Models of misbelief: Integrating motivational and deficit theories of delusions.

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McKay, Ryan; Langdon, Robyn; Coltheart, Max

2007-12-01

The impact of our desires and preferences upon our ordinary, everyday beliefs is well-documented [Gilovich, T. (1991). How we know what isn't so: The fallibility of human reason in everyday life. New York: The Free Press.]. The influence of such motivational factors on delusions, which are instances of pathological misbelief, has tended however to be neglected by certain prevailing models of delusion formation and maintenance. This paper explores a distinction between two general classes of theoretical explanation for delusions; the motivational and the deficit. Motivational approaches view delusions as extreme instances of self-deception; as defensive attempts to relieve pain and distress. Deficit approaches, in contrast, view delusions as the consequence of defects in the normal functioning of belief mechanisms, underpinned by neuroanatomical or neurophysiological abnormalities. It is argued that although there are good reasons to be sceptical of motivational theories (particularly in their more floridly psychodynamic manifestations), recent experiments confirm that motives are important causal forces where delusions are concerned. It is therefore concluded that the most comprehensive account of delusions will involve a theoretical unification of both motivational and deficit approaches.

"Jumping to conclusions" in delusion-prone participants: an experimental economics approach.

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van der Leer, Leslie; McKay, Ryan

2014-01-01

That delusional and delusion-prone individuals "jump to conclusions" on probabilistic reasoning tasks is a key finding in cognitive neuropsychiatry. Here we focused on a less frequently investigated aspect of "jumping to conclusions" (JTC): certainty judgments. We incorporated rigorous procedures from experimental economics to eliminate potential confounds of miscomprehension and motivation and systematically investigated the effect of incentives on task performance. Low- and high-delusion-prone participants (n = 109) completed a series of computerised trials; on each trial, they were shown a black or a white fish, caught from one of the two lakes containing fish of both colours in complementary ratios. In the betting condition, participants were given £4 to distribute over the two lakes as they wished; in the control condition, participants simply provided an estimate of how probable each lake was. Deviations from Bayesian probabilities were investigated. Whereas high-delusion-prone participants in both the control and betting conditions underestimated the Bayesian probabilities (i.e. were conservative), low-delusion-prone participants in the control condition underestimated but those in the betting condition provided accurate estimates. In the control condition, there was a trend for high-delusion-prone participants to give higher estimates than low-delusion-prone participants, which is consistent with previous reports of "jumping to conclusions" in delusion-prone participants. However, our findings in the betting condition, where high-delusion-prone participants provided lower estimates than low-delusion-prone participants (who were accurate), are inconsistent with the jumping-to-conclusions effect in both a relative and an absolute sense. Our findings highlight the key role of task incentives and underscore the importance of comparing the responses of delusion-prone participants to an objective rational standard as well as to the responses of non-delusion

Content and affect in persecutory delusions.

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Green, Catherine; Garety, Philippa A; Freeman, Daniel; Fowler, David; Bebbington, Paul; Dunn, Graham; Kuipers, Elizabeth

2006-11-01

The study aimed to explore the content of persecutory delusions and its potential links with levels of affective disturbance. Detailed examinations of the phenomenology of delusional beliefs have been rare, but are important for furthering theoretical and clinical understanding. A cross-sectional investigation of 70 individuals with current persecutory delusions was conducted. Taped semi-structured clinical interviews were transcribed for each participant. Using a coding frame devised for the current study, a detailed description of persecutory content was made. Scores on the Beck Depression and Anxiety Inventories, the Rosenberg Self-esteem Scale and the Psychotic Symptom Rating Scales were used as indicators of emotional distress. Data were gathered on the identity and type of persecutor, pervasiveness of threat and the power of the persecutor. Reliability was good. Beliefs involving multiple persecutors, human in nature and identifiable to the individual were common. For the majority threat was severe, ongoing and enduring and coupled with frequent feelings of vulnerability. Specific aspects of delusional content were found to be associated with emotional distress. For example, if participants felt more power in the face of persecution this was coupled with lower depression and higher self-esteem. Persecutory delusions are beliefs concerning severe threat, particularly of physical harm including death, which is personally significant, frequently involving multiple persecutors known to the individual. Depression is higher in those who felt less powerful than their persecutors. Associations, such as this, with emotional distress support a direct role for emotion in delusion formation and maintenance. It is consistent with cognitive models of delusions which emphasize the importance of considering emotional distress in the context of belief appraisal, although interpretation of the results is limited by the cross-sectional study design. Recognizing these links may

Decreased Left Putamen and Thalamus Volume Correlates with Delusions in First-Episode Schizophrenia Patients

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Xiaojun Huang

2017-11-01

Full Text Available BackgroundDelusional thinking is one of the hallmark symptoms of schizophrenia. However, the underlying neural substrate for delusions in schizophrenia remains unknown. In an attempt to further our understanding of the neural basis of delusions, we explored gray matter deficits and their clinical associations in first-episode schizophrenia patients with and without delusions.MethodsTwenty-four first-episode schizophrenia patients with delusions and 18 without delusions as well as 26 healthy controls (HC underwent clinical assessment and whole-brain structural imaging which were acquired a 3.0 T scanner. Voxel-based morphometry was used to explore inter-group differences in gray matter volume using analysis of covariance, and Spearman correlation coefficients (rho between the Scale for the Assessment of Positive Symptoms (SAPS-delusion scores and mean regional brain volumes was obtained.ResultsPatients with delusions showed decreased brain gray matter volumes in the left putamen, thalamus, and caudate regions compared with HC. Patients with delusions also showed decreased regional volume in the left putamen and thalamus compared with patients without delusions. SAPS-delusion scores were negatively correlated with the gray matter volumes of the left putamen and thalamus.DiscussionLeft putamen and thalamus volume loss may be biological correlates of delusions in schizophrenia.

The affective neuropsychology of confabulation and delusion.

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Fotopoulou, Aikaterini

2010-01-01

The paper reviews the history of the scientific understanding of the role of emotion in confabulation and delusion. I argue that the significance of emotion in the pathogenesis of these symptoms was obscured by academic polarisation between psychodynamic and neurocognitive traditions and was also often obfuscated by rigid distinctions between psychogenic and neurogenic explanations. This tradition of epistemic dualism was implicitly maintained in the fields of cognitive neuropsychology and cognitive neuropsychiatry. This paper focuses on memory-related confabulation following ventromedial frontal lobe lesions, awareness-related confabulation following right perisylvian lesions, and delusions of various aetiologies. Ambiguity regarding the definition and taxonomy of symptoms renders direct comparison difficult, but certain overriding principles are becoming discernible. Recent findings suggest that emotion and motivation influence both confabulation and delusion. These influences may be instigated directly by neural dysfunction or indirectly by life changes and altered social circumstances, or by a combination of these. Importantly, the rejection of epistemic dualism in the conceptualisation of both symptoms can allow us to study them in parallel and draw conclusions about the relation between cognition and emotion. Specifically, confabulation and delusion can be described as faulty attempts to balance the conflicting demands of accurate and self-serving reality representation.

Emotional awareness and delusions in schizophrenia and schizoaffective disorder.

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D'Antonio, Emily; Kahn, Jennifer; McKelvey, Jennifer; Berenbaum, Howard; Serper, Mark R

2015-02-01

Emotion plays a significant role in schizophrenia. Emotional awareness (i.e., attention to and clarity of emotions) is associated with a wide range of outcomes. Given that individuals with schizophrenia and schizoaffective disorder differ in the significance of their mood symptoms, the present research examined whether the association between emotional awareness and delusions differs for these two groups of patients. Emotional awareness (i.e., attention to and clarity of emotions) was measured with self-report in a sample of 44 individuals diagnosed with either schizophrenia or schizoaffective disorder. Clinical ratings of delusions were made using the Scale for the Assessment of Positive Symptoms. For the sample as a whole, individuals with higher levels of attention to emotion tended to have more severe delusions. In addition, diagnostic group significantly moderated the relation between emotional clarity and delusions. Conclusions regarding causality cannot be drawn due to the cross-sectional design. Replication is particularly important given the small sample sizes. The present research indicates that emotional awareness is associated with delusions. The results raise the possibility that the emotional factors that contribute to delusional beliefs among individuals with schizophrenia differ in at least some ways from the emotional factors that contribute to delusional beliefs among individuals with schizoaffective disorder. Copyright © 2014 Elsevier Inc. All rights reserved.

[Delusion and Gender in Paranoid Schizophrenia: Results of a Clinical Study].

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Rössler, V; Richter, R; Walter, M H

2016-11-01

Aim: The aim of the present study was to investigate whether men and women differ in the frequency and phenomenology of delusions. Sample: Medical records of all patients who had been admitted to a psychiatric hospital in Germany between 2008 and 2011 for paranoid schizophrenia were analyzed. The sample consisted of 182 delusional inpatients (90 women, 92 men) with the diagnosis of a paranoid schizophrenia. Results: Men and women did not differ in the frequency of delusional themes. Analysis of delusional content, however, revealed considerable differences between them. Women with delusion of reference felt more often as being under constant surveillance compared to men. Men with delusion of reference showed a tendency to involve unspecified persons in their delusions and more often had the feeling of being talked about. Delusion of grandeur in women was more often built upon significant relationships with others. © Georg Thieme Verlag KG Stuttgart · New York.

Relationship between Delusion of Theft and Cognitive Functions in Patients with Mild Alzheimer's Disease.

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Na, Hae-Ran; Kang, Dong Woo; Woo, Young-Sup; Bahk, Won-Myong; Lee, Chang-Uk; Lim, Hyun Kook

2018-04-01

Although delusion of theft (DT) is the most frequent type of delusion in Alzheimer's disease (AD), its relationship to cognitive functions remains unclear. The aim of this study was to demonstrate the relationship between DT and cognitive functions in mild AD. Two hundred eighty-nine mild AD patients were enrolled in this study. These subjects were classified into three groups: patients with no delusions (ND, n=82), patients with paranoid delusions (PD, n=114) and patients with DT (n=93). Cognitive functions and their associations with the degree of delusion were compared among the three groups. The results showed that verbal Fluency scores were significantly lower in the PD group than in the DT and ND groups. Word List Recall scores were significantly lower in the DT group than in the PD and ND groups. Interestingly, delusion severity measured with the Neuropsychiatric Inventory delusion subscale correlated negatively with the Word List Recall scores in the DT group. In this study, we demonstrated that episodic memory functions in mild AD patients were associated with DT, but not with PD. Further studies might be needed to clarify the pathophysiology of delusions associated with AD.

T84. DO SIMILAR COGNITIVE MECHANISMS ENCOURAGE DELUSION-LIKE IDEATION AND BELIEF IN FAKE NEWS?

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Bronstein, Michael; Pennycook, Gordon; Bear, Adam; Cannon, Tyrone; Rand, David

2018-01-01

Abstract Background Increasingly, the positive symptoms of psychosis are recognized as being on a continuum with phenomena that are experienced by many members of the general population (i.e., non-clinical samples). Delusions are no exception. These fixed false beliefs, which are common in individuals with psychosis, are echoed by inflexible false beliefs in the general population that have delusion-like qualities (e.g., belief in clairvoyance). In a series of studies, we sought to determine whether belief in a particular type of disinformation (fake news) might represent a point on the same continuum as delusions and delusion-like ideation. To this end, we examined whether individuals who endorsed more delusion-like ideation were also more prone to believing fake news. We then examined whether the cognitive mechanisms behind any relationship between delusion-like ideation and fake news were similar to those associated with delusion-like ideation generally. Methods 503 participants were recruited using Amazon’s Mechanical Turk (MTurk). Participants completed a test of ability to discriminate real from fake news along with several individual difference measures. These included measures of delusion-like ideation (the Peters et al. Delusion Inventory [PDI]), engagement in analytic thinking (the Cognitive Reflection Test [CRT]), and the degree to which one values evidence in forming and revising beliefs (the Actively Open-Minded Thinking Questionnaire [AOT]). Mediation tests were conducted using the PROCESS macro for SPSS (model 4, with 5000 bootstrapped samples and bias-corrected 95% confidence intervals). Results Delusion-like ideation was positively correlated with belief in fake news (rho(501) = .20, p fake news and delusion-like ideation was partially explained by lower levels of analytic thinking ability (as measured by the CRT; completely standardized 95% CI = [.02 .07]) and lower evidence valuation (as measured by AOT scores; completely standardized 95% CI

The nature of delusion: psychologically explicable? psychologically inexplicable? philosophically explicable? Part 2.

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Cutting, J; Musalek, M

2016-03-01

The first part of this article dealt with the extant formulations of delusion, psychiatric and psychological, suggestions which, respectively, regard delusion as psychologically inexplicable or explicable. All this was subjected to critique. This second part puts forward informed philosophical thesis whereby delusion can be explained within the philosophical movement known as phenomenology and, in particular, Max Scheler's version of this. © The Author(s) 2015.

Cotard's delusion or syndrome?: a conceptual history.

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Berrios, G E; Luque, R

1995-01-01

This report offers an account of the historical construction of Cotard's syndrome showing that by délire des négations the French author meant a subtype of depressive illness. Subsequent debate led first to the belief that it was just a collection of symptoms associated with agitated depression (anxious melancholia) or general paralysis, and later to the view that it might after all constitute a separate entity. At the present moment, and impervious to the fact that the French term délire means far more than "delusion," some authors use Cotard's syndrome to refer to the belief of being dead and suggest that such a delusion might have a specific brain location. From the clinical and evolutionary perspective, it is unclear why a delusion should merit, simply because of its "nihilistic" content, a special brain location or presage chronicity. It is suggested here that before neurobiologic speculation starts, efforts should be made to map out the clinical features and correlations of the délire des négations.

Multiple Realities and Hybrid Objects: A Creative Approach of Schizophrenic Delusion

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Michel Cermolacce

2018-02-01

Full Text Available Delusion is usually considered in DSM 5 as a false belief based on incorrect inference about external reality, but the issue of delusion raises crucial concerns, especially that of a possible (or absent continuity between delusional and normal experiences, and the understanding of delusional experience. In the present study, we first aim to consider delusion from a perspectivist angle, according to the Multiple Reality Theory (MRT. In this model inherited from Alfred Schütz and recently addressed by Gallagher, we are not confronting one reality only, but several (such as the reality of everyday life, of imaginary life, of work, of delusion, etc.. In other terms, the MRT states that our own experience is not drawing its meaning from one reality identified as the outer reality but rather from a multiplicity of realities, each with their own logic and style. Two clinical cases illustrate how the Multiple Realities Theory (MRT may help address the reality of delusion. Everyday reality and the reality of delusion may be articulated under a few conditions, such as compossibility [i.e., Double Book-Keeping (DBK, in Bleulerian terms] or flexibility. There are indeed possible bridges between them. Possible links with neuroscience or psychoanalysis are evoked. As the subject is confronting different realities, so do the objects among and toward which a subject is evolving. We call such objects Hybrid Objects (HO due to their multiple belonging. They can operate as shifters, i.e., as some functional operators letting one switch from one reality to another. In the final section, we will emphasize how delusion flexibility, as a dynamic interaction between Multiple Realities, may offer psychotherapeutic possibilities within some reality shared with others, entailing relocation of the present subjects in regained access to some flexibility via Multiple Realities and perspectivism.

History of religious delusions and psychosocial functioning among Mexican patients with paranoid schizophrenia.

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Robles-García, Rebeca; López-Luna, Sonia; Páez, Francisco; Escamilla, Raúl; Camarena, Beatriz; Fresán, Ana

2014-12-01

The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.

Relationship between Delusion of Theft and Cognitive Functions in Patients with Mild Alzheimer’s Disease

Science.gov (United States)

Na, Hae-Ran; Kang, Dong Woo; Woo, Young-Sup; Bahk, Won-Myong; Lee, Chang-Uk; Lim, Hyun Kook

2018-01-01

Although delusion of theft (DT) is the most frequent type of delusion in Alzheimer’s disease (AD), its relationship to cognitive functions remains unclear. The aim of this study was to demonstrate the relationship between DT and cognitive functions in mild AD. Two hundred eighty-nine mild AD patients were enrolled in this study. These subjects were classified into three groups: patients with no delusions (ND, n=82), patients with paranoid delusions (PD, n=114) and patients with DT (n=93). Cognitive functions and their associations with the degree of delusion were compared among the three groups. The results showed that verbal Fluency scores were significantly lower in the PD group than in the DT and ND groups. Word List Recall scores were significantly lower in the DT group than in the PD and ND groups. Interestingly, delusion severity measured with the Neuropsychiatric Inventory delusion subscale correlated negatively with the Word List Recall scores in the DT group. In this study, we demonstrated that episodic memory functions in mild AD patients were associated with DT, but not with PD. Further studies might be needed to clarify the pathophysiology of delusions associated with AD. PMID:29669410

Delusions of Gender

OpenAIRE

Overgaard, Anne Cecilie; Nielsen, Simone Barnekow; Joensen, Saskia van Dam; Arabi, Sara Albu

2015-01-01

This project strives to examine how gender is established in children. Throughout the project, we have taken into consideration what roles society and biological determinism play in the establishment of gender. Furthermore, the project examines how gender performativity and societal influence can help us get a better picture of the gender establishment. The paper is written as a philosophical discussion with a point of departure in experimental psychologist Cordelia Fine’s book ‘Delusions of ...

A pilot trial of cognitive behavioural therapy for interpersonal sensitivity in individuals with persecutory delusions.

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Bell, Victoria; Freeman, Daniel

2014-12-01

Advances in understanding delusions may be used to improve clinical interventions. Interpersonal sensitivity - feeling vulnerable in the presence of others due to the expectation of criticism or rejection - has been identified as a potential causal factor in the occurrence of persecutory delusions. The purpose of this study was to examine the potential impact on persecutory delusions of a (newly devised) cognitive behavioural intervention targeting interpersonal sensitivity (CBT-IPS). CBT-IPS was tested in an uncontrolled pilot study with eleven patients with persistent persecutory delusions in the context of a psychotic disorder. Patients had two baseline assessments over a fortnight period to establish the stability of the delusions, which was followed by six sessions of CBT-IPS, a post-therapy assessment, and a further follow-up assessment one month later. Interpersonal sensitivity and the persecutory delusions were stable during the baseline period. At the post-therapy assessment there were significant reductions of large effect size for both interpersonal sensitivity and the persecutory delusions. These gains were maintained at follow-up. The main limitation is that in this initial test there was no control group. The intervention may not have caused the reduction in delusions. Further, bias may have been introduced by the outcome data being collected by the therapist. The findings from this evaluation are consistent with the hypothesised causal role for interpersonal sensitivity in the occurrence of persecutory delusions. CBT-IPS shows promise as a therapeutic intervention but requires a rigorous test of its efficacy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Pathologies of Hyperfamiliarity in Dreams, Delusions and Déjà Vu

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Philip eGerrans

2014-02-01

Full Text Available The ability to challenge and revise thoughts prompted by anomalous experiences depends on activity in right dorsolateral prefrontal circuitry. When activity in those circuits is absent or compromised subjects are less likely to make this kind of correction. This appears to be the cause of some delusions of misidentification consequent on experiences of hyperfamiliarity for faces. Comparing the way the mind responds to the experience of hyperfamiliarity in different conditions such as delusions, dreams, pathological and non pathological déjà vu, provides a way to understand claims that delusions and dreams are both states characterized by deficient reality testing.

Self-Disturbance and the Bizarre: On Incomprehensibility in Schizophrenic Delusions.

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Sass, Louis A; Byrom, Greg

2015-01-01

The notion of 'bizarre delusion' has come into question in contemporary anglophone psychopathology. In DSM-5, it no longer serves as a special criterion for diagnosing schizophrenia nor as an exclusion criterion for delusional disorder. Empirical studies influencing this development have, however, been relatively sparse and subject to methodological criticism. Major reviews have concluded that current conceptualizations of bizarre delusions may require rethinking and refinement. Defining bizarreness entails a return to Jaspers, whose influential views on the supposed incomprehensibility of bizarre delusions and schizophrenic experience are more nuanced than is generally recognized. Jaspers insisted we must 'get behind' three 'external characteristics' (extraordinary conviction, imperviousness, impossible content) in order to acknowledge a 'primary experience traceable to the illness' in the 'delusions proper' of schizophrenia. He also denied that one could empathize with or otherwise 'understand' this basis. Here, we focus on three features of bizarre delusions that Jaspers foregrounded as illustrating schizophrenic incomprehensibility: disturbance of the cogito, certitude combined with inconsequentiality, delusional mood. We link these with the contemporary ipseity disturbance model of schizophrenia, arguing that Jaspers' examples of incomprehensibility can be understood as manifestations of the three complementary aspects of ipseity-disturbance: diminished self-presence, hyperreflexivity and disturbed grip/hold. We follow Jaspers' lead in acknowledging a distinctive strangeness that defies ready comprehension, but we challenge the absolutism of Jaspers' skepticism by offering a phenomenological account that comprehends bizarreness in two ways: rendering it psychologically understandable, and fitting the various instances of bizarreness into a comprehensive explanatory framework. © 2015 S. Karger AG, Basel.

Virtual reality and persecutory delusions: safety and feasibility.

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Fornells-Ambrojo, Miriam; Barker, Chris; Swapp, David; Slater, Mel; Antley, Angus; Freeman, Daniel

2008-09-01

Virtual reality (VR) has begun to be used to research the key psychotic symptom of paranoia. The initial studies have been with non-clinical individuals and individuals at high risk of psychosis. The next step is to develop the technology for the understanding and treatment of clinical delusions. Therefore the present study investigated the acceptability and safety of using VR with individuals with current persecutory delusions. Further, it set out to determine whether patients feel immersed in a VR social environment and, consequently, experience paranoid thoughts. Twenty individuals with persecutory delusions and twenty non-clinical individuals spent 4 min in a VR underground train containing neutral characters. Levels of simulator sickness, distress, sense of presence, and persecutory ideation about the computer characters were measured. A one-week follow-up was conducted to check longer-term side effects. The VR experience did not raise levels of anxiety or symptoms of simulator sickness. No side effects were reported at the follow-up. There was a considerable degree of presence in the VR scenario for all participants. A high proportion of the persecutory delusions group (65%) had persecutory thinking about the computer characters, although this rate was not significantly higher than the non-clinical group. The study indicates that brief experiences in VR are safe and acceptable to people with psychosis. Further, patients with paranoia can feel engaged in VR scenes and experience persecutory thoughts. Exposure to social situations using VR has the potential to be incorporated into cognitive behavioural interventions for paranoia.

Delusion of pregnancy in a patient with bipolar affective disorder: A ...

African Journals Online (AJOL)

Delusion of pregnancy is when one believes that one is pregnant despite contrary evidence and it is most times accompanied with classical symptoms of pregnancy. This rare disorder appears to be on the increase in Nigeria. We here report a case of delusion of pregnancy seen in a patient with bipolar affective disorder.

Delusion of pregnancy and other pregnancy-mimicking conditions: Dissecting through differential diagnosis

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Seshadri Sekhar Chatterjee

2014-01-01

Full Text Available The delusion of pregnancy is defined as the belief of being pregnant despite factual evidence to the contrary. Even being more common in a developing country, the literature about delusion of pregnancy from India is meager. The present article reports the case of delusion of pregnancy in an unmarried female associated with subclinical hypothyroidism and prominent sibling rivalry from psychological aspect. The literature in this field has addressed for the organic and psychodynamic, psychosocial aspect of this disorder and its difference from other disorders mimicking pregnancy and its relevance to the treatment plan.

Pathologies of hyperfamiliarity in dreams, delusions and déjà vu.

Science.gov (United States)

Gerrans, Philip

2014-01-01

The ability to challenge and revise thoughts prompted by anomalous experiences depends on activity in right dorsolateral prefrontal circuitry. When activity in those circuits is absent or compromised subjects are less likely to make this kind of correction. This appears to be the cause of some delusions of misidentification consequent on experiences of hyperfamiliarity for faces. Comparing the way the mind responds to the experience of hyperfamiliarity in different conditions such as delusions, dreams, pathological and non-pathological déjà vu, provides a way to understand claims that delusions and dreams are both states characterized by deficient "reality testing."

The Fregoli delusion: a disorder of person identification and tracking.

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Langdon, Robyn; Connaughton, Emily; Coltheart, Max

2014-10-01

Fregoli delusion is the mistaken belief that some person currently present in the deluded person's environment (typically a stranger) is a familiar person in disguise. The stranger is believed to be psychologically identical to this known person (who is not present) even though the deluded person perceives the physical appearance of the stranger as being different from the known person's typical appearance. To gain a deeper understanding of this contradictory error in the normal system for tracking and identifying known persons, we conducted a detailed survey of all the Fregoli cases reported in the literature since the seminal Courbon and Fail (1927) paper. Our preliminary reading of these cases revealed a notable lack of definitional clarity. So, we first formulated a classification scheme of different person misidentification delusions so as to identify those cases that qualified as instances of Fregoli according to the above characterization: the mistaken belief that a known person is present in the environment in a different guise to his or her typical appearance. We identified 38 clear cases of this type and set out to answer a series of questions motivated by current hypotheses about the origin of the Fregoli delusion. We asked whether the patients misidentified particular strangers, made reference to the misidentified known persons using wigs or plastic surgery (or other techniques to disguise their appearance), misidentified many different strangers or only one, showed other symptoms (in particular, other misidentification delusions), and made inferences about the motives of the known persons in disguise. We conclude by discussing the implications of our findings for current hypotheses concerning the origin of the Fregoli delusion. Copyright © 2014 Cognitive Science Society, Inc.

Analogical reasoning in schizophrenic delusions.

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Simpson, Jane; Done, D John

2004-09-01

Reasoning ability has often been argued to be impaired in people with schizophrenic delusions, although evidence for this is far from convincing. This experiment examined the analogical reasoning abilities of several groups of patients, including non-deluded and deluded schizophrenics, to test the hypothesis that performance by the deluded schizophrenic group would be impaired. Eleven deluded schizophrenics, 10 depressed subjects, seven non-deluded schizophrenics and 16 matched non-psychiatric controls, who were matched on a number of key variables, were asked to solve an analogical reasoning task. Performance by the deluded schizophrenic group was certainly impaired when compared with the depressed and non-psychiatric control groups though less convincingly so when compared with the non-deluded schizophrenic group. The impairment shown by the deluded schizophrenic group seemed to occur at the initial stage of the reasoning task. The particular type of impairment shown by the deluded subjects was assessed in relation to other cognitive problems already researched and the implications of these problems on reasoning tasks and theories of delusions was discussed.

Delusions of parasitosis.

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Wong, Jillian W; Koo, John Ym

2013-01-01

Patients with delusions of parasitosis (DOP) are more commonly recognized in dermatology practices today. However, dermatologists may feel uncomfortable treating these patients because of the psychiatric nature of their disorder. As a result of the fact that DOP patients strongly prefer to seek treatment from dermatologists rather than mental health professionals, it is important for dermatologists to be well equipped with a basic understanding of the disorder and with tools to assist this patient population. In this review, we discuss the epidemiology, presentation, differential diagnosis and treatment strategy for patients with DOP.

Delusions of parasitosis

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Jillian W Wong

2013-01-01

Full Text Available Patients with delusions of parasitosis (DOP are more commonly recognized in dermatology practices today. However, dermatologists may feel uncomfortable treating these patients because of the psychiatric nature of their disorder. As a result of the fact that DOP patients strongly prefer to seek treatment from dermatologists rather than mental health professionals, it is important for dermatologists to be well equipped with a basic understanding of the disorder and with tools to assist this patient population. In this review, we discuss the epidemiology, presentation, differential diagnosis and treatment strategy for patients with DOP.

[Neuropsychological approach to elucidating delusion and psychotic symptoms].

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Kato, Motoichiro

2012-01-01

Neuropsychological symptom-oriented approach is a critical method to elucidate delusion and psychotic symptoms in patients with focal brain damages and schizophrenia. In Capgras delusion (CD), the delusional misidentification of familiar people disguised as others, the patients with right amygdala damage and bilateral ventromedial prefrontal lesions have a deficient or reduced emotional valence of the person with intact configurational processes of the face. Reduplicative paramnesia (RP) is a specific phenomenon characterized by subjective certainty that a familiar place or person has been duplicated. Clinical evidences indicated that the patient with RP following right prefrontal damages showed the lack of emotional valence for the present hospital. This abnormal sense of familiarity triggered the deficits of the orientation of self to the outside world, that is, double orientation, resulting in the development of geographical reduplicative paramnesia. In line with the pathogenesis of CD and RP after brain damages, the delusion in schizophrenia may have a germ as developmental origins, which include the aberrant or salient perceptual experiences and abnormal sense of agency, and might be further aggravated by the impairment of causal reasoning process such as the jumping-to-conclusions bias.

Risk factors for delusion of theft in patients with Alzheimer's disease showing mild dementia in Japan.

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Murayama, N; Iseki, E; Endo, T; Nagashima, K; Yamamoto, R; Ichimiya, Y; Arai, H; Sato, K

2009-07-01

The mechanism underlying delusion in Alzheimer's disease patients has not been fully clarified; however, the occurrence of delusion is a critical issue for dementia patients and their caregivers. In Japan, delusion of theft is the most frequent delusion in AD patients. We examined the risk factors for delusion of theft in AD patients showing mild dementia. Fifty-six AD patients were administered HDS-R, MMSE and COGNISTAT, including the 'speech sample', to assess their neuropsychological and social cognitive functions. The age, years of education, presence of cohabiting family members and premorbid personality traits were obtained from family members. About 25.0% of AD patients showed delusion of theft (D-group), and 75% did not (non-D-group). About 33.3% of female patients and 5.9% of male patients were included in the D-group (p theft in AD patients was related to female gender, absence of cohabiting family members, neurotic personality and retained social cognitive function.

Somatic delusions and obsessive-compulsive disorder in ...

African Journals Online (AJOL)

2009-10-12

Oct 12, 2009 ... Case Study: Somatic delusions and obsessive-compulsive disorder in schizophrenia. 527. Vol 52 No 6 ... liver function, and urea and electrolytes), including an ... neurotransmitter systems (such as serotonin and dopamine).

Pathologies of hyperfamiliarity in dreams, delusions and déjà vu

Science.gov (United States)

Gerrans, Philip

2014-01-01

The ability to challenge and revise thoughts prompted by anomalous experiences depends on activity in right dorsolateral prefrontal circuitry. When activity in those circuits is absent or compromised subjects are less likely to make this kind of correction. This appears to be the cause of some delusions of misidentification consequent on experiences of hyperfamiliarity for faces. Comparing the way the mind responds to the experience of hyperfamiliarity in different conditions such as delusions, dreams, pathological and non-pathological déjà vu, provides a way to understand claims that delusions and dreams are both states characterized by deficient “reality testing.” PMID:24600415

Strategic retrieval, confabulations, and delusions: theory and data.

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Gilboa, Asaf

2010-01-01

Based on Moscovitch and Winocur's "working with memory" framework, confabulation is described as a deficit in strategic retrieval processes. The present paper suggests that only a confluence of deficits on multiple memory-related processes leads to confabulation. These are divided into three categories. Core processes that are unique to confabulation and required for its evolution include: (1) an intuitive, rapid, preconscious "feeling of rightness" monitoring, (2) an elaborate conscious "editor" monitoring, and (3) control processes that mediate the decision whether to act upon a retrieved memory. The second category is deficits on constitutional processes which are required for confabulation to occur but are not unique to it. These include the formation of erroneous memory representation, (temporal) context confusion, and deficits in retrieval cue generation. Finally, associated Features of confabulations determine the content "flavour" and frequency of confabulation but are not required for their evolution. Some associated features are magnification of normal reconstructive memory processes such as reliance on generic/schematic representations, and positivity biases in memory, whereas others are abnormal such as perseveration or source memory deficits. Data on deficits in core processes in confabulation are presented. Next, the apparent correspondences between confabulation and delusion are discussed. Considering confabulation within a strategic memory framework may help elucidate both the commonalities and differences between the two symptoms. Delusions are affected by a convergence of abnormal perception and encoding of information, associated with aberrant cognitive schema structure and disordered belief monitoring. Whereas confabulation is primarily a disorder of retrieval, mnemonic aspects of delusions can be described as primarily a disorder of input and integration of information. It is suggested that delusions might share some of the associated features

More Delusions May Be Observed in Low-Proficient Multilingual Alzheimer's Disease Patients.

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Liu, Yi-Chien; Liu, Yen-Ying; Yip, Ping-Keung; Akanuma, Kyoko; Meguro, Kenichi

2015-01-01

Language impairment and behavioral symptoms are both common phenomena in dementia patients. In this study, we investigated the behavioral symptoms in dementia patients with different language backgrounds. Through this, we aimed to propose a possible connection between language and delusion. We recruited 21 patients with Alzheimer's disease (AD), according to the DSM-IV and NINCDS-ADRDA criteria, from the memory clinic of the Cardinal Tien Hospital in Taipei, Taiwan. They were classified into two groups: 11 multilinguals who could speak Japanese, Taiwanese and Mandarin Chinese, and 10 bilinguals who only spoke Taiwanese and Mandarin Chinese. There were no differences between age, education, disease duration, disease severity, environment and medical care between these two groups. Comprehensive neuropsychological examinations, including Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), Verbal fluency, Chinese version of the Boston naming test (BNT) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), were administered. The multilingual group showed worse results on the Boston naming test. Other neuropsychological tests, including the MMSE, CASI and Verbal fluency, were not significantly different. More delusions were noted in the multilingual group. Three pairs of subjects were identified for further examination of their differences. These three cases presented the typical scenario of how language misunderstanding may cause delusions in multilingual dementia patients. Consequently, more emotion and distorted ideas may be induced in the multilinguals compared with the MMSE-matched controls. Inappropriate mixing of language or conflict between cognition and emotion may cause more delusions in these multilingual patients. This reminds us that delusion is not a pure biological outcome of brain degeneration. Although the cognitive performance was not significantly different

Reasoning under uncertainty: heuristic judgments in patients with persecutory delusions or depression.

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Corcoran, Rhiannon; Cummins, Sinead; Rowse, Georgina; Moore, Rosie; Blackwood, Nigel; Howard, Robert; Kinderman, Peter; Bentall, Richard P

2006-08-01

The substantial literature examining social reasoning in people with delusions has, to date, neglected the commonest form of decision making in daily life. We address this imbalance by reporting here the findings of the first study to explore heuristic reasoning in people with persecutory delusions. People with active or remitted paranoid delusions, depressed and healthy adults performed two novel heuristic reasoning tasks that varied in emotional valence. The findings indicated that people with persecutory delusions displayed biases during heuristic reasoning that were most obvious when reasoning about threatening and positive material. Clear similarities existed between the currently paranoid group and the depressed group in terms of their reasoning about the likelihood of events happening to them, with both groups tending to believe that pleasant things would not happen to them. However, only the currently paranoid group showed an increased tendency to view other people as threatening. This study has initiated the exploration of heuristic reasoning in paranoia and depression. The findings have therapeutic utility and future work could focus on the differentiation of paranoia and depression at a cognitive level.

Virtual reality in the treatment of persecutory delusions: randomised controlled experimental study testing how to reduce delusional conviction

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Freeman, Daniel; Bradley, Jonathan; Antley, Angus; Bourke, Emilie; DeWeever, Natalie; Evans, Nicole; Černis, Emma; Sheaves, Bryony; Waite, Felicity; Dunn, Graham; Slater, Mel; Clark, David M.

2016-01-01

Background Persecutory delusions may be unfounded threat beliefs maintained by safety-seeking behaviours that prevent disconfirmatory evidence being successfully processed. Use of virtual reality could facilitate new learning. Aims To test the hypothesis that enabling patients to test the threat predictions of persecutory delusions in virtual reality social environments with the dropping of safety-seeking behaviours (virtual reality cognitive therapy) would lead to greater delusion reduction than exposure alone (virtual reality exposure). Method Conviction in delusions and distress in a real-world situation were assessed in 30 patients with persecutory delusions. Patients were then randomised to virtual reality cognitive therapy or virtual reality exposure, both with 30 min in graded virtual reality social environments. Delusion conviction and real-world distress were then reassessed. Results In comparison with exposure, virtual reality cognitive therapy led to large reductions in delusional conviction (reduction 22.0%, P = 0.024, Cohen's d = 1.3) and real-world distress (reduction 19.6%, P = 0.020, Cohen's d = 0.8). Conclusion Cognitive therapy using virtual reality could prove highly effective in treating delusions. PMID:27151071

Perceptual instability in schizophrenia: Probing predictive coding accounts of delusions with ambiguous stimuli

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Katharina Schmack

2015-06-01

Conclusion: Our results indicate an association between a weakened effect of sensory predictions in perceptual inference and delusions in schizophrenia. We suggest that attenuated predictive signaling during perceptual inference in schizophrenia may yield the experience of aberrant salience, thereby providing the starting point for the formation of delusions.

Explaining Delusions: Reducing Uncertainty Through Basic and Computational Neuroscience.

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Feeney, Erin J; Groman, Stephanie M; Taylor, Jane R; Corlett, Philip R

2017-03-01

Delusions, the fixed false beliefs characteristic of psychotic illness, have long defied understanding despite their response to pharmacological treatments (e.g., D2 receptor antagonists). However, it can be challenging to discern what makes beliefs delusional compared with other unusual or erroneous beliefs. We suggest mapping the putative biology to clinical phenomenology with a cognitive psychology of belief, culminating in a teleological approach to beliefs and brain function supported by animal and computational models. We argue that organisms strive to minimize uncertainty about their future states by forming and maintaining a set of beliefs (about the organism and the world) that are robust, but flexible. If uncertainty is generated endogenously, beliefs begin to depart from consensual reality and can manifest into delusions. Central to this scheme is the notion that formal associative learning theory can provide an explanation for the development and persistence of delusions. Beliefs, in animals and humans, may be associations between representations (e.g., of cause and effect) that are formed by minimizing uncertainty via new learning and attentional allocation. Animal research has equipped us with a deep mechanistic basis of these processes, which is now being applied to delusions. This work offers the exciting possibility of completing revolutions of translation, from the bedside to the bench and back again. The more we learn about animal beliefs, the more we may be able to apply to human beliefs and their aberrations, enabling a deeper mechanistic understanding. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

More Delusions May Be Observed in Low-Proficient Multilingual Alzheimer’s Disease Patients

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Liu, Yi-Chien; Liu, Yen-Ying; Yip, Ping-Keung; Akanuma, Kyoko; Meguro, Kenichi

2015-01-01

Background Language impairment and behavioral symptoms are both common phenomena in dementia patients. In this study, we investigated the behavioral symptoms in dementia patients with different language backgrounds. Through this, we aimed to propose a possible connection between language and delusion. Methods We recruited 21 patients with Alzheimer’s disease (AD), according to the DSM-IV and NINCDS-ADRDA criteria, from the memory clinic of the Cardinal Tien Hospital in Taipei, Taiwan. They were classified into two groups: 11 multilinguals who could speak Japanese, Taiwanese and Mandarin Chinese, and 10 bilinguals who only spoke Taiwanese and Mandarin Chinese. There were no differences between age, education, disease duration, disease severity, environment and medical care between these two groups. Comprehensive neuropsychological examinations, including Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), Verbal fluency, Chinese version of the Boston naming test (BNT) and the Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD), were administered. Results The multilingual group showed worse results on the Boston naming test. Other neuropsychological tests, including the MMSE, CASI and Verbal fluency, were not significantly different. More delusions were noted in the multilingual group. Three pairs of subjects were identified for further examination of their differences. These three cases presented the typical scenario of how language misunderstanding may cause delusions in multilingual dementia patients. Consequently, more emotion and distorted ideas may be induced in the multilinguals compared with the MMSE-matched controls. Conclusion Inappropriate mixing of language or conflict between cognition and emotion may cause more delusions in these multilingual patients. This reminds us that delusion is not a pure biological outcome of brain degeneration. Although the cognitive

the God Particle & the Delusion of Grandeur

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Maksoed, Wh-

2016-11-01

It had been established that it was crystalline The inner core is isolated from the rest of earth by the low-viscosity fluid outer core, and it can rotate, nod, precess, wobble, oscillate and even flip over, being only loosely constrained by the surrounding shells- Anderson, 2002. Furthers in accordances of PMRI from Dr.Robert K. Sembiring to ASTRANOMICS, herewith Richard Dawkins: "the God delusion" - 2006 ever quotes by the Rector of the University of INDONESIA 2006 HE. Mr. Prof. Dr.derSoz Gumilar Rusliwa SOMANTRI: "Beyond 'delusion of grandeur' menuju INDONESIA baru Bebas Kemiskinan"ever retrieves Lester G. Telser- 1994: "the Usefulness of Core Theory in Economics" - "core theory furnishes a useful framework for a wide variety of economic problems. It has an undeserved reputation of being too abstract owing mainly to the manner in which it is employed in the theory of general equilibrium." Heartfelt Gratitudes to HE. Mr. Prof. Ir. Handojo.

Neurocognitive deficits are relevant for the jumping-to-conclusions bias, but not for delusions: A longitudinal study

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Christina Andreou

2015-03-01

Full Text Available Patients with delusions exhibit an increased tendency to arrive at decisions based on very limited evidence (jumping-to-conclusions; JTC, making this reasoning bias relevant for the treatment of delusions. Neurocognitive deficits contribute to JTC, but it is not known whether this has any bearing on the clinical syndrome of delusions. We addressed this question by reanalyzing data from an efficacy study of non-pharmacological interventions as adjunctive treatments in schizophrenia. We investigated the longitudinal associations of cognitive functioning, JTC and delusions in patients with psychotic disorders receiving either a metacognitive intervention addressing reasoning biases (n = 59, or cognitive remediation (n = 58. Both interventions improved JTC; in the cognitive remediation group, tentative evidence suggested that better neurocognitive performance contributed to this improvement. However, JTC gains were associated with delusion improvement only in the metacognitive intervention group, suggesting a content-specific mechanism of action.

Facing our Delusions: Rosenzweig’s Defence of Subtlety

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Camelia Gradinaru

2011-12-01

Full Text Available Review of: Phil Rosenzweig, Efectul de halou si alte opt iluzii economice care îi induc în eroare pe manageri [The Halo Effect... and the Eight Other Business Delusions that Deceive Managers], Bucuresti: Publica, 2010, 296 p.

Delusion and bi-ocular vision.

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De Masi, Franco

2015-10-01

The delusional experience is the result of a grave disjunction in the psyche whose outcome is not readily predictable. Examination of the specific mode of disjunction may help us understand the nature and radical character of delusion. I will present the therapy of a psychotic patient who after many years of analysis and progresses in his life continues to show delusional episodes although limited and contained. In his case, the two visions, one delusional and the other real, remain distinct and differentiated from each other because they both possess the same perceptual character, that of reality. He has a bi-ocular vision of reality and not a binocular one because his vision lacks integration, as would necessarily be the case if the two visions could be compared with each other. The principle of non-contradiction ceases to apply in delusion. A corollary of the failure of the principle of non-contradiction is that, if a statement and its negation are both true, then any statement is true. Logicians call this consequence the principle of explosion. For this reason, the distinction between truth, reality, improbability, probability, possibility and impossibility is lost in the delusional system, thus triggering an omnipotent, explosive mechanism with a potentially infinite progression. The paper presents some thoughts for a possible analytic transformation of the delusional experience. Copyright © 2015 Institute of Psychoanalysis.

SU34. A Systematic Review of Behavioral Research and Lesion Evidence for the 2-Factor Theory of Monothematic Delusions

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Neustadter, Eli; Pinder, Juno; Corlett, Philip

2017-01-01

Abstract Background: Two-factor theory (TFT) posits monothematic delusion formation requires damage producing delusion content (factor 1) and a deficit in belief evaluation (factor 2, posited to be localized in right frontal cortex). The purpose of the current study was 2-fold: (1) to review the behavioral data supporting TFT and (2) to assess whether locations of delusion-inducing lesions were consistent with TFT predictions: ie, common factor 1 damage within a particular monothematic delusion and common factor 2 damage across delusions. Furthermore, factor 2 damage ought to distinguish Capgras syndrome (the delusion that a previously familiar person is an imposter) from nondelusional-affective agnosia (unfamiliarity without delusion). Methods: We reviewed all papers concerned with TFT and all studies of galvanic skin response (GSR) in monothematic delusions (frequently cited as behavioral evidence for TFT). Next, we reviewed case reports of lesion-induced monothematic delusions including Capgras, Fregoli, Cotard, and somatoparaphrenia, as well as affective agnosia. We report lesion location frequencies in 12 regions of interest. Results: We found 27 articles on TFT. Only 3 contained empirical evidence (11%, all hypnosis studies): one had no direct hypothesis regarding TFT, one was inconclusive, and another failed to support TFT. We found 7 additional GSR studies of Capgras, 6 of which reported statistically significant abnormal GSR, but no effects were specific to the familiar person accused of being an imposter. One neuroimaging case study of Capgras did find fMRI correlates of perceiving the imposter in the left hemisphere. One study of somatoparaphrenia reported a GSR deficit to noxious stimuli approaching the denied limb. There were no published studies testing TFT predictions about Cotard or Fregoli. We analyzed 46 reports of lesion-induced delusions and 20 cases of affective agnosia. Right hemisphere damage was most common in monothematic delusion cases (�

Making Sense of Pain: Delusions, Syphilis, and Somatic Pain in London County Council Asylums, c. 1900

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Louise Hide

2012-12-01

Full Text Available During the late nineteenth century, a high percentage of male deaths in asylums was attributed to various forms of tertiary syphilis, most notably General Paralysis of the Insane (GPI and tabes dorsalis. It was not unusual for patients to present symptoms of both conditions, the latter of which could be agonizingly painful. Some patients also suffered from persecutory delusions, believing that electricity was running through them or that their limbs were gnawed by lions and wolves at night. Drawing on a theory advanced by a number of key alienists and pathologists of the period, I suggest that these delusions were misinterpretations of felt sensations and, as such, illusions rather than delusions. Despite the well-known problems around using these historical sources, I contend that recorded delusions in asylum case notes can be treated as narratives of pain that provide invaluable insights into patients' subjective experiences.

