Mania with psychotic symptoms at a first contact with mental health

Abstract

Mania with psychotic symptoms presents with increased self-esteem, ideas of grandeur that can lead to delusions, irritability, flight of ideas, logorrhoea and intense physical activity which, together with the neglect of eating and hygiene, can create dangerous situations. We present the case of a 22-year-old woman with no previous contact with mental health who is admitted to a short-stay unit after an episode of agitation, with elevated mood, insomnia, megalomaniacal and mystical-religious delusions, substance use since the age of 13, dysfunctional family relationships and a history of abuse in childhood. After assessment according to Marjory Gordon’s functional health patterns and prioritization by means of Daniel Pesut’s reasoning web (AREA model), the diagnoses of unstable emotional control, acute confusion and ineffective health management were formulated, with their NOC outcomes and NIC interventions. After discharge and referral to the mental health centre, a decrease in irritability was observed, but family communication difficulties and poor adherence persisted, requiring readmission due to abandonment of outpatient treatment.