BACKGROUND: The bio-psycho-social model is mostly used to understand the etiology and pathogenesis of psychiatric disorders. Even though in our era, the biological factors became more dominant in the field, the stress-diathesis model is quite acceptable to explain and understand the evolution of psychotic as well as affective disorders.
BACKGROUND: In this case report we present a patient, in her late 40\'s, admitted to our department with a manic-psychotic episode for the first time in her life, after the massive terror attack of October 7, and in which we suggest that the signs and symptoms might be explained using the psycho-dynamic theory.
CONCLUSIONS: We conclude suggesting that the equilibrium of the bio-psycho-social model, should be adjusted in the context of time and space, especially during a situation of catastrophic scale in the patient environment.
CONCLUSIONS: Although stress is a risk factor for the development of affective disorders and especially manic-psychotic episodes, there is scarce literature to support it. On the other hand, psycho-dynamic theories sometimes consider stressful life events as a causative factor for the development of depressive as well as manic episodes.

BACKGROUND: Delirious mania (DM) is a severe psychiatric condition having rapid onset of delirium, mania, and psychosis. It is an emergency condition as it has acute onset and is characterized by extreme hyperactivity. Catatonic signs may also be present. Very few cases have been reported from India, hence making it imperative to study its clinical characteristics and possible treatment, which can help in providing care to such patients in emergency settings.
UNASSIGNED: This paper describes four cases with a diagnosis of DM - demography, clinical features, investigations, treatment. All the patients had an acute onset and rapid progression of symptoms, with clinical symptoms of talkativeness, increased psychomotor activity, decreased need for sleep, aggressive and violent behavior, increased libido, increased appetite with delusion of grandiosity, disorientation to time/place/person, impaired memory of recent events, impaired attention with fluctuating course, negativism, echolalia, and echopraxia.
CONCLUSIONS: There is a high likelihood of misdiagnosing DM in the absence of diagnostic guidelines. There should be an active search for the underlying aetiology in all cases of DM. Atypical antipsychotics and mood stabilizers may be used to treat less severe forms of DM. Modified electric convulsive treatment and intravenous benzodiazepines elicit a good response.
UNASSIGNED: Делириозная мания (ДМ) — это тяжелое психическое нарушение, характеризующееся быстрым возникновением и сочетанием делирия, мании и психоза, также возможны симптомы кататонии. Такое состояние является неотложным ввиду характерных для него острого начала и крайнего возбуждения. В Индии зарегистрировано очень мало случаев этого расстройства, поэтому важно изучать его клинические характеристики и приемлемые методы лечения, чтобы иметь возможность обеспечить таким пациентам адекватную неотложную помощь.
UNASSIGNED: В статье описано 4 случая пациентов с диагнозом ДМ — их демографические характеристики, клинические особенности, лабораторные и инструментальные данные, лечение. У всех пациентов отмечали острое начало и быстрое прогрессирование клинических симптомов. Частыми проявлениями были многоречивость, повышенная и психомоторная активность, сниженная потребность во сне, агрессивное и буйное поведение, усиление либидо, повышенный аппетит, бред величия, дезориентация во времени/пространстве/личности, нарушение памяти на недавние события, нарушение внимания по типу неустойчивости, негативизм, эхолалия, эхопраксия.
UNASSIGNED: В связи с отсутствием специфических диагностических рекомендаций для делириозной мании высока вероятность допущения диагностической ошибки. Во всех подобных случаях необходимо активно искать этиологические факторы, лежащие в основе ДМ. Для лечения менее тяжёлых форм ДМ могут применяться атипичные антипсихотические препараты и нормотимики. Хороший терапевтический эффект дают модифицированная электросудорожная терапия и внутривенное введение бензодиазепинов.

UNASSIGNED: Deep brain stimulation (DBS) can be an effective therapy to control motor signs in patients with Parkinson\'s disease (PD). However, subthalamic nucleus (STN) DBS can induce undesirable psychiatric adverse effects, including elevated mood.
UNASSIGNED: We reported a video case of a 73-year-old male implanted with bilateral STN DBS who experienced stimulation-induced elevated mood. A correlation between mood changes and enhanced activation of the ventromedial region in the left STN was observed.
UNASSIGNED: This video case report illustrates STN DBS-induced elevated mood and enhances early symptom recognition for patients and diagnostic awareness for professionals.

This case report presents the clinical presentation, diagnosis, and management of a 16-year-old female with elevated cortisol levels who was diagnosed with mania. The patient exhibited symptoms consistent with a manic episode, including extreme euphoria, decreased need for sleep, impulsivity, and heightened irritability. Laboratory investigations revealed an elevated morning cortisol level, prompting further psychiatric evaluation. A diagnosis of bipolar I disorder, manic episode, was made based on established criteria. The patient was initiated on mood stabilizers and antipsychotic medications alongside psychoeducation for the patient and her family. This case underscores the potential association between cortisol dysregulation and mood disorders, highlighting the importance of comprehensive assessment and personalized treatment approaches in adolescents with bipolar disorder. Further research is needed to elucidate the underlying mechanisms linking cortisol dysregulation and mood disturbances and explore novel therapeutic interventions targeting hypothalamic-pituitary-adrenal axis dysfunction.

