jabbrv-ltwa-all.ldf
jabbrv-ltwa-en.ldfPatient 1
Patient 1 is a 57-year-old male who first came into contact with
psychiatry at age 33, presenting with depressive symptoms including
rumination and social withdrawal. He was diagnosed with major depressive
disorder (MDD, Table 1). He also had a childhood onset of anxiety and
was diagnosed with GAD in adulthood. Over time, the depressive symptoms
worsened, leading to suicidal ideation, and he was hospitalized after a
suicide attempt. He subsequently developed alcohol and benzodiazepine
dependence, requiring treatment from an addiction psychiatry unit.
Despite achieving three years of remission from alcohol and
benzodiazepine use disorder, the depression and anxiety symptoms
persisted, continuing to meet the criteria for MDD and GAD. Patient 1
also had a history of thyrotoxicosis and underwent a thyroidectomy at
age 38. He later developed type II diabetes mellitus, \soutand
sarcoidosis and suffered from chronic lumbar pain.
Throughout his contact with specialized psychiatric care, he tried
numerous medications for depression and GAD, including antidepressants
(paroxetine, mirtazapine, citalopram, escitalopram, tranylcypromine, and
venlafaxine), lamotrigine, and lithium, all with insufficient
antidepressant effect. Electroconvulsive therapy (ECT) was administered
on three separate occasions, providing only temporary relief of symptoms
lasting from a few hours to a few days. He also underwent several rounds
of psychotherapy and physiotherapy treatments. Over the years,
benzodiazepines (e.g. oxazepam, alprazolam), pregabalin, and gabapentin
were prescribed for anxiety symptoms, but without long-lasting effects.
Ultimately, due to the severity and treatment-resistant nature of his
depressive and anxiety symptoms, he was referred for DBS.