Psychosis risk syndrome comorbid with panic attack disorder in a cannabis-abusing patient affected by Arnold-Chiari malformation type I

Gen Hosp Psychiatry. 2012 Nov-Dec;34(6):702.e5-7. doi: 10.1016/j.genhosppsych.2011.12.008. Epub 2012 Jan 27.

Abstract

Objective: An 18-year-old man with Arnold-Chiari malformation (ACM) type I developed sudden panic attacks. He also manifested sleep disorder, cannabis abuse, and psychosis-risk syndrome (PRS). Although with average-superior intelligence, he had executive dysfunction. This prompted us to explore the relation between ACM, cannabis abuse, PRS and panic disorder.

Method: We report the case and briefly review the literature focusing on ACM and psychiatric disorders.

Results: Behavior therapy led to gradual abstinence from cannabis with disappearance of anxiety symptoms. The patient is currently well and maintained on omega-3 polyunsaturated fatty acids.

Conclusions: Locus coeruleus compression and cannabis abuse may have triggered the symptoms, and the latter might also be PRS-related. PRS and anxiety symptoms should be explored in ACM patients to allow better prevention of psychosis and anxiety disorders.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Arnold-Chiari Malformation / complications*
  • Arnold-Chiari Malformation / pathology
  • Arnold-Chiari Malformation / psychology
  • Behavior Therapy
  • Fatty Acids, Omega-3 / therapeutic use
  • Humans
  • Locus Coeruleus / pathology
  • Locus Coeruleus / physiopathology
  • Male
  • Marijuana Abuse / complications*
  • Marijuana Abuse / therapy
  • Panic Disorder / complications*
  • Panic Disorder / therapy
  • Prodromal Symptoms
  • Psychotic Disorders / complications*
  • Psychotic Disorders / therapy
  • Syndrome

Substances

  • Fatty Acids, Omega-3