Work

Palliative psychiatry in ultra-treatment resistant schizophrenia with refractory somatic hallucinations: A case report

Year: 2025

Type: article

Abstract: We report the case of a middle-aged male with ultra-treatment-resistant schizophrenia and severe multimodal hallucinations, including rare and difficult-to-manage somatic hallucinations. Conventional treatment strategies, including multiple antipsychotic regimens, clozapine, and electroconvulsive therapy, provided limited benefit. Care was reframed within a palliative psychiatric framework that prioritized symptom relief, dignity, and quality of life via integration of creative therapies, peer counselling, alongside supportive pharmacotherapy. Despite the persistence of psychotic symptoms, the framework contributed to meaningful improvement in the patient’s well-being and functionality by reducing distress, avoiding polypharmacy with adverse effects, enhancing engagement with treatment, and within the community. This case contributes to the limited clinical literature by demonstrating the structured application of palliative psychiatry in UTRS, highlighting its potential to enhance quality of life even when all evidence-based treatments have been exhausted. This framework offers palliative psychiatry as a humane and practical framework for clinicians to consider in cases of ultra-treatment-resistant schizophrenia when complete symptom remission is unattainable.

Source: Psychiatry Research Case Reports

DOI: 10.1016/j.psycr.2025.100303

Authors: Marian Taiwo, Simrit K. Toor, Myles Turkson, Monique Du Boulay

Institution: St. George's University

Language: English

Topic: Schizophrenia research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $950