A Forgotten Disease in the Land of Citrus Fruit

Neri S, Pollicino C, Rizzot

Abstract

 Scurvy is a nearly-forgotten disease in developed countries where adequate nutrition is easily available, the few cases of scurvy reported in the 21st century have mainly occurred in the neglected elderly, alcoholics and food faddist. Nutritional deficiency, however, may be a presenting sign of undiagnosed psychiatric illness (eating disorders, psychotic depression and Obsessive Compulsive Disorder-OCD). We report the case of a 15-year-old patient with depression who developed scurvy as a secondary complication to a primary psychiatric pathology regarding depression. With vitamin C replacement, psychiatric medication and behavioural therapy there was an improvement in his condition. We strongly recommend a high index of suspicion for this disease in the specific populations at risk, described as the socially isolated adult or elderly patient with a history of destructive behavior, who lives alone, and is mentally or chronically ill. The early identification of a psychiatric pathology and a good and prompt treatment can, in fact, improve the course of the illness and its prognosis.\r\n