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Toothache

Published online by Cambridge University Press:  13 August 2021

E. Rodríguez Vázquez*
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
C. Capella Meseguer
Affiliation:
Psiquiatría, HCUV, Valladolid, Spain
J. Gonçalves Cerejeira
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
I. Santos Carrasco
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
G. Guerra Valera
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
M. Queipo De Llano De La Viuda
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
A. Gonzaga Ramírez
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
C. Vallecillo Adame
Affiliation:
Psiquiatría, Hospital Clínico Universitario Valldolid, Valladolid, Spain
T. Jiménez Aparicio
Affiliation:
Psiquiatría, Hospital Clínico Universitario Valladolid, Valladolid, Spain
C. De Andrés Lobo
Affiliation:
Psiquiatría, HCUV, Valladolid, Spain
A. Pérez Escudero
Affiliation:
Psiquiatría, Hospital Clínico Universitario Valladolid, Valladolid, Spain
*
*Corresponding author.

Abstract

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Introduction

Mental retardation (RM) is defined as by a deficient intellectual capacity as well as by alterations of the adaptive capacity that are externalized in two or more functional areas (Personal autonomy, Communication, Orientation in the environment, Work and Free time).

Objectives

Present a patient with a severe behavioural disturbance with an associated intellectual deficit, who remained hospitalized for 2 months and after observing an oral alteration her symptoms improved.

Methods

A descriptive study of a clinical case

Results

54-year-old woman, single. You have a moderate intellectual disability. In January 2019, she began mental health consultations with a diagnosis of adjustment disorder, on treatment with aripiprazole 5 mg/day, mirtazapine 15 mg/day, lorazepam 0.5 mg/day and dipotassium clorazepate 10 mg/day. Went to the emergency room with mutism, hyporesponsiveness and refuse to intake, having lost 25 kg in 6 months. Abdominal and thoracic CT and upper gastrointestinal endoscopy without significant findings. Consultation with otorhinolaryngology, dermatology, traumatology without significant findings. Odontostomatology consultation: Deep cavities are observed, so it is necessary to carry out extractions of the pieces in poor condition. After this intervention, the patient returns to accept oral intake.

Conclusions

People with intellectual disabilities have a wide range of medical problems that in many cases are directly associated with the underlying disease or syndrome and, in others, with poor physical health due to problems in basic self-care skills or the ability to express verbally. Usually, the first manifestation of pain is an alteration in behaviour, which must be taken into account when making a differential diagnosis.

Disclosure

No significant relationships.

Type
Abstract
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), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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