The Impact of COVID-19 and Quarantine on Suicidality in Geriatric Inpatients-A Case Report.

The mental health burden of COVID-19 and associated quarantine can be enormous for the elderly. Being at higher risk for serious illnesses results in them being further isolated at a time of prolonged social distancing. In the following suicide-attempt cases, we examine the effects of quarantine and a global pandemic that expose the elderly to increased risk for negative mental health outcomes. Examining defense mechanisms and the effects of quarantine may help healthcare professionals better identify individuals at higher risk during times of crises that warrant isolation and quarantine, and provide appropriate interventions.

From Mushrooms to Myolysis: A Case of Rhabdo in Psilocybin-Induced Mood and Psychotic Disorder.

ABSTRACT: The involvement of certain recreational drugs, namely, hallucinogens, in the development of hyperactive syndromes is well known, but not well studied. In this report, we expand on this relationship by documenting the development of substance-induced psychosis in a young patient who used a large amount of psilocybin and developed symptoms of a first psychotic and manic episode, complicated by violent behavior and rhabdomyolysis. We further evaluate the association between psilocybin use and rhabdomyolysis and explore this understudied phenomenon and differentiate it from the diagnoses of other hyperactive syndromes seen in psychiatry. This case exemplifies the need for increased vigilance in psilocybin microdosing therapy and for physicians to be mindful of how each patient responds to its use to prevent life-threatening hyperactive syndromes in its wake.

A Case of Clutter and Chaos: Attention Deficit Hyperactivity Disorder Confounding Hoarding.

ABSTRACT: Hoarding disorder is a chronic disorder defined as the persistent difficulty in parting with possessions and the need to save items, regardless of their actual value. Severe hoarding has largely been a hidden clinical problem, and awareness has mostly been limited to voyeuristic depictions of the plight of hoarders in popular media. Approximately 28% to 32% of individuals with attention deficit hyperactivity disorder (ADHD), especially the inattentive subtype, have been reported to have clinically significant hoarding. It has been hypothesized that patients with ADHD initially acquire objects impulsively and later develop emotional attachments or intrinsic meaning, resulting in a perpetuating cycle of reliance on hoarding as a coping mechanism. Treatment focused on impaired attention has shown improved prognosis, which further signifies the relationship between inattentive ADHD and hoarding. We discuss the case of a patient with ADHD (inattentive type), major depressive disorder, and hoarding traits.

Prevalence of Hoarding in an Adult Inpatient Population and Its Association With Axis I Diagnoses.

OBJECTIVE: Hoarding behavior is not limited to obsessive-compulsive disorder (OCD) alone. With the objective of highlighting the association between hoarding behavior and common psychiatric disorders, we explored its occurrence in psychiatric inpatients and co-occurrence with Axis I diagnoses. METHODS: In this prospective cohort study, we enrolled adult psychiatric inpatients by simple random sampling at an urban, community-based, academic medical center. Patients were screened for hoarding using the validated Hoarding Rating Scale-Interview, and those meeting criteria for clinically significant hoarding were assessed for Axis I disorders. RESULTS: Clinically significant hoarding was observed in 33% of the 200 acute psychiatry patients admitted to the study. Mood disorders were positively associated with hoarding (p = 0.033), whereas psychotic spectrum disorders had a weaker association with it (p = 0.015). CONCLUSION: This study indicates a need for clinicians to be mindful that hoarding manifests in many forms of mental illness and is not limited to OCD alone.