Authors
1 Rafsanjan University of Medical Sciences, Rafsanjan, Iran
2 Tehran University of Medical Sciences, faculty of medicine, Tehran, Iran
3 Medical Students Research Center, School of Medicine, Isfahan University of Medical Sciences,faculty of medicine, Isfahan, Iran
Abstract
Wilson's disease (WD) or hepatolenticular degeneration is an inherited neurodegenerative disorder of copper metabolism (autosomal recessive, chromosome13). Psychiatric disorders in WD include dementia, characterized by mental slowness, poor concentration, and memory impairment. Symptoms may progress rapidly, especially in younger patients, but are more often gradual in development with periods of remission and exacerbation. Delusional disorder and schizophrenia-like psychosis are rare forms of psychiatric presentation. In this report, the patient with WD presented by psychosis symptoms and treated mistaken as schizophrenia for almost ten years. Although he has treated with antipsychotics, he had periods of remissions and relapses and never was symptoms free. Since psychosis can be the manifestation of medical diseases such as WD, overall view of these patients is necessary and medical diseases should be considered as a differential diagnosis.
Keywords
1. | Dening TR, Berrios GE. Wilson's disease. Psychiatric symptoms in 195 cases. Arch Gen Psychiatry 1989;46:1126-34. |
2. | Greenberg DA, Aminoff MJ, Simon RP. Clinical neurology. 5 th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2005. p. 252. |
3. | Akil M, Schwartz JA, Dutchak D, Yuzbasiyan-Gurkan V, Brewer GJ. The psychiatric presentations of Wilson's disease. J Neuropsychiatry Clin Neurosci 1991;3:377-82. |
4. | Kaplan HI, Sadock BJ. Comprehensive text book of psychiatry. 7 th ed. Baltimore, Maryland: Williams & Wilkins; 1999. p. 291. |
5. | Wichowicz HM, Cuba³a WJ, S³awek J. Wilson's disease associated with delusional disorder. Psychiatry Clin Neurosci 2006;60:758-60. |
6. | Huang C, Chu N. Psychosis and epileptic seizures in Wilson's disease with predominantly white matter lesions in the frontal lobe. Parkinsonism Relat Disord 1995;1:53-8. |
7. | Saint-Laurent M. Schizophrenia and Wilson's disease. Can J Psychiatry 1992;37:358-60. |
8. | Jukiæ I, Titliæ M, Tonkiæ A, Dodig G, Rogosiæ V. Psychosis and Wilson's disease: A case report. Psychiatr Danub 2006;18:105-7. |
9. | Mcdonald L, Lake CR. Psychosis in an adolescent patient with Wilson's disease: Effects of chelation therapy. Psychosom Med 1995;57:202-4. |