguishable from Alzheimer's disease. From a psychopathological point of view, affective or psychotic symptoms and/or behavioral disorganization may also appear. In few cases, HNT onset shows with prominent psychiatric symptoms instead of neurological impairment. These symptoms may improve with pharmacological and surgical treatment. Thus, it is important to get an accurate diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Viewing: Schizophrenia and other psychotic disorders
Copyright
Copyright © European Psychiatric Association 2017
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