Psychological and Behavioral Factors Associated with Cyclic Vomiting Syndrome: Case Report

I. Putu Candra S. Sutarta; I. Gusti Ayu I. Ardani; Luh Nyoman A. Aryani; I. Gusti Ayu T. Windiani; I. Gusti Ngurah S. Adnyana; Yunias Setiawati

doi:10.3889/oamjms.2022.8014

Authors

I. Putu Candra S. Sutarta Department of Psychiatry, Medical Faculty, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
I. Gusti Ayu I. Ardani Department of Psychiatry, Medical Faculty, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
Luh Nyoman A. Aryani Department of Psychiatry, Medical Faculty, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
I. Gusti Ayu T. Windiani Department of Paediatrics, Medical Faculty, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
I. Gusti Ngurah S. Adnyana Department of Paediatrics, Medical Faculty, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
Yunias Setiawati Department of Psychiatry, Medical Faculty, Airlangga University, Dokter Soetomo Hospital, Surabaya, East Java, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8014

Keywords:

Cyclic vomiting syndrome, Psychological factors, Amytriptiline

Abstract

Introduction:Cyclic vomiting syndrome is a disorder of unknown etiology and pathogenesis characterized by recurrent and stereotypical vomiting episodes with varying intervals from baseline or normal health in between. The biopsychosocial model proposes that disease does not result from a single etiology but from systems that interact simultaneously at the cellular, tissue, organismal, interpersonal, and environmental levels. In addition, psychosocial factors have direct and reverse physiological and pathological consequences. Case: In this case report, A 17-year-old boy was consulted to the psychiatry department because of repeated vomiting suspected of psychological factors. The patient was hospitalized due to vomiting. This vomiting has been experienced by the patient since around 2 months before the examination. Patient’s father and stepmother actually really love this patient, but in the patient's perception, the patient's father and mother are less adequate in how to show their affection. The patient realized that his father loved him but felt in some ways, the patient was uncomfortable because he felt that he did not fit his father's mindset.

Conclusion:The patient was diagnosed with Psychological and Behavioral Factors Associated with Cyclic Vomiting Syndrome (F54). Pharmacological therapy with 12.5 mg Amytriptiline tablet, 0.5 mg Risperidone tablet, and 5 mg Clobazam tablet every 24 hours orally (evening), while the non-pharmacological therapy given was supportive psychotherapy and psychoeducation to the parent.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Person H, Keefer L. Psychological comorbidity in gastrointestinal disease: Update on the brain-gut-microbiome axis. Prog Neuropsychopharmacol Biol Psychiatry. 2020;107(20):110209. https://doi.org/10.1016/j.pnpbp.2020.110209 PMid:33326819 DOI: https://doi.org/10.1016/j.pnpbp.2020.110209

Mader SS. Understanding Human Anatomy and Physiology. New York: The McGrew-Hill; 2006.

Sleisenger MH, Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. Philadelpia, PA: Saunders/Elsevier; 2010.

Leigh H, Streltzer J. Handbook of Consultation-Liaison Psychiatry. New York: Springer; 2008. DOI: https://doi.org/10.1007/978-0-387-69255-5

Garralda ME. Functional somatic symptoms and somatoform disorders in children. In: A Clinician’s Handbook of Child and Adolescent Psychiatry. Cambridge: Cambridge University Press; 2005. p. 246-70.

World Health Organization. Available from: http://www.who.int/tropics/depression/en. [Last accessed on 2017 Mar 6].

Boland R, Verduin ML, Ruiz P. Kaplan and Saddock’s Synopsis of Psychiatry. 12th ed. Philadelphia, PA: Wolters Kluwer; 2022.

Sunku B, Li BU. Cyclic vomiting syndrome. In: Textbook of Gastroenterology and Nutrition. London: Taylor and Francis Group; 2004. p. 289-302.

Amos JJ, Robinson RG. Psychosomatic Medicine an Introduction to Consultation-Liaison Psychiatry. Cambridge: Cambridge University Press; 2010. DOI: https://doi.org/10.1017/CBO9780511776878

Yao X, Yang Y, Zhang S, Shi Y, Zhang Q, Wang Y. The impact of overlapping functional dyspepsia, belching disorders nad functional heratburn anxiety, depression and quality of life of chinese patients with irritable bowel syndrome. BMC Gastroenterol. 2020;20:209. DOI: https://doi.org/10.1186/s12876-020-01357-1

Rathi P, Gill A, Vankar GK, Ohri N, Patel A. Study of depression and anxiety in endoscopically diagnosed cases of gastro-oesophageal reflux disease (GERD). Indian J Ment Health. 2018;5(3):307-16. DOI: https://doi.org/10.30877/IJMH.5.3.2018.307-316

Departemen Kesehatan R.I. Direktorat Jenderal Pelayanan Medik, Pedoman Penggolongan Diagnosis Gangguan Jiwa di Indonesia III, Jakarta: Departemen Kesehatan RI; 1993.

American Psychiatric Association. Diagnosis and Statistical Manual for Mental Disorders. Arlington: American Psychiatric Association, 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596

Kim SY, Kim HJ, Lim H, Kong IG, Kim M, Choi HG. Bidirectional Association Between Gastrophageal Reflux Disease and Depression: Two Different Nested Case-control Studies Using A National Sample Cohort, Scientific Reports; 2018. p. 1-8. DOI: https://doi.org/10.1038/s41598-018-29629-7

Wise MG, Rundell JR. Clinical Manual of Psychosomatic Medicine A Guide to Consultation-Liaison Psychiatry. Arlington: American Psychiatric Publishing, Inc.; 2005.

Badihian N, Saneian H, Badihian S, Yaghini O. Prophylactic therapy of cyclic vomiting syndrome in children: Comparison of amitriptyline and cyproheptadine: A randomized clinical trial. Am J Gastroenterol. 2018;113(1):135-40. https://doi.org/10.1038/ajg.2017.194 PMid:28719594 DOI: https://doi.org/10.1038/ajg.2017.194