Socijalna psihijatrija, Vol. 54 No. 2, 2026.
Sažetak sa skupa
https://doi.org/10.24869/spsih.2026.202
From Involuntary Hospitalization to the Bar Examination – Functional Recovery Following a Severe Course of Psychosis
Dino Žujić
; Zavod za integrativnu psihijatriju, Klinika za psihijatriju Sveti Ivan Zagreb, Jankomir 11, 10090 Zagreb, Hrvatska
*
Tali Horvat
; Zavod za integrativnu psihijatriju, Klinika za psihijatriju Sveti Ivan Zagreb, Jankomir 11, 10090 Zagreb, Hrvatska
Linda Rossini Gajšak
; Zavod za integrativnu psihijatriju, Klinika za psihijatriju Sveti Ivan Zagreb, Jankomir 11, 10090 Zagreb, Hrvatska; Fakultet za dentalnu medicinu i zdravstvo Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Crkvena 21, 31000 Osijek, Hrvatska
Sandra Vuk Pisk
; Zavod za integrativnu psihijatriju, Klinika za psihijatriju Sveti Ivan Zagreb, Jankomir 11, 10090 Zagreb, Hrvatska; Fakultet za dentalnu medicinu i zdravstvo Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Crkvena 21, 31000 Osijek, Hrvatska; Zdravstveno veleučilište Zagreb, Sveučilište u Zagrebu, Mlinarska cesta 38, 10000 Zagreb, Hrvatska
Igor Filipčić
; Zavod za integrativnu psihijatriju, Klinika za psihijatriju Sveti Ivan Zagreb, Jankomir 11, 10090 Zagreb, Hrvatska; Fakultet za dentalnu medicinu i zdravstvo Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Crkvena 21, 31000 Osijek, Hrvatska; Zdravstveno veleučilište Zagreb, Sveučilište u Zagrebu, Mlinarska cesta 38, 10000 Zagreb, Hrvatska; Medicinski fakultet, Sveučilište u Zagrebu, Šalata 3, 10000 Zagreb, Hrvatska
* Dopisni autor.
Sažetak
Introduction: Treating patients with long‑standing
untreated psychotic disorders is a substantial
clinical challenge, especially when accompanied
by pronounced treatment resistance, aggressive
behavior, and a complete lack of insight into
the illness. Achieving clinical remission and full
functional recovery in such patients requires a
complex, individualized pharmacotherapeutic
strategy and the management of potentially severe
medication side effects. Aim: To present a
female patient with severe psychotic decompensation and years‑long social isolation in whom,
despite initial non‑adherence, involuntary treatment,
and the development of hematologic side
effects, optimization of therapy led to an exceptional
functional and professional recovery. Case
report: We present a 32‑year‑old female patient,
a law school graduate, admitted for her first psychiatric
hospitalization following an intervention
by emergency medical services and the police. At
admission, she was psychomotorly agitated, with
a paranoid ideation structure, heteroaggressive,
without insight into her illness, and in complete
opposition to treatment. Due to endangerment of
her own health and safety, court‑approved involuntary
hospitalization proceedings were initiated
in accordance with the Law on the Protection of
Persons with Mental Disorders. The initial therapeutic
attempt to introduce clozapine and olanzapine
had to be discontinued due to the development
of side effects in the form of leukopenia and
neutropenia. The therapeutic strategy was then
adjusted by introducing lamotrigine and long‑acting
injectable aripiprazole (960 mg depot every
two months). Through this change in pharmacotherapy
and an individualized approach, gradual
but stable clinical improvement was achieved. The
patient developed insight into her illness, became
cooperative, and her mental status stabilized.
With family support, she attained a high level
of social reintegration and is actively preparing
to take the bar exam. Conclusion: The presented
case highlights the complexity of treating psychosis
with long‑standing untreated symptoms and
a severe initial course. Despite therapeutic challenges,
including leukopenia during the use of
otherwise effective pharmacotherapy, transition
to a modern long‑acting depot treatment, together
with family support, enabled not only stable
clinical remission but also full social reintegration
and a high level of professional recovery.
Ključne riječi
long‑acting antipsychotics; functional recovery; leukopenia; involuntary hospitalization; psychosis
Hrčak ID:
352329
URI
Datum izdavanja:
15.6.2026.
Posjeta: 0 *