Clinical review for general practice

ISSN (Print) 2713-2552
ISSN (Online) 2782-5671
  • Home
  • about
  • archives
  • contacts
left
FULLSCREEN > Archive > 2024 > Vol 5, №12 (2024) > Recurrence of schizophreniform psychosis, coincident with the detection of ovarian tumors. The case of 30-year-old patient

Recurrence of schizophreniform psychosis, coincident with the detection of ovarian tumors. The case of 30-year-old patient

Vladimir D. Mendelevich , Enver I. Bogdanov , Konstantin S. Sergienko , Elena G. Mendelevich , Venera M. Butlerovskaya

For citation:


  • Abstract
  • About the Author
  • References

Abstract

The article presents a unique clinical case of 30-year-old patient G. Over the course of eight years, the patient suffered two psychotic episodes with schizophreniform symptoms – the first was dominated by affective-delusional symptoms, and the second was catatonic. Each time, psychosis occurred against the background of elevated body temperature. Initially, she was diagnosed with schizophrenia, for which she underwent psychopharmacotherapy with antipsychotics. At the second time, the neuropsychiatric condition was considered to be related to seronegative anti-NMDA receptor encephalitis and she received hormonal therapy. During the interictal period, G. led an active lifestyle, was socially adapted, and did not exhibit any psychotic symptoms. The peculiarity of her condition was that during the first episode she was diagnosed with a cystadenoma of the right ovary, and 8 years before the second episode she was diagnosed with a teratoma of the left ovary. In addition, according to relatives, recovery after the first attack of the disease coincided with the radical gynecological operation performed (right-sided oophorectomy), and the lack of significant improvement during the second psychotic episode was associated with an insufficient amount of surgical intervention for teratoma of the left ovary (resection). At the time of this examination of patient G., it was not possible to draw an unambiguous conclusion that her mental disorder had common pathogenetic mechanisms. Further observation will allow us to make a more convincing diagnostic conclusion.
Keywords: schizophrenia, schizophreniform psychosis, catatonia, anti-NMDA-receptor encephalitis, ovarian tumors, cystadenoma, teratoma.

About the Author

Vladimir D. Mendelevich 1 , Enver I. Bogdanov 1 , Konstantin S. Sergienko 1 , Elena G. Mendelevich 1 , Venera M. Butlerovskaya 2

