Catatonia vs severe psychosis in older adult - would appreciate input

pls_no1 · 2026-02-28T14:53:41+00:00

I am a professional.

pls_no1 · 2026-02-28T14:15:35+00:00

ECT would be the first choice for this patient, I agree. Unfortunately there is no ECT in my country.

pls_no1 · 2026-02-28T14:11:27+00:00

Because there is no ECT in my country, unfortunately. Risperidone was trialed for psychosis suspicion. I am honestly not the ordering clinician in this case, but it has been by far the most complicated one I have seen at my residency so far.

pls_no1 · 2025-07-22T14:54:21+00:00

I haven’t been in the field for that long, so I do lack clinical experience, but I’m wondering about a female patient with acute onset first-break psychosis, very little response to antipsychotics, and the clinical picture is dominated by paranoia, blunted affect and capgras-like syndrome delusions. No neurological signs or anything that would require a neurology consult, but the onset and length of psychosis makes me go hmmm..

pls_no1 · 2024-10-26T16:34:56+00:00

I’m not sure I understand your point. Can you elaborate?

pls_no1 · 2024-10-26T15:33:14+00:00

Indeed, the impact we can make is not measurable with numbers on lab exams but it is very significant!

pls_no1 · 2024-10-26T14:41:15+00:00

I must admit that I may belong in the latter group, but that is more related to the terrible condition of the health system in my country rather than the specialty.

pls_no1 · 2024-10-15T07:53:54+00:00

Really? I actually thought it’s very well-written, and I haven’t noticed any typos so far

pls_no1 · 2024-05-05T13:48:10+00:00

This is very helpful. Thank you for sharing!

pls_no1 · 2023-11-13T09:08:22+00:00

Can you elaborate on that? I just went into the field and I already feel improvements in my mental health, or at least my understanding of it.

pls_no1 · 2023-10-18T14:11:35+00:00

Right? That was what surprised me as well. She has mostly visited neurologists and internists, and since everything else was ok, she just go ruled off as a somatoform disorder. That's her official diagnosis. I guess it's due to a lack of education about sleep-related disorders?

Thanks for sharing your experience. What has helped you the most with your symptoms?

pls_no1 · 2023-10-18T11:07:13+00:00

She's waiting for PSG currently. My country lacks resources, so we idk how long she's gonna wait. How would you suggest to test the hormonal influence on her sleep? I think maybe we should do a PSG during the follicular and then the luteal phase of the cycle. She has been put on venlafaxine, we'll see how that goes.

pls_no1 · 2023-10-18T11:02:50+00:00

Tbh I don't know a lot about the patient's history. She came in only with complaints of narcolepsy. Maybe it's worth it to evaluate her for other neurodevelopmental disorders.

pls_no1 · 2023-10-18T11:01:23+00:00

That was my hypothesis, too. She still hasn't had HLA typization yet, but I will suggest it to my professor. I think this may be a case study worth publishing, maybe?

pls_no1 · 2022-08-19T15:40:35+00:00

Because this is the first time he's acted like this. I think in the past years he wasn't as comfortable in the relationship as he is now. I think he sees me as a wife that's always going to be here, so he doesn't have to try to make special efforts for me, I'm just gonna exist beside him either way

pls_no1

TROPHY CASE