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Bipolar disorder is not difficult to treat! Surgery may have advantages over drug therapy

Time:2022-11-27 09:54:51 source:psychiatricethics.com author:Depression Read:356次
Bipolar disorder is not difficult to treat! Surgery may have advantages over drug therapy

Original article, misappropriation must be investigated. Recently, our department admitted a patient with bipolar disorder. The main reason for the attack was the dual pressure of study and examination. After 8 years of drug treatment, it still relapsed. The most annoying thing for family members is that the patient becomes special after the illness. Generosity, even profligacy, makes it harder for families that are already struggling. A 24-year-old girl, Xiao Ai (pseudonym), became depressed and depressed all day because of her declining academic performance and the pressure of exams during her schooling eight years ago. She described by herself that she was not interested in everything at that time, she didn't like to talk, she didn't want to go to school, she suspected that someone was targeting her and talking about her behind her back, and she was afraid that someone would follow and monitor her and want to harm her, and she could listen when no one was around. When someone scolded her, she talked to herself, laughed to herself, had an impulsive temper, and was hostile to her parents. Finally, under the persuasion of her family, the patient went to the psychiatry department of a local hospital and was diagnosed with schizophrenia, and she was given risperidone and other drug treatment in the outpatient department. , the condition did not improve significantly. After 2 months of outpatient treatment, Xiao Ai went to Wuhan Psychiatric Hospital with her parents and was finally diagnosed with bipolar disorder. She was treated with clozapine in the hospital. Xiao Ai was discharged after her condition improved. , was hospitalized for 3 times, and tried various antipsychotic drugs (clozapine, aripiprazole, risperidone) for symptomatic treatment, but still had auditory hallucinations, heard her mother cut her wrists, and heard someone say that she Gossip, thinks life is meaningless, thinks of suicide, sometimes babbles, speaks beyond the border, treats guests everywhere, buys things without looking at the price, brags about his ability and wants to make a lot of money in the future, loses his temper if his parents don’t give money , scolding parents, throwing things, affecting the normal life of the family. In general, people with bipolar disorder experience alternating symptoms of depression and mania. Some patients get up before dawn and start a very busy day; or do something out of line without thinking about it, and the results are always different, and there is no end to it. Most patients become extra generous after illness, and even spend extravagantly, buying some valuable but unnecessary items as decorations or giving them away at will; in severe cases, they often stop day and night, screaming, singing and dancing, and even unable to sit down to eat. Behavior without a clear purpose. Xiao Ai's symptoms are typical of refractory bipolar disorder. After regular drug treatment, the symptoms are still repeated. Therefore, the most suitable treatment for her at this stage is not drugs, but psychosurgery. In July 2022, Xiao Ai accompanied her parents to the Department of Functional Neurology of Shanghai Dongfang Hospital for hospitalization, and completed the operation one week after admission. After the operation, the patient's mood is stable, the sleep quality is improved, the symptoms such as sensitivity and suspicion, hallucinations, changes in emotional polarities, and family indifference are effectively controlled, the relationship with family members is eased, the parent's hard work can be understood, and the patient can get along well with other patients in the ward. Functional recovery, admitting that he is ill, self-reported hallucinations, exaggerated spending and other symptoms are eliminated, willing to cooperate with drug consolidation treatment after discharge. Video loading... Psychosurgery for the treatment of refractory bipolar disorder mainly regulates the emotional circuit nerve nuclei of the limbic system in the brain responsible for emotional conduction, corrects the abnormal conduction information, and balances the nerve nuclei in the nerve nuclei. Transmitter secretion, thereby controlling or eliminating mental symptoms. Of course, the operation is not a large craniotomy in the traditional sense, but a minimally invasive technique. The trauma to the patient's head is small, the invasiveness is small, and the postoperative recovery is fast. It only takes one week of hospitalization to be discharged. But surgery is definitely not the treatment of choice for people with schizophrenia. Patients must be carefully considered for use when they cannot control the condition and show progressive aggravation after various drug, psychological, instrumental treatment and other treatment methods. Before surgery, patients need to undergo strict approval procedures according to regulations, and be determined by expert evaluation and consultation, and undergo CT, MRI, DTI and other imaging examinations to maximize the safety of surgery.

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