We report a case of 40-year-old man who had a diagnose case of schizophrenia on olanzapine had develop symptomatic hypothermia. The majority of documented cases involve short duration of hypothermia often <24 h. Antipsychotics that are a more potent antagonists at 5-hydroxytryptamine 2 (5HT2) than at dopamine 2 receptors appear more likely to cause hypothermia. Hypothermia is an adverse drug reaction of antipsychotic drug use. It is strong 5HT2 antagonistic characteristics which induced hypothermia has been proposed. 55% of hypothermia reports are for atypical antipsychotics. A 40-year-old man with schizophrenia who was being treated with a therapeutic dose of olanzapine presented with shivering, slurred speech, and confusion. He had a core temperature of 31.5°C. Electrocardiogram showed sinus bradycardia with Osborn waves or J waves. He did not have any risk factors for developing hypothermia except the use of olanzapine. There was an improvement in his clinical condition with reversal of electrocardiogram changes following gradual re-warming and withhold of olanzapine. Olanzapine-induced hypothermia is rare and has been reported during initiation and increasing the dose or even in stable dose, but this case report raises the possibility of hypothermia even in the patients who are on stable doses of olanzapine for a long period of time. Clinicians should consider the possibility of drug-induced illness in hypothermic patients who are taking antipsychotics.

Hiccups are repeated involuntary, intermittent spasmodic contractions of the diaphragm and inspiratory intercostal muscles which results in sudden inspiration, followed by a sudden closure of the glottis. It is naturally benign, self-limited but maybe most of the time organic in nature and in some cases, chronic, debilitating, and psychogenic. Here, we report a case of a 16-year-old female student who developed hiccups of a psychogenic origin started by stress, which last up to 48 hours sometimes for a month and is successfully treated by antipsychotics haloperidol and psychological interventions. Physicians always face a diagnostic challenge, especially when no identifiable organic cause is elicited. However, such cases are invariably referred for psychiatric evaluation and treatment.

Onychophagia (nail biting): a body focused repetitive behavior due to psychiatric co-morbidity Onychophagia is an habit of biting one's nails and finger tips. It is also called nail biting (NB). It is a stress relieving oral habit adopted by many children and adults. People usually do it when they are nervous, stressed, hungry or bored. All the above situations are having a common phenomenon between them which is anxiety. Here, we present a case of onychophagia (NB), who had psychiatric comorbidity. Onychophagia cannot be managed without considering some related factors such as comorbidities, precedent and consequences of the behavior. The best way to treat a nail biter is to educate them, encourage good habits and should provide emotional support and encouragement. Behavior modification therapy has proved to be a successful means of treatment along with drug management.

No abstract

Internet use and video game playing are experiencing rapid growth among both youth and adult populations. Internet gaming is one of the most popular sources of entertainment for people in all ages, but excess playing this game causes negative consequences including video game addiction. Internet gaming disorder (IGD) is not currently a recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). However, IGD has been noted to warrant further research for possible future inclusion in the DSM. The excessive usage in the majority of cases was purely symptomatic and was highlighted how the subject used the Internet or computer to counteract other problems. IGD strongly resembles substance and gambling addictions. Such characteristics include tolerance, withdrawal, and social and occupational neglect resulting from increased time invested in video game use and acquisition. We report a case of 20-year old student who used to addict Internet video gaming to counteract his stress and social problem. ARTICLE HISTORY