Detailed contribution information
| Contribution title | Pharmacological Management of Complex Psychotic Symptom Constellations - A Case Report |
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| Contribution code | D3.117 |
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| Form of presentation | Poster |
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| Abstract |
Patient background: We saw a 14-year-old patient who presented for the first time in 10/24 with suspected psychosis on the recommendation of the outpatient child and adolescent psychiatrist. The patient reported visual hallucinations (seeing symbols) and auditory hallucinations in the sense of hearing imperative or commenting voices (voice of the Holy Spirit). The patient also reported increased prayer (up to 20 times per day), as he was convinced that he had sinned and could not obtain forgiveness. Clinical findings and diagnosis: Physical examination, blood tests, ECG, cMRI, lumbar puncture and a drug screen were all normal. The psychopathological picture showed formal thought disorder (thought inhibition, response latencies) and disorders of thought content (acoustic and visual hallucinations). For differential diagnostic purposes, we discussed an obsessive-compulsive disorder, suspicious in psychological assessments. Therapy and outcome: Due to clear indications of psychotic development, we started treatment with aripiprazole and gradually increased the dose to 15 mg daily. The symptoms initially improved significantly. During the course of treatment, there was a renewed exacerbation, which is why we increased the dose to 20 mg per day. Formal thought disorders in particular improved significantly However, the treatment also revealed an obsessive-compulsive disorder, which we treated additionally with sertraline up to 150mg. The combination treatment then resulted in a stable significant symptom improvement Learning points: Differential diagnoses for suspected psychosis should include obsessive-compulsive disorders. The drug treatment should be symptom-oriented and initially dosed up to the maximum dose before changing the drug. |