Neuroleptic malignant syndrome in a case of post-partum psychosis

Article Abstract:

Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication of neuroleptics (antipsychotic drugs) characterized by muscle rigidity, tremor, fever, autonomic instability, and altered states of consciousness. The combination of postpartum psychosis and NMS has not been previously described. The case report of a 27-year-old woman admitted to a psychiatric unit one day postpartum with confusion and odd behavior is reported. She complained of chest pain, although laboratory tests and chest X-ray were normal. Delivery had been normal, and there was no history of medical or psychiatric illness. The woman became excitable, delusional, and stuporous, refusing all contact with her infant. Neuroleptics were administered, but the patient remained agitated and difficult to manage. Five days after beginning neuroleptic therapy she developed a high fever, rapid heart beat, and erratic blood pressure. Neuroleptics were discontinued and she was treated with electroconvulsive therapy (ECT). Symptoms improved, but 18 days postpartum stereotyped movements, rigidity, and odd posturing developed. A single dose of neuroleptic medication was administered. Within four hours she developed a high fever, erratic blood pressure, and became catatonic. NMS was diagnosed, and treatment with dantrolene and bromocriptine followed. Thirty-seven days postpartum the NMS subsided and all drugs were withdrawn. A second course of ECT relieved her catatonia, and the patient recovered fully. Because there have been reports of an association between NMS and exhaustion, patients with postpartum psychosis may be at risk for NMS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Complications and side effects, Postpartum depression, Postpartum psychiatric disorders, Neuroleptic malignant syndrome

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Season of birth and childhood psychosis

Article Abstract:

In order to validate the results of several studies which have found that winter birth is a risk factor for childhood psychosis, 162 male and 46 female psychotic children who had been treated in a psychiatric center in Paris from 1960 to 1986 and a comparison group of 1,040 nonpsychotic children (controls) matched by sex and birth year were studied. Data analysis revealed that a significantly high number of boys who became psychotic had been born during the month of December. Male psychotic children were then divided into two groups: those with a relatively high intelligence quotient (IQ above 70) and those with IQ scores below 70. A significantly higher number of boys with low IQs in the psychotic group were born in December. This was not so for boys with low IQs in the control group. December births were then stratified by five-year periods. The relationship between December births and psychosis was not found to be uniform across period intervals. One third of all the December-born psychotic individuals had been born in 1966 and 1967. Since previous studies have examined the role of extreme temperatures and mental illness, the average temperature of different winter periods was assessed. Winters were not harsher than average during 1966 and 1967, so that the prevalence of cases during these two years remains unexplained. The excess of December births among male psychotic children is similar to findings of high winter births among adult schizophrenics, suggesting that adult schizophrenia and childhood psychosis may share a common risk factor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surveys, Intelligence (Psychology), Child mental health, Intelligence levels

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Season of birth in Alzheimer's disease

Article Abstract:

Seasonal birth patterns have been demonstrated among patients with a variety of disorders, including Down's syndrome, schizophrenia and Parkinson's disease. To see if seasonal birth variation is related to Alzheimer's disease (AD), the month and year of birth were identified for all Caucasian patients from an English memory clinic, geriatric psychiatric clinic, and ongoing AD study. Eighty-nine patients were diagnosed with organic psychoses, 188 with psychiatric illnesses, and 239 with AD. All patients diagnosed with AD had previously taken a full battery of screening tests, including a computerized tomography brain scan. Although there were an excess of AD patients born in the first quarter of the year (January through March), the numbers did not reach statistical significance. The other groups of patients showed no seasonal birth variation patterns. Family history data were available for 193 of the AD patients. Seventy-four had at least one first-degree relative with dementia or AD. There was a significant excess of January and February births among AD patients with no family history of dementia. However, there were hardly any first-quarter births among the group of AD patients with a family history of dementia. Findings remain unexplained. (Consumer Summary produced by Reliance Medical Information, Inc.)

Alzheimer's disease, Senile dementia

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