Mehmet ASOGLU, Mustafa OZKAN, Abdullah ATLİ, Aslihan Okan IBİLOGLU

A rare case of first attack psychosis and Wilson’s disease

Wilson disease (WD) is an infrequent genetic disorder of copper metabolism (chromosome 13), with decreased transport of copper by hepatic lysosomes due to mutation in the Wilson disease protein (ATP7B) gene. Hence, accumulating copper is primarily affecting the liver, brain, cornea, and kidneys, after then leading to their symptomatic damages. During early ages, the patients are mostly presymptomatic. The worldwide prevalence was reported to be 1 in 30.000. Psychiatric symptoms are common with Wilson’s disease. Pychosis can be an initial manifestation and often leads to an inaccurate diagnosis. As is seen, clinical syndrome may be very complex. Therefore, detecting mental health disorders of secondary origin is very important for the mental health professionals. In conclusion, one must be aware of the possibility of an organic cause in patients who are admitted with psychiatric symptoms, for the first time. On the other hand, medical causes of psychiatric symptoms should always be considered. Here, we report on a case of psychotic disorder due to Wilson’s disease, presenting with psychotic symptoms and bizarre behaviour.

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1. Kaplan HI, Sadock BJ. Comprehensive textbook of psychiatry. 7th ed. Baltimore, Maryland: Williams&Wilkins. 1999; p.291.
2. Scheinberg I, Sternlieb I. Wilson’s Disease. Major Probl Intern Med. 1984;23:1-24.
3. Akil M, Brewer GJ. Psychiatric and behavioral abnormalities in Wilson’s disease. Adv Neurol. 1995;65:171-8.
4. Akil M, Schwartz JA, Dutchak D, Yuzbasiyan-Gurkan V, Brewer GJ. The psychiatric presentations of Wilson’s disease. J Neuropsychiatry Clin Neurosci. 1991;3(4):377-82. [CrossRef]
5. Dening TR. The neuropsychiatry of Wilson’s disease: a review. Int J Psychiatry Med. 1991;21(2):135-48. [CrossRef]
6. Zucker S, Gollan J. Copper metabolism and Wilson’s disease. Anion recent advances. In: Modern Concepts in Gastroenterology, eds ABR Thomas and S Shaffer, vol 3, New York: Plenum Medical Book Co, 1992;223-226. [CrossRef]
7. Dening TR, Berrios GE. Wilson’s disease: a longitudinal study of psychiatric symptoms. Biol Psychiatry. 1990;28(3):255-65. [CrossRef]
8. Wichowicz HM, Cubała WJ, Sławek J. Wilson’s disease associated with delusional disorder. Psychiatry Clin Neurosci. 2006;60(6):758- 60. [CrossRef]
9. Shanmugiah A, Sinha S, Taly AB, Prashanth LK, Tomar M, Arunodaya GR, et al. Psychiatric manifestations in Wilson’s disease: a cross-sectional analysis. J Neuropsychiatry Clin Neurosci. 2008;20(1):81-5. [CrossRef]
10. American Psychiatric Association. Diagnostic and statistical manual of psychiatric disorders. 5th ed. Washington (DC): American Psychiatric Association; 2013.
11. Bidaki R, Zarei M, Mirhosseini SM, Moghadami S, Hejrati M, Kohnavard M, et al. Mismanagement of Wilson’s disease as psychotic disorder. Adv Biomed Res. 2012;1:61. [CrossRef]
12. Zimbrean PC, Schilsky ML. Psychiatric aspects of Wilson disease: A review. Gen Hosp Psychiatry. 2014;36(1):53-62. [CrossRef]
13. Walshe JM, Yealland M. Not Wilson’s disease: a review of misdiagnosed cases. QJM 1995;88(1):55-9.
14. Dening TR, Berrios GE. Wilson’s disease. Psychiatric symptoms in 195 cases. Arch Gen Psychiatry. 1989;46(12):1126-34. [CrossRef]
15. Ferenci P, Caca K, Loudianos G, Mieli-Vergani G, Tanner S, Sternlieb I, et al. Diagnosis and phenotypic classification of Wilson disease. Liver Int. 2003;23(3):139-42. [CrossRef]