When a loved one feels unfamiliar: a case study on the neural basis of Capgras delusion.

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Thiel, Christiane M; Studte, Sara; Hildebrandt, Helmut; Huster, Rene; Weerda, Riklef

2014-03-01

Perception of familiar faces depends on a core system analysing visual appearance and an extended system dealing with inference of mental states and emotional responses. Damage to the core system impairs face perception as seen in prosopagnosia. In contrast, patients with Capgras delusion show intact face perception but believe that closely related persons are impostors. It has been suggested that two deficits are necessary for the delusion, an aberrant perceptual or affective experience that leads to a bizarre belief as well as an impaired ability to evaluate beliefs. Using functional magnetic resonance imaging, we compared neural activity to familiar and unfamiliar faces in a patient with Capgras delusion and an age matched control group. We provide evidence that Capgras delusion is related to dysfunctional activity in the extended face processing system. The patient, who developed the delusion for the partner after a large right prefrontal lesion sparing the ventromedial and medial orbitofrontal cortex, lacked neural activity to the partner's face in left posterior cingulate cortex and left posterior superior temporal sulcus. Further, we found impaired functional connectivity of the latter region with the left superior frontal gyrus and to a lesser extent with the right superior frontal sulcus/middle frontal gyrus. The findings of this case study suggest that the first factor in Capgras delusion may be reduced neural activity in the extended face processing system that deals with inference of mental states while the second factor may be due to a lesion in the right middle frontal gyrus. Copyright © 2013 Elsevier Ltd. All rights reserved.

Delusion or obsession: Clinical dilemma

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Gandhi Priya

2012-07-01

Full Text Available Abstract Background A 52-year old lady presented for admission with severe depression characterised by suicidal ideation and delusional belief. Case presentation Her treatment regime was reviewed and modified. The dilemma was whether she suffered from a psychotic depression with delusion or an obsessional disorder. She responded well to change of antipsychotic medication. Conclusions Her depression went in remission and her delusional belief decreased in intensity. She also gained reasonable insight into her problem. She is currently being followed up in the psychiatric outpatient clinic.

The Perseverative Thinking Questionnaire in Patients with Persecutory Delusions.

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Černis, Emma; Dunn, Graham; Startup, Helen; Kingdon, David; Wingham, Gail; Evans, Nicole; Lister, Rachel; Pugh, Katherine; Cordwell, Jacinta; Mander, Helen; Freeman, Daniel

2016-07-01

Ruminative negative thinking has typically been considered as a factor maintaining common emotional disorders and has recently been shown to maintain persecutory delusions in psychosis. The Perseverative Thinking Questionnaire (PTQ) (Ehring et al., 2011) is a transdiagnostic measure of ruminative negative thinking that shows promise as a "content-free" measure of ruminative negative thinking. The PTQ has not previously been studied in a psychosis patient group. In this study we report for the first time on the psychometric properties of Ehring et al.'s PTQ in such a group. The PTQ was completed by 142 patients with current persecutory delusions and 273 non-clinical participants. Participants also completed measures of worry and paranoia. A confirmatory factor analysis was performed on the clinical group's PTQ responses to assess the factor structure of the measure. Differences between groups were used to assess criterion reliability. A three lower-order factor structure of the PTQ (core characteristics of ruminative negative thinking, perceived unproductiveness, and capturing mental capacity) was replicated in the clinical sample. Patients with persecutory delusions were shown to experience significantly higher levels of ruminative negative thinking on the PTQ than the general population sample. The PTQ demonstrated high internal reliability. This study did not include test-retest data, and did not compare the PTQ against a measure of depressive rumination but, nevertheless, lends support for the validity of the PTQ as a measure of negative ruminative thinking in patients with psychosis.

Mirror agnosia and the mirrored-self misidentification delusion: a hypnotic analogue.

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Connors, Michael H; Cox, Rochelle E; Barnier, Amanda J; Langdon, Robyn; Coltheart, Max

2012-05-01

Mirrored-self misidentification is the delusional belief that one's reflection in the mirror is a stranger. Current theories suggest that one pathway to the delusion is mirror agnosia (a deficit in which patients are unable to use mirror knowledge when interacting with mirrors). This study examined whether a hypnotic suggestion for mirror agnosia can recreate features of the delusion. Ten high hypnotisable participants were given either a suggestion to not understand mirrors or to see the mirror as a window. Participants were asked to look into a mirror and describe what they saw. Participants were tested on their understanding of mirrors and received a series of challenges. Participants then received a detailed postexperimental inquiry. Three of five participants given the suggestion to not understand mirrors reported seeing a stranger and maintained this belief when challenged. These participants also showed signs of mirror agnosia. No participants given the suggestion to see a window reported seeing a stranger. Results indicate that a hypnotic suggestion for mirror agnosia can be used to recreate the mirrored-self misidentification delusion. Factors influencing the effectiveness of hypnotic analogues of psychopathology, such as participants' expectations and interpretations, are discussed.

Aspects of Theory of Mind that attenuate the relationship between persecutory delusions and social functioning in schizophrenia spectrum disorders.

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Phalen, Peter L; Dimaggio, Giancarlo; Popolo, Raffaele; Lysaker, Paul H

2017-09-01

Despite the apparent relevance of persecutory delusions to social relationships, evidence linking these beliefs to social functioning has been inconsistent. In this study, we examined the hypothesis that theory of mind moderates the relationship between persecutory delusions and social functioning. 88 adults with schizophrenia or schizoaffective disorder were assessed concurrently for social functioning, severity of persecutory delusions, and two components of theory of mind: mental state decoding and mental state reasoning. Mental state decoding was assessed using the Eyes Test, mental state reasoning using the Hinting Task, and social functioning assessed with the Social Functioning Scale. Moderation effects were evaluated using linear models and the Johnson-Neyman procedure. Mental state reasoning was found to moderate the relationship between persecutory delusions and social functioning, controlling for overall psychopathology. For participants with reasoning scores in the bottom 78th percentile, persecutory delusions showed a significant negative relationship with social functioning. However, for those participants with mental state reasoning scores in the top 22nd percentile, more severe persecutory delusions were not significantly associated with worse social functioning. Mental state decoding was not a statistically significant moderator. Generalizability is limited as participants were generally men in later phases of illness. Mental state reasoning abilities may buffer the impact of persecutory delusions on social functioning, possibly by helping individuals avoid applying global beliefs of persecution to specific individuals or by allowing for the correction of paranoid inferences. Published by Elsevier Ltd.

Chronic persecutory delusion and autobiographical memories in patients with schizophrenia: a diary study.

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Berna, Fabrice; Huron, Caroline; Kazès, Mathilde; Offerlin-Meyer, Isabelle; Willard, Dominique; Verry, Paulina; Hedélin, Guy; Krebs, Marie-Odile; Danion, Jean-Marie

2014-01-01

While chronic persecutory delusions are typically anchored into patients' everyday life situations, no investigation has ever looked at how situations associated with a feeling of persecution are recorded and later retrieved. a diary methodology combined with a recognition task involving ten patients with schizophrenia who presented chronic persecutory delusions and ten control participants. Diaries of everyday persecutory events (Pe) and non-persecutory events (nPe) were kept. in both groups, 1) Pe were associated with higher anxiety scores than nPe, 2) Pe were experienced as less distinctive and more stereotyped than nPe, 3) the frequency of incorrect recognition of altered descriptions of Pe was higher than that of nPe. because high levels of motivation are required of the diarists, our sample size was small. Memories of persecutory events were highly emotional and semanticized. they were frequently incorrectly recognized, suggesting the existence of bias resulting from interactions between their processing and persecutory delusions.

The proximity between hallucination and delusion dimensions: An observational, analytic, cross-sectional, multicentre study

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Diogo Telles-correia

2016-11-01

Full Text Available 5.In the current psychiatric classifications, hallucinations (mainly auditory hallucinations are one of the fundamental criteria for establishing a schizophrenia diagnosis or any of the related psychotic disorder’s diagnoses.6.Throughout the history of Psychiatry the conceptual proximity between delusions and hallucinations in the psychiatric patient was maintained until the end of the XIX century,with several supporters during the XX century. Their frontier was not yet definitely defined in terms of Descriptive Psychopathology, and much less so in terms of biochemical and anatomical models.7.In this article we aimed to analyse the dimensions of both hallucinations and delusions in a sample of patients with schizophrenia and schizoaffective disorder. We also intend to find the determinants of the main dimensions of hallucinations.8.One hundred patients with schizophrenia or schizoaffective disorder from both the outpatient and inpatient units of the Psychiatry Department of Hospital of Santa Maria and the Centro Hospitalar Psiquiátrico de Lisboa were assessed by means of the Psychotic Symptom Rating Scales (PSYRATS. 9.In this study we found an empirical based model, where the main dimensions of hallucinations are determined by the central dimensions of delusions. 10.Keywords: Psyrats, Hallucinations, Psychopathology, Psychosis, delusions

Capgras delusion for animals and inanimate objects in Parkinson?s Disease: a case report

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Islam, Lucrezia; Piacentini, Sylvie; Soliveri, Paola; Scarone, Silvio; Gambini, Orsola

2015-01-01

Background Capgras delusion is a delusional misidentification syndrome, in which the patient is convinced that someone that is well known to them, usually a close relative, has been replaced by an impostor or double. Although it has been frequently described in psychotic syndromes, including paranoid schizophrenia, over a third of the documented cases of Capgras delusion are observed in patients with organic brain lesions or neurodegenerative disease, including Parkinson?s Disease. Variants o...

Severe Mental Illness, Somatic Delusions, and Attempted Mass Murder.

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Sarteschi, Christine M

2016-01-01

A case of an attempted mass shooting at a large psychiatric hospital in the United States by a 30-year-old male with severe mental illness, somatic delusions, and exceptional access to healthcare professionals is reported. Six persons were shot, one died at the scene, and the shooter was then killed by the police. Data were gathered from court documents and media accounts. An analysis of the shooter's psychiatric history, his interactions with healthcare professionals, and communications prior to the shooting suggest a rare form of mass murder, a random attack by a documented psychotic and delusional individual suffering with somatic delusions. Despite his being psychotic, the killer planned the attack and made a direct threat 1 month prior to the shootings. This case highlights problems with the healthcare system, indicating that it might be ill equipped to appropriately deal with severe mental illness. © 2015 American Academy of Forensic Sciences.

Capgras delusion for animals and inanimate objects in Parkinson's Disease: a case report.

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Islam, Lucrezia; Piacentini, Sylvie; Soliveri, Paola; Scarone, Silvio; Gambini, Orsola

2015-04-08

Capgras delusion is a delusional misidentification syndrome, in which the patient is convinced that someone that is well known to them, usually a close relative, has been replaced by an impostor or double. Although it has been frequently described in psychotic syndromes, including paranoid schizophrenia, over a third of the documented cases of Capgras delusion are observed in patients with organic brain lesions or neurodegenerative disease, including Parkinson's Disease. Variants of Capgras involving animals or inanimate objects have also been described. The etiology of Capgras in Parkinson's remains unclear, but may arise from a combination of factors, such as frontal lobe dysfunction and dopaminergic medication. We present the case of a 53-year old right-handed female with Parkinson's disease who developed Capgras delusion during treatment with dopamine agonists and Levodopa/Carbidopa. She became convinced that her pet dogs and the plants in her garden had been substituted by identically looking ones. Our patient was initially treated with Quetiapine, with no improvement, and subsequently treated with Clozapine, which lead to partial regression of her symptoms. Neuropsychological Evaluation showed Mild Cognitive Impairment in Executive Functions. Given the clinical history, onset and evolution of symptoms we believe our patient's delusion resulted from the overlap of dopaminergic medication and Mild Cognitive Impairment in executive functions. Zoocentric Capgras, the variant we describe, has been rarely described in scientific literature, and we believe it is of interest due to its unusual characteristics.

Diurnal variation in Cotard's syndrome (copresent with Capgras delusion) following traumatic brain injury.

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Butler, P V

2000-08-01

The aim of this paper is to document regular nocturnal intensification of delusional nihilistic and persecutory ideas (Cotard delusion) linked with extreme depersonalisation and hypervivid dreaming. A 17-year-old man presented with Cotard and Capgras delusions after sustaining multiple cognitive impairments secondary to traumatic brain injury. Delusional ideation fully resolved within 14 days of commencement of olanzapine 5 mg daily. This patient's experience of perceptual abnormalities and impairments in meta-abilities related to self-monitoring and critical inferencing lends support to multicomponent sensory processing accounts of brain injury related, content-specific delusional syndromes.

New findings in delusions of parasitosis.

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Fellner, Michael J

2012-01-01

Two new cases are presented with delusions of parasitosis. Both were women, one middle-aged and one elderly, and exhibited classic symptoms of parasites and "strings" in the skin indicative of Morgellons disease. Each had an additional psychiatric disorder: drug addiction to cocaine and senile dementia. They also illustrate the difficulty encountered by the dermatologist in providing adequate therapy because of resistance to psychiatric referral as well as to standard accepted medication. Newer psychotropics, such as risperdal and lexapro, show promise in helping these patients and add to the therapeutic armamentarium of pimozide.

The effects of reducing worry in patients with persecutory delusions: study protocol for a randomized controlled trial

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Freeman Daniel

2012-11-01

Full Text Available Abstract Background Our approach to advancing the treatment of psychosis is to focus on key single symptoms and develop interventions that target the mechanisms that maintain them. In our theoretical research we have found worry to be an important factor in the development and maintenance of persecutory delusions. Worry brings implausible ideas to mind, keeps them there, and makes the experience distressing. Therefore the aim of the trial is to test the clinical efficacy of a cognitive-behavioral intervention for worry for patients with persecutory delusions and determine how the worry treatment might reduce delusions. Methods/Design An explanatory randomized controlled trial - called the Worry Intervention Trial (WIT - with 150 patients with persecutory delusions will be carried out. Patients will be randomized to the worry intervention in addition to standard care or to standard care. Randomization will be carried out independently, assessments carried out single-blind, and therapy competence and adherence monitored. The study population will be individuals with persecutory delusions and worry in the context of a schizophrenia spectrum diagnosis. They will not have responded adequately to previous treatment. The intervention is a six-session cognitive-behavioral treatment provided over eight weeks. The control condition will be treatment as usual, which is typically antipsychotic medication and regular appointments. The principal hypotheses are that a worry intervention will reduce levels of worry and that it will also reduce the persecutory delusions. Assessments will be carried out at 0 weeks (baseline, 8 weeks (post treatment and 24 weeks (follow-up. The statistical analysis strategy will follow the intention-to-treat principle and involve the use of linear mixed models to evaluate and estimate the relevant between- and within-subjects effects (allowing for the possibility of missing data. Both traditional regression and newer instrumental

When Passive Feels Active--Delusion-Proneness Alters Self-Recognition in the Moving Rubber Hand Illusion.

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Louzolo, Anaïs; Kalckert, Andreas; Petrovic, Predrag

2015-01-01

Psychotic patients have problems with bodily self-recognition such as the experience of self-produced actions (sense of agency) and the perception of the body as their own (sense of ownership). While it has been shown that such impairments in psychotic patients can be explained by hypersalient processing of external sensory input it has also been suggested that they lack normal efference copy in voluntary action. However, it is not known how problems with motor predictions like efference copy contribute to impaired sense of agency and ownership in psychosis or psychosis-related states. We used a rubber hand illusion based on finger movements and measured sense of agency and ownership to compute a bodily self-recognition score in delusion-proneness (indexed by Peters' Delusion Inventory - PDI). A group of healthy subjects (n=71) experienced active movements (involving motor predictions) or passive movements (lacking motor predictions). We observed a highly significant correlation between delusion-proneness and self-recognition in the passive conditions, while no such effect was observed in the active conditions. This was seen for both ownership and agency scores. The result suggests that delusion-proneness is associated with hypersalient external input in passive conditions, resulting in an abnormal experience of the illusion. We hypothesize that this effect is not present in the active condition because deficient motor predictions counteract hypersalience in psychosis proneness.

The erotic transference: dream or delusion?

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De Masi, Franco

2012-12-01

The erotic transference can be seen as the Janus face of clinical work in psychoanalysis: it may either arise out of the positive emotions necessary for the building of new shared realities, or be fueled by falsified and distorted constructions. In the former case, the erotic transference expresses the capacity to anticipate, or "dream," the emotional relationship with the object-which is why Freud valued its transformative aspect as one of the "forces impelling [the patient] to . . . make changes"-whereas in the latter it is equivalent to a flight from psychic reality and may be imperceptibly transformed into an actual delusion.

Belief revision and delusions: how do patients with schizophrenia take advice?

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Kaliuzhna, Mariia; Chambon, Valérian; Franck, Nicolas; Testud, Bérangère; Van der Henst, Jean-Baptiste

2012-01-01

The dominant cognitive model that accounts for the persistence of delusional beliefs in schizophrenia postulates that patients suffer from a general deficit in belief revision. It is generally assumed that this deficit is a consequence of impaired reasoning skills. However, the possibility that such inflexibility affects the entire system of a patient's beliefs has rarely been empirically tested. Using delusion-neutral material in a well-documented advice-taking task, the present study reports that patients with schizophrenia: 1) revise their beliefs, 2) take into account socially provided information to do so, 3) are not overconfident about their judgments, and 4) show less egocentric advice-discounting than controls. This study thus shows that delusional patients' difficulty in revising beliefs is more selective than had been previously assumed. The specificities of the task and the implications for a theory of delusion formation are discussed.

Nature of Persecutors and Their Behaviors in the Delusions of Schizophrenia: Changes between the 1990s and the 2000s.

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Oh, Hyun Young; Kim, Daeho; Park, Yong-Chon

2012-12-01

Research suggests that the contents of delusions in schizophrenia are influenced by culture and social environment. However, few studies have investigated the chronological change of such delusions within a society. To investigate specifically the changes in the persecutory delusions of schizophrenia that have occurred over time, we compared the nature of the persecutors and their persecutory behaviors among inpatients with schizophrenia. All admissions to the psychiatric unit of Hanyang University Guri Hospital with discharge diagnoses of schizophrenia during two different five-year time frames (1996-2000 and 2006-2010) were reviewed. From their inpatient medical records, we investigated the descriptions of persecutors and their persecutory behaviors in the delusions of 124 patients (54 in the1990s and 72 in the 2000s). Overall, persecutory behaviors and nature of persecutors in the delusions of schizophrenia did not differ between the two time frames. However, subgroup analysis revealed that in women but not in men, rejection as a persecutory behavior was significantly higher in the 1990s (p<0.05). The ten-year time interval may be too short to find significant changes in delusional content in general. However, our additional finding in women may be a result of the tremendous change in status of Korean women during the last decade.

Spontaneous Activity Associated with Delusions of Schizophrenia in the Left Medial Superior Frontal Gyrus: A Resting-State fMRI Study.

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Bin Gao

Full Text Available Delusions of schizophrenia have been found to be associated with alterations of some brain regions in structure and task-induced activation. However, the relationship between spontaneously occurring symptoms and spontaneous brain activity remains unclear. In the current study, 14 schizophrenic patients with delusions and 14 healthy controls underwent a resting-state functional magnetic resonance imaging (RS-fMRI scan. Patients with delusions of schizophrenia patients were rated with Positive and Negative Syndrome Scale (PANSS and Characteristics of Delusional Rating Scale (CDRS. Regional homogeneity (ReHo was calculated to measure the local synchronization of the spontaneous activity in a voxel-wise way. A two-sample t-test showed that ReHo of the right anterior cingulate gyrus and left medial superior frontal gyrus were higher in patients, and ReHo of the left superior occipital gyrus was lower, compared to healthy controls. Further, among patients, correlation analysis showed a significant difference between delusion scores of CRDS and ReHo of brain regions. ReHo of the left medial superior frontal gyrus was negatively correlated with patients' CDRS scores but not with delusional PANSS scores. These results suggested that altered local synchronization of spontaneous brain activity may be related to the pathophysiology of delusion in schizophrenia.

Spontaneous Activity Associated with Delusions of Schizophrenia in the Left Medial Superior Frontal Gyrus: A Resting-State fMRI Study.

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Gao, Bin; Wang, Yiquan; Liu, Weibo; Chen, Zhiyu; Zhou, Heshan; Yang, Jinyu; Cohen, Zachary; Zhu, Yihong; Zang, Yufeng

2015-01-01

Delusions of schizophrenia have been found to be associated with alterations of some brain regions in structure and task-induced activation. However, the relationship between spontaneously occurring symptoms and spontaneous brain activity remains unclear. In the current study, 14 schizophrenic patients with delusions and 14 healthy controls underwent a resting-state functional magnetic resonance imaging (RS-fMRI) scan. Patients with delusions of schizophrenia patients were rated with Positive and Negative Syndrome Scale (PANSS) and Characteristics of Delusional Rating Scale (CDRS). Regional homogeneity (ReHo) was calculated to measure the local synchronization of the spontaneous activity in a voxel-wise way. A two-sample t-test showed that ReHo of the right anterior cingulate gyrus and left medial superior frontal gyrus were higher in patients, and ReHo of the left superior occipital gyrus was lower, compared to healthy controls. Further, among patients, correlation analysis showed a significant difference between delusion scores of CRDS and ReHo of brain regions. ReHo of the left medial superior frontal gyrus was negatively correlated with patients' CDRS scores but not with delusional PANSS scores. These results suggested that altered local synchronization of spontaneous brain activity may be related to the pathophysiology of delusion in schizophrenia.

Ketamine Effects on Memory Reconsolidation Favor a Learning Model of Delusions

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Corlett, Philip R.; Cambridge, Victoria; Gardner, Jennifer M.; Piggot, Jennifer S.; Turner, Danielle C.; Everitt, Jessica C.; Arana, Fernando Sergio; Morgan, Hannah L.; Milton, Amy L.; Lee, Jonathan L.; Aitken, Michael R. F.; Dickinson, Anthony; Everitt, Barry J.; Absalom, Anthony R.; Adapa, Ram; Subramanian, Naresh; Taylor, Jane R.; Krystal, John H.; Fletcher, Paul C.

2013-01-01

Delusions are the persistent and often bizarre beliefs that characterise psychosis. Previous studies have suggested that their emergence may be explained by disturbances in prediction error-dependent learning. Here we set up complementary studies in order to examine whether such a disturbance also

Belief revision and delusions: how do patients with schizophrenia take advice?

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Mariia Kaliuzhna

Full Text Available The dominant cognitive model that accounts for the persistence of delusional beliefs in schizophrenia postulates that patients suffer from a general deficit in belief revision. It is generally assumed that this deficit is a consequence of impaired reasoning skills. However, the possibility that such inflexibility affects the entire system of a patient's beliefs has rarely been empirically tested. Using delusion-neutral material in a well-documented advice-taking task, the present study reports that patients with schizophrenia: 1 revise their beliefs, 2 take into account socially provided information to do so, 3 are not overconfident about their judgments, and 4 show less egocentric advice-discounting than controls. This study thus shows that delusional patients' difficulty in revising beliefs is more selective than had been previously assumed. The specificities of the task and the implications for a theory of delusion formation are discussed.

Fast and slow thinking in distressing delusions:A review of the literature and implications for targeted therapy

OpenAIRE

Ward, Thomas; Garety, Philippa A.

2017-01-01

The recent literature on reasoning biases in psychosis and delusions is reviewed. The state-of-the-art knowledge from systematic reviews and meta-analyses on the evidence for jumping to conclusions is briefly summarised, before a fuller discussion of the more recent empirical literature on belief flexibility as applied to delusions. The methodology and evidence in relation to studies of belief flexibility and the Bias Against Disconfirmatory Evidence (BADE) across the delusional continuum wil...

Hallucinations and delusions: the price we pay for our creative brains

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Frith, Christopher

2008-01-01

there is no difference in principle between perceptions and beliefs: both depend upon a process of updating models of the world on the basis of new evidence with Bayes’ theorem providing the underlying computational mechanism. Many hallucinations and delusions can be explained as the consequence of faulty evidence being...... used to generate models of the world. The mechanism by which we use evidence to discover about the physical world of objects can also be used to discover about the mental world of ideas in the minds of others. However, when modelling other people’s minds the process becomes more complex, since......, in a true interaction, each person in the dialogue is trying to model the mind of the other. For success in such interactions it is not sufficient to model what is in the other’s mind. We must also model what the other thinks is in our mind (closing the loop). The hallucinations and delusions associated...

Fast and slow thinking in distressing delusions: A review of the literature and implications for targeted therapy.

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Ward, Thomas; Garety, Philippa A

2017-09-16

The recent literature on reasoning biases in psychosis and delusions is reviewed. The state-of-the-art knowledge from systematic reviews and meta-analyses on the evidence for jumping to conclusions is briefly summarised, before a fuller discussion of the more recent empirical literature on belief flexibility as applied to delusions. The methodology and evidence in relation to studies of belief flexibility and the Bias Against Disconfirmatory Evidence (BADE) across the delusional continuum will be critically appraised, and implications drawn for improving cognitive therapy. It will be proposed that dual process models of reasoning, which Kahneman (Kahneman, 2011) popularised as 'fast and slow thinking', provide a useful theoretical framework for integrating further research and informing clinical practice. The emergence of therapies which specifically target fast and slow thinking in people with distressing delusions will be described. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

A Neuropsychiatric Analysis of the Cotard Delusion.

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Sahoo, Aradhana; Josephs, Keith A

2018-01-01

Cotard's syndrome, a condition in which the patient denies his or her own existence or the existence of body parts, is a rare illness that has been reported in association with several neuropsychiatric diagnoses. The majority of published literature on the topic is in the form of case reports, many of which are several years old. The authors evaluated associated diagnoses, neuroimaging, and treatments recorded in patients diagnosed with Cotard's syndrome at their institution. A search of the Mayo Clinic database for patients with mention of signs and symptoms associated with Cotard's in their records between 1996 and 2016 was conducted. The electronic medical records of the identified patients were then reviewed for evidence of a true diagnosis of Cotard's. Clinical and neuroimaging data were also recorded for these patients. The search identified 18 patients, 14 of whom had Cotard delusions. Two of the 14 were excluded due to them being under age 18. The resulting 12 patients had a median age of 52 years (range: 30-85 years). On neuroimaging, four patients exhibited frontal lobe changes, four demonstrated generalized volume loss, and five had ischemic changes; seven patients demonstrated right-sided or bilateral hemisphere lesions. Treatments included ECT, pharmacotherapy, behavioral therapy, psychotherapy, rehydration, and removal of offending drugs. To conclude, Cotard delusions occur in the context of a relatively wide spectrum of neurological, psychiatric, and medical disorders and present with various neural changes. Nondominant hemisphere lesions may play a role in the pathophysiology. A number of effective treatments are available.

How do people with persecutory delusions evaluate threat in a controlled social environment? A qualitative study using virtual reality.

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Fornells-Ambrojo, Miriam; Freeman, Daniel; Slater, Mel; Swapp, David; Antley, Angus; Barker, Chris

2015-01-01

Environmental factors have been associated with psychosis but there is little qualitative research looking at how the ongoing interaction between individual and environment maintains psychotic symptoms. The current study investigates how people with persecutory delusions interpret events in a virtual neutral social environment using qualitative methodology. 20 participants with persecutory delusions and 20 controls entered a virtual underground train containing neutral characters. Under these circumstances, people with persecutory delusions reported similar levels of paranoia as non-clinical participants. The transcripts of a post-virtual reality interview of the first 10 participants in each group were analysed. Thematic analyses of interviews focusing on the decision making process associated with attributing intentions of computer-generated characters revealed 11 themes grouped in 3 main categories (evidence in favour of paranoid appraisals, evidence against paranoid appraisals, other behaviour). People with current persecutory delusions are able to use a range of similar strategies to healthy volunteers when making judgements about potential threat in a neutral environment that does not elicit anxiety, but they are less likely than controls to engage in active hypothesis-testing and instead favour experiencing "affect" as evidence of persecutory intention.

When paranoia fails to enhance self-esteem: explicit and implicit self-esteem and its discrepancy in patients with persecutory delusions compared to depressed and healthy controls.

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Kesting, Marie-Luise; Mehl, Stephanie; Rief, Winfried; Lindenmeyer, Johannes; Lincoln, Tania M

2011-04-30

The hypothesis that persecutory delusions function to enhance self-esteem implies that patients will show normal explicit, but low implicit self-esteem. As evidence for this has been inconsistent, our study assessed delusional state, explicit and implicit self-esteem and depression in a large sample (n=139) of schizophrenia patients with acute persecutory delusions (n=28), patients with remitted persecutory delusions (n=31), healthy controls (n=59), and depressed controls (n=21). Patients with delusions and patients with depression both showed decreased levels of explicit, but normal levels of implicit self-esteem when compared to healthy controls. The direct comparison of levels of explicit and implicit self-esteem within each group revealed that healthy controls had higher explicit than implicit self-esteem, while the converse pattern was found for depressed controls. No discrepancy between explicit and implicit self-esteem was found for acute deluded or remitted patients with schizophrenia. Although these findings do not support the hypothesis that delusions serve to enhance self-esteem, they underline the relevance of low self-esteem in patients with persecutory delusions and point to the necessity of enhancing self-esteem in therapy. Copyright © 2010 Elsevier Ltd. All rights reserved.

Metacognitive group training for schizophrenia spectrum patients with delusions : a randomized controlled trial

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van Oosterhout, B.; Krabbendam, L.; de Boer, K.; Ferwerda, J.; van der Helm, M.; Stant, A. D.; van der Gaag, M.

2014-01-01

Background. Metacognitive training (MCT) for patients with psychosis is a psychological group intervention that aims to educate patients about common cognitive biases underlying delusion formation and maintenance, and to highlight their negative consequences in daily functioning. Method. In this

Metacognitive group training for schizophrenia spectrum patients with delusions: A randomized controlled trial

NARCIS (Netherlands)

van Oosterhout, B.; Krabbendam, L.; de Boer, K.; Ferwerda, J.; van der Helm, M.; Stant, A.D.; van der Gaag, M.

2014-01-01

Background: Metacognitive training (MCT) for patients with psychosis is a psychological group intervention that aims to educate patients about common cognitive biases underlying delusion formation and maintenance, and to highlight their negative consequences in daily functioning. Method: In this

Fronto-limbic novelty processing in acute psychosis: disrupted relationship with memory performance and potential implications for delusions

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Björn H Schott

2015-06-01

Full Text Available Recent concepts have highlighted the role of the hippocampus and adjacent medial temporal lobe (MTL in positive symptoms like delusions in schizophrenia. In healthy individuals, the MTL is critically involved in the detection and encoding of novel information. Here, we aimed to investigate whether dysfunctional novelty processing by the MTL might constitute a potential neural mechanism contributing to the pathophysiology of delusions, using functional magnetic resonance imaging (fMRI in 16 unmedicated patients with paranoid schizophrenia and 20 age-matched healthy controls. All patients experienced positive symptoms at time of participation. Participants performed a visual target detection task with complex scene stimuli in which novel and familiar rare stimuli were presented randomly intermixed with a standard and a target picture. Presentation of novel relative to familiar images was associated with hippocampal activation in both patients and healthy controls, but only healthy controls showed a positive relationship between novelty-related hippocampal activation and recognition memory performance after 24 hours. Patients, but not controls, showed a robust neural response in the orbitofrontal cortex (OFC during presentation of novel stimuli. Functional connectivity analysis in the patients further revealed a novelty-related increase of functional connectivity of both the hippocampus and the OFC with the rostral anterior cingulate cortex (rACC and the ventral striatum. Notably, delusions correlated positively with the difference of the functional connectivity of the hippocampus versus the OFC with the rACC. Taken together, our results suggest that alterations of fronto-limbic novelty processing may contribute to the pathophysiology of delusions in patients with acute psychosis.

Dual-stream modulation failure: a novel hypothesis for the formation and maintenance of delusions in schizophrenia.

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Speechley, William J; Ngan, Elton T C

2008-01-01

Delusions, a cardinal feature of schizophrenia, are characterized by the development and preservation of false beliefs despite reason and evidence to the contrary. A number of cognitive models have made important contributions to our understanding of delusions, though it remains unclear which core cognitive processes are malfunctioning to enable individuals with delusions to form and maintain erroneous beliefs. We propose a modified dual-stream processing model that provides a viable and testable mechanism that can account for this debilitating symptom. Dual-stream models divide decision-making into two streams: a fast, intuitive and automatic form of processing (Stream 1); and a slower, conscious and deliberative process (Stream 2). Our novel model proposes two key influences on the way these streams interact in everyday decision-making: conflict and emotion. Conflict: in most decision-making scenarios one obvious answer presents itself and the two streams converge onto the same conclusion. However, in instances where there are competing alternative possibilities, an individual often experiences dissonance, or a sense of conflict. The detection of this conflict biases processing towards the more deliberative Stream 2. Emotion: highly emotional states can result in behavior that is reflexive and action-oriented. This may be due to the power of emotionally valenced stimuli to bias reasoning towards Stream 1. We propose that in schizophrenia, an abnormal response to these two influences results in a pathological schism between Stream 1 and Stream 2, enabling erroneous intuitive explanations to coexist with contrary logical explanations of the same event. Specifically, we suggest that delusions are the result of a failure to reconcile the two streams due to both a failure of conflict to bias decision-making towards Stream 2 and an accentuated emotional bias towards Stream 1.

Cotard Delusion in the Context of Schizophrenia: A Case Report and Review of the Literature

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Nicholas Bott

2016-09-01

Full Text Available Background: The Cotard delusion (CD is one of a variety of narrowly defined monothematic delusions characterized by nihilistic beliefs about the body’s existence or life itself. The presence of CD within the context of schizophrenia is rare (<1%, and remains understudied.Case: ‘Mr. C’ is a 58-year-old veteran with a prior diagnosis of schizophrenia, who presented with CD in the context of significant depression, suicidal ideation (SI, violence, and self-harm behavior. He perseverated in his belief that he was physically dead and possessed by demons for several weeks. This delusion was reinforced by his religious belief that life was an attribute of God, and by inference, he as a human, was dead. His condition gradually improved over the course of treatment with Divalproex and quetiapine with discussions about the rationale for his belief. Upon discharge, Mr. C. demonstrated awareness of his fixation on death and an ability to redirect himself.Discussion: This case highlights the need to better understand the co-occurrence of CD in schizophrenia, their differentiation, the increased risk of violence and self-harm behavior in this presentation, and how specific events and religious factors can influence delusional themes of CD. Pharmacotherapy and aspects of cognitive-behavioral therapy (CBT may be effective in ameliorating these symptoms in CD.

Does dissociation mediate the relationship between childhood trauma and hallucinations, delusions in first episode psychosis?

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Sun, Pamela; Alvarez-Jimenez, Mario; Simpson, Katrina; Lawrence, Katherine; Peach, Natalie; Bendall, Sarah

2018-04-11

Childhood trauma has been linked to the presence of delusions and hallucinations in psychosis, although the mechanisms underlying this relationship require elucidation. Dissociation, characterized by disruptions to the integrative functioning of several core mental domains, has emerged as a potential mechanism. There is a paucity of research using a clinician-rated measure of dissociation to test the indirect effect of dissociation on the relationship between childhood trauma and psychotic symptoms. This study aimed to investigate whether dissociation mediated both the relationships between childhood trauma and hallucinations, and childhood trauma and delusions utilizing a clinician-administered measure of dissociation, namely the Structured Clinical Interview for DSM-IV Dissociative Disorders - Revised (SCID-D-R). Sixty-six first-episode psychosis (FEP) participants completed a research interview and questionnaires. Information about experiences of childhood trauma, psychosis, dissociation, general psychopathology and demographics were collected. When using the SCID-D-R, childhood trauma positively correlated with dissociation. Further, dissociation mediated the relationship between childhood trauma and delusions. Contrary to previous findings, we found no relationship between dissociation and hallucinations and no mediating effect of dissociation on the association between childhood trauma and hallucinations. The results of the SCID-D-R differed significantly from those of the Dissociative Experiences Scale-II (DES-II) which were consistent with previous research. Our findings are the first to use a clinician-rated measure to test the mediating effect of dissociation on the relationship between childhood trauma and positive symptoms (i.e., hallucinations and delusions). Given the discrepancies in results between the SCID-D-R and DES-II, how dissociation is measured in future research is an important consideration. The results add to a body of work that

Analytic cognitive style predicts paranormal explanations of anomalous experiences but not the experiences themselves: Implications for cognitive theories of delusions.

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Ross, Robert M; Hartig, Bjoern; McKay, Ryan

2017-09-01

It has been proposed that delusional beliefs are attempts to explain anomalous experiences. Why, then, do anomalous experiences induce delusions in some people but not in others? One possibility is that people with delusions have reasoning biases that result in them failing to reject implausible candidate explanations for anomalous experiences. We examine this hypothesis by studying paranormal interpretations of anomalous experiences. We examined whether analytic cognitive style (i.e. the willingness or disposition to critically evaluate outputs from intuitive processing and engage in effortful analytic processing) predicted anomalous experiences and paranormal explanations for these experiences after controlling for demographic variables and cognitive ability. Analytic cognitive style predicted paranormal explanations for anomalous experiences, but not the anomalous experiences themselves. We did not study clinical delusions. Our attempts to control for cognitive ability may have been inadequate. Our sample was predominantly students. Limited analytic cognitive style might contribute to the interpretation of anomalous experiences in terms of delusional beliefs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Delusions of Disseminated Fungosis

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Ian Gassiep

2014-01-01

Full Text Available Introduction. Delusional infestation is a rare monosymptomatic hypochondriacal psychosis according to The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013. It can be a primary disorder or associated with an underlying psychological or physical disorder. It commonly presents as delusional parasitosis, and less than 1% may be fungi related. We present this case as it is a rare presentation of a rare condition. Case Presentation. Our patient is a 60-year-old Caucasian man who presented with a 7-year history of delusional infestation manifested as a disseminated fungal infection. He had previously been reviewed by multiple physicians for the same with no systemic illness diagnosed. After multiple reviews and thorough investigation we diagnosed him with a likely delusional disorder. As is common with this patient cohort he refused psychiatric review or antipsychotic medication. Conclusion. A delusion of a disseminated fungal infestation is a rare condition. It is exceedingly difficult to treat as these patients often refuse to believe the investigation results and diagnosis. Furthermore, they either refuse or are noncompliant with treatment. Multidisciplinary outpatient evaluation may be the best way to allay patient fears and improve treatment compliance.

Negative cognitions about the self in patients with persecutory delusions: An empirical study of self-compassion, self-stigma, schematic beliefs, self-esteem, fear of madness, and suicidal ideation.

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Collett, Nicola; Pugh, Katherine; Waite, Felicity; Freeman, Daniel

2016-05-30

There has been growing awareness of the high prevalence of negative cognitions about the self in patients with persecutory delusions, and it has been proposed that paranoid fears build upon these perceived vulnerabilities. This study aimed to investigate for the first time a wide range of different conceptualisations of the negative self, and to examine associations with suicidal ideation, in patients with persecutory delusions. Twenty-one patients with persecutory delusions and twenty-one non-clinical individuals completed measures relating to negative self cognitions. The delusions group also completed a measure of suicidal ideation. It was found that the patients with persecutory delusions had low self-compassion, low self-esteem, increased fears of being mad, beliefs of inferiority to others, negative self-schemas, and low positive self-schemas when compared to the non-clinical control group. The effect sizes (Cohen's d) were large, and the different conceptualisations of negative self cognitions were highly associated with one another. Self-stigma did not differ between the two groups. Furthermore, suicidal ideation was highly associated with low self-compassion, low self-esteem, fears of madness, and negative self-schema but not self-stigma. This study shows marked negative self cognitions in patients with persecutory delusions. These are likely to prove targets of clinical interventions, with patient preference most likely determining the best conceptualisation of negative self cognitions for clinicians to use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Ways of understanding of religious delusions associated with a change of identity on the example of identification with Jesus Christ.

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Dyga, Krzysztof; Stupak, Radosław

2018-02-28

Identification with Christ among psychiatric patients is an example of a complex and multifaceted phenomenon. As a delusion it includes a misidentification (change of identity) in the layer of content and, usually, grandiosity and/or paranoid traits in the formal aspect. What is more, it fits in the category of religious delusions, which are perhaps the most controversial type of delusions and as such require special sensitivity as well as knowledge beyond psychology or psychiatry. The aim of the articleis to show the phenomenon of identification with Christ among psychiatric patients, taking into account different ways of its explaining and understanding. Papers relating to the topic, both theoretical considerations and case studies, found in the EBSCO database were analyzed. Searching for the articles the following key words were used: identity, identification, delusion, Jesus/Christ/Messiah, psychosis, schizophrenia. The analysis included all (actually not numerous) articles except for the one linked to cognitive approach which did not significantly contribute to the issue. Given the multiplicity of ways of explaining and understanding the experience of identification with the figure of the Messiah, it seems to be a mistake to hold both objectivist and one-sided, based on one theory, attitude towards it. Such an experience should be recognized in the context of the history of patient's life and the all possible mechanisms leading to its occurrence, as well as the meanings hidden beneath the symptom, should be take into account. It is also important to be well-oriented in the system of religious beliefs and spiritual needs of the patient.

Culture-specific delusions. Sense and nonsense in cultural context.

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Gaines, A D

1995-06-01

It can be said that a definition of delusions requires the invocation of cultural understandings, standards of acceptability, as well as conceptions of reality and the forces that animate it. For these reasons, the determination of delusional or normative ideation can only be effected properly within particular cultural contexts. The cross-cultural record suggests that it is difficult to separate the delusional from the cultural; a belief that is patterened and culturally specific is, by definition a cultural, not a delusional belief. One must rely upon particular, relevant local cultural understandings to ascertain when the bounds of culture have been transgressed and meaning has given way to unshareable nonsense.

"Far from the heart far from the eye": evidence from the Capgras delusion.

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Brighetti, Gianni; Bonifacci, Paola; Borlimi, Rosita; Ottaviani, Cristina

2007-05-01

Capgras syndrome is characterised by the belief that a significant other has been replaced by an identical-looking impostor. These patients have no difficulties with visual recognition but fail to show a skin conductance response (SCR) to the objects of the delusion. A case of Capgras delusion (YY), specifically characterised by the absence of brain lesions, constituted a good opportunity to test the relationship between SCR hyporesponsiveness and eye movement patterns to familiar and unfamiliar faces. Visual scan path and SCR were recorded for YY and 8 controls during the presentation of family members' photographs matched with unfamiliar faces of the same sex, age, and physical likeness. Eye movement patterns were explored by selecting three specific areas of interest (AOI) involving the eyes, the mouth, and the face regions. In contrast with controls, YY showed a reduction in number and sum of fixation durations to the eyes (p.05) to familiar vs. nonfamiliar faces. SCR and fixation duration to family members' eyes were significantly correlated (r=.77) in both YY and controls. Eye region exploration seems to be related to the autonomic reactivity elicited by the affective valence of familiar faces.

[Chronic Koro-like Syndrome (KLS) in recurrent depressive disorder as a variant of Cotard's delusion in an italian male patient. A case report and historical review].

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Bandinelli, Pier Luca; Trevisi, Manuela; Kotzalidis, Giorgio Demetrio; Manfredi, Giovanni; Rapinesi, Chiara; Ducci, Giuseppe

2011-01-01

Cotard’s syndrome is a delusional syndrome, first described in the 1880ies by Cotard, characterized by a nihilistic delusions about the self and/or the world. In same other cases there is an intense nihilistic belief that the patient’s entire body or parts of it are disintegrated or dead. The syndrome is often associated with severe depression, but are also described neurological cases. Koro was described a little later from Asia and consisted in the belief that one’s own genitalia are shrinking or disappearing and death will ensue thereafter, but there are many cultural variants and the syndrome may present in an incomplete form. We report on a KLS sharing more features with annihilation delusions, such as Cotard’s syndrome. In KLS, the délire de négation may be limited to localized systems or organs. We believe that some complete and incomplete forms of Koro, when embedded in a depressive core, may represent a variant of Cotard’s delusion. In fact, our patient did not reach a complete denial of his entire body, but rather focused on sexual identity. We analysed the psychosexual issues of our case according to Kretschmer’s 1918 view of a “bipolar setting” between sthenic and asthenic characters of a patient suffering from sensitive delusions of (self-) reference. This view may allow us to relate the personological character to the genetic comprehensibility of the delusion.

The cognitive and affective structure of paranoid delusions: a transdiagnostic investigation of patients with schizophrenia spectrum disorders and depression.

