Brief Psychotic Disorder during Consolidation Therapy for Acute Lymphoblastic Leukemia in an Adolescent

概要

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A 12-year-old boy developed a brief psychotic disorder during consolidation chemotherapy at 4 mo after the initiation of therapy for acute lymphoblastic leukemia (ALL), with symptoms such as confusion, illusion, delusion and disassociated conversation. Till then, his clinical course was uneventful with little side effect of chemotherapy. He had been informed of his laboratory data, and thus suspected the disease, but the ALL diagnosis was not openly notified to the patient. He could not confide anyone regarding the anxiety of his suspected illness although he had concerns he might not be getting well. With the assistance of counseling therapy and an antipsychotic drug (haloperidol), he managed to quickly recover from the psychotic disorder, at which time we found brain SPECT studies were useful. To avoid such psychotic episodes in ALL patients, providing sufficient information at the time of diagnosis announcement the disease and information on management to the patients seems necessary not only at the onset or discharge of the disease, but also at any time during treatment, whenever necessary. Needless to say, it is more important for pediatric hemato-oncologists to confirm how much patients understand about their disease status and release them from their anxieties.
特定非営利活動法人　日本小児血液・がん学会の論文