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Bronstein, Michael, Gordon Pennycook, Jutta Joormann, Philip Corlett i Tyrone Cannon. "T70. DUAL-PROCESS THEORY, CONFLICT PROCESSING, AND DELUSIONAL BELIEF". Schizophrenia Bulletin 46, Supplement_1 (kwiecień 2020): S258. http://dx.doi.org/10.1093/schbul/sbaa029.630.
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Abstract Background Individuals endorsing delusions exhibit multiple reasoning biases, including a bias toward lower decision thresholds, a bias toward gathering less data before forming conclusions, and a bias toward discounting evidence against one’s beliefs. Although these biases have been repeatedly associated with delusions, it remains unclear how they might arise, how they might be interrelated, and whether any of them play a causal role in forming or maintaining delusions. Progress toward answering these questions may be made by examining delusion-related reasoning biases from the perspective of dual-process theories of reasoning. Dual-process theories posit that human reasoning proceeds via two systems: an intuitive system (which is autonomous, does not require working memory) and an analytic system (which relies on working memory, supports hypothetical thought). Importantly, when the outputs of one or both systems conflict with one another, successful detection of this conflict is thought to produce additional engagement in analytic reasoning. Thus, the detection of and ensuing neurocognitive response to conflict may modulate analytic reasoning engagement. Working from this dual-process perspective, recent theories have hypothesized that more limited engagement in analytic reasoning, perhaps resulting from conflict processing deficits, may engender delusion-inspiring reasoning biases in people with schizophrenia. Methods Given this hypothesis, a literature review (Bronstein et al., 2019, Clinical Psychology Review, 72, 101748) was conducted to critically evaluate whether impaired conflict processing might be a primary initiating deficit in pathways relevant to the generation of delusion-relevant reasoning biases and the formation and/or maintenance of delusions themselves. Results Research examined in this review suggested that in healthy people, successful conflict detection raises decision thresholds. Conflict-processing deficits in delusional individuals with schizophrenia might impair this process. Consistent with this possibility, delusional individuals with schizophrenia (vs. healthy controls) make more decisions when they perceive their favored choice to be only marginally better than alternatives. Lower decision thresholds in individuals who endorse delusions may limit analytic thinking (which takes time). Reductions in decision-making thresholds and in analytic reasoning engagement may encourage these individuals to jump to conclusions, potentially promoting delusion formation, and may also increase bias against disconfirmatory evidence, which may help delusions persist. Discussion Extant literature suggests that conflict processing deficits might encourage delusion-related cognitive biases, which is broadly consistent with the idea that these deficits may be causally primary in pathways leading to delusions. This conclusion lends credence to previous theories suggesting that reduced modulation toward analytic reasoning in the presence of conflict might promote delusions. Future research should attempt to more specifically determine the source of deficits related to analytic reasoning engagement in delusional individuals with schizophrenia. It is often unclear whether analytic-reasoning-related deficits observed in existing literature result from impairments in conflict detection, responsiveness to conflict, or both. Tasks used to study dual-process reasoning in the general population may be useful platforms for specifying the nature of analytic-reasoning-related deficits in delusional individuals with schizophrenia.
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Gibbs, Ayana A., i Anthony S. David. "Delusion formation and insight in the context of affective disturbance". Epidemiologia e Psichiatria Sociale 12, nr 3 (wrzesień 2003): 167–74. http://dx.doi.org/10.1017/s1121189x00002943.
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SummaryObjective – Delusions and lack of insight have traditionally been viewed as the defining characteristics of insanity and in modern psychiatry continue to be central to the diagnosis of psychosis. Little is known about the mechanisms of delusion formation and much of the research into delusions and lack of insight has been focussed on schizophrenia, in spite of the fact that these symptoms are also prominent in other disorders e.g., affective psychosis. The objective of this paper is to review the literature on existing theories of delusions and insight with reference to the effects of affective disturbance on memory processes. Method – Narrative review supplemented by literature searches using Medline, PsycINFO and EMBASE databases for the period 1980 to present using terms “delusion”, “insight” and “affect”. Results – The role of affect on memory in normal psychology and delusions in psychopathology is being increasingly recognised. We sketch out a theory which gives weight to locating the formation and maintenance of mood congruent and mood incongruent delusional beliefs (and insight into such beliefs) within a model of normal memory processes. Conclusion – We conclude that delusional beliefs may represent false or biased memories of internal or external events modified and strengthened of by affective states. We propose that insight rests on an ability to identify these memories as internally generated or biased. In view of the growing body of knowledge accumulating from the study of memory, emotion and their neuropsychological correlates we would suggest using this as an evidence base for the further neuropsychiatric investigation of delusional beliefs.Declaration of Interest: none.
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Porcher, José Eduardo. "Can dispositionalism about belief vindicate doxasticism about delusion?" Principia: an international journal of epistemology 19, nr 3 (31.12.2015): 379. http://dx.doi.org/10.5007/1808-1711.2015v19n3p379.
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http://dx.doi.org/10.5007/1808-1711.2015v19n3p379Clinical delusions have traditionally been characterized as beliefs in psychiatry. However, philosophers have recently engaged with the empirical literature and produced a number of objections to the so-called doxastic status of delusion, stemming mainly from the mismatch between the functional role of delusions and that expected of beliefs. In response to this, an appeal to dispositionalism about the nature of belief has been proposed to vindicate the doxastic status of delusion. In this paper, I first present the objections to attributing beliefs to delusional patients and the application of dispositionalism in the attempt to vindicate doxasticism. I then assess this application and some responses to the objections to the doxastic characterization. Finally, I offer some conclusions about the limits of folk-psychological concepts in the characterization and explanation of complex psychological phenomena such as delusions.
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Lemonde, Ann-Catherine, Ridha Joober, Ashok Malla, Srividya Iyer, Martin Lepage, Patricia Boksa i Jai Shah. "M114. DELUSIONAL CONTENT AT INITIAL PRESENTATION TO A CATCHMENT-BASED EARLY INTERVENTION SERVICE FOR PSYCHOSIS". Schizophrenia Bulletin 46, Supplement_1 (kwiecień 2020): S178. http://dx.doi.org/10.1093/schbul/sbaa030.426.
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Abstract Background During a psychotic episode, patients frequently suffer from severe maladaptive beliefs known as delusions. Despite the abundant literature investigating the simple presence or absence of these beliefs, there exists little detailed knowledge regarding their actual content and severity at the onset of illness. Investigating delusions in early clinical samples is critical, because their relatively young, treatment-naïve presentations are less likely to be confounded by the effects of long-term illness or previous interventions. Furthermore, a more detailed view of the association between clinical factors and delusion severity, both globally and per theme, in a larger and more representative sample may improve psychological models and ultimately treatment options. This study reports on delusions during the initiation of indicated treatment for a first episode psychosis (FEP). Methods Data were systematically collected from a sample of 637 service users entering an early intervention service for FEP. The FEP service provides a comprehensive standardized assessment battery with longitudinal follow-up for two years of treatment. The average severity and frequency of each delusional theme at baseline was reported using the Scale for Assessment of Positive Symptoms. Delusional severity, both globally and per theme, was examined across a number of sociodemographic and clinical variables. Results Delusions of a moderate severity or higher were present in the vast majority of individuals experiencing onset of a FEP (94.0%), with persecutory (77.7%), reference (65.5%), and grandiose (40.2%) being the most common themes. Eighty-one percent of service users presented with two or more delusion themes. Persecutory delusions remained consistent in severity across diagnoses, but were more severe with older age of onset (r = .144). No meaningful differences in delusional severity were observed across sex, affective versus non-affective psychosis, or presence/absence of substance abuse or dependence. Global delusion severity was associated with anxiety (r = .205) but not with depression (r = .052), with specific relationships emerging per theme. Delusions commonly referred to as passivity experiences and/or thought alienation, mind reading delusions (r = .242) and delusions of control (r = .247), were related to hallucinatory experiences. We will also examine delusions longitudinally by investigating their relationship to the duration of untreated psychosis and outcomes, along with the stability of delusional content across episodes. Discussion Unlike the more selected samples, confounded treatment effects, and/or varying levels of chronicity seen in previous reports, this community representative sample offers a rare clinical lens into the severity and content of delusions in FEP. While delusional severity remained consistent across certain sociodemographic and clinical variables, this was not always the case. Future work may wish to investigate the evolution of delusions over time, including focusing on specific themes and/or their overlaps, including with smaller samples and in-depth, phenomenologically oriented interviews.
