RESUMO
A middle-aged woman presented with a history of symptoms of depression with psychotic features severely affecting her physical health. Neuroimaging of her brain suggested pathological changes out of keeping with her age, leading to further investigations including genetic testing for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis was also considered as a differential diagnosis as an initial serum test for anti-NMDAR autoantibodies was positive. Her symptoms resolved following treatment with electroconvulsive therapy. Despite her initial neuroimaging, her genetic test for CADASIL was negative and her subsequent test for anti-NMDAR autoantibodies was negative, suggesting that the initial test may have been a false positive.
Assuntos
Depressão/etiologia , Depressão/terapia , Transtornos Psicóticos/etiologia , Transtornos Psicóticos/terapia , Depressão/diagnóstico por imagem , Diagnóstico Diferencial , Eletroconvulsoterapia , Feminino , Humanos , Pessoa de Meia-Idade , Neuroimagem , Transtornos Psicóticos/diagnóstico por imagem , Resultado do TratamentoRESUMO
Quality of life was measured in 348 women attending gynaecological outpatients using EuroQol 5D. Their responses were compared to the results taken from a UK national questionnaire (Kind et al., 1998). Quality of life was then measured in 131 women before and after hysterectomy. Of the outpatient group 50% of the women reported problems with pain and 40% with depression which were significantly more than a representative sample of normal UK women. Women undergoing hysterectomy reported similar preoperative levels of pain and depression. However, 6 months postoperatively there were significantly fewer women complaining of both pain and depression. Mean calculated scores of self-rated quality of life improved significantly from 0.72 preoperatively to 0.89 postoperatively (P < 0.0001). In conclusion, quality of life can be simply quantified using the EuroQol instrument and is suitable for gynaecological patients. Hysterectomy for the treatment of benign conditions improves the overall quality of life for the majority of women.