Transient psychosis due to caregiver burden in a patient caring for severely demented spouses

Caring for demented people has been associated with negative effect on caregiver health. One or more severe stress factors can precipitate brief reactive psychosis.

A 59-year-old Caucasian married woman with no prior psychosis has been caring for her severely demented husband for more than 3 years. She was treated for anxiety disorder and reaction to severe stress in our clinic for 1 year.

Five days after husband's nursing home placement our patient developed the abnormal thought, that someone might tell her neighbours of her laziness and failures. She believed that she was under constant surveillance. These ideas grew rapidly into delusions and hallucinations. She was diagnosed as having transient psychosis with associated acute stress and was treated with risperidone. The psychosis lasted for two months.

Careful differential diagnosis is necessary in the cases of transient psychosis. Psychotic symptoms in overloaded individuals may be more common than was previously thought.