Crazy Divers?

Craziness, it seems, can mimic decompression illness, say researchers at Brigham Young University. They uncovered two cases in which acute psychosis mimicked the bends.

In the first case, a 39-year-old diver was searching a river bottom for a drowning victim at 30 ft. for 45 minutes. Upon arriving home he complained of severe headache, hip and joint pain, then became uncommunicative and had difficulty recalling events. He went to a local hospital, where, his brain CT, EEG, and laboratory tests were normal. His neuropsychological tests, however, were abnormal — for example, he could not remember his wife’s name. Suspecting DCS, doctors treated him in a chamber, but he showed no improvement. After doctors interviewed him further, he recalled finding a decomposed body that came apart in his hands — an event that apparently spawned psychosis.

In the second case, a 22-year-old California diver made several dives to 85 ft. for up to 30 minutes. Within 12 hours of diving he experienced delusions and hallucinations: e.g., the television told him to go visit President Clinton. Testing showed impaired attention, verbal memory impairments, and a distorted thought process; toxicological tests were normal as were neurological tests. And he had no pain. Still, the symptoms after diving suggested DCS, so they treated him in the chamber, but there was no change in cognitive impairments. After further interviewing, the diagnosis was psychosis secondary to schizophrenia.

RO Hopkins, LK Weavers, Acute Psychosis Presenting as Decompression Illness., Psychology Dept., Brigham Young University, Provo, Utah; Department of Hyperbaric Medicine, LDS Hospital, SLC, Utah; Undersea & Hyperbaric Medicine, Volume 27, 2000 Supplement.