Bortoletto Riccardo, Candolo Anna, Nicotra Alessandra, Saetti Luana, Perini Laura, Balestrieri Matteo, Colizzi Marco, Comacchio Carla
Unit of Psychiatry, Department of Medicine (DMED), University of Udine, 33100 Udine, Italy.
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
Brain Sci. 2024 Apr 6;14(4):362. doi: 10.3390/brainsci14040362.
Dandy-Walker complex (DWC) consists of a continuum of brain malformations involving the posterior fossa, often leading to psychiatric manifestations during adulthood. We discussed the case of a young woman with Dandy-Walker variant (DWV) and a comorbid complex neuropsychiatric presentation, who was diagnosed with an eating disorder, obsessive-compulsive disorder, and a tic disorder. Afterwards, we conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review reappraising all evidence of psychiatric outcomes in adults with DWC. Overall, 34 studies were eligible for data extraction, comprising 36 patients. Psychiatric profiles were more common among young adult males, with DWC lesions, especially DWV subtype, being often discovered incidentally after admission to mental health inpatient facilities. Most patients were diagnosed with psychosis and bipolar disorder, often comorbid with cognitive impairment. Psychotropic polypharmacy was frequently prescribed, generally leading to complete recovery. Evidence from our case report and systematic review indicates the importance of monitoring long-term psychiatric sequelae among adult patients with DWC malformations.
丹迪-沃克综合征（DWC）由一系列累及后颅窝的脑畸形组成，常导致成年期出现精神症状。我们讨论了一名患有丹迪-沃克变异型（DWV）并伴有复杂神经精神症状的年轻女性病例，她被诊断患有进食障碍、强迫症和抽动障碍。之后，我们进行了一项符合系统评价与Meta分析的首选报告项目（PRISMA）2020标准的系统评价，重新评估了成年DWC患者精神科结局的所有证据。总体而言，34项研究符合数据提取条件，共涉及36例患者。精神科症状在成年男性中更为常见，DWC病变，尤其是DWV亚型，常在入住精神科住院设施后偶然发现。大多数患者被诊断为精神病和双相情感障碍，常伴有认知障碍。经常开具多种精神药物联合治疗，通常可实现完全康复。我们的病例报告和系统评价证据表明，监测成年DWC畸形患者的长期精神科后遗症具有重要意义。
