Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica
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Seishin Shinkeigaku Zasshi · Jan 2006
Case Reports[A case of Brugada syndrome with convulsive seizure during antidepressant administration: relation of antidepressant agents and arrhythmia leading to sudden death].
Brugada syndrome is an arrhythmogenetic disease characterized by electrocardiographic ST segment elevation in right precordial leads, which is called "coved type", and an increased risk of sudden death as the result of ventricular fibrillation. We presented a case of Brugada syndrome with a convulsive seizure, during administration of a tricyclic antidepressant for the treatment of a depressive state. A 43-year-old man with bipolar II disorder and obsessive-compulsive disorder was admitted to our hospital for the treatment of a depressive state. ⋯ However, in the present case, the abnormal ECG findings occurred following a usual dosage of nortriptyline. Thus, it is suggested that Brugada syndrome is related to a susceptibility to antidepressants in the present case. Every psychiatrist managing antidepressant therapy should be aware of Brugada syndrome and this ECG pattern, which may be a marker of sudden death.
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Seishin Shinkeigaku Zasshi · Jan 2006
Case Reports[Case of bonding disorder effectively treated by Naikan therapy].
The perinatal period is important for establishing the mother-to-infant bond. Especially, psychiatric disorders during this period, such as postnatal depression, significantly affect mother-to-infant attachment. Recently, the concept of "Bonding Disorder" has been proposed to identify attachment disturbances between mothers and infants. ⋯ Through Naikan therapy, mothers may recall that they themselves have received love from their parents, which strengthens the feeling of basic trust. Consequently, they are encouraged to love their children. Therefore, Nikan therapy is suggested to be one of the effective therapies to treat attachment disturbances between mothers and infants.
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Seishin Shinkeigaku Zasshi · Jan 2006
Case Reports[A case of left dorsomedial thalamic infarction with unilateral schizophrenia-like auditory hallucinations].
We report a case of a right-handed, 73-year-old woman with auditory hallucinations lateralized to the right ear. A brain MRI revealed a small infarction in the left dorsomedial nucleus (DM) of the thalamus. The patient did not have either psychiatric or neurological prior history, and had otherwise been treated for ischemic heart disease, hypertension, and hyperlipidemia for 10 years. ⋯ Localized neuronal deficits evoked by infarction in the left DM probably caused the schizophrenia-like hallucinations; the lateralization phenomenon further indicates the involvement of specific neuronal mechanisms in the mediation of the hallucinations. According to the knowledge of the functional anatomy of the DM and the lateralization phenomenon of auditory hallucinations, it is possible that the neuronal loop, comprised of the prefrontal cortex and thalamus, designated as "basal ganglia-thalamocortical circuits", in addition to the left temporal cortex, plays an important role in the development of the hallucinations in this case. This possibility might also shed light on the neurological basis of schizophrenia.