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Bentall, Richard P; Rowse, Georgina; Shryane, Nick; Kinderman, Peter; Howard, Robert; Blackwood, Nigel; Moore, Rosie; Corcoran, Rhiannon

2009-03-01

Paranoid delusions are a common symptom of a range of psychotic disorders. A variety of psychological mechanisms have been implicated in their cause, including a tendency to jump to conclusions, an impairment in the ability to understand the mental states of other people (theory of mind), an abnormal anticipation of threat, and an abnormal explanatory style coupled with low self-esteem. To determine the structure of the relationships among psychological mechanisms contributing to paranoia in a transdiagnostic sample. Cross-sectional design, with relationships between predictor variables and paranoia examined by structural equation models with latent variables. Publicly funded psychiatric services in London and the North West of England. One hundred seventy-three patients with schizophrenia spectrum disorders, major depression, or late-onset schizophrenia-like psychosis, subdivided according to whether they were currently experiencing paranoid delusions. Sixty-four healthy control participants matched for appropriate demographic variables were included. Assessments of theory of mind, jumping to conclusions bias, and general intellectual functioning, with measures of threat anticipation, emotion, self-esteem, and explanatory style. The best fitting (chi(2)(96) = 131.69, P = .01; comparative fit index = 0.95; Tucker-Lewis Index = 0.96; root-mean-square error of approximation = 0.04) and most parsimonious model of the data indicated that paranoid delusions are associated with a combination of pessimistic thinking style (low self-esteem, pessimistic explanatory style, and negative emotion) and impaired cognitive performance (executive functioning, tendency to jump to conclusions, and ability to reason about the mental states of others). Pessimistic thinking correlated highly with paranoia even when controlling for cognitive performance (r = 0.65, P < .001), and cognitive performance correlated with paranoia when controlling for pessimism (r = -0.34, P < .001). Both

Better theory-of-mind skills in children hearing voices mitigate the risk of secondary delusion formation

NARCIS (Netherlands)

Bartels-Velthuis, A. A.; Blijd-Hoogewys, E. M. A.; van Os, J.

Objective: To examine the social cognitive vulnerabilities mediating delusion formation in children presenting with hallucinatory experiences. Method: A sample of 259 12- and 13-year-old children, from a baseline case-control sample of children with and without auditory hallucinations (AH), were

[Delirium in delusions of negations of Cotard: syndrome versus disorder].

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Huertas, D; Molina, J D; Chamorro, L; Toral, J

1997-01-01

This article constitutes the first of a series directed to review fundamental disorders in clinical psychogeriatrics. This sort of publication is intended to retrieve clinical practice as the cornerstone for research and teaching in psychiatry. Besides, and particularly in geriatry, we try to expand the strategy of liaison work with primary physicians. In this case, a nosological review of the so called "delusion of negations" is presented. The Jules Cotard's original concept of subtype of delusional melancholia is contrasted to the view of numerous authors in this century who have described it as a form of non-specific delusional syndrome.

Cognitive mechanisms of change in delusions: an experimental investigation targeting reasoning to effect change in paranoia.

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Garety, Philippa; Waller, Helen; Emsley, Richard; Jolley, Suzanne; Kuipers, Elizabeth; Bebbington, Paul; Dunn, Graham; Fowler, David; Hardy, Amy; Freeman, Daniel

2015-03-01

Given the evidence that reasoning biases contribute to delusional persistence and change, several research groups have made systematic efforts to modify them. The current experiment tested the hypothesis that targeting reasoning biases would result in change in delusions. One hundred and one participants with current delusions and schizophrenia spectrum psychosis were randomly allocated to a brief computerized reasoning training intervention or to a control condition involving computer-based activities of similar duration. The primary hypotheses tested were that the reasoning training intervention, would improve (1) data gathering and belief flexibility and (2) delusional thinking, specifically paranoia. We then tested whether the changes in paranoia were mediated by changes in data gathering and flexibility, and whether working memory and negative symptoms moderated any intervention effects. On an intention-to-treat analysis, there were significant improvements in state paranoia and reasoning in the experimental compared with the control condition. There was evidence that changes in reasoning mediated changes in paranoia, although this effect fell just outside the conventional level of significance after adjustment for baseline confounders. Working memory and negative symptoms significantly moderated the effects of the intervention on reasoning. The study demonstrated the effectiveness of a brief reasoning intervention in improving both reasoning processes and paranoia. It thereby provides proof-of-concept evidence that reasoning is a promising intermediary target in interventions to ameliorate delusions, and thus supports the value of developing this approach as a longer therapeutic intervention. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

Delusions and the Right Hemisphere: A Review of the Case for the Right Hemisphere as a Mediator of Reality-Based Belief.

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Gurin, Lindsey; Blum, Sonja

2017-01-01

Delusions are beliefs that remain fixed despite evidence that they are incorrect. Although the precise neural mechanism of delusional belief remains to be elucidated, there is a predominance of right-hemisphere lesions among patients with delusional syndromes accompanied by structural pathology, suggesting that right-hemisphere lesions, or networks with key nodes in the right hemisphere, may be playing a role. The authors discuss the potential theoretical basis and empiric support for a specific right-hemisphere role in delusion production, drawing on its roles in pragmatic communication; perceptual integration; attentional surveillance and anomaly/novelty detection; and belief updating.

Machine medical ethics when a human is delusive but the android has its wits about him

NARCIS (Netherlands)

Hoorn, J.F.; van Rysewyk, S.P.; Pontier, M.A.

2015-01-01

When androids take care of delusive patients, ethic-epistemic concerns crop up about an agency’s good intent and why we would follow its advice. Robots are not human but may deliver correct medical information, whereas Alzheimer patients are human but may be mistaken. If humanness is not the

Book Review: Dams, displacement, and the delusion of development: Cahora Bassa and its legacies in Mozambique, 1965–2007

CSIR Research Space (South Africa)

Meissner, Richard

2015-10-01

Full Text Available Journal of International Affairs Book Review: Dams, displacement, and the delusion of development: Cahora Bassa and its legacies in Mozambique, 1965–2007 Richard Meissner Council for Scientific and Industrial Research, Pretoria, South Africa...

Jumping to the wrong conclusions? An investigation of the mechanisms of reasoning errors in delusions

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Jolley, Suzanne; Thompson, Claire; Hurley, James; Medin, Evelina; Butler, Lucy; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth; Garety, Philippa

2014-01-01

Understanding how people with delusions arrive at false conclusions is central to the refinement of cognitive behavioural interventions. Making hasty decisions based on limited data (‘jumping to conclusions’, JTC) is one potential causal mechanism, but reasoning errors may also result from other processes. In this study, we investigated the correlates of reasoning errors under differing task conditions in 204 participants with schizophrenia spectrum psychosis who completed three probabilistic reasoning tasks. Psychotic symptoms, affect, and IQ were also evaluated. We found that hasty decision makers were more likely to draw false conclusions, but only 37% of their reasoning errors were consistent with the limited data they had gathered. The remainder directly contradicted all the presented evidence. Reasoning errors showed task-dependent associations with IQ, affect, and psychotic symptoms. We conclude that limited data-gathering contributes to false conclusions but is not the only mechanism involved. Delusions may also be maintained by a tendency to disregard evidence. Low IQ and emotional biases may contribute to reasoning errors in more complex situations. Cognitive strategies to reduce reasoning errors should therefore extend beyond encouragement to gather more data, and incorporate interventions focused directly on these difficulties. PMID:24958065

[Transsexualism or delusions of sex change? Avoiding misdiagnosis].

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Urban, Małgorzata

2009-01-01

The aim of this paper was to present basic data about gender identity disorders and psychotic transsexual desires. From time to time in scientific literature there are descriptions of a diagnosis of psychotic disorders in persons previously diagnosed and treated as transsexuals, in whom the transsexual thinking disappears after using antipsychotic agents. Coexistence of transsexualism and schizophrenia causes a lot of doubt--it is observed in scientists opinions but also in the diagnostic criteria of DSM-IV and ICD-10. Moreover, delusions of sex change are probably more frequent than it is thought. It causes, that in some cases the differential diagnosis of psychosis and gender identity disorders may be very difficult. Transsexuals treatment is on one hand connected with expected effects but on the other hand with many serious, often irreversible health consequences (e.g. cardiovascular disease, risk of neoplasma development, infertility, consequences of surgical sex reassignment). That is why the differential diagnosis of transsexualism and schizophrenia should be made carefully and thoughtfully.

Aberrant functioning of the putamen links delusions, antipsychotic drug dose, and compromised connectivity in first episode psychosis--Preliminary fMRI findings.

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Raij, Tuukka T; Mäntylä, Teemu; Kieseppä, Tuula; Suvisaari, Jaana

2015-08-30

The dopamine theory proposes the relationship of delusions to aberrant signaling in striatal circuitries that can be normalized with dopamine D2 receptor-blocking drugs. Localization of such circuitries, as well as their upstream and downstream signaling, remains poorly known. We collected functional magnetic resonance images from first-episode psychosis patients and controls during an audiovisual movie. Final analyses included 20 patients and 20 controls; another sample of 10 patients and 10 controls was used to calculate a comparison signal-time course. We identified putamen circuitry in which the signal aberrance (poor correlation with the comparison signal time course) was predicted by the dopamine theory, being greater in patients than controls; correlating positively with delusion scores; and correlating negatively with antipsychotic-equivalent dosage. In Granger causality analysis, patients showed a compromised contribution of the cortical salience network to the putamen and compromised contribution of the putamen to the default mode network. Results were corrected for multiple comparisons at the cluster level with primary voxel-wise threshold p < 0.005 for the salience network contribution, but liberal primary threshold p < 0.05 was used in other group comparisons. If replicated in larger studies, these findings may help unify and extend current hypotheses on dopaminergic dysfunction, salience processing and pathogenesis of delusions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Covariation assessment for neutral and emotional verbal stimuli in paranoid delusions.

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Díez-Alegría, Cristina; Vázquez, Carmelo; Hernández-Lloreda, María J

2008-11-01

Selective processing of emotion-relevant information is considered a central feature in various types of psychopathology, yet the mechanisms underlying these biases are not well understood. One of the first steps in processing information is to gather data to judge the covariation or association of events. The aim of this study was to explore whether patients with persecutory delusions would show a covariation bias when processing stimuli related to social threat. We assessed estimations of covariation in-patients with current persecutory (CP) beliefs (N=40), patients with past persecutory (PP) beliefs (N=25), and a non-clinical control (NC) group (N=36). Covariation estimations were assessed under three different experimental conditions. The first two conditions focused on neutral behaviours (Condition 1) and psychological traits (Condition 2) for two distant cultural groups, while the third condition included self-relevant material by exposing the participant to either protective social (positive) or threatening social (negative) statements about the participant or a third person. Our results showed that all participants were precise in their covariation estimations. However, when judging covariation for self-relevant sentences related to social statements (Condition 3), all groups showed a significant tendency to associate positive social interaction (protection themed) sentences to the self. Yet, when using sentences related to social-threat, the CP group showed a bias consisting of overestimating the number of self-referent sentences. Our results showed that there was no specific covariation assessment bias related to paranoid beliefs. Both NCs and participants with persecutory beliefs showed a similar pattern of results when processing neutral or social threat-related sentences. The implications for understanding of the role of self-referent information processing biases in delusion formation are discussed.

Jumping to the wrong conclusions? An investigation of the mechanisms of reasoning errors in delusions.

Science.gov (United States)

Jolley, Suzanne; Thompson, Claire; Hurley, James; Medin, Evelina; Butler, Lucy; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth; Garety, Philippa

2014-10-30

Understanding how people with delusions arrive at false conclusions is central to the refinement of cognitive behavioural interventions. Making hasty decisions based on limited data ('jumping to conclusions', JTC) is one potential causal mechanism, but reasoning errors may also result from other processes. In this study, we investigated the correlates of reasoning errors under differing task conditions in 204 participants with schizophrenia spectrum psychosis who completed three probabilistic reasoning tasks. Psychotic symptoms, affect, and IQ were also evaluated. We found that hasty decision makers were more likely to draw false conclusions, but only 37% of their reasoning errors were consistent with the limited data they had gathered. The remainder directly contradicted all the presented evidence. Reasoning errors showed task-dependent associations with IQ, affect, and psychotic symptoms. We conclude that limited data-gathering contributes to false conclusions but is not the only mechanism involved. Delusions may also be maintained by a tendency to disregard evidence. Low IQ and emotional biases may contribute to reasoning errors in more complex situations. Cognitive strategies to reduce reasoning errors should therefore extend beyond encouragement to gather more data, and incorporate interventions focused directly on these difficulties. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The role of fear in delusions of the paranormal.

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Lange, R; Houran, J

1999-03-01

Based on an extended process model derived from attribution theory, we hypothesized that pervasive and persistent delusions of the paranormal are characterized by the existence of a positive (self-reinforcing), rather than a negative (self-correcting), feedback loop involving paranormal beliefs, fears, and experiences, as moderated by gender and tolerance of ambiguity. A cross-cultural sample of "international" students who reported poltergeist-like experiences showing high fear of the paranormal was identified. As in earlier research, path analysis showed statistically significant and positive effects of belief on experience and/or fear on belief. However, paranormal experience now had a positive effect on fear as well. Thus, as predicted, increased fear removes the option of neutralizing ambiguous events by labeling them as "paranormal." Although female subjects showed significantly greater fear of the paranormal than male subjects, there is no evidence that the nature of the delusional process is gender specific.

Stable aesthetic standards delusion: changing 'artistic quality' by elaboration.

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Carbon, Claus-Christian; Hesslinger, Vera M

2014-01-01

The present study challenges the notion that judgments of artistic quality are based on stable aesthetic standards. We propose that such standards are a delusion and that judgments of artistic quality are the combined result of exposure, elaboration, and discourse. We ran two experiments using elaboration tasks based on the repeated evaluation technique in which different versions of the Mona Lisa had to be elaborated deeply. During the initial task either the version known from the Louvre or an alternative version owned by the Prado was elaborated; during the second task both versions were elaborated in a comparative fashion. After both tasks multiple blends of the two versions had to be evaluated concerning several aesthetic key variables. Judgments of artistic quality of the blends were significantly different depending on the initially elaborated version of the Mona Lisa, indicating experience-based aesthetic processing, which contradicts the notion of stable aesthetic standards.

Morgellons disease and delusions of parasitosis.

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Robles, David T; Olson, Jonathan M; Combs, Heidi; Romm, Sharon; Kirby, Phil

2011-02-01

Morgellons disease is a controversial and poorly defined symptom cluster of skin lesions and somatic symptoms, most notably 'fibers' in the skin. Because of widespread coverage in the media and on the Internet, there are an increasing number of patients presenting to dermatologists. We present three patients who believed that they had fibers in their skin. We offer a discussion of delusions of parasitosis to demonstrate similarities between these conditions. It has been suggested by a limited number of healthcare providers that an unknown infectious agent underlies this symptom complex yet no available evidence supports this assertion. Laboratory values that would be reflective of an infectious process (e.g. elevated white blood cells, sedimentation rate, C reactive protein) are routinely normal and biopsies often reflect only nonspecific findings such as acute and chronic inflammation with erosion or ulceration. Patients with Morgellons disease generally lack insight into their disease and reject the need for psychiatric help. The goal is to build trust and refrain from minimizing what the patient experiences. Attentive examination of the patient's skin and fragments they present is necessary to rule out a true underlying pathologic process and to establish a trusting relationship. A supportive, non-confrontational approach is ideal. The patient is best treated by a team of practitioners of several specialties, including dermatologists, psychiatrists, and counselors.

'Paranoia and its historical development (systematized delusion)', by Eugenio Tanzi (1884).

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Castagnini, Augusto

2016-06-01

This was the first paper by the Italian alienist Eugenio Tanzi (1856-1934). It surveyed existing works and provided an analysis of clinical categories such as monomania, sensory madness, moral insanity, Wahnsinn, Verrücktheit and systematized delusions, which had been used in France, Germany, Britain and Italy since the early nineteenth century to deal with paranoia. As pointed out by Tanzi, discrepancies and discontinuities in diagnostic concepts affected both psychiatric nosology and practice. Paranoia (from the Greek παρά and νοια) made for greater clarity in psychiatric terminology, and denoted a broad category, including both acute and chronic delusional states which were considered to be distinct from mania and melancholia, and usually not to lead to mental deterioration. © The Author(s) 2016.

"Capgras" Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures.

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Lilly, Brandon; Maynard, Erika; Melvin, Kelly; Holroyd, Suzanne

2018-01-01

Capgras syndrome is characterized by the delusional belief that a familiar person has been replaced by a visually similar imposter or replica. Rarely, the delusional focus may be objects rather than people. Numerous etiologies have been described for Capgras to include seizures. Similarly, visual hallucinations, both simple and complex, can occur secondary to seizure activity. We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology.

Delusional misidentifications and duplications: right brain lesions, left brain delusions.

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Devinsky, Orrin

2009-01-06

When the delusional misidentification syndromes reduplicative paramnesia and Capgras syndromes result from neurologic disease, lesions are usually bifrontal and/or right hemispheric. The related disorders of confabulation and anosognosis share overlapping mechanisms and anatomic pathology. A dual mechanism is postulated for the delusional misidentification syndromes: negative effects from right hemisphere and frontal lobe dysfunction as well as positive effects from release (i.e., overactivity) of preserved left hemisphere areas. Negative effects of right hemisphere injury impair self-monitoring, ego boundaries, and attaching emotional valence and familiarity to stimuli. The unchecked left hemisphere unleashes a creative narrator from the monitoring of self, memory, and reality by the frontal and right hemisphere areas, leading to excessive and false explanations. Further, the left hemisphere's cognitive style of categorization, often into dual categories, leads it to invent a duplicate or impostor to resolve conflicting information. Delusions result from right hemisphere lesions. But it is the left hemisphere that is deluded.

Association of religion with delusions and hallucinations in the context of schizophrenia: implications for engagement and adherence.

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Gearing, Robin Edward; Alonzo, Dana; Smolak, Alex; McHugh, Katie; Harmon, Sherelle; Baldwin, Susanna

2011-03-01

The relationship of religion and schizophrenia is widely acknowledged, but often minimized by practitioners and under investigated by researchers. In striving to help fill this gap, this paper focuses on examining four aims: 1) how research has investigated the association between religiosity and schizophrenia; 2) how is religiosity associated with delusions and hallucinations; 3) what are the risk and protective factors associated with religiosity and schizophrenia; and 4) does religion influence treatment adherence with individuals diagnosed with schizophrenia. A systematic literature search of PsycINFO and MEDLINE databases from January 1, 1980 through January 1, 2010 was conducted using the terms schizophrenia, schizoaffective, schizophreniform, psychotic disorder not otherwise specified (NOS) and religion, religiosity, spirituality, or faith. Seventy (n=70) original research studies were identified. Religion can act as both a risk and protective factor as it interacts with the schizophrenia symptoms of hallucination and delusions. Cultural influences tend to confound the association of religion and schizophrenia. Adherence to treatment has a mixed association with religiosity. The relationship between religion and schizophrenia may be of benefit to both clinicians and researchers through enhancing adherence to treatment, and enhancement of the protective aspects while minimizing associated risk. The relationship of religion and schizophrenia needs further research that is more nuanced and methodologically rigorous, specifically concerning its influence on engagement and adherence to treatment. Copyright © 2010 Elsevier B.V. All rights reserved.

Extraordinary system of delusions and the social functioning - a case study

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Skoczeń Nikodem

2016-03-01

Full Text Available Schizophrenic psychoses are a heterogeneous group of diseases that affect about 1% of the world’s population. The first symptoms of the disease usually manifest between ages 20 and 30. The diagnostic criteria for schizophrenia and its subtypes are characterized in detail in ICD-10. Diagnosis is based primarily on the presence of productive symptoms such as delusions or hallucinations occurring for at least one month which cannot be explained in another way. Schizophrenia is a disease which largely affects social functioning of patients, such as occupational performance, family life, interpersonal relationships or housing situation. Apart from the sociological aspect, social lives of schizophrenia sufferers are significantly impoverished due to cognitive impairment associated with improper functioning of NMDA receptors. The study describes a case of a patient suffering from paranoid schizophrenia which sheds light on the social functioning of this group of patients.

Mad scientist: the unique case of a published delusion.

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Shelomi, Matan

2013-06-01

In 1951, entomologist Jay Traver published in the Proceedings of the Entomological Society of Washington her personal experiences with a mite infestation of her scalp that resisted all treatment and was undetectable to anyone other than herself. Traver is recognized as having suffered from Delusory Parasitosis: her paper shows her to be a textbook case of the condition. The Traver paper is unique in the scientific literature in that its conclusions may be based on data that was unconsciously fabricated by the author's mind. The paper may merit retraction on the grounds of error or even scientific misconduct "by reason of insanity," but such a retraction raises the issue of discrimination against the mentally ill. This article asks what responsibilities journals have when faced with delusions disguised as science, what right editors have to question the sanity of an author, and what should be done about the Traver paper itself. By placing higher emphasis on article content than author identity, scientific integrity is maintained and a balance is struck between avoiding discrimination against the mentally ill and not preventing patients from seeking needed treatment.

Ancient schwannoma of thoracic spine in a schizophrenic patient with somatic delusion

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Ya-Ting Wen

2016-03-01

Full Text Available Ancient schwannoma is a rare variant of schwannoma characterized by histopathologic degenerative changes, which are thought to be the result of long-term tumor growth and aging. However, ancient schwannoma in the spinal canal is particularly rare. We report a case of thoracic spine intradural extramedullary ancient schwannoma in a schizophrenic patient, who kept saying that “something in his back was giving him electric shock” for a long time. Unfortunately, this complaint was misinterpreted as somatic delusion symptoms. A spinal cord tumor was taken into consideration only after paraparesis developed. We have highlighted this case to remind every clinician to remain alert about the possibility of organic disease while treating patients with psychotic disorder history. Thorough neurological examination is required to avoid misdiagnosis. Spinal canal schwannoma can be totally removed successfully with good functional outcome and prognosis.

Hypochondriacal delusion in an elderly woman recovers quickly with electroconvulsive therapy

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Dols, Annemieke; Rhebergen, Didi; Eikelenboom, Piet; Stek, Max L.

2012-01-01

A 72-year-old woman without any medical and psychiatric history, suffered from nausea, pain in the epigastria and constipation for over a year. She eventually lost 20 kilograms despite nightly drip-feeding. Extensive additional tests did not reveal any clues for her complaints. She remained convinced that her symptoms were a side-effect of anti-fungal medication she used. She was diagnosed with hypochondria. In the course of time her ideas about her somatic symptoms became delusional and she was diagnosed with a hypochondriacal delusion as part of melancholia, without depressed mood or loss of interest or pleasure as prominent features. It is important to recognize melancholia as soon as possible by continually evaluating other symptoms of depression. This may enable to avoid repetitive and exhaustive somatic examinations, which are not indicated, and to start effective treatment. In our patient electroconvulsive therapy resulted in a fast and complete recovery. PMID:24765410

Hypochondriacal delusion in an elderly woman recovers quickly with electroconvulsive therapy

Directory of Open Access Journals (Sweden)

Annemieke Dols

2012-01-01

Full Text Available A 72-year-old woman without any medical and psychiatric history, suffered from nausea, pain in the epigastria and constipation for over a year. She eventually lost 20 kilograms despite nightly drip-feeding. Extensive additional tests did not reveal any clues for her complaints. She remained convinced that her symptoms were a side-effect of anti-fungal medication she used. She was diagnosed with hypochondria. In the course of time her ideas about her somatic symptoms became delusional and she was diagnosed with a hypochondriacal delusion as part of melancholia, without depressed mood or loss of interest or pleasure as prominent features. It is important to recognize melancholia as soon as possible by continually evaluating other symptoms of depression. This may enable to avoid repetitive and exhaustive somatic examinations, which are not indicated, and to start effective treatment. In our patient electroconvulsive therapy resulted in a fast and complete recovery.

“Capgras” Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures

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Brandon Lilly

2018-01-01

Full Text Available Capgras syndrome is characterized by the delusional belief that a familiar person has been replaced by a visually similar imposter or replica. Rarely, the delusional focus may be objects rather than people. Numerous etiologies have been described for Capgras to include seizures. Similarly, visual hallucinations, both simple and complex, can occur secondary to seizure activity. We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology.

The delusion of the Master: the last days of Henry James.

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Bartolomeo, Paolo

2013-11-01

The novelist Henry James shared with his brother William, the author of the Principles of Psychology, a deep interest in the ways in which personal identity is built through one's history and experiences. At the end of his life, Henry James suffered a vascular stroke in the right hemisphere and developed a striking identity delusion. He dictated in a perfectly clear and coherent manner two letters as if they were written by Napoleon Bonaparte. He also showed signs of reduplicative paramnesia. Negative symptoms resulting from right hemisphere damage may disrupt the feelings of "warmth and intimacy and immediacy" and the "resemblance among the parts of a continuum of feelings (especially bodily feelings)", which are the foundation of personal identity according to William James. On the other hand, a left hemisphere receiving inadequate input from the damaged right hemisphere may produce positive symptoms such as delusional, confabulatory narratives. Other fragments dictated during Henry James's final disease reveal some form of insight, if partial and disintegrated, into his condition. Thus, even when consciousness is impaired by brain damage, something of its deep nature may persist, as attested by the literary characteristics of the last fragments of the Master.

Brain Metabolic Dysfunction in Capgras Delusion During Alzheimer's Disease: A Positron Emission Tomography Study.

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Jedidi, H; Daury, N; Capa, R; Bahri, M A; Collette, F; Feyers, D; Bastin, C; Maquet, P; Salmon, E

2015-11-01

Capgras delusion is characterized by the misidentification of people and by the delusional belief that the misidentified persons have been replaced by impostors, generally perceived as persecutors. Since little is known regarding the neural correlates of Capgras syndrome, the cerebral metabolic pattern of a patient with probable Alzheimer's disease (AD) and Capgras syndrome was compared with those of 24-healthy elderly participants and 26 patients with AD without delusional syndrome. Comparing the healthy group with the AD group, the patient with AD had significant hypometabolism in frontal and posterior midline structures. In the light of current neural models of face perception, our patients with Capgras syndrome may be related to impaired recognition of a familiar face, subserved by the posterior cingulate/precuneus cortex, and impaired reflection about personally relevant knowledge related to a face, subserved by the dorsomedial prefrontal cortex. © The Author(s) 2013.

Defensive function of persecutory delusion and discrepancy between explicit and implicit self-esteem in schizophrenia: study using the Brief Implicit Association Test.

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Nakamura, Mitsuo; Hayakawa, Tomomi; Okamura, Aiko; Kohigashi, Mutsumi; Fukui, Kenji; Narumoto, Jin

2015-01-01

If delusions serve as a defense mechanism in schizophrenia patients with paranoia, then they should show normal or high explicit self-esteem and low implicit self-esteem. However, the results of previous studies are inconsistent. One possible explanation for this inconsistency is that there are two types of paranoia, "bad me" (self-blaming) paranoia and "poor me" (non-self-blaming) paranoia. We thus examined implicit and explicit self-esteem and self-blaming tendency in patients with schizophrenia and schizoaffective disorder. We hypothesized that patients with paranoia would show lower implicit self-esteem and only those with non-self-blaming paranoia would experience a discrepancy between explicit and implicit self-esteem. Participants consisted of patients with schizophrenia and schizoaffective disorder recruited from a day hospital (N=71). Participants were assessed for psychotic symptoms, using the Brief Psychiatric Rating Scale (BPRS), and self-blaming tendency, using the brief COPE. We also assessed explicit self-esteem, using the Rosenberg Self-Esteem Scale (RSES), implicit self-esteem, using Brief Implicit Association Test (BIAT), and discrepancy between explicit and implicit self-esteem. Contrary to our hypothesis, implicit self-esteem in paranoia and nonparanoia showed no statistical difference. As expected, only patients with non-self-blaming paranoia experienced a discrepancy between explicit and implicit self-esteem; other groups showed no such discrepancy. These results suggest that persecutory delusion plays a defensive role in non-self-blaming paranoia.

Capturing the will: Imposture, delusion, and exposure in Alfred Russel Wallace's defence of spirit photography.

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Mitchell, Benjamin David

2014-06-01

The co-discoverer of natural selection, Alfred Russel Wallace, found himself deeply embroiled in a range of controversies surrounding the relationship between science and spiritualism. At the heart of these controversies lay a crisis of evidence in cases of delusion or imposture. He had the chance to observe the many epistemic impasses brought about by this crisis while participating in the trial of the American medium Henry Slade, and through his exchanges with the physiologist William Benjamin Carpenter and the psychical researcher Frederic Myers. These contexts help to explain the increasing value that Wallace placed on the evidence of spirit photography. He hoped that it could simultaneously break these impasses, while answering once and for all the interconnected questions of the unity of the psyche and the reliability of human observation. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Delusion of Enchantment in Miguel Cervantes’s Don Quixote and William Shakespeare’s Midsummer Night’s Dream

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Kodó Krisztina

2017-12-01

Full Text Available The aim of the present article is to investigate the conceptual framework of magic and enchantment in the works of Miguel Cervantes de Saavedra and William Shakespeare. The works chosen for this comparative study are Don Quixote and Midsummer Night’s Dream. Shakespeare and Cervantes portray an ironic vision that may seem comic and grotesque on the surface, but in fact shows a violent and malign world. The portrayal of fantasy and realism parallel with the delusionary aspects of enchantment create an interplay between the ironic mockery and reality as seen through the experiences of the characters themselves. The delusions of enchantment experienced by the protagonists present a flawed world where jealousy, greed and corruption prevail.

Analysis of 11 cases of delusions of parasitosis reported to the Mississippi Department of Health.

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Goddard, J

1995-08-01

Delusions of parasitosis (DOP) is a psychiatric disorder in which people have an unshakable false belief that they are infested with arthropod parasites. To rid themselves of the "bugs" patients with DOP may become desperate and quit their jobs, burn furniture, abandon homes, and use pesticides dangerously and repeatedly. Data from 11 cases of DOP, reported to the Mississippi Department of Health between 1989 and 1993, are presented in an attempt to identify common factors among the cases. Seven of the 11 patients (64%) were elderly white women. Five patients complained of "mites," 3 of "insects," and 3 of "bugs"; and all characteristically offered "proof" of their infestation such as bits of debris or skin scrapings wrapped in paper or in tiny jars. Only one complained of itching. Six patients reported extensive use of pesticides. These results elucidate the clinical presentation of DOP cases, thus aiding in diagnosis of the disorder.

Defensive function of persecutory delusion and discrepancy between explicit and implicit self-esteem in schizophrenia: study using the Brief Implicit Association Test

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Nakamura, Mitsuo; Hayakawa, Tomomi; Okamura, Aiko; Kohigashi, Mutsumi; Fukui, Kenji; Narumoto, Jin

2015-01-01

Background If delusions serve as a defense mechanism in schizophrenia patients with paranoia, then they should show normal or high explicit self-esteem and low implicit self-esteem. However, the results of previous studies are inconsistent. One possible explanation for this inconsistency is that there are two types of paranoia, “bad me” (self-blaming) paranoia and “poor me” (non-self-blaming) paranoia. We thus examined implicit and explicit self-esteem and self-blaming tendency in patients with schizophrenia and schizoaffective disorder. We hypothesized that patients with paranoia would show lower implicit self-esteem and only those with non-self-blaming paranoia would experience a discrepancy between explicit and implicit self-esteem. Methods Participants consisted of patients with schizophrenia and schizoaffective disorder recruited from a day hospital (N=71). Participants were assessed for psychotic symptoms, using the Brief Psychiatric Rating Scale (BPRS), and self-blaming tendency, using the brief COPE. We also assessed explicit self-esteem, using the Rosenberg Self-Esteem Scale (RSES), implicit self-esteem, using Brief Implicit Association Test (BIAT), and discrepancy between explicit and implicit self-esteem. Results Contrary to our hypothesis, implicit self-esteem in paranoia and nonparanoia showed no statistical difference. As expected, only patients with non-self-blaming paranoia experienced a discrepancy between explicit and implicit self-esteem; other groups showed no such discrepancy. Conclusion These results suggest that persecutory delusion plays a defensive role in non-self-blaming paranoia. PMID:25565849

Altered attentional and perceptual processes as indexed by N170 during gaze perception in schizophrenia: Relationship with perceived threat and paranoid delusions.

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Tso, Ivy F; Calwas, Anita M; Chun, Jinsoo; Mueller, Savanna A; Taylor, Stephan F; Deldin, Patricia J

2015-08-01

Using gaze information to orient attention and guide behavior is critical to social adaptation. Previous studies have suggested that abnormal gaze perception in schizophrenia (SCZ) may originate in abnormal early attentional and perceptual processes and may be related to paranoid symptoms. Using event-related brain potentials (ERPs), this study investigated altered early attentional and perceptual processes during gaze perception and their relationship to paranoid delusions in SCZ. Twenty-eight individuals with SCZ or schizoaffective disorder and 32 demographically matched healthy controls (HCs) completed a gaze-discrimination task with face stimuli varying in gaze direction (direct, averted), head orientation (forward, deviated), and emotion (neutral, fearful). ERPs were recorded during the task. Participants rated experienced threat from each face after the task. Participants with SCZ were as accurate as, though slower than, HCs on the task. Participants with SCZ displayed enlarged N170 responses over the left hemisphere to averted gaze presented in fearful relative to neutral faces, indicating a heightened encoding sensitivity to faces signaling external threat. This abnormality was correlated with increased perceived threat and paranoid delusions. Participants with SCZ also showed a reduction of N170 modulation by head orientation (normally increased amplitude to deviated faces relative to forward faces), suggesting less integration of contextual cues of head orientation in gaze perception. The psychophysiological deviations observed during gaze discrimination in SCZ underscore the role of early attentional and perceptual abnormalities in social information processing and paranoid symptoms of SCZ. (c) 2015 APA, all rights reserved).

Use of modified electroconvulsive therapy in a case of polymyositis presenting with delusion of nihilism of proxy (Odysseus syndrome).

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Shah, Ruchita; Grover, Sandeep; Krishna, Kodakandla; Singh, Dharminder

2011-03-01

We present a case of psychotic depression with polymyositis presenting with the distinct phenomenon of nihilism by proxy, which was treated with electroconvulsive therapy (ECT). A female patient with polymyositis was initially treated with pharmacotherapy. After initial response, there was deterioration in her mental state and hence, after careful consideration, neurological, and anaesthetic consultations, modified ECT was given with close monitoring. The mental state of the patient improved with a course of ECT, which proceeded without any complications. Her depressive symptoms including the delusion of nihilism by proxy responded to ECT. To the best of our knowledge, the use of ECT has not been reported in a case of polymyositis before, and this case shows that modified ECT can be given successfully in patients with polymyositis.

"I Can Remember Sort of Vivid People…but to Me They Were Plasticine." Delusions on the Intensive Care Unit: What Do Patients Think Is Going On?

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Julie L Darbyshire

Full Text Available Patients who develop intensive care unit (ICU acquired delirium stay longer in the ICU, and hospital, and are at risk of long-term mental and physical health problems. Despite guidelines for patient assessment, risk limitation, and treatment in the ICU population, delirium and associated delusions remain a relatively common occurrence on the ICU. There is considerable information in the literature describing the incidence, suspected causes of, and discussion of the benefits and side-effects of the various treatments for delirium in the ICU. But peer-reviewed patient-focused research is almost non-existent. There is therefore a very limited understanding of the reality of delusions in the intensive care unit from the patient's point of view.A secondary analysis of the original interviews conducted by the University of Oxford Health Experiences Research Group was undertaken to explore themes relating specifically to sleep and delirium.Patients describe a liminal existence on the ICU. On the threshold of consciousness their reality is uncertain and their sense of self is exposed. Lack of autonomy in an unfamiliar environment prompts patients to develop explanations and understandings for themselves with no foothold in fact.Patients on the ICU are perhaps more disoriented than they appear and early psychological intervention in the form of repeated orientation whilst in the ICU might improve the patient experience and defend against development of side-effects.

Suicidality in schizophrenia spectrum disorders: the relationship to hallucinations and persecutory delusions.

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Kjelby, E; Sinkeviciute, I; Gjestad, R; Kroken, R A; Løberg, E-M; Jørgensen, H A; Hugdahl, K; Johnsen, E

2015-10-01

Assessment of suicide risk is crucial in schizophrenia and results concerning risk contributed by hallucinations and persecutory delusions are inconsistent. We aimed to determine factors associated with suicidal ideation and plans at the time of acute admission in patients suffering from schizophrenia spectrum disorders. One hundred and twenty-four patients older than 18 years admitted to an acute psychiatric ward due to psychosis were consecutively included. Predictors of suicidal ideation and suicide plans at the time of admission were examined with multinominal logistic regression and structural equation modelling (SEM). The study design was pragmatic, thus entailing a clinically relevant representation. Depression Odds Ratio (OR) 12.9, Drug use OR 4.07, Hallucinations OR 2.55 and Negative symptoms OR 0.88 significantly predicted Suicidal ideation. Suspiciousness/ Persecution did not. Only Depression and Hallucinations significantly predicted Suicide plans. In the SEM-model Anxiety, Depression and Hopelessness connected Suspiciousness/Persecution, Hallucinations and Lack of insight with Suicidal ideation and Suicide plans. The study contributes to an increasing evidence base supporting an association between hallucinations and suicide risk. We want to emphasise the importance of treating depression and hallucinations in psychotic disorders, reducing hopelessness while working with insight and reducing drug abuse in order to lower suicide risk. ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/NCT00932529. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Attributional style and theory of mind in people with Alzheimer disease and persecutory delusions.

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Rowse, Georgina; McCarthy-Jones, Simon; Knowles, Rebecca; Corcoran, Rhiannon; Bentall, Richard P

2013-09-01

Between 7% and 40% of people with Alzheimer disease (AD) experience persecutory delusions (PDs) during the course of their dementia. Although attributional style and theory of mind processes have been linked with PDs in people with psychosis, they have not yet been examined in those with AD and PDs. The objective of this study was, hence, to explore the role of these cognitive processes in groups of participants with AD with and without PDs, as well as a nonclinical comparison group. Measures of attributional style and theory of mind were administered to three groups: people with AD and PDs (n = 22), people with AD without PDs (n = 22), and a nonclinical group (n = 23). Although no clear differences in attributional style between the three groups were found, the group with AD and PDs were found to perform worse on the first-order (but not second-order) theory of mind task than the other two groups. Interventions designed to enhance theory of mind skills might be beneficial for individuals with AD and PDs. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Testing the connections within face processing circuitry in Capgras delusion with diffusion imaging tractography

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Maria A. Bobes

2016-01-01

Full Text Available Although Capgras delusion (CD patients are capable of recognizing familiar faces, they present a delusional belief that some relatives have been replaced by impostors. CD has been explained as a selective disruption of a pathway processing affective values of familiar faces. To test the integrity of connections within face processing circuitry, diffusion tensor imaging was performed in a CD patient and 10 age-matched controls. Voxel-based morphometry indicated gray matter damage in right frontal areas. Tractography was used to examine two important tracts of the face processing circuitry: the inferior fronto-occipital fasciculus (IFOF and the inferior longitudinal (ILF. The superior longitudinal fasciculus (SLF and commissural tracts were also assessed. CD patient did not differ from controls in the commissural fibers, or the SLF. Right and left ILF, and right IFOF were also equivalent to those of controls. However, the left IFOF was significantly reduced respect to controls, also showing a significant dissociation with the ILF, which represents a selective impairment in the fiber-tract connecting occipital and frontal areas. This suggests a possible involvement of the IFOF in affective processing of faces in typical observers and in covert recognition in some cases with prosopagnosia.

Brain SPECT in psychiatry: Delusion or reality?

International Nuclear Information System (INIS)

Pavel, D.G.; Davis, G.; Epstein, P.; Kohn, R.; Antonino, F.; Devore-Best, S.; Craita, I.; Liu, P.

2002-01-01

temporals. The cataloging of the various shape and magnitude increases and/or decreases in any of these areas for any given patient has often provided definite guidance about the drug (s) of choice and, most importantly, about the sequencing of medication. A follow-up SPECT has proven especially important in the confirmation/prognosis of dementia-s. Conclusion: provided high resolution Brain SPECT is properly performed and a multiparametric and semi-quantitative color display is used, brain SPECT in Psychiatry is a reality not a delusion. This does not mean using SPECT as a routine, but as a well thought procedure aimed at tailoring treatment and/or establishing prognosis

Ketamine effects on memory reconsolidation favor a learning model of delusions.

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Philip R Corlett

Full Text Available Delusions are the persistent and often bizarre beliefs that characterise psychosis. Previous studies have suggested that their emergence may be explained by disturbances in prediction error-dependent learning. Here we set up complementary studies in order to examine whether such a disturbance also modulates memory reconsolidation and hence explains their remarkable persistence. First, we quantified individual brain responses to prediction error in a causal learning task in 18 human subjects (8 female. Next, a placebo-controlled within-subjects study of the impact of ketamine was set up on the same individuals. We determined the influence of this NMDA receptor antagonist (previously shown to induce aberrant prediction error signal and lead to transient alterations in perception and belief on the evolution of a fear memory over a 72 hour period: they initially underwent Pavlovian fear conditioning; 24 hours later, during ketamine or placebo administration, the conditioned stimulus (CS was presented once, without reinforcement; memory strength was then tested again 24 hours later. Re-presentation of the CS under ketamine led to a stronger subsequent memory than under placebo. Moreover, the degree of strengthening correlated with individual vulnerability to ketamine's psychotogenic effects and with prediction error brain signal. This finding was partially replicated in an independent sample with an appetitive learning procedure (in 8 human subjects, 4 female. These results suggest a link between altered prediction error, memory strength and psychosis. They point to a core disruption that may explain not only the emergence of delusional beliefs but also their persistence.

From real-world events to psychosis: the emerging neuropharmacology of delusions.

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Morrison, Paul D; Murray, R M

2009-07-01

The earliest stages of delusion are characterized by an overabundance of meaningful coincidences impinging on the sufferer's existing worldview. Successive events are seen by him as pointing to, and then confirming, a fundamentally new reality that takes him over and engulfs his everyday life. Research over the last 4 decades has revealed the importance of dopamine (DA), D2 receptors, and the basal ganglia in psychotic thinking. Recent work has implicated the aberrant reward learning initiated by the excess release of striatal DA in the attribution of excessive importance or "salience" to insignificant stimuli and events. But our knowledge of what is happening beyond D2 receptors has remained scant. The gap is especially apparent at the cellular and microcircuit levels, encompassing the plastic changes, which are believed to be essential for new learning, and whose processes may go awry in major mental illness. Now new pharmacological findings are advancing our understanding of information processing and learning within the striatum. DA has an important role in setting the strength of individual striatal connections, but it does not act in isolation. Two other modulator systems are critical, the endocannabinoids and adenosine. Thus, at medium spiny neurons belonging to the indirect pathway, D2 stimulation evokes endocannabinoid-mediated depression of cortical inputs. Adenosine acting at A2A receptors elicits the opposite effect. Remarkably, drugs that target the endocannabinoid and purinergic systems also have pro- or antipsychotic properties. Here, we discuss how the 3 modulators regulate learning within the striatum and how their dysfunction may lead to delusional thinking.

A transdiagnostic investigation of 'theory of mind' and 'jumping to conclusions' in patients with persecutory delusions.

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Corcoran, R; Rowse, G; Moore, R; Blackwood, N; Kinderman, P; Howard, R; Cummins, S; Bentall, R P

2008-11-01

A tendency to make hasty decisions on probabilistic reasoning tasks and a difficulty attributing mental states to others are key cognitive features of persecutory delusions (PDs) in the context of schizophrenia. This study examines whether these same psychological anomalies characterize PDs when they present in the context of psychotic depression. Performance on measures of probabilistic reasoning and theory of mind (ToM) was examined in five subgroups differing in diagnostic category and current illness status. The tendency to draw hasty decisions in probabilistic settings and poor ToM tested using story format feature in PDs irrespective of diagnosis. Furthermore, performance on the ToM story task correlated with the degree of distress caused by and preoccupation with the current PDs in the currently deluded groups. By contrast, performance on the non-verbal ToM task appears to be more sensitive to diagnosis, as patients with schizophrenia spectrum disorders perform worse on this task than those with depression irrespective of the presence of PDs. The psychological anomalies associated with PDs examined here are transdiagnostic but different measures of ToM may be more or less sensitive to indices of severity of the PDs, diagnosis and trait- or state-related cognitive effects.

Prominent and persistent loss of past awareness in amnesia: delusion, impaired consciousness or coping strategy?

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Wilson, Barbara A; Kopelman, Michael; Kapur, Narinder

2008-01-01

Profound loss of awareness for the past in amnesia has implications for our understanding of memory and belief systems, and how they may become disrupted in neurological conditions. We report the case of CW, a professional musician who became severely amnesic in 1985 following herpes simplex viral encephalitis (HSVE) at the age of 46 years. For many years CW stated several times a day that he had just woken up. He frequently wrote this in his diary too. When shown examples of his diary entries or videos of himself playing or conducting music, he recognised both his handwriting and himself on the video screen but stated vehemently that he "was not conscious then". In a previous paper (Wilson, Baddeley, & Kapur 1995), it was suggested that this lack of awareness for the past was a delusion, defined as a strongly held belief in the face of contradictory evidence (rather than implying any kind of psychiatric disorder per se). As a contribution to the academic debate regarding theories of "self", in the present paper we will review this explanation of CW's state as it had been in those early years, and we will also consider two other possibilities - namely, that CW had suffered from a loss of "autobiographical self" or "extended consciousness" (see Damasio, 2000, pp. 198-199), and that his verbal reports simply reflected a form of coping strategy to help him deal with the limited evidence he had available in "declarative" memory.

Clinico-Epidemiological Comparison of Delusion-Prominent and Hallucination-Prominent Clinical Subgroups of Paranoid Schizophrenia.

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Kreinin, Anatoly; Krishtul, Vladimir; Kirsh, Zvi; Menuchin, Michael

2015-01-01

Though hallucinations and delusions are prominent basic impairments in schizophrenia, reports of the relationship between hallucinatory and delusional symptoms among schizophrenia patients are scant. To examine the epidemiological and clinical differences between mainly hallucinatory and mainly delusional subgroups of paranoid schizophrenia patients. One hundred schizophrenia patients, paranoid type, were recruited. In a cross-sectional study, participants were divided into Mainly Hallucinatory (H) and Mainly Delusional (D) subgroups. Demographic variables were compared and clinical characteristics were evaluated using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Clinical Global Impression Scale. The Quality-of-Life Enjoyment and Satisfaction Questionnaire-18 was used to assess quality of life. Clinically, the H group was more heterogeneous as expressed by the broader range of scores that described the clinical picture of patients in that subgroup (in 43 of 78 variables, 55.13%) and similar ranges of scores (31 of 78 variables, 39.74%) for patients in the D group. Duration of hospitalization was significantly longer in group H than in group D (p=0.047). There was no statistically significant difference between the H and D subgroups in demographic characteristics. There are distinct epidemiological and clinical differences between the H and D subgroups, with more severe positive and negative symptoms and greater functional impairment in the H group. Paranoid schizophrenia patients with prominent hallucinations have poorer prognosis and need intensive therapeutic rehabilitation beginning with onset-of-illness. Further genetic studies and comparisons of fMRI and/or PET findings are warranted to investigate additional distinctive characteristics of these subgroups.