1 Kazan State Medical University, Kazan, Russia

2 Bekhterev Republican Clinical Psychiatric Hospital, Kazan, Russia

References

1. Шмуклер А.Б. Позволяют ли новые знания улучшить диагностику психических расстройств: проблема анти-NMDA-рецепторного энцефалита. Неврологический вестник. 2024;56(1):95-104. DOI: 10.17816/nb625638
Shmukler A.B. Does new knowledge allow us to improve the diagnosis of mental disorders: the problem of anti-NMDA receptor encephalitis. Neurology Bulletin. 2024;56(1):95-104. DOI: 10.17816/nb625638 (in Russian).
2. Менделевич В.Д., Сергиенко К.С., Яхин К.К., Абдуллина Э.А. Случай летального исхода анти-NMDA-рецепторного энцефалита, ошибочно принятый за дебют шизофрении: дьявол кроется в психопатологических деталях. Неврологический вестник. 2024;56(3):299-310. DOI: 10.17816/nb633510
Mendelevich V.D., Sergienko K.S., Yakhin K.K., Abdullina E.A. A case of fatal anti-NMDA receptor encephalitis misdiagnosed as onset of schizophrenia: the devil is in the psychopathological details. Neurology Bulletin. 2024;56(3):299-310. DOI: 10.17816/nb633510 (in Russian).
3. Клинические рекомендации. Шизофрения. Российское общество психиатров. М., 2019; с. 119. Режим доступа: psychiatr.ru/download/4244?view=1&name=КР_+Шизофрения+25-11.pdf
Clinical recommendations. Schizophrenia. Russian Society of Psychiatrists. Moscow, 2019; p. 119. Available at: psychiatr.ru/download/ 4244?view=1&name=KR_+Schizophrenia+25-11.pdf (in Russian).
4. Lennox BR, Lennox GG. Mind and movements: the neuropsychiatry of movement disorders. J Neourol Neurosurg Psychiatry 2002;72(1):128-31. DOI: 10.1136/jnnp.72.suppl_1.128
5. Кататония: история и современность (мультидисциплинарое исследование). Под ред. А.Б. Смулевича. М., 2023; c. 296.
Catatonia: history and modernity (multidisciplinary research). Edited by A.B. Smulevich. Moscow, 2023; p. 296 (in Russian).
6. Международная классификация болезней 10-го пересмотра. Психические и поведенческие расстройства. М.: РОП. 1998. Режим доступа: psychiatr.ru/download/1998?view=1&name=МКБ-10_с_ гиперссылками.pdf
International classification of diseases 10th revision. Mental and behavioral disorders. Moscow: ROP. 1998. Available at: psychiatr.ru/ download/1998?view=1&name=ICD-10_with_hyperlinks.pdf
7. Мурашко А.А. Антитела к NMDA-рецепторам: аутоиммунный энцефалит и психотические расстройства. Социальная и клиническая психиатрия. 2019;29(4):78-83.
Murashko A.A. Antibodies to NMDA receptors: autoimmune encephalitis and psychotic disorders. Social and clinical psychiatry. 2019;29(4):78-83 (in Russian).
8. Al-Diwani A, Handel A, Townsend L et al. The psychopathology of NMDAR-antibody encephalitis in adults: a systematic review and phenotypic analysis of individual patient data. Lancet Psychiatry 2019;6:235-46.
9. Servén GE, Quintana BE, Buscà GN. Considerations of psychotic symptomatology in anti-NMDA encephalitis: Similarity to cycloid psychosis. Clin Case Rep 2019;7:2456-61. DOI: 10.1002/ccr3.2522
10. Kamil SH Anti-NMDA Receptor Encephalitis in a Female with Previous Psychiatric Illness. Ann Psychiatry Ment Health 2015;3(2):1024.
11. Simabukuro MM, Freitas CHA, Castro LHM. A patient with a long history of relapsing psychosis and mania presenting with anti-NMDA receptor encephalitis ten years after first episode. Dement Neuropsychol 2015;9(3):311-4. DOI: 10.1590/1980-57642015DN93000016
12. Васенина Е.Е., Левин О.С. Энцефалит с антителами к NMDA-рецепторам как курабельная причина острого психоза: возможности диагностики. (Комментарий к статье Е.В. Снедкова «Существует ли анти-NMDA-рецепторный энцефалит?»). Неврологический вестник. 2023;LV(4):79-88. DOI: 10.17816/nb624853
Vasenina E.E., Levin O.S. Encephalitis with antibodies to NMDA receptors as a curable cause of acute psychosis: diagnostic possibilities. (Commentary to the article by E.V. Snedkov “Does anti-NMDA receptor encephalitis exist?”). Neurology Bulletin. 2023;LV(4):79-88. DOI: 10.17816/nb624853 (in Russian).
13. Barry H, Hardiman O, Healy DG et al. Anti-NMDA receptor encephalitis: an important differential diagnosis in psychosis. Br J Psychiatry 2011;199:508-9. DOI: 10.1192/bjp.bp.111.092197
14. Dalmau J, Armangué T, Planagumà J et al. An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models. Lancet Neurol 2019;18(11):1045-57. DOI: 10.1016/S1474-4422(19)30244-3
