Multivitamin abuse as a manifestation of residual schizophrenia: A case report.

Abstract

Introduction: Schizophrenia is a chronic mental disorder characterized by psychotic, negative, and cognitive symptoms that significantly impair functioning and quality of life. Between 1990 and 2021, the global burden of schizophrenia increased in absolute numbers, although age-standardized rates remained relatively stable; males consistently exhibit a higher risk. In Colombia, recent data show territorial variations in diagnostic rates. Residual schizophrenia is characterized by the predominance of persistent negative and cognitive symptoms, leading to substantial functional decline. To date, no reports have described compulsive supplement consumption as a psychopathological manifestation in this clinical context.

Objective: To describe the clinical and behavioral manifestations associated with residual schizophrenia in an adult patient, highlighting unsupervised supplement use as a potential expression of residual symptomatology and impaired judgment.

Case Presentation: A 50-year-old male from Barranquilla was brought to psychiatric emergency services by his mother due to an 8-month history of compulsive multivitamin intake (up to 10 tablets daily). He presented with social withdrawal, hyporexia, insomnia, and somatic preoccupation without objective medical findings. Mental status examination revealed poor self-care, marked hypoprosexia, bradypsychia, blunted affect, and delusional ideation, without perceptual disturbances. He had longstanding social and occupational dysfunction, limited social network, and financial dependence on his mother. Residual schizophrenia was diagnosed, and treatment with olanzapine was initiated with inpatient admission.

Conclusions: Indiscriminate supplement use may represent a marker of persistent symptomatology in residual schizophrenia. Early identification is essential to prevent medical risks, improve treatment adherence, and strengthen psychoeducational interventions within a comprehensive care approach.