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Bu sayfa, 26. Dünya Psikiyatri Kongresi'nde sunulan çalışmanın yapay zekâ desteğiyle hazırlanmış Türkçe özetidir. Çalışmanın sahibi sunan yazarlardır; atıf için orijinal kaynağa başvurun.

EV1233

Hidden in plain sight: schizoaffective disorder undiagnosed for fifteen years in an advanced healthcare system

HIDDEN IN PLAIN SIGHT: FIFTEEN YEARS OF UNDIAGNOSED SCHIZOAFFECTIVE DISORDER IN A DEVELOPED HEALTH SYSTEM

Even in a well-resourced healthcare system, schizoaffective disorder can progress unrecognized for approximately 15 years; the absence of contact with psychiatric services does not mean the absence of psychiatric illness.

This presentation explores how severe mental disorders can remain unrecognized for years, even in well-resourced mental healthcare systems, through a case of schizoaffective disorder with a course spanning approximately 15 years before the first contact with psychiatric services. The patient is a 51-year-old woman who has been unemployed since 2010 and had no previous contact with psychiatric services. Collateral history from relatives indicates approximately 15 years of mood fluctuations, progressive functional decline, and psychotic symptoms. The course began in 2010 with divorce, progressive withdrawal, and loss of occupational functioning; between 2010 and 2025, she experienced recurrent depressive episodes and periods of elevated mood or increased activation, increasing suspiciousness, and interpersonal difficulties; in the summer of 2025, she experienced a marked exacerbation of psychosis, with erotomanic, persecutory, and referential delusions, mystical and religious grandiosity, and behavioral disinhibition. Her first psychiatric assessment took place upon voluntary admission in January 2026, when she was diagnosed with schizoaffective disorder, and marked improvement was achieved after 2 months of inpatient treatment and 3 medication trials. Reasons for the missed diagnosis included limited insight and lack of help-seeking, normalization of functional decline by attributing it to life circumstances, accommodation of psychotic beliefs and behavioral changes within family dynamics, and fragmented healthcare contacts that did not include psychiatric assessment until marked deterioration occurred. The authors emphasize that severe mental illness can progress insidiously through functional decline and behavioral changes before an overt crisis, and that early diagnosis requires attention to the longitudinal course, functional decline, and collateral history from relatives.

Tüm WCP 2026 özetleri