Differential Diagnosis of an Elderly Manic-Depressive Patient with Depersonalization and Other Symptoms
The case study of an elderly man having persecutory delusions and bizarre complaints at the first psychiatric interview is reported. The patient complained: “I have no sense of time” and “I have no sense of money.” He refused nursing care. He had delusions centered on himself including that of his o...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2016/1454781 |
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| author | Shigehiro Ogata Yu Itohiya Yuri Sakamoto Yuki Sato Yudai Suyama Hidenori Atsuta Ken Iwata |
| author_facet | Shigehiro Ogata Yu Itohiya Yuri Sakamoto Yuki Sato Yudai Suyama Hidenori Atsuta Ken Iwata |
| author_sort | Shigehiro Ogata |
| collection | DOAJ |
| description | The case study of an elderly man having persecutory delusions and bizarre complaints at the first psychiatric interview is reported. The patient complained: “I have no sense of time” and “I have no sense of money.” He refused nursing care. He had delusions centered on himself including that of his own death, which were difficult to diagnose but suggested the possibility of Cotard’s syndrome. We assumed that the man was depressed and treated him for depression. However, as a result of this treatment he became temporarily manic but finally recovered completely. After his recovery, we learnt the patient’s past history of hospitalization for psychiatric problems, and based on that history he was diagnosed as suffering from a bipolar I disorder. The lack of typical symptoms of depression and the remarkable depersonalization and derealization in this patient made it difficult to infer a depressive state. Nevertheless, being attentive to his strange feelings related to the flow of time would have helped us to make an accurate diagnosis earlier. |
| format | Article |
| id | doaj-art-7e3276beb6f54106864e3b13b12a0649 |
| institution | Kabale University |
| issn | 2090-682X 2090-6838 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-7e3276beb6f54106864e3b13b12a06492025-02-03T05:49:36ZengWileyCase Reports in Psychiatry2090-682X2090-68382016-01-01201610.1155/2016/14547811454781Differential Diagnosis of an Elderly Manic-Depressive Patient with Depersonalization and Other SymptomsShigehiro Ogata0Yu Itohiya1Yuri Sakamoto2Yuki Sato3Yudai Suyama4Hidenori Atsuta5Ken Iwata6Department of Biochemistry and Cellular Biology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1 Ogahahigashi, Kodaira, Tokyo 187-8502, JapanDepartment of Psychiatry, Toshima Hospital, 33-1 Sasae, Itabashi-ku, Tokyo 173-0015, JapanDepartment of Neuropsychiatry, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, JapanDepartment of Neuropsychiatry, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, JapanDepartment of Neuropsychiatry, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, JapanDepartment of Neuropsychiatry, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, JapanDepartment of Neuropsychiatry, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, JapanThe case study of an elderly man having persecutory delusions and bizarre complaints at the first psychiatric interview is reported. The patient complained: “I have no sense of time” and “I have no sense of money.” He refused nursing care. He had delusions centered on himself including that of his own death, which were difficult to diagnose but suggested the possibility of Cotard’s syndrome. We assumed that the man was depressed and treated him for depression. However, as a result of this treatment he became temporarily manic but finally recovered completely. After his recovery, we learnt the patient’s past history of hospitalization for psychiatric problems, and based on that history he was diagnosed as suffering from a bipolar I disorder. The lack of typical symptoms of depression and the remarkable depersonalization and derealization in this patient made it difficult to infer a depressive state. Nevertheless, being attentive to his strange feelings related to the flow of time would have helped us to make an accurate diagnosis earlier.http://dx.doi.org/10.1155/2016/1454781 |
| spellingShingle | Shigehiro Ogata Yu Itohiya Yuri Sakamoto Yuki Sato Yudai Suyama Hidenori Atsuta Ken Iwata Differential Diagnosis of an Elderly Manic-Depressive Patient with Depersonalization and Other Symptoms Case Reports in Psychiatry |
| title | Differential Diagnosis of an Elderly Manic-Depressive Patient with Depersonalization and Other Symptoms |
| title_full | Differential Diagnosis of an Elderly Manic-Depressive Patient with Depersonalization and Other Symptoms |
| title_fullStr | Differential Diagnosis of an Elderly Manic-Depressive Patient with Depersonalization and Other Symptoms |
| title_full_unstemmed | Differential Diagnosis of an Elderly Manic-Depressive Patient with Depersonalization and Other Symptoms |
| title_short | Differential Diagnosis of an Elderly Manic-Depressive Patient with Depersonalization and Other Symptoms |
| title_sort | differential diagnosis of an elderly manic depressive patient with depersonalization and other symptoms |
| url | http://dx.doi.org/10.1155/2016/1454781 |
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