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Psychosis risk syndrome comorbid with panic attack disorder in a cannabis-abusing patient affected by Arnold–Chiari malformation type I - 20/10/12

Doi : 10.1016/j.genhosppsych.2011.12.008 
Antonio Del Casale, M.D. a, , Daniele Serata, M.D. a, Chiara Rapinesi, M.D. a, b, Alessio Simonetti, M.D. a, Stefano Maria Tamorri, M.D. a, Anna Comparelli, M.D., Ph.D. a, Antonella De Carolis, M.D. a, Valeria Savoja, M.D. a, Georgios D. Kotzalidis, M.D. a, Gabriele Sani, M.D. a, Roberto Tatarelli, M.D. a, Paolo Girardi, M.D. a, b
a NESMOS Department (Neuroscience, Mental Health and Sensory Organs), School of Medicine and Psychology, Saint Andrea Hospital of Rome, Sapienza University of Rome, Rome, Italy 
b Department of Neuropsychiatry, Villa Rosa, SuoreHospitaliere of the Sacred Heart of Jesus, Viterbo, Italy 

Corresponding author. Tel.: +39 06 33 77 5951; fax: +39 06 33 77 5342.

Abstract

Objective

An 18-year-old man with Arnold–Chiari malformation (ACM) type I developed sudden panic attacks. He also manifested sleep disorder, cannabis abuse, and psychosis-risk syndrome (PRS). Although with average–superior intelligence, he had executive dysfunction. This prompted us to explore the relation between ACM, cannabis abuse, PRS and panic disorder.

Method

We report the case and briefly review the literature focusing on ACM and psychiatric disorders.

Results

Behavior therapy led to gradual abstinence from cannabis with disappearance of anxiety symptoms. The patient is currently well and maintained on omega-3 polyunsaturated fatty acids.

Conclusions

Locus coeruleus compression and cannabis abuse may have triggered the symptoms, and the latter might also be PRS-related. PRS and anxiety symptoms should be explored in ACM patients to allow better prevention of psychosis and anxiety disorders.

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Keywords : Arnold–Chiari malformation, Subtype I, Psychosis-risk syndrome, Cannabis abuse, Panic disorder, Behavior therapy


Esquema


 Financial and competing interest disclosure: Paolo Girardi in the past 3 years has received research support from Lilly and Janssen, has participated in the advisory boards for Lilly, Organon, Pfizer and Schering, and received honoraria from Lilly and Organon. Roberto Tatarelli in the past 3 years has participated in the advisory boards for Schering, Servier and Pfizer, and received honoraria from the same companies. Valeria Savoja and Giorgio D. Kotzalidis are recipients of Italian Ministry of Education Ph.D. Grants for Early Intervention in the Psychoses. None of these authors has any relevant affiliation or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
☆☆ All other authors of this article have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.


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Vol 34 - N° 6

P. 702.e5-702.e7 - novembre 2012 Regresar al número
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