{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:35:14Z","timestamp":1790832914592,"version":"4.1.0"},"reference-count":11,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2014,6,24]],"date-time":"2014-06-24T00:00:00Z","timestamp":1403568000000},"content-version":"unspecified","delay-in-days":3065,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Acta Neuropsychiatr."],"published-print":{"date-parts":[[2006,2]]},"abstract":"<jats:sec><jats:title><jats:bold>Objective:<\/jats:bold><\/jats:title><jats:p>Wilson's disease commonly presents with neurological or hepatic manifestations. When it presents with only psychiatric symptoms, or with extrapyramidal symptoms secondary to neuroleptic exposure, the diagnosis of underlying Wilson's disease may be missed.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Methods:<\/jats:bold><\/jats:title><jats:p>An 18-year-old boy presented to the psychiatric clinic with a manic syndrome and high propensity for extrapyramidal symptoms to neuroleptic. Initial examination revealed splenomegaly and pancytopenia. Subsequent detection of Kayser\u2013Fleischer ring and typical biochemical findings confirmed the diagnosis of Wilson's disease.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Results:<\/jats:bold><\/jats:title><jats:p>While the psychiatric symptoms came under control with lithium carbonate, extrapyramidal symptoms continue to persist even after neuroleptic withdrawal. Pancytopenia thought to be due to hypersplenism persists, and patient has developed features of liver cirrhosis. Treatment with zinc and folic acid has been started, and the patient is under evaluation for treatment with penicillamine.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Conclusion:<\/jats:bold><\/jats:title><jats:p>The psychiatrist needs to recognize that Wilson's disease can uncommonly present with isolated psychiatric symptoms, including mania. Early and severe extrapyramidal symptoms secondary to neuroleptic exposure in an adolescent age group warrants a detailed evaluation to rule out underlying neuropsychiatric conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.0924-2708.2006.00108.x","type":"journal-article","created":{"date-parts":[[2006,3,9]],"date-time":"2006-03-09T16:40:05Z","timestamp":1141922405000},"page":"47-49","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Mania as a presenting symptom of Wilson's disease"],"prefix":"10.1017","volume":"18","author":[{"given":"Prabhat Kumar","family":"Chand","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratima","family":"Murthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2014,6,24]]},"reference":[{"key":"S0924270800003690_b4","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.133.5.429"},{"key":"S0924270800003690_b9","first-page":"82","article-title":"Depression in Wilson's disease","volume":"23","author":"Pandey","year":"1981","journal-title":"Ind J Psychiatry"},{"key":"S0924270800003690_b2","first-page":"171","volume-title":"Advances in neurology","author":"Akil","year":"1995:"},{"key":"S0924270800003690_b7","first-page":"75","article-title":"Psychiatric manifestation in Wilson's disease","volume":"124","author":"Schwartz","year":"1993","journal-title":"Harefuah"},{"key":"S0924270800003690_b3","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/34.4.295"},{"key":"S0924270800003690_b5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1970.tb02066.x"},{"key":"S0924270800003690_b10","first-page":"35","article-title":"Clinical spectrum of Wilson's disease (Hepatolenticular degeneration)","volume":"54","author":"Dobyns","year":"1979","journal-title":"Mayo Clin Proc"},{"key":"S0924270800003690_b1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50252"},{"key":"S0924270800003690_b8","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1989.01810120068011"},{"key":"S0924270800003690_b6","volume-title":"The ICD-10 classification of mental and behavioral disorders: clinical descriptions and diagnostic guidelines","year":"1992"},{"key":"S0924270800003690_b11","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1176\/ajp.138.12.1628","article-title":"Dopamine beta-hydroxylase inhibition in a patient with Wilson's disease and manic symptoms","volume":"138","author":"Pandey","year":"1981","journal-title":"Am J Psychiatry"}],"container-title":["Acta Neuropsychiatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0924270800003690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T19:05:35Z","timestamp":1556910335000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0924270800003690\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,2]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2006,2]]}},"alternative-id":["S0924270800003690"],"URL":"https:\/\/doi.org\/10.1111\/j.0924-2708.2006.00108.x","relation":{},"ISSN":["0924-2708","1601-5215"],"issn-type":[{"value":"0924-2708","type":"print"},{"value":"1601-5215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,2]]},"assertion":[{"value":"Copyright \u00a9 2006 Blackwell Munksgaard","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}