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Mullen, Richard. "Delusions: The Continuum Versus Category Debate". Australian & New Zealand Journal of Psychiatry 37, nr 5 (październik 2003): 505–11. http://dx.doi.org/10.1046/j.1440-1614.2003.01239.x.
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Objective: In this paper I critically review the recently developed idea that delusions are best considered as part of a continuum along with more ordinary human beliefs. Method: A literature review of the area was guided by a Medline search, and supplemented with material already known to the author. Claims that recent research supports the continuum hypothesis is critiqued. Results: The argument and evidence advanced for the continuum approach to delusions depends largely on: (i) inadequacies of prevailing definitions of delusion, particularly in the light of evidence that delusional conviction is often not absolute; and (ii) the high prevalence of unusual beliefs in community populations. To the extent that the delusion construct contains much in addition to conviction and unusual or false belief content, the continuity approach is weak. The category of delusions continues to have some validity. Conclusion: Both categorical and continuous approaches to delusions have validity that depends at any time on our immediate clinical or scientific needs. No definitive resolution of the category versus continuum debate is likely to emerge.
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Cummings, Jeffrey L. "Organic Delusions: Phenomenology, Anatomical Correlations, and Review". British Journal of Psychiatry 146, nr 2 (luty 1985): 184–97. http://dx.doi.org/10.1192/bjp.146.2.184.
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SummaryOrganic delusions are common, but have received little systematic study. Review of the literature reveals that they occur most commonly in toxicmetabolic processes and in disorders affecting the limbic system and basal ganglia. A prospective study of 20 consecutive patients with organic delusions revealed four general types of false beliefs: simple persecutory delusions, complex persecutory delusions, grandiose delusions, and those associated with specific neurological defects (anosognosia, reduplicative paramnesia). Simple delusions responded best to treatment, and complex delusions were more resistent. Acting on delusional beliefs was not unusual, and treatment of the delusions was an important aspect of management of the patient.
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White, Thomas G. "Folie Simultanée in Monozygotic Twins". Canadian Journal of Psychiatry 40, nr 7 (wrzesień 1995): 418–20. http://dx.doi.org/10.1177/070674379504000710.
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Objective To present a case report of folie simultanée in monozygotic twins. The literature describing folie à deux in twins is also reviewed and the common clinical findings are presented. Method Case presentation and review of the literature. Results Clinical observations of monozygotic twins with folie simultanée suggest that the delusions tend to progress over time with each twin reinforcing the delusion in the second. Conclusions The concept of a delusion resonating between individuals may account for the rapid progression and escalation of these delusions.
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Yumatova, P. E. "The Historical Aspect of Depressive Delusions Phenomenon Studies". Psikhiatriya 18, nr 3 (20.09.2020): 65–75. http://dx.doi.org/10.30629/2618-6667-2020-18-3-65-75.
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The aim: to provide an overview of domestic and international studies examining various aspects of issue of depressive delusional ideas in endogenous delusional depression disease patternMaterials and method: in order to compile a literature review for the keywords depressive delusions and delusional depressions, data from scientific articles posted in MedLine and PubMed databases as well as other bibliographic sources have been searched and analyzed during the formation of scientific psychiatry to the present.Discussion: based on the analysis of scientific publications, this paper presents data on the psychopathological description of depressive delusions and its relatedness to the depressive affect. The researchers’ viewpoints on primary and secondary characteristics of depressive delusions are being analyzed. We have identified pathogenetic characteristics of the latter that affect the prognostic assessment, such as features of the depressive triad in endogenous depression, severity and type of depressive affect, risk of suicidal behavior, characteristics of premorbid personality traits, genetic background, as well as therapeutic efficacy of treatment methods for depressive delusions in patients with delusional depression. This research reveals the controversial nature of some provisions of scientific publications that gradually divert from clinical diagnostic approaches, which tend to be replaced by psychological and psychoanalytic ones when carrying out prognostic assessment in cases of depressive delirium, which is characteristic of current psychiatric science.Conclusions: scientific publications data analysis testifies to the priority of the clinical and psychopathological method in studying the issues of depressive delusions structure in delusional depression disease pattern as well as in clinical differentiation of depressive delusions, justifies its clinical and prognostic value and enables to choose the treatment effectively.
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Trindade, P., C. Laginhas, C. Adão, H. Canas-Simião, A. Ribeirinho Marques i R. Caetano. "Therapeutic challenge in delusional disorder: a case report and literature review". European Psychiatry 65, S1 (czerwiec 2022): S767. http://dx.doi.org/10.1192/j.eurpsy.2022.1979.
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Introduction Delusional disorder (DD) is defined by the presence of one or more delusions, of at least one month’s duration, in the absence of prominent hallucinations or other symptoms of schizophrenia. Although functioning may not be markedly impaired, the delusion(s) or its ramifications may have a significant impact in the patient’s life. With a life-time prevalence of 0.18%, DD is still neglected in terms of approved treatment recommendations. Objectives We present the case of a patient diagnosed with DD and discuss the treatment of DD according to current evidence. Methods Relevant clinical information was extracted from the patient’s clinical process. A non-systematic review was made in Pubmed database with the terms “Delusional Disorder” and “Treatment”. Results Male, 76 years old, divorced, living alone, autonomous. First admitted at age 62 in our inpatient psychiatry ward for a persecutory delusion regarding his neighbors. He was discharged with the diagnosis of DD and started a follow-up in a mental health community team. He abandoned treatment and psychiatric consultation after 9 years. During 17 years he moved home more than 10 times due to a progressive dynamism of the delusion, leading to recent marked behavior changes towards his neighbors. He is again admitted in our inpatient psychiatry ward. Conclusions This case illustrates the impact that untreated DD can have on its patients. Although consensus using antipsychotics, there are still insufficient studies to make evidence-based recommendations to treat people with DD. Further research is needed in this sense. Disclosure No significant relationships.
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Cimino, L., A. Atti, F. Moretti, V. Morini, T. Attili, M. Forlani, A. Biondini i D. De Rochi. "Capgras’ syndrome: A case report". European Psychiatry 26, S2 (marzec 2011): 770. http://dx.doi.org/10.1016/s0924-9338(11)72475-0.
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IntroductionThe delusional misidentification syndromes (syndromes of Frégoli, Intermetamorphosis, Subjective Doubles and Capgras) are characterized by delusions of misidentification of other persons or of one-self. Aggressive ideas or behaviours often go with these delusions, but the problem received relatively little attention. Capgras’ Syndrome is characterized by the delusional belief that a well-known person has been replaced by a double. The delusion frequently involves significant others and takes place in a paranoid atmosphere with feelings of strangeness and unreality. We stress the importance of considering the potential dangerousness and homicidal acts directed towards family members of patients with Capgras’ Syndrome.MethodsWe report a case with histories of paranoid schizophrenia and alcohol and cannabis intoxications who developed a Capgras’ Syndrome associated with homicidal behaviours toward his wife.ResultsOur case met DSM IV-TR diagnostic criteria for paranoid schizophrenia, according to previous studies which show that paranoid schizophrenia is the most frequent mental disorder associated with delusional misidentification. The psychopathological analysis show that homicidal acts are connected to anguish of the ego disintegration and failure of defense mechanisms.ConclusionsAccording to the most recent literature, our findings suggest that Capgras’ Syndrome may be linked to a genesis of aggressive behaviours; alcohol and substance intoxications facilitates impulsivity and dissociation. The patients’ acting out directed toward family members occurs during a psychotic breakdown. Capgras’ Syndrome should always be evaluated in order to prevent violent acts.
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Menzies, Robin P. D., J. Paul Fedoroff, Christopher M. Green i Kari Isaacson. "Prediction of Dangerous Behaviour in Male Erotomania". British Journal of Psychiatry 166, nr 4 (kwiecień 1995): 529–36. http://dx.doi.org/10.1192/bjp.166.4.529.
