Citation

Ygland Rödström M, Johansson BA, Bäckström B, Movahed P, Forslund CM, Rask O. Case Rep. Psychiatry 2021; 2021.

Copyright

(Copyright © 2021, Hindawi Publishing)

DOI

10.1155/2021/3371591

PMID

unavailable

Abstract

Background. Turner syndrome (TS) is an X-linked chromosomal abnormality with a global prevalence of 1/2000 live-born girls. The physiological symptoms of TS have been thoroughly characterized, but only a few studies have described associated psychiatric symptoms. We report a case of an adolescent girl who presented with acute mania with psychotic features and was successfully treated with electroconvulsive therapy (ECT). She was subsequently diagnosed with bipolar syndrome and TS. Case Presentation. A 17-year-old girl presented to us with manic symptoms, including disorganized speech, auditory hallucinations, and affect lability. Initially, she was treated with antipsychotics and benzodiazepines, whereby the positive affective symptoms declined. However, the psychotic symptoms progressed, and she developed a catatonic state. ECT was started 6 days after admission, with improvement after two treatments. When ECT was tapered after seven sessions, she relapsed, and the treatment was extended to twelve sessions, with successful outcome. Following discharge, she was diagnosed with TS with partial loss on one of the X-chromosomes (46X, del (X)(p21)), which might have contributed to the development of her sudden acute manic episode.

CONCLUSIONS. This case demonstrates for the first time that ECT may be a safe and efficient treatment strategy for acute mania in adolescents with concomitant TS and that severely affected adolescents may require a prolonged series with gradual tapering of ECT. The present case also demonstrates a possible association between TS and bipolar syndrome and that the clinical presentation of a manic episode in a patient with this comorbidity could be more complex and the treatment response slower. © 2021 Maria Ygland Rödström et al.

Language: en

Keywords

adolescent; human; Sweden; suicide; female; case report; bipolar disorder; depression; schizophrenia; anxiety; psychosis; mood; lithium; treatment outcome; inflammation; fatigue; vitamin D deficiency; neuroleptic agent; clinical article; rating scale; child psychiatry; hospital admission; acute disease; tachycardia; headache; sleep disorder; electroconvulsive therapy; emergency ward; diazepam; delusion; family history; treatment refusal; benzodiazepine derivative; follow up; psychosocial care; olanzapine; hospital discharge; self esteem; disease exacerbation; urinalysis; computer assisted tomography; outpatient department; biperiden; catatonia; erythrocyte sedimentation rate; mania; relapse; apathy; heart rate; amnesia; menstrual irregularity; anemia; obsessive compulsive disorder; electroencephalography; anesthetic agent; electrocardiography; body temperature; anesthesia; propofol; melatonin; hyperventilation; cerebrospinal fluid analysis; aripiprazole; treatment response; auditory hallucination; blood analysis; Article; persecutory delusion; speech disorder; drug dose increase; menorrhagia; Clinical Global Impression scale; Positive and Negative Syndrome Scale; visual hallucination; logorrhea; Young Mania Rating Scale; autumn; zuclopenthixol; iron deficiency; antibody; DSM-5; echolalia; grandmother; alimemazine; Turner syndrome