15. Endres D, Leypoldt F, Bechter K et al. Autoimmune encephalitis as a differential diagnosis of schizophreniform psychosis: clinical symptomatology, pathophysiology, diagnostic approach, and therapeutic considerations. Eu Arch Psychiatry Clin Neurosci 2020;(270):803-18. DOI: 10.1007/s00406-020-01113-2
16. Funayama M, Koreki A, Takata T et al. Differentiating autoimmune encephalitis from schizophrenia spectrum disorders among patients with first-episode psychosis. J Psychiatric Res 2022;(151):419-26. DOI: 10.1016/j.jpsychires.2022.05.008
17. Conroy MA, Finch T, Levin TT et al. Chronic Schizophrenia Later Diagnosed with Anti-NMDA Receptor Encephalitis: Case Report and Review of the Literature. Clin Schizophr Relat Psychoses 2018;11(4):201-4. DOI: 10.3371/CSRP.MCTF.071317
18. Pollak TA, McCormack R, Peakman M et al. Prevalence of anti-N-methyl-D-aspartate (NMDA) receptor [corrected] antibodies in patients with schizophrenia and related psychoses: a systematic review and meta-analysis. Psychol Med 2014;44(12):2475-87. DOI: 10.1017/S003329171300295X
19. Giri YR, Korie I, Hashmi S et al. Anti-NMDA Receptor Encephalitis Masquerades as Psychosis: A Case Report. J Psychiatric Pract 2022;28(1). DOI: 10.1097/PRA.0000000000000603
20. Luo Y, Li J, Jiang F et al. Autoimmune Encephalitis With Psychotic Manifestations and Cognitive Impairment Presenting as Schizophrenia: Case Report and Literature Review. Front Psychiatry 2022;13:827138. DOI: 10.3389/fpsyt.2022.827138
21. Paluch Z, Borys M, Krawczyk M, Duda P. Autoimmune anti-N-methyl-D-aspartate (NMDA)-receptor encephalitis as a rare cause of the complex psychiatric and neurologic manifestations. A case report and review of the literature. J Pre-Clin Clin Res 2022;16(3):75-8. DOI: 10.26444/jpccr/152424
22. Менделевич В.Д. Концепт шизофреноформности. Социальная и клиническая психиатрия. 2024;34(3):75-81.
Mendelevich V.D. The concept of schizophreniformity. Social and clinical psychiatry. 2024;34(3):75-81 (in Russian).
23. Ponte A, Brito A, Nóbrega C, Pinheiro S. Catatonia in Anti-N-Methyl-D-Aspartate (NMDA) Receptor Encephalitis Misdiagnosed as Schizophrenia. Acta Med Port 2020;33(3):208-11. DOI: 10.20344/amp.11077
24. Huang Ch, Kang Y, Zhang B et al. Anti-N-methyl-d-aspartate receptor encephalitis in a patient with a 7-year history of being diagnosed as schizophrenia: complexities in diagnosis and treatment. Neuropsychiatric Dis Treat 2015;(11):1437-42. DOI: 10.2147/NDT.S82930
25. Vaux A, Robinson K, Saglam B et al. Autoimmune Encephalitis in Long-Standing Schizophrenia: A Case Report. Front Neurol 2022;(12):810926. DOI: 10.3389/fneur.2021.810926
26. Yasuda K, Uenishi Sh, Sakamoto K et al. Schizophrenia after remission of anti-NMDA receptor encephalitis. Asian J Psychiatry 2022;(70):103027. DOI: 10.1016/j.ajp.2022.103027
27. Давыдовская М.В., Бойко А.Н., Беляева И.А. и др. Аутоиммунные энцефалиты. Журнал неврологии и психиатрии. 2015;4:95-101. DOI: 10.17116/jnevro20151154195-101
Davydovskaya M.V., Boyko A.N., Belyaeva I.A. et al. Autoimmune encephalitis. Journal of Neurology and Psychiatry. 2015;4:95-101. DOI: 10.17116/jnevro20151154195-101 (in Russian).
28. Подзолкова Н.М., Коренная В.В., Левин О.С. и др. Аутоиммунный энцефалит с антителами к рецепторам N-метил-D-аспартата и тератомы яичников: существует ли взаимосвязь? Вопросы гинекологии, акушерства и перинатологии. 2020;19(5):124-31. DOI: 10.20953/1726-1678-2020-5-124-131
Podzolkova N.M., Korennaya V.V., Levin O.S., et al. Autoimmune encephalitis with antibodies to N-methyl-D-aspartate receptors and ovarian teratoma: is there a relationship? Issues of gynecology, obstetrics and perinatology. 2020;19(5):124-31. DOI: 10.20953/1726-1678-2020-5-124-131 (in Russian).
29. English K, De Leon D. A rare and challenging case of teratoma-associated Anti-NMDA receptor encephalitis. South Sudan Med J 2024;17(3):121-5. DOI: 10.4314/ssmj.v17i3.org/10.4314/ssmj.v17i3.5
30. Lutz B, Sheikh E, Klinic E et al. Acute Psychosis Secondary to Anti-NMDA Receptor Encephalitis: An Underdiagnosed Disorder in Healthy, Young Women. Cureus 2023;15(2):e.
31. Plaikner A, Jacob A, Rother J, Kohler C. Autoimmune encephalitis associated with an ovarian teratoma in a 29-year old woman. Clin J Obstet Gynecol 2019;(2):013-6. DOI: 10.29328/journal.cjog.1001018
32. Kristianto CS. Psychotic Symptoms Related Anti NMDA Receptor in Ovarian Teratoma. Scientia Psychiatrica 2020;1(2):37-42. DOI: 10.37275/scipsy.v1i2.6
