Making a medical diagnosis in an elderly person presenting with first time psychiatric symptoms can be challenging.
A 61 year old lady presented with 4 years history of tactile hallucinations in her legs and delusions of persecution,
and 2 weeks history of depression and mild cognitive impairment. There were no other significant physical findings,
except for dysarthria and fine bilateral hand tremors. As patient had no prior psychiatric history, she was investigated
for differential diagnoses of late-onset schizophrenia, psychotic depression and early dementia. A thorough
investigation for concomitant medical illnesses was done which revealed low serum calcium, high serum phosphate
and relatively low serum parathyroid hormone levels. A diagnosis of Fahr’s syndrome (FS) was made based on
history, hematological findings of idiopathic hypoparathyroidism and bilateral basal ganglia calcifications (BGC)
on neuroimaging. Treatment of FS is non-specific and mainly symptomatic. This patient improved with treatment
comprising antidepressant, antipsychotic and calcium supplement.
Objective: According to Malaysian law, defendants found not guilty by reason of insanity may be admitted to a psychiatric hospital and discharge is subject to the state ruler’s assent. The objective of this study is to examine the clinical, socio-demographic and forensic factors that influence inpatient duration of insanity acquittees in a Malaysian mental institution. Methods:This is a cross-sectional study of one hundred and twelve insanity acquittee inpatients in Hospital Bahagia Ulu Kinta from January 2007 to February 2007. Patients with a clinical diagnosis of schizophrenia, major depressive disorder and bipolar disorder were assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD) and Young Mania Rating Scale (YMRS) respectively. Other relevant sociodemographic, clinical and forensic factors were also assessed. Results: The inpatient duration varied widely from three months to forty-seven years with a median of seven years. Seventy five percent of patients were in remission. According to the multiple linear regression model, the strongest predictor of a longer duration of hospital stay for insanity acquittees was older age (p
To determine the behavioural impact of chemotherapy in survivors of acute lymphoblastic leukaemia (ALL) treated with chemotherapy only and to identify treatment-related or sociodemography-related factors that might be associated with behavioural outcome.