Case study Fear of losing control again, an indication for exposure or prodromal?

Zeeuws, D. (Dieter)¹, Vanderbruggen, N. (Vanderbruggen)¹, Van Geit, N. (Nele)^1
1Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, België

 

Submission type

Poster only

Scheduled

Poster, Beurs van Berlage , Grote Zaal

Kernwoorden

OCD Rorschach Disclosure Psychotic vulnerability

Onderzoeksgebied

Assessment, differential diagnosis & comorbidity

Introductie

Psychocybine use induced a, possibly excessive, fear to dissociate. After a single intake several years ago, an educated young man experienced multiple episodes of derealisation and depersonalisation (“like being in a cartoon”) while maintaining a high level of functioning. As an adolescent he was treated for obsessive compulsive disorder and he seemed to cope with his current perceptual distortions using mechanisms of control such as shifting his focus and distraction.

Materiaal en methodes

Considering his bad trip as a traumatic experience, we contemplated on the use of exposure therapy with anxiety and psychosis inducing stimuli, but wanted to test the vulnerability for psychosis first. Posttraumatic stress disorder is often treated with exposure and psychosis does not form a contra-indication, but less is known in case of psychotic vulnerability.

Resultaten

In this report of a man in fear of becoming psychotic, we describe the differential diagnosis as discussed in our multidisciplinary staff-meeting and with the patient. Elaborating on the test results and a scheme with complaints, circumstances and personal factors. We comment on the therapeutical implications, ethical considerations and psychological distress following early disclosure of his presumed diagnosis.

Auteurs