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conferenceseries
.com
Volume 7, Issue 5 (Suppl)
J Psychol Psychother, an open access journal
ISSN: 2161-0487
Psychosomatic Medicine & Forensic Congress 2017
October 12-14, 2017
JOINT EVENT
24
th
International Conference on
PSYCHIATRY & PSYCHOSOMATIC MEDICINE
2
nd
International Congress on
FORENSIC SCIENCE AND PSYCHOLOGY
&
October 12-14, 2017 London, UK
A complicated presentation of acute psychosis in a young adult
Priyanka Patil, Andy Beltran, Seetha Ramanathan, Luba Leontieva
and
James L Megna
SUNY Upstate Medical University, USA
T
his is a case report of an 18-year-old male who presented with first episode psychosis (FEP) with symptoms of catatonia, negativity
& religious delusions and was admitted in our unit for 2 months. This was a case in which we had difficulty in diagnosis, difficulty
in treating & for those of us who were closely involved in his care, had difficulty dealing with a myriad of emotions, including
helplessness and anger. Differential diagnoses of NMS, malignant catatonia &NMDA encephalitis was considered. We were limited in
the use of antipsychotics as the patient developed EPS & increased CPK, along with unstable vital signs on 4 different antipsychotics.
He neither responded to high doses of up to 22 mg Lorazepam; nor did he respond to i/V Solumedrol. There was a pattern of
high expressed emotion amongst the family; so much so that their visits would become a major trigger for the patient’s aggressive
outbursts. There were also some cultural barriers that contributed to communication gaps during family meetings. Religious themes
had to be considered with highly religious family members and religious delusions in both patient and his sister. During his inpatient
stay there were repeated episodes of assaultive behavior towards multiple staff members leading to a high tension atmosphere in
the unit and a non-nurturing milieu. In this case report we would like to discuss the diagnostic uncertainty in FEP; the control of
aggressive behavior when one is limited in the use of antipsychotics & influence of psychosocial factors on patient’s stay in the unit.
We also want to concentrate on what we could have done differently or better. Although the patient is now improved on Clozapine,
considering the family dynamics, we would also like to discuss how we can work on preventing a relapse.
Biography
Priyanka Patil is a third year Psychiatry Resident at SUNY Upstate Medical University, Syracuse New York, USA.
patilp@upstate.eduPriyanka Patil et al., J Psychol Psychother 2017, 7:5(Suppl)
DOI: 10.4172/2161-0487-C1-017