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BackgroundNew cases of erotomania in men, plus cases from the literature, were analysed to explore any association between erotomania and dangerousness, and to identify possible predictors.MethodFiles at two in-patient facilities were examined to determine the presence of DSM–III–R delusional disorder, erotomanic type. The sample (13 cases) was divided into dangerous and benign groups on the basis of serious antisocial behaviour directly related to erotomanic delusions. These cases were combined with all reports of erotomania in men (16 cases), found in the English language psychiatric literature, to allow for statistical analysis.ResultsTwo factors, multiple delusional objects (P < 0.0005) and serious antisocial behaviour unrelated to the delusions (P < 0.05), were found to be significantly associated with dangerousness. Using a combination of these two variables it was possible to predict dangerousness with an accuracy of 88.9% (weighted prediction accuracy or ‘hit rate’). We identified no false negatives but three false positives.ConclusionsThe presence of multiple objects, and a history of serious antisocial behaviour unrelated to the erotomanic delusions, are useful predictors of dangerous behaviour in men with erotomania.
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van der Leer, Leslie, Bjoern Hartig, Maris Goldmanis i Ryan McKay. "Why Do Delusion-Prone Individuals “Jump to Conclusions”? An Investigation Using a Nonserial Data-Gathering Paradigm". Clinical Psychological Science 5, nr 4 (25.05.2017): 718–25. http://dx.doi.org/10.1177/2167702617698811.
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That delusional and delusion-prone individuals gather less evidence before reaching a decision (“jumping to conclusions”) is arguably the most influential finding in the literature on cognitive theories of delusions. However, the cognitive basis of this data-gathering tendency remains unclear. Suggested theories include that delusion-prone individuals gather less data because they (a) misjudge the information value of evidence, (b) find data gathering more taxing than do controls, or (c) make noisier decisions than controls. In the present study we developed a novel, incentivized, nonserial data-gathering task to tease apart these alternatives. Higher delusion-proneness was associated with gathering less information on this task, even when accounting for gender, risk aversion, and intelligence. Our findings suggest that misjudging the information value of evidence contributes substantially to the “jumping to conclusions” bias and that neither higher subjective costs nor noisy decision making can fully account for it.
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Bermanzohn, Paul C., Linda Porto, Phyllis B. Arlow, Sylvia Axelrod, Roslyn Stronger, Jeannette Martino-beyer, Simcha Pollack i Samuel G. Siris. "Obsessions and Delusions: Separate and Distinct, or Overlapping?" CNS Spectrums 2, nr 3 (marzec 1997): 58–61. http://dx.doi.org/10.1017/s1092852900004636.
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AbstractThe convergence of obsessive and schizophrenic symptoms, particularly the blending of obsessional and delusional features into complex symptoms, calls for a clarification of the relationship between obsessions and delusions, which are usually thought of as separate and distinct, even opposite entities. This brief review is a preliminary attempt to assess some of the difficult issues raised by these phenomena.We evaluate obsessions and delusions, and how they may overlap. A patient's degree of insight has been deemed a determining factor in distinguishing between these primary symptoms. However, our review of the literature shows that a definite distinction between obsessions and delusions cannot be made solely on the basis of insight.
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Adhikari, Baikuntha Raj, S. Mishra, S. Nepal i N. Sapkota. "Psychotic symptoms in bipolar disorder: Two years’ retrospective study". Health Renaissance 13, nr 1 (6.08.2017): 49–57. http://dx.doi.org/10.3126/hren.v13i1.17947.
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Background: Psychosis in bipolar disorder is common but still not well understood. There is paucity of literature from our country and none from this institute which serves the eastern part of Nepal.Objective: To describe the hallucinations and delusions in bipolar disorders in our place.Methods: Patients-record files of bipolar disorders with psychosis discharged in two years’ time from 2012 to 2014 were analysed. Patients with unipolar depression, recurrent depressive disorder, serious organic illness, and primary substance use disorders were excluded. Information was collected in a structured performa. Association of delusion and hallucination was observed.Results: During the study period, ninety-five patients with bipolardisorder had psychosis. Hallucination was present in 29 (30.5%) cases, and out of these 23 (79.3%) were cases of mania. In 26 (89.7%) patients, the hallucinations were mood congruent. The median duration of appearance of hallucination was 10 days and appeared early in mania. Among hallucinations, auditory verbal hallucinations were present in all 29 patients. Delusions were present in 77 (81.1%) of patients, and grandiose delusions were the most common. Grandiose delusions tended to occur even in the absence of hallucinations. Conclusion: Psychosis is common in bipolar disorder. Grandiose delusions are the most common delusion and are relatively independent of hallucination. The auditory verbal hallucinations are the most common type of hallucination. Hallucinations in mania tend to manifest earlier than in bipolar depression and mixed episode, and most of the hallucinations in bipolar disorder are mood congruent. Health Renaissance 2015;13 (1): 49-57
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O'Dwyer, Anne-Marie, i Isaac Marks. "Obsessive-compulsive disorder and delusions revisited". British Journal of Psychiatry 176, nr 3 (marzec 2000): 281–84. http://dx.doi.org/10.1192/bjp.176.3.281.
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BackgroundThe concept of fixed, unshakeable (delusional) beliefs within the context of obsessive–compulsive disorder (OCD) is one that has received varying amounts of attention in the literature, and has not yet received universal acknowledgement. There are good grounds for including these cases within the diagnostic concepts of OCD, with significant implications for clinical management.AimsTo present cases with unusual OCD, in order to re-evaluate the issue of delusions and OCD.MethodThe cases of five subjects with delusions in the course of obsessive–compulsive disorder are presented to illustrate ‘delusional’ OCD. The management and outcome of these cases are discussed.ResultsFixity and bizarreness of beliefs in OCD occur on a continuum from ‘none’ to ‘delusional intensity’ and may fluctuate within subjects.ConclusionsThe idea that these cases may represent a form of OCD has implications for management, as, if this is correct, they should be able to respond to appropriate behavioural and/or pharmacological strategies used in OCD.
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Garety, P. A., i D. Freeman. "The past and future of delusions research: from the inexplicable to the treatable". British Journal of Psychiatry 203, nr 5 (listopad 2013): 327–33. http://dx.doi.org/10.1192/bjp.bp.113.126953.
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BackgroundProblems with the diagnosis and treatment of schizophrenia have led for a call to change strategy and focus on individual psychotic experiences. In recent years, research on delusions has led the way.AimsTo update our 1999 review of almost 40 studies on delusions.MethodA systematic literature search was conducted of reasoning and affective processes related to delusions.ResultsOver 200 studies were identified. The presence of jumping to conclusions' in individuals with delusions has been substantiated, the theory of mind account has not stood up to subsequent testing, and there is a promising new focus on the ways that affective processes contribute to delusional experience.ConclusionsTheoretical work rendering delusions understandable can be translated into treatment; future clinical trials should focus on individual psychotic experiences as outcomes.
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Fennema, J., S. Petrykiv, L. De Jonge i M. Arts. "Citalopram–induced delusions in an older adult". European Psychiatry 41, S1 (kwiecień 2017): S751—S752. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1399.
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IntroductionSelective serotonin reuptake inhibitors (SSRIs) are the most prescribed antidepressants worldwide. In older adults, citalopram is generally well tolerated and safe in the therapeutic dose range of 20 to 40 mg/day. In literature, there are cases of SSRI-induced psychosis, but mainly with fluoxetine. There are only three reported cases of citalopram-induced delusions, however, these case-reports did not involve an older adult.Objectives and aimsTo provide a case of citalopram–induced psychosis in an older adult, followed by the review of available literature.MethodsA case report is presented and discussed followed by a literature review.ResultsA 64-year-old woman without somatic illnesses was referred by a general practitioner with depressive symptoms. One week after initiation of citalopram 10 mg/day she suddenly developed delusions, predominantly in the early morning. No other medical evidence was found that could explain her delusions. After discontinuation of citalopram her delusions quickly resolved.ConclusionThis is the first case report of a SSRI-induced delusion in an older adult. Citalopram has been reported to be one of the safest SSRIs. Although most SSRI's have a mild side-effect profile, care should be taken when initiating SSRIs since unpredictable adverse effects may occur.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kelly, Brendan D. "Love as delusion, delusions of love: erotomania, narcissism and shame". Medical Humanities 44, nr 1 (8.07.2017): 15–19. http://dx.doi.org/10.1136/medhum-2017-011198.
