D N Mendhekar1. 1. Department of Psychiatry, G.B. Pant Hospital, New Delhi, India. dnmendhekar@vsnl.net
Abstract
METHOD: Pathological laughter has been known to occur in organic and functional psychotic disorders and is sometimes seen in hysteria. Though it is an important phenomenon, its significance in other psychiatric disorders has been negligible. This case report highlights the phenomenology of pathological laughter as an obsessive-compulsive phenomenon in an adolescent girl. RESULTS: The girl was brought by her parents with a history of laughing without reason, but on detail evaluation, it was found that her laughing was an irrational and ego-dystonic phenomenon. She also showed resistance to her symptom. A family history of obsessive-compulsive disorder in the parental grandfather, the habit of smiling in her father and her childhood emotional trauma and sexual abuse could have contributed to the formation of the symptom. Selective serotonin reuptake inhibitor drugs and behavior therapy showed good improvement in this case. DISCUSSION: Pathological laughter, though common in organic and psychotic disorders, can present primarily as an obsessive-compulsive phenomenon as well. This case suggests that each and every patient with a history of pathological laughter in a psychiatry clinic should not be labeled as psychotic unless he or she is assessed in detail. Copyright 2004 S. Karger AG, Basel
METHOD: Pathological laughter has been known to occur in organic and functional psychotic disorders and is sometimes seen in hysteria. Though it is an important phenomenon, its significance in other psychiatric disorders has been negligible. This case report highlights the phenomenology of pathological laughter as an obsessive-compulsive phenomenon in an adolescent girl. RESULTS: The girl was brought by her parents with a history of laughing without reason, but on detail evaluation, it was found that her laughing was an irrational and ego-dystonic phenomenon. She also showed resistance to her symptom. A family history of obsessive-compulsive disorder in the parental grandfather, the habit of smiling in her father and her childhood emotional trauma and sexual abuse could have contributed to the formation of the symptom. Selective serotonin reuptake inhibitor drugs and behavior therapy showed good improvement in this case. DISCUSSION: Pathological laughter, though common in organic and psychotic disorders, can present primarily as an obsessive-compulsive phenomenon as well. This case suggests that each and every patient with a history of pathological laughter in a psychiatry clinic should not be labeled as psychotic unless he or she is assessed in detail. Copyright 2004 S. Karger AG, Basel