[Schizophrenia and Wilson’s disease].

Can J Psychiatry. 1992 Jun;37(5):358-60.
[Article in French]

Source

Université de Montréal, Québec.

Abstract

An 18 year-old male first presented a clinical picture of acute psychosis with two recurrences at ages 22 and 23. The diagnosis made at that time was paranoid schizophrenia. Twelve years after his first psychiatric hospitalization, it was discovered that he was suffering from Wilson’s disease. In retrospect, the clinical picture was atypical, notably with an important neurologic involvement mainly parkinsonism almost uncontrollable and aggravated with neuroleptics. The chelating treatment with d-penicillamine resulted in partial improvement of the neurological involvement because the extrapyramidal and neurovegetative symptoms persisted. The psychiatric symptoms improved with fewer neuroleptics than during the 12 previous years. However, neuroleptics had to be continued because of the delay in diagnosing the illness, which diminished the efficiency of the single chelating treatment. The clinical presentation and therapeutic response of this patient strongly suggest a link between the cerebral intoxication by copper and the psychiatric symptoms.

PMID:
1353405
[PubMed – indexed for MEDLINE]

Psychosis in an adolescent patient with Wilson’s disease: effects of chelation therapy.

Psychosom Med. 1995 Mar-Apr;57(2):202-4.

Source

Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City 66160-7341, USA.

Abstract

Wilson’s disease is a rare genetic disorder involving the liver and brain, with onset frequently in adolescence. Psychiatric symptoms are often the first manifestation of the disease and can obscure the diagnosis. Chelation therapy can reverse the fatal outcome of untreated patients, so early detection is critically important. This paper describes an adolescent with Wilson’s disease who, after initiation of penicillamine therapy, developed florid psychosis that improved as copper levels were decreased and that did not require use of neuroleptic medication.

Resolved Psychosis after Liver Transplantation in a Patient with Wilson’s Disease.

Clin Pract Epidemiol Ment Health. 2011;7:182-4. Epub  2011 Dec 30.

Source

Reparto di Gastroenterologia Azienda Ospedaliero Universitaria , Cagliari, Italy.

Abstract

A psychiatric involvement is frequently present in Wilson’s disease. Psychiatric symptoms are sometimes the first and only manifestation of Wilson’s disease. More often a psychiatric involvement is present beside a neurologic or hepatic disease.We describe the case of a 18 years-old male patient who shows a clinic and laboratoristic pattern of cirrhosis and an history of subchronic hallucinatory psychosis, behavioral symptoms and mood disturbances with depressed mood. He hadn’t familiar history of liver or psychiatric disease. Laboratory and imaging tests confirmed the diagnosis of Wilson’s disease with psichiatric involvement. After liver transplantation copper metabolism and liver function normalised and we noticed no recurrency of the psichiatric illness. Very few cases of psychiatric improvement after orthotopic liver transplantation (OLT) has been described until now.

Psychosis in an adolescent patient with Wilson’s disease: effects of chelation therapy.

Psychosom Med. 1995 Mar-Apr;57(2):202-4.

Source

Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City 66160-7341, USA.

Abstract

Wilson’s disease is a rare genetic disorder involving the liver and brain, with onset frequently in adolescence. Psychiatric symptoms are often the first manifestation of the disease and can obscure the diagnosis. Chelation therapy can reverse the fatal outcome of untreated patients, so early detection is critically important. This paper describes an adolescent with Wilson’s disease who, after initiation of penicillamine therapy, developed florid psychosis that improved as copper levels were decreased and that did not require use of neuroleptic medication.

Neuropsychological aspects of Wilson’s disease.

Int J Neurosci. 1996 Apr;85(3-4):221-9.

Rathbun JK. SourceUniversity of Michigan, Department of Psychology, Ann Arbor 48103, USA.

Abstract: A consecutive series of 34 patients with confirmed diagnoses of Wilson’s disease (WD) was administered complete neuropsychological examinations upon admission to a university medical center for routine laboratory tests.

Twenty-five patients with neurological and/or hepatic symptoms (symptomatics) revealed frequent and severe motor deficits and infrequent and mild cognitive deficits in contrast to nine patients with genetic findings of Wilson’s disease but no symptomatic findings (asymptomatics). Somato-sensory tests were normal in all.

One of the most intriguing findings was the absence of a significant correlation between the level of copper toxicity and the degree, nature, and frequency of associated neurological deficits in both symptomatic and asymptomatic patients.

Fifty per cent of the present sample received psychiatric treatment, including hospitalization, for schizophrenia, depression, anxiety, and related disorders prior to confirmed diagnosis of WD.

The present findings provide additional evidence that patients with the initial presenting psychological symptoms may be easily misdiagnosed and mistreated if the possibilities of Wilson’s disease are not ruled out first. PMID: 8734560

[PubMed – indexed for MEDLINE]

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