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重症肌无力患者的共病抑郁和焦虑症状

Comorbid Depressive and Anxiety Symptoms in a Patient with Myasthenia Gravis.

作者信息

Cherukupally Karthik R, Kodjo Kodjovi, Ogunsakin Oluwaseun, Olayinka Olaniyi, Fouron Patrice

机构信息

Department of Psychiatry, Interfaith Medical Center, Brooklyn, New York, USA.

出版信息

Case Rep Psychiatry. 2020 Jan 8;2020:8967818. doi: 10.1155/2020/8967818. eCollection 2020.

Abstract

INTRODUCTION

Myasthenia gravis (MG) is a chronic illness most commonly found in women under 40 years. The most common psychiatric comorbidities found in MG include depressive and anxiety disorders.

CLINICAL PRESENTATION

We describe a case of a 43-year-old African American female with MG who was brought in for shortness of breath. History included MG diagnosed twelve years prior to the current presentation and a history of seven intubations. The patient was admitted to the ICU and intubated. She endorsed poor sleep, easy fatigability, and feeling hopeless in the context of psychosocial stressors-being single, homeless, and unemployed. The patient was started on Zoloft 50 mg per oral daily for depression and Atarax 50 mg per oral three times a day for anxiety. The patient responded well to the treatment and was discharged on day 10 after the resolution of her symptoms with appropriate aftercare in place.

DISCUSSION

Depressive and anxiety symptoms usually develop as comorbidity during MG disease. Depressive and anxiety symptoms, besides motor symptoms, have a negative impact on the quality of life. Mental health must be a clinical focus during the treatment of somatic symptoms during MG.

摘要

引言

重症肌无力(MG)是一种慢性病,最常见于40岁以下的女性。MG中最常见的精神共病包括抑郁和焦虑障碍。

临床表现

我们描述了一例43岁非裔美国女性重症肌无力患者,因呼吸急促入院。病史包括本次就诊前12年被诊断为重症肌无力以及有7次插管史。患者被收入重症监护病房并插管。她表示睡眠不佳、容易疲劳,并且在面临社会心理压力因素(单身、无家可归和失业)时感到绝望。患者开始每天口服50毫克左洛复治疗抑郁症,每天口服3次50毫克安泰乐治疗焦虑症。患者对治疗反应良好,在症状缓解后第10天出院,并得到了适当的后续护理。

讨论

抑郁和焦虑症状通常在MG疾病期间作为共病出现。除了运动症状外,抑郁和焦虑症状对生活质量有负面影响。在MG躯体症状治疗期间,心理健康必须成为临床关注的重点。

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