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Erotomania has a long, colourful history in psychiatry. It is a rare condition in which the patient (‘subject’) develops the belief that he or she is loved from afar by another person (‘object’). The subject is generally female, though men predominate in forensic samples. The object is generally perceived to belong to a higher social class, reflecting a sociopolitical element in the construction of love. Erotomania requires active treatment and risk management as it can be associated with stalking and other offending behaviour. In addition to featuring in the psychiatry literature, erotomania features in the biography of the economist John Maynard Keynes (the apparent ‘object’ of a woman’s erotomanic delusions in the early 1900s) and in fiction (eg, Ian McEwan’s Enduring Love); this reflects, in part, the general popularity of romantic themes in broader literature and society. In psychological terms, certain cases of erotomania might be underpinned by combinations of longing, disappointment, shame and narcissism in specific social contexts. Lesser forms of delusional exaggeration of true love might also exist in some stable relationships, and might even be essential for their continued existence. Overall, the division between love and delusions of love is not as distinct as one might imagine. The potential presence of an element of delusional love in many relationships might well serve important social functions, conferring specific advantages on the parties involved and increasing social and community stability. After all, delusions persist; love dies.
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Bondareff, William. "Neuropathology of Psychotic Symptoms in Alzheimer's Disease". International Psychogeriatrics 8, S3 (maj 1997): 233–37. http://dx.doi.org/10.1017/s1041610297003402.
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An impressive body of literature has been published on the relationship between psychotic symptoms in Alzheimer's disease and pathology demonstrated primarily by neuroimaging and biochemistry studies. Jacoby and Levy in 1980 and Burns and colleagues in 1990, for example, reported less severe atrophy in delusional patients with Alzheimer's disease than in nondelusional patients with Alzheimer's disease. The author and colleagues have found that smaller ventricle-brain ratios are associated with delusions of theft in Alzheimer's disease. Zubenko (1991) and Doty (1989) have reported that delusions and hallucinations in patients with Alzheimer's disease are associated with decreased amounts of serotonin.
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Camilo, J., R. Silva, I. Vaz i M. Roque. "“I am the coronavirus”: A case report and review". European Psychiatry 64, S1 (kwiecień 2021): S294. http://dx.doi.org/10.1192/j.eurpsy.2021.788.
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IntroductionAs disorders of thought, delusions are modified by patients’ background, and so their content varies widely according to location and throughout the ages. The COVID-19 pandemic has shown its global impact on society and mental health of the population, thus becoming a new delusional topic.ObjectivesWe report a case where the COVID-19 pandemic has been integrated into a patient’s delusion in an attempt to raise professional awareness for this new psychotic presentation.MethodsReview of clinical notes and literature review.ResultsA 38-year-old female patient with no prior psychiatric history presented with psychotic symptoms characterized by self-referential ideas, feelings of guilt and delusions of ruin, with a sudden onset of less than 24 hours prior to observation. The patient claimed that she was the coronavirus and, as such, she was a common topic of conversation in both television and social media, and the reported deaths caused by COVID-19 were her own doing. As a result of this, the patient was asking doctors to kill her in order to save everyone else affected by the virus. After evaluation, a diagnosis of Acute and Transient Psychotic Disorder was considered. The patient was initially treated with paliperidone, but due to hyperprolactinemia and menstrual changes this was switched to aripiprazole. Symptoms remitted fully after 21 days of treatment, and six months later no recurrences have been described.ConclusionsThis case illustrates the potential of the coronavirus pandemic outbreak as a new delusional topic. Possible side effects of treatment are also discussed.
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Veling, W., B. Sizoo, J. Van Buuren, C. Van Den Berg, W. Sewbalak, G. Pijnenborg, N. Boonstra, S. Castelein i L. Van Der Meer. "Are conspiracy theorists psychotic? A comparison between conspiracy theories and paranoid delusions". European Psychiatry 65, S1 (czerwiec 2022): S796—S797. http://dx.doi.org/10.1192/j.eurpsy.2022.2059.
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Introduction Conspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions. Objectives To explore the nature, consequences, and social-psychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions. Methods Critically assessing relevant literature about conspiratorial thinking and paranoid delusions. Results Conspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost always the only target of the presumed conspiracy, and they usually stand alone in their conviction. Furthermore, conspiracy theories are not based as much on unusual experiences of their inner self, reality, or interpersonal contacts. Conclusions Conspirational thinking is common in uncertain circumstances. It gives grip, certainty, moral superiority and social support. Extreme conspirational thinking seems to fit current psychiatric definitions of paranoid delusions, but there are also important differences. To make a distinction with regard to conspiratorial thinking, deepening of conventional definitions of delusions is required. Instead of the strong focus on the erroneous content of delusions, more attention should be given to the underlying idiosyncratic, changed way of experiencing reality. Disclosure No significant relationships.
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Buscarino, Martha, Jaime Saal i Joel L. Young. "Delusional Parasitosis in a Female Treated with Mixed Amphetamine Salts: A Case Report and Literature Review". Case Reports in Psychiatry 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/624235.
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Objectives. To explore factors underlying the onset of delusional parasitosis; a condition in which an individual has a fixed, false belief that he/she is infested with insects.Case Description. MJ is a 57-year-old female who presents with symptoms of fatigue and AD/HD. Upon treatment with extended release mixed amphetamine salts, the patient displayed symptoms of delusional parasitosis. After eventual discontinuation of this medication, her delusions resolved.Comments. In order to maintain confidentiality, all identifying information was removed. To this end, please note that MJ is a fictitious name.
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Guillard, V., J. Mallet i F. Limosin. "Erotomania and mood disorder: A case report and literature review". European Psychiatry 33, S1 (marzec 2016): S632. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2375.
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IntroductionErotomania is a rare delusional disorder. De Clerambault, a French psychiatrist, was the first who advanced the concept of pure erotomania, one of the “passionate psychosis”, as a distinct disorder. However, some authors tend to consider this syndrome as related to other psychiatric disorders.ObjectivesTo describe the case of a female patient with erotomanic delusion with no remission under an antipsychotic and to review the links between erotomania and other psychiatric disorders.MethodsLiterature review and a case report.ResultsWe report the case of a 32 year-old epileptic woman, hospitalized for a delusional erotomanic disorder. Initially, the patient was treated with an antipsychotic, with partial effectiveness. In fact, it appeared that the conviction of being loved began while she was depressed. After one month of combined antipsychotic and antidepressive medication, she became euthymic and her erotomanic delusions disappeared. Major depressive disorder with psychotic symptoms was diagnosed. After reviewing the literature we found that erotomanic symptoms frequently appear secondarily in other psychiatric disorders. Several publications indicate a frequent association between erotomania and mood disorder, especially bipolar affective disorder and major depression, and describe the efficacy of antidepressant and mood stabilizers. Numerous theories may explain the link between erotomania and mood disorder: from narcissistic needs, to the capacity of empathy and emotional processing. Further studies are needed to clarify the nature of this link.ConclusionIn clinical practice, a mood disorder must systematically be searched for and treated in a patient with erotomanic delusions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Wixson. "Dilemmas and Delusions". Shaw 34, nr 1 (2014): 1. http://dx.doi.org/10.5325/shaw.34.1.0001.
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Kozumplik, Oliver, Suzana Uzun, Dubravka Kalinic, Ivan Pozgain i Ninoslav Mimica. "Occurrence of Delusions in Patients with Dementia – Literature Review". Socijalna psihijatrija 47, nr 3 (11.11.2019): 318–24. http://dx.doi.org/10.24869/spsih.2019.318.
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Arts, M., S. Petrykiv, J. Fennema i L. De Jonge. "A Case of Erotomanic Delusion in Dementia". European Psychiatry 41, S1 (kwiecień 2017): S646. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1071.
