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一名希腊男性β地中海贫血特征患者的双相情感障碍易感性:包括新冠病毒病在内的外部因素及其他临床意义

Bipolar Disorder Predisposition in a Greek Male With β-Thalassemia Trait: External Factors, Including COVID-19, and Other Clinical Implications.

作者信息

Tedesco Sarah, Reyes Katherine, Meiselman Alec I, Secondino Julian A, Tarnoverskyy Nelya

机构信息

Psychiatry, Richmond University Medical Center, Staten Island, USA.

Psychiatry, American University of Antigua, New York, USA.

出版信息

Cureus. 2024 Apr 29;16(4):e59303. doi: 10.7759/cureus.59303. eCollection 2024 Apr.

DOI:10.7759/cureus.59303
PMID:38813331
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11136509/
Abstract

The present case study examines an adult male of Greek descent diagnosed with the β-thalassemia trait during adulthood. The individual had psychiatric symptoms after the sudden cessation of anabolic steroid injections, which had been utilized improperly for nearly a decade. Furthermore, the administration of an increased dosage of bupropion in conjunction with the absence of treatment for manic symptoms may have contributed to worsening his illness. The individual's contraction of COVID-19 and the subsequent discontinuation of steroid medication resulted in a notable psychosis despite the absence of any prior psychiatric conditions. Following initial therapy and hospitalization, which resulted in a stable discharge, the patient experienced a relapse due to later alterations in his medication. Consequently, this relapse necessitated a second admission to the hospital. The patient's therapeutic regimen consisted of a concurrent administration of lithium, antipsychotics, and an intense program of psychiatric counseling. This particular example highlights the distinctive connection between β-thalassemia and bipolar disorder, focusing on a Greek patient with the β-thalassemia trait and a genetic predisposition to mood disorders. The present study provides a comprehensive narrative of the patient's clinical progression, with particular emphasis on the impact of the β-thalassemia trait on his mental health trajectory. This observation highlights the limited availability of data about the interplay between hemoglobinopathies and mood disorders, hence emphasizing the need for further research in this niche intersection of genetics and psychiatry.

摘要

本病例研究考察了一名成年男性,他为希腊裔,成年后被诊断出患有β地中海贫血特征。该个体在不当使用合成代谢类固醇注射近十年后突然停止注射,出现了精神症状。此外,增加安非他酮剂量并同时未对躁狂症状进行治疗,可能导致了他病情的恶化。尽管该个体此前没有任何精神疾病史,但感染新冠病毒以及随后停用类固醇药物导致了明显的精神病症状。经过初步治疗和住院,患者病情稳定出院,但后来由于药物调整,病情复发。因此,这次复发需要再次住院治疗。患者的治疗方案包括同时服用锂盐、抗精神病药物以及强化的心理咨询项目。这个特殊案例突出了β地中海贫血与双相情感障碍之间的独特联系,重点关注一名具有β地中海贫血特征且有情绪障碍遗传易感性的希腊患者。本研究全面叙述了患者的临床病程,特别强调了β地中海贫血特征对其心理健康轨迹的影响。这一观察结果凸显了关于血红蛋白病与情绪障碍之间相互作用的数据有限,因此强调了在遗传学和精神病学这一特定交叉领域进行进一步研究的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/456d/11136509/7997b68c2a60/cureus-0016-00000059303-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/456d/11136509/7997b68c2a60/cureus-0016-00000059303-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/456d/11136509/7997b68c2a60/cureus-0016-00000059303-i01.jpg

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