Meeting abstract

https://doi.org/10.24869/spsih.2026.316

A Distance of 500 km – A Challenge, Not a Barrier: The Importance of Dialogue in the Successful Treatment of Psychosis

Tali Horvat ; University Psychiatric Hospital Sveti Ivan, Jankomir 11, 10090 Zagreb, Croatia *
Dino Žujić ; University Psychiatric Hospital Sveti Ivan, Jankomir 11, 10090 Zagreb, Croatia
Linda Rossini-Gajšak ; University Psychiatric Hospital Sveti Ivan, Jankomir 11, 10090 Zagreb, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena ulica 21, 31000 Osijek, Croatia
Sandra Vuk Pisk ; University Psychiatric Hospital Sveti Ivan, Jankomir 11, 10090 Zagreb, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena ulica 21, 31000 Osijek, Croatia; Faculty of Health Studies, University of Zagreb, Mlinarska cesta 38, 10000 Zagreb, Croatia
Igor Filipčić ; University Psychiatric Hospital Sveti Ivan, Jankomir 11, 10090 Zagreb, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena ulica 21, 31000 Osijek, Croatia; Faculty of Health Studies, University of Zagreb, Mlinarska cesta 38, 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia

* Corresponding author.

Abstract

Introduction: Dialogue between physician and patient
is one of the fundamental prerequisites for
successful treatment in psychiatry. High-quality
communication and a therapeutic alliance enable
timely recognition of difficulties, increase adherence,
and contribute to better treatment outcomes.
Aim: The aim of this case report is to highlight the
importance of good-quality communication between
physician and patient in achieving favorable
treatment outcomes, regardless of geographical
distance. Case report: We present a 39‑year‑old
female patient from a town 500 km away from our institution, admitted as a transfer from the
competent county general hospital due to a first
psychotic episode. The clinical picture was dominated
by religious delusions, delusional ideas of
reference, and auditory hallucinations. After treatment,
she was discharged in a remitted state on
antipsychotic therapy. A year and a half later, she
was hospitalized again because of a relapse of the
illness. Due to olanzapine side effects, pharmacotherapy
was modified, and paliperidone palmitate
was introduced. At a follow-up outpatient visit, the
patient reported absence of menstruation for two
months and was therefore referred for gynecological
evaluation. Since, due to her mental difficulties,
she had previously neglected preventive examinations,
a full gynecological workup was performed.
After adjustment of antipsychotic therapy and
switching to depot aripiprazole, her menstrual cycle
normalized, and as part of the workup, premalignant
changes of the cervix were detected, with
timely treatment preventing further disease progression.
Conclusion: This case report underscores
the importance of continuous dialogue and trust
between psychiatrist and patient, which made
successful treatment possible despite a distance of
more than 500 km. Good-quality communication
contributed to maintaining remission and safely
changing depot therapy, while careful monitoring
of side effects led to timely diagnostic evaluation
and prevention of the development of malignant
disease. The case confirms that the therapeutic alliance
is a key factor in successful treatment and in
preserving the patient’s overall health.

Keywords

psychosis; dialogue; antipsychotics; drug side effects

Hrčak ID:

353012

URI

https://hrcak.srce.hr/353012

Publication date:

15.6.2026.

Article data in other languages: croatian

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