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IntroductionIn dementia, delusions are common with prevalence up to 75%. However, erotomanic delusions, or De Clerambault's syndrome, are a rarity in dementia. To date, only six case-reports have been described in vascular dementia, frontotemporal dementia, and Alzheimer's dementia.ObjectivesTo present a case of De Clerambault's syndrome in an older adult diagnosed with vascular dementia.AimsTo review available literature on De Clerambault's syndrome in dementia.MethodsA case report is presented and discussed followed by a literature review.ResultsWe report a 72-year-old female with a history of right posterior cerebral artery infarction. The patient developed a sudden onset erotomanic delusion after she met a male patient of her age during her stay in a dementia day care center. She was agitated, disorientated, presented with confabulation, and showed a dysphoric mood. On MMSE she scored 14/30, the clock-drawing test revealed visuospatial deficits. On MRI, the right occipital lobe showed an encephalomalacia. The patient was treated with sertraline 50 mg/day and olanzapine 5 mg/day. Her erotomanic delusions improved after 3 months of treatment.ConclusionDe Clerambault's syndrome is a rare and poorly understood disorder with generally a poor response to treatment. Some cases were successfully treated with atypical anti-psychotics. However, further research is needed to explore the course and treatment of this delusion.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Strauss, John S. "The Person with Delusions". British Journal of Psychiatry 159, S14 (listopad 1991): 57–61. http://dx.doi.org/10.1192/s0007125000296499.
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“And the end of our exploring Will be to arrive where we started And know the place for the first time.” (Eliot, 1952, p. 145)In preparing this report I made the mistake of looking back in the literature, the literature not only of delusions, but also including some more general works of the earlier clinical writers, such as Birnbaum (1923), Conrad (1958), Jaspers (1963) and Kretschmer (1927). It was a humbling experience; these were obviously people who knew something about patients and about the realities of symptoms. For these writers, notions such as delusions were not just abstractions, not even just abstractions with operational definitions. These authors described real experiences of people, and their descriptions reflect the importance of studying patients from close clinical contact.
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van der Leer, L., B. Hartig, M. Goldmanis i R. McKay. "Delusion proneness and ‘jumping to conclusions’: relative and absolute effects". Psychological Medicine 45, nr 6 (30.09.2014): 1253–62. http://dx.doi.org/10.1017/s0033291714002359.
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Background.That delusional and delusion-prone individuals ‘jump to conclusions’ is one of the most robust and important findings in the literature on delusions. However, although the notion of ‘jumping to conclusions’ (JTC) implies gathering insufficient evidence and reaching premature decisions, previous studies have not investigated whether the evidence gathering of delusion-prone individuals is, in fact, suboptimal. The standard JTC effect is a relative effect but using relative comparisons to substantiate absolute claims is problematic. In this study we investigated whether delusion-prone participants jump to conclusions in both a relative and an absolute sense.Method.Healthy participants (n = 112) completed an incentivized probabilistic reasoning task in which correct decisions were rewarded and additional information could be requested for a small price. This combination of rewards and costs generated optimal decision points. Participants also completed measures of delusion proneness, intelligence and risk aversion.Results.Replicating the standard relative finding, we found that delusion proneness significantly predicted task decisions, such that the more delusion prone the participants were, the earlier they decided. This finding was robust when accounting for the effects of risk aversion and intelligence. Importantly, high-delusion-prone participants also decided in advance of an objective rational optimum, gathering fewer data than would have maximized their expected payoff. Surprisingly, we found that even low-delusion-prone participants jumped to conclusions in this absolute sense.Conclusions.Our findings support and clarify the claim that delusion formation is associated with a tendency to ‘jump to conclusions’. In short, most people jump to conclusions, but more delusion-prone individuals ‘jump further’.
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Gedevani, E., G. Kopeiko, O. Borisova, A. Iznak i P. Orekhova. "Clinical case of religious delusion in a combination of schizoaffective disorder and epilepsy". European Psychiatry 65, S1 (czerwiec 2022): S707. http://dx.doi.org/10.1192/j.eurpsy.2022.1822.
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Introduction Despite existing observations of religious delusions in epilepsy in classical psychiatric literature, such clinical cases are rare in current practice. Objectives To reveal features of disease progression, interference of combined mental pathology, treatment specifics, markers of possible harmful behavior. Methods Psychopathological, Multichannel eyes closed resting EEG in interictal period. Results Patient N, 39 years old, manifested her illness at age 13 with affective bipolar disorder; phases lasted several months each. From age 19, rare recurrent generalized convulsive paroxysms preceded by an aura; non-convulsive paroxysms were observed. The patient was uncritical of paroxysms and discontinued anticonvulsive therapy. At age 29 and 30 she suffered two psychotic attacks (lasting several weeks) with sensory delusions of meaning, staging, persecution, megalomaniacal ideas of apocalyptic content (ideas that she was responsible for possible outbreak of nuclear war, coming of the Apocalypse, her son was the antichrist). Delusional behavior (tried to take the naked infant out into the cold, throwing him out of the window). Anticonvulsive therapy accompanied by antipsychotic medications. Schizoaffective disorder and epilepsy diagnosed. From age 35, acute psychotic attacks with apocalyptic delirium preceded by the same aura lasted maximum one day, followed by partial amnesia. Epileptiform polyspikes (up to 150 μV) registered in the right temporal-central EEG leads. Conclusions Presence of religious delusion in combined schizoaffective disorder and epilepsy, requires special approach: combination of anticonvulsants and antipsychotics. Religiosity of patient should be taken into account as well. Disclosure No significant relationships.
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González-Rodríguez, Alexandre, i Mary V. Seeman. "Addressing Delusions in Women and Men with Delusional Disorder: Key Points for Clinical Management". International Journal of Environmental Research and Public Health 17, nr 12 (25.06.2020): 4583. http://dx.doi.org/10.3390/ijerph17124583.
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Delusional disorders (DD) are difficult conditions for health professionals to treat successfully. They are also difficult for family members to bear. The aim of this narrative review is to select from the clinical literature the psychosocial interventions that appear to work best for these conditions and to see whether similar strategies can be modeled or taught to family members so that tensions at home are reduced. Because the content of men’s and women’s delusions sometimes differ, it has been suggested that optimal interventions for the two sexes may also differ. This review explores three areas: (a) specific treatments for men and women; (b) recommended psychological approaches by health professionals, especially in early encounters with patients with DD; and (c) recommended psychoeducation for families. Findings are that there is no evidence for differentiated psychosocial treatment for men and women with delusional disorder. What is recommended in the literature is to empathically elicit the details of the content of delusions, to address the accompanying emotions rather than the logic of the presented argument, to teach self-soothing techniques, and to monitor behavior with respect to its safety. These recommendations have only been validated in individual patients and families. More rigorous clinical trials need to be conducted.
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González-Rodríguez, Alexandre, José Antonio Monreal, Mentxu Natividad i Mary V. Seeman. "Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders". Healthcare 10, nr 9 (8.09.2022): 1729. http://dx.doi.org/10.3390/healthcare10091729.
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Background: There is increasing evidence that individuals with psychosis are at increased risk for cardiovascular disease, diabetes, metabolic syndrome, and several other medical comorbidities. In delusional disorder (DD), this is particularly so because of the relatively late onset age. Aims: The aim of this narrative review is to synthesize the literature on the necessity for medical collaboration between psychiatrists and other specialists. Methods: A non-systematic narrative review was carried out of papers addressing referrals and cooperation among specialists in the care of DD patients. Results: Psychiatrists, the primary care providers for DD patients, depend on neurology to assess cognitive defects and rule out organic sources of delusions. Neurologists rely on psychiatry to help with patient adherence to treatment and the management of psychotropic drug side effects. Psychiatrists require ophthalmology/otolaryngology to treat sensory deficits that often precede delusions; reciprocally, psychiatric consults can help in instances of functional sensory impairment. Close collaboration with dermatologists is essential for treating delusional parasitosis and dysmorphophobia to ensure timely referrals to psychiatry. Conclusions: This review offers many other examples from the literature of the extent of overlap among medical specialties in the evaluation and effective treatment of DD. Optimal patient care requires close collaboration among specialties.
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Viseu, M., F. Tavares i M. Barbosa Pinto. "Capgras and Fregoli delusions - a case report". European Psychiatry 65, S1 (czerwiec 2022): S704. http://dx.doi.org/10.1192/j.eurpsy.2022.1813.
