COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.

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Anxiety disorders are of great importance in emergency psychiatry, both because of the frequency with which they occur, and because of the relevance of somatic diseases that can underlie an anxious condition. It is imperative to determine, from the initial diagnostic approach, whether the signs and...

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Detalles Bibliográficos
Autores: Rodríguez-León, Jamie, Ortiz-Pinillos, Lorena Lucía, Cruzado, Lizardo
Formato: artículo
Fecha de Publicación:2021
Institución:Universidad Peruana Cayetano Heredia
Repositorio:Revistas - Universidad Peruana Cayetano Heredia
Lenguaje:español
OAI Identifier:oai:revistas.upch.edu.pe:article/3937
Enlace del recurso:https://revistas.upch.edu.pe/index.php/RNP/article/view/3937
Nivel de acceso:acceso abierto
Materia:Anxiety
diabetic ketoacidosis
coronavirus infections
Ansiedad
cetoacidosis diabética
infecciones por coronavirus.
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spelling COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.Covid-19 y cetoacidosis diabética erróneamente diagnosticadas como ansiedad primaria: Reporte de un caso acerca de causas médicas versus psiquiátricas de ansiedad.Rodríguez-León, JamieOrtiz-Pinillos, Lorena LucíaCruzado, LizardoAnxietydiabetic ketoacidosiscoronavirus infectionsAnsiedadcetoacidosis diabéticainfecciones por coronavirus.Anxiety disorders are of great importance in emergency psychiatry, both because of the frequency with which they occur, and because of the relevance of somatic diseases that can underlie an anxious condition. It is imperative to determine, from the initial diagnostic approach, whether the signs and symptoms of anxiety constitute either a response to stress, are manifestations of an underlying somatic pathology, or are explained as symptoms of a specific, primary psychiatric disorder. Currently, the COVID-19 pandemic --in which Peru has had the highest mortality rate in the world—is overwhelming the health services with complex and confusing pictures in which both the symptoms of the viral infection itself, as well as the of anxious reactions and stress responses are combined. On the basis of an illustrative case, in which the medical screening process was deficient and the patient was labeled as  a primary case of “anxiety”, with a regrettably ominous outcome, the literature about medical clearance is briefly reviewed, to categorically highlight the importance of a comprehensive and unbiased diagnostic consideration, based on well-developed and substantiated clinical criteria. On the other hand, the psychiatrist nowadays needs to be updated on the forms of psychopathological presentations associated with the symptoms of COVID-19.Los trastornos de ansiedad tienen gran importancia en la psiquiatría de urgencias, tanto por la frecuencia con la que se presentan, como por la relevancia de las enfermedades somáticas que pueden subyacer a un cuadro ansioso. Resulta imperativo determinar desde el abordaje diagnóstico inicial si los signos y síntomas de la ansiedad constituyen una plena respuesta a situaciones de estrés, son manifestaciones de una patología somática subyacente, o se pueden explicar como síntomas de un trastorno psiquiátrico primario específico. En el momento actual, la pandemia de COVID-19 –en la que el Perú ha llegado a tener la mayor tasa de mortalidad mundial-- desborda los servicios de salud con abigarrados cuadros en los que se combinan tanto los síntomas de la infección viral por sí misma, como los de reacciones ansiosas y respuestas al estrés. A propósito de un caso ilustrativo, en el que el proceso de tamizaje médico fue deficitario y se etiquetó al paciente como un caso primario de “ansiedad”, con un desenlace lamentablemente ominoso, se revisa brevemente la literatura acerca del proceso de medical clearance  (o descarte de condiciones  médicas) y se reafirma concluyentemente la importancia de una consideración diagnóstica inicial abarcadora, no sesgada, y basada en criterios clínicos sólidamente elaborados y sustentados. Es evidente, por otro lado, que el psiquiatra requiere estar permanentemente actualizado sobre las formas de presentación psicopatológica asociadas a la sintomatología de COVID-19.Universidad Peruana Cayetano Heredia2021-04-08info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://revistas.upch.edu.pe/index.php/RNP/article/view/393710.20453/rnp.v84i1.3937Revista de Neuro-Psiquiatria; Vol. 84 No. 1 (2021): January - March; 51-57Revista de Neuro-Psiquiatría; Vol. 84 Núm. 1 (2021): Enero-Marzo; 51-57Revista de Neuro-Psiquiatria; v. 84 n. 1 (2021): Enero-Marzo; 51-571609-73940034-8597reponame:Revistas - Universidad Peruana Cayetano Herediainstname:Universidad Peruana Cayetano Herediainstacron:UPCHspahttps://revistas.upch.edu.pe/index.php/RNP/article/view/3937/4483info:eu-repo/semantics/openAccessoai:revistas.upch.edu.pe:article/39372023-10-05T15:35:49Z
dc.title.none.fl_str_mv COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.
