Diagnosis and Treatment of Psychiatric Comorbidity in a Patient with Charles Bonnet Syndrome

Background. A significant proportion of patients with neurological disorders may have comorbid psychiatric symptomology, which may be managed by primary outpatient neurologists. Referral to their psychiatric colleagues is mediated by available consultation-liaison units and according to clinical opi...

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Main Author: Jasper J. Chen
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Psychiatry
Online Access:http://dx.doi.org/10.1155/2014/195847
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author Jasper J. Chen
author_facet Jasper J. Chen
author_sort Jasper J. Chen
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description Background. A significant proportion of patients with neurological disorders may have comorbid psychiatric symptomology, which may be managed by primary outpatient neurologists. Referral to their psychiatric colleagues is mediated by available consultation-liaison units and according to clinical opinion. Aims of Case Report. We present the case of a patient whose initial referral to epilepsy clinic led to a workup which ultimately diagnosed her with nonepileptic seizures (NES). In the course of her follow-up, she developed intractable headaches, and worsening mood symptoms and eventually exhibited Psychotic Features for which psychiatry became coinvolved in her care. Major Depression with Psychotic Features and Charles Bonnet syndrome were considered as a likely comorbid diagnoses. Her pharmacologic management on venlafaxine and quetiapine eventually caused substantial amelioration of her psychiatric symptomology as longitudinally followed by PHQ-9 and GAD-7 scores. Conclusion. Optimal evaluation and management of mental illness in patients with complex neurologic symptomology may require independent evaluation and treatment by psychiatrists when clinically appropriate.
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spelling doaj-art-99ecf58f6fd74a5ca58053d0cf737cc32025-08-20T03:36:49ZengWileyCase Reports in Psychiatry2090-682X2090-68382014-01-01201410.1155/2014/195847195847Diagnosis and Treatment of Psychiatric Comorbidity in a Patient with Charles Bonnet SyndromeJasper J. Chen0Behavioral Health Services, Cheyenne Regional Medical Center, Cheyenne, WY 82001, USABackground. A significant proportion of patients with neurological disorders may have comorbid psychiatric symptomology, which may be managed by primary outpatient neurologists. Referral to their psychiatric colleagues is mediated by available consultation-liaison units and according to clinical opinion. Aims of Case Report. We present the case of a patient whose initial referral to epilepsy clinic led to a workup which ultimately diagnosed her with nonepileptic seizures (NES). In the course of her follow-up, she developed intractable headaches, and worsening mood symptoms and eventually exhibited Psychotic Features for which psychiatry became coinvolved in her care. Major Depression with Psychotic Features and Charles Bonnet syndrome were considered as a likely comorbid diagnoses. Her pharmacologic management on venlafaxine and quetiapine eventually caused substantial amelioration of her psychiatric symptomology as longitudinally followed by PHQ-9 and GAD-7 scores. Conclusion. Optimal evaluation and management of mental illness in patients with complex neurologic symptomology may require independent evaluation and treatment by psychiatrists when clinically appropriate.http://dx.doi.org/10.1155/2014/195847
spellingShingle Jasper J. Chen
Diagnosis and Treatment of Psychiatric Comorbidity in a Patient with Charles Bonnet Syndrome
Case Reports in Psychiatry
title Diagnosis and Treatment of Psychiatric Comorbidity in a Patient with Charles Bonnet Syndrome
title_full Diagnosis and Treatment of Psychiatric Comorbidity in a Patient with Charles Bonnet Syndrome
title_fullStr Diagnosis and Treatment of Psychiatric Comorbidity in a Patient with Charles Bonnet Syndrome
title_full_unstemmed Diagnosis and Treatment of Psychiatric Comorbidity in a Patient with Charles Bonnet Syndrome
title_short Diagnosis and Treatment of Psychiatric Comorbidity in a Patient with Charles Bonnet Syndrome
title_sort diagnosis and treatment of psychiatric comorbidity in a patient with charles bonnet syndrome
url http://dx.doi.org/10.1155/2014/195847
work_keys_str_mv AT jasperjchen diagnosisandtreatmentofpsychiatriccomorbidityinapatientwithcharlesbonnetsyndrome