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Major Depressive Disorder With Psychotic Symptoms in Elderly. A Case Report

Published online by Cambridge University Press:  23 March 2020

J.M. Hernández Sánchez ,
M.C. Cancino Botello ,
M.F. Molina Lopez ,
M.Á. Canseco Navarro ,
S. Arnés González ,
M. Muñoz Carril  and
J.A. Monzó
J.M. Hernández Sánchez*
Affiliation:
Valencia, SpainValencia, Spain
M.C. Cancino Botello
Affiliation:
Hospital General de Valencia, Psychiatry, Valencia, Spain
M.F. Molina Lopez
Affiliation:
Hospital General de Valencia, Psychiatry, Valencia, Spain
M.Á. Canseco Navarro
Affiliation:
Hospital General de Valencia, Psychiatry, Valencia, Spain
S. Arnés González
Affiliation:
Hospital General de Valencia, Emergency Medicine, Valencia, Spain
M. Muñoz Carril
Affiliation:
Hospital General de Valencia, Emergency Medicine, Valencia, Spain
J.A. Monzó
Affiliation:
Hospital General de Valencia, Internal Medicine, Valencia, Spain
*
*Corresponding author.

Abstract

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Introduction

The proportion of elderly people and affective syndromes are more and more common in developed countries. Elderly people have physiological conditions that may limit our intervention.

Objectives

To present a case of a major depressive disorder with psychotic symptoms in a 72-year-old woman.

Methods

Medline search and review of the clinical history and the related literature.

Results

We present the case of a 72-year-old woman with psychiatric history of a major depressive disorder 14 years ago with ad integrum restitution after pharmacological treatment. In 2015, our patient was admitted to the psychiatry ward due to major depressive symptomatology (apathy, anhedonia, global insomnia, weight loss) that associated mood-congruent delusions (nihilistic, ruin, guilt, catastrophic) with deregulated behaviour. The patient was resistant to combined pharmacological treatment with aripiprazole, desvenlafaxine, mirtazapine and lorazepam, therefore, we decided to administer ECT, with successful results after 5 sessions. Brain tomography, blood and urine tests were normal. Clinical signs of dementia were not present.

Conclusions

Inpatients with deregulated behaviour; it is important to rule out organic causes, especially in elderly, in whom dementia, brain tumors or metabolic disturbances may simulate psychiatric syndromes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Keywords

“Major depressive disorder” ;“Psychosis” ;“Late onset psychosis”
Type
EV979
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S531
Copyright
Copyright © European Psychiatric Association 2016

References

Further readings

Colijn, MA, et al. Psychosis in later life: a review and update. Harv Rev Psychiatry 2015;;23(5)::354–67CrossRefGoogle ScholarPubMed
Reinhard, MM., et al. Late-life psychosis: diagnosis and treatment. Curr Psychiatry Rep 2015;17(2):1.CrossRefGoogle Scholar
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