Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)

Introduction A 47 y.o. female patient was admitted to the female PICU with a manic episode. Upon admission she presented with mood elation, psychosis, pressured speech, lack of sleep and agitation. Objectives To investigate negative prognostic factors such as the co-morbidity with a personality...

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Main Authors: A. Sarafopoulos, D. Antoniadis, V. Karpouza
Format: Article
Language:English
Published: Cambridge University Press 2021-04-01
Series:European Psychiatry
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S092493382101662X/type/journal_article
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author A. Sarafopoulos
D. Antoniadis
V. Karpouza
author_facet A. Sarafopoulos
D. Antoniadis
V. Karpouza
author_sort A. Sarafopoulos
collection DOAJ
description Introduction A 47 y.o. female patient was admitted to the female PICU with a manic episode. Upon admission she presented with mood elation, psychosis, pressured speech, lack of sleep and agitation. Objectives To investigate negative prognostic factors such as the co-morbidity with a personality disorder in patients presenting with severe mania. Methods The patient was assessed regularly by the psychiatric team consisting of a CT doctor and one General Adult Consultant. Appropriate psychological assessments for mania and laboratory investigations took place. Results The patient initially scored above 45 in the Young Mania Rating Scale (YMRS), establishing a diagnosis of severe mania. She was treated with Olanzapine titrated up to 20mg OD and augmentation with Lithium treatment. Lithium plasma levels were at 0,6. Due to the treatment resistant manic presentation a second antipsychotic agent was administered and the patient was also treated with Zuclopenthixol depot 400mg every two weeks. Clinical improvement was observed after 16 days from admission. Conclusions The clinical team wondered about the clinical challenges of the case. According to the literature having a Personality Disorder diagnosis is a negative prognostic factor for patients with mania and this is relevant to this case as well. Disclosure No significant relationships.
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spelling doaj.art-b4cd1fee192a4097b11cc1fbe602ee9c2023-11-17T05:06:39ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S625S62510.1192/j.eurpsy.2021.1662Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)A. Sarafopoulos0D. Antoniadis1V. Karpouza24th Picu, Psychiatric Hospital of Thessaliniki, Thessaloniki, Greece4th Picu, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece4th Picu, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece Introduction A 47 y.o. female patient was admitted to the female PICU with a manic episode. Upon admission she presented with mood elation, psychosis, pressured speech, lack of sleep and agitation. Objectives To investigate negative prognostic factors such as the co-morbidity with a personality disorder in patients presenting with severe mania. Methods The patient was assessed regularly by the psychiatric team consisting of a CT doctor and one General Adult Consultant. Appropriate psychological assessments for mania and laboratory investigations took place. Results The patient initially scored above 45 in the Young Mania Rating Scale (YMRS), establishing a diagnosis of severe mania. She was treated with Olanzapine titrated up to 20mg OD and augmentation with Lithium treatment. Lithium plasma levels were at 0,6. Due to the treatment resistant manic presentation a second antipsychotic agent was administered and the patient was also treated with Zuclopenthixol depot 400mg every two weeks. Clinical improvement was observed after 16 days from admission. Conclusions The clinical team wondered about the clinical challenges of the case. According to the literature having a Personality Disorder diagnosis is a negative prognostic factor for patients with mania and this is relevant to this case as well. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S092493382101662X/type/journal_articlemaníaBPD
spellingShingle A. Sarafopoulos
D. Antoniadis
V. Karpouza
Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)
European Psychiatry
manía
BPD
title Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)
title_full Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)
title_fullStr Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)
title_full_unstemmed Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)
title_short Treatment resistant manic episode with commorbidity with borderline personality disorder (BPD)
title_sort treatment resistant manic episode with commorbidity with borderline personality disorder bpd
topic manía
BPD
url https://www.cambridge.org/core/product/identifier/S092493382101662X/type/journal_article
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AT vkarpouza treatmentresistantmanicepisodewithcommorbiditywithborderlinepersonalitydisorderbpd