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Introduction Capgras and Fregoli delusions are psychotic complex conditions that integrate a larger group of Delusional Misidentification Syndromes (DMS), where the patient misidentifies people, places or objects. Objectives Review of the literature and exposure of a case report of a first psychotic episode with DMS. Methods Case report and a nonsystematic review through databases. With the keywords: Capgras; Fregoli; DMS. Results This case presents a caucasian male, 34-year-old, with no personal or family history of psychiatric pathology. He was taken to the emergency service, due to behavior disorder with verbal aggressiveness to his mother. During the psychiatric emergency he was restless, with accelerated speech and presented Capgras and Fregoli delusion. He believed that his mother had been replaced by an imposter and that the doctor was actually his childhood friend disguised, all with the intention of harming him. The patient was hospitalized, analytical and brain scan show no abnormally. Improvement in symptoms was been seen when a long-term injectable antipsychotic was started. The diagnosis was Bipolar type I disorder. Conclusions DSM are more frequent than previously considered, they often occur in association with psychiatric or neurological disorders. Case reports like this one helps to clarify the association between DMS and psychiatric disorders. Given the high incidence of DMS, it is essential to recognize them, carry out an early treatment and be alert to other psychopathological or neurological symptoms that may coexist. Disclosure No significant relationships.
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Gold, Allen, Zhanna Roit i Ingrid Llovera. "Pitfalls and Pearls in Delusional Parasitosis". Clinical Practice and Cases in Emergency Medicine 3, nr 4 (14.10.2019): 387–89. http://dx.doi.org/10.5811/cpcem.2019.8.44619.
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Delusional parasitosis is an uncommon psychiatric disorder that manifests as having parasitic delusions. Due to its rarity, delusional parasitosis is a challenging and costly diagnosis of exclusion and proves difficult to manage for many providers. Although this syndrome is frequently discussed in psychiatric and dermatology reports, it is not commonly described in emergency medicine (EM) literature. As a result, best practices for workup and treatment remain unclear from an EM perspective. Patients typically return multiple times for medical evaluation and exhaust numerous resources. In this case report we review the appropriate steps for initial evaluation of patients with suspected delusional parasitosis, differential diagnoses, and increase awareness for prudent treatment strategies.
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Lewis, Tess, Hans Magnus Enzensberger i Martin Chalmers. "Delusions of Mediocrity". Hudson Review 45, nr 4 (1993): 689. http://dx.doi.org/10.2307/3852501.
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Higgins, Oliver, Brooke L. Short, Stephan K. Chalup i Rhonda L. Wilson. "Interpretations of Innovation: The Role of Technology in Explanation Seeking Related to Psychosis". Perspectives in Psychiatric Care 2023 (8.02.2023): 1–16. http://dx.doi.org/10.1155/2023/4464934.
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Background. The prominence of technology in modern life cannot be understated. However, for some people, these innovations or their related plausible advancements can be associated with perceptual misinterpretation and/or incorporation into delusional concepts. Objective. This paper aims to explore the intersection of technological advancement and experiencing psychosis. We present a discussion about the explanation seeking that incorporates the concept, that for some people, of technological innovation becoming intertwined with delusional symptoms over the past 100 years. Methods. A longitudinal review of the literature was conducted to synthesize and draw these concepts together, mapping them to a timeline that aligns computing science and healthcare expertise and presents the significant technological changes of the modern era charted against mental health milestones and reports of technology-related delusions. Results. It is possible for technology to be incorporated into the content of delusions with evidence supporting a link between the rate of technological change, the content of delusions, and the use of technology as a way of seeking an explanation. Moreover, analysis suggests a need to better understand how innovations may impact the mental health of people at risk of psychosis and other mental health conditions. Conclusions. Clinical experts and lived experience experts need to be informed about and collaborate with future research and development of technology, specifically artificial intelligence and machine learning, early in the development cycle. This concurs with other artificial intelligence research recommendations calling for design attention to the development and implementation of technological innovation applied in a mental health context.
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de Silva, Nipun Lakshitha, Janith Galhenage, Madhubhashinee Dayabandara i Noel Somasundaram. "Sheehan Syndrome Presenting with Psychotic Manifestations Mimicking Schizophrenia in a Young Female: A Case Report and Review of the Literature". Case Reports in Endocrinology 2020 (4.12.2020): 1–6. http://dx.doi.org/10.1155/2020/8840938.
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Introduction. Sheehan syndrome presents with features of multiple hormone deficiencies including lactation failure and amenorrhoea as well as with features of central hypothyroidism and adrenocorticotropic hormone deficiency. Psychiatric manifestations are mostly limited to cognitive impairment. Psychotic presentations are rare and limited to case reports. Case Presentation. A 32-year-old female was evaluated for fearfulness and delusions for one year. She had persecutory and bizarre delusions, delusion of thought possession, and elementary auditory hallucinations. These began four months after the birth of her third child. The delivery had been complicated with postpartum haemorrhage. Her symptoms caused the functional decline and progressively worsened, resulting in suicidal ideation. Cognitive assessment revealed mild impairment in attention. Further inquiry revealed lethargy, constipation, cold intolerance, and lactation failure. She was slow, having dry skin, puffy face, and bradycardia with a blood pressure of 80/60 mmHg (supine) and 70/50 mmHg (standing). She had hyponatraemia, elevated creatine phosphokinase, low thyroxine, prolactin, FSH, LH, and IGF-1. She had poor cortisol and growth hormone response to the insulin tolerance test. MRI-pituitary showed empty sella. A diagnosis of Sheehan syndrome was made. Her symptoms improved completely after the initiation of levothyroxine and hydrocortisone. Conclusions. Sheehan syndrome can present with psychotic symptoms mimicking schizophrenia with variable involvement of cognition. Detailed reporting of these patients would enhance better characterization of the clinical presentation and risk profile of these patients.
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Kelly, Brendan D., Zainab Abood i David Shanley. "Vampirism and schizophrenia". Irish Journal of Psychological Medicine 16, nr 3 (wrzesień 1999): 114–15. http://dx.doi.org/10.1017/s0790966700005413.
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AbstractA case of schizophrenia with vampiric delusions is described. The relevant classical and contemporary literature is reviewed, both in relation to clinical vampirism and the relationship between vampirism and schizophrenia. In patients with vampiric delusions, the possibility of future vampiric behaviour should be considered, and appropriate treatment initiated.
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Francis, Richard, Hui Ching, Himanshu Tyagi, Orlando Swayne, Sara Ajina i Bernadette Monaghan. "17 Presentation of Capras syndrome in anti-NMDA receptor encephalitis: a neuro-rehabilitation approach". Journal of Neurology, Neurosurgery & Psychiatry 91, nr 8 (20.07.2020): e14.2-e15. http://dx.doi.org/10.1136/jnnp-2020-bnpa.34.
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Objectives/AimsCapgras syndrome is not often seen in neuro-rehabilitation and few case-reports of Capgras syndrome after anti-NMDA receptor encephalitis exist in literature. This case is relevant in light of how the Capgras sydrome and delusional beliefs affected this patient’s discharge planning, engagement with the multi- disciplinary team during rehabilitation and side-effects of pharmacological management. The challenging aspects of the case revolve around the patient’s persecutory beliefs, his delusional misidentifation disorder and its subsequent management.MethodsThe patient is a middle-aged gentleman with a background of relapsing- remitting multiple sclerosis who presented with seizures, headache, rash and intermittent fevers. He was initially treated as infectious meningoencephalitis and his condition deteriorated due to combination of behavioural change and seizures. A MRI-head suggested viral encephalitis but lumbar puncture and serum showed strongly positive for anti-NMDA receptor antibodies, thought potentially secondary to the patient’s disease-modifying drugs for his multiple sclerosis. After step-down from Intensive Care, the patient was noted to have fixed persecutory delusions regarding his wife and children. He believed that his wife and children were imposters and that the hospital and doctors within it were conspiring against him. He was managed initially with risperidone however the dose could not be increased due to the sedating side-effects resulting in an inability to engage with rehabilitation. He was subsequently changed to aripiprazole and escitalopram with the intention to decrease his delusional misidentification disorder. His delusions partially resolved with the patient accepting his children as his own, but not accepting his wife as truly ‘his wife’. The discharge destination represented a difficulty due to concerns that he may become aggressive (physically/verbally) to his wife if he continued to deem her an ‘imposter’. The patient was managed by sidestepping the conflict; he was more accepting of his wife if introduced as a ‘friend who loves him’. The patient was also allowed to drive the narrative rather than forced to deal with his Capgras syndrome. Results: A discharge home with support (including his wife) became feasible as his delusion thawed.ConclusionsManaging complicated patients like this involves not only pharmacological options but also psychological/psychiatric intervention and employment of non-confrontational techniques to help better engagement with rehabilitation.