33. Yu M, Li Sh, Cheng J, Zhou L. Ovarian teratoma-associated anti–NMDAR encephalitis: a single-institute series of six patients from China. Arch Gynecol Obstet 2021;303:1283-94. DOI: 10.1007/s00404-020-05861-3
34. Banach W, Banach P, Szweda H et al. Ovarian teratoma-associated Anti-NMDAR encephalitis in women with first-time neuropsychiatric symptoms: A meta-analysis and systematic review of reported cases. Heliyon 2024;10:e36042. DOI: 10.1016/j.heliyon.2024.e36042
35. Câmara-Pestana P, Magalhães AD, Mendes T et al. Anti-NMDA Receptor Encephalitis Associated With an Ovarian Teratoma Presenting as First-episode Psychosis: A Case Report. J Psychiatric Practice 2022;28(1):84-8. DOI: 10.1097/PRA.0000000000000598
36. Voice J, Ponterio JM, Lakhi N. Psychosis secondary to an incidental teratoma: a «heads-up» for psychiatrists and gynecologists. Arch Womens Ment Health 2017;20:703-7. DOI: 10.1007/s00737-017-0751-8
37. Xu X, Dalmau J, Graus F. Antibody-Mediated Encephalitis. N Engl J Med 2018;378(9):840-51. DOI: 10.1056/NEJMra1708712
38. Cho EH, Byun JM, Park HY et al. The first case of Anti-N-methyl-D-aspartate receptor encephalitis (Anti-NMDAR encephalitis) associated with ovarian mucinous cystadenoma: A case report. Taiwanese J Obstet Gynecol 2019;(58):557e559.
39. Liu CY, Zhu J, Zheng XY et al. Anti-N-Methyl-D-aspartate Receptor Encephalitis: A Severe, Potentially Reversible Autoimmune Encephalitis. Mediators Inflamm 2017:6361479. DOI: 10.1155/2017/6361479
40. Van Steenhoven RW, Titulaer MJ. Seronegative autoimmune encephalitis: exploring the unknown. Brain 2022;145(10):3339-40. DOI: 10.1093/brain/awac338
41. Guasp M, Módena Y, Armangue T et al. Clinical features of seronegative, but CSF antibody-positive, anti-NMDA receptor encephalitis. Neurol Neuroimmunol Neuroinflamm 2020;7(2):e659. DOI: 10.1212/NXI.0000000000000659
42. Gong X, Chen Ch, Liu X. Long-term Functional Outcomes and Relapse of Anti-NMDA Receptor Encephalitis. A Cohort Study in Western China. Neurol Neuroimmunol Neuroinflamm 2021;8:e958. DOI: 10.1212/NXI.0000000000000958
43. Gabilondo I, Saiz A, Galán L. Analysis of relapses in anti-NMDAR encephalitis. Neurology 2011;77:996. DOI: 10.1212/WNL.0b013e318 22cfc6b
44. Fink M, Shorter E, Taylor MA. Catatonia Is not Schizophrenia: Kraepelin’s Error and the Need to Recognize Catatonia as an Independent Syndrome in Medical Nomenclature. Schizophrenia Bulletin 2010;36(2):314-20. DOI:10.1093/schbul/sbp059
45. Cиволап Ю.П., Портнова А.А. Кататоническая шизофрения: историческая ошибка психиатрической систематики? Неврологический вестник. 2021;LIII(4):5-10. DOI: 10.17816/nb90 541
Sivolap Yu.P., Portnova A.A. Catatonic schizophrenia: a historical error in psychiatric systematics? Neurological Bulletin. 2021;LIII(4):5-10. DOI: 10.17816/nb90541 (in Russian).
46. Пискарев М.В., Лобанова В.М., Ильина Н.А. Периодическая кататония при расстройствах шизофренического спектра. Журнал неврологии и психиатрии им. С.С. Корсакова. 2023;123(8):98-106. DOI: 10.17116/jnevro202312308198
Piskarev M.V., Lobanova V.M., Ilyina N.A. Periodic catatonia in schizophrenia spectrum disorders. Journal of Neurology and Psychiatry named after. S.S. Korsakov. 2023;123(8):98-106. DOI: 10.17116/jnevro202312308198 (in Russian).
47. Hansen N. NMDAR autoantibodies in psychiatric disease – An immunopsychiatric continuum and potential predisposition for disease pathogenesis. J Translational Autoimmunity 2022;(5):100165. DOI: 10.1016/j.jtauto.2022.100165
48. Rogers JP, Pollak TA, Blackman G et al. Catatonia and the immune system: a review. Lancet Psychiatry 2019;(6):620-30. DOI: http://dx.doi. org/10.1016

For citation:Mendelevich V.D., Bogdanov E.I., Sergienko K.S., Mendelevich E.G., Butlerovskaya V.M. Recurrence of schizophreniform psychosis, coincident with the detection of ovarian tumors. The case of 30-year-old patient. Clinical review for general practice. 2024; 5 (12): 80–88 (In Russ.). DOI: 10.47407/kr2024.5.12.00541


All accepted articles publish licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

  • About
  • Editorial board
  • Ethics
  • For authors
  • Author fees
  • Peer review
  • Contacts

oa
crossref
анри


  Indexing

doaj
elibrary

Address of the Editorial Office:

127055, Moscow, s/m 37

Correspondence address:

115054, Moscow, Zhukov passage, 19, fl. 2, room XI


Managing Editor:

+7 (495) 926-29-83

id@con-med.ru