Retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide: A single case report
We present the case of a 49-year-old man who was diagnosed with depressive disorder, with the first episode having a strong reactive factor. He was involuntarily admitted to a psychiatric hospital after a failed attempt at taking his own life, where he responded to psychotherapy and antidepressant t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1002215/full |
| _version_ | 1797870459768799232 |
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| author | Tomáš Rakús Tomáš Rakús Katarína Hubčíková Katarína Hubčíková Lucia Bruncvik Lucia Bruncvik Zuzana Petrášová Zuzana Petrášová Martin Brunovsky Martin Brunovsky |
| author_facet | Tomáš Rakús Tomáš Rakús Katarína Hubčíková Katarína Hubčíková Lucia Bruncvik Lucia Bruncvik Zuzana Petrášová Zuzana Petrášová Martin Brunovsky Martin Brunovsky |
| author_sort | Tomáš Rakús |
| collection | DOAJ |
| description | We present the case of a 49-year-old man who was diagnosed with depressive disorder, with the first episode having a strong reactive factor. He was involuntarily admitted to a psychiatric hospital after a failed attempt at taking his own life, where he responded to psychotherapy and antidepressant therapy, as evidenced by a >60% reduction in his MADRS total score. He was discharged after 10 days of treatment, denied having suicidal ideations, and was motivated to follow the recommended outpatient care. The risk for suicide during hospitalization was also assessed using suicide risk assessment tools and psychological assessments, including projective tests. The patient underwent a follow-up examination with an outpatient psychiatrist on the 7th day after discharge, during which the suicide risk assessment tool was administered. The results indicated no acute suicide risk or worsening of depressive symptoms. On the 10th day after discharge, the patient took his own life by jumping out of the window of his flat. We believe that the patient had dissimulated his symptoms and possessed suicidal ideations, which were not detected despite repeated examinations specifically designed to assess suicidality and depression symptoms. We retrospectively analyzed his quantitative electroencephalography (QEEG) records to evaluate the change in prefrontal theta cordance as a potentially promising biomarker of suicidality, given the inconclusive results of studies published to date. An increase in prefrontal theta cordance value was found after the first week of antidepressant therapy and psychotherapy in contrast to the expected decrease due to the fading of depressive symptoms. As demonstrated by the provided case study, we hypothesized that prefrontal theta cordance may be an EEG indicator of a higher risk of non-responsive depression and suicidality despite therapeutic improvement. |
| first_indexed | 2024-04-10T00:27:49Z |
| format | Article |
| id | doaj.art-84994225a26747b79376decf251df5be |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-10T00:27:49Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-84994225a26747b79376decf251df5be2023-03-15T05:39:52ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-03-011410.3389/fpsyt.2023.10022151002215Retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide: A single case reportTomáš Rakús0Tomáš Rakús1Katarína Hubčíková2Katarína Hubčíková3Lucia Bruncvik4Lucia Bruncvik5Zuzana Petrášová6Zuzana Petrášová7Martin Brunovsky8Martin Brunovsky9Department of Neuropsychiatry, Philippe Pinel Psychiatric Hospital, Slovak Medical University in Bratislava, Pezinok, SlovakiaThird Faculty of Medicine, Charles University in Prague, Prague, CzechiaDepartment of Neuropsychiatry, Philippe Pinel Psychiatric Hospital, Slovak Medical University in Bratislava, Pezinok, SlovakiaThird Faculty of Medicine, Charles University in Prague, Prague, CzechiaThird Faculty of Medicine, Charles University in Prague, Prague, CzechiaLandesklinikum Hainburg, Hainburg an der Donau, AustriaDepartment of Neuropsychiatry, Philippe Pinel Psychiatric Hospital, Slovak Medical University in Bratislava, Pezinok, SlovakiaThird Faculty of Medicine, Charles University in Prague, Prague, CzechiaThird Faculty of Medicine, Charles University in Prague, Prague, CzechiaDepartment of Neurophysiology and EEG, National Institute of Mental Health, Klecany, CzechiaWe present the case of a 49-year-old man who was diagnosed with depressive disorder, with the first episode having a strong reactive factor. He was involuntarily admitted to a psychiatric hospital after a failed attempt at taking his own life, where he responded to psychotherapy and antidepressant therapy, as evidenced by a >60% reduction in his MADRS total score. He was discharged after 10 days of treatment, denied having suicidal ideations, and was motivated to follow the recommended outpatient care. The risk for suicide during hospitalization was also assessed using suicide risk assessment tools and psychological assessments, including projective tests. The patient underwent a follow-up examination with an outpatient psychiatrist on the 7th day after discharge, during which the suicide risk assessment tool was administered. The results indicated no acute suicide risk or worsening of depressive symptoms. On the 10th day after discharge, the patient took his own life by jumping out of the window of his flat. We believe that the patient had dissimulated his symptoms and possessed suicidal ideations, which were not detected despite repeated examinations specifically designed to assess suicidality and depression symptoms. We retrospectively analyzed his quantitative electroencephalography (QEEG) records to evaluate the change in prefrontal theta cordance as a potentially promising biomarker of suicidality, given the inconclusive results of studies published to date. An increase in prefrontal theta cordance value was found after the first week of antidepressant therapy and psychotherapy in contrast to the expected decrease due to the fading of depressive symptoms. As demonstrated by the provided case study, we hypothesized that prefrontal theta cordance may be an EEG indicator of a higher risk of non-responsive depression and suicidality despite therapeutic improvement.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1002215/fullsuicidalitydepressive disordertheta cordancequantitative electroencephalographydissimulation |
| spellingShingle | Tomáš Rakús Tomáš Rakús Katarína Hubčíková Katarína Hubčíková Lucia Bruncvik Lucia Bruncvik Zuzana Petrášová Zuzana Petrášová Martin Brunovsky Martin Brunovsky Retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide: A single case report Frontiers in Psychiatry suicidality depressive disorder theta cordance quantitative electroencephalography dissimulation |
| title | Retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide: A single case report |
| title_full | Retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide: A single case report |
| title_fullStr | Retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide: A single case report |
| title_full_unstemmed | Retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide: A single case report |
| title_short | Retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide: A single case report |
| title_sort | retrospective analysis of quantitative electroencephalography changes in a dissimulating patient after dying by suicide a single case report |
| topic | suicidality depressive disorder theta cordance quantitative electroencephalography dissimulation |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1002215/full |
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