J Neuropsychiatry Clin Neurosci 1991; 3:377-382
Copyright © 1991 by American Neuropsychiatric Association
The psychiatric presentations of Wilson's disease
M Akil, JA Schwartz, D Dutchak, V Yuzbasiyan-Gurkan and GJ Brewer
Department of Psychiatry, University of Michigan, Ann Arbor.
We reviewed the records of 42 patients with Wilson's disease participating
in a zinc acetate treatment protocol and interviewed 17 of them. Five of
the patients studied were asymptomatic. A significant number of symptomatic
patients (64.8%) reported psychiatric symptoms at the time of initial
presentation. These symptoms were severe enough to warrant psychiatric
intervention in almost half of all symptomatic patients before the
diagnosis of Wilson's disease was made. Personality changes, particularly
irritability and aggression, were most commonly described (45.9%), followed
by depression (27%). Cognitive changes, anxiety, psychosis, and catatonia,
while less frequent, also occurred. These data underscore the need to
include Wilson's disease in the differential diagnosis of psychiatric
disorders.
