A 68-Year-Old Woman with Lung Cancer and Late-Onset Bipolar Disorder

Abstract

A 68-year-old white woman was diagnosed with poorly differentiated, stage 1A, non-small cell lung cancer with possible hilar node involvement in spring 2008. To treat her cancer, she received one dose of the chemotherapeutic agents docetaxel and cisplatin and 3 days of the oral steroid dexamethasone. Within 6 weeks, she developed mild paranoid ideations and subsequent fl orid mania with delusions. All of this was despite having no prior personal or family history of psychiatric illness. Upon evaluation, she was placed on a psychiatric hold due to her inability to care for herself and was admitted for psychiatric treatment. On admission, she exhibited the following symptoms: delusions of jealousy and grandeur; increased goal-directed activity; rapid, pressured speech with fl ight of ideas; and a decreased need for sleep. After achieving a reduction in her symptoms and when it no longer appeared to be a safety concern to either herself or others, the state mental health court granted her discharge request.