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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0365

The importance of an integrative approach in psychotic patients with oncological and pulmonary comorbidities: a case report

DR. SPEC. PSIHIJATAR

In a case of first-episode psychosis with cervical cancer and chronic pulmonary thromboembolism, diagnosis and treatment could only be managed through an integrative, multidisciplinary approach involving specialties beyond psychiatry.

The aim is to discuss the importance of an integrative approach in psychotic patients with oncological and pulmonary comorbidities through a single case. The patient is a 34-year-old woman with a history of cervical cancer (FIGO IIIc1), treated with surgery and postoperative radiotherapy (PORT); radiotherapy consisted of a total dose of 46 Gy to the pelvis in 25 fractions, a total dose of 54 Gy to the bilateral iliac lymph nodes, and brachytherapy at 5 × 7 Gy. She was admitted for psychotic decompensation characterized by hallucinations, disorganized thinking, delusional ideas concerning relationships, and aggression toward others. Her psychiatric history included mood episodes (F33, F41.3, F32) that had been treated inconsistently and had not been assessed psychologically. The current episode represented the first emergence of prominent psychotic symptoms, and a diagnosis of F29 was assigned at discharge. Laboratory testing on the first day of admission revealed an elevated D-dimer level of 15.91 µg/mL. Pulmonary angiography showed mural filling defects consistent with chronic thromboembolism in the segmental branches and the superior segmental branch of the right lower lobe, leading to a diagnosis of pulmonary embolism. Throughout psychiatric treatment, a collaborative treatment approach was implemented, incorporating consultations with oncology, radiology, neurology, and internal medicine/pulmonology. This case highlights the importance of an integrative, multidisciplinary approach and the need for continued diagnostic assessment during outpatient follow-up.

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