Grey matter morphological anomalies in the caudate head in first-episode psychosis patients with delusions of reference.

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Tao, Haojuan; Wong, Gloria H Y; Zhang, Huiran; Zhou, Yuan; Xue, Zhimin; Shan, Baoci; Chen, Eric Y H; Liu, Zhening

2015-07-30

Delusions of reference (DOR) are theoretically linked with aberrant salience and associative learning. Previous studies have shown that the caudate nucleus plays a critical role in the cognitive circuits of coding prediction errors and associative learning. The current study aimed at testing the hypothesis that abnormalities in the caudate nucleus may be involved in the neuroanatomical substrate of DOR. Structural magnetic resonance imaging of the brain was performed in 44 first-episode psychosis patients (with diagnoses of schizophrenia or schizophreniform disorder) and 25 healthy controls. Patients were divided into three groups according to symptoms: patients with DOR as prominent positive symptom; patients with prominent positive symptoms other than DOR; and patients with minimal positive symptoms. All groups were age-, gender-, and education-matched, and patient groups were matched for diagnosis, duration of illness, and antipsychotic treatment. Voxel-based morphometric analysis was performed to identify group differences in grey matter density. Relationships were explored between grey matter density and DOR. Patients with DOR were found to have reduced grey matter density in the caudate compared with patients without DOR and healthy controls. Grey matter density values of the left and right caudate head were negatively correlated with DOR severity. Decreased grey matter density in the caudate nucleus may underlie DOR in early psychosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Jumping to conclusions and the continuum of delusional beliefs.

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Warman, Debbie M; Lysaker, Paul H; Martin, Joel M; Davis, Louanne; Haudenschield, Samantha L

2007-06-01

The present study examined the jumping to conclusions reasoning bias across the continuum of delusional ideation by investigating individuals with active delusions, delusion prone individuals, and non-delusion prone individuals. Neutral and highly self-referent probabilistic reasoning tasks were employed. Results indicated that individuals with delusions gathered significantly less information than delusion prone and non-delusion prone participants on both the neutral and self-referent tasks, (preferent task (p=.002). Those with delusions and those who were delusion prone reported higher confidence in their performance on the self-referent task than they did the neutral task (p=.02), indicating that high self-reference impacted information processing for individuals in both of these groups. The results are discussed in relation to previous research in the area of probabilistic reasoning and delusions.

The relevance of self-esteem and self-schemas to persecutory delusions: a systematic review.

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Kesting, Marie-Luise; Lincoln, Tania Marie

2013-10-01

Self-esteem is frequently targeted in psychological approaches to persecutory delusions (PD). However, its precise role in the formation and maintenance of PD is unclear and has been subject to a number of theories: It has been hypothesized that PD function to enhance self-esteem, that they directly reflect negative conceptualizations of the self, that self-esteem follows from the perceived deservedness of the persecution (poor-me versus bad-me-paranoia) and that the temporal instability of self-esteem is relevant to PD. In order to increase our understanding of the relevance of self-esteem to PD, this article systematically reviews the existing research on self-esteem in PD in the light of the existing theories. We performed a literature search on studies that investigated self-esteem in PD. We included studies that either investigated self-esteem a) within patients with PD or compared to controls or b) along the continuum of subclinical paranoia in the general population. We used a broad concept of self-esteem and included paradigms that assessed implicit self-esteem, specific self-schemas and dynamic aspects of self-esteem. The literature search identified 317 studies of which 52 met the inclusion criteria. The reviewed studies consistently found low global explicit self-esteem and negative self-schemas in persons with PD. The studies therefore do not support the theory that PD serve to enhance self-esteem but underline the theory that they directly reflect specific negative self-schemas. There is evidence that low self-esteem is associated with higher perceived deservedness of the persecution and that PD are associated with instable self-esteem. Only few studies investigated implicit self-esteem and the results of these studies were inconsistent. We conclude by proposing an explanatory model of how self-esteem and PD interact from which we derive clinical implications. Copyright © 2013 Elsevier Inc. All rights reserved.

Folie a deux and delusional disorder by proxy: an atypical presentation.

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Daulatabad, Deepashree; Sonthalia, Sidharth; Srivastava, Ankur; Bhattacharya, Sambit Nath; Kaul, Subuhi; Moyal, Deepak

2017-08-01

Delusion of parasitosis is a rare condition characterised by an individual harbouring the delusion of being infested with insects or parasites. We report a rare and interesting case of delusion of parasitosis presenting as folie a deux, that is, the delusion is shared by both the parents of an 18-month-old child, with proxy projection of parental delusion on the child. The case highlights the rare concomitant occurrence of two psychocutaneous disorders and emphasizes the importance of early recognition and appropriate intervention to safeguard the well-being of the child. © 2016 The Australasian College of Dermatologists.

On incomprehensibility in schizophrenia

DEFF Research Database (Denmark)

Henriksen, Mads Gram

2013-01-01

the notion of understanding that deems these delusions incomprehensible and to see if it is possible to comprehend these delusions if we apply another notion of understanding. First, I discuss the contemporary schizophrenia definitions and their inherent problems, and I argue that the notion...... of incomprehensibility in these definitions rests heavily on Jaspers’ notions of understanding and empathy. Secondly, I discuss two Wittgensteinian attempts to comprehend bizarre delusions: (a) Campbell’s proposal to conceive delusions as framework propositions and (b) Sass’s suggestion to interpret delusions...... in the light of solipsism. Finally, I discuss the phenomenological conception of schizophrenia, which conceives delusion formation as resulting from alterations of the structure of experiencing and from underlying self-disorders. I argue that although a psychological understanding that seeks to grasp meaning...

The syndrome of Capgras.

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Sinkman, Arthur

2008-01-01

The delusional belief that a close relative has been replaced by a look-alike impostor was named the Capgras delusion in honor of Joseph Capgras, who described the first case. Capgras's original patient, Mme M., had a complex mental illness with various symptoms in addition to the delusion of substitution. The focus in the literature has always been on her eponymous delusion, ignoring the rest of her condition. However, studying the substitution delusion in isolation from the rest of her illness has led to inadequate conclusions. It is necessary to understand the delusion within the broad context of her illness. Toward that goal, her mental illness is described here in detail. A particular pattern of delusions and illness is identified. This same pattern is noted in other cases of Capgras in the literature. Three new cases are reported here, each with the same overall pattern of illness that Mme M. had. This pattern is labeled the Syndrome of Capgras. A hypothesis is offered to explain the Capgras delusion within the context of this illness.

Delusional Themes Across Affective and Non-Affective Psychoses

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Angelo Picardi

2018-04-01

Full Text Available The current debate about the diagnostic significance of delusion revolves around two positions. The neurocognitive position conceives delusion as a non-specific, though polymorphic, symptom. The psychopathological position views features of delusion such as content and structure as having meaningful connections with diagnostic entities. This study aims at contributing to this debate by examining the association between delusional themes and diagnosis in a sample of 830 adult psychotic patients. All diagnoses were made by experienced psychiatrists according to DSM-IV or ICD-10 criteria, and in 348 patients were established with the SCID-I. All patients were administered the Brief Psychiatric Rating Scale (BPRS. In each patient, the presence of somatic delusions and delusions of guilt, grandiosity, and persecution was determined by examining the scores on relevant BPRS items. Delusions of guilt were almost pathognomonic for a psychotic depressive condition (psychotic major depression 40%; psychotic bipolar depression 30%; depressed schizoaffective disorder 8%; bipolar and schizoaffective mixed states 6 and 7%, respectively. Only 1% of patients with schizophrenia and no patient with delusional disorder or bipolar or schizoaffective manic state showed such delusions. The difference between unipolar and bipolar depression and the other diagnostic groups was highly significant. Delusions of grandiosity characterized mostly patients with manic symptoms (bipolar mania 20%; bipolar mixed states 19%; manic schizoaffective disorder 10%. They were observed significantly more often in bipolar mania than in schizophrenia (7%. Persecutory delusions were broadly distributed across diagnostic categories. However, they were significantly more frequent among patients with schizophrenia and delusional disorder compared with depressed and manic patients. Somatic delusions were also observed in all diagnostic groups, with no group standing out as distinct from the

Creativity and positive symptoms in schizophrenia revisited: Structural connectivity analysis with diffusion tensor imaging.

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Son, Shuraku; Kubota, Manabu; Miyata, Jun; Fukuyama, Hidenao; Aso, Toshihiko; Urayama, Shin-ichi; Murai, Toshiya; Takahashi, Hidehiko

2015-05-01

Both creativity and schizotypy are suggested to be manifestations of the hyperactivation of unusual or remote concepts/words. However, the results of studies on creativity in schizophrenia are diverse, possibly due to the multifaceted aspects of creativity and difficulties of differentiating adaptive creativity from pathological schizotypy/positive symptoms. To date, there have been no detailed studies comprehensively investigating creativity, positive symptoms including delusions, and their neural bases in schizophrenia. In this study, we investigated 43 schizophrenia and 36 healthy participants using diffusion tensor imaging. We used idea, design, and verbal (semantic and phonological) fluency tests as creativity scores and Peters Delusions Inventory as delusion scores. Subsequently, we investigated group differences in every psychological score, correlations between fluency and delusions, and relationships between these scores and white matter integrity using tract-based spatial statistics (TBSS). In schizophrenia, idea and verbal fluency were significantly lower in general, and delusion score was higher than in healthy controls, whereas there were no group differences in design fluency. We also found positive correlation between phonological fluency and delusions in schizophrenia. By correlation analyses using TBSS, we found that the anterior part of corpus callosum was the substantially overlapped area, negatively correlated with both phonological fluency and delusion severity. Our results suggest that the anterior interhemispheric dysconnectivity might be associated with executive dysfunction, and disinhibited automatic spreading activation in the semantic network was manifested as uncontrollable phonological fluency or delusions. This dysconnectivity could be one possible neural basis that differentiates pathological positive symptoms from adaptive creativity. Copyright © 2015 Elsevier B.V. All rights reserved.

Cognitive therapy for punishment paranoia: a single case experiment.

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Chadwick, P; Trower, P

1996-04-01

There is growing agreement that at least certain kinds of delusions defend against negative self-evaluation, and in consequence that cognitive therapy for delusions needs to address issues of self-evaluation more explicitly. However, in practice it can be difficult to enable clients to see the connection between delusions and self-esteem. The present single-case study exemplifies the conceptual and practical application of cognitive therapy for individuals who are both paranoid and have strong negative self-evaluative beliefs. A multiple-baseline approach is used, whereby one man's negative self-evaluative belief and two paranoid delusions are challenged sequentially. Conviction in two of the three beliefs changes at the point of intervention; conviction in the third changes prior to intervention. We discuss the details of the case, as well as the wider implications for cognitive approaches to delusions.

Rethinking Psychosis in Dementia: An Analysis of Antecedents and Explanations.

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Cohen-Mansfield, Jiska; Golander, Hava; Cohen, Rinat

2017-08-01

An in-depth analysis of qualitative data regarding antecedents, consequences, and descriptions of delusions of persons with dementia (PwD) provided by family caregivers is presented. Three broad classifications of reasons given behind types of delusions are included, namely environmental factors, personal factors, and dementia, with dementia being the most prominent factor. We observed an overlap between known cognitive symptoms of dementia and the characteristics of the reported "delusions" in dementia. It therefore appears that what is often classified as a delusion of a seemingly psychotic nature is in fact the PwD's disorientation combined with an attempt to fill in gaps caused by cognitive deficiencies.

ALCOHOLIC HALLUCINOSIS AND PARANOID SCHIZOPHRENIA?A COMPARATIVE (CLINICAL AND FOLLOW UP) STUDY

OpenAIRE

Sampath, G.; Kumar, Y. Vikram; Channabasavanna, S. M.; Keshavan, M. S.

1980-01-01

SUMMARY In a Study Of 90 patients of Alcoholic Hallucinosis and 30 patients of Paranoid Schizophrenia, it was found that delusions, delusions of infidelity, third person and running commentary auditory hallucinations and insight were not different in the two groups. Delusions of grandeur, passivity, thought echo and thought broadcast were significantly more frequent in paranoid schizophrenic patients. Anxiety, visual iiafracinatians and hallucinations in more than one modality at the same tim...

[Cotard's syndrome: Case report and a brief review of literature].

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Moschopoulos, N P; Kaprinis, S; Nimatoudis, J

2016-01-01

The term "Cotard's syndrome" is used to describe a number of clinical features, mostly hypochondriac and nihilistic delusions, the most characteristic of which are the ideas "I am dead" and "my internal organs do not exist". Besides, anxious and depressed mood, delusions of damnation, possession and immortality, suicidal and self-mutilating behavior are included. The first description of the syndrome was made in 1880 by Cotard, who presented the case of a female patient in a lecture. He originally named it "hypochondriac delusion", and some years later "delusion of negations", while it was named "Cotard delusion" after his death. In international literature, the terms "nihilistic delusion" and "Cotard's syndrome" prevailed over "delusion of negations" and "Cotard delusion". In the present study we report the case of a 59 year-old woman, who was admitted to our department after a suicide attempt, and who showed symptoms of Cotard's syndrome for about two years, namely depressed mood, hypochondriac and nihilistic delusions, delusions of immortality and damnation, suicidal ideation, severe psychomotor retardation, diminished motivation and tendency to stay in bed. She never took the medication she was prescribed, and at times she refused to eat. During her hospitalization, there was performed a full blood panel and medical imaging, that showed chronic ischemic infarctions, periventricular leukoencephalopathy and diffuse cerebral atrophy in MRI. All the other test results were normal. She was administered treatment with haloperidol, mirtazapine and venlafaxine. Gradually, her psychomotor ability, motivation and mood improved, she didn't express suicidal ideation, her delusions were less intense and she was able to question them, but they weren't eliminated. She was discharged in improved condition, after 44 days. Cotard's syndrome isn't mentioned in the current classification systems (ICD-10, DSM-5). In literature though, it has been divided into three types, according

O delírio à luz da teoria dos atos de fala Delusion according to the theory of speech acts

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Francisco Martins

2000-01-01

Full Text Available Este trabalho apresenta uma possível solução para problemas suscitados pelo entendimento do fenômeno delirante segundo o modelo de uma teoria restrita da referência absoluta, na qual as palavras e, consequentemente, os juízos, corresponderiam às coisas como um alfabeto lógico. Na concepção pragmática aqui adotada, a linguagem é tomada por um jogo regido por regras em que é mais importante a eficácia da cooperação discursiva que o significado ideal das expressões. A teoria dos atos de fala se mostra a mais bem acabada solução da pragmática filosófica nesse sentido e é usada como princípio metodológico na análise dos excertos de fala de pacientes delirantes que constituem os corpus discursivos. O delírio termina por se mostrar como uma solução inédita para questões cruciais da história do indivíduo psicótico.This paper presents a possible solution to the problems aroused by the understanding of the delusional phenomenon according to the model of a restricted theory of absolute reference in which the words and, consequently, the judgements, correspond to the things as a logical alphabet. In the pragmatic conception adopted here, language is taken as a game guided by rules in which effective discursive cooperation is more important than the ideal meaning of expressions. In this sense, the theory of acts of speech seems to be the best solution offered by the philosophical pragmatics and it is used as a methodological principle on the analysis of speech excerpts of delusional patients. Delusion shows itself as an original solution to decisive questions in the history of a psychotic person.

Capgras' syndrome in dementia with Lewy bodies.

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Marantz, Andrew G; Verghese, Joe

2002-01-01

We report the occurrence of Capgras' syndrome, or the delusion of doubles, in a patient with dementia with Lewy bodies. The patient believed that several similar-looking impostors had replaced his wife of over 50 years. Uncharacteristically, he adopted a friendly attitude with these impostors. This unusual convivial reaction to the impostors may result from differential involvement of the dual visual pathways processing facial recognition and emotional responses to faces. The delusion resolved spontaneously, coincident with worsening of the dementia. In a retrospective chart review of 18 autopsy-confirmed cases of dementia with Lewy bodies, delusions were reported in 5 subjects (27.8%), of whom 1 had misidentification delusions much like Capgras' syndrome.

[Cotard's syndrome: historical and conceptual aspects].

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Luque Luque, R; Valls Blanco, J M

1994-01-01

The history of the concept of Cotard's syndrome is traced from its inception in 1880 to the present day. Nihilistic delusions were described by Cotard to refer to a special type of hypochondriacal delusion associated to melancholia. Although Cotard himself and other XIX and XX centuries' psychiatrists have considered it from different approaches a specific clinical entity, most of the authors estimate that nihilistic delusion is either a syndrome or a symptom which can appear in different psychiatric disorders.

Postpartum Psychosis

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... survivors of postpartum psychosis never had delusions containing violent commands. Delusions take many forms, and not all ... and families PP Psychosis Books Resources and Creative Media Help in an Emergency Emergency Hotlines are available ...

Frontal responses during learning predict vulnerability to the psychotogenic effects of ketamine : Linking cognition, brain activity, and psychosis

NARCIS (Netherlands)

Corlett, Philip R.; Honey, Garry D.; Aitken, Michael R. F.; Dickinson, Anthony; Shanks, David R.; Absalom, Anthony R.; Lee, Michael; Pomarol-Clotet, Edith; Murray, Graham K.; McKenna, Peter J.; Robbins, Trevor W.; Bullmore, Edward T.; Fletcher, Paul C.

Context: Establishing a neurobiological account of delusion formation that links cognitive processes, brain activity, and symptoms is important to furthering our understanding of psychosis. Objective: To explore a theoretical model of delusion formation that implicates prediction error - dependent

Wittgenstein and the limits of empathic understanding in psychopathology.

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Thornton, Tim

2004-08-01

The aim of this paper is three-fold. Firstly, to briefly set out how strategic choices made about theorising about intentionality or content have actions at a distance for accounting for delusion. Secondly, to investigate how successfully a general difficulty facing a broadly interpretative approach to delusions might be eased by the application of any of three Wittgensteinian interpretative tools. Thirdly, to draw a general moral about how the later Wittgenstein gives more reason to be pessimistic than optimistic about the prospects of a philosophical psychopathology aimed at empathic understanding of delusions.

Prevalence and clinical presentation of HIV positive female ...

African Journals Online (AJOL)

Nine of the 19 HIV positive patients (47%) had a pre-existing primary psychiatric diagnosis, most commonly Bipolar Disorder, recent episode mania with psychotic symptoms. The most common psychotic symptoms were grandiose delusions followed by auditory hallucinations, paranoid delusions and visual hallucinations.

Folie à deux and delusional disorder by proxy in a family

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Atefeh Ghanbari Jolfaei

2011-01-01

Full Text Available This report presents a 52-year-old woman who was admitted to nephrology ward with hypernatremia. She shared a persecutory delusion of poisoning with her 22-year-old daughter and did not feed her 8-year-old son due to her delusion.

Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders.

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McKetin, Rebecca; Baker, Amanda L; Dawe, Sharon; Voce, Alexandra; Lubman, Dan I

2017-05-01

We examined the lifetime experience of hallucinations and delusions associated with transient methamphetamine-related psychosis (MAP), persistent MAP and primary psychosis among a cohort of dependent methamphetamine users. Participants were classified as having (a) no current psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient MAP, n=85); (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent MAP, n=37), or (d) meeting DSM-IV criteria for lifetime schizophrenia or mania (primary psychosis, n=52). Current psychotic symptoms were classified as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content in the past month. Lifetime psychotic diagnoses and symptoms were assessed using the Composite International Diagnostic Interview. Transient MAP was associated with persecutory delusions and tactile hallucinations (compared to the no symptom group). Persistent MAP was additionally associated with delusions of reference, thought interference and complex auditory, visual, olfactory and tactile hallucinations, while primary psychosis was also associated with delusions of thought projection, erotomania and passivity. The presence of non-persecutory delusions and hallucinations across various modalities is a marker for persistent MAP or primary psychosis in people who use methamphetamine. Copyright © 2017. Published by Elsevier B.V.

Vulnerable self, poor understanding of others' minds, threat anticipation and cognitive biases as triggers for delusional experience in schizophrenia: a theoretical model.

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Salvatore, Giampaolo; Lysaker, Paul H; Popolo, Raffaele; Procacci, Michele; Carcione, Antonino; Dimaggio, Giancarlo

2012-01-01

It remains unclear what processes lead to the establishment of persecutory delusions in acute phases of schizophrenia. Recently, it has been argued that persecutory delusions arise from an interaction among a range of emotional, cognitive and social factors. In this work, we explored this possibility by first discussing the relevant aspects of recent theoretical models of the causes of persecutory delusions. Then, we offered an analysis of the literature, illustrated with clinical observations suggesting that persecutory delusions are triggered during stressful intersubjective transactions by the interactions of (a) an alteration in empathetic perspective taking and in pragmatic understanding of others' minds; (b) a perception/representation of the self as vulnerable or subordinate and of the other as dominant and threatening; and (c) a hyperfunctioning of the threat/self-protection system when faced with perceived danger. Implications for future research and treatment of people suffering from this symptom are discussed. Copyright © 2011 John Wiley & Sons, Ltd.

Beads task vs. box task: The specificity of the jumping to conclusions bias.

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Balzan, Ryan P; Ephraums, Rachel; Delfabbro, Paul; Andreou, Christina

2017-09-01

Previous research involving the probabilistic reasoning 'beads task' has consistently demonstrated a jumping-to-conclusions (JTC) bias, where individuals with delusions make decisions based on limited evidence. However, recent studies have suggested that miscomprehension may be confounding the beads task. The current study aimed to test the conventional beads task against a conceptually simpler probabilistic reasoning "box task" METHODS: One hundred non-clinical participants completed both the beads task and the box task, and the Peters et al. Delusions Inventory (PDI) to assess for delusion-proneness. The number of 'draws to decision' was assessed for both tasks. Additionally, the total amount of on-screen evidence was manipulated for the box task, and two new box task measures were assessed (i.e., 'proportion of evidence requested' and 'deviation from optimal solution'). Despite being conceptually similar, the two tasks did not correlate, and participants requested significantly less information on the beads task relative to the box task. High-delusion-prone participants did not demonstrate hastier decisions on either task; in fact, for box task, this group was observed to be significantly more conservative than low-delusion-prone group. Neither task was incentivized; results need replication with a clinical sample. Participants, and particularly those identified as high-delusion-prone, displayed a more conservative style of responding on the novel box task, relative to the beads task. The two tasks, whilst conceptually similar, appear to be tapping different cognitive processes. The implications of these results are discussed in relation to the JTC bias and the theoretical mechanisms thought to underlie it. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Don Quijote, a lucid mad].

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Alonso Fernández, Francisco

2004-01-01

The case of a 50-year-old hidalgo who believed to be transformed into a knight-errant named Don Quijote is a megalomaniac systematized delusion of transformation of the self, a delusion of metamorphosis in reference to the patient's own identity. The outward projection of this syndrome produces some delusional misidentifications of others, things and animals and include elements of a persecutory delusion which increase the grandiosity of the self. At the same time the hidalgo was maniac with a pathway of bipolar disorder. The phenomenon of donquijotismo is described as the defence of wasted causes and Sancho Panza as an illiterate Sócrates.

The Malthus delusion

DEFF Research Database (Denmark)

Persson, Karl Gunnar

2008-01-01

the historical record contradicts Greg Clark it is not allowed to stand in the way of his noble aim and declared intention of writing big history. At least in one respect he has succeeded: this book is the widescreen version of the Postan Thesis, although M. M. Postan (1966, 1972) is remarkably missing...... in the credits. The book is also big in rhetorical gestures, starting with the title, and a reader must be forgiven for occasionally asking whether the author should be interpreted literally, or whether statements should simply be deflated by common sense. I have decided to go nominal on Clark....

The Growth Delusion

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Bob Lloyd

2009-08-01

Full Text Available Concern for the environment and a move towards “sustainable development” has assisted progress in a wide range of renewable energy technologies in recent years. The science suggests that a transition from fossil fuels to sustainable sources of energy in a time frame commensurate with the demise of the fossil fuels and prevention of runaway climate change is needed. However, while the movement towards sustainable energy technologies is underway, the World does not want to give up the idea of continuing economic growth. In recent times the financial collapse of October 2008 has given rise to yet another set of pleas from corporations and politicians alike to restart the growth machine. The transition to renewable energy technologies will be difficult to achieve as nowhere within existing economic and political frameworks are the limits to when growth will be curtailed being set. It is possible that the irrational insistence on endless growth as a non negotiable axiom, by a large proportion of the world’s population, may in fact be akin to the similarly irrational belief, by a similarly large proportion of the world’s population, that a supernatural being controls our existence and destiny. The irrationality of religion has recently been examined by Richard Dawkins in “The God Delusion”. Dawkins’ book is used as a starting point to investigate similarities between a belief in God and a belief in continuous growth.

The role of the right inferior frontal gyrus in the pathogenesis of post-stroke psychosis.

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Devine, Michael J; Bentley, Paul; Jones, Brynmor; Hotton, Gary; Greenwood, Richard J; Jenkins, I Harri; Joyce, Eileen M; Malhotra, Paresh A

2014-03-01

Psychotic symptoms have previously been reported following right hemisphere brain injury. We sought to identify the specific neuroanatomical basis of delusions following stroke by studying a series of patients with post-stroke psychosis. Lesion overlap analysis was conducted on three individuals with delusions following right hemisphere stroke. These cases were compared with a control group of patients with similar anatomical damage. The main outcome measures were presence of delusions and presence of behavioural susceptibility. The right inferior frontal gyrus and underlying white matter, including the superior longitudinal fasciculus and anterior corona radiata, were involved in all three cases. All three had a preexisting untreated psychiatric disorder. In contrast, only one of nine control cases with equivalent lesions had evidence of previous psychiatric disorder (p = 0.0182, Fisher's exact test), and this was being treated at the time of stroke. We provide clinical evidence from patients with structural brain lesions implicating damage to the right inferior frontal lobe in the generation of persistent psychosis following stroke. We suggest that preexisting psychiatric disease provided a behavioural susceptibility to develop delusions in these individuals.

A new perspective on delusional states: Evidence for claustrum involvement

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Cristina Maria Patru

2015-11-01

Full Text Available Delusions are a hallmark positive symptom of schizophrenia, although they are also associated with a wide variety of other psychiatric and neurological disorders. The heterogeneity of clinical presentation and underlying disease, along with a lack of experimental animal models, make delusions exceptionally difficult to study in isolation, either in schizophrenia or other diseases. To date, no detailed studies have focused specifically on the neural mechanisms of delusion, although some studies have reported characteristic activation of specific brain areas or networks associated with them. Here we present a novel hypothesis and extant supporting evidence implicating the claustrum, a relatively poorly understood forebrain nucleus, as a potential common center for delusional states.

Reasoning heuristics across the psychosis continuum: the contribution of hypersalient evidence-hypothesis matches.

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Balzan, Ryan; Delfabbro, Paul; Galletly, Cherrie; Woodward, Todd

2012-01-01

Hypersalience of evidence-hypothesis matches has recently been proposed as the cognitive mechanism responsible for the cognitive biases which, in turn, may contribute to the formation and maintenance of delusions. However, the construct lacks empirical support. The current paper investigates the possibility that individuals with delusions are hypersalient to evidence-hypothesis matches using a series of cognitive tasks designed to elicit the representativeness and availability reasoning heuristics. It was hypothesised that hypersalience of evidence-hypothesis matches may increase a person's propensity to rely on judgements of representativeness (i.e., when the probability of an outcome is based on its similarity with its parent population) and availability (i.e., estimates of frequency based on the ease with which relevant events come to mind). A total of 75 participants (25 diagnosed with schizophrenia with a history of delusions; 25 nonclinical delusion-prone; 25 nondelusion-prone controls) completed four heuristics tasks based on the original Tversky and Kahnemann experiments. These included two representativeness tasks ("coin-toss" random sequence task; "lawyer-engineer" base-rates task) and two availability tasks ("famous-names" and "letter-frequency" tasks). The results across these four heuristics tasks showed that participants with schizophrenia were more susceptible than nonclinical groups to both the representativeness and availability reasoning heuristics. These results suggest that delusional ideation is linked to a hypersalience of evidence-hypothesis matches. The theoretical implications of this cognitive mechanism on the formation and maintenance of delusions are discussed.

Capgras syndrome related to diazepam treatment.

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Stewart, Jonathan T

2004-01-01

Capgras syndrome, the delusion that identical-appearing impostors have replaced familiar people, is an unusual phenomenon usually seen in schizophrenia or dementia. We recently cared for a 78 year old man who seemed to develop Capgras syndrome as an adverse reaction to diazepam. An iatrogenic cause should be considered in the differential diagnosis of any new delusion, including Capgras syndrome.

Jules Cotard (1840-1889): his life and the unique syndrome which bears his name.

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Pearn, J; Gardner-Thorpe, C

2002-05-14

Dr. Jules Cotard (1840-1889) was a Parisian neurologist who first described the délire des négations. Cotard's syndrome or Cotard's delusion comprises any one of a series of delusions ranging from the fixed and unshakable belief that one has lost organs, blood, or body parts to believing that one has lost one's soul or is dead. In its most profound form, the delusion takes the form of a professed belief that one does not exist. Encountered primarily in psychoses such as schizophrenia and bipolar disorder, Cotard's syndrome has also been described in organic lesions of the nondominant temporoparietal cortex as well as in migraine. Cotard's delusion is the only self-certifiable syndrome of delusional psychosis. Jules Cotard, a Parisian neurologist and psychiatrist and former military surgeon, was one of the first to induce cerebral atrophy by the experimental embolization of cerebral arteries in animals and a pioneer in studies of the clinicopathologic correlates of cerebral atrophy secondary to perinatal and postnatal pathologic changes. He was the first to record that unilateral cerebral atrophy in infancy does not necessarily lead to aphasia and was also the pioneer of studies of altered conscious states in diabetic hyperglycemia.

Cotard's syndrome: analysis of 100 cases.

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Berrios, G E; Luque, R

1995-03-01

In 1880, Jules Cotard reported a clinical state he believed was a new type of agitated melancholia. A statistical analysis has been carried out of 100 cases of Cotard's syndrome to determine how this clinical concept has fared since its inception. In terms of clinical profile, no difference was found between men and women or between underlying diagnostic categories; age seemed to increase the likelihood of developing délire des négations. Depression was reported in 89% of subjects; the most common nihilistic delusions concerned the body (86%) and existence (69%). Anxiety (65%) and guilt (63%) were also common, followed by hypochondriacal delusions (58%) and delusions of immortality (55). An exploratory factor analysis extracted 3 factors: psychotic depression, Cotard type I and Cotard type II. The psychotic depression factor included patients with melancholia and few nihilistic delusions. Cotard type 1 patients, on the other hand, showed no loadings for depression or other disease and are likely to constitute a pure Cotard syndrome whose nosology may be closer to the delusional than the affective disorders. Type II patients showed anxiety, depression and auditory hallucinations and constitute a mixed group. This new grouping cuts across the more traditional view and may have therapeutic implications. Authors, in general, have considered délire des négations as a syndrome rather than a new disease and do not seem to support the view that the completeness of the syndrome is a function of presence or severity of depression. The view that délire des négations refers only to the delusion of being dead has also carried little favour as its likely to waste information.

Comparing schizophrenia symptoms in the Iban of Sarawak with other populations to elucidate clinical heterogeneity.

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McLean, Duncan; Barrett, Robert; Loa, Peter; Thara, Rangaswamy; John, Sujit; McGrath, John; Gratten, Jake; Mowry, Bryan

2015-03-01

The symptom profile of schizophrenia can vary between ethnic groups. We explored selected symptom variables previously reported to be characteristic of schizophrenia in the Iban of Sarawak in transethnic populations from Australia, India, and Sarawak, Malaysia. We tested site differences to confirm previous research, and to explore implications of differences across populations for future investigations. We recruited schizophrenia samples in Australia (n = 609), India (n = 310) and Sarawak (n = 205) primarily for the purposes of genetic studies. We analyzed seven identified variables and their relationship to site using logistic regression, including: global delusions, bizarre delusions, thought broadcast/insertion/withdrawal delusions, global hallucinations, auditory hallucinations, disorganized behavior, and prodromal duration. We identified a distinct symptom profile in our Sarawak sample. Specifically, the Iban exhibit: low frequency of thought broadcast/insertion/withdrawal delusions, high frequency of auditory hallucinations and disorganized behavior, with a comparatively short prodrome when compared with Australian and Indian populations. Understanding between-site variation in symptom profile may complement future transethnic genetic studies, and provide important clues as to the nature of differing schizophrenia expression across ethnically distinct groups. A comprehensive approach to subtyping schizophrenia is warranted, utilizing comprehensively ascertained transethnic samples to inform both schizophrenia genetics and nosology. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Religious content of hallucinations in paranoid schizophrenia.

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Krzystanek, Marek; Krysta, Krzysztof; Klasik, Adam; Krupka-Matuszczyk, Irena

2012-09-01

Different environmental factors are thought to be responsible for 15-20% of schizophrenia pathogenesis. Religion has long been considered a major force in human life, regardless of economic, social or political affiliation. How the perception of religion has changed over time, especially in the context of mental illness, was the focal point of this long-term comparative study. A random selection of 100 case histories from the years 1932, 1952, 1972 and 1992 was selected. By reviewing the subject history and medical notes, information on the presence of religious hallucinations and/or delusions were collected and grouped. Religious topics were demonstrated in 46.8% of the test population. Whereas there was a clear diversity of religious-themed delusions, "God", "Christ", "Mary", "Satan/devil" and "hell" all figured prominently across all reviewed years. There is a progressive decrease in the number of religious topics in paranoid schizophrenia. The transfer of holiness from historical saints onto a subject was observed. Evil dominates over good in productive symptoms in paranoid schizophrenia. The phenomenon of apocalyptic subjects in paranoid hallucinations and delusions increased after the Second World War. Religious topics of hallucinations and delusions change over time and relate to objective historical events and reflect changes in religiosity in society.

Bayesian accounts and black swans: Questioning the erotetic theory of delusional thinking.

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McKay, Ryan

2015-01-01

Parrott and Koralus argue that a particular cognitive factor--"impaired endogenous question raising"--offers a parsimonious account of three delusion-related phenomena: (1) the development of the Capgras delusion; (2) evidence that patients with schizophrenia outperform healthy control participants on a conditional reasoning task; and (3) evidence that deluded individuals "jump to conclusions". In this response, I assess these claims, and raise my own questions about the "erotetic" theory of delusional thinking.

Cotard’s Syndrome in a Patient with Schizophrenia: Case Report and Review of the Literature

OpenAIRE

Huarcaya-Victoria, Jeff; Ledesma-Gastañadui, Mario; Huete-Cordova, Maria

2016-01-01

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 co...

[On the "folkloric" psychotherapy to schizophrenic patients--based on phenomenological study].

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Yamada, T; Yamada, Y

1998-01-01

Psychotherapeutic treatment of schizophrenia is generally considered difficult. One reason for this is that the doctor and patient can easily fall into a relationship of conflict with each other concerning the propriety of "judgments which are morbidly and mistakenly made (K. Jaspers)", referred to as delusions. We carried out close phenomenological structure-analyses of the delusions and of patients' fundamental experiences, based on the premise that a patient with delusions probably has some actual grounding for these in the patient's own concepts, considering the fact that the patient firmly believes these delusions. As a result, we have clarified the following matters from the primary experience of delusions. 1) We found that patients are in a conflicted mental condition which can be considered a collapse of adaptability to "Seken". 2) In this condition of conflict, patients feel guilt relative to "Seken" or feel that they are indebted and should be punished. When patients complained of their primary experience, we were able to persuade them to reserve their judgment of their primary experience, by 3) having each patient listen to the folktale "Torikuyou" in which the "logic of stealing" and the "logic of being stolen", appear in a reciprocal relationship relative to the constitution of crime and punishment, by 4) explaining to each patient about the ambiguity and reciprocity of reality experienced, 5) instead of disputing the propriety of patient's judgment about primary experience, doctor and patient worked together to enable the patient to form a positive understanding of the primary experience. 6) We reduced the patient's psychological conflict relative to primary experience, and were able to defuse and distance the patient's delusions caused by erroneous judgment of primary experience. 7) Regarding the area in which this type of psychotherapeutic approach shows efficacy, we analyzed the concept of "Seken" as a world which can cause conflicts relative to

Mental illness, violence and delusional misidentifications: the role of Capgras' syndrome in matricide.

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Carabellese, Felice; Rocca, Gabriele; Candelli, Chiara; Catanesi, Roberto

2014-01-01

Violent behavior has frequently been reported in cases of Capgras' delusion, a misidentification syndrome characterized by the false belief that imposters have replaced people familiar to the individual. To better understand the relationship between Capgras' syndrome and violence. After a brief overview of the scientific knowledge of delusional misidentification syndromes, we present two cases of psychotic sons suffering from this kind of delusion who killed their mothers and we analyzed the phenomenology of Capgras' delusion in-depth, focusing on the role of this syndrome in the etiology of violence. Capgras' syndrome may be a specific risk factor for violence towards others, particularly the murder of the delusionally misidentified person. Looking for the signs of Capgras' syndrome may be crucial to assessing the risk of violence in mentally disordered patients. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study.

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Oher, F J; Demjaha, A; Jackson, D; Morgan, C; Dazzan, P; Morgan, K; Boydell, J; Doody, G A; Murray, R M; Bentall, R P; Jones, P B; Kirkbride, J B

2014-08-01

The extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments. We collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10-F33) in two centres of the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation. Reality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06-0.24] and depressive symptoms (EES 0.21, 95% CI 0.07-0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES -0.06, 95% CI -0.10 to -0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83-1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12-1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09-1.61). In people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These

Psychosis, agnosia, and confabulation: an alternative two-factor account.

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Turner, Mark A

2014-01-01

Theories of delusions which rely on a combination of abnormal experience and defective belief evaluation and/ or cognitive bias are the subject of an emerging consensus. This paper challenges the validity of these theories and constructs a two factor alternative. The paper starts by identifying the difficulty the current theories have explaining the complex delusions of schizophrenia and then, by considering, first, the aetiology of somatopsychotic symptoms, and second, the literature on the relationship between confabulation and allopsychotic symptoms, demonstrates that the natural solution is to retain the experiential factor whilst replacing the second factor with confabulation. The paper is then able to demonstrate that the resultant two-factory theory can clarify recent work on the aetiological role of autonoetic agnosia and on the relationships between confabulation, delusion, and thought disorder. The theory supersedes currently available theories in terms of its simplicity, fruitfulness, scope and conservatism and represents an advance in the search for unified theory of psychosis.

COTARD SYNDROME IN SEMANTIC DEMENTIA

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Mendez, Mario F.; Ramírez-Bermúdez, Jesús

2011-01-01

Background Semantic dementia is a neurodegenerative disorder characterized by the loss of meaning of words or concepts. semantic dementia can offer potential insights into the mechanisms of content-specific delusions. Objective The authors present a rare case of semantic dementia with Cotard syndrome, a delusion characterized by nihilism or self-negation. Method The semantic deficits and other features of semantic dementia were evaluated in relation to the patient's Cotard syndrome. Results Mrs. A developed the delusional belief that she was wasting and dying. This occurred after she lost knowledge for her somatic discomforts and sensations and for the organs that were the source of these sensations. Her nihilistic beliefs appeared to emerge from her misunderstanding of her somatic sensations. Conclusion This unique patient suggests that a mechanism for Cotard syndrome is difficulty interpreting the nature and source of internal pains and sensations. We propose that loss of semantic knowledge about one's own body may lead to the delusion of nihilism or death. PMID:22054629

Threatening auditory hallucinations and Cotard syndrome in Parkinson disease.

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Factor, Stewart A; Molho, Eric S

2004-01-01

Psychotic symptoms are commonly reported in patients with Parkinson disease (PD). In particular, patients experience nonthreatening visual hallucinations that can occur with insight (so called hallucinosis) or without. Auditory hallucinations are uncommon, and schizophrenialike symptoms such as pejorative and threatening auditory hallucinations and delusions that are persecutory, referential, somatic, religious, or grandiose have rarely been reported. The authors present 2 PD patients who experienced threatening auditory hallucinations, without visual hallucinations, and schizophrenialike delusions with detailed description of the clinical phenomenology including 1 patient with Cotard syndrome.

Understanding attributional biases, emotions and self-esteem in 'poor me' paranoia: findings from an early psychosis sample.

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Fornells-Ambrojo, M; Garety, P A

2009-06-01

Trower and Chadwick's (1995) theory of two types of paranoia ('poor me' and 'bad me') provides a framework for understanding the seemingly contradictory evidence on persecutory delusions. Paranoia has been argued to defend against low self-esteem, but people with persecutory delusions report high levels of emotional distress and, in some instances, low self-worth. The current study investigates attributions and emotions in a sample of people with early psychosis who have persecutory delusions. 'Poor me' paranoia has been found to be more frequent than 'bad me' paranoia in the early stages of psychosis. Anger and a tendency to blame other people are hypothesized to characterize 'poor me' paranoia. The study had a cross-sectional design. Twenty individuals with early psychosis, 21 clinical controls with depression and 32 healthy volunteers completed a thorough assessment of emotions and attributions. The 'poor me' paranoia group showed higher levels of anger, anxiety and depression than the non-clinical control group. Self-esteem and guilt were however preserved. A tendency to blame others but not themselves was characteristic of the 'poor me' paranoia group whereas people in the clinical control group tended to self-blame for failures. Anger, but not self-esteem, was associated with an attributional bias characterized by blaming other people instead of oneself. In conclusion, anger, a previously overlooked emotion in the study of persecutory delusions, warrants further attention. The other-directed nature of this emotion highlights the potential role of interpersonal schemas in understanding paranoia.

Folie à Deux – A Clinical Case of Folie Imposée in a Mother/Child Relationship

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Marta Nascimento

2012-12-01

Full Text Available Background: Even though the origin of the concept of shared delusion is not consensual, the term folie a deux was introduced in 1877 by two french researchers – Lasègue and Falret. According to the original concept, a person (inductor, cognitively dominant, develops a delusional idea that progressively imposes to a second person (induced, with whom he keeps a close relationship. The four psychopathologic subtypes known – folie imposée, folie simultanée, folie communiquée and folie induite, were described in the final of the XIX century, but its classification and conceptualization was assigned to the american researcher Gralnick (1942. Aim, materials and methods: It is intended to highlight some clinical aspects of the shared delusion disorder, its epidemiological and psycopathogenic characterization and therapeutical approach. In order to achieve it, the authors presented a clinical case report and respective non systematic literature review. Results: It is a case of shared delusion of the type folie imposée in a pair mother/son. The inductor (son suffers from bipolar disorder and asperger syndrome and shared with his mother (induced and carer a persecutory delusion. Conclusions: It is highlighted the importance of a social isolation context and close contact between both members in the genesis of the disease; it is discussed the subject of the cognitive dominance between the inductor and the induced and the implications of the separation of the pair mother/son, as primary therapeutic action.

Folie à Deux – A Clinical Case of Folie Imposée in a Mother/Child Relationship

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Marta Nascimento

2013-11-01

Full Text Available Background: Even though the origin of the concept of shared delusion is not consensual, the term folie a deux was introduced in 1877 by two french researchers – Lasègue and Falret. According to the original concept, a person (inductor, cognitively dominant, develops a delusional idea that progressively imposes to a second person (induced, with whom he keeps a close relationship. The four psychopathologic subtypes known – folie imposée, folie simultanée, folie communiquée and folie induite, were described in the final of the XIX century, but its classification and conceptualization was assigned to the american researcher Gralnick (1942. Aim, materials and methods: It is intended to highlight some clinical aspects of the shared delusion disorder, its epidemiological and psycopathogenic characterization and therapeutical approach. In order to achieve it, the authors presented a clinical case report and respective non systematic literature review. Results: It is a case of shared delusion of the type folie imposée in a pair mother/son. The inductor (son suffers from bipolar disorder and asperger syndrome and shared with his mother (induced and carer a persecutory delusion. Conclusions: It is highlighted the importance of a social isolation context and close contact between both members in the genesis of the disease; it is discussed the subject of the cognitive dominance between the inductor and the induced and the implications of the separation of the pair mother/son, as primary therapeutic action.

[Analysis of the Structure of Acute Psychotic Disorder].

