Acute polymorphic psychotic disorder with symptoms of schizophrenia – A case report

Abstract

Introduction: Acute polymorphic psychotic disorder (APPD) with symptoms of schizophrenia is a rare psychiatric presentation with a rapidly changing and variable clinical state. There is much scope to explore the effectiveness of homoeopathy in acute psychotic disorders. Due to the rarity of its presentation, a case of APPD managed with homoeopathic medicines is reported here. Case Summary: A 49-year-old female was brought in a restrained state due to disorganized behaviour, violent anger with hurting tendency, irrelevant talk, bizarre delusions, and markedly variable perceptual disturbances. The case was diagnosed as APPD with symptoms of schizophrenia and the improvement was assessed with the brief psychiatric rating scale (BPRS). The case was treated with homoeopathic medicines in the in-patient unit of the National Homoeopathy Research Institute in Mental Health, Kottayam. The BPRS score at baseline of 91 turned to 18 (normal) on the fifth day with Hyoscyamus 200 single dose and the patient was discharged with totally normal behaviour on the eighth day. The patient was given a dose of Aurum sulph 200 as a constitutional remedy in the 2nd week after discharge. The remedy was infrequently repeated during monthly visits for up to 1 year. There was no relapse of psychotic episodes and there was good psychosocial adaptation. Future research based on well-planned study designs is necessary to establish the evidence. The likelihood of causality between intervention and outcome has been discussed as per Modified Naranjo Criteria for Homoeopathy.