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Category: Volume 07 Issue 12 December 2019
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Title: The Dilemma of Comorbidity: Borderlands between Bipolarity and Conversion

Authors; Dr Pavithra Arunachaleeswaran, Dr Vinod G Kulkarni, Dr Shashidara HL, Dr Mruthyunjaya N

 DOI: https://dx.doi.org/10.18535/jmscr/v7i12.142

Abstract

In this case report, we discuss a case with overlapping features of mania and conversion disorder and discuss the diagnostic dilemma.30yr old married woman, pre-morbidly argumentative and sensitive to criticism, was brought with complaints of episodic altered behaviour for 2 months, in form of physical aggression, episodes of singing and dancing at inappropriate times, proclaiming to be God, with sudden episodes of unresponsiveness, reduced sleep and appetite. Past history of similar illness 3 years ago, with poor treatment compliance. No depressive symptoms during course of illness. MSE: pt not communicative; not cooperative with Placid facial expression; closes her eyes tightly and refuses to open even against efforts.  Management: T. Olanzapine 5mg was started, considering her aggression and manic symptoms. Throughout her hospital stay, aggression/ altered behaviour was not observed.  With the suggestion of discharge only on grounds of improvement, she was noticed to have change in prior behaviour in form of better communication with family members.

Our case attempts to explore the overlap between Bipolar disorder and dissociative disorder with points in favour of both, necessitating a current symptomatic approach and better understanding of the comorbid interface.

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Corresponding Author

Dr Pavithra Arunachaleeswaran

Junior Resident, Department of Psychiatry, SS Institute of Medical Science and Research Centre, Davangere