Unnecessary surgical treatment in a case of olfactory reference syndrome.

We present a case of olfactory reference syndrome (ORS) with complaints of bromhidrosis. This patient underwent a lumbar sympathectomy to correct the imagined body odor problem. The patient reported experiencing an improvement after surgery, but later, the olfactory symptoms returned. The main objective with ORS patients should be to begin psychiatric treatment early. Other treatments usually appear to be ineffective and cause great dissatisfaction.

Aspectos neuropsiquiátricos de la parálisis supranuclear progresiva: análisis de un caso / Neuropsychiatric aspects of progressive supranuclear palsy: Case report

La parálisis supranuclear progresiva (PSP) es una enfermedad neurodegenerativa de etiología desconocida descrita por primera vez en 1964 por Steele, Richardson y Olszewsy. Cursa con inestabilidad postural prominente como síntoma de comienzo, seguida posteriormente de parálisis supranuclear de la mirada vertical y sintomatología parkinsoniana como bradicinesia y rigidez. Incluye deterioro cognitivo y trastornos neuropsiquiátricos. En este trabajo se describe el caso de una paciente que tras ser vista por varios especialistas es derivada a Salud Mental por síndrome depresivo, siendo finalmente diagnosticada como PSP. A pesar de la importancia de los aspectos neuropsiquiátricos en el cuadro clínico de la PSP, estos han sido descritos de forma menos detallada en la literatura que los síntomas neurológicos. Cabe recordar que los ganglios basales desarrollan un papel muy importante en la regulación de las emociones, el ánimo, la motivación y la cognición, además del conocido respecto al control motor. El diagnóstico temprano de la PSP es difícil, las quejas iniciales suelen ser vagas, inespecíficas e inducen a error, es muy frecuente que estos pacientes sean diagnosticados erróneamente como depresivos. Un mayor conocimiento de la enfermedad que permita realizar un diagnóstico temprano puede prevenir tratamientos con medicaciones inútiles y llevar a cabo las intervenciones necesarias. Revisaremos los aspectos diferenciales psicopatológicos y cognoscitivos de la PSP en relación con otras enfermedades neurodegenerativas, prestando especial atención a la apatía como síntoma y su diferenciación con lo depresivo (AU)

Progressive supranuclear palsy (PSP) is a neurodegenerative disease of unknown etiology, first described in 1964 by Steele, Richardson and Olszewsy. It presents with prominent postural instability as an onset symptom, followed by vertical supranuclear gaze palsy and Parkinsonian symptomatology, such as bradykinesia and rigidity. It also includes cognitive impairment and neuropsychiatric disorders. This paper describes the case of a patient, who after being evaluated by several specialists was referred due to a depressive syndrome to our mental health service, and was finally diagnosed with PSP. Despite the importance of neuropsychiatric aspects in the clinical manifestation of PSP, these have been less described in the literature than the neurological symptoms. Basal ganglia have an important role in the regulation of emotions, mood, motivation, and cognition, as well as in motor control. Early diagnosis of PSP is difficult, and as initial complaints are often vague, unspecific and misleading, it is common for these patients to be misdiagnosed as depression. Increased awareness of the disease to enable an early diagnosis to be made can prevent unnecessary treatment with medications and lead to appropriate interventions. The differential psychopathological and cognitive aspects of the PSP in relation to other neurodegenerative diseases will be reviewed, with special attention to apathy as symptom and its differentiation with depression (AU)

Major depressive episode secondary to condylomata acuminata.

Psychiatric and psychological morbidity is often associated with skin diseases. Recent research has focused on the epidemiological and clinical aspects of human papillomavirus infection, whereas the psychosocial and emotional factors related to the disease have not been well established. We describe the experience of a 22-year-old male who, after being diagnosed of condyloma acuminata, developed a major depressive disorder.

Psychological factors in gastroesophageal reflux disease measured by scl-90-R questionnaire.

BACKGROUND: An association between psychological factors and gastroesophageal reflux disease has been recognized. Psychological distress can influence the outcomes of the disease. AIMS: To determine the existence of psychological factors in our gastroesophageal reflux disease sample, as well as determine their influence on the outcome of the disease and treatment response. METHODS: A cross-sectional study was performed from February 2006 to December 2007. Patients referred to gastrointestinal specialists who reported symptoms of gastroesophageal reflux were asked to fill out the SCL-90-R questionnaire. All underwent endoscopy and pH-metry studies. RESULTS: Fifty-five patients with gastroesophageal reflux disease were analyzed. Subjects with reflux symptoms had higher scores compared to healthy controls on sommatization, obsessiveness, interpersonal sensitivity, being phobic, being psychotic, and the global index (P < 0.05). Patients with high frequency of symptoms and long duration of disease have increased psychological distress. There was no relationship among pH-metry results, endoscopy findings, and SCL-90-R scores. CONCLUSIONS: Psychosocial factors can predispose to gastroesophageal reflux disease. The SCL-90-R questionnaire can be useful in investigating psychological factors in those patients with unsuccessful outcome of the symptoms despite correct management.