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Concomitant diagnosis of bipolar disorder and tuberous sclerosis - a case report

Published online by Cambridge University Press:  01 September 2022

M. Santos ,
T. Ferreira ,
P. Neves  and
J. Peres
M. Santos*
Affiliation:
Hospital Prof. Doutor Fernando Fonseca, Psychiatry, Amadora, Portugal
T. Ferreira
Affiliation:
Hospital Prof Doutor Fernando Fonseca, Mental Health Department, Amadora, Portugal
P. Neves
Affiliation:
Hospital Prof Doutor Fernando Fonseca, Amadora, Portugal, Neurology, Amadora, Portugal
J. Peres
Affiliation:
Hospital Prof Doutor Fernando Fonseca, Amadora, Portugal, Neurology, Amadora, Portugal
*
*Corresponding author.

Abstract

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Introduction

Tuberous sclerosis is a multisystem genetic disorder. It is associated with significant psychiatric comorbidity mainly autistic disorders, hyperkinetic disorders, depression and anxiety. It is rarely associated with psychosis and bipolar disorder.

Objectives

To describe the case of a 34-year-old male with concomitant diagnosis of bipolar disorder and tuberous sclerosis.

Methods

Case report based on clinical records. Brief literature review using articles searched in the PubMed/MEDLINE database using the terms “tuberous sclerosis”, “bipolar disorder” and “neuropsychiatric”.

Results

The patient presented at our Emergency Department 3 years ago with a mixed episode with psychotic symptoms with 1 month of duration. Prior history of two hypomanic episodes, but no depressive episodes. High baseline functionality. Sporadic use of alcohol and cannabis. No family history of psychiatric or neurological diseases. Diagnostic work-up showed no relevant results, aside from small calcifications in brain CT. He was admitted to our ward and medicated with aripiprazol (titrated up to 30 mg), leading to full remission of the clinical picture. The patient was referred to our outpatient clinic and stayed with medication for 1,5 years. One year after, he presented a sudden episode of mutism and perplexity with quick remission. The EEG wielded no relevant results. New brain CT showed signs of tuberous sclerosis. He was referred to Neurology and subsequent assessments, including brain MRI, led to the fulfilment of clinical criteria for tuberous sclerosis.

Conclusions

This case illustrates the possibility of concomitant diagnosis of bipolar disorder and tuberous sclerosis. The possible association between these disorders is discussed.

Disclosure

No significant relationships.

Keywords

Tuberous sclerosisNeuropsychiatrybipolar disorder
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S878
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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