Comorbidity Between Anorexia Nervosa and Depressive Disorder: A Narrative Review.

OBJECTIVE: Anorexia nervosa (AN) is a disorder with a significantly high prevalence. Affective disorders, including depressive disorder (DD), often coexist with this eating disorder (ED). In this review we will focus on its prevalence, associated vulnerability factors, clinical manifestations, possible etiological factors and its prognosis. METHODS: A bibliographic search was carried out in the PubMed database selecting those articles that approached the subject of comorbidity between AN and DD. The search was limited to articles published from January 1990 to December 2021. RESULTS: Of the 1891 abstracts reviewed, 33 studies met inclusion criteria. The prevalence of this comorbidity was extremely variable between studies, which exposed their heterogeneity. As to symptomatology this comorbidity presents itself with more severity, greater expression of psychological traits and greater cognitive impairment. Certain personality traits are postulated as vulnerability factors. Genetic factors such as neurochemicals seem to be involved in its pathogenesis. CONCLUSION: The comorbidity between DD and ED have important influence in its symptomatic expression, severity and prognosis. Some of the analyzed studies provide consistent data, but there are others that are contradictory. It would be necessary to increase the number of studies and use a unified methodology.

Paraganglioma neuroendocrine tumor and psychiatric implications. A case report / Tumores neuroendocrinos de tipo paraganglioma e implicaciones psiquiátricas: Caso clínico

Objective: Paragangliomas are rare neuroendocrine tumors. Occasionally they secrete catecholamines in sufficient quantities to cause symptoms. The majority of the cases, with the resection of the tumor, the psychotic symptoms disappeared and that is associated with the decreased levels of catecholamines. Clinical case: We report the case of 56-year-old women with residual schizophrenia who started with acute symptoms characterized by palpitations, dyspnea, headache and facial rubbing with no response to antihypertensive treatment. At the same time she suddenly had positive psychosis symptoms, after a long time with residual and negative symptoms. Conclusions: With the presentation of this case we want to highlight the signs that suggest the autonomic instability in psychosis patients, and how crucial is excluding underlying somatic conditions. We also examine the possible relationships between neural crest cell tumor that secrete catecholamines and schizophrenia. (AU)

Objetivo: Los paragangliomas son tumores neuroendocrinos infrecuentes. Ocasionalmente secretan catecolaminas en cantidades suficientes para causar síntomas. En la mayoría de los casos, los síntomas psicóticos desaparecen con la resección del tumor, lo cual está asociado con la reducción en los niveles de catecolaminas. Caso clínico: Reportamos el caso de una mujer de 56 años de edad con esquizofrenia residual, que comenzó con síntomas agudos caracterizados por palpitaciones, disnea, cefalea y rubor facial, que no respondían al tratamiento antihipertensivo. Al mismo tiempo, tuvo síntomas psicóticos repentinos y positivos, tras un largo periodo de síntomas residuales y negativos. Conclusiones: Con la presentación de este caso queremos resaltar los signos que sugieren inestabilidad autónoma en los pacientes psicóticos, así como la esencialidad de excluir las condiciones somáticas subyacentes. También examinamos las posibles relaciones entre los tumores de las células de la cresta neural que secretan catecolaminas, y la esquizofrenia. (AU)

Successful treatment of psychosis induced by interferon alpha and ribavirin with paliperidone: first case reported.

Several clinical studies have shown a large number of mental symptoms by immunomodulatory treatment with interferon (IFN). The most frequently described symptoms are depression, suicidal behaviour, manic symptoms, anxiety, psychosis and delirium, associated with other non-specific symptoms such as fatigue, irritability, psychomotor retardation, decreased libido, insomnia, difficulty in concentration and attention. Having a history of mental disorder contraindicates the use of IFN-alpha. These adverse effects that affect the mental state appear usually at the beginning of the treatment (most after 3 weeks of treatment). The incidence of psychotic episodes is low and the episodes usually remit when treatment is interrupted; only some cases require antipsychotic treatment. We present the case of a patient affected with hepatitis C who began to present self-referential delirious symptoms after receiving the treatment with IFN and who was successfully treated with paliperidone. This patient could be classified within the group of high-risk psychiatric patients given the family history of schizophrenia and his personal history of illegal drug consumption. The pharmacological actions of paliperidone are similar to other high potency atypical antipsychotics. The receptor-binding profile of paliperidone most closely resembles that of risperidone and ziprasidone. Paliperidone differs from risperidone and most other antipsychotics by its relatively low extent of enzymatic hepatic metabolism. To the best of our knowledge, this is the first case described that was successfully treated with paliperidone.