[Pseudobulbar affect in the prodromal phase of psychosis: a case report]

Laughter and crying are fundamental human expressions integral to social interaction and emotional communication. In certain neurological conditions or psychiatric disorders, these behaviors may become pathological, leading to significant impairments in interpersonal and social functioning. We report a patient presenting with uncontrollable episodes of laughter and crying who developed a psychotic episode three weeks later. We review the epidemiology, pathophysiology, diagnostic considerations, and the emerging therapeutic option for pathological laughter and crying (pseudobulbar affect), such as dextromethorphan/quinidine. There seems to be a lack of information for the treatment of these symptoms in other than neurological disorders, such as psychosis. This case also underscores the lack of clear definitions in the literature and highlights the diagnostic challenges in distinguishing neurological from psychiatric etiologies of pathological affective expression.