A Case Report of Confusional Psychosis with Abrupt Onset and Rapid Resolution of Symptoms

Autor: Bruce H. Price, Oliver Freudenreich, Evan D. Murray, Benalfew Legesse
Rok vydání: 2011
Předmět:
Zdroj: Psychosomatics. 52:468-471
ISSN: 0033-3182
Popis: Psychiatric consultants are frequently asked to evaluate patients with acute confusion. Since confusion is a prominent symptom of delirium, a thorough medical and neurologic evaluation is always warranted. However, primary psychotic disorders should be considered in the differential diagnosis of confusion even though confusion-predominant psychotic disorders with an abrupt onset may not appear to be “psychiatric” in etiology. The Kraepelinian dichotomy of psychotic illnesses into schizophrenia and manic-depressive illness has had an enormous influence on the psychiatric classification. However, because Kraepelin emphasized the deteriorating course of schizophrenia, patients with psychotic illnesses and good outcome can be difficult to categorize. Cycloid psychosis, bouffee delirante, reactive psychosis, and atypical psychosis all describe transient psychotic disorders classifiable as neither schizophrenia nor manic-depressive illness. The existence of non-affective transient psychotic disorders is acknowledged in both ICD-10 and DSM-IV-TR. The ICD-10 classifies these transient psychotic disorders into the category of acute transient psychotic disorders (ATPD), while in DSM-IV-TR, brief psychotic disorder and schizophreniform disorder are designed to capture these remitting psychotic illnesses. We report the case of a young woman who presented with an acute change of behavior and prominent confusion, with rapid resolution of symptoms. We review cycloid psychosis and the ICD-10 classification scheme of transient psychotic syndromes to alert clinicians to rare yet well-described psychiatric syndromes that can mimic deliria or acute confusional states.
Databáze: OpenAIRE
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