title: Psychosis risk syndrome comorbid with panic attack disorder in a cannabis-abusing patient affected by Arnold-Chiari malformation type I.
abstract: OBJECTIVE
  An 18-year-old man with Arnold-Chiari malformation (ACM) type I developed sudden panic attacks. He also manifested sleep disorder, cannabis abuse, and psychosis-risk syndrome (PRS). Although with average-superior intelligence, he had executive dysfunction. This prompted us to explore the relation between ACM, cannabis abuse, PRS and panic disorder.
  
  
  METHODS
  We report the case and briefly review the literature focusing on ACM and psychiatric disorders.
  
  
  RESULTS
  Behavior therapy led to gradual abstinence from cannabis with disappearance of anxiety symptoms. The patient is currently well and maintained on omega-3 polyunsaturated fatty acids.
  
  
  CONCLUSIONS
  Locus coeruleus compression and cannabis abuse may have triggered the symptoms, and the latter might also be PRS-related. PRS and anxiety symptoms should be explored in ACM patients to allow better prevention of psychosis and anxiety disorders.
authors.affiliation: NESMOS Department (Neuroscience, Mental Health and Sensory Organs), School of Medicine and Psychology, Saint Andrea Hospital of Rome, Sapienza University of Rome, Rome, Italy. antonio.delcasale@uniroma1.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Casale
authors.forename: Daniele
authors.initials: D
authors.lastname: Serata
authors.forename: Chiara
authors.initials: C
authors.lastname: Rapinesi
authors.forename: Alessio
authors.initials: A
authors.lastname: Simonetti
authors.forename: Stefano Maria
authors.initials: SM
authors.lastname: Tamorri
authors.forename: Anna
authors.initials: A
authors.lastname: Comparelli
authors.forename: Antonella
authors.initials: A
authors.lastname: De Carolis
authors.forename: Valeria
authors.initials: V
authors.lastname: Savoja
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Kotzalidis
authors.forename: Gabriele
authors.initials: G
authors.lastname: Sani
authors.forename: Roberto
authors.initials: R
authors.lastname: Tatarelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000473:pathology / Q000523:psychology; D001521:Behavior Therapy; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D006801:Humans; D008125:Locus Coeruleus / Q000473:pathology / Q000503:physiopathology; D008297:Male; D002189:Marijuana Abuse / Q000150:complications* / Q000628:therapy; D016584:Panic Disorder / Q000150:complications* / Q000628:therapy; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000150:complications* / Q000628:therapy; D013577:Syndrome
chemical_list: D015525:Fatty Acids, Omega-3