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Aissa, A., H. Ghabi, D. Khattech, S. Meddouri, U. Ouali i F. Nacef. "A delusion of pregnancy in man with hyperprolactinemia". European Psychiatry 64, S1 (kwiecień 2021): S767. http://dx.doi.org/10.1192/j.eurpsy.2021.2031.
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IntroductionA delusion of pregnancy in men has been rarely reported in psychiatric disorders. The literature on this delusion in male schizophrenia is limited. It was reported especially in medical conditions. In psychiatric disorders, it has been explained for a long time by psychodynamic theories.ObjectivesTo present a case of a pregnancy delusion in man associated temporally to neuroleptic-induced hyperprolactinemia and a review of literature of medical and psychological etiologies of this symptomMethodsWe presented a case of a pregnancy delusion in man associated temporally to neuroleptic-induced hyperprolactinemia and we elucidated through a review of literature of medical and psychological etiologies of this symptom.ResultsCase report A 46-year-old man, unmarried, who had a mild intellectual disability and a 22-year history of schizophrenia. He was admitted to our hospital for psychotic relapse due to the interruption of his medication. This patient had been treated for years with long action injection medication. On admission he was disorganized, verbalizing a poorly-systematized fuzzy delirium. And he believed he was pregnant. Serum prolactin levels was 38 ng/ml (3-25ng/ml). He was put on Haldol decanoate 150mg/month, chlorpromazine 150mg/day, and diazepam 15mg/day.ConclusionsThe presentation of a delusion of pregnancy in man is rather infrequent. The delusion may have many social, psychological, and biological determinants to its genesis. This case highlights the importance of medical investigations notably the assay of prolactin in the assessment of patients who present with delusions of pregnancy.DisclosureNo significant relationships.
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Corcoran, R. "The allusive cognitive deficit in paranoia: the case for mental time travel or cognitive self-projection". Psychological Medicine 40, nr 8 (5.01.2010): 1233–37. http://dx.doi.org/10.1017/s003329170999211x.
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Delusional beliefs are characteristic of psychosis and, of the delusions, the paranoid delusion is the single most common type associated with psychosis. The many years of research focused on neurocognition in schizophrenia, using standardized neurocognitive tests, have failed to find conclusive cognitive deficits in relation to positive symptoms. However, UK-based psychological research has identified sociocognitive anomalies in relation to paranoid thinking in the form of theory of mind (ToM), causal reasoning and threat-related processing anomalies. Drawing from recent neuroscientific research on the default mode network, this paper asserts that the common theme running through the psychological tests that are sensitive to the cognitive impairment of paranoia is the need to cognitively project the self through time, referred to as mental time travel. Such an understanding of the cognitive roots of paranoid ideation provides a synthesis between psychological and biological accounts of psychosis while also retaining the powerful argument that understanding abnormal thinking must start with models of normal cognition. This is the core theme running through the cognitive psychological literature of psychiatric disorders that enables research from this area to inform psychological therapy.
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Borsje, Petra, Roland B. Wetzels, Peter L. Lucassen, Anne Margriet Pot i Raymond T. Koopmans. "The course of neuropsychiatric symptoms in community-dwelling patients with dementia: a systematic review". International Psychogeriatrics 27, nr 3 (18.11.2014): 385–405. http://dx.doi.org/10.1017/s1041610214002282.
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ABSTRACTBackground:Neuropsychiatric symptoms (NPS) often occur in patients with dementia. Understanding the course of NPS in dementia is important for healthcare professionals for psycho-educational purposes and adequate and timely interventions to prevent or diminish NPS as much as possible.Methods:We conducted a systematic literature search in several electronic databases. We combined search strings for the terms dementia, community-dwelling, cohort studies and NPS. Screening titles and abstracts, assessing the methodological quality and data-extraction were independently conducted by at least two authors.Results:This literature search revealed 6605 unique records of which 23 studies were included in data synthesis. In total 7184 patients participated in the included studies with a mean number of 312. Sixty percent of the participants were female and the mean age of all participants was 74.8 years. Follow-up varied between 1 and 6 years; in 17 studies loss to follow-up was less than 20% per year. NPS are highly prevalent, incident and persistent although frequency parameters vary considerably across studies. Delusions/delusional misidentification, wandering/agitation, aberrant motor behavior/motor hyperactivity and apathy are the most common NPS. For hallucinations, delusions/delusional misidentification, paranoia, aggression, wandering/agitation, aberrant motor behavior/motor hyperactivity, disinhibition, apathy, and sleep disturbance increasing trends in point prevalence rates have been found.Conclusions:NPS in community-dwelling patients are frequent and persistent. The increasing trends of several NPS in the course of dementia require a preventive approach of professional caretakers. For such an approach, a timely diagnosis and adequate professional support to prevent or diminish these problems is necessary.
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Pruccoli, Jacopo, Giulia Joy Leone, Cristina Di Sarno, Luigi Vetri, Giuseppe Quatrosi, Michele Roccella i Antonia Parmeggiani. "Adjunctive Clotiapine for the Management of Delusions in Two Adolescents with Anorexia Nervosa". Behavioral Sciences 11, nr 12 (10.12.2021): 173. http://dx.doi.org/10.3390/bs11120173.
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Clotiapine is an atypical antipsychotic indicated for the management of a series of acute psychotic disorders. The current literature lacks evidence concerning the tolerability and clinical use of this drug in the management of individuals with anorexia nervosa (AN). In this study, we report two cases of adolescents with AN, treated with clotiapine. The reason for the administration of clotiapine was, for both patients, the manifestation of bizarre delusions concerning food and calories. Patient 1 presented a presyncope after the first dose of clotiapine, and treatment was rapidly discontinued. Patient 2 was treated with clotiapine for 9 months; doses were titrated from 20 mg/day to 70 mg/day, with an improvement in the reported delusions, which also enhanced compliance with psychological and nutritional interventions. EKG, QTc, white blood count, and red blood count were not relevantly influenced by the introduction of clotiapine in either patient. No extrapyramidal effect was documented. These reports stress the need for further studies assessing the tolerability and potential effect of clotiapine in treating adolescents with AN and delusional symptomatology.
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Turk, M. L., i J. Rosen. "The emergence of psychosis in a patient with severe hypothyroidism: A case report and literature review". European Psychiatry 41, S1 (kwiecień 2017): s842. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1662.
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Hypothyroidism is associated with changes in mental state that can range from mild cognitive impairment to depression to florid myxedema coma. A few cases have linked the occurence of psychotic symptoms in the context of severe hypothyroidism, an event referred in the literature as “myxedema madness”. We describe the case of a 48-year-old male with no past psychiatric history and a past medical history of hypertension and hypothyroidism who presented to the psychiatric unit for management of new-onset psychosis, particularly paranoid delusions. On basic medical screening, the patient was found to have severe hypothyroidism manifested by a TSH level of 51.85 and a free T4 level less than 0.4. The patient was treated with both an antipsychotic and thyroid hormone replacement, after which his hypothyroid symptoms and his psychosis improved. Liothyronine was also prescribed to speed up the recovery course, as his delusions were thought to be due to his hypothyroidism. The aim of this poster is to shed light on the possibility of development of psychosis concomitantly with severe hypothyroidism, given the rarity of such events, as well as to illustrate the importance of treating the underlying medical cause rather than only focusing on the treatment of the psychiatric symptoms. The use of Liothyronine proved to be beneficial in this case, as the patient's symptoms drastically improved after its administration. This could potentially illustrate the importance of using Liothyronine particularly in the treatment of delusional disorder in severe hypothyroidism.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Vieira, S., i G. Marinho. "Cotard syndrome in a patient with multiple sclerosis: A case report". European Psychiatry 64, S1 (kwiecień 2021): S800—S801. http://dx.doi.org/10.1192/j.eurpsy.2021.2117.