Gender confusion in the context of mania is very less frequently described in the literature. The actuality of a primary psychiatric condition in gender identity complaint has significant bearing on the applicable operation and prognostic. This case series describes cases of bipolar affective complaint presenting in a manic occasion whose mania was marked by hypersexuality and the desire to be of opposite gender. Both of these symptoms resolved with treatment of the manic occasion. Case 1 describes a 17-year-old male presenting with an episodic illness, with current manic episode. He is currently interested in boys and has started enjoying feminine activities. Upon treatment, his symptoms showed improvement. Case 2 describes a 22-year-old gay male, with a total duration of 7 years, current episode mania. Now, he is considering himself a lesbian and feels he is mentally a modern female. After 4 months of treatment, there was significant improvement in his complaints and he stopped cross-dressing as a female. Case 3 shows a 21-year-old female, with manic episode. After 1 month, the patient began acting and speaking more like a boy. The patient has shown improvement while taking lithium 900 mg, divalproex sodium 1000 mg, risperidone 6 mg, and chlorpromazine 150 mg. Gender dysphoria occurring along with a psychotic episode and resolving with management of the primary psychiatric disorder are rarely recorded. The central issue in similar cases is a proper workup and diagnosis. Psychiatrists should be aware of this scenario so that proper treatment strategies for gender incongruence can be planned and not be brushed aside as \"just another symptom.\"

Acute phase COVID-19 has been associated with an increased risk for several mental health conditions, but less is known about the interaction of long COVID and mental illness. Prior reports have linked long COVID to PTSD, depression, anxiety, obsessive compulsive symptoms, and insomnia. This case report describes a novel presentation of mania arising in the context of long COVID symptoms with attention given to possible interacting etiological pathways. The case report also highlights the need for integrated, multidisciplinary treatment to support patients whose alarming, confusing, and multidetermined symptoms increase risk of psychological deterioration.

暂无摘要。

A large number of people who have had COVID-19 have developed mental symptoms and mood disorders. Anxiety and depression prevail among affective pathology. Evidence is accumulating that the Sars-CoV-2 virus can induce mania or hypomania in people with no personal psychopathological history. Some clinical, anamnestic and paraclinical patterns of new-onset mania and hypomania have been found. In cases of severe manic symptoms, it is possible to quickly assume the occurrence of bipolar affective disorder. The predominance of depressive and anxiety syndromes in the long-term disease and the presence of vivid vegetative symptoms can mask brief and syndromally incomplete episodes of hypomania, which distorts the understanding of the disease as a bipolar disorder. This article presents such a clinical case of the occurrence of bipolar affective disorder in a patient who had COVID-19 with an asymptomatic course. Approaches to rational diagnosis and treatment are discussed.
У большого числа людей, перенесших COVID-19, развились симптомы психических расстройств. Среди аффективной патологии преобладают тревожные и депрессивные расстройства. Накапливаются данные, что вирус SARS-CoV-2 может индуцировать возникновение мании или гипомании у людей с отсутствием психопатологического анамнеза. Обнаружены некоторые клинико-анамнестические и параклинические закономерности впервые возникших постковидных маний и гипоманий. В случаях выраженной маниакальной симптоматики можно достаточно быстро предположить наличие биполярного аффективного расстройства. Преобладание в длиннике болезни депрессивных и тревожных синдромов и наличие ярких вегетативных симптомов могут маскировать короткие и синдромально незавершенные эпизоды гипомании, что затрудняет диагностику состояния как биполярного расстройства. В статье представлен клинический случай развития биполярного аффективного расстройства у пациента, перенесшего COVID-19 с бессимптомным течением. Обсуждены подходы к рациональной диагностике и терапии.

There is a lack of randomized clinical trials and few studies regarding long-acting injectable antipsychotics (LAIs) in adolescents. Non-adherence, aggressiveness, comorbid substance use disorder and lack of insight may represent the main reasons for starting LAIs. Hereby we describe a 16-year-old male adolescent subject with bipolar type I disorder and comorbid cannabinoid use disorder, successfully treated with two-injection start regimen of LAI aripiprazole. Two-injection start regime of aripiprazole could represent an effective and safe therapeutic option for adolescents with early onset bipolar disorder.

Antibiomanic episodes, or as the DSM-5 refers to them, drug-induced manic episodes, pose a clinical challenge that is still poorly understood. There is insufficient information on the most common clinical presentation, patient profile, or underlying aetiopathogenic mechanisms. We present the clinical case of a 67-year-old woman who, after starting treatment (clarithromycin and amoxicillin) for the eradication of Helicobacter pylori, bacteria presented with a brief manic episode, which resolved after withdrawal of both drugs and with antipsychotic treatment. The possible interaction of both drugs, as GABA antagonists, in the generation of such episodes is discussed, and the clinical importance of such episodes in psychiatric emergency departments and liaison and interconsultation psychiatry, is highlighted.