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The Psychotic Couple--Sharing Drugs or Delusions?

Authors: Julien, Springs;

The Psychotic Couple--Sharing Drugs or Delusions?

Abstract

Mephedrone and methylenedioxypyrovalerone (MDPV) are common compounds found in "Bath Salts," a recreational drug which has skyrocketed in popularity, resulting in increasing annual emergency room visits across the country. As users are often young and without previous psychiatric history it is often difficult to discern if symptoms are substance induced or related to an organic disorder. Our patient was a 38-year-old woman with no history of psychosis who presented to the emergency room following two failed suicide attempts via overdose and self-mutilation. On initial examination, the patient was somnolent yet arousable and oriented. She endorsed auditory and visual hallucinations as well as paranoid delusions regarding being spied on by her son. Upon further questioning, patient admitted to use of bath salts one day prior to admission and urine toxicology was positive for phenycyclidine. She was admitted for stabilization but despite improvement in her hallucinations, her paranoia persisted. She was visited by her husband who also expressed similar paranoid delusions, raising the question as to whether her symptoms were truly substance induced or if the patient was experiencing a shared psychotic disorder with her spouse. Prior to discharge, her hallucinations and paranoia had improved with abstinence from bath salts and the initiation of olanzapine. She was able to gain some insight, recognizing the delusions were false yet her husband still continued to believe they were true. As such, we concluded that the couple's psychotic symptoms were more likely related to shared bath salts rather than shared delusions.

Keywords

Adult, Male, Psychiatric Status Rating Scales, Psychoses, Substance-Induced, Shared Paranoid Disorder, Hospitalization, Substance Abuse Detection, Benzodiazepines, Alkaloids, Treatment Outcome, Olanzapine, Humans, Central Nervous System Stimulants, Female, Antipsychotic Agents

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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