Abstract
The patient was a man in his 60s with a history of schizophrenia that was diagnosed during his 30s due to incoherent behavior. When the patient was in his 40s, he stopped taking his medication. At that time he was confined to his bed and diagnosed with substupor of schizophrenia, and he was prescribed neuroleptics and complied with his drug schedule. Later, during his 50s, the patient was diagnosed and treated for idiopathic thrombocytopenic purpura. His condition proved refractory, and when he was in his 60s, the patient underwent a splenectomy. Immediately following surgery, he demonstrated delirium and attempted suicide. A small cortical infarction was detected and he was diagnosed with anti-phospholipid syndrome and medicated with antiplatelet therapy. Approximately 2 years later, the patient demonstrated echolalia, minimal verbal response, visual hallucinations, and strange cries, and went outside without purpose; hence, he was diagnosed with catatonia, resulting in repeated hospitalizations. Despite adequate regulation of neuroleptic and anticoagulation therapies, he experienced recurrent catatonic episodes and committed suicide 4 years after being diagnosed with anti-phospholipid syndrome. Before his death, the patient did not have other cerebral infarctions, nor any apparent abnormalities in cerebrospinal fluid, nor any abnormalities detected on electroencephalography.
