Psychosis secondary to recurrent spinal meningioma

To the Editor:A 27-year-old man without psychiatric history presented with a 2-month history of apathy,decreased responsiveness,and malaise.The onset of these new behavioral changes was preceded by fatigue and insomnia.On physical examination,the patient's limbs had normal muscle tone and strength and no pathological reflexes were detected.Four years earlier,the patient underwent an operation for spinal meningioma resection.Before the operation,some analogous symptoms,like apathy and reduced responsiveness,appeared;the symptoms lasted for a month and remitted after the operation.Four days later,the patient developed mutism and irresponsiveness.He was diagnosed with organic psychosis and was admitted to a psychiatric unit.The patient began regular anti-psychotic treatment,including olanzapine,escitalopram,sertraline,and oxazepam,but there was no improvement in his mutism and irresponsiveness.