Covid-19 y cetoacidosis diabética erróneamente diagnosticadas como ansiedad primaria: Reporte de un caso acerca de causas médicas versus psiquiátricas de ansiedad.
title COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.
spellingShingle COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.
Rodríguez-León, Jamie
Anxiety
diabetic ketoacidosis
coronavirus infections
Ansiedad
cetoacidosis diabética
infecciones por coronavirus.
title_short COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.
title_full COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.
title_fullStr COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.
title_full_unstemmed COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.
title_sort COVID-19 and diabetic ketoacidosis misdiagnosed as primary anxiety: A case report on medical versus psychiatric causes of anxiety.
dc.creator.none.fl_str_mv Rodríguez-León, Jamie
Ortiz-Pinillos, Lorena Lucía
Cruzado, Lizardo
author Rodríguez-León, Jamie
author_facet Rodríguez-León, Jamie
Ortiz-Pinillos, Lorena Lucía
Cruzado, Lizardo
author_role author
author2 Ortiz-Pinillos, Lorena Lucía
Cruzado, Lizardo
author2_role author
author
dc.subject.none.fl_str_mv Anxiety
diabetic ketoacidosis
coronavirus infections
Ansiedad
cetoacidosis diabética
infecciones por coronavirus.
topic Anxiety
diabetic ketoacidosis
coronavirus infections
Ansiedad
cetoacidosis diabética
infecciones por coronavirus.
description Anxiety disorders are of great importance in emergency psychiatry, both because of the frequency with which they occur, and because of the relevance of somatic diseases that can underlie an anxious condition. It is imperative to determine, from the initial diagnostic approach, whether the signs and symptoms of anxiety constitute either a response to stress, are manifestations of an underlying somatic pathology, or are explained as symptoms of a specific, primary psychiatric disorder. Currently, the COVID-19 pandemic --in which Peru has had the highest mortality rate in the world—is overwhelming the health services with complex and confusing pictures in which both the symptoms of the viral infection itself, as well as the of anxious reactions and stress responses are combined. On the basis of an illustrative case, in which the medical screening process was deficient and the patient was labeled as  a primary case of “anxiety”, with a regrettably ominous outcome, the literature about medical clearance is briefly reviewed, to categorically highlight the importance of a comprehensive and unbiased diagnostic consideration, based on well-developed and substantiated clinical criteria. On the other hand, the psychiatrist nowadays needs to be updated on the forms of psychopathological presentations associated with the symptoms of COVID-19.
publishDate 2021
dc.date.none.fl_str_mv 2021-04-08
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://revistas.upch.edu.pe/index.php/RNP/article/view/3937
10.20453/rnp.v84i1.3937
url https://revistas.upch.edu.pe/index.php/RNP/article/view/3937
identifier_str_mv 10.20453/rnp.v84i1.3937
dc.language.none.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv https://revistas.upch.edu.pe/index.php/RNP/article/view/3937/4483
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
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dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad Peruana Cayetano Heredia
publisher.none.fl_str_mv Universidad Peruana Cayetano Heredia
dc.source.none.fl_str_mv Revista de Neuro-Psiquiatria; Vol. 84 No. 1 (2021): January - March; 51-57
Revista de Neuro-Psiquiatría; Vol. 84 Núm. 1 (2021): Enero-Marzo; 51-57
Revista de Neuro-Psiquiatria; v. 84 n. 1 (2021): Enero-Marzo; 51-57
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