Obsessive compulsive disorder in a patient with twiddler's syndrome.
Twiddler's or twist syndrome is the twisting of pulse generators around themselves. It may result from mechanical manipulation that can induce the malfunction of the device. In this case, twiddler's syndrome resulted from compulsive checking of the device. The implantable cardioverter-defibrillator (ICD) triggered the development of an obsessive compulsive disorder (OCD). Two invasive procedures were required to replace the ICD. Psychiatric intervention prevented the recurrence of twiddler's syndrome in this patient for more than 2 years. We believe that preimplant psychiatric assessment should be the rule.
Jaafari
Nematollah
N
Department of Psychiatry, Centre Hospitalier Henri Laborit, CIC-INSERM U 802, Université de Poitiers, Poitiers, France. n.jaafari@wanadoo.fr
Bachollet
Marie-Sophie
MS
Paillot
Celine
C
Amiel
Alain
A
Rotge
Jean-Yves
JY
Lafay
Nicolas
N
Quentin
Solene
S
Wassouf
Issa
I
Camus
Vincent
V
Senon
Jean-Louis
JL
El Hage
Wissam
W
D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D013577:Syndrome; D016896:Treatment Outcome