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2015 ; 37
(3
): 333-8
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New Onset Psychosis as The First Manifestation of Neuro-Psychiatric Lupus A
Situation Causing Diagnostic Dilemma
#MMPMID26664084
Chandra SR
; Issac TG
; Ayyappan K
Indian J Psychol Med
2015[Jul]; 37
(3
): 333-8
PMID26664084
show ga
First episode of psychosis can occur at any age and it can be primarily
psychiatric or secondary to other occult diseases. It is of great therapeutic
relevance to be cautious about organic etiology as early diagnosis can help in
early initiation of disease modifying treatments. To study patients who presented
with first episode of psychosis and later turned out to be due to lupus
erythematosus with varying periods of delay. Details of patients who were
considered as treatment unresponsive psychosis and later turned out to be due to
vasculitis were entered in excel sheet and analyzed. The details of patients
including neuropsychological features, apparent soft signs which were initially
ignored, lab data and signs during follow-up were tabulated and warning signs
analysed. All our patients were highly intelligent young females and there were
stressors in all of them. They presented with panic, followed by psychotic
symptoms which was resistant to regular psychiatric treatment and therefore
possibility of organicity explored. All of them had history of transient symptoms
referable to other systems which were treated as such and patients did not
volunteer the same unless questioned. During follow-up full-fledged features of
SLE came up in all patients. When a young female with no past or family history
of mental illness presents with psychotic features, unprovoked panic, and limbic
symptoms always ask for minor or transient symptoms and signs referable to the
other systems which might give valuable clues.