Jasminka Milosevic and Jessica Henry
University of Auckland, New Zealand
Waitemata District Health Board, New Zealand
Posters & Accepted Abstracts: Brain Disord Ther
This case report outlines challenges the authors faced in diagnosing and engaging a Caucasian woman with Systemic Lupus Erythematosus (SLE) psychosis to accept treatment. Presentation: The patient is a 57 year old Caucasian woman (Lana) who lives alone, works as a caregiver in a resthome, and has four adult children. She presented disorganised in behaviour, with persecutory delusions and auditory hallucinations, mistrustful and guarded. Prior to the onset of psychotic symptoms she had a prolonged exposure to sunlight which caused development of rash and skin lesions. She also has cognitive impairment. Diagnosis of cutanous lupus was made in 1999. She is smoking tobacco and cannabis, and drinking alcohol, sometimes in excess (binge). Past History: Two admissions to psychiatric units; the first one was in Australia in 2003/4. Details of this admission and treatment are unknown. The second one was in New Zealand nine months previously, under Mental Health Act. Lana recovered quickly with treatment. Following the discharge from the psychiatric hospital, Lana did not engage with the community mental health service (MHS) and she stopped treatment two months post discharge. Challenge: To provide accurate diagnosis and a long term treatment to prevent relapse of psychosis in a person who is mistrustful, unwilling to engage with MHS and take medication. Lana stated her preference for herbal and naturopathic treatment and remedies. Outcome: Lana engaged with MHS and she was treated in the community. She is taking olanzapine at recommended dose by MHS and is under her family doctor’s care.
Jasminka Milosevic is a Consultant Psychiatrist and Honorary Senior Lecturer. She is Fellow of Royal Australia and New Zealand College of Psychiatrists. She works at the Waitemata District Health Board in Auckland. She attained a Doctor of Medicine degree at Medical School, University of Zagreb, Croatia; Graduate diploma in Arts (Psychology), Massey University New Zealand; Certificate in Child, Infant and Adolescent Mental Health, University of Otago, New Zealand; and Post graduate Diploma in Public Health, University of Otago, New Zealand.
Dr. Jessica Henry is Senior Psychiatric Registrar at the Waitemata District Health Board in Auckland, New Zealand.