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Introduction“Cotard syndrome” is a rare condition characterized by a constellation of clinical features, including hypochondriac and nihilistic delusions, the most characteristic of which are the ideas that one is dead or that their organs do not exist. It is more commonly associated with psychotic depression and schizophrenia but can also be found in several neurological disorders. In the clinical practice it generally appears as an “incomplete Cotard”, reduced to hypochondriac delusions attributed to the malfunction or occlusion of the organs, usually the digestive tract and abdominal viscera. Consequently it is common for these patients to reject food or medications. In literature it has been divided into three types, according to the clinical symptoms: psychotic depression, Cotard type I, and Cotard type II.ObjectivesLiterature review on Cotard Syndrome and its link with Multiple Sclerosis, based on a clinical case.MethodsPubmed and Google Scholar search using the keywords Cotard Syndrome, Multiple Sclerosis.ResultsHereby we present a clinical case of a 53-year-old female patient, with multiple sclerosis, who presented with hypochondriac and nihilistic delusions and refusal of food and medication. The patient was treated with olanzapine with rapid remission of delusional activity.ConclusionsMultiple sclerosis is an immunemediated chronic disease, affecting predominantly the sensory and motor function. In addition, psychiatric comorbidity is very frequent with up to 50 % lifetime risk of depression. While various neurological disorders have been described in association with Cotard syndrome, its link with multiple sclerosis has been scarcely reported.DisclosureNo significant relationships.
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Huarcaya-Victoria, Jeff, Mario Ledesma-Gastañadui i Maria Huete-Cordova. "Cotard’s Syndrome in a Patient with Schizophrenia: Case Report and Review of the Literature". Case Reports in Psychiatry 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/6968409.
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Jules Cotard described, in 1880, the case of a patient characterized by delusions of negation, immortality, and guilt as well as melancholic anxiety among other clinical features. Later this constellation of symptoms was given the eponym Cotard’s syndrome, going through a series of theoretical vicissitudes, considering itself currently as just the presence of nihilistic delusions. The presentation of the complete clinical features described by Cotard is a rare occurrence, especially in the context of schizophrenia. Here we present the case of a 50-year-old male patient with schizophrenia who developed Cotard’s syndrome. The patient was treated with aripiprazole, showing improvement after two weeks of treatment. A review of the literature is performed about this case.
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Hardie, Philip. "Lucretius and the Delusions of Narcissus". Materiali e discussioni per l’analisi dei testi classici, nr 20/21 (1988): 71. http://dx.doi.org/10.2307/40235906.
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Rodrigues, C., M. Andrade, V. Palma i C. Cardoso. "When a Man Loves a Woman: a Case of Erotomania in the 21st Century". European Psychiatry 33, S1 (marzec 2016): S464. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1687.
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IntroductionErotomania, or De Clerambault's Syndrome, was first described in 1921. However, cases of Insane Love were long known before. Presently, this condition is classified as a delusional disorder typically affecting women. However, in forensic samples, most of these reports relate to men with violent behaviour, associated to harassing or stalking of a woman.ObjectiveTo present the case of a man, diagnosed with Erotomania and literature review of similar cases.AimTo bring awareness to the infrequent diagnosis of this condition in males and the legal implications this condition may have.MethodsConsultation of the patient's clinical process and published articles focusing on Erotomania in men.ResultsA 50-year-old man was referred from Court for persistently stalking a woman on the past few years. He revealed erotomanic and persecutory delusions, believing these accusations were all part of a scheme to restrain his alleged relationship.There was a clinical improvement during hospitalization and treatment with antipsychotics. Due to the legal process in court, a forensic examination was also performed.ConclusionsOn the follow-up, the patient remained stabilized. He would not verbalize any delusional content, and calmly deny any inadequate behaviour. However, some of his stalking attitude remains. As many of these patients, we believe his delusion is still present, although his behaviour is more controlled with treatment. Recognizing the characteristics and course of this disorder in our patients, grants a better chance of intervention and attentiveness towards the legal implications that may arise.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Mateen, Yasir, John Lally i Sumira Qambar Bokhari. "Chronic, Unipolar, Treatment-Resistant Mania: A Case Report and Literature Review". BJPsych Open 8, S1 (czerwiec 2022): S122—S123. http://dx.doi.org/10.1192/bjo.2022.363.
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AimsChronic mania is variably defined but classically recognized as the presence of manic symptoms for more than 2 years without remission. The reported incidence ranges between 6–15% among all patients with bipolar disorders. Although it has been described in psychiatry literature for a long time, it has not yet found a place in current nosological systemsMethodsWe present a 32-year-old single and unemployed man who is supported by his family and living with a sudden-onset, continuous illness of 12 years’ duration characterized by a resistant and markedly euphoric and expansive mood with grandiose delusions. Other features such as distractibility, pressured speech, racing thoughts and psychomotor disturbance remain significant but vary and are more responsive to medical interventions. Psychotic symptoms are largely confined to mood-congruent delusions, grandiose and religious, and are reported to have followed the mood disturbance from early on. There is no history of substance use, past psychiatric or medical illness, or head trauma and no evidence of a neurological cause on workup. This gentleman has been treated with a range of mood stabilizers and antipsychotics and two courses of ECT over the years. In the recent years, he has been on a combination of Clozapine, Valproate, and Pregabalin with relatively favorable but inadequate response and limited functional improvement.ResultsChronic mania lasting for 12 years, in the absence of an organic cause, despite the use of a wide gamut of modern psychotropics, alone and in combination with ECT, and with adequate compliance is an exceptionally rare entity. It poses manifold challenges both in terms of diagnostic considerations and therapeutic approaches. The overlap of symptoms of mania, schizophrenia, and schizoaffective disorders along with chronicity adds a particular layer of complexity. The hallmark of chronic mania is euphoric and expansive mood along with grandiose delusions and the presentation is relatively less centered on sleep disturbance, hypersexuality, and psychomotor agitation as compared to an acute manic episode. It is distinguished from schizophrenia spectrum disorders as it lacks flat or inappropriate affect, incongruent delusions and disorganized thought. Course of illness, prior mood episodes and family history are important in differentiating from a schizoaffective pattern of disease.ConclusionUnremitting mania of this duration is unique in its psychiatric morbidity and devastating in its impact on the individual in terms of psychosocial functioning, quality of life, physical health and safety. It also brings unprecedented stress on the family and other support systems.
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Delgado, L., A. González-Rodríguez, A. Alvarez Pedrero, A. Guàrdia, G. F. Fucho, M. V. Seeman, S. Acebillo, J. A. Monreal, J. Labad i D. Palao Vidal. "Successful treatment of primary delusional parasitosis with paroxetine: A case report and narrative review". European Psychiatry 64, S1 (kwiecień 2021): S317. http://dx.doi.org/10.1192/j.eurpsy.2021.851.
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IntroductionAntipsychotics have been classically considered the treatment of choice for delusional disorder (DD) and antidepressant medications have been restricted to patients with comorbid depression.ObjectivesOur aim is to describe the case of a patient with DD with delusions of parasitosis, who responded to paroxetine as monotherapy. We also aimed to review the recent literature on the potential use of antidepressants as the main treatment for somatic type DD.MethodsAfter the case report, we present a narrative review on the use of antidepressants in DD, somatic type (DSM-criteria) by using PubMed database from inception until 2020.ResultsCase: 74 year-old woman without previous psychiatric diagnosis who suffered from long-term cutaneous and vulvar pruritus. She was referred to psychiatry from dermatology to assess thought content and sensoperceptive disturbances. In the past, she had received unsuccessful treatment with antihistamines. The patient brought a collection of “the identified parasite” (matchbox sign) to our first appointment. On assessment, she was diagnosed with DD with delusions of parasitosis. Risperidone 1mg/day was poorly tolerated (excessive sedation). She refused further antipsychotic treatment, so we started paroxetine up to 20mg/day. The patient went into total remission of her pruritus and delusions of parasitosis. Review. In line with our case, 6 studies reported on the successful use of antidepressants as monotherapy for DD, somatic type. Most of studies report the successful use of an antipsychotic/antidepressant combination (case-series, case reports).ConclusionsAlthough antipsychotics are the treatment of choice, antidepressant medications may be an effective alternative in somatic type DD when patients refuse antipsychotics.
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Riggs, Larry W. "Delusions of Self-Fashioning:Moralismeas Critique of Modernity". Romance Quarterly 49, nr 1 (styczeń 2002): 21–29. http://dx.doi.org/10.1080/08831150209600882.
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