Perekopskiy David, Zoghi Shervin, Dobrick Jenna, Aboud Orwa, Bourgeois James Alan
Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, United States.
Department of Neurological Surgery, University of California, Davis Medical Center, Sacramento, CA, United States.
Front Psychiatry. 2025 Jan 6;15:1485502. doi: 10.3389/fpsyt.2024.1485502. eCollection 2024.
It is estimated that the incidence of first episode psychotic disorder is about 33 people out of 100,000 each year. Beyond primary psychotic illness (e.g., schizophrenia, schizophreniform disorder), some of these patients will develop psychotic disorder due to a complex interplay of genetics, anatomical variations, traumatic brain injury (TBI), environment, substance use, and/or other causes. A small subset of patients will develop psychotic disorder due to a structural anatomic lesion, such as a CNS tumor. Here we present a 35-year-old male with worsening auditory hallucinations after surgical resection and radiation of a right temporal lobe astrocytoma in the setting of co-morbid methamphetamine usage. This case report helps illustrate how a neuroimaging work-up is important for the first incidence of psychotic disorder and how a tumor can produce a psychotic disorder that persists after oncologic treatment. This paper adds to the literature on the presentation and treatment of post-resection tumor-induced psychotic disorder.
据估计，首发精神障碍的发病率约为每年每10万人中有33人。除原发性精神疾病（如精神分裂症、分裂样障碍）外，其中一些患者会由于遗传、解剖变异、创伤性脑损伤（TBI）、环境、物质使用和/或其他原因的复杂相互作用而发展为精神障碍。一小部分患者会由于结构性解剖病变，如中枢神经系统肿瘤，而发展为精神障碍。在此，我们报告一名35岁男性，在右颞叶星形细胞瘤手术切除和放疗后，伴有甲基苯丙胺使用共病的情况下，幻听症状加重。本病例报告有助于说明神经影像学检查对于首发精神障碍的重要性，以及肿瘤如何引发一种在肿瘤治疗后仍持续存在的精神障碍。本文补充了关于切除术后肿瘤诱发精神障碍的表现和治疗的文献。