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Gerardo, Téllez R; Ricardo, Sánchez P; Luis, Eduardo Jaramillo

2012-03-01

Schizophrenia is a clinically heterogeneous disorder. A multifactorial structure of this syndrome has been described in previous reports. The aim of this study was to evaluate what are the possible diagnostic categories in patients having acute psychotic symptoms, studying their clinical characteristics in a cross-sectional study. An instrument for measuring psychotic symptoms was created using previous scales (SANS, SAPS, BPRS, EMUN, Zung depression scale). Using as criteria statistical indexes and redundance of items, the initial instrument having 101 items has been reduced to 57 items. 232 patients with acute psychotic symptoms, in most cases schizophrenia, attending Clínica Nuestra Señora de la Paz in Bogotá and Hospital San Juan de Dios in Chía have been evaluated from April, 2008 to December, 2009. Multivariate statistical methods have been used for analyzing data. A six-factor structure has been found (Deficit, paranoid-aggressive, disorganized, depressive, bizarre delusions, hallucinations). Cluster analysis showed eight subtypes that can be described as: 1) bizarre delusions-hallucinations; 2) deterioration and disorganized behavior; 3) deterioration; 4) deterioration and paranoid-aggressive behavior; 5) bizarre delusions; 6) paranoia-anxiety- aggressiveness; 7) depressive symptoms and bizarre delusions; 8) paranoia and aggressiveness with depressive symptoms These subtypes allow a more exhaustive characterization that those included in standard classification schemes and should be validated in longitudinal studies. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Is fear of others linked to an uncertain sense of self? The relevance of self-worth, interpersonal self-concepts, and dysfunctional beliefs to paranoia.

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Lincoln, Tania M; Mehl, Stephanie; Ziegler, Michael; Kesting, Marie-Luise; Exner, Cornelia; Rief, Winfried

2010-06-01

The assumption that a low sense of self-worth can give rise to paranoid delusions is relevant from a therapeutic perspective, but research has been inconsistent. The present study sought to investigate how interpersonal self-concepts and global self-worth relate to psychotic and depressive psychopathology in persons with psychosis. Participants with psychosis (n=83) and healthy controls (n=33) were assessed for global self-worth, interpersonal self-concepts, and dysfunctional beliefs using the Frankfurt Self-Concept Scale and the Dysfunctional Attitude Scale. Symptoms were assessed with the Positive and Negative Syndrome Scale, the Peters et al. Delusions Inventory, the Paranoia Checklist, and the Beck Depression Inventory. We hypothesized that perceived threat to self-worth, as expressed in dysfunctional acceptance beliefs and negative interpersonal self-concepts, would be uniquely associated with persecutory delusions. In contrast, low global self-worth would be strongly associated with symptoms of depression. Multiple regression analyses were used to investigate the association between symptoms and self-concepts. As expected, low global self-worth was associated with depression, whereas the more specific perception of not being accepted by relevant others was most clearly related to psychotic symptoms. Almost half of the variance in paranoia scores was explained by negative interpersonal self-concepts and the interaction between negative interpersonal self-concepts and dysfunctional acceptance beliefs. Thus, cognitive interventions for delusions might be improved by focusing more on interpersonal self-concepts. 2009. Published by Elsevier Ltd.

Psychotic experiences co-occur with sleep problems, negative affect and mental disorders in preadolescence

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Jeppesen, Pia; Clemmensen, Lars; Munkholm, Anja

2015-01-01

or definitely present. The Development and Well-Being Assessment (DAWBA) was used independently to diagnose DSM-IV-mental disorders. Puberty development and sleep disturbance were self-reported. The associations between PE (any lifetime hallucination and/or delusion) and various mental problems and disorders......-reported mental health difficulties in absence of a diagnosis (31.4%). The risk of delusions increased with onset of puberty. The risk of PE increased with emotional and neurodevelopmental disorders, subthreshold depressive symptoms, sleep problems and lack of sleep, regardless of whether PE were expressed...

DSM-IV "criterion A" schizophrenia symptoms across ethnically different populations: evidence for differing psychotic symptom content or structural organization?

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McLean, Duncan; Thara, Rangaswamy; John, Sujit; Barrett, Robert; Loa, Peter; McGrath, John; Mowry, Bryan

2014-09-01

There is significant variation in the expression of schizophrenia across ethnically different populations, and the optimal structural and diagnostic representation of schizophrenia are contested. We contrasted both lifetime frequencies of DSM-IV criterion A (the core symptom criterion of the internationally recognized DSM classification system) symptoms and types/content of delusions and hallucinations in transethnic schizophrenia populations from Australia (n = 776), India (n = 504) and Sarawak, Malaysia (n = 259), to elucidate clinical heterogeneity. Differences in both criterion A symptom composition and symptom content were apparent. Indian individuals with schizophrenia reported negative symptoms more frequently than other sites, whereas individuals from Sarawak reported disorganized symptoms more frequently. Delusions of control and thought broadcast, insertion, or withdrawal were less frequent in Sarawak than Australia. Curiously, a subgroup of 20 Indian individuals with schizophrenia reported no lifetime delusions or hallucinations. These findings potentially challenge the long-held view in psychiatry that schizophrenia is fundamentally similar across cultural groups, with differences in only the content of psychotic symptoms, but equivalence in structural form.

Genetic or Psychogenic? A Case Study of “Folie à Quatre” Including Twins

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Tohru Ohnuma

2015-01-01

Full Text Available Shared psychotic disorder, characterized by shared delusion among two or more subjects (termed “Folie à deux,” “trois,” etc., is often associated with strong religious beliefs or social isolation, factors creating strong psychological sympathy. Recently, we treated a rare familial case of “Folie à quatre” in central Tokyo without such influences. The proband was a schizophrenia patient and younger brother within monozygotic twins. Positive symptoms were “transmitted” to remaining family members, his elder brother, mother, and father father, in a relatively short period of three months. Although the pathophysiology of these positive symptoms (delusions and hallucinations remains unclear, the transmission pattern suggests the primacy of social and environmental factors (and/or their interaction, while genetics appeared less influential in this “Folie à famille.” Although undiagnosed psychoses in the whole family cannot be excluded, they did not share the other negative schizophrenia symptoms of the proband. A strong familial connection appeared to be the most important factor for the common delusion and hallucination.

CAPITALISM IN ILLUSION AND DELUSION

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DORU CÎRNU

2011-12-01

Full Text Available The current crisis seems to shake the foundations of contemporary society as a whole and generated increasingly more opinions that show the capitalist society has begun and continues to lose ground. This is because capitalism has changed something inside so deeply that eternal truths of capitalism – economic growth, full employment, financial stability – seem to have crashed like the New York twin towers. Beyond all the shortcomings, quite a lot in numbers, known and recognized, the world and those who analyze it agree that , at least so far, has not been invented a better mechanism to obstruct and retain tyranny and so it is possible to consider the evolution of capitalism only in and through democracy.

The Cotard syndrome. Report of two patients: with a review of the extended spectrum of 'délire des négations'.

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Gardner-Thorpe, C; Pearn, J

2004-08-01

The Cotard syndrome is characterized by the delusion where an individual insists that he has died or part of his body has decayed. Although described classically in schizophrenia and bipolar disorder, physical disorders including migraine, tumour and trauma have also been associated with the syndrome. Two new cases are described here, the one associated with arteriovenous malformations and the other with probable multiple sclerosis. The delusion has been embarrassing to each patient. Study of such cases may have wider implications for the understanding of the psychotic interpretation of body image, for example that occurring in anorexia nervosa.

Concepts of ecstasy in Euripides’ “Bacchanals” and their interpretation

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Lilian Portefaix

1982-01-01

Full Text Available In dealing with ecstasy in antiquity, scholars usually refer to Euripides' "Bacchanals"' as one of the most reliable sources with regard to this phenomenon. This drama can also be supplemented by vase paintings, which to a great extent deal with motives from the circle of Dionysos. We can observe that the ecstatic experience, as depicted by Euripides contains such psychological phenomena as hallucinations, including optical, acoustic and olfactive delusion, anesthesia, delusion as to one's own strength and possession. Euripides' description can be explained in different ways according to the view taken of religion and its function.

A comparison of symptoms and family history in schizophrenia with and without prior cannabis use: implications for the concept of cannabis psychosis.

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Boydell, J; Dean, K; Dutta, R; Giouroukou, E; Fearon, P; Murray, R

2007-07-01

There is considerable interest in cannabis use in psychosis. It has been suggested that the chronic psychosis associated with cannabis use, is symptomatically distinct from idiopathic schizophrenia. Several studies have reported differences in psychopathology and family history in people with schizophrenia according to whether or not they were cannabis users. We set out to test the hypotheses arising from these studies that cannabis use is associated with more bizarre behaviour, more thought disorder, fewer negative symptoms including blunted affect, more delusions of reference, more paranoid delusions and a stronger family history of schizophrenia. We used a case register that contained 757 cases of first onset schizophrenia, 182 (24%) of whom had used cannabis in the year prior to first presentation, 552 (73%) had not and 3% had missing data. We completed the OPCRIT checklist on all patients and investigated differences in the proportion of people with distractibility, bizarre behaviour, positive formal thought disorder, delusions of reference, well organised delusions, any first rank symptom, persecutory delusions, abusive/accusatory hallucinations, blunted affect, negative thought disorder, any negative symptoms (catatonia, blunted affect, negative thought disorder, or deterioration), lack of insight, suicidal ideation and a positive family history of schizophrenia, using chi square tests. Logistic regression modelling was then used to determine whether prior cannabis use affected the presence of the characteristics after controlling for age, sex and ethnicity. There was no statistically significant effect of cannabis use on the presence of any of the above. There remained however a non-significant trend towards more insight (OR 0.65 p=0.055 for "loss of insight") and a finding of fewer abusive or accusatory hallucinations (OR 0.65 p=0.049) of borderline significance amongst the cannabis users. These were in the hypothesised direction. There was no evidence of

Sustained and "sleeper" effects of group metacognitive training for schizophrenia: a randomized clinical trial.

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Moritz, Steffen; Veckenstedt, Ruth; Andreou, Christina; Bohn, Francesca; Hottenrott, Birgit; Leighton, Lucy; Köther, Ulf; Woodward, Todd S; Treszl, András; Menon, Mahesh; Schneider, Brooke C; Pfueller, Ute; Roesch-Ely, Daniela

2014-10-01

Cognitive interventions increasingly complement psychopharmacological treatment to enhance symptomatic and functional outcome in schizophrenia. Metacognitive training (MCT) is targeted at cognitive biases involved in the pathogenesis of delusions. To examine the long-term efficacy of group MCT for schizophrenia in order to explore whether previously established effects were sustained. A 2-center, randomized, controlled, assessor-blind, parallel group trial was conducted. A total of 150 inpatients or outpatients with DSM-IV diagnoses of schizophrenia spectrum disorders were enrolled. All patients were prescribed antipsychotic medication. The second follow-up assessment took place 3 years later after the intervention phase was terminated. Group MCT targeting cognitive biases vs neuropsychological training (COGPACK). Patients received a maximum of 16 sessions. The primary outcome measure was a delusion score derived from the Positive and Negative Syndrome Scale (PANSS). The PANSS positive syndrome and total scores, the Psychotic Symptom Rating Scales, the jumping to conclusions bias, self-esteem, and quality of life served as secondary outcome measures. The intention-to-treat analyses demonstrated that patients in the MCT group had significantly greater reductions in the core PANSS delusion score, after 3 years compared with the control group (η2partial = .037; P = .05). Among the secondary outcomes, the intention-to-treat analyses also demonstrated that patients in the MCT group had significantly greater reductions in the PANSS positive syndrome score (η2partial = .055; P = .02) and the Psychotic Symptom Rating Scales delusion score (η2partial = .109; P = .001). Significant group differences at the 3-year follow-up were also found on measures of self-esteem and quality of life, which did not distinguish groups at earlier assessment points. Attention was improved in the neuropsychological training group relative to the MCT group. The

[Depression in the elderly. Clinical aspects].

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Barbier, D

2001-02-24

DIFFICULT DIAGNOSIS: Depression in the elderly can take on many often misleading aspects. Sadness may be considered legitimate or "normal" for an elderly person. Depression may masquerade as an organic disorder where somatic complaints, pain and anxiety predominate. All these different clinical forms may mislead the clinician. THE MASK OF HYPOCHONDRIA: A tendency to hypochondria, found in more than one-half of all depressed elderly subjects, may be reinforced by bouts of complementary examinations. The patient is convinced of having an unrecognized organic disease. The mask of hypochondria must be considered with special care because it is a major risk factor for attempted and successful suicide. THE MASK OF DELUSIONS: Elderly patients often develop a state of melancolia-like depression with delusions. Delusions may be congruent with the predominant depressed mood, for example a guilt feeling for an act never committed, or inversely, non-congruent with the thymic state (persecution, negation delusin), for example Cotard syndrome where the patient is persuaded that his/her organs are malfunctioning or have disappeared. Despite these impressive mood disorders that often incite prescription of a neuroleptic, these elderly patients respond favorably to antidepressor treatment.

How psychotic-like are paranormal beliefs?

Science.gov (United States)

Cella, Matteo; Vellante, Marcello; Preti, Antonio

2012-09-01

Paranormal beliefs and Psychotic-like Experiences (PLE) are phenotypically similar and can occur in individuals with psychosis but also in the general population; however the relationship of these experiences for psychosis risk is largely unclear. This study investigates the association of PLE and paranormal beliefs with psychological distress. Five hundred and three young adults completed measures of paranormal beliefs (Beliefs in the Paranormal Scale), psychological distress (General Health Questionnaire), delusion (Peters et al. Delusions Inventory), and hallucination (Launay-Slade Hallucination Scale) proneness. The frequency and intensity of PLE was higher in believers in the paranormal compared to non-believers, however psychological distress levels were comparable. Regression findings confirmed that paranormal beliefs were predicted by delusion and hallucination-proneness but not psychological distress. The use of a cross-sectional design in a specific young adult population makes the findings exploratory and in need of replication with longitudinal studies. The predictive value of paranormal beliefs and experiences for psychosis may be limited; appraisal or the belief emotional salience rather than the belief per se may be more relevant risk factors to predict psychotic risk. Copyright © 2012 Elsevier Ltd. All rights reserved.

The erotetic theory of delusional thinking.

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Parrott, Matthew; Koralus, Philipp

2015-01-01

In this paper, we argue for a novel account of one cognitive factor implicated in delusional cognition. According to the erotetic theory of delusion we present, the central cognitive factor in delusion is impaired endogenous question raising. After presenting the erotetic theory, we draw on it to model three distinct patterns of reasoning exhibited by delusional and schizophrenic patients, and contrast our explanations with Bayesian alternatives. We argue that the erotetic theory has considerable advantages over Bayesian models. Specifically, we show that it offers a superior explanation of three phenomena: the onset and persistence of the Capgras delusion; recent data indicating that schizophrenic subjects manifest superior reasoning with conditionals in certain contexts; and evidence that schizophrenic and delusional subjects have a tendency to "jump to conclusions." Moreover, since the cognitive mechanisms we appeal to are independently motivated, we avoid having to posit distinct epistemic states that are intrinsically irrational in order to fit our model to the variety of data. In contrast to Bayesian models, the erotetic theory offers a simple, unified explanation of a range of empirical data. We therefore conclude that it offers a more plausible framework for explaining delusional cognition.

Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis.

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Romm, Kristin Lie; Rossberg, Jan Ivar; Hansen, Charlotte Fredslund; Haug, Elisabeth; Andreassen, Ole A; Melle, Ingrid

2011-08-19

Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. A total of 113 patients from the Thematically Organized Psychosis research study (TOP) were included at first treatment. The Positive and Negative Syndrome Scale (PANSS) was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS) and self-esteem by the Rosenberg Self-Esteem Scale (RSES). Premorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression. There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.

Insomnia and paranoia.

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Freeman, Daniel; Pugh, Katherine; Vorontsova, Natasha; Southgate, Laura

2009-03-01

Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are predictors of paranoia. Thus insomnia may contribute to the formation and maintenance of persecutory ideation. The aim was to examine for the first time the association of insomnia symptoms and paranoia in the general population and the extent of insomnia in individuals with persecutory delusions attending psychiatric services. Assessments of insomnia, persecutory ideation, anxiety, and depression were completed by 300 individuals from the general population and 30 individuals with persecutory delusions and a diagnosis of non-affective psychosis. Insomnia symptoms were clearly associated with higher levels of persecutory ideation. Consistent with the theoretical understanding of paranoia, the association was partly explained by the presence of anxiety and depression. Moderate or severe insomnia was present in more than 50% of the delusions group. The study provides the first direct evidence that insomnia is common in individuals with high levels of paranoia. It is plausible that sleep difficulties contribute to the development of persecutory ideation. The intriguing implication is that insomnia interventions for this group could have the added benefit of lessening paranoia.

Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis

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Haug Elisabeth

2011-08-01

Full Text Available Abstract Background Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. Method A total of 113 patients from the Thematically Organized Psychosis research study (TOP were included at first treatment. The Positive and Negative Syndrome Scale (PANSS was used to assess present symptoms. Premorbid adjustment was measured with the Premorbid Adjustment Scale (PAS and self-esteem by the Rosenberg Self-Esteem Scale (RSES. Results Premorbid social adjustment was significantly related to lower self-esteem and explained a significant proportion of the variance in self-esteem. Self-esteem was significantly associated with the levels of persecutory delusions and hallucinations experienced by the patient and explained a significant proportion of the variance even after adjusting for premorbid functioning and depression. Conclusion There are reasons to suspect that premorbid functioning is an important aspect in the development of self- esteem, and, furthermore, that self-esteem is associated with the development of delusions and hallucinations.

When the Patient Believes That the Organs Are Destroyed: Manifestation of Cotard's Syndrome.

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Machado, Leonardo; Filho, Luiz Evandro de Lima; Machado, Liliane

2016-01-01

Cotard's Syndrome (CS) is a rare clinical event described for the first time in 1880 by the neurologist and psychiatrist Jules Cotard and characterized by negation delusions (or nihilists). Immortality and hypochondriac delusions are also typical. Nowadays, it is known that CS can be associated with many neuropsychiatric conditions. In this article, we describe the case of a patient that believed not having more organs and having the body deformed and whose CS was associated with a bigger depressive disorder. Although the electroconvulsive therapy is the most described treatment modality in the literature, the reported case had therapeutic success with association of imipramine and risperidone.

When the Patient Believes That the Organs Are Destroyed: Manifestation of Cotard’s Syndrome

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Leonardo Machado

2016-01-01

Full Text Available Cotard’s Syndrome (CS is a rare clinical event described for the first time in 1880 by the neurologist and psychiatrist Jules Cotard and characterized by negation delusions (or nihilists. Immortality and hypochondriac delusions are also typical. Nowadays, it is known that CS can be associated with many neuropsychiatric conditions. In this article, we describe the case of a patient that believed not having more organs and having the body deformed and whose CS was associated with a bigger depressive disorder. Although the electroconvulsive therapy is the most described treatment modality in the literature, the reported case had therapeutic success with association of imipramine and risperidone.

Two cases of male genital self-mutilation

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Vinay Singh Chauhan

2016-01-01

Full Text Available Male genital self-mutilation (GSM is a rare but serious phenomenon. Some of the risk factors for this act are the presence of religious delusions, command hallucinations, low self-esteem, and feelings of guilt associated with sexual offences. Other risk factors include failures in the male role, problems in the early developmental period, such as experiencing difficulties in male identification and persistence of incestuous desires, depression, and having a history of GSM. The eponym Klingsor Syndrome, which involves the presence of religious delusions, is proposed for GSM. Psychiatric case reports of male GSM in the literature are rare and mostly anecdotal.

Cotard's Syndrome in a Patient with Schizophrenia: Case Report and Review of the Literature.

Science.gov (United States)

Huarcaya-Victoria, Jeff; Ledesma-Gastañadui, Mario; Huete-Cordova, Maria

2016-01-01

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.

From Hallucination to Fiction: The Invention of Meaning in Psychosis.

Science.gov (United States)

Lippi, Silvia; Lehaire, Célia; Petit, Laetitia

2016-12-01

Taking their inspiration from a case history, the authors explore the effects of a writing workshop led by a professional writer for patients in a psychiatric hospital. This workshop allowed different modes of transference to unfold: transference to the analyst-therapist, transference to the writer who led the workshop, and transference to the other members of the group. The writing activity created conditions in which there could be a movement from hallucination to delusion-a delusion expressed in fiction through the act of writing. Psychotic patients "invent" a writing that remains unfinished and that relates to the experiences of persecution. Writing thus makes it possible for them to tolerate language, through its transformation into writing.

Effectiveness of Electroconvulsive Therapy for Depression and Cotard’s Syndrome in a Patient with Frontotemporal Lobe Dementia

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Toshiyuki Kobayashi

2012-01-01

Full Text Available In the field of psychogeriatrics, the differential diagnosis of depression and dementia, as well as the treatment of depression and comorbid dementia, is an important issue. In this paper, the authors present the case of a 72-year-old woman with Cotard’s syndrome and frontotemporal dementia (FTD who was admitted to a psychiatric hospital with delusions of negation accompanied by depressive symptoms. Pharmacotherapy over a 2-year hospitalization was unsuccessful, and she was subsequently transferred to our university hospital. A total of 18 sessions of electroconvulsive therapy released her from psychomotor inhibition, appetite loss, and Cotard’s delusions. The indication for electroconvulsive therapy in patients with dementia is discussed.

Cotard Syndrome.

Science.gov (United States)

Dieguez, Sebastian

2018-01-01

Cotard's syndrome is often described as the delusional belief that one is dead or non-existent. However, Jules Cotard's initial description (1880) of the "delusion of negations" was much richer and also involved delusions and claims of immortality and enormity, feelings of damnation, and illusions of bodily dissolution and transformation. Alternatively conceived as an extreme case of depression, hypochondria, or psychosis, the condition is considered rare and remains poorly understood. Cotard himself provided a taxonomy and several explanations for the condition, focusing on its distinction from classical persecutory delusions and suggesting that it could be a kind of reversed grandiosity. He proposed a psychosensory basis in the dissolution of mental imagery, which he then extended to a more general psychomotor impairment of volition. Other early authors highlighted a disorder of the bodily self, and more recent theories postulated an impairment of right hemispheric functions, leading to perceptual and somatosensory feelings of unreality, which coupled with reasoning impairments and an internalized attributional style led in turn to beliefs of non-existence. However, despite its striking presentation and its relevance to our understanding of self-awareness, Cotard's syndrome remains an elusive condition, rarely reported and poorly researched. © 2018 S. Karger AG, Basel.

What Is Psychiatry?

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Index Scriptorium Estoniae

2008-01-01

Uutest heliplaatidest Mord "Necrosodomic Abyss", Origin "The Antithesis", Pin-Up Went Down "2 Unlimited", Spyder Baby "Let Us Prey", Starofash "The Thread", Testament "The Formation Of Damnation", To-Mera "Delusions"

Cotard’s Syndrome in a Patient with Schizophrenia: Case Report and Review of the Literature

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Jeff Huarcaya-Victoria

2016-01-01

Full Text Available 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.

New atheistic approaches in the cognitive science of religion

DEFF Research Database (Denmark)

Geertz, Armin W.

2009-01-01

Bidraget diskuterer, hvorledes Dennetts og Dawkins bøger om religion kan opfattes som bidrag til nyere religionsteorier. Bidraget kritisk analyserer henholdsvis Breaking the spell (Dennett) og The God delusion (Dawkins)....

Toxic cannabis psychosis IS a valid entIty

African Journals Online (AJOL)

1990-10-20

Oct 20, 1990 ... Psychotic features included: formal thought disorder; hallucinations; delusions; ..... Major depressive episode. Manic episode ... Anxiety disorder. Temporal ... admission to hospital were in fact suffering from a mixed dagga and ...

Are Psychotic Experiences Related to Poorer Reflective Reasoning?

Directory of Open Access Journals (Sweden)

Martin J. Mækelæ

2018-02-01

Full Text Available Background: Cognitive biases play an important role in the formation and maintenance of delusions. These biases are indicators of a weak reflective mind, or reduced engaging in reflective and deliberate reasoning. In three experiments, we tested whether a bias to accept non-sense statements as profound, treat metaphorical statements as literal, and suppress intuitive responses is related to psychotic-like experiences.Methods: We tested deliberate reasoning and psychotic-like experiences in the general population and in patients with a former psychotic episode. Deliberate reasoning was assessed with the bullshit receptivity scale, the ontological confabulation scale and the cognitive reflection test (CRT. We also measured algorithmic performance with the Berlin numeracy test and the wordsum test. Psychotic-like experiences were measured with the Community Assessment of Psychic Experience (CAPE-42 scale.Results: Psychotic-like experiences were positively correlated with a larger receptivity toward bullshit, more ontological confabulations, and also a lower score on the CRT but not with algorithmic task performance. In the patient group higher psychotic-like experiences significantly correlated with higher bullshit receptivity.Conclusion: Reduced deliberate reasoning may contribute to the formation of delusions, and be a general thinking bias largely independent of a person's general intelligence. Acceptance of bullshit may be facilitated the more positive symptoms a patient has, contributing to the maintenance of the delusions.

Assessment of documentation of DSM-IV-TR Criteria A for diagnosis of schizophrenia in psychiatric unit, tertiary hospital, Malaysia.

Science.gov (United States)

Maung, K; Ohnmar, H; Than, W; Ramli, M; Najwa Hanim, M R; Ali Sabri, R; Ahmad Zafri, A B

The purposes of this study were to investigate the documentation of the DSM-IV-TR- Criteria A in diagnoses of schizophrenia and to identify the symptoms associated with over diagnosis of schizophrenia. This study involved a retrospective review and analysis of data from case notes. Data of 107 newly diagnosed patients with schizophrenia were keyed in and analyzed using SPSS v 19. The cases were then evaluated for the use of the DSM-IV-TR- Criteria A. Over diagnosis was noted in 37.39% of the patients. Disorganised behaviour (12.5%), affective flattening (12.5%), hallucination (16%) and non-bizarre delusion (18.3%) significantly contributed to the over-diagnosis of schizophrenia. Symptoms such as non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia and were statistically significant with p ≤0.05. There was a significant lack of DSM-IV-TR Criteria A among the data documented to diagnose schizophrenia and non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia. This key problem needs to be addressed. The reliability of a diagnosis is indispensable and achievable with the proper clinical application of DSM-IV-TR Criteria A. The DSM-IV-TR Criteria have been perceived to be useful and reliable and is most widely used throughout the world.

Sleep Issues and Sundowning

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Grief and Loss as Alzheimer's Progresses

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Changes to Your Relationships

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Late-Stage Caregiving

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Middle-State Caregiving

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Stages and Behaviors

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Early-Stage Caregiving

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Self‐Disorders as schizophrenia spectrum vulnerability phenotypes

DEFF Research Database (Denmark)

Raballo, Andrea

2011-01-01

Schizophrenia spectrum disorders are characterised by manifold psychopathological expressions, which might include major symptoms (such as delusions, hallucinations or social withdrawal), psychobehavioural enduring personality patterns (e.g. schizoid/schizotypal traits), or more subtle, quasi...

Inhalant Abuse: Is Your Child at Risk?

Science.gov (United States)

... dizziness, headache, slurred speech, and loss of coordination, inhibition and control. Hallucinations and delusions are possible. If ... counselor or a local drug rehabilitation facility. The support of a mental health professional can be valuable ...

TRANSSEXUALISM AND SCHIZOPHRENIA: A CASE REPORT

OpenAIRE

Bhargava, Subhash C.; Sethi, Sujata

2002-01-01

Delusion of sex change is not uncommon as a pan] of the schizophrenic illness. But the coexistence of gender identity disorder (GID) and schizophrenia is rare and show differential response to treatment with antipsychotics.

Hearing Voices and Seeing Things

Science.gov (United States)

... Facts for Families Guide Facts for Families - Vietnamese Hearing Voices and Seeing Things No. 102; Updated October ... delusions (a fixed, false, and often bizarre belief). Hearing voices or seeing things that are not there ...

Delusional disorder-jealous type: how inclusive are the DSM-IV diagnostic criteria?

Science.gov (United States)

Easton, Judith A; Shackelford, Todd K; Schipper, Lucas D

2008-03-01

Delusional disorder-jealous type is a new diagnostic category in the Diagnostic and Statistical Manual for Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) in which delusions concerning a partner's infidelity must be present. Therefore, patients who experience a jealousy disorder, but do not experience delusions will not fit the diagnostic criteria. Using a database of 398 case histories of jealousy disorders reported in the literature from 1940-2002, we examined the percentage of these cases that met the diagnostic criteria for delusional disorder-jealous type. Only 4% of the cases met all diagnostic criteria. This is the first systematic comparison of the prevalence of these disorders. The results provide evidence that the diagnostic criteria are not inclusive, as most individuals suffering with a jealousy disorder were excluded from the diagnosis.

Alternative psychosis (forced normalisation) in epilepsy

African Journals Online (AJOL)

changed, this should always be considered as a potential cause of a new or ... psychosis with thought disorder, delusions, hallucinations. • significant .... On mental status examination, the patient's behaviour was .... appeared for the first time.

38 CFR 3.355 - Testamentary capacity for insurance purposes.

Science.gov (United States)

2010-07-01

... subject and extent of his disposition, recognition of the object of his bounty, and appreciation of the consequence of his act, uninfluenced by any material delusion as to the property or persons involved. (b) Due...

Scientific Letter: Self-inflicted bilateral orchidectomy precipitated by ...

African Journals Online (AJOL)

Scientific Letter: Self-inflicted bilateral orchidectomy precipitated by erotic bizarre delusions: a case report. ... African Journal of Psychiatry. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home ...

GABAergic Mechanisms in Schizophrenia : Linking Postmortem and In Vivo Studies

NARCIS (Netherlands)

de Jonge, Jeroen C; Vinkers, Christiaan H; Hulshoff Pol, Hilleke E; Marsman, Anouk

2017-01-01

Schizophrenia is a psychiatric disorder characterized by hallucinations, delusions, disorganized thinking, and impairments in cognitive functioning. Evidence from postmortem studies suggests that alterations in cortical γ-aminobutyric acid (GABAergic) neurons contribute to the clinical features of

Parkinson's Disease Videos

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Full Text Available ... the Urinary System? What Are the Risks and Benefits of DBS Surgery? NPF Caregiver Summit 2016: Tools ... Depression and Parkinson's Disease? What Are the Neuroprotective Benefits of Exercise for PD Patients? Hallucinations and Delusions ...

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Full Text Available ... What Do We Really Know? Nurse Webinars: Nursing Solutions: Improving Caregiver Strain through Science and Model Interventions ... Psychosis: Hallucinations, Delusions and Paranoia Nurse Webinars: Nursing Solutions: Understanding Fatigue and Apathy in Parkinson's Disease Nurse ...

AFRREV IJAH, Vol.3 (1) January, 2014

African Journals Online (AJOL)

Toshiba

2014-01-09

Jan 9, 2014 ... People are living in delusion of things getting better, forgetting that the .... Environmental Day. It is obvious that the chemicals released into the .... global threats of pollution (acid deposition, stratospheric ozone depletion, air ...

Parkinson's Disease Videos

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Full Text Available ... Delusions and Paranoia Nurse Webinars: Nursing Solutions: Understanding Fatigue and Apathy in Parkinson's Disease Nurse Webinars: Interdisciplinary ... Missing? Communication and the PD Partnership Expert Briefings: Fatigue, Sleep Disorders and Parkinson's Disease Expert Briefings: What's ...

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Full Text Available ... PD: What Do We Really Know? Nurse Webinars: Nursing Solutions: Improving Caregiver Strain through Science and Model ... Disease Psychosis: Hallucinations, Delusions and Paranoia Nurse Webinars: Nursing Solutions: Understanding Fatigue and Apathy in Parkinson's Disease ...

Parkinson's Disease Videos

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Full Text Available ... Marijuana and PD: What Do We Really Know? Nurse Webinars: Nursing Solutions: Improving Caregiver Strain through Science ... Briefings: Parkinson's Disease Psychosis: Hallucinations, Delusions and Paranoia Nurse Webinars: Nursing Solutions: Understanding Fatigue and Apathy in ...

Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic.

Science.gov (United States)

Hylwa, Sara A; Foster, Ashley A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

2012-01-01

Delusional infestation, which encompasses both delusions of parasitosis and delusions of infestation with inanimate objects (sometimes called Morgellons disease), has been said to represent a distinct and encapsulated delusion, that is, a stand-alone diagnosis. Anecdotally, we have observed that patients with delusional infestation often have one or more psychiatric comorbid conditions and that delusional infestation should not be regarded as a stand-alone diagnosis. The purpose of this study was to identify whether patients with delusional infestation have psychiatric comorbid conditions. We therefore identified patients who had been formally evaluated in the Department of Psychiatry during their visit to Mayo Clinic. We retrospectively searched for and reviewed the cases of all patients with delusional infestation seen from 2001 through 2007 at Mayo Clinic, Rochester, Minnesota, and who underwent psychiatric evaluation. The diagnoses resulting from psychiatric evaluation were analyzed. During the 7-year study period, 109 patients seen for delusional infestation at Mayo Clinic were referred to the Department of Psychiatry, 54 (50%) of whom actually followed through with psychiatric consultation. Of these 54 patients, 40 (74%) received additional active psychiatric diagnoses; 14 patients (26%) had delusional infestation alone. Abnormal personality traits were rarely documented. Most patients with delusional infestation have multiple coexisting or underlying psychiatric disorders. Therefore, evaluation by a psychiatrist, when possible, is advised for all patients with delusional infestation. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Steroid-Responsive Chronic Schizophreniform Syndrome in the Context of Mildly Increased Antithyroid Peroxidase Antibodies

Directory of Open Access Journals (Sweden)

Ludger Tebartz van Elst

2017-04-01

Full Text Available BackgroundSchizophreniform syndromes can be divided into primary forms from polygenic causes or secondary forms due to immunological, epileptiform, monogenic, or degenerative causes. Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT is a secondary immunological form associated with increased thyroid antibodies, such as antithyroid peroxidase antibodies and shows a good response to corticosteroids.Case presentationWe present the case of a 41-year-old woman suffering from a schizophreniform syndrome. Starting at the age of 35, she developed psychotic exacerbations with formal thought disorder, acoustic hallucinations, cenesthopathic experiences, and loss of ego boundaries. At the same time, she began to suffer from chronic sexual delusions and olfactory hallucinations, which did not respond to neuroleptic medication. Her levels of antithyroid peroxidase antibodies were slightly increased, and the blood–brain barrier was disturbed. An electroencephalogram (EEG showed intermittent generalized slowing, and cerebral magnetic resonance imaging (cMRI depicted mild temporolateral atrophy. High-dose corticosteroid treatment led to convincing improvement of attentional performance and the disappearance of delusions and olfactory hallucinations.ConclusionSREAT can mimic typical symptoms of schizophreniform syndromes. The increased titer of antithyroid peroxidase antibodies in combination with the EEG slowing, blood–brain barrier dysfunction, and the cMRI alterations were the basis for suspecting an immunological cause in our patient. Chronic delusions, olfactory hallucinations, and cognitive deficits were successfully treated with corticosteroids. The occurrence of secondary immunological forms of schizophreniform syndromes demonstrates the need for innovative immunosuppressive treatment options.

Moderating effects of positive symptoms of psychosis in suicidal ideation among adults diagnosed with schizophrenia

Science.gov (United States)

Bornheimer, Lindsay A.

2018-01-01

Background Suicide is among the leading causes of death for adults diagnosed with schizophrenia, with risk estimates being over eight folds greater than the general population. While the majority of research to date focuses on the role of symptoms of depression in suicide risk, there is a lack of consensus and understanding of the relationship between positive symptoms of psychosis and both suicidal ideation and attempt. The current study examined pathways of influence between symptoms of depression, positive symptoms of psychosis (i.e. hallucinations and delusions), hopelessness, and suicidal ideation among a population of adults diagnosed with schizophrenia. Methods Data were obtained from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE; n = 1460) at baseline. Suicidal ideation, hopelessness, and symptoms of depression were measured by the Calgary Depression Scale (CDRS) and hallucinations and delusions by the Positive and Negative Syndrome Scale (PANSS). Data were analyzed with Structural Equation Modeling (SEM) using Mplus 7. Results Symptoms of depression, positive symptoms of psychosis, and hopelessness independently predicted suicidal ideation. Hopelessness significantly mediated the relationship between symptoms of depression and suicidal ideation. Lastly, positive symptoms of psychosis were found to moderate the relationship between symptoms of depression and suicidal ideation. Conclusions The current study provides evidence for the role that positive symptoms of psychosis (specifically hallucinations and delusions) play in suicidal ideation, pointing towards the implication that beyond symptoms of depression, positive symptoms must be evaluated for and treated. PMID:27450776

What Is Psychiatry?

Medline Plus

Full Text Available ... Antidepressants – used to treat depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders. Antipsychotic medications – used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder. Sedatives and ...

Parkinson's Disease Videos

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Full Text Available ... Bringing Care to You Expert Care Programs Professional Education Expert Care Research shows people with Parkinson’s who ... Psychosis: Hallucinations, Delusions and Paranoia Nurse Webinars: Interdisciplinary Education on Parkinson's Disease Expert Briefings: Getting Around: Transportation ...

What Is Psychiatry?

Medline Plus

Full Text Available ... used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder. Sedatives and anxiolytics – used to treat ... Personality Disorders Postpartum Depression Posttraumatic Stress Disorder (PTSD) Schizophrenia Sleep Disorders Somatic Symptom Disorder Specific Learning Disorder ...

Parkinson's Disease Videos

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Full Text Available ... When Is It Time to Get Help? Unconditional Love CareMAP: Rest and Sleep: Part 1 What Are ... Around the House: Part 2 What Is the Relationship Between Depression and Parkinson's Disease? Hallucinations and Delusions ...

Parkinson's Disease Videos

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Full Text Available ... Managing Depression, Anxiety & Psychosis OHSU - Parkinson's Disease: Pharmacological Management of Depression, Anxiety & Psychosis What Is the Relationship Between Depression and Parkinson's Disease? What Are Some Strategies for Problems with Urination? Hallucinations and Delusions CareMAP: ...

DELUSIONS OF PROGRESS: A Case For Reconceptualising ...

African Journals Online (AJOL)

A Case For Reconceptualising Environmental Education ... assuming that economic growth and technological progress are ways to a cleaner environment ... overseas teachers came. ... this experience are several: that students .... humanity, but in an African context, they .... cross-cultural connections that recognise this.

Cardiocentric neurophysiology: the persistence of a delusion.

Science.gov (United States)

Smith, C U M

2013-01-01

Aristotle is well known to have taught that the brain was a mere coolant apparatus for overheated blood and to have located the hegemonikon in the heart. This teaching was hotly disputed by his immediate successors in the Alexandrian Museum, who showed that the brain played the central role in psychophysiology. This was accepted and developed by the last great biomedical figure of classical antiquity - Claudius Galen. However, Aristotle's cardiocentric theory did not entirely disappear and this article traces its influence through the Arabic physicians of the Islamic ascendancy, into the European Middle Ages where Albertus Magnus' attempt to reconcile cardiocentric and cerebrocentric physiology was particularly influential. It shows how cardiocentricity was sufficiently accepted to attract the attention of, and require refutation by, many of the great names of the Renaissance, including Vesalius, Fernel, and Descartes, and was still taken seriously by luminaries such as William Harvey in the mid-seventeenth century. The article, in rehearsing this history, shows the difficulty of separating the first-person perspective of introspective psychology and the third-person perspective of natural science. It also outlines an interesting case of conflict between philosophy and physiology.

Disorder or delusion? Living with Morgellons disease.

Science.gov (United States)

Simpson, Lindsay; Baier, Marjorie

2009-08-01

Whether Morgellons disease is a delusional disorder or even a disease has been a mystery for more than 300 years. Symptoms of Morgellons include crawling and stinging sensations, feeling of "bugs" and/or fiber-like material beneath the skin, disabling fatigue, and memory loss. The cause, transmission, and treatment are unknown. Research about Morgellons is staggeringly sparse and limited in scope. However, in recent years, discussion about Morgellons has become more common because of the Internet and online support groups. Mental health professionals and the general public need to be aware of the signs, symptoms, and treatment of this disease. Focusing on the disease and listening to patients can make a difference in the way health care professionals provide the best possible care for people with Morgellons. Copyright (c) 2009, SLACK Incorporated.

Self-Synchronization: Splendid Promise or Dangerous Delusion

National Research Council Canada - National Science Library

Hatter, Steven

2000-01-01

... with extraordinary efficiency and precision. Proponents of Network-Centric Warfare build upon the optimism in JV 2010 by offering a war-fighting paradigm that promises "an information superiority enabled concept of operations that generates...

Art and Delusion: Unreality in Art School

Science.gov (United States)

Neher, Ross

2010-01-01

The author teaches painting in a Master of Fine Arts (MFA) program at Pratt Institute in Brooklyn, New York. Each fall semester he asks his students why they have come to Pratt and what they want to do when they graduate. The common answer is to develop as artists and find a commercial gallery to show and sell their work. Some want the MFA degree…

Intensive care delirium - effect on memories and health-related quality of life - a follow-up study

DEFF Research Database (Denmark)

Svenningsen, Helle; Tønnesen, Else K; Videbech, Poul

2013-01-01

after intensive care unit. Interviews were repeated after two and six months and supplemented with Short Form-36 and the Barthel Index. RESULTS: Delirium was detected in 60% of the patients in our study, and delirious patients had significantly fewer factual memories and more memories of delusion than...... than half of the patients in intensive care unit experience delirium, which is associated with fewer factual memories and more memories of delusions. Short Form-36 might not be sensitive to delirium-related outcomes. Future research should include the development of better assessment tools to determine...... the long-term consequences of intensive care unit delirium. RELEVANCE TO CLINICAL PRACTICE: We recommend regular assessment to prevent, detect and treat delirium. We also recommend an intensive care unit follow-up programme providing an opportunity for postintensive care unit patients, particularly...

Cotard's Syndrome after breast surgery successfully treated with aripiprazole augmentation of escitalopram: a case report.

Science.gov (United States)

De Berardis, Domenico; Brucchi, Maurizio; Serroni, Nicola; Rapini, Gabriella; Campanella, Daniela; Vellante, Federica; Valchera, Alessandro; Fornaro, Michele; Iasevoli, Felice; Mazza, Monica; Lucidi, Giuliana; Martinotti, Giovanni; di Giannantonio, Massimo

2015-01-01

In 1880 the French neurologist Jules Cotard described a condition characterized by delusion of negation (nihilistic delusion) in a melancholia context. Recently, there has been a resurgence of interest in Cotard's syndrome (CS), but the nosographical figure of CS remains unclear. It isn't determined if it pertains to the delusional themes area or if it is related to the sense of immanent ruin in some depressive episodes. For these reasons CS has recently been supposed to be an intermediate form. Furthermore, since even less is known about secondary CS in subjects who had never suffered of psychiatric disorders, in the present case we report the development of a secondary CS in a female patient who underwent a lumpectomy for the removal of a benign fibroadenoma. The patient responded well to aripiprazole augmentation of escitalopram and totally remitted.

[Hypochondria circumscripta (to the problem of coenesthesiopathic paranoia)].

Science.gov (United States)

Smulevich, A B; Frolova, V I

2006-01-01

Hypochondria circumscripta manifests in patients with paranoial personality and signs of somatopsychic accentuation. A sample included 11 patients (6 men, 5 women, mean age 54 years) who referred to dermatologists or had been admitted to gastroenterological and psychiatric units. Pathokinesis of hypochondria circumscripta comprises three stages: idiopathic algias, overmastering sensations and possession of pain. In the latter stage, delusional behavior targeted to the elimination of a part of the body, which is perceived as the source of pain, develops. Psychopathological disorders are realized in limits of coenesthesiopathic spectrum without tendency to interpretive delusion manifestation as well as transformation to systematic delusion of persecution during the disease course. As a consequence of above mentioned peculiarities of psychopathological structure, the stage of possession of pain may be designated as coenesthesiopathic paranoia. Because of the small sample, the findings can be considered as preliminary ones.

Parkinson's Disease Videos

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Full Text Available ... Spouse About Sexual Dysfunction? Attachment: consultation.jpg OHSU - Therapeutic Approaches for PD: Depression, Anxiety & Psychosis What Is the Relationship Between Depression and Parkinson's Disease? CareMAP: Travel and Transportation: Part 2 Hallucinations and Delusions CareMAP: ...

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Full Text Available ... el Comportamiento, Parte 1 CareMAP: Medicamentos y la Salud en General, Parte 1 Expert Briefings: Apathy or ... Caregiving Hallucinations and Delusions CareMAP: Medicamentos y la Salud en General, Parte 2 Dra. Claudia Martinez, MAPC - ...

Parkinson's Disease Videos

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Full Text Available ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping ... and Parkinson's Disease? Hallucinations and Delusions CareMAP: Balancing Life and Caregiving CareMAP: Travel and Transportation: Part 1 ...

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Full Text Available ... Parkinson's Disease Expert Briefings: Getting Around: Transportation and Travel with PD Expert Briefings: Sleep and Parkinson's Nurse: ... the Relationship Between Depression and Parkinson's Disease? CareMAP: Travel and Transportation: Part 1 Hallucinations and Delusions CareMAP: ...

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Full Text Available ... Distance Caregiving NPF Caregiver Summit 2016: Tools For Family Caregivers: Caremap and Caring & Coping CareMAP: Preparing Paid ... or Delusions? How Does Depression Affect the Patient's Family and Social Network? CareMAP: When Is It Time ...

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Full Text Available ... PTA, NPF - National Parkinson Foundation CareMAP: Managing Caregiver Stress CareMAP: End-of-Life Care CareMAP: Thinking Changes: ... and Delusions How Does Depression Affect the Patient's Family and Social Network? CareMAP: Medicamentos y la Salud ...

DECEMBER JMBR 13 - 2 correction.cdr

African Journals Online (AJOL)

Fine Print

case report is to create awareness on this disorder and its treatment outcome. The patient is a .... In Mood disorder with psychotic symptom, delusion of having HIV/AIDS may occur. But the ... the patient at risk of violence, suicide or homicide.

English Pronunciation Errors: A Case Study of Amhara and Oromia ...

African Journals Online (AJOL)

unique firstlady

speak better than introverts who are always shy to interact with others. Historical Factor: ... over of education by the natives after the fall of the Imperial regime. After the ..... delusion of native or local technology as some people are campaigning.

