Muñoz P, González Torres M A
Servicio de Psiquiatría, Hospital de Basurto, Bilbao.
Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1997 May-Jun;25(3):197-200.
Organic Personality Disorder is a clinical diagnosis included in ICD-10 classification and also, under a different name, in DSM-IV. Many different treatments have been proposed to improve this condition, carbamazepine being one of them. A case report is presented of a 28 years old patient who, six years before, had suffered a severe brain injury in a car accident. From then on, an intensification of previous personality traits could be observed besides sexual exhibitionism, promiscuity, aggressive episodes, suspiciousness and low impulse control. A chaotic socio-familial situation induced two psychiatric admissions. The patient was initially treated with neuroleptics, benzodiazepines and antidepressants, with no response. Treatment with carbamazepine was then started, reaching a dose of 1,200 mg/day and maintaining plasma levels of 8.8 mcg/ml. After two months of this treatment a marked improvement was observed with absence of exhibitionistic behavior and aggressive episodes, a tendency towards normalization of mood and anxiety, stabilization of his social and family relationships and starting some paid work.
器质性人格障碍是国际疾病分类第10版(ICD - 10)分类中包含的一种临床诊断,在《精神疾病诊断与统计手册》第四版(DSM - IV)中也有不同名称的收录。人们提出了许多不同的治疗方法来改善这种状况,卡马西平就是其中之一。本文报告了一名28岁患者的病例,该患者在六年前的一场车祸中遭受了严重的脑损伤。从那时起,除了露阴癖、滥交、攻击性行为、多疑和低冲动控制外,还观察到其先前人格特质的强化。混乱的社会家庭状况导致该患者两次入院接受精神科治疗。患者最初接受了抗精神病药物、苯二氮䓬类药物和抗抑郁药物治疗,但没有效果。随后开始使用卡马西平治疗,剂量达到1200毫克/天,血浆水平维持在8.8微克/毫升。经过两个月的这种治疗,观察到明显改善,露阴行为和攻击性行为消失,情绪和焦虑趋于正常化,社会和家庭关系稳定,并开始从事一些有报酬的工作。