Psychiatry and Clinical Psychopharmacology

Negativism associated globe vesicale

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S209-S210
Read: 372 Published: 17 February 2021

Negativism is roughly known as a tendency to resist external commands, suggestions, or expectations, or internal stimuli, as hunger, by doing nothing or something contrary or unrelated to the stimulus. Patient may keep the food in his or her mouth and resist eating or may not answer any question asked and speak after the examination. Negativism is mostly associated with catatonia.(2) Here we describe a case of negativism associated globe vesicale without catatonia. A 37-year-old female patient with 10 weeks of gestation attended to our clinic with her husband. She was refusing to talk so psychiatric history was acquired from her husband. According to him, she had a seven years history of psychosis and she had been on olanzapine treatment during last year before her referral until she learned she was pregnant 6 weeks ago. During the last ten days, patient was not speaking, eating, drinking or sleeping so she had been hospitalized to our psychiatry clinic. On physical examination, her abdomen seemed to be bigger than expected for a gestation of ten weeks. On clinical observation, her refusal for going to toilet was realized and a gynecological consultation was requested. In abdominal ultrasound, her urinary bladder volume was nearly 1500 cc and compressing on uterus. Due to patient’s resistance to urinate, a urinary catheter was placed and globe vesicale was resolved. Electroconvulsive therapy (ECT) was planned for her psychotic symptoms. After 7 sessions of ECT, she was discharged from the hospital with full recovery. Pulmonary complications like pulmonary embolism, pneumonia and aspiration; gastrointestinal complications like constipation due to decreased food intake and dehydration; dental complications due to decreased oral hygiene; genitourinary complications like urinary retention or urinary incontinence or infections; şexion contractures, postural nerve palsies and rhabdomyolysis due to immobilization can be seen in catatonia. Globe vesicale was associated with catatonia in literature but in our case, globe vesicale is associated with negativism without catatonia. Caution should be given to negativist pregnant woman because globe vesicale could be concealed by pregnancy.

EISSN 2475-0581