A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia
Introduction The appearance of inhibitory symptoms encompassed in what are known as negative symptoms is part of the usual symptoms of schizophrenia. Sometimes this inhibition reaches a significant severity, so it is essential to know its approach. Objectives Case report and literature review rega...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382202034X/type/journal_article |
| _version_ | 1827753529421332480 |
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| author | P. Coucheiro Limeres B. Díez Valle A. Cerame C. Lozano Serrano E. Navas Collado |
| author_facet | P. Coucheiro Limeres B. Díez Valle A. Cerame C. Lozano Serrano E. Navas Collado |
| author_sort | P. Coucheiro Limeres |
| collection | DOAJ |
| description |
Introduction
The appearance of inhibitory symptoms encompassed in what are known as negative symptoms is part of the usual symptoms of schizophrenia. Sometimes this inhibition reaches a significant severity, so it is essential to know its approach.
Objectives
Case report and literature review regarding the treatment of resistant schizophrenia with a predominance of negative symptoms
Methods
We present the clinical case of a 28-year-old man diagnosed with schizophrenia at 23 years old, whose onset was characterized by delusional ideas of harm (poisoning) and delusions with a mystic-religious theme that lead him to reduce his intake until requiring a first admission for severe desnutrition. Subsequently, after two more admissions, the patient presents selective reduction in food intake, decrease in daily activity and apathy without positive symptoms.
Results
Throughout the treatment, several lines of antipsychotic treatments have been tried at the maximum tolerated dose (haloperidol, oral paliperidone and depot, aripiprazole and clozapine up to a dose of 600 mg). Clozapine resistance required testing various augmentation strategies (Venlafaxine, Lamotrigine and Electroconvulsive therapy) with low results. Finally, to complement the treatment, the patient was transferred to a mid-stay unit where psychosocial treatment with a multidisciplinary approach was started. This has allowed more continuous follow-up and thus a partial improvement of the clinic.
Conclusions
Numerous studies describe numerous augmentation strategies for clozapine-resistant schizophrenia with negative symptoms. However, the results are still inconclusive, needing more research. Meanwhile, we want to highlight the importance of complementing the treatment with psychosocial approaches.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:37:38Z |
| format | Article |
| id | doaj.art-ffd44a046ca14f8a8c86a7934ec98710 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:37:38Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-ffd44a046ca14f8a8c86a7934ec987102023-11-17T05:09:19ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S787S78810.1192/j.eurpsy.2022.2034A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophreniaP. Coucheiro Limeres0B. Díez Valle1A. Cerame2C. Lozano Serrano3E. Navas Collado4Hospital Universitario José Germain, Psychiatry Department, Leganés, SpainHospital Severo Ochoa, Psychiatry, Leganés, SpainHospital Universitario José Germain, Psychiatry Department, Leganés, SpainHospital Universitario José Germain, Psychiatry Department, Leganés, SpainHospital Universitario José Germain, Psychiatry Department, Leganés, Spain Introduction The appearance of inhibitory symptoms encompassed in what are known as negative symptoms is part of the usual symptoms of schizophrenia. Sometimes this inhibition reaches a significant severity, so it is essential to know its approach. Objectives Case report and literature review regarding the treatment of resistant schizophrenia with a predominance of negative symptoms Methods We present the clinical case of a 28-year-old man diagnosed with schizophrenia at 23 years old, whose onset was characterized by delusional ideas of harm (poisoning) and delusions with a mystic-religious theme that lead him to reduce his intake until requiring a first admission for severe desnutrition. Subsequently, after two more admissions, the patient presents selective reduction in food intake, decrease in daily activity and apathy without positive symptoms. Results Throughout the treatment, several lines of antipsychotic treatments have been tried at the maximum tolerated dose (haloperidol, oral paliperidone and depot, aripiprazole and clozapine up to a dose of 600 mg). Clozapine resistance required testing various augmentation strategies (Venlafaxine, Lamotrigine and Electroconvulsive therapy) with low results. Finally, to complement the treatment, the patient was transferred to a mid-stay unit where psychosocial treatment with a multidisciplinary approach was started. This has allowed more continuous follow-up and thus a partial improvement of the clinic. Conclusions Numerous studies describe numerous augmentation strategies for clozapine-resistant schizophrenia with negative symptoms. However, the results are still inconclusive, needing more research. Meanwhile, we want to highlight the importance of complementing the treatment with psychosocial approaches. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S092493382202034X/type/journal_articledesnutritionnegative symptomsresistant schizophrenia |
| spellingShingle | P. Coucheiro Limeres B. Díez Valle A. Cerame C. Lozano Serrano E. Navas Collado A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia European Psychiatry desnutrition negative symptoms resistant schizophrenia |
| title | A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia |
| title_full | A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia |
| title_fullStr | A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia |
| title_full_unstemmed | A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia |
| title_short | A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia |
| title_sort | case report of inhibition and severe desnutrition negative symptoms in resistant schizophrenia |
| topic | desnutrition negative symptoms resistant schizophrenia |
| url | https://www.cambridge.org/core/product/identifier/S092493382202034X/type/journal_article |
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