Detailed contribution information
| Contribution title | Lycanthropy Finding in a Male Adolescent with Generalized Anxiety Disorder: A Case Report |
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| Contribution code | D3.009 |
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| Form of presentation | Poster |
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| Abstract |
Case Presentation: A 17-year-and-8-month-old male presented to the emergency department with aggression and delusional beliefs that he was a werewolf. Following stabilization with 5 mg/ml haloperidol and 5 mg/ml biperiden injections, a psychiatric evaluation revealed depressive mood, congruent affect, disrupted sleep, and normal appetite. The patient reported persecutory delusions and reference ideas related to a newly acquainted girlfriend, leading to anxiety, shouting, and aggression toward family members. He connected these behaviors to seeing himself as a werewolf in a mirror, perceiving "something coming out of him," and losing control. The patient’s first visit occurred eight months earlier with complaints of social withdrawal, anxiety, stuttering, and forgetfulness lasting for a year. Diagnosed with Generalized Anxiety Disorder (GAD), he was prescribed fluoxetine (20 mg/day) and referred to Pediatric Neurology, where tests showed no abnormalities. However, he discontinued fluoxetine, citing fears of electronic viruses and difficulty concentrating. Methylphenidate (27 mg/day) was prescribed, but subsequent evaluations at another center resulted in paroxetine (30 mg/day), olanzapine (10 mg/day), and as-needed lorazepam. Family history revealed his sister’s diagnosis of anxiety disorder, treated with mirtazapine (30 mg/day) and escitalopram (15 mg/day). Substance screening was negative, and biochemical tests were normal. Treatment was adjusted to paroxetine (20 mg/day), olanzapine (5 mg/day), risperidone (1 mg/day), and lorazepam (2 mg/day). During a follow-up visit, the patient experienced an episode involving contextual dissociation, anger escalation, growling like a wolf, and aggression. Outside episodes, psychiatric evaluations showed preserved memory, attention, and orientation; however, communication was impaired during episodes. He described intense anger before episodes, perceiving himself as a wolf, and memory gaps afterward. Excessive involvement with werewolf-themed video games was also noted. Treatment with risperidone injections, olanzapine (10 mg/day), valproate (1000 mg/day), and clonazepam (1 mg/day) reduced episode frequency. Discussion: This case highlights lycanthropy symptoms in an adolescent with poorly managed anxiety, exacerbated by environmental triggers. Managing anxiety and behavioral symptoms is critical to preventing perceptual pathologies in similar cases. |