American Journal of Psychiatry and Neuroscience
Volume 7, Issue 4, December 2019, Pages: 78-82
Received: Aug. 19, 2019;
Accepted: Oct. 4, 2019;
Published: Oct. 17, 2019
Views 419 Downloads 177
Prakash Barman, Department of Psychiatry, Silchar Medical Colege and Hospital, Silchar, India
Madhurima Khasnobis, Department of Psychiatry, Silchar Medical Colege and Hospital, Silchar, India
Kamal Nath, Department of Psychiatry, Fakharuddin Ali Ahmed Medical College and Hospital, Barpeta, India
Wilsons Disease also known as hepatolenticular degeneration is a autosomal recessive disorder, characterized by abnormal copper deposition in the liver, brain, and other tissues caused by mutation in the copper transporting gene ATP7B. Patients presents with neurological and hepatic disorder. Psychiatric manifestation are common along with movement disorder but its association with paraphilic disorders like zoophilia is very rare and there is practically no literature regarding this in North-Eatern India. In this article we report the unique case of a 21 year old boy from rural Assam suffering from Wilson’s disease with multiple neuropsychiatric manifestations among which zoophilia was noteworthy. This case report highlights a rare and atypical association between an adolescent patient of Wilson disease & zoophilia--- a relatively rare paraphilic disorder. A 21 year old boy presented in the Psychiatry emergency department in a tertiary care hospital with aggressive, disorganized behavior with reported sexual act with a cow. Examination of the patient also revealed massive organomegaly and K-F ring which on further investigation confirmed the diagnosis of Wilsons Disease. The occurrence of zoophilic behavior in Wilsons disease is very rare and we have not come across any such report regarding this. To conclude, the association between copper deposition in specific brain areas due to Wilsons disease and zoophilic behaviour we need further studies with better investigative modalities, which will in turn help in drawing an individualise treatment plan.
A Rare Case of Wilsons Disease with Zoophilia, American Journal of Psychiatry and Neuroscience.
Vol. 7, No. 4,
2019, pp. 78-82.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
European Association for the Study of the Liver Disease. EASL clinical practice guidelines: Wilson’s disease. J Hepatol 2012; 56: 671–685.
Soltanzadeh A, Soltanzadeh P, Nafissi S, et al: Wilson’s disease: a great masquerader. Eur Neurol 2007; 57: 80–85.
Kinnier-Wilson SA: Progressive lenticular degeneration: a familial nervous disease associated with cirrhosis of the liver. Brain 1912; 34: 295–509.
Svetel M, Potrebic A, Pekmezovic T, et al. Neuropsychiatric aspects of treated Wilson’s disease. Parkinsonism Relat Disord 2009; 15: 772–725.
Akil M and Brewer GJ. Psychiatric and behavioral abnormalities in Wilson’s disease. Adv Neurol 1995; 65: 171–178.
Kumar R, Datta S, Jaysellan L, et al. The psychiatric aspects of Wilson’s disease: a study from neurologic unit. Indian J Psychiatry 1996; 38: 208–211.
Denning TR and Berrios G. Wilson’s disease psychiatric symptoms in 195 cases. Arch GenPsychiatry 1989; 46: 1126–1134.
Portala K, Westermark K, Ekselius L, et al. Personality traits in treated Wilson’s disease determined by means of the Karolinska Scales of Personality (KSP). Eur Psychiatry 2001; 16: 362–371.
Scheinberg IH and Sternlieb I. Wilson’s disease. Philadelphia: WB Saunders, 1984.
Carta MG, Sorbello O, Moro MF, Bhat KM, Demelia E, Serra A, Mura G, Sancassiani F, Piga M, Demelia L. Bipolar disorders and Wilson’s disease. BMC psychiatry. 2012 Dec; 12 (1): 52.
Walter G and Lyndon B. Depression in hepatolenticular degeneration (Wilson’s disease). Aust N Z J Psychiatry 1997; 31: 880–882.
Chung YS, Ravi SD, Borge GF: Psychosis in Wilson’s disease. Psychosomatics 1986; 27: 65–66.
Sagawa M, Takao M, Nogawa S, et al: [Wilson’s disease associated with olfactory paranoid syndrome and idiopathic thrombocytopenic purpura]. No to Shinkei 2003; 55: 899–902 (Japanese).
Castagnini AC and Fusar-Poli P. Diagnostic validity of ICD-10 acute and transient psychotic disorders and DSM-5 brief psychotic disorders. Eur Psychiatry 2017; 45; 104–113.
Chand PK and Murthy P. Mania as a presenting symptom of Wilson’s disease. Acta Neuropsychiatr 2006; 18: 47–49.
Zimbrean PC and Schilsky ML. Psychiatric aspects of Wilson’s disease: a review. Gen Hosp Psychiatry 2014; 36: 53–62.
Cummings J. Subcortical dementia: neuropsychology, neuropsychiatry and pathophysiology. Br J Psychiatry 1986; 149: 682–697.
Nevsimalova S, Buskova J, Bruha R, et al. Sleep disorders in Wilson’s disease. Eur J Neurol 2011; 18: 184–190.
Portala K, Westermark K, von Knorring L, et al. Psychopathology in treated Wilson’s disease determined by means of CPRS expert and selfratings. Acta Psychiatr Scand 2000; 101: 104–109.
Sadock BJ, Sadock VA. Human Sexuality. In Kaplan and Sadock’s Synopsis of Psychiatry, 8th ed. Philadelphia: Lippincott Williams and Wilkins, 2003: 718-728.
Amoo G. Zoophilic recidivism in schizophrenia: a case report. African journal of psychiatry. 2012; 15 (4).
Poujois A, Trocello JM, Djebrani-Oussedik N, Poupon J, Collet C, Girardot-Tinant N, Sobesky R, Habès D, Debray D, Vanlemmens C, et al. Exchangeable copper: reflection of the neurological severity in Wilson’s disease. Eur J Neurol. 2017
Aggarwal A, Bhatt M. Advances in Treatment of Wilson Disease. Tremor Other Hyperkinet Mov (N Y) 2018; 8: 525.