Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy

Creativity and the production of artwork can have an impact on the course and treatment of comorbid severe mental illness and neurodegeneration. We report on a 70-year-old male patient with highly original artistic behavior, who suffered from lifelong recurrent major depression and subsequently deve...

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Main Authors: Felix Geser, Tibor C. G. Mitrovics, Laura Obexer, Peter Streicher, Johannes Haybaeck, Deniz Yilmazer-Hanke
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/14/12/1171
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author Felix Geser
Tibor C. G. Mitrovics
Laura Obexer
Peter Streicher
Johannes Haybaeck
Deniz Yilmazer-Hanke
author_facet Felix Geser
Tibor C. G. Mitrovics
Laura Obexer
Peter Streicher
Johannes Haybaeck
Deniz Yilmazer-Hanke
author_sort Felix Geser
collection DOAJ
description Creativity and the production of artwork can have an impact on the course and treatment of comorbid severe mental illness and neurodegeneration. We report on a 70-year-old male patient with highly original artistic behavior, who suffered from lifelong recurrent major depression and subsequently developed symptoms of progressive bulbar palsy (PBP). In the context of a systematic literature review, we detail the patient’s personal and artistic biographies and portray artwork from his artistic portfolio together with his disease history, clinical examination, psychopathological and neuropsychological evaluations, blood and cerebrospinal fluid analyses, neuroimaging, neurophysiological testing, and psychotherapeutic treatment. The patient’s 1–2-year history of primarily bulbar motor symptoms and signs aligned with electromyography, showing widespread signs of continuing denervation/chronic neurogenic changes. Slight impairments in semantic fluency, executive control, and visuoconstructive abilities were observed in neuropsychological testing, in conjunction with right-sided medial temporal lobe atrophy in an MRI. He was prescribed medication, including extended-release venlafaxine, trazodone, pramipexole, and zolpidem, and took his medication regularly, usually at high doses. For most of his life, the patient had attributed professional “success” and artistic output to, at times, excessive alcohol consumption. Later, however, his interest in creative work continued despite alcohol reduction and cessation. Psychotherapy grounded him in reality via goal-centered behaviors, making him realize that his physical and mental ailments rather hindered his creative output. In summary, creative behavior can be utilized in the treatment of patients with psychiatric conditions (affective or addictive disorders) and/or neurodegenerative diseases. In the reported case, specific psychopharmacology and psychotherapy that address goal-directed self-efficacy experiences of reality were critical to the patient’s treatment.
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spelling doaj-art-8b056ea2ed0a4a27bf9ae4d22b5ef29a2025-08-20T02:53:18ZengMDPI AGBrain Sciences2076-34252024-11-011412117110.3390/brainsci14121171Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar PalsyFelix Geser0Tibor C. G. Mitrovics1Laura Obexer2Peter Streicher3Johannes Haybaeck4Deniz Yilmazer-Hanke5Department of Geriatric Psychiatry and Psychotherapy, Christophsbad Göppingen, 73035 Göppingen, GermanyDepartment of Radiology and Neuroradiology, Christophsbad Göppingen, 73035 Göppingen, GermanyDepartment of Geriatric Psychiatry and Psychotherapy, Christophsbad Göppingen, 73035 Göppingen, GermanyDepartment of Neurology, Neurophysiology, Early Rehabilitation and Sleep Medicine, Christophsbad Göppingen, 73035 Göppingen, GermanyDiagnostic & Research Center for Molecular Biomedicine, Institute of Pathology, Medical University of Graz, 8010 Graz, AustriaClinical Neuroanatomy, Department of Neurology, University Hospital Ulm, 89081 Ulm, GermanyCreativity and the production of artwork can have an impact on the course and treatment of comorbid severe mental illness and neurodegeneration. We report on a 70-year-old male patient with highly original artistic behavior, who suffered from lifelong recurrent major depression and subsequently developed symptoms of progressive bulbar palsy (PBP). In the context of a systematic literature review, we detail the patient’s personal and artistic biographies and portray artwork from his artistic portfolio together with his disease history, clinical examination, psychopathological and neuropsychological evaluations, blood and cerebrospinal fluid analyses, neuroimaging, neurophysiological testing, and psychotherapeutic treatment. The patient’s 1–2-year history of primarily bulbar motor symptoms and signs aligned with electromyography, showing widespread signs of continuing denervation/chronic neurogenic changes. Slight impairments in semantic fluency, executive control, and visuoconstructive abilities were observed in neuropsychological testing, in conjunction with right-sided medial temporal lobe atrophy in an MRI. He was prescribed medication, including extended-release venlafaxine, trazodone, pramipexole, and zolpidem, and took his medication regularly, usually at high doses. For most of his life, the patient had attributed professional “success” and artistic output to, at times, excessive alcohol consumption. Later, however, his interest in creative work continued despite alcohol reduction and cessation. Psychotherapy grounded him in reality via goal-centered behaviors, making him realize that his physical and mental ailments rather hindered his creative output. In summary, creative behavior can be utilized in the treatment of patients with psychiatric conditions (affective or addictive disorders) and/or neurodegenerative diseases. In the reported case, specific psychopharmacology and psychotherapy that address goal-directed self-efficacy experiences of reality were critical to the patient’s treatment.https://www.mdpi.com/2076-3425/14/12/1171depressionalcohol use disorderprogressive bulbar palsyfrontotemporal dementiacreativityartistic work
spellingShingle Felix Geser
Tibor C. G. Mitrovics
Laura Obexer
Peter Streicher
Johannes Haybaeck
Deniz Yilmazer-Hanke
Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy
Brain Sciences
depression
alcohol use disorder
progressive bulbar palsy
frontotemporal dementia
creativity
artistic work
title Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy
title_full Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy
title_fullStr Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy
title_full_unstemmed Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy
title_short Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy
title_sort creativity and mental illness a case study of a patient with progressive bulbar palsy
topic depression
alcohol use disorder
progressive bulbar palsy
frontotemporal dementia
creativity
artistic work
url https://www.mdpi.com/2076-3425/14/12/1171
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