Ontwikkelingshulp

NARCIS (Netherlands)

Jansen, J.J.G.

1997-01-01

Wetenschappelijk is er over ontwikkelingshulp eigenlijk geen discussie meer. De kwestie is duidelijk. Hulp kan niet helpen, zie vooral: P.T. Bauer, Equality, The Third World & Economic Delusion, Londen 1981 Graham Hancock, Lords of Poverty, Londen 1989 Catherine Caufield, Masters of

I spy with my little eye - the detection of intentional contingency in early psychosis

NARCIS (Netherlands)

Fett, A.J.; Berdugo, C.I.G.; Hanssen, E.; Lemmers-Jansen, I.; Shergill, S.S.; Krabbendam, L.

2015-01-01

Introduction: Paranoid delusions have been associated with a tendency to over-attribute intentionality and contingency to others' actions and incidental events in individuals with chronic psychosis. However, this hyper-associative perception bias has not been investigated in the early illness stages

[Psychodynamic and forensic approach of constitutional mythomania: a case report].

Science.gov (United States)

Ben Thabet, J; Zouari, N; Charfeddine, F; Zouari, L; Maâlej, M

2012-12-01

Constitutional mythomania presents several diagnostic, aetiopathogenic and forensic problems for the doctor. We have discussed these aspects through the analysis of a case report. The case report relates to a 43 year-old man, who was subjected to a penal expertise following the emission of cheques without provision. During the examination, he pretended being both a doctor and a lawyer at the same time. He was in charge, among other things, of sale contracts dealing sometimes with high value transactions, obviously without following the required legal procedure. He was pursued subsequently for many other affairs of swindle. Data collected from his medical file indicated that he was the only boy of his family. Since his father had suffered from psychotic episodes, his grandfather had reared him; which he did it in a strictly religious way. He spent his childhood isolated. He was 15 years old when his grandfather died. He had then expressed religious and megalomaniac ideas that had motivated psychiatric management. Later on, he expressed imaginative ideas evoking unsystematized delusion (he pretended to have made a trip to America and to have seen a fish flying and turning into a woman). From a psychodynamic point of view, constitutional mythomania is considered as a borderline personality. It reflects an important narcissisic cleavage. The deceitfulness of the mythomaniac allows him to keep in touch with reality and to avoid mental disintegration. The recognition, by others, of these delusions allows the mythomaniac to have access to his proper level of existence. For a while, to the experts our patient appeared to be suffering from schizophrenia. Therefore, we can apply the Maleval theory to him, which identifies four periods as delusion structuring levels in psychosis : P0 (consequence of the phallic signification deficiency, it includes anxiety, annihilation, perplexity, interrogative attitude), P1 (stage of paranoid delusion), P2 (stage of paranoiac delusion

Effect of virtual reality exposure therapy on social participation in people with a psychotic disorder (VRETp) : study protocol for a randomized controlled trial

NARCIS (Netherlands)

Pot-Kolder, Roos; Veling, Wim; Geraets, Chris; van der Gaag, Mark

2016-01-01

Background: Many patients with a psychotic disorder participate poorly in society. When psychotic disorders are in partial remission, feelings of paranoia, delusions of reference, social anxiety and self-stigmatization often remain at diminished severity and may lead to avoidance of places and

Schizophrenia among Sesotho speakers in South Africa | Mosotho ...

African Journals Online (AJOL)

Results: Core symptoms of schizophrenia among Sesotho speakers do not differ significantly from other cultures. However, the content of psychological symptoms such as delusions and hallucinations is strongly affected by cultural variables. Somatic symptoms such as headaches, palpitations, dizziness and excessive ...

Between green growth and degrowth: Decoupling, rebound effects and the politics for long-term sustainability

DEFF Research Database (Denmark)

Nørgaard, Jørgen; Xue, Jin

2016-01-01

Taking the simple equation: I(impact) = P(population) A(affluence) T(technology) as the point of departure, this chapter discusses the delusion of decoupling economic activities from environmental impacts by resorting to reduce eco-intensities through technological advancement alone. It is argued...

Neurocognitive capabilities modulate the integration of evidence in schizophrenia

NARCIS (Netherlands)

Eifler, Sarah; Rausch, Franziska; Schirmbeck, Frederike; Veckenstedt, Ruth; Englisch, Susanne; Meyer-Lindenberg, Andreas; Kirsch, Peter; Zink, Mathias

2014-01-01

Previous studies have demonstrated a cognitive bias in the integration of disconfirmatory evidence (BADE) in patients with schizophrenia. This bias has been associated with delusions. So far, it is unclear how the integration of evidence is associated with neurocognitive capabilities. In the current

The nature of emotional abnormalities in schizophrenia: Evidence from patients and high-risk individuals

NARCIS (Netherlands)

Wout, M. van 't

2006-01-01

Schizophrenia is a psychiatric disorder that affects about one out of 100 people with symptoms generally emerging in early adulthood. According to the DSM-IV, schizophrenia is characterized by psychotic symptoms, such as hallucinations, delusions, bizarre behavior or speech and negative symptoms

A Parallel Distributed Processing Approach to Behavior and Biology in Schizophrenia

Science.gov (United States)

1989-10-01

delusions) and the other that reflects dopamine underactivity (negative symptoms - e.g., avolition, amotivation and withdrawal). Several authors have... amotivation . While both may be related to frontal lobe Behavior and Biology in Schizophrenia Cohen and Servan-Schreiber 32 deficits, the models in their

An integrated network model of psychotic symptoms

NARCIS (Netherlands)

Looijestijn, Jasper; Blom, Jan Dirk; Aleman, Andre; Hoek, Hans W.; Goekoop, Rutger

2015-01-01

The full body of research on the nature of psychosis and its determinants indicates that a considerable number of factors are relevant to the development of hallucinations, delusions, and other positive symptoms, ranging from neurodevelopmental parameters and altered connectivity of brain regions to

dnAGEnetics: genomic copy number variants and parental age as risk factors for psychiatric disorders

NARCIS (Netherlands)

Buizer - Voskamp, J.E.

2011-01-01

Introduction: Schizophrenia is a debilitating psychiatric disorder with a life-time risk of 0.46 – 1% in the general population. It is characterized by psychotic symptoms, including delusions and hallucinations. Its predisposition is influenced by a complex interaction of genetic and environmental

Sensing the Worst: Neurophenomenological Perspectives on Neutral Stimuli Misperception in Schizophrenia Spectrum

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Mariateresa Sestito

2017-06-01

Full Text Available While investigating social cognitive impairments in schizophrenia, prominent evidence has been found that patients with schizophrenia show a tendency to misclassify neutral stimuli as negatively valenced. Within this population, patients presenting delusions are more prone to this phenomenon. In a previous study, Schizophrenia spectrum (SzSp patients rated positive, negative and neutral stimuli that were multimodally presented, while assessed with a checklist exploring anomalous subjective experiences and evaluated for positive and negative symptomatology. In the present work, we aimed to further explore the relationship between neutral stimuli misperception, anomalous experiences and positive/negative symptoms in SzSp patients. To this end, we adopted a dimensional approach by reconstructing from available data: (1 four a priori scales representing essential dimensions of SzSp experiential pathology following Parnas et al. (2005; and (2 five clinically meaningful factors to describe illness severity derived by Toomey et al. (1997. Results showed that although overall patients correctly recognized the target emotions, those who misinterpreted neutral auditory cues as negatively valenced also presented higher scores in Perplexity (PY, Bizarre Delusions (BD and Disorganization (Di dimensions. Moreover, a positive association between BD and both PY and Self-Disorder (SD dimensions emerged, suggesting that psychotic symptoms may be directly linked to patients’ subjectivity. In an attempt to comprehensively capture the multilayered neutral stimuli misperception phenomenon in SzSp, we aimed at bridging phenomenology and neurobiology by connecting the levels of molecular neurochemistry (i.e., altered dopaminergic neurotransmission, system neuroscience (aberrant salience of perceptual details and psychopathology (the chain involving hyper-reflexivity, self-disorders and the emergence of delusions.

Motoric subtypes of delirium in geriatric patients

Directory of Open Access Journals (Sweden)

Sandeep Grover

2014-01-01

Results: On amended DMSS, hyperactive subtype (N = 45; 45.9% was the most common motoric subtype of delirium, followed by hypoactive subtype (N = 23; 23.5%, and mixed subtype (N = 21; 21.4%. On DRS-R-98, all patients fulfilled the criteria of ′acute (temporal onset of symptoms′, ′presence of an underlying physical disorder′ and ′difficulty in attention′. In the total sample, >90% of the patients had disturbances in sleep-wake cycle, orientation and fluctuation of symptoms. The least common symptoms were delusions, visuospatial disturbances and motor retardation. When compared to hypoactive group, significantly higher proportion of patients with hyperactive subtype had delusions, perceptual disturbances, and motor agitation. Whereas, compared to hyperactive subtype, significantly higher proportion of patients with hypoactive subtype had thought process abnormality and motor retardation. When the hyperactive and mixed motoric subtype groups were compared, patients with mixed subtype group had significantly higher prevalence of thought process abnormality and motor retardation. Comparison of hypoactive and mixed subtype revealed significant differences in the frequency of perceptual disturbances, delusions and motor agitation and all these symptoms being found more commonly in patients with the mixed subtype. Severity of symptoms were found to be significantly different across the various motoric subtypes for some of the non-cognitive symptoms, but significant differences were not seen for the cognitive symptoms as assessed on DRS-R-98. Conclusion: In elderly patients, motor subtypes of delirium differ from each other on non-cognitive symptom profile in terms of frequency and severity.

Social cognition in schizophrenia

NARCIS (Netherlands)

Maat, A.

2014-01-01

Schizophrenia is a chronic psychiatric disorder, incorporating a wide range of symptoms that may occur at certain stages of the disease. The core symptoms can largely be divided into positive symptoms, e.g. hallucinations and delusions, and negative symptoms, e.g. apathia and emotional flattening.

Pharmacological Interventions for the MATRICS Cognitive Domains in Schizophrenia: What's the Evidence?

NARCIS (Netherlands)

Vingerhoets, Wilhelmina A. M.; Bloemen, Oswald J. N.; Bakker, Geor; van Amelsvoort, Therese A. M. J.

2013-01-01

Schizophrenia is a disabling, chronic psychiatric disorder with a prevalence rate of 0.5-1% in the general population. Symptoms include positive (e.g., delusions, hallucinations), negative (e.g., blunted affect, social withdrawal), as well as cognitive symptoms (e.g., memory and attention problems).

Parkinson's Disease Videos

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Full Text Available ... Movement and Falls: Part 1 What Is the Relationship Between Depression and Parkinson's Disease? CareMAP: Plans and Scheduling: Part 2 Hallucinations and Delusions What Are the Common Sleep Disorders Encountered in Patients with PD? CareMAP: Medicamentos y la Salud en ...

Body dysmorphic disorder screening in maxillofacial outpatients presenting for orthognathic surgery

NARCIS (Netherlands)

Vulink, N. C. C.; Rosenberg, A.; Plooij, J. M.; Koole, R.; Bergé, S. J.; Denys, D.

2008-01-01

Body dysmorphic disorder (BDD) is a severe psychiatric disease with delusions about defects in appearance for which patients seek surgical help. This is the first European study to determine the half-year prevalence of BDD in a maxillofacial outpatient clinic. A total of 160 patients with

Monosymptomatic Hypochondriacal Psychosis (somatic delusional ...

African Journals Online (AJOL)

bodily sensations or functions; such as feeling malodorous, ... of symptoms of psychiatric disability other than the central delusion ... psychotic or physical illness.3,6-9 The following two cases of ... history of olfactory hallucinations of bad odour coming from ... withdrew from social activities, avoided interaction with people.

Psychiatric consultations and the management of associated ...

African Journals Online (AJOL)

of medicine: 'the psychosomatic unity of the body and ... ¹ Department of Psychiatry, Faculty of Health Sciences, University of the ... assessment, and was more likely to be managed in the medical wards for delirium, ... and ongoing interaction between mental disorders and general ..... such as hallucinations and delusions.

Abortion in Adolescence.

Science.gov (United States)

Campbell, Nancy B.; And Others

1988-01-01

Explored differences between 35 women who had abortions as teenagers and 36 women who had abortions as adults. Respondents reported on their premorbid psychiatric histories, the decision-making process itself, and postabortion distress symptoms. Antisocial and paranoid personality disorders, drug abuse, and psychotic delusions were significantly…

Subclinical delusional ideation and a self-reference bias in everyday reasoning.

Science.gov (United States)

Galbraith, Niall; Manktelow, Ken; Morris, Neil

2008-02-01

Previous studies (e.g. Moller & Husby, 2000; Blackwood et al., 2004) have revealed that delusional thinking is accompanied by an exaggerated focus upon the self and upon stimuli that are perceived to be related to the self. The objective was to examine whether those high in subclinical delusional ideation exhibit a heightened tendency for self-reference. Using a mixed design, healthy individuals, classified into high- and low-scoring groups on the Peters et al. Delusions Inventory (Peters, Day, & Garety, 1996), were compared on everyday reasoning tasks across three experiments. High-PDI scorers, in contrast to the low-PDI group, rated self-referent objections to everyday arguments as stronger than other-referent objections and formulated more self-referent assertion-based objections to everyday arguments. The findings support the notion that subclinical delusional ideation is linked to a self-reference bias, which is evident in the sort of everyday thinking that people engage in when forming or evaluating their beliefs and which may contribute to delusion formation.

Sexual Behavior in Patients with Psychosis Admitted to a Hospital Unit.

Science.gov (United States)

Del Mar Baños-Martín, María; Márquez-Hernández, Verónica V; Gutiérrez-Puertas, Lorena; Aguilera-Manrique, Gabriel; Gutiérrez-Puertas, Vanesa; Granados-Gámez, Genoveva

2017-06-01

The sexual dimension is part of a person's functionality. Patients with mental disorders have the same sexual needs as any other person, although they may not always be recognized. This is a retrospective observational study to describe the information on sexuality of patients with mental disorders, admitted to an acute short-stay inpatient unit between 2011 and 2015. We analyzed 293 clinical histories of patients, comprising diagnoses in the ICD-10 (International Classification of Diseases) between F20 and F29, inclusively. The information collected corresponded to the beginning of hospitalization, its duration and discharge. The results showed that 24% of the patients had sexual delusions. These delusions were more frequent in women, who in turn had more emotional symptoms, persecutory deception being the most common. There were few reports found on sexual dysfunction. In conclusion, the lack of data in the reports shows little recognition of sexuality in hospitalized patients with mental disorder, highlighting the need to promote the training of health personnel.

[Cenesthopathies: a disorder of background emotions at the crossroads of the cognitive sciences and phenomenology].

Science.gov (United States)

Graux, J; Lemoine, M; Gaillard, P; Camus, V

2011-10-01

Cenesthesia and cenesthopathy have played a fundamental role in 19th and early 20th century French and German psychiatry. Cenesthesia refers to the internal, global, implicit and affective perception of one's own body. The concept of cenesthopathy was coined by Dupre and Camus in 1907 to describe a clinical entity characterized by abnormal and strange bodily sensations. In this review, we examine the history of these concepts and the influence they have had on clinical, nosographical and phenomenological psychiatry and on cognitive neuropsychiatry. We performed a narrative review of the published research literature. Classical French and German psychiatrists have written extensively on cenesthesia and cenesthopathy although these notions are no longer in the mainstream of contemporary psychiatry. However, they are still present in contemporary psychiatric nosography in the form of some controversial clinical entities clearly related to cenesthesia such as cenesthetic schizophrenia, hypochondriacal monothematic delusions, or the Capgras and the Cotard syndromes. These clinical entities are all associated with a state of depersonalization. We point out the similarities between Ey's description of the depersonalization syndrome, especially in psychosis, and the characteristics of cenesthesia. Philosophers like Sartre or Merleau-Ponty have developed the concept of cenesthesia, and in particular have added new concepts like "body schema". Similarly, phenomenological psychiatrists like Minkowski or Tellenbach have attempted to describe psychiatric disorders associated with cenesthesia and have also proposed new concepts (i.e. atmospheric sense) in order to understand them better. More recently, cognitive neuropsychiatry has tried to discover the mechanisms, which cause or contribute to the genesis of delusions. The majority of delusion theories developed in cognitive neuropsychiatry consider that the explanation of monothematic delusions involves one or two explanatory

At forstå med kroppen

DEFF Research Database (Denmark)

Pahuus, Anne Marie

2010-01-01

Løgstrup scholars have long discussed whether Løgstrup's critique of Kant constitutes a farewell to transcendental thinking or only a revision of it. In order to present Løgstrup's critique of what is called the ‘epistemological delusion', the article argues that Løgstrup's own work on philosophy...

The Validity and Sensitivity of PANSS-6 in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Study

DEFF Research Database (Denmark)

Østergaard, Søren D; Foldager, Leslie; Mors, Ole

2017-01-01

It was recently demonstrated in acutely exacerbated schizophrenia that a 6-item version (PANSS-6: P1 = delusions, P2 = conceptual disorganization, P3 = hallucinations, N1 = blunted affect, N4 = social withdrawal, N6 = lack of spontaneity/flow of conversation) of the 30-item Positive and Negative...

Emotion, desire and reverie in the consumption practices from the recyclable material collectors

Directory of Open Access Journals (Sweden)

Josilene Barbosa do Nascimento

2014-08-01

imagination. Thus, pointing out how works the self delusion of the collectors, characteristic of modern consumption, as we watch for the excitement and the individual values governing their consumption practices as pointing work. In this sense, the collectors consume to satiate subjectively established wills: it is the emotional consumption.

“We are not free, admit it... but we cling onto tomorrow”

DEFF Research Database (Denmark)

Awad, Sarah H.

2017-01-01

This chapter discusses the role of imagination as a higher mental function that facilitates coping in disempowering social settings. It builds on Carlos Cornejo’s (this volume) account on the cultural history of imagination and the development of the concept from that of delusion to that of reason...

The continuing problem with misoprostol

African Journals Online (AJOL)

discovered additional benefit, it is predominantly a psychotropic agent for the treatment of psychotic delusions in schizophrenia. Misoprostol can be used in low doses to soften the cervix to allow instrumentation for suction evacuation of the uterus in termination or incomplete miscarriage, or to soften the cervix prior.

Stemcell Information: SKIP000253 [SKIP Stemcell Database[Archive

Lifescience Database Archive (English)

Full Text Available 21490598 10.1038/nature09915 Modelling schizophrenia using human induced pluripo... SKIP000253 ... Diseased GM23760 GM23760 ... 統合失調症 F20 Schizophrenia 181500 ... ...(SCZD) .episodes of agitatation, delusions of persecutation, fear of assassination, father also affected. 統合失調症

Jumping to conclusions in schizophrenia

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Evans SL

2015-07-01

Full Text Available Simon L Evans,1 Bruno B Averbeck,2 Nicholas Furl31School of Psychology, University of Sussex, Brighton, East Sussex, UK; 2Laboratory of Neuropsychology, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA; 3Department of Psychology, Royal Holloway, University of London, Egham, Surrey, UKAbstract: Schizophrenia is a mental disorder associated with a variety of symptoms, including hallucinations, delusions, social withdrawal, and cognitive dysfunction. Impairments on decision-making tasks are routinely reported: evidence points to a particular deficit in learning from and revising behavior following feedback. In addition, patients tend to make hasty decisions when probabilistic judgments are required. This is known as “jumping to conclusions” (JTC and has typically been demonstrated by presenting participants with colored beads drawn from one of two “urns” until they claim to be sure which urn the beads are being drawn from (the proportions of colors vary in each urn. Patients tend to make early decisions on this task, and there is evidence to suggest that a hasty decision-making style might be linked to delusion formation and thus be of clinical relevance. Various accounts have been proposed regarding what underlies this behavior. In this review, we briefly introduce the disorder and the decision-making deficits associated with it. We then explore the evidence for each account of JTC in the context of a wider decision-making deficit and then go on to summarize work exploring JTC in healthy controls using pharmacological manipulations and functional imaging. Finally, we assess whether JTC might have a role in therapy.Keywords: ketamine, decision making, delusions, fMRI, urn task

French version validation of the psychotic symptom rating scales (PSYRATS for outpatients with persistent psychotic symptoms

Directory of Open Access Journals (Sweden)

Favrod Jerome

2012-09-01

Full Text Available Abstract Background Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. Methods A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS. Results ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. Conclusions The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience.

History of Morgellons disease: from delusion to definition

OpenAIRE

Middelveen,Marianne J; Fesler,Melissa C; Stricker,Raphael B

2018-01-01

Marianne J Middelveen,1 Melissa C Fesler,2 Raphael B Stricker2 1Atkins Veterinary Services, Calgary, AB, Canada; 2Union Square Medical Associates, San Francisco, CA, USA Abstract: Morgellons disease (MD) is a skin condition characterized by the presence of multicolored filaments that lie under, are embedded in, or project from skin. Although the condition may have a longer history, disease matching the above description was first reported in the US in 2002. Since that time, the condition tha...

The mystery of Morgellons disease: infection or delusion?

Science.gov (United States)

Savely, Virginia R; Leitao, Mary M; Stricker, Raphael B

2006-01-01

Morgellons disease is a mysterious skin disorder that was first described more than 300 years ago. The disease is characterized by fiber-like strands extruding from the skin in conjunction with various dermatologic and neuropsychiatric symptoms. In this respect, Morgellons disease resembles and may be confused with delusional parasitosis. The association with Lyme disease and the apparent response to antibacterial therapy suggest that Morgellons disease may be linked to an undefined infectious process. Further clinical and molecular research is needed to unlock the mystery of Morgellons disease.

History of Morgellons disease: from delusion to definition.

Science.gov (United States)

Middelveen, Marianne J; Fesler, Melissa C; Stricker, Raphael B

2018-01-01

Morgellons disease (MD) is a skin condition characterized by the presence of multicolored filaments that lie under, are embedded in, or project from skin. Although the condition may have a longer history, disease matching the above description was first reported in the US in 2002. Since that time, the condition that we know as MD has become a polemic topic. Because individuals afflicted with the disease may have crawling or stinging sensations and sometimes believe they have an insect or parasite infestation, most medical practitioners consider MD a purely delusional disorder. Clinical studies supporting the hypothesis that MD is exclusively delusional in origin have considerable methodological flaws and often neglect the fact that mental disorders can result from underlying somatic illness. In contrast, rigorous experimental investigations show that this skin affliction results from a physiological response to the presence of an infectious agent. Recent studies from that point of view show an association between MD and spirochetal infection in humans, cattle, and dogs. These investigations have determined that the cutaneous filaments are not implanted textile fibers, but are composed of the cellular proteins keratin and collagen and result from overproduction of these filaments in response to spirochetal infection. Further studies of the genetics, pathogenesis, and treatment of MD are warranted.

Oppositional Culture Theory and the Delusion of Colorblindness

Science.gov (United States)

Berlowitz, Marvin J.; Hutchins, Brandi N.; Jenkins, Derrick J.; Mussman, Mark P.; Schneider, Carri A.

2006-01-01

Oppositional culture theory is a widely accepted explanation for disparities in academic performance between middle class Whites and middle class African Americans. The authors make the case that oppositional culture theory has its roots in cultural deficit theory popularized in the early 1960s and present a significant body of evidence to refute…

Strategic Delusions - The Cold Start Doctrine: Proactive Strategy

Science.gov (United States)

2016-05-26

In a post 9/11 scenario, India finds it convenient to brand these insurgencies as terrorism and associate most of them with Pakistan. Given these...strategic and operational imperatives following the 2008 Mumbai terror attacks denied the Indian government the luxury of attaining her objectives

History of Morgellons disease: from delusion to definition

Directory of Open Access Journals (Sweden)

Middelveen MJ

2018-02-01

Full Text Available Marianne J Middelveen,1 Melissa C Fesler,2 Raphael B Stricker2 1Atkins Veterinary Services, Calgary, AB, Canada; 2Union Square Medical Associates, San Francisco, CA, USA Abstract: Morgellons disease (MD is a skin condition characterized by the presence of multicolored filaments that lie under, are embedded in, or project from skin. Although the condition may have a longer history, disease matching the above description was first reported in the US in 2002. Since that time, the condition that we know as MD has become a polemic topic. Because individuals afflicted with the disease may have crawling or stinging sensations and sometimes believe they have an insect or parasite infestation, most medical practitioners consider MD a purely delusional disorder. Clinical studies supporting the hypothesis that MD is exclusively delusional in origin have considerable methodological flaws and often neglect the fact that mental disorders can result from underlying somatic illness. In contrast, rigorous experimental investigations show that this skin affliction results from a physiological response to the presence of an infectious agent. Recent studies from that point of view show an association between MD and spirochetal infection in humans, cattle, and dogs. These investigations have determined that the cutaneous filaments are not implanted textile fibers, but are composed of the cellular proteins keratin and collagen and result from overproduction of these filaments in response to spirochetal infection. Further studies of the genetics, pathogenesis, and treatment of MD are warranted. Keywords: Morgellons disease, dermopathy, Lyme disease, Borrelia burgdorferi, spirochetes

Delusion of fetal duplication in a Capgras patient.

Science.gov (United States)

Silva, J A; Leong, G B; Longhitano, M; Botello, T E

1991-02-01

A case of Capgras syndrome in a pregnant patient is described. In addition to perceiving living family members as impostors, she believed that there was a double or twin of her fetus. She conceptualized her "twins" differently than the way she viewed doubles of family members. Her fetus may represent the youngest "person" to have been duplicated. The relationship of Capgras syndrome to misidentification phenomena is discussed.

Delusions of success. How optimism undermines executives' decisions.

Science.gov (United States)

Lovallo, Dan; Kahneman, Daniel

2003-07-01

The evidence is disturbingly clear: Most major business initiatives--mergers and acquisitions, capital investments, market entries--fail to ever pay off. Economists would argue that the low success rate reflects a rational assessment of risk, with the returns from a few successes outweighing the losses of many failures. But two distinguished scholars of decision making, Dan Lovallo of the University of New South Wales and Nobel laureate Daniel Kahneman of Princeton University, provide a very different explanation. They show that a combination of cognitive biases (including anchoring and competitor neglect) and organizational pressures lead managers to make overly optimistic forecasts in analyzing proposals for major investments. By exaggerating the likely benefits of a project and ignoring the potential pitfalls, they lead their organizations into initiatives that are doomed to fall well short of expectations. The biases and pressures cannot be escaped, the authors argue, but they can be tempered by applying a very different method of forecasting--one that takes a much more objective "outside view" of an initiative's likely outcome. This outside view, also known as reference-class forecasting, completely ignores the details of the project at hand; instead, it encourages managers to examine the experiences of a class of similar projects, to lay out a rough distribution of outcomes for this reference class, and then to position the current project in that distribution. The outside view is more likely than the inside view to produce accurate forecasts--and much less likely to deliver highly unrealistic ones, the authors say.

IQ Tests Are Not for Machines, Yet

Science.gov (United States)

Dowe, David L.; Hernandez-Orallo, Jose

2012-01-01

Complex, but specific, tasks--such as chess or "Jeopardy!"--are popularly seen as milestones for artificial intelligence (AI). However, they are not appropriate for evaluating the intelligence of machines or measuring the progress in AI. Aware of this delusion, Detterman has recently raised a challenge prompting AI researchers to evaluate their…

A sociological approach to the concept of God amongst Iranian youth

African Journals Online (AJOL)

The Iranian society is in transition, faced with delusion about the traditional and modern belief systems, and multiplicity of interpretations and new presentation of One God Allah. A spectrum of these plural presentations of God embodies micro and macro social levels. Some of the most important of these concepts are: ...

Bipolar disorder: an overview | Bronkhorst | South African Family ...

African Journals Online (AJOL)

The typical presentation of these episodes of mania includes high energy hallucinations and delusions, sleep deprivation, fast speech and a constant need to be active. Risk factors that contribute to development of BD include the use of cannabis, influenza during the third trimester of pregnancy, as well as smoking during ...

New-Onset Psychosis in a Multi-Drug Resistant Tuberculosis Patient ...

African Journals Online (AJOL)

He also displayed negativisim with paranoid delusions and insomnia. He was managed by a psychiatrist with anti-psychotic drugs. The dose of cycloserine was also reduced while that of pyridoxine was increased. He remained in a state of periodic confusion and psychosis for nine days after which his condition ameliorated ...

Parkinson's Disease Videos

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Full Text Available ... What Do I Do if I Suspect Compulsive Behavior in a Loved One with PD? How Do I Know if My Loved One Has Experienced Hallucinations or Delusions? Caregiver Summit 2016: Coping Strategy: Mindfulness Ask the Helpline: What Is a Movement Disorder Specialist? How Do I Manage Non-Motor Problems ...

Delusional patterns and its pre-morbid personality linkages in ...

African Journals Online (AJOL)

DSM IVTR, psychological tests: MMPI, SCL-90R and clinical observations were used for the diagnosis of the patients according to the centre policy. Two recording scales designed by the researchers were used to assign the participants to different types of delusions and pre-morbid personalities. The study design was a ...

The Research Imagination in a World on the Move

Science.gov (United States)

Kenway, Jane; Fahey, Johannah

2006-01-01

This paper focuses on the shifting terrain of mobile researchers beginning with an overview of research and research policy on "brain mobility", and then discussing what we call their optical illusions/delusions. Subsequently, our main purpose is to elaborate on a line of inquiry that offers richer notions of researcher mobility, connectivity and…

Effects of typical antipsychotic, haloperidol on regional cerebral blood flow in drug-naive schizophrenic patients-study with 99mTc-HMPAO SPECT

International Nuclear Information System (INIS)

Kamoya, Masatoshi

2001-01-01

For the purpose of examining antipsychotic action of haloperidol (HPD), effects of chronic perioral administration of HPD 4.5 mg/day on regional cerebral blood flow (rCBF) with 99mTc-HMPAO SPECT were investigated in 12 drug-naive schizophrenic patients with acute hallucinatory and delusional state. Further, the SPECT examinations were performed on 20 normal adult volunteers to investigate differences in rCBFs between schizophrenics and the normal subjects. Results are itemized as follows. The rCBF values were significantly increased in the bilateral superior and middle frontal, cingulate, middle temporal, pre-and post-central gyri, the left superior temporal gyrus, the bilateral inferior parietal lobule, and the bilateral hippocampal and thalamic cortices in comparison between normal subjects and before the HPD dose in schizophrenics. However, the rCBF values after the HPD dose showed significant increases only in the bilateral pre-and post-central gyri in comparison with the normal subjects. The rCBF values were significantly decreased in the bilateral superior, middle and inferior frontal, superior and middle temporal gyri, and the left insular gyrus after the HPD dose in comparison with before the HPD dose. The psychiatric assessment with PANSS showed an improvement of positive symptoms consisting of auditory hallucination and delusions after the HPD dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the HPD dose showed positive correlations between the right inferior frontal gyrus and auditory hallucination or positive symptoms, between the right superior temporal gyrus, left thalamus and delusions, and between the left thalamus, insular gyrus and negative symptoms. These results suggest that acute drug-naive schizophrenic patients have widespread cortico-subcortical energic hypermetabolism and HPD reduces the hypermetabolism, leading to whole normalized brain metabolism, in particular with the larger region

Behavioural and psychological symptoms in general hospital patients with dementia, distress for nursing staff and complications in care: results of the General Hospital Study.

Science.gov (United States)

Hessler, J B; Schäufele, M; Hendlmeier, I; Junge, M N; Leonhardt, S; Weber, J; Bickel, H

2018-06-01

Little is known about how behavioural and psychological symptoms of dementia (BPSD) manifest in the general hospital. The aim was to examine the frequency of BPSD in general hospitals and their associations with nursing staff distress and complications in care. Cross-sectional representative study with 1469 patients aged ≥65, including 270 patients with dementia, of 33 randomly selected general hospitals in Germany. BPSD and complications were reported by nurses. Overall frequency of BPSD was higher in patients with dementia (76%) than without (38%). The most frequent symptoms in patients with dementia were nighttime disturbances (38%), depression (29%) and aberrant motor behaviour (28%) and the most distressing symptoms for nursing staff were delusions, aggression and nighttime disturbances. The overall frequency of BPSD increased from 67% in mild dementia, to 76% in moderate dementia and to 88% in severe dementia. The most frequent symptoms in patients without dementia were depression (19%), nighttime disturbances (13%) and irritability (13%). The most distressing symptoms were aggression and delusions, while the same symptoms were consistently rated as less distressing than in patients with dementia. Factor analysis revealed three independent groups of BPSD that explained 45% of the total variance. First, expansive symptoms (aggression, irritability, nighttime disturbances, aberrant motor behaviour and disinhibition) were frequent, distressing for nursing staff and associated with many complications. Second, psychotic symptoms (delusions and hallucinations) were infrequent, distressing and associated with some complications. Third, affective symptoms (apathy, anxiety and depression) were frequent, non-distressing and associated with few complications. The results did not change when cases with delirium were excluded from both groups. BPSD are common in older hospital patients with dementia and associated with considerable distress in nursing staff, as well as

Shared Psychotic Disorder (Folie à Deux in Turkey

Directory of Open Access Journals (Sweden)

Buket Cinemre

2009-09-01

Full Text Available Shared psychotic disorder or folie à deux is a rare and relatively unknown syndrome. Large case series are needed to find out and clarify the etiological factors and the phenomenology of shared psychotic disorder by comparing the cases from different society and cultures. In this study, we reviewed all reported cases of shared psychotic disorder that had been published or presented in Turkey since 1962. To reach this aim, we have searched Pubmed/Medline, ScienceDirect, Google Scholar, Ulakbim Turkish Medical Index, Turkish Psychiatric Index databases for published records originating from Turkey. We have also manually searched poster abstract books of congresses held in Turkey between 1962 and 2009. All cases eligible for inclusion into this study have been evaluated one by one and grouped as primary or secondary cases. The features of these cases were investigated for a number of variables including age, sex, educational level, occupation, the presence of shared delusion and hallucinations, diagnosis, management, onset of illness, family history, IQ, social isolation, the nature of the relationship and classification system used for diagnosis. The results have showed that the syndrome is more frequently observed among women, within same family members and between sisters. Social isolation was the most common risk factor in these patients and most patients shared hallucinations with their partners along with their delusions. Several secondary cases required antipsychotic drugs for the treatment of their symptoms. Though these features were inline with literature findings, the present findings from Turkish population were different from previous studies with regards to the presence of olfactory hallucinations, absence of grandiose delusions and the number of affected family members. The results mostly supported the challenges and discussions in western countries. To understand this most pathological form of interpersonal relationships

Effects of typical antipsychotic, haloperidol on regional cerebral blood flow in drug-naive schizophrenic patients-study with 99mTc-HMPAO SPECT

Energy Technology Data Exchange (ETDEWEB)

Kamoya, Masatoshi [Kanazawa Medical Univ., Ishikawa (Japan)

2001-03-01

For the purpose of examining antipsychotic action of haloperidol (HPD), effects of chronic perioral administration of HPD 4.5 mg/day on regional cerebral blood flow (rCBF) with 99mTc-HMPAO SPECT were investigated in 12 drug-naive schizophrenic patients with acute hallucinatory and delusional state. Further, the SPECT examinations were performed on 20 normal adult volunteers to investigate differences in rCBFs between schizophrenics and the normal subjects. Results are itemized as follows. The rCBF values were significantly increased in the bilateral superior and middle frontal, cingulate, middle temporal, pre-and post-central gyri, the left superior temporal gyrus, the bilateral inferior parietal lobule, and the bilateral hippocampal and thalamic cortices in comparison between normal subjects and before the HPD dose in schizophrenics. However, the rCBF values after the HPD dose showed significant increases only in the bilateral pre-and post-central gyri in comparison with the normal subjects. The rCBF values were significantly decreased in the bilateral superior, middle and inferior frontal, superior and middle temporal gyri, and the left insular gyrus after the HPD dose in comparison with before the HPD dose. The psychiatric assessment with PANSS showed an improvement of positive symptoms consisting of auditory hallucination and delusions after the HPD dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the HPD dose showed positive correlations between the right inferior frontal gyrus and auditory hallucination or positive symptoms, between the right superior temporal gyrus, left thalamus and delusions, and between the left thalamus, insular gyrus and negative symptoms. These results suggest that acute drug-naive schizophrenic patients have widespread cortico-subcortical energic hypermetabolism and HPD reduces the hypermetabolism, leading to whole normalized brain metabolism, in particular with the larger region

Parkinson's Disease Videos

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Full Text Available ... About Depression? CareMAP: Movimientos y Caídas, Parte 1 ¿Cuáles Son las Causas del Parkinson? ¿Existen Otros Trastornos que Tienen ... or Delusions? CareMAP: Plans and Scheduling: Part 1 ¿Cuáles son las diferentes formas y etapas del Parkinson? ¿Cómo es ...

Behavioral Experiments in the Treatment of Paranoid Schizophrenia: A Single Case Study

Science.gov (United States)

Hagen, Roger; Nordahl, Hans M.

2008-01-01

Since the first description of cognitive therapy of paranoid delusions appeared in the literature, the empirical support for cognitive behavioral therapy in treating psychotic symptoms has been widely established. The aim of the present case study is to show how the behavioral experiment can be used as a powerful tool to change delusional thinking…

Subclinical delusional ideation and appreciation of sample size and heterogeneity in statistical judgment.

Science.gov (United States)

Galbraith, Niall D; Manktelow, Ken I; Morris, Neil G

2010-11-01

Previous studies demonstrate that people high in delusional ideation exhibit a data-gathering bias on inductive reasoning tasks. The current study set out to investigate the factors that may underpin such a bias by examining healthy individuals, classified as either high or low scorers on the Peters et al. Delusions Inventory (PDI). More specifically, whether high PDI scorers have a relatively poor appreciation of sample size and heterogeneity when making statistical judgments. In Expt 1, high PDI scorers made higher probability estimates when generalizing from a sample of 1 with regard to the heterogeneous human property of obesity. In Expt 2, this effect was replicated and was also observed in relation to the heterogeneous property of aggression. The findings suggest that delusion-prone individuals are less appreciative of the importance of sample size when making statistical judgments about heterogeneous properties; this may underpin the data gathering bias observed in previous studies. There was some support for the hypothesis that threatening material would exacerbate high PDI scorers' indifference to sample size.

Using Co-Occurrence to Evaluate Belief Coherence in a Large Non Clinical Sample

Science.gov (United States)

Pechey, Rachel; Halligan, Peter

2012-01-01

Much of the recent neuropsychological literature on false beliefs (delusions) has tended to focus on individual or single beliefs, with few studies actually investigating the relationship or co-occurrence between different types of co-existing beliefs. Quine and Ullian proposed the hypothesis that our beliefs form an interconnected web in which the beliefs that make up that system must somehow “cohere” with one another and avoid cognitive dissonance. As such beliefs are unlikely to be encapsulated (i.e., exist in isolation from other beliefs). The aim of this preliminary study was to empirically evaluate the probability of belief co-occurrence as one indicator of coherence in a large sample of subjects involving three different thematic sets of beliefs (delusion-like, paranormal & religious, and societal/cultural). Results showed that the degree of belief co-endorsement between beliefs within thematic groupings was greater than random occurrence, lending support to Quine and Ullian’s coherentist account. Some associations, however, were relatively weak, providing for well-established examples of cognitive dissonance. PMID:23155383

Understanding Egorrhea from Cultural-Clinical Psychology

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Jun eSasaki

2013-11-01

Full Text Available Based on his observations in Japanese clinical settings, Fujinawa (1972 conceptualized egorrhea syndrome, which includes symptoms such as olfactory reference syndrome, fear of eye-to-eye confrontation, delusions of sleep talking, delusions of soliloquy, and thought broadcasting. The key feature of this syndrome is self-leakage, a perceived sense that one’s personal internal information, such as feelings and thoughts, are leaking out. To reach a more comprehensive understanding of egorrhea, this paper aims to present general overview and reconsider the phenomenon of self-leakage using cultural-clinical psychology as a framework. First, the symptoms of egorrhea are reviewed in relation to other related psychopathologies such as social anxiety disorder (SAD and taijin kyofusho (TKS, as well as schizophrenia. Second, a series of empirical studies conducted using Japanese non-clinical samples are summarized. The results of these studies form the basis for subsequent discussions, which incorporates the cultural-clinical psychology perspective proposed by Ryder, Ban, Chentsova-Dutton (2011. This paper ends with a general discussion regarding implications for research and clinical practice.

Overconfidence in psychosis: The foundation of delusional conviction?

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Ryan P. Balzan

2016-12-01

Full Text Available A number of recent studies have identified an “overconfidence effect” in psychosis, whereby people with schizophrenia are overconfident in errors while simultaneously slightly underconfident when accurate. This effect may have implications for why delusions, which are based on inaccurate inferences, perceptions and judgements, are typically held with high conviction. Given the importance the overconfidence effect may have in accounting for delusional conviction, the current narrative review aims to summarise and critique the recent evidence for the effect within schizophrenia. People with schizophrenia were consistently found to be overconfident in errors and slightly underconfident in correct appraisals, and this effect appears not to be an artefact of poor task performance. While the overconfidence effect has been linked to delusion-proneness in the general population, there was less direct evidence linking overconfidence to delusional symptoms in clinical populations. Future studies need to adopt longitudinal designs and include additional measures of overconfidence to investigate this association more appropriately, and to also investigate possible mediators of this postulated relationship, such as dopaminergic activity.

Schizophrenia: Impact of psychopathology, faith healers and psycho-education on adherence to medications.

Science.gov (United States)

Abdel Aziz, Karim; Elamin, Mohammed H; El-Saadouni, Nisrin M; El-Gabry, Dina Aly; Barakat, Mahmoud; Alhayyas, Fatima; Moselhy, Hamdy F

2016-12-01

Many patients suffering from psychosis are nonadherent to their medications. Nonadherence can range from treatment refusal to irregular use or partial change in daily medication doses. To investigate whether symptom dimensions, post-discharge care plans and being involved with faith healer affect the adherence to treatment in patients with schizophrenia. A total of 121 patients with schizophrenia were examined 6 weeks post-discharge from the inpatient unit and assessed for full, partial or nonadherence to medication. There was a significant association between family involvement and partial adherence and between community team involvement post-discharge and full adherence to medications. Psycho-education was a predictor for adherence to medications, persecutory delusions and lack of insight predicted partial adherence, while being involved with faith healers predicted nonadherence. Adherence to medications and socio-demographic variables are independent. This study demonstrated that nonadherence or partial adherence to medications is associated with lack of insight and persecutory delusions. Psycho-education could improve the adherence to medication compliances. © The Author(s) 2016.

Using co-occurrence to evaluate belief coherence in a large non clinical sample.

Directory of Open Access Journals (Sweden)

Rachel Pechey

Full Text Available Much of the recent neuropsychological literature on false beliefs (delusions has tended to focus on individual or single beliefs, with few studies actually investigating the relationship or co-occurrence between different types of co-existing beliefs. Quine and Ullian proposed the hypothesis that our beliefs form an interconnected web in which the beliefs that make up that system must somehow "cohere" with one another and avoid cognitive dissonance. As such beliefs are unlikely to be encapsulated (i.e., exist in isolation from other beliefs. The aim of this preliminary study was to empirically evaluate the probability of belief co-occurrence as one indicator of coherence in a large sample of subjects involving three different thematic sets of beliefs (delusion-like, paranormal & religious, and societal/cultural. Results showed that the degree of belief co-endorsement between beliefs within thematic groupings was greater than random occurrence, lending support to Quine and Ullian's coherentist account. Some associations, however, were relatively weak, providing for well-established examples of cognitive dissonance.

Insecure attachment is associated with paranoia but not hallucinations in psychotic patients: the mediating role of negative self-esteem.

Science.gov (United States)

Wickham, S; Sitko, K; Bentall, R P

2015-05-01

A growing body of research has investigated associations between insecure attachment styles and psychosis. However, despite good theoretical and epidemiological reasons for hypothesising that insecure attachment may be specifically implicated in paranoid delusions, few studies have considered the role it plays in specific symptoms. We examined the relationship between attachment style, paranoid beliefs and hallucinatory experiences in a sample of 176 people with a diagnosis of schizophrenia spectrum disorders and 113 healthy controls. We also investigated the possible role of negative self-esteem in mediating this association. Insecure attachment predicted paranoia but not hallucinations after co-morbidity between the symptoms was controlled for. Negative self-esteem partially mediated the association between attachment anxiety and clinical paranoia, and fully mediated the relationship between attachment avoidance and clinical paranoia. It may be fruitful to explore attachment representations in psychological treatments for paranoid patients. If future research confirms the importance of disrupted attachment as a risk factor for persecutory delusions, consideration might be given to how to protect vulnerable young people, for example those raised in children's homes.

Attribution bias and social anxiety in schizophrenia

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Amelie M. Achim

2016-06-01

Full Text Available Studies on attribution biases in schizophrenia have produced mixed results, whereas such biases have been more consistently reported in people with anxiety disorders. Anxiety comorbidities are frequent in schizophrenia, in particular social anxiety disorder, which could influence their patterns of attribution biases. The objective of the present study was thus to determine if individuals with schizophrenia and a comorbid social anxiety disorder (SZ+ show distinct attribution biases as compared with individuals with schizophrenia without social anxiety (SZ− and healthy controls. Attribution biases were assessed with the Internal, Personal, and Situational Attributions Questionnaire in 41 individual with schizophrenia and 41 healthy controls. Results revealed the lack of the normal externalizing bias in SZ+, whereas SZ− did not significantly differ from healthy controls on this dimension. The personalizing bias was not influenced by social anxiety but was in contrast linked with delusions, with a greater personalizing bias in individuals with current delusions. Future studies on attribution biases in schizophrenia should carefully document symptom presentation, including social anxiety.

Cotard syndrome with catatonia: unique combination.

Science.gov (United States)

Basu, Aniruddha; Singh, Priti; Gupta, Rajiv; Soni, Sandeep

2013-07-01

Cotard syndrome is a rare psychiatric condition characterized by extreme nihilistic delusions. Catatonia though common, its combination with the Cotard syndrome is exceeding rare and more so the response with the pharmacotherapy as in our case. Since, both are found in organic conditions the importance of studying such a case is to understand the underlying neurobiologic determinants.

Cotard Syndrome with Catatonia: Unique Combination

OpenAIRE

Basu, Aniruddha; Singh, Priti; Gupta, Rajiv; Soni, Sandeep

2013-01-01

Cotard syndrome is a rare psychiatric condition characterized by extreme nihilistic delusions. Catatonia though common, its combination with the Cotard syndrome is exceeding rare and more so the response with the pharmacotherapy as in our case. Since, both are found in organic conditions the importance of studying such a case is to understand the underlying neurobiologic determinants.

Research: Rags to Rags? Riches to Riches?

Science.gov (United States)

Bracey, Gerald W.

2004-01-01

Everyone has read about what might be called the "gold gap"--how the rich in this country are getting richer and controlling an ever-larger share of the nation's wealth. The Century Foundation has started publishing "Reality Check", a series of guides to campaign issues that sometimes finds gaps in these types of cherished delusions. The guides…

MYSTICISM AND MENTAL HEALTH : A CRITICAL DIALOGUE

African Journals Online (AJOL)

2010-04-12

Apr 12, 2010 ... Patients and physicians have begun to realize the value of ... health and quality of life has led to research in this field in an attempt to ... has caught both social scientists and religious leaders by surprise, albeit for ... self-delusion at best, or a form of uncritical superstition at worst, issues of authority arise.

[The clinico-psychopathological differentiation of schizoaffective psychoses with a predominance of affective disorders].

Science.gov (United States)

Korenev, A N

1994-01-01

Basing on the clinico-psychopathological analysis of 43 patients with an affect-dominant form of schizoaffective psychosis, their typological division has been suggested. The interrelations of clinical types of delusional disturbances with affective disorders, their polarity, congruent and noncongruent delusions were shown. The discussion covers differential-diagnostic characteristics of affective states in schizoaffective and affective psychoses.

Browse Title Index

African Journals Online (AJOL)

Issue, Title. Vol 13, No 2 (2013), Using Mindfulness as a Teaching Aid for Phenomenology, Abstract PDF. IR Owen. Vol 8, No 1 (2008), Were Nietzsche's Cardinal Ideas – Delusions? Abstract PDF. Eva M Cybulska. Vol 12, No 1 (2012), What did you learn in school today? Abstract PDF. Carina Henriksson. Vol 5, No 1 (2005) ...

Catecholamine-based treatment in AD patients: Expectations and delusions

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Alessandro eStefani

2015-05-01

Full Text Available In Alzheimer disease, the gap between excellence of diagnostics and efficacy of therapy is wide. Despite sophisticated imaging and biochemical markers, the efficacy of available therapeutic options is limited.Here we examine the possibility that assessment of endogenous catecholamine levels in cerebrospinal fluid (CSF may fuel new therapeutic strategies.In reviewing the available literature, we consider the effects of levodopa, monoamine oxidase inhibitors (MAOI, and noradraneline (NE modulators, showing disparate results. We present a preliminary assessment of CSF concentrations of dopamine (DA and NE, determined by HPLC, in a small dementia cohort of either Alzheimer’s disease (AD or frontotemporal dementia (FTD patients, compared to control subjects. Our data reveal detectable levels of DA, NE in CSF, though we found no significant alterations in the dementia population as a whole. AD patients exhibit a small impairment of the DA axis and a larger increase of NE concentration, likely to represent a compensatory mechanism.While waiting for preventive strategies, a pragmatic approach to AD may re-evaluate catecholamine modulation, possibly stratified to dementia subtypes, as part of the therapeutic armamentarium.

What is bizarre in bizarre delusions? A critical review

DEFF Research Database (Denmark)

Cermolacce, Michel René Joseph; Jensen, Lars Meldgaard Sass; Parnas, J

2010-01-01

or incomprehensible. Then, we provide a critical review of contemporary studies on the reliability of BD and their methodological and conceptual limitations. Current approaches have focused intensely on BD's reliability and have defined BD strictly in terms of delusional content--mainly in terms of the physical...... to delusional contents alone and requires taking into account the subjective side of BD (how altered experience manifests itself) as well as the conditions of intersubjective encounter (how BD are expressed to and experienced by the clinician). The notion of "bizarreness" in schizophrenia is not purely...

Illusion or delusion--Lean management in the health sector.

Science.gov (United States)

McIntosh, Bryan; Sheppy, Bruce; Cohen, Ivan

2014-01-01

There has been considerable interest in the implementation of practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach that has attracted particular interest is Lean management and the purpose of this paper is to engage with this topic. Secondary research. Despite widespread enthusiasm about the potential of Lean management processes, evidence about its contribution to higher organisational performance remains inconsistent. This paper engages with the major Lean concepts of operations management and human resource management, including just-in-time, total quality management, total productive maintenance and does not engage in-depth with concepts related to employee empowerment, and training This paper contributes to the organisational management literature in healthcare by showing that although Lean management seems to have the potential to improve organisational performance it is far from a panacea against under performing hospitals. It informs policy making by suggesting that a progressive managerial philosophy has a stronger impact on healthcare performance than the adoption of practices from any particular managerial approach. This paper provides a critical evaluation of the impact of Lean practices in informing healthcare policy. The paper contributes to the organisational management literature in healthcare by showing that even though Lean management in healthcare appears to have the potential to improve organisational performance; there remain problems with its application.

What is bizarre in bizarre delusions? A critical review

DEFF Research Database (Denmark)

Cermolacce, Michel René Joseph; Jensen, Lars Meldgaard Sass; Parnas, J

2010-01-01

. These studies provide highly heterogenous results because they are based on different experimental paradigms, in terms of definition, clinical sample, and number of raters. Here, we first discuss the psychopathological sources of the concept of BD, which were initially described as either nonsensical...... or incomprehensible. Then, we provide a critical review of contemporary studies on the reliability of BD and their methodological and conceptual limitations. Current approaches have focused intensely on BD's reliability and have defined BD strictly in terms of delusional content--mainly in terms of the physical...... impossibility or the cultural or historical incomprehensibility of the delusional claims. These approaches have neglected formal features of experience that underlie BD and the crucial issue of the nature and validity of BD. In the discussion, we argue that clinical diagnosis of BD cannot be limited...

Symptomatology and social inference: a theory of mind study of schizophrenia and psychotic affective disorder.

Science.gov (United States)

Marjoram, Dominic; Gardner, Clare; Burns, Jonathan; Miller, Patrick; Lawrie, Stephen M; Johnstone, Eve C

2005-11-01

There is evidence that certain patients with schizophrenia have deficits in theory of mind (ToM) capabilities. It is, however, unclear whether these are symptom or diagnosis-specific. A ToM hinting task was given to 15 patients with a DSM-IV diagnosis of schizophrenia, 15 patients with affective disorder and 15 healthy controls. Severity of the current psychopathology was measured using the Krawiecka standardised scale of psychotic symptoms (Krawiecka, Goldberg, & Vaughan, 1977); IQ was estimated via the Ammons and Ammons Quick Test (Ammons & Ammons, 1962). The group with schizophrenia performed significantly worse than the affective and control groups. Poor performance on the hinting task was found to be significantly related to the presence of positive symptoms (instead of negative ones) and specifically related to delusions and hallucinations. These findings remained when covariance for potentially confounding variables was applied. Individuals with high levels of delusions and hallucinations performed significantly worse on this ToM task, regardless of diagnosis, implying ToM impairment is not exclusive to schizophrenia but is evident in other forms of psychosis. Between-group analyses showed the schizophrenia group had a significantly poorer performance on this task than the others.

The Structure of The Extended Psychosis Phenotype in Early Adolescence—A Cross-sample Replication

Science.gov (United States)

Wigman, Johanna T. W.; Vollebergh, Wilma A. M.; Raaijmakers, Quinten A. W.; Iedema, Jurjen; van Dorsselaer, Saskia; Ormel, Johan; Verhulst, Frank C.; van Os, Jim

2011-01-01

The extended psychosis phenotype, or the expression of nonclinical positive psychotic experiences, is already prevalent in adolescence and has a dose-response risk relationship with later psychotic disorder. In 2 large adolescent general population samples (n = 5422 and n = 2230), prevalence and structure of the extended psychosis phenotype was investigated. Positive psychotic experiences, broadly defined, were reported by the majority of adolescents. Exploratory analysis with Structural Equation Modelling (Exploratory Factor Analysis followed by Confirmatory Factor Analysis [CFA]) in sample 1 suggested that psychotic experiences were best represented by 5 underlying dimensions; CFA in sample 2 provided a replication of this model. Dimensions were labeled Hallucinations, Delusions, Paranoia, Grandiosity, and Paranormal beliefs. Prevalences differed strongly, Hallucinations having the lowest and Paranoia having the highest rates. Girls reported more experiences on all dimensions, except Grandiosity, and from age 12 to 16 years rates increased. Hallucinations, Delusions, and Paranoia, but not Grandiosity and Paranormal beliefs, were associated with distress and general measures of psychopathology. Thus, only some of the dimensions of the extended psychosis phenotype in young people may represent a continuum with more severe psychopathology and predict later psychiatric disorder. PMID:20044595

A Theory of Mind investigation into the appreciation of visual jokes in schizophrenia

Directory of Open Access Journals (Sweden)

Owens David

2005-02-01

Full Text Available Abstract Background There is evidence that groups of people with schizophrenia have deficits in Theory of Mind (ToM capabilities. Previous studies have found these to be linked to psychotic symptoms (or psychotic symptom severity particularly the presence of delusions and hallucinations. Methods A visual joke ToM paradigm was employed where subjects were asked to describe two types of cartoon images, those of a purely Physical nature and those requiring inferences of mental states for interpretation, and to grade them for humour and difficulty. Twenty individuals with a DSM-lV diagnosis of schizophrenia and 20 healthy matched controls were studied. Severity of current psychopathology was measured using the Krawiecka standardized scale of psychotic symptoms. IQ was estimated using the Ammons and Ammons quick test. Results Individuals with schizophrenia performed significantly worse than controls in both conditions, this difference being most marked in the ToM condition. No relationship was found for poor ToM performance and psychotic positive symptomatology, specifically delusions and hallucinations. Conclusion There was evidence for a compromised ToM capability in the schizophrenia group on this visual joke task. In this instance this could not be linked to particular symptomatology.

Testing the continuum of delusional beliefs: an experimental study using virtual reality.

Science.gov (United States)

Freeman, Daniel; Pugh, Katherine; Vorontsova, Natasha; Antley, Angus; Slater, Mel

2010-02-01

A key problem in studying a hypothesized spectrum of severity of delusional ideation is determining that ideas are unfounded. The first objective was to use virtual reality to validate groups of individuals with low, moderate, and high levels of unfounded persecutory ideation. The second objective was to investigate, drawing upon a cognitive model of persecutory delusions, whether clinical and nonclinical paranoia are associated with similar causal factors. Three groups (low paranoia, high nonclinical paranoia, persecutory delusions) of 30 participants were recruited. Levels of paranoia were tested using virtual reality. The groups were compared on assessments of anxiety, worry, interpersonal sensitivity, depression, anomalous perceptual experiences, reasoning, and history of traumatic events. Virtual reality was found to cause no side effects. Persecutory ideation in virtual reality significantly differed across the groups. For the clear majority of the theoretical factors there were dose-response relationships with levels of paranoia. This is consistent with the idea of a spectrum of paranoia in the general population. Persecutory ideation is clearly present outside of clinical groups and there is consistency across the paranoia spectrum in associations with important theoretical variables.

A Dementia Case Presenting with Psychotic Symptoms

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Osman Ozdemir

2013-06-01

Full Text Available Dementia is a progressive clinical syndrome in which affected areas of brain function may be affected, such as memory, language, abstract thinking, problem solving and attention. Psychotic symptoms include auditory and visual hallucinations and delusions, which usually occur in the dementia. In this paper, a dementia case presenting with psychotic symptoms is presented. [Cukurova Med J 2013; 38(3.000: 482-486

Inductive Reasoning in Patients with Paranoid Type Schizophrenia

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Mehmet Emrah Karadere

2017-08-01

According to this study apart from the area of delusions, it can be say that the reasoning of the patients is normal. Our study indicates that when the delusional patients are compared to the control group in terms of jumping to conclusion and modifying their initial beliefs, they are not different when given similarly sufficient amount of data. [JCBPR 2017; 6(2.000: 67-74

Cerebral correlates of psychotic syndromes in neurodegenerative diseases

OpenAIRE

Jellinger, Kurt A

2012-01-01

Abstract Psychosis has been recognized as a common feature in neurodegenerative diseases and a core feature of dementia that worsens most clinical courses. It includes hallucinations, delusions including paranoia, aggressive behaviour, apathy and other psychotic phenomena that occur in a wide range of degenerative disorders including Alzheimer?s disease, synucleinopathies (Parkinson?s disease, dementia with Lewy bodies), Huntington?s disease, frontotemporal degenerations, motoneuron and prion...

Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosis

OpenAIRE

Romm, Lie K; Ivar Rossberg, Jan; Fredslund Hansen, Charlotte; Haug, Elisabeth; Andreassen, Ole A; Melle, Ingrid

2011-01-01

Background Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. The main aims of the study were to examine whether premorbid adjustment has an impact on the subject's self-esteem, and whether lowered self-esteem contributes to the development of delusions and hallucinations. Method A total of 113 patients from the Thematically Organized Psychosis...

Delusional parasitosis with hyperthyroidism in an elderly woman: a case report

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Ozten Eylem

2013-01-01

Full Text Available Abstract Introduction Delusional parasitosis is a rare, monosymptomatic psychosis involving a delusion of being infested with parasites. It is commonly observed among female patients over the age of 50. It is classified as a ‘delusional disorder’ according to the 10th revision of the International Classification of Diseases and as a ‘delusional disorder - somatic type’ according to the Diagnostic and Statistical Manual, Fourth Edition. Delusional parasitosis was reported to be associated with physical disorders such as hypoparathyroidism, Huntington’s chorea and Alzheimer’s disease, among others. Other than vitamin deficiencies however, a causal relationship has not to date been identified. We present this case due to the rarity of Turkish patients with this condition, its duration of follow-up, and its temporal pattern of symptoms paralleling thyroid function tests. Case presentation Our patient was a 70-year-old white Anatolian Turkish woman with primary school education who had been living alone for the past five years. She presented to our psychiatry department complaining of ‘feeling large worms moving in her body’. The complaints started after she was diagnosed with hyperthyroidism, increased when she did not use her thyroid medications and remitted when she was compliant with treatment. She was treated with pimozide 2mg/day for 20 months and followed-up without any antipsychotic treatment for an additional nine months. At her last examination, she was euthyroid, not receiving antipsychotics and was not having any delusions. Conclusion Although endocrine disorders, including hyperthyroidism, are listed among the etiological factors contributing to secondary delusional parasitosis, as far as we are aware this is the first case demonstrating a temporal pattern of thyroid hyperfunction and delusions through a protracted period of follow-up. It may be that the treatment of delusional parasitosis depends on clarifying the

Management of non-motor complications in Parkinson's disease.

Science.gov (United States)

Fujimoto, Ken-ichi

2009-08-01

This paper summarizes the methods we devised for the treatment of psychosis, orthostatic hypotension, and mood disorders among the various non-motor complications of Parkinson's disease. Psychosis may not manifest when a patient believes in his/her delusions. If left untreated over a prolonged period, however, the delusions progress to paranoia that is very difficult to cure. Accordingly, enquiries should be made during routine examinations to detect the presence of psychosis and facilitate early discovery. Atypical antipsychotics are used when psychosis does not improve after reducing the doses of antiparkinson drugs. We achieved favorable results by using mianserin hydrochloride prior to this step, with efficacy being observed for hallucinations and mild delusions that often manifested at night. This drug does not act as a dopamine receptor blocker, so it has the advantage of not aggravating motor symptoms. With this therapy, it is also possible to improve motor symptoms without inducing psychosis by reducing the doses of antiparkinson drugs and locally stimulating the motor loop by deep brain stimulation of the subthalamic nucleus. We previously introduced leg-holding exercises for the treatment of orthostatic hypotension, through which blood pooled in the veins is returned to the systemic circulation by holding the knees. This can be done easily and is free of adverse reactions. Mood disorders are difficult to cope with in patients with Parkinson's disease, but may be treated by selecting an appropriate dopamine agonist while giving consideration to affinity for the dopamine D3 receptor. However, treatment becomes complicated when the dopamine receptor is overstimulated. Here we report on cases of successfully treated pathological gambling and dopamine dysregulation syndrome, which are considered difficult to manage. The solution may differ depending on a patient's environment, and it is not easy to prescribe therapy based on evidence-based medicine. The best

Common psychotic symptoms can be explained by the theory of ecological perception.

Science.gov (United States)

Golembiewski, Jan Alexander

2012-01-01

The symptoms of psychiatric illness are diverse, as are the causes of the conditions that cause them. Yet, regardless of the heterogeneity of cause and presentation, a great deal of symptoms can be explained by the failure of a single perceptual function--the reprocessing of ecological perception. It is a central tenet of the ecological theory of perception that we perceive opportunities to act. It has also been found that perception automatically causes actions and thoughts to occur unless this primary action pathway is inhibited. Inhibition allows perceptions to be reprocessed into more appropriate alternative actions and thoughts. Reprocessing of this kind takes place over the entire frontal lobe and it renders action optional. Choice about what action to take (if any) is the basis for the feeling of autonomy and ultimately for the sense-of-self. When thoughts and actions occur automatically (without choice) they appear to originate outside of the self, thereby providing prima facie evidence for some of the bizarre delusions that define schizophrenia such as delusional misidentification, delusions of control and Cotard's delusion. Automatic actions and thoughts are triggered by residual stimulation whenever reprocessing is insufficient to balance automatic excitatory cues (for whatever reason). These may not be noticed if they are neutral and therefore unimportant or where actions and thoughts have a positive bias and are desirable. Responses to negative stimulus, on the other hand, are always unwelcome, because the actions that are triggered will carry the negative bias. Automatic thoughts may include spontaneous positive feelings of love and joy, but automatic negative thoughts and visualisations are experienced as hallucinations. Not only do these feel like they emerge from elsewhere but they carry a negative bias (they are most commonly critical, rude and are irrationally paranoid). Automatic positive actions may include laughter and smiling and these are

Psychosis in dengue fever

OpenAIRE

Suprakash Chaudhury; Biswajit Jagtap; Deepak Kumar Ghosh

2017-01-01

An 18-year-old male student developed abnormal behavior while undergoing treatment for dengue fever. He was ill-kempt, irritable and had auditory and visual hallucinations and vague persecutory delusions in clear sensorium with impaired insight. The psychotic episode had a temporal correlation with dengue fever. Psychiatric comorbidities of dengue fever including mania, anxiety, depression, and catatonia are mentioned in literature but the literature on the psychosis following dengue is spars...

Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient.

OpenAIRE

Morgado, P; Ribeiro, R; Cerqueira, JJ

2015-01-01

Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient Introduction . Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method . We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Res...

Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies.

LENUS (Irish Health Repository)

Kelleher, Ian

2012-07-01

Epidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.

The Effects of Psychodrama and Cognitive Behavioral Therapy-Based Group Work on Test Anxiety

Directory of Open Access Journals (Sweden)

Necla Taspinar Goveci

2017-04-01

In the analyses relating to comparison; in terms of total exam anxiety, perception, delusion sublevel and trait anxiety points of the students, psychodrama techniques applied in the first group have been more affective with reference to the cognitive behavioral techniques applied in the second group. No meaningful difference has been detected when two experimental groups have been compared according to continuity anxiety points. [JCBPR 2017; 6(1.000: 22-30

Reversible dementia with psychosis: Hashimoto's encephalopathy.

Science.gov (United States)

Mocellin, Ramon; Lubman, Dan I; Lloyd, John; Tomlinson, E Bruce; Velakoulis, Dennis

2006-12-01

A case of presumed Hashimoto's encephalopathy (HE) is presented. The presentation included memory loss, delusions, functional decline and culminated in a generalized seizure. Anti-thyroid antibodies were detected and symptoms resolved with prednisolone. Patients with HE may present with prominent neuropsychiatric symptoms, attract psychiatric diagnoses and present to psychiatric services. Primarily a diagnosis of exclusion, HE should be considered in cases of encephalopathy in which standard investigations are negative.

Dreams as a source of supernatural agent concepts

OpenAIRE

McNamara, Patrick; Bulkeley, Kelly

2015-01-01

We present a theory of the creativity of dreams as well as psychopathology of religious delusions with respect to production of fundamental forms of religious cognition—specifically supernatural agent (SA) cognitions. We suggest that dream cognitions are particularly efficient at producing highly memorable and impactful experiences with SAs because dreams involve three processes that are prerequisites for the generation of god concepts: (1) mental simulations of alternative realities, (2) the...

["I am but mad north-north-west"--Hamlet's portrayed delusion].

Science.gov (United States)

Schulte Herbrüggen, H

1996-01-01

Whereas science refers to the real world existing independently and conditioned by cause and effect, the world of literature is fictitious, created by the artist in our imagination by means of language, an artefact conditioned by aesthetic laws, a world sui generis. Accordingly, Hamlet is no person, but a literary figure, doing, saying, thinking and feeling only what the poet dictated him word for word. The essential difference between the two worlds is often overlooked. That "blind spot" has a long-standing tradition in European intellectual history and goes back i.a. to the German "Hamlet experience" in the eighteenth, the "Hamlet fever" and the felt spiritual kinship (Seelenverwandtschaft) in the nineteenth century. Teleological literary criticism, centering around Hamlet's "character" and isolating his psychologically evaluated monologues (e.g. Bradley), refrained from Hamlet's fictionality and role-play and led to blurring beyond recognition the boundaries between real person and literary figure (e.g. Freud, Jones) and assisted in reducing a dramatic role to a medical case history. Speaking of Hamlet, one has to start from Shakespeare's text, our subject matter. A dramatic play being a plot turned into dialogue, the poet's vocabulary used (but indirectly also the vocabulary not used) is particularly informative. When referring to Hamlet's "antic disposition", Shakespeare uses a wide range of over 20 different terms, the most frequented being mad/madness (44 times). Evidence of primary importance are the five occasions after the apparition of his father's ghost, when Hamlet speaks of hist "madness" as an assumed role. In Act I "madness occurs first as a mere possibility when Hamlet informs his friends, he might "put an antic disposition on"; in Act II vis-a-vis Rosencrantz and Guildenstern ("I am but mad north-north-west") it is his deliberate action under certain conditions; in Act III it occurs thrice, first in his declaration of intent ("They are coming to the play, I must be idle" (i.e. "mad"), next in answering the king ("I fare of the chamaeleon's dish"), and once again in a particularly explicit distinction for his mother ("I am essentially not in madness, but mad in craft"). The evidence of all other instances of mad/madness represented here corroborates these findings: madness as an adopted role and not as a character trait. - It should also be noted that Shakespeare's main source (Belleforests adaptation of the Amleth-story from Saxo Grammaticus) already knew of the motive of stimulated madness as a cover for revenge. Hamlet assumes the role of a "madman" in order to have full scope for action, first, to test by help of the "play in the play" the truth of his father's apparition as a ghost demanding revenge as well as the actual guilt of Claudius and, when that is established, for preparing and executing his revenge. By acting himself, Hamlet becomes guilty and (Shakespeare having chosen the dramatic genre of tragedy) pays for his success with his life. Considering the constant border-crossings between the spheres of real persons and fictive literary figures in psychological approaches to Hamlet, we stressed the essential difference of a literary work of art from real life. At the same time, the inherent limitations of that difference must be shown as well. Although the world of belles lettres is fictive and non-existent in reality, it does not play in a vacuum. It is fed, in many ways, by the poet's experience of his own days as well as by the work's position within the realm of literary tradition (genre, sources, etc.). It is perhaps easy, to insist on the self-contained nature of literature, making literary criticism an arcane activity of a few elected professionals. The price to pay would be, as Laurence Lerner points out, that great literature will no longer tell us anything about life, and the poet's subtle insights, his wisdom, his understanding of the soul and of the world cease to enrich the general read

Delusions and Responsibility for Action: Insights from the Breivik Case.

Science.gov (United States)

Bortolotti, Lisa; Broome, Matthew R; Mameli, Matteo

2014-01-01

What factors should be taken into account when attributing criminal responsibility to perpetrators of severe crimes? We discuss the Breivik case, and the considerations which led to holding Breivik accountable for his criminal acts. We put some pressure on the view that experiencing certain psychiatric symptoms or receiving a certain psychiatric diagnosis is sufficient to establish criminal insanity. We also argue that the presence of delusional beliefs, often regarded as a key factor in determining responsibility, is neither necessary nor sufficient for criminal insanity.

Kyrle’s Disease in a Patient with Delusions of Parasitosis

Directory of Open Access Journals (Sweden)

Tampa M.

2016-03-01

Full Text Available Acquired perforating disorders are a group of uncommon skin conditions characterized by transepidermal extrusion of altered dermal material, most often associated with diabetes mellitus and chronic kidney failure. Delusional parasitosis is a primary psychiatric disorder in which affected patients have fixed, false beliefs that their skin is infested by parasites, in the absence of any evidence supporting their statements.

Dostoyevski and Don Quijote: Poetics and Aesthetics of a Delusion

Directory of Open Access Journals (Sweden)

Tamara Djermanovic

2015-12-01

Full Text Available In Fedor Mikhailovich Dostoevsky’s body of work (1821-1881 one can find more than thirty references to Don Quixote; while some of them allude to the novel of Don Quixote itself, other ones refer to Cervantes’ hero as an archetypal figure. Since decades ago, the Russian literary criticism has been interested in the Russian quixotism – including Dostoevsky’s work – and important studies on this subject have been published recently. This study follows Dostoevsky’s references on La Mancha’s Knight as an independent figure of Cervantes’ novel, and the different symbolism Don Quixote’s figure has had in both Russian people and Russian intelligentsia.

Application of molecular markers in wheat breeding: Reality or delusion?

Directory of Open Access Journals (Sweden)

Kobiljski Borislav

2004-01-01

Full Text Available Conventional plant breeding use morphological and phenotypic markers for the identification of important agronomic traits. Plant breeders and scientists continuously seek to develop new techniques, which can be used for faster and more accurate introgression of desirable traits into plants. Over the last several years there has been significant increase in the application of molecular markers in the breeding programmes of different species. So far, detected level of polymorphism and informatitivnes of different molecular marker methods applied in MAS (Marker Assisted Selection studies (RFLP, AFLP, etc. were insufficient either to validate their further use or there were very expensive and of huge healthy risk. Fortunately for wheat (and other crops breeders, the new class of molecular markers - microsatellites have prove recently to be most powerful for MAS. But, due to lack of the knowledge, experience, valid informations and even tradition and habits, many breeders have either negative or repulsive attitude towards implementation of MAS in breeding programes. In this paper the relevant facts regarding implementation of MAS in breeding are discussed in general, and for wheat breeding in particular, in order to summarize merits and limitations in application of microsatellites in MAS selection. .

Delusions of Liberty: Rethinking Democracy Promotion in American Grand Strategy

Science.gov (United States)

2016-06-01

scenarios in which cooperating with autocratic regimes serve American 2 The White House, (2015...individual leaders for removal but leave the underlying political institutions of a regime intact, democratization is unlikely to occur, even if conditions...within autocratic regimes located in the Middle East (where America has already experimented with democracy promotion within a formerly autocratic

Confabulations: a conceptual history.

Science.gov (United States)

Berrios, G E

1998-12-01

Confabulations are inaccurate or false narratives purporting to convey information about world or self. It is the received view that they are uttered by subjects intent on "covering up" for a putative memory deficit. The epidemiology of confabulations is unknown. Speculated causes include amnesia, embarrassment, "frontal lobe" damage, a subtype of "personality", a dream-like event, and a disturbance of the self. Historical analysis shows that "confabulation" was constructed at the turn of the century as part of a network of concepts (e.g. delusion, fixed idea, etc.) meant to capture narratives with dubious content. This paper deals with the history of the construction of the word and concept of confabulation and with earlier recognitions of the behaviours that serve as their referent and puts forward a model based on historical data. Two phenomena are included under "confabulation": "untrue" utterances by subjects with memory impairment and "fantastic" utterances marshalled with conviction by subjects suffering from psychoses and no memory deficit. Under different disguises, the "covering up" or "gap filling" hypothesis is still going strong. Although superficially plausible, it poses problems in regards to the issue of "awareness of purpose": if full awareness is presumed then the semantics of the concept of "purpose" is severely stretched and confabulations cannot be differentiated from delusions.

[The Cotard syndrome in schizophrenic disorders].

Science.gov (United States)

Stompe, Thomas; Schanda, Hans

2013-01-01

The Cotard-Syndrome (CS), the belief of being dead, was described for the first time in 1880. Since then it met the interest not only of psychopathologists but also of philosophers. With a few exceptions, the literature is mainly restricted to case reports of anxious-depressive, demented or paranoid patients. It was the aim of our study to investigate the prevalence and the psychopathological context of the CS. We analyzed the Austrian data (N = 346) of the International Study of Psychotic Symptoms in Schizophrenia. A CS could be diagnosed in three cases (0.87%). In all of them, CS developed on the basis of nihilistic-hypochondriac delusions and a progressive loss of energy. Two patients bridged the logical inconsistencies between obviously being alive and the belief of being dead by visual illusions, the third patient, however, by locating himself in an intermediate region between this world and the afterworld. On the one hand the CS can be considered as a special manifestation of the topic of death in schizophrenic delusions, on the other as a nihilistic delusional identity. Without doubt, this uncommon and bizarre psychotic phenomenon will be an object of interest for general psychopathology as well as for the philosophy of mind also in future.

Ever-present threats from information technology: the Cyber-Paranoia and Fear Scale

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Oliver John Mason

2014-11-01

Full Text Available Delusions involving technology, and specifically the internet, are increasingly common, and fear-reality statistics suggest computer-related fears are very widespread. These fears form a continuum from the widely understandable and realistic to the unrealistic, and frankly paranoid. The present study investigated the validity of this construct in a non-clinical population by constructing a novel self-report measure. The new Cyber-Paranoia and Fear Scale aims to measure the perception of information technology-related threats originating from or enabled by computers, smartphones, social networks and digital surveillance. Psychometric properties of the new Cyber-Paranoia and Fear Scale are reported alongside an established measure of suspiciousness and paranoia in 181 participants including a sub-group of fifty information technology professionals. Exploratory factor analysis suggested the presence of two, related, dimensions that we term Cyber-Fear and Cyber-Paranoia. Both sub-scales were internally consistent and produced a normal distribution of scores. The relationships of the sub-scales with age, gender, trait paranoia, digital literacy and digital inclusion are supportive of construct validity. The distinctiveness of ‘cyber-paranoia’ from general trait paranoia appears to mirror the clinical distinctiveness of ‘internet’ and other technology fuelled delusions. Knowledge provision to increase technological proficiency and awareness may bring about a reduction in cyber-paranoia.

Ever-present threats from information technology: the Cyber-Paranoia and Fear Scale.

Science.gov (United States)

Mason, Oliver J; Stevenson, Caroline; Freedman, Fleur

2014-01-01

Delusions involving technology, and specifically the internet, are increasingly common, and fear-reality statistics suggest computer-related fears are very widespread. These fears form a continuum from the widely understandable and realistic to the unrealistic, and frankly paranoid. The present study investigated the validity of this construct in a non-clinical population by constructing a novel self-report measure. The new Cyber-Paranoia and Fear Scale aims to measure the perception of information technology-related threats originating from or enabled by computers, smartphones, social networks, and digital surveillance. Psychometric properties of the new Cyber-Paranoia and Fear Scale are reported alongside an established measure of suspiciousness and paranoia in 181 participants including a sub-group of fifty information technology professionals. Exploratory factor analysis suggested the presence of two, related, dimensions that we term cyber-paranoia and cyber-fear. Both sub-scales were internally consistent and produced a normal distribution of scores. The relationships of the sub-scales with age, gender, trait paranoia, digital literacy, and digital inclusion are supportive of construct validity. The distinctiveness of 'cyber-paranoia' from general trait paranoia appears to mirror the clinical distinctiveness of 'internet' and other technology-fuelled delusions. Knowledge provision to increase technological proficiency and awareness may bring about a reduction in cyber-paranoia.

I spy with my little eye - the detection of intentional contingency in early psychosis.

Science.gov (United States)

Fett, Anne-Kathrin J; González Berdugo, Clara Isabel; Hanssen, Esther; Lemmers-Jansen, Imke; Shergill, Sukhi S; Krabbendam, Lydia

2015-01-01

Paranoid delusions have been associated with a tendency to over-attribute intentionality and contingency to others' actions and incidental events in individuals with chronic psychosis. However, this hyper-associative perception bias has not been investigated in the early illness stages of psychosis, during which it may play a particularly crucial role in the formation of symptoms. We used an experimental paradigm with 20 short film clips of simple animate and inanimate shapes that either moved in a contingent or non-contingent manner to investigate the perception of contingency in 38 adolescents with early psychosis and 93 healthy control adolescents. Participants rated the contingency between the shapes' movements on a scale from 0 to 10. The data were analysed with multilevel regression analyses to account for repeated measures within subjects. There were no significant differences between patients and controls; both perceived the contingency of the shapes' movements similarly across all conditions and patients' contingency perception was unrelated to their levels of paranoid delusions. Contingency perception was unimpaired in patients with early psychosis, suggesting that it might still be intact in the early illness stages. Future studies should set out to determine whether the early illness stages could offer a window for interventions that counteract the development of hyper-associative perceptions of contingency.

Severe Psychosis, Drug Dependence, and Hepatitis C Related to Slamming Mephedrone

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Helen Dolengevich-Segal

2016-01-01

Full Text Available Background. Synthetic cathinones (SCs, also known as “bath salts,” are β-ketone amphetamine compounds derived from cathinone, a psychoactive substance found in Catha edulis. Mephedrone is the most representative SC. Slamming is the term used for the intravenous injection of these substances in the context of chemsex parties, in order to enhance sex experiences. Using IV mephedrone may lead to diverse medical and psychiatric complications like psychosis, aggressive behavior, and suicide ideation. Case. We report the case of a 25-year-old man admitted into a psychiatric unit, presenting with psychotic symptoms after slamming mephedrone almost every weekend for the last 4 months. He presents paranoid delusions, intense anxiety, and visual and kinesthetic hallucinations. He also shows intense craving, compulsive drug use, general malaise, and weakness. After four weeks of admission and antipsychotic treatment, delusions completely disappear. The patient is reinfected with hepatitis C. Discussion. Psychiatric and medical conditions related to chemsex and slamming have been reported in several European cities, but not in Spain. Psychotic symptoms have been associated with mephedrone and other SCs’ consumption, with the IV route being prone to produce more severe symptomatology and addictive conducts. In the case we report, paranoid psychosis, addiction, and medical complications are described.

Severe Psychosis, Drug Dependence, and Hepatitis C Related to Slamming Mephedrone

Science.gov (United States)

Rodríguez-Salgado, Beatriz; Sánchez-Mateos, Daniel

2016-01-01

Background. Synthetic cathinones (SCs), also known as “bath salts,” are β-ketone amphetamine compounds derived from cathinone, a psychoactive substance found in Catha edulis. Mephedrone is the most representative SC. Slamming is the term used for the intravenous injection of these substances in the context of chemsex parties, in order to enhance sex experiences. Using IV mephedrone may lead to diverse medical and psychiatric complications like psychosis, aggressive behavior, and suicide ideation. Case. We report the case of a 25-year-old man admitted into a psychiatric unit, presenting with psychotic symptoms after slamming mephedrone almost every weekend for the last 4 months. He presents paranoid delusions, intense anxiety, and visual and kinesthetic hallucinations. He also shows intense craving, compulsive drug use, general malaise, and weakness. After four weeks of admission and antipsychotic treatment, delusions completely disappear. The patient is reinfected with hepatitis C. Discussion. Psychiatric and medical conditions related to chemsex and slamming have been reported in several European cities, but not in Spain. Psychotic symptoms have been associated with mephedrone and other SCs' consumption, with the IV route being prone to produce more severe symptomatology and addictive conducts. In the case we report, paranoid psychosis, addiction, and medical complications are described. PMID:27247820

'No man is an island'. Testing the specific role of social isolation in formal thought disorder.

Science.gov (United States)

de Sousa, Paulo; Spray, Amy; Sellwood, William; Bentall, Richard P

2015-12-15

Recent work has focused on the role of the environment in psychosis with emerging evidence that specific psychotic experiences are associated with specific types of adversity. One risk factor that has been often associated with psychosis is social isolation, with studies identifying isolation as an important feature of prodromal psychosis and others reporting that social networks of psychotic patients are smaller and less dense than those of healthy individuals. In the present study, we tested a prediction that social isolation would be specifically associated with formal thought disorder. 80 patients diagnosed with psychosis-spectrum disorder and 30 healthy participants were assessed for formal thought disorder with speech samples acquired during an interview that promoted personal disclosure and an interview targeting everyday topics. Social isolation was significantly associated with formal thought disorder in the neutral interview and in the salient interview, even when controlling for comorbid hallucinations, delusions and suspiciousness. Hallucinations, delusions and suspiciousness were not associated with social isolation when formal thought disorder was controlled for. Formal thought disorder is robustly and specifically associated with social isolation. Social cognitive mechanisms and processes are discussed which may explain this relationship as well as implications for clinical practice and future research. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Persistent psychotic symptoms after long-term heavy use of mephedrone: A two-case series.

Science.gov (United States)

Barrio, Pablo; Gaskell, Matthew; Goti, Javier; Vilardell, Sergi; Fàbregas, Josep Maria

2016-06-15

Mephedrone (4-methylmethcathinone) is a synthetic stimulant drug of the cathinone class. Similar effects to those of cocaine and ecstasy are reported by users, with a high addictive potential. Given its increasing rate of consumption in Europe, it is getting more and more attention from the addiction field. In spite of that, little is known about the long-term consequences of prolonged heavy use. The two following cases might depict some of them. Case 1 was a middle-age man who reported three years of intravenous use of mephedrone. He used to binge for several days in a row. Psychotic symptoms appeared after a few months, especially paranoid delusions. Sent to aftercare in a therapeutic community, delusions kept reappearing after prolonged abstinence. A good response to risperidone was observed. Case 2 was a young man who used mephedrone heavily for two years, always snorted. Upon admission to the therapeutic community, the patient reported auditory hallucinations that partially remitted with olanzapine. Both cases showed a good insight and no personality deterioration. Given its similarities to other substances that are known to induce psychotic symptoms, and the increasing consumption of mephedrone around Europe, similar cases are expected in the near future. Conventional antipsychotic treatment seems a reasonable pharmacological approach.

Role of the extended MAPT haplotype in the worsening of psychotic symptoms and treatment response in Alzheimer disease.

Science.gov (United States)

Creese, Byron; Corbett, Anne; Jones, Emma; Fox, Chris; Ballard, Clive

2014-12-01

There is evidence that neurofibrillary tangle (NFT) burden is associated with psychotic symptoms in Alzheimer disease (AD). However, it is not clear whether this association is direct or mediated through the increased cognitive impairment associated with NFTs. We sought to determine whether the extended MAPT haplotype was associated with the worsening of delusions and hallucinations in a combined cohort of 95 patients who participated in 2 clinical trials of treatment with memantine. After controlling for baseline dementia severity, exposure to memantine, and antipsychotics, analysis shows that carriers of at least one H2 allele had a 5.4-fold (P = .03) increased risk of worsening hallucinations. There was some evidence of association with worsening delusions but only in analysis by allele. These results are the first to indicate that the H2 allele of the extended MAPT haplotype negatively affects the course of psychotic symptoms in AD independently of disease severity. It will be important for future research to examine MAPT transcription in people with AD with and without psychotic symptoms to understand the exact mechanisms underlying these findings. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Nature, form and content of deceit as a way of committing fraud in the sphere of motor transport

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Villi A. Maslov

2014-01-01

Full Text Available Objective to realize the specifics of deceit as a means of committing fraud in the sphere of transport to define the general concept of deceit. Methods the dialectical method of cognition systemic logicallegal and comparative legal methods. Results the conclusion is proved that the delusion of the victim is not a sign of deceit because deceit is the behavior activity of the deceiver and delusion is the mental state of the deceived that occurs as the result of the deceiverrsquos activity. Attention is drawn to the key characteristic according to which the fraudulent actions in transport fraud can be divided into two groups the deceits about the external objective factors and the deceits about the internal subjective factors. Scientific novelty the traditional provisions of fraud in the context of road transport fraud are viewed which need a more detailed legal interpretation. Deceit in transport are grouped on a feature basis reflecting the typical kinds of deceit. The most complete from the terminological point of view definition of deceit is formulated. Practical value the results can be used in scientific and law enforcement activities in particular can be included in educationalmethodical literature for use in the preparation of practitioners and scientificpedagogical personnel in the field of jurisprudence.

Delusional Confusion of Dreaming and Reality in Narcolepsy

Science.gov (United States)

Wamsley, Erin; Donjacour, Claire E.H.M.; Scammell, Thomas E.; Lammers, Gert Jan; Stickgold, Robert

2014-01-01

Study Objectives: We investigated a generally unappreciated feature of the sleep disorder narcolepsy, in which patients mistake the memory of a dream for a real experience and form sustained delusions about significant events. Design: We interviewed patients with narcolepsy and healthy controls to establish the prevalence of this complaint and identify its predictors. Setting: Academic medical centers in Boston, Massachusetts and Leiden, The Netherlands. Participants: Patients (n = 46) with a diagnosis of narcolepsy with cataplexy, and age-matched healthy healthy controls (n = 41). Interventions: N/A. Measurements and Results: “Dream delusions” were surprisingly common in narcolepsy and were often striking in their severity. As opposed to fleeting hypnagogic and hypnopompic hallucinations of the sleep/wake transition, dream delusions were false memories induced by the experience of a vivid dream, which led to false beliefs that could persist for days or weeks. Conclusions: The delusional confusion of dreamed events with reality is a prominent feature of narcolepsy, and suggests the possibility of source memory deficits in this disorder that have not yet been fully characterized. Citation: Wamsley E; Donjacour CE; Scammell TE; Lammers GJ; Stickgold R. Delusional confusion of dreaming and reality in narcolepsy. SLEEP 2014;37(2):419-422. PMID:24501437

[Structural correlation of schizophrenic thought and language disorders with delusional perception and variations of intentionality].

Science.gov (United States)

Holm-Hadulla, R

1988-01-01

This study originated from a phenomenological and speech-act theoretical concept of schizophrenic concretism. An experimental study was performed showing a highly significant lack in the schizophrenic patients' ability to use metaphors correctly. Basing on the interpretation of proverbs, the hypothesis is rejected that false interpretations of schizophrenic patients are due to intermingling of personal conflicts. On the other hand, it could be shown that concretistic interpretations of proverbs represent an avoidance of conflicts. The concepts of "substitution" and "transfer" enabled us to measure pathological concreteness and "deconflictualisation". The differentiation between schizophrenic and nonpsychotic patients was found to be highly significant. In a complementary study it could be shown that the chronic schizophrenics' disability to transfer images of proverbs to an interpersonally relevant context does not differ significantly from that of patients with their first schizophrenic episode. Discussing our empirical findings, we try to show that the concretistic reduction of thought and speech is also a paradigma of delusion. The "incorrigibility" of schizophrenic delusion was seen to be based on reification of verbal signs and metaphors. After trying to show a connection between the concretistic "Lebensform" (Wittgenstein) and the disordered intentionality of schizophrenic patients, pointers towards psychotherapeutic implications are given.

Effect of Cultural Themes on Forming Cotard’s Syndrome: Reporting a Case of Cotard’s Syndrome with Depersonalization and Out of Body Experience Symptoms

OpenAIRE

Ghaffari Nejad, Alireza; Mehdizadeh Zare Anari, Ali; Pouya, Fatemeh

2013-01-01

Objective: Cotard’s syndrome is a rare psychiatric syndrome. Its core symptom is nihilistic ideation or delusion. Case Report: A female patient with Cotard’s syndrome symptoms associated with out of body experience and depersonalization, and complicated grief was referred for evaluation. She believed that she was killed by a creature named "Aal" in the Persian folklore Conclusions: Cultural and superstitious beliefs could affect the forming of the complex constellation of the patient’s sympto...

Hourly price elasticity pattern of electricity demand in the German day-ahead market

OpenAIRE

Knaut, Andreas; Paulus, Simon

2016-01-01

System security in electricity markets relies crucially on the interaction between demand and supply over time. However, research on electricity markets has been mainly focusing on the supply side arguing that demand is rather inelastic. Assuming perfectly inelastic demand might lead to delusive statements regarding the price formation in electricity markets. In this article we quantify the short-run price elasticity of electricity demand in the German day-ahead market and show that demand is...

Schizophrenia and Violence: Systematic Review and Meta-Analysis

OpenAIRE

Fazel, Seena; Gulati, Gautam; Linsell, Louise; Geddes, John R.; Grann, Martin

2009-01-01

Editors' Summary Background Schizophrenia is a lifelong, severe psychotic condition. One in 100 people will have at least one episode of schizophrenia during their lifetime. Symptoms include delusions (for example, patients believe that someone is plotting against them) and hallucinations (hearing or seeing things that are not there). In men, schizophrenia usually starts in the late teens or early 20s; women tend to develop schizophrenia a little later. The causes of schizophrenia include gen...

Insomnia and paranoia

OpenAIRE

Freeman, Daniel; Pugh, Katherine; Vorontsova, Natasha; Southgate, Laura

2009-01-01

Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are predictors of paranoia. Thus insomnia may contribute to the formation and maintenance of persecutory ideation. The aim was to examine for the first time the association of insomnia symptoms and paranoia in the general population and the extent of insomnia in individuals with persecutory delusions attending psychiatric services....

The inferiority complex in paranoia readdressed. A study with the Implicit Association Test

OpenAIRE

von Collani, Gernot; Werner, Ronny; Moritz, Steffen

2006-01-01

It has been theorised that patients with persecutory delusions display a lack of covert self-esteem (formerly termed the 'inferiority complex'), while at the same time displaying normal or even heightened levels of explicit self-esteem. However, the empirical basis for this assumption is inconsistent. Methods. In view of apparent shortcomings of prior studies to assess implicit self-esteem, the Implicit Association Test was utilised to readdress this theory. The Rosenberg scale served as an i...

Cotard and Capgras syndrome after ischemic stroke.

Science.gov (United States)

Sottile, Fabrizio; Bonanno, Lilla; Finzi, Giuseppina; Ascenti, Giorgio; Marino, Silvia; Bramanti, Placido; Corallo, Francesco

2015-04-01

Capgras and Cotard are delusional misidentification syndromes characterized by delusions about oneself, others, places, and objects. To date, there are few cases of comorbidity of both syndromes. We describe a case of aphasic stroke patient affected by cerebral ischemia localized in right temporoparietal region. The patient showed a typical clinical picture of delusional disorder attributable, through psychological assessment, to comorbidity of both Capgras and Cotard syndromes. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Coexistence of Reverse Capgras Syndrome, Subjective Double and Cotard Syndrome

Directory of Open Access Journals (Sweden)

Azadeh Mashayekhi

2016-01-01

Full Text Available Misidentification syndrome is a condition in which the person thinks that familiar persons have been replaced with other one. Coexistence of some types of this syndrome has been reported with other psychiatric syndromes. In this report, we present a 47-year-old married man with coexistence of reverse Capgras and subjective double syndromes with Cotard syndrome. There is no previous report of coexistence of these three forms of delusions in a single case.

Madness in Shakespeare's Characters

Directory of Open Access Journals (Sweden)

Nuno Borja-Santos

2014-10-01

Full Text Available This paper begins with an introduction where the aims are explained: a psychopathological analysis of a Shakespearean character - Othello – followed by the discussion of the English dramatist’s importance in helping us understand madness in the emergent world of Renaissance. The main characteristics of Othello’s personality, which allowed the development of his jealousy delusion, are described. Finally, the conclusions underline the overlap of the symptoms developed by the character with the DSM-IV classification.

The Road from Foolishness to Fraud

Science.gov (United States)

Park, R. L.

2000-12-01

Ancient beliefs in demons and magic still sweep across the modern landscape, but they are now dressed in the language and symbols of science. This is pseudoscience. At least in the beginning, its practitioners may believe it to be science, just as witches and faith healers may truly believe they can call forth supernatural powers. What may begin as honest error, however, has a way of evolving through almost imperceptible steps from self-delusion to fraud.

The Strategic Defense Initiative. Issues and Implications for the Atlantic Alliance.

Science.gov (United States)

1988-05-01

Schwartz (Washington, D.C.: The Brookings Institution, 1984), p. 41. 10 Ibid., pp. 41-42. 11 Ibid., pp. 332-333. 12 Barash, p. 142. 13 Brian Green , "The...Initiative. New York: John Wiley and Sons, 1986. Freedman, Lawrence. Arms Control-Management or Reform? Chatham House Papers 31. London: Routledge and Kegan ...Delusions." Policy Review. (Summer 1986) : pp. 48-53. Green , Brian. "The New Case For Civil Defense." The Heritage Foundation Backgrounder. No. 377, August 29

[The Capgras syndrome].

Science.gov (United States)

Anikina, M A; Levin, O S

2013-01-01

The Capgras syndrome is one of delusional-like misidentification syndrome in which a person holds a delusion that one or several his/her friends or relatives have been replaced by an identical-looking impostor. As any other delusional disorder, the Capgras syndrome is characterized by stability despite the indisputable arguments against fault views. Initially, this syndrome was considered as a presentation of schizophrenia but later it has been described in brain organic disorders, primarily in elderly patients with dementia.

Dreams as a source of supernatural agent concepts.

Science.gov (United States)

McNamara, Patrick; Bulkeley, Kelly

2015-01-01

We present a theory of the creativity of dreams as well as psychopathology of religious delusions with respect to production of fundamental forms of religious cognition-specifically supernatural agent (SA) cognitions. We suggest that dream cognitions are particularly efficient at producing highly memorable and impactful experiences with SAs because dreams involve three processes that are prerequisites for the generation of god concepts: (1) mental simulations of alternative realities, (2) theory of mind attributions to the extra-natural dream characters and divine beings, and (3) attribution of ultimate value (exemplified by 'good spirit beings'), and dis-value (exemplified by demonic monsters) to the supernatural dream characters. Because prefrontal cortex is deactivated during rapid eye movements (REM) sleep agentic impulses and internally generated ideas are not reliably attributed to Self or dreamer. Instead an exaggerated degree of agency is attributed to these supernatural dream characters who are then embedded in stories in dreams and in myths of waking life which explain their supernatural abilities. These dream-based SAs are salient characters that are processed in sleep-related memory systems according to rules of Lleweelyn's ancient art of memory model and therefore more easily remembered and reflected upon during waking life. When REM sleep intrudes into waking consciousness, as is the case with some forms of schizophrenia, religious delusions are more likely to emerge.

The fear of others: a qualitative analysis of interpersonal threat in social phobia and paranoia.

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Stopa, Luisa; Denton, Ruth; Wingfield, Megan; Taylor, Katherine Newman

2013-03-01

The cognitive models indicate that people with social phobia and paranoia share a common fear of others. While we recognize clinical differences, it is likely that some of the same psychological processes contribute to the maintenance of both presentations, yet the nature and extent of these similarities and differences are not yet clearly understood. This study explored threat experiences in people with social phobia and persecutory delusions in order to elucidate these aspects of the respective cognitive models. Accounts of interpersonal threat experiences were examined in nine people with social phobia and nine people with persecutory delusions. Verbatim transcripts were analyzed using thematic analysis. Three major themes emerged from the data: participants' experience of threat, reactions while under threat, and subsequent reflections. Narrative coherence emerged as a superordinate theme. Typical fear responses were found in both groups, particularly in their reactions to threat. The key differences were in participants' perceptual experiences, ability to stand back from the threat following the event, and narrative coherence. The findings are discussed in relation to current cognitive models of social phobia and paranoia. Theoretical and clinical implications are drawn out, and highlight the need to examine attentional and metacognitive processes more closely if we are to understand the maintenance of perceived threat in these groups, and means of alleviating associated distress.

Dissociation and psychosis in dissociative identity disorder and schizophrenia.

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Laddis, Andreas; Dell, Paul F

2012-01-01

Dissociative symptoms, first-rank symptoms of schizophrenia, and delusions were assessed in 40 schizophrenia patients and 40 dissociative identity disorder (DID) patients with the Multidimensional Inventory of Dissociation (MID). Schizophrenia patients were diagnosed with the Structured Clinical Interview for the DSM-IV Axis I Disorders; DID patients were diagnosed with the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised. DID patients obtained significantly (a) higher dissociation scores; (b) higher passive-influence scores (first-rank symptoms); and (c) higher scores on scales that measure child voices, angry voices, persecutory voices, voices arguing, and voices commenting. Schizophrenia patients obtained significantly higher delusion scores than did DID patients. What is odd is that the dissociation scores of schizophrenia patients were unrelated to their reports of childhood maltreatment. Multiple regression analyses indicated that 81% of the variance in DID patients' dissociation scores was predicted by the MID's Ego-Alien Experiences Scale, whereas 92% of the variance in schizophrenia patients' dissociation scores was predicted by the MID's Voices Scale. We propose that schizophrenia patients' responses to the MID do not index the same pathology as do the responses of DID patients. We argue that neither phenomenological definitions of dissociation nor the current generation of dissociation instruments (which are uniformly phenomenological in nature) can distinguish between the dissociative phenomena of DID and what we suspect are just the dissociation-like phenomena of schizophrenia.

Revisiting Cotard’s Syndrome: Illustration of Two Psychiatric Clinical Cases

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Lídia Sousa

2016-07-01

Full Text Available Background: Cotard’s Syndrome (CS is a rare and severe neuropsychiatric condition in which the central feature is the existence of nihilistic delusions. Controversy has ensued about the precise clinical picture Jules Cotard meant to describe and attempts have been made, more recently, not only to clarify the terminology, but also to define different types of this syndrome and explore its biological basis. Aims: We intend to briefly review the terminology, etiology, epidemiology and differential diagnosis of this syndrome, based on two clinical cases. Methods: Bibliographic search conducted through the electronic databases Medline and Gallica (French National Library, consultation of clinical records and direct interviews with the patients. Results and Conclusions: Typically the patients diagnosed with CS manifest the delusional idea that they are dying or already dead. However, it is also possible that they deny the existence of only some parts of their own body, or the functioning of some organs, and they may even sometimes deny the existence of the external world. We illustrate the case of a 66-year-old woman, diagnosed with bipolar affective disorder, admitted in the context of a severe depressive episode with psychotic symptoms, compatible with CS type II and the case of a young male aged 22, admitted due to a first  psychotic episode with schizophrenia like characteristics, presenting with nihilistic delusions compatible with CS type I.

Late Onset First Episode Psychosis Emerging as Delusional Misidentification of Familiar Sacred Places During a Holy Pilgrimage: A Case Report and Literature Review.

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Awara, Mahmoud A; Moselhy, Hamdy F; Elnenaei, Manal O

2017-11-07

The delusional misidentification syndromes (DMS) include a myriad of discrete but related syndromes, which have wide spectrum anomalies of familiarity. Several misidentification syndromes have been described in the psychiatric literature, the most common of these delusions are: the Capgras syndrome; the Fregoli syndrome; the syndrome of inter-metamorphosis; reduplicative paramnesia; and environmental reduplication. The reported case highlights the emergence of late onset first episode psychosis in a Middle Eastern 65-year-old female who has no previous psychiatric history. The nature of psychosis was mainly delusions of misidentification and persecution. DMS are relatively rare and occur predominantly in association with schizophrenia and affective psychosis. Between 25 and 40% are associated with organic conditions such as dementia, head injuries, brain tumors, and epilepsy. Only three cases of misidentification of sacred places have been reported previously in the literature. This case report is the first to present a DMS, emerging as a late onset first episode psychosis during the sacred journey of Hajj. The reported case highlights the importance of early recognition and treatment of mental health conditions that may appear de novo during the Hajj sacred journey. Readily available psychiatric resources, psychotropic medications, and psycho-education may be pivotal in ensuring mental well-being of pilgrims, which is fundamental to maintain the mental capacity required for completing these journeys.

Dreams as a source of supernatural agent concepts

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McNamara, Patrick; Bulkeley, Kelly

2015-01-01

We present a theory of the creativity of dreams as well as psychopathology of religious delusions with respect to production of fundamental forms of religious cognition—specifically supernatural agent (SA) cognitions. We suggest that dream cognitions are particularly efficient at producing highly memorable and impactful experiences with SAs because dreams involve three processes that are prerequisites for the generation of god concepts: (1) mental simulations of alternative realities, (2) theory of mind attributions to the extra-natural dream characters and divine beings, and (3) attribution of ultimate value (exemplified by ‘good spirit beings’), and dis-value (exemplified by demonic monsters) to the supernatural dream characters. Because prefrontal cortex is deactivated during rapid eye movements (REM) sleep agentic impulses and internally generated ideas are not reliably attributed to Self or dreamer. Instead an exaggerated degree of agency is attributed to these supernatural dream characters who are then embedded in stories in dreams and in myths of waking life which explain their supernatural abilities. These dream-based SAs are salient characters that are processed in sleep-related memory systems according to rules of Lleweelyn’s ancient art of memory model and therefore more easily remembered and reflected upon during waking life. When REM sleep intrudes into waking consciousness, as is the case with some forms of schizophrenia, religious delusions are more likely to emerge. PMID:25852602

Dreams as a source of supernatural agent concepts

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Patrick eMcnamara

2015-03-01

Full Text Available We present a theory of the creativity of dreams as well as psychopathology of religious delusions with respect to production of fundamental forms of religious cognition—specifically supernatural agent cognitions. We suggest that dream cognitions are particularly efficient at producing highly memorable and impactful experiences with supernatural agents because dreams involve three processes that are prerequisites for the generation of god concepts: 1 mental simulations of alternative realities, 2 theory of mind attributions to the extra-natural dream characters and divine beings and 3 attribution of ultimate value (exemplified by ‘good spirit beings’ and dis-value (exemplified by demonic monsters to the supernatural dream characters. Because prefrontal cortex is deactivated during REM sleep agentic impulses and internally generated ideas are not reliably attributed to Self or dreamer. Instead an exaggerated degree of agency is attributed to these supernatural dream characters who are then embedded in stories in dreams and in myths of waking life which explain their supernatural abilities. These dream-based supernatural agents are salient characters that are processed in sleep-related memory systems according to rules of Lleweelyn’s AAOM model and therefore more easily remembered and reflected upon during waking life. When REM sleep intrudes into waking consciousness, as is the case with some forms of schizophrenia, religious delusions are more likely to emerge.

Management of Patients Who Make Threats Against Elected Officials: A Case Report

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Paulina Riess

2018-05-01

Full Text Available Federal law makes it a crime to threaten the President of the United States. The Secret Service conducts thousands of violence risk assessments each year. Literature suggests that 75% of individuals who make threats have been diagnosed with a mental illness (1. Studies show that prominent symptoms in presidential assassins include persecutory and grandiose delusions, hence falling into the category of psychotic disorders. We present a case of a patient diagnosed with Schizoaffective Disorder brought to CPEP (Comprehensive Psychiatric Emergency Program by the Secret Service for repeatedly dialing 911 and making threats to the President. In the past year the patient had been hospitalized three times for similar behavior. Initial presentation included acute symptoms of psychosis and mania including persecutory delusions, command auditory hallucinations, grandiosity, and thought disorder. Clinicians were faced with unique challenges and consulted the forensic service to navigate the role of the Secret Service and develop a plan to prevent future episodes. The patient was discharged with a court order for treatment, long acting medication, as well as an outpatient appointment. The treatment plan has been effective and the Secret Service has ceased their investigation. We aim to explore issues in patient confidentiality, duty to both report and protect. We will also provide strategies and recommendations for such patients on the inpatient unit.

Karl Jaspers y la distinción hermenéutica entre entender y explicar en psicopatología. ¿Podríamos reencontrarnos en alguien que padeciera el síndrome de Cotard tipo I?

OpenAIRE

Ariso Salgado, José María (UNIR)

2011-01-01

Though Karl Jaspers stated in his General Psychopathology that the genesis of delusions is un-understandable rational and empathically, millions of people all over the world and lots of cinema critics seem to have understood in both ways the genesis of the case of Cotard syndrome which appears by the end of the film The Sixth Sense (1999). In this paper, however, I will show that the possibility of understanding rational and empathically the genesis of this case is just unrealisti...

17. DR Aswani Book Review of Richard Dawkins The God Delusion ...

African Journals Online (AJOL)

REGINALDS

pride should assert itself. These propositions run coordinated threads in the entire book. The text is punctuated by jokes and abuses, and laced with a tone of personal vendetta against religion. This is illustrated in some atheistic remarks such as the assertion that the Old. Testament God is a “petty, unjust, unforgiving control ...

[Othello syndrome--jealousy and jealous delusions as symptoms of psychiatric disorders].

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Soyka, M

1995-12-01

Jealousy as a psychopathological symptom has long been neglected by psychiatric research. Despite the obvious difficulty to prove or exclude the infidelity of a spouse, delusional jealousy can clearly be considered as pathological, but the evaluation and classification of non-psychotic jealousy remains a challenge. Typical psychopathological symptoms which usually accompany pathological jealousy and the prevalence of delusional jealousy in different psychiatric disorders are described. In delusional jealousy neuroleptic treatment is necessary. Positive results have been reported especially with pimozide. For non-psychotic jealousy various forms of psychotherapy have been advocated to improve self-esteem or to treat other psychological disorders. Other possible interventions are alcohol therapy or family counselling. Many studies show that jealousy is a frequent motive in homicide with the spouse being nearly exclusively the victim. Finally some forensic aspects of jealousy are discussed.

Cotard's syndrome: Two case reports and a brief review of literature

OpenAIRE

Grover, Sandeep; Aneja, Jitender; Mahajan, Sonali; Varma, Sannidhya

2014-01-01

Cotard′s syndrome is a rare neuropsychiatric condition in which the patient denies existence of one′s own body to the extent of delusions of immortality. One of the consequences of Cotard′s syndrome is self-starvation because of negation of existence of self. Although Cotard′s syndrome has been reported to be associated with various organic conditions and other forms of psychopathology, it is less often reported to be seen in patients with catatonia. In this report we present two cases of Cot...

Cotard's syndrome and delayed diagnosis in Kashmir, India

OpenAIRE

Wani, Zaid A; Khan, Abdul W; Baba, Aijaz A; Khan, Hayat A; Wani, Qurat-ul Ain; Taploo, Rayeesa

2008-01-01

Abstract Cotard's syndrome is a rare syndrome, characterized by the presence of nihilistic delusions. The syndrome is typically related to depression and is mostly found in middle-aged or older people. A few cases have been reported in young people with 90% of these being females. We present a case of a young pregnant woman suffering from Cotard's syndrome. This is the first report of this syndrome in a pregnant woman. The case was diagnosed late, due to lack of awareness of psychiatric probl...

Generosity

DEFF Research Database (Denmark)

Høyrup, Jens

2008-01-01

One of the ways in which the artificial languages of mathematics are ‘‘generous'', that is, in which they assist the advance of thought, is through their establishment of advanced operatory structures that permit an even further advance of intuition. However, this generosity may be delusive, sugg...... and products, one perilous case-Cantor's introduction of transfinite numbers from 1895-and (in modern terms) a failed attempt to extend the semi-group of algebraic powers into a complete group, also from c. 1340...

Did Mozart suffer from Asperger syndrome?

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Raja, Michele

2015-05-01

The most reliable biographies of Mozart highlight elements that are compatible with current diagnostic criteria for Asperger syndrome including qualitative impairment in social interaction and stereotyped and repetitive motor mannerisms. Furthermore, numerous features are documented including difficulty in communicating his emotional state and in inferring the mental state of his interlocutors, motor clumsiness, specific skills and genius, left-handedness, special sense of humour, physical developmental abnormalities, bizarre thinking, overvalued ideas and delusions. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Psychosis in behavioral variant frontotemporal dementia

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Gossink FT

2017-04-01

Full Text Available Flora T Gossink,1,2 Everard GB Vijverberg,2,3 Welmoed Krudop,2 Philip Scheltens,2 Max L Stek,1 Yolande AL Pijnenburg,1,2 Annemiek Dols1,2 1Department of Old Age Psychiatry, GGZinGeest, 2Alzheimer Center & Department of Neurology, VU University Medical Center, Amsterdam, 3Department of Neurology, HagaZiekenhuis, The Hague, the Netherlands Background: Dementia is generally characterized by cognitive impairment that can be accompanied by psychotic symptoms; for example, visual hallucinations are a core feature of dementia with Lewy bodies, and delusions are often seen in Alzheimer’s disease. However, for behavioral variant of frontotemporal dementia (bvFTD, studies on the broad spectrum of psychotic symptoms are still lacking. The aim of this study was to systematically and prospectively subtype the wide spectrum of psychotic symptoms in probable and definite bvFTD.Methods: In this study, a commonly used and validated clinical scale that quantifies the broad spectrum of psychotic symptoms (Positive and Negative Symptom Scale was used in patients with probable and definite bvFTD (n=22 and with a primary psychiatric disorder (n=35 in a late-onset frontal lobe cohort. Median symptom duration was 2.8 years, and the patients were prospectively followed for 2 years.Results: In total, 22.7% of bvFTD patients suffered from delusions, hallucinatory behavior, and suspiciousness, although the majority of the patients exhibited negative psychotic symptoms such as social and emotional withdrawal and blunted affect (95.5% and formal thought disorders (81.8%. “Difficulty in abstract thinking” and “stereotypical thinking” (formal thought disorders differentiated bvFTD from psychiatric disorders. The combined predictors difficulty in abstract thinking, stereotypical thinking, “anxiety”, “guilt feelings,” and “tension” explained 75.4% of variance in the diagnosis of bvFTD versus psychiatric diagnoses (P<0.001.Conclusion: Delusions

Are delusional contents replayed during dreams?

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D'Agostino, Armando; Aletti, Giacomo; Carboni, Martina; Cavallotti, Simone; Limosani, Ivan; Manzone, Marialaura; Scarone, Silvio

2013-09-01

The relationship between dream content and waking life experiences remains difficult to decipher. However, some neurobiological findings suggest that dreaming can, at least in part, be considered epiphenomenal to ongoing memory consolidation processes in sleep. Both abnormalities in sleep architecture and impairment in memory consolidation mechanisms are thought to be involved in the development of psychosis. The objective of this study was to assess the continuity between delusional contents and dreams in acutely psychotic patients. Ten patients with a single fixed and recurring delusional content were asked to report their dreams during an acute psychotic break. Sixteen judges with four different levels of acquaintance to the specific content of the patients' delusions were asked to group the dreams, expecting that fragments of the delusional thought would guide the task. A mathematical index (f,t) was developed in order to compare correct groupings between the four groups of judges. Most judges grouped the dreams slightly above chance level and no relevant differences could be found between the four groups [F(3,12)=1.297; p=n.s.]. Scoring of dreams for specific delusional themes suggested a continuity in terms of dream and waking mentation for two contents (Grandiosity and Religion). These findings seem to suggest that at least some delusional contents recur within patients' dreams. Future studies will need to determine whether such continuity reflects ongoing consolidation processes that are relevant to current theories of delusion formation and stabilization. Copyright © 2013 Elsevier Inc. All rights reserved.

Immune markers of social cognitive bias in schizophrenia.

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Dunne, Patrick W; Roberts, David L; Quinones, Marlon P; Velligan, Dawn I; Paredes, Madelaine; Walss-Bass, Consuelo

2017-05-01

Social cognition is impaired in schizophrenia, is relatively independent of purely neurocognitive domains such as attention and executive functioning, and may be the strongest predictor of functional outcome in this disease. Within a motivated reasoning framework, we tested the hypothesis that the anti-inflammatory Th2-associated cytokines, IL-10 and MDC, would be correlated with behavioral measures of social cognitive threat-detection bias (self-referential gaze detection bias and theory of mind (ToM) bias) in delusional versus non-delusional patients. We administered to schizophrenia patients with delusions (n=21), non-delusional patients (n=39) and controls (n=20) a social cognitive task designed to be sensitive to psychosocial stress response (the Waiting Room Task) and collected plasma levels of inflammatory markers using a bead-based flow immunoassay. Results partially supported our hypothesis. The anti-inflammatory cytokine IL-10 was associated with self-referential ToM bias in the delusional cohort as predicted, and not with non-delusional patients or healthy controls. This bias reflects a documented tendency of schizophrenia patients with delusions to excessively attribute hostile intentions to people in their environment. Since this cytokine correlated only with ToM bias and only in delusional patients, elevated levels of this cytokine in the blood may eventually serve as a useful biomarker distinguishing delusional patients from both non-delusional patients and healthy controls. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Bimanual coupling paradigm as an effective tool to investigate productive behaviors in motor and body awareness impairments.

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Garbarini, Francesca; Pia, Lorenzo

2013-11-05

When humans move simultaneously both hands strong coupling effects arise and neither of the two hands is able to perform independent actions. It has been suggested that such motor constraints are tightly linked to action representation rather than to movement execution. Hence, bimanual tasks can represent an ideal experimental tool to investigate internal motor representations in those neurological conditions in which the movement of one hand is impaired. Indeed, any effect on the "moving" (healthy) hand would be caused by the constraints imposed by the ongoing motor program of the 'impaired' hand. Here, we review recent studies that successfully utilized the above-mentioned paradigms to investigate some types of productive motor behaviors in stroke patients. Specifically, bimanual tasks have been employed in left hemiplegic patients who report illusory movements of their contralesional limbs (anosognosia for hemiplegia). They have also been administered to patients affected by a specific monothematic delusion of body ownership, namely the belief that another person's arm and his/her voluntary action belong to them. In summary, the reviewed studies show that bimanual tasks are a simple and valuable experimental method apt to reveal information about the motor programs of a paralyzed limb. Therefore, it can be used to objectively examine the cognitive processes underpinning motor programming in patients with different delusions of motor behavior. Additionally, it also sheds light on the mechanisms subserving bimanual coordination in the intact brain suggesting that action representation might be sufficient to produce these effects.

The Vicious Cycle of Family Atmosphere, Interpersonal Self-concepts, and Paranoia in Schizophrenia-A Longitudinal Study.

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Hesse, Klaus; Kriston, Levente; Mehl, Stephanie; Wittorf, Andreas; Wiedemann, Wolfgang; Wölwer, Wolfgang; Klingberg, Stefan

2015-11-01

Recent cognitive models of paranoid delusions highlight the role of self-concepts in the development and maintenance of paranoia. Evidence is growing that especially interpersonal self-concepts are relevant in the genesis of paranoia. In addition, negative interpersonal life-experiences are supposed to influence the course of paranoia. As dysfunctional family atmosphere corresponds with multiple distressing dyadic experiences, it could be a risk factor for the development and maintenance of paranoia. A total of 160 patients with a diagnosis of schizophrenia were assessed twice within 12 months. Standardized questionnaires and symptom rating scales were used to measure interpersonal self-concepts, perceived family atmosphere, and paranoia. Data were analyzed using longitudinal cross-lagged structural equation models. Perceived negative family atmosphere was associated with the development of more pronounced negative interpersonal self-concepts 12 months later. Moreover, paranoia was related to negative family atmosphere after 12 months as well. As tests revealed that reversed associations were not able to explain the data, we found evidence for a vicious cycle between paranoia, family atmosphere, and interpersonal self-concepts as suggested by theoretical/cognitive model of paranoid delusions. Results suggest that broader interventions for patients and their caretakers that aim at improving family atmosphere might also be able to improve negative self-concepts and paranoia. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

The predictive value of early maladaptive schemas in paranoid responses to social stress.

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Sundag, Johanna; Ascone, Leonie; Lincoln, Tania M

2018-01-01

Social stress and negatively valenced cognitive representations of the self (self-schemas) play an important role in the formation of delusions. However, it has not been investigated whether and which self-schemas explain paranoid responses to social stress. Building on the framework of schema theory, the aim of this study was thus to investigate whether more pronounced early maladaptive schemas (EMSs) were associated with increased paranoid ideation after a social stress induction in patients with persecutory delusions (PD). Patients with PD (n = 20) and healthy controls (n = 40) were assessed for EMSs with the Young Schema Questionnaire. They were then exposed to a social stress situation in which they were socially excluded in a Cyberball paradigm. Prior to and after the social stress induction, paranoid symptoms were assessed. Patients with PD responded with a stronger increase in paranoia and revealed a significantly higher EMS total score compared to the healthy controls. As expected, higher increases in paranoia following the social stress were accounted for by higher EMS total scores. Exploratory analyses showed that particularly the specific EMSs Defectiveness/Shame and Enmeshment/Undeveloped Self were associated with the increase in paranoia. EMSs are associated with stress-related symptom increases in patients with PD. It thus seems worthwhile to further investigate the relevance of specific schemas for paranoia. The findings also suggest that addressing EMSs in psychological treatment of patients with PD holds potential. Copyright © 2017 John Wiley & Sons, Ltd.

A study of skin disorders in patients with primary psychiatric conditions

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Kuruvila Maria

2004-09-01

Full Text Available BACKGROUND: The skin occupies a powerful position as an organ of communication and plays an important role in socialization throughout life. The interface between dermatology and psychiatry is complex and of clinical importance. AIMS: To document the incidence of cutaneous disorders in patients with primary psychiatric conditions. METHODS: Three hundred patients with a primary psychiatric condition who had cutaneous disease were entered into the study group. The patients were classified appropriately based on the classification of psychocutaneous disorders. The control group included 300 patients presenting with a skin disorder and without any known psychiatric complaint. RESULTS: The majority of the cases in the study group were in the 3rd-5th decade. In this study, the most common primary psychiatric conditions were manic depressive psychosis (53.33%, depression (36.33%, schizophrenia (8.33% and anxiety (2%. Of the study group, 68.66% patients had infective dermatoses and the rest had non-infective dermatoses. A high incidence of pityriasis versicolor and dermatophyte infections was noted in males from the study group. Among non-infective dermatoses, 8% had eczema, and psychogenic skin disorders were seen in 4.67% of the study group. Of these, delusions of parasitosis were the commonest (2% followed by venereophobia (1%. CONCLUSIONS: A statistically significant higher incidence of tinea versicolor and dermatophyte infections was seen in the study group. Delusion of parasitosis was the most common psychogenic skin disorder seen in the study group, followed by venereophobia.

Neuropsychiatric Symptoms in Alzheimer Disease, Vascular Dementia, and Mixed Dementia.

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Anor, Cassandra J; O'Connor, Sean; Saund, Amardeep; Tang-Wai, David F; Keren, Ron; Tartaglia, Maria Carmela

2017-01-01

Neuropsychiatric symptoms (NPS) are common in Alzheimer disease (AD) and vascular dementia (VaD), and are distressful to patients and caregivers. NPS are likely related to the underlying pathology. Previous studies suggest that frontal lobe lesions and vascular changes such as white matter hyperintensities (WMH) have a significant association with specific NPS. The current study aimed to compare NPS in patients with AD, VaD, and mixed AD/VaD, and to evaluate the differences in the prevalence of NPS in relation to frontal WMH volume. In total, 180 patients with NPS and MRI data (92 probable AD, 51%; 34 probable VaD, 19%; and 54 probable mixed AD/VaD, 30%) were included in the study. Regression analyses were performed to determine the relationships between NPS prevalence and diagnosis, and between NPS and frontal WMH. VaD patients had significantly more agitation (p < 0.05; 40 vs. 14%) and sleep disturbances (p < 0.05; 57 vs. 32%) than AD patients, and significantly more depression (p < 0.05; 48 vs. 20%) and aberrant motor behaviors (p < 0.05; 31 vs. 13%) than mixed AD/VaD patients. AD patients with delusions had significantly greater right frontal WMH volumes than those without (p < 0.05; delusions 1/0 = 314.8/112.6 mm3). Differences in NPS prevalence are likely related to the underlying pathology and warrant further study as they have implications for treatment. © 2017 S. Karger AG, Basel.

Delusional disorder and schizophrenia: a comparative study across multiple domains.

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Peralta, V; Cuesta, M J

2016-10-01

Delusional disorder (DD) is an under-researched condition and its relationship to schizophrenia (SZ) controversial. This study aimed to further characterize DD and to examine multi-domain evidence for the distinction between DD and SZ. Using univariate analyses we examined 146 subjects with DD, 114 subjects with paranoid SZ and 244 subjects with non-paranoid SZ on 52 characteristics from several domains including demographics, risk factors, premorbid features, illness characteristics, index episode features, delusional-related features, response to treatment and outcome. In a further step, we searched for independent associations of the examined characteristics with DD v. SZ. Univariate analyses showed that DD differed from either form of SZ in 40 characteristics, the pattern of findings indicated that paranoid SZ was much more similar to non-paranoid SZ than DD. Relative to subjects with SZ, those with DD were more likely to have drug abuse before illness onset, better premorbid sexual adjustment, later age at illness onset, higher levels of affective symptoms and lack of insight, poorer response to antipsychotic medication, better functioning in the domains of personal care, paid work and social functioning; last, subjects with DD had fewer but more severe delusions and higher ratings of conviction of delusional experience than those with SZ. Predominance of jealousy and somatic delusions was confined to subjects with DD. DD and SZ represent two distinct classes of disorders, the differential features of DD being of nosological, aetiological and therapeutic relevance.

[EEG frequency and regional properties in patients with paranoid schizophrenia: effects of positive and negative symptomatology prevalence].

Science.gov (United States)

Bochkarev, V K; Kirenskaya, A V; Tkachenko, A A; Samylkin, D V; Novototsky-Vlasov, V Yu; Kovaleva, M E

2015-01-01

EEG changes in schizophrenic patients are caused by a multitude of factors related to clinical heterogeneity of the disease, current state of patients, and conducted therapy. EEG spectral analysis remains an actual methodical approach for the investigation of the neurophysiological mechanisms of the disease. The goal of the investigation was the study of frequency and regional EEG correlating with the intensity of productive and negative disorders. Models of summary prevalence of positive/negative disorders and evidence of concrete clinical indices of the PANSS scale were used. Spectral characteristics of background EEG in the frequency range of 1-60 Hz were studied in 35 patients with paranoid schizophrenia free from psychoactive medication and in 19 healthy volunteers. It was established that the main index of negative symptomatology in summary assessment was diffuse increase of spectral power of gamma and delta ranges. Deficient states with the predominance of volitional disorders were characterized by a lateralized increase of spectral power of beta-gamma ranges in the left hemisphere, and of delta range - in frontal areas of this hemisphere. Positive symptomatology was noticeably less reflected in EEG changes than negative ones. An analysis of psychopathological symptom complexes revealed the significance of spatially structured EEG patterns in the beta range: for the delusion disturbances with psychic automatism phenomena - in frontal areas of the left hemisphere, and for the paranoid syndrome with primary interpretative delusion - in cortical areas of the right hemisphere.

SCHIZOAFFECTIVE DISORDER WITH MANIC TYPE : A CASE REPORT

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A.A. Gede Ocha Rama Kharisma Putra

2014-02-01

Full Text Available Schizoaffective disorder is a disease with persistent psychotic symptoms, such ashallucinations or delusions, occurs together with mood disorder such as depression,manic, or mixed episodes. Schizoaffective disorder is estimated to occur morefrequently than bipolar disorder. A psychotic disorder with symptoms of schizophreniaand manic air equally prominent in one episode of the same disease. This reportdescribes the case of b schizoaffective disorder with manic type in women aged 42years. These patients get therapy is pharmacotherapy Carbamazepine 2x200 mg orallyand Stelazine 2x5 mg orally.

A Case of Genital Self-mutilation Committed Before Suicide

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S. Yadukul

2015-06-01

Full Text Available Male genital self-mutilation (GSM is a rare, but serious phenomenon. Some of the risk factors for this act are: presence of religious delusions, command hallucinations, low self-esteem and feelings of guilt associated with sexual offences. Other risk factors include failures in the male role, problems in the early developmental period, such as experiencing difficulties in male identification and persistence of incestuous desires; depression and having a history of GSM. We present a case of a suicide wherein the deceased before committing the suicidal act had GSM.

Association of the 3′ Region of COMT with Schizophrenia in Taiwan

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Yi-Ling Chien

2009-04-01

Conclusion: The SNP rs165599, which has been mapped to the 3′-UTR region of the COMT gene, was significantly associated with schizophrenia in our family study, and possibly associated with the age of onset, delusion/hallucination symptom dimension, and CPT performance. Therefore, COMT may contribute to the genetic risk for schizophrenia not through the Val108/158 Met polymorphism, but through other variants that are situated 3′ to this region, in the Taiwanese population. Nevertheless, the true associated functional variants in our subjects remain to be elucidated.

Wyndham Lewis: From Proudhon to Hitler (and back: the Strange Political Journey of Wyndham Lewis

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Alan MUNTON

2006-10-01

Full Text Available IThe trajectory of Wyndham Lewis’s politics is not yet well understood. Indeed, there is widespread scepticism as to whether there was a trajectory at all, rather than an intrinsic and intransigent right-wing attitude which varied only in acquiring a particularly reprehensible aspect with the rise of Fascism in the 1930s. For many, the publication of Lewis’s uncritical Hitler in 1931 settles the matter: an already-present tendency climaxes in the delusions that Hitler was “a Man of Peace” (ti...

Meeting overview: Sensory perception and schizophrenia, Lausanne, Switzerland June 31–July 1, 2014

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Daniel C. Javitt, M.D., Ph.D.

2015-06-01

Third, several visual measures were found to correlate highly with symptoms and/or neurocognitive processing. Deficits in contour integration, for example, correlated highly with conceptual disorganization, whereas perceptual instability correlated with delusion formation. These findings highlight links between perceptual-level disturbance and clinical manifestation. Finally, the potential involvement of specific neurotransmitter receptors, including N-methyl-D-aspartate (NMDA-type glutamate receptors and alpha7 nicotinic receptors were discussed as potential etiological mechanisms. Overall, the meeting highlighted the contributions of visual pathway dysfunction to the etiopathogenesis of neurocognitive dysfunction in schizophrenia.

Religion and psychosis: a common evolutionary trajectory?

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Dein, Simon; Littlewood, Roland

2011-07-01

In this article we propose that schizophrenia and religious cognition engage cognate mental modules in the over-attribution of agency and the overextension of theory of mind. We argue similarities and differences between assumptions of ultrahuman agents with omniscient minds and certain ''pathological'' forms of thinking in schizophrenia: thought insertion, withdrawal and broadcasting, and delusions of reference. In everyday religious cognition agency detection and theory of mind modules function ''normally,'' whereas in schizophrenia both modules are impaired. It is suggested that religion and schizophrenia have perhaps had a related evolutionary trajectory.

Pre-storm NmF2 enhancements at middle latitudes: delusion or reality?

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A. V. Mikhailov

2009-03-01

Full Text Available A critical analysis of recent publications devoted to the NmF2 pre-storm enhancements is performed. There are no convincing arguments that the observed cases of NmF2 enhancements at middle and sub-auroral latitudes bear a relation to the following magnetic storms. In all cases considered the NmF2 pre-storm enhancements were due to previous geomagnetic storms, moderate auroral activity or they presented the class of positive quiet time events (Q-disturbances. Therefore, it is possible to conclude that there is no such an effect as the pre-storm NmF2 enhancement as a phenomenon inalienably related to the following magnetic storm. The observed nighttime NmF2 enhancements at sub-auroral latitudes may result from plasma transfer from the plasma ring area by meridional thermospheric wind. Enhanced plasmaspheric fluxes into the nighttime F2-region resulted from westward substorm-associated electric fields is another possible source of nighttime NmF2 enhancements. Daytime positive Q-disturbances occurring under very low geomagnetic activity level may be related to the dayside cusp activity.

NATOs Deterrence Strategy is Failing. The Enhanced Forward Presence: Delusion or Renewal

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2018-04-20

with serving, senior leaders across the NATO Alliance. Research reveals a variety of shortcomings and associated recommendations to improve the EFP...levers, answerable to a single NDCC exploits Russia’s autocratic politics and grand strategy of mobilization. Routine, democratic checks and...the reduction of commitment in Afghanistan. Senior leaders are aligned on the requirement for an updated deterrence strategy and what might be termed

'Theory of mind' skills during an acute episode of psychosis and following recovery.

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Drury, V M; Robinson, E J; Birchwood, M

1998-09-01

A neuropsychological formulation of schizophrenia has suggested that problems with meta-representation underpin both positive and negative symptoms. This study tested Frith's account by asking patients experiencing an acute episode of psychosis to complete a set of tasks that involved Theory of Mind (ToM) skills. Fourteen patients who fulfilled criteria for schizophrenia, 10 deluded patients who were suffering from psychotic disorders other than schizophrenia and 12 depressed patients completed second-order false belief tasks, a test which involved substitution of a co-referential term in a linguistic description of an event, and metaphor and irony tasks. The battery of tests was completed during the acute phase and following recovery. Selection of these patient groups allowed comparisons to be made between schizophrenia patients and non-schizophrenia patients and between patients with and without persecutory delusions. Schizophrenia patients, who had a multiplicity of positive and negative symptoms, performed significantly worse than non-schizophrenia patients on some of the ToM tasks during an acute episode. Patients with delusions of persecution and reference did not perform significantly worse than non-deluded patients on ToM tasks. There was no significant difference between groups in performance on any of the tasks at recovery. The results provide at best weak support for Frith's account and it remains unclear whether the ToM deficits demonstrated are genuine deficits or are a result of information-processing overload. However, it is clear that difficulties interpreting interpersonal contexts, as shown by some schizophrenia patients, are state rather than trait characteristics.

The relationship of specific items on the Neuropsychiatric Inventory to caregiver burden in dementia: a systematic review.

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Terum, Toril Marie; Andersen, John Roger; Rongve, Arvid; Aarsland, Dag; Svendsboe, Ellen J; Testad, Ingelin

2017-07-01

Neuropsychiatric symptoms (NPSs) are common in dementia, and they have been identified as important care-recipient variables in terms of their impact on caregiver burden. The aim of this review was to describe how individual NPSs in dementia, assessed using the Neuropsychiatric Inventory, are associated with caregiver burden. We performed a systematic review of English language, peer-reviewed articles retrieved from MEDLINE, PSYCINFO, and EMBASE. A total of 13 studies met the inclusion criteria. Four studies examined the association between individual NPSs and caregiver burden using the Spearman rank correlation test, while three used Pearson's correlation test. Of the remaining studies, five used multiple regression analyses and one the chi-squared test. The majority of included studies did not differentiate between dementia subtypes in the analysis or mainly included only caregivers of people with Alzheimer's disease. The Clinical Dementia Rating score and mean Mini-Mental State Examination score indicate mild to moderate dementia. The majority of caregivers were women, most of whom were children (53.8%) or spouses (36%). The data indicated that irritability, followed by agitation, sleep disturbances, anxiety, apathy, and delusion seem to impact caregiver burden the most. Our principal finding is that irritability, agitation, sleep disturbances, anxiety, apathy, and delusion seem to exert the most impact on caregiver burden. Heterogeneity in the measures and statistical analyses used, however, makes it difficult to make conclusive interpretations. Future research in this field would benefit from standardization of the scientific methodology in use. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Síndrome de Cotard associada ao uso de ecstasy Cotard’s syndrome induced by ecstasy

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Rodrigo Nicolato

2007-01-01

Full Text Available O termo ecstasy é usado para descrever diversas substâncias que compartilham estruturas químicas e efeitos semelhantes, referindo-se mais comumente a 3,4-metilenodioximetanfetamina (3,4-MDMA. Os efeitos psíquicos da MDMA são, sobretudo, alucinógenos e estimulantes. A tendência atual considera o delírio de Cotard como sendo a crença delirante de estar morto ou de que seus órgãos estejam paralisados ou podres, independentemente do diagnóstico do paciente. Neste artigo, relatamos o caso clínico de um paciente que apresentou quadro psicótico com delírios hipocondríacos e alucinações olfativas com características de síndrome de Cotard associado ao uso crônico de ecstasy. Foi medicado com olanzapina e obteve remissão completa dos sintomas.The term ecstasy is used to describe various substances that share similar chemical structures and effects, often referring to 3,4-methylenedioxy-N-methylamphetamine (3,4-MDMA. MDMA psychic effects are mainly hallucinatory and stimulatory. Current trends consider Cotard’s delusion as a delusional belief of being dead or having paralyzed or rotten organs, independent of the diagnosis the patient has received. This case report is about a psychotic episode where the patient presented with hypochondriac delusion and olfactory hallucinations resembling Cotard’s syndrome and associated with ecstasy abuse. He was given olanzapine and achieved total remission from symptoms.

Delusional Jealousy (Othello Syndrome) in 67 Patients with Parkinson’s Disease

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Kataoka, Hiroshi; Sugie, Kazuma

2018-01-01

Othello syndrome (OS) is a type of paranoid delusional jealousy, characterized by the false absolute certainty of the infidelity of a partner. Because OS has infrequently occurred in patients with Parkinson’s disease (PD), the characteristics of OS in PD remain unclear. We reviewed the clinical characteristics of this syndrome in PD. We reviewed 67 patients who had PD with OS. OS was more common in men (45 patients) than in women (22 patients), and it frequently occurred in middle-aged patients. Until the onset of OS, the duration of PD (range, 2–19.8 years) and the duration of treatment with PD medications (range, 2 months to 18.5 years) varied. At the onset of OS, cognition was preserved in most patients. 42 of 47 patients had other psychiatric disorders in addition to OS, and 5 patients had isolated OS. Persecutory or other paranoid delusions developed in 34 patients with OS. OS was associated with PD medication in 25 of 26 patients, especially in patients, used the dopamine agonists. The dose of the PD medication associated with OS was decreased or these drugs were withdrawn to facilitate the treatment of OS. In most patients, OS disappeared or the severity of OS was reduced. OS is infrequent in patients with PD, but is likely to be easily detected because OS is commonly accompanied by persistent paranoid and sexual delusions. When clinicians encounter such patients, the withdrawal or reduction of dopamine agonists should be attempted, and if necessary, additional treatment with clozapine is recommended. PMID:29563893

Delusional Jealousy (Othello Syndrome in 67 Patients with Parkinson’s Disease

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Hiroshi Kataoka

2018-03-01

Full Text Available Othello syndrome (OS is a type of paranoid delusional jealousy, characterized by the false absolute certainty of the infidelity of a partner. Because OS has infrequently occurred in patients with Parkinson’s disease (PD, the characteristics of OS in PD remain unclear. We reviewed the clinical characteristics of this syndrome in PD. We reviewed 67 patients who had PD with OS. OS was more common in men (45 patients than in women (22 patients, and it frequently occurred in middle-aged patients. Until the onset of OS, the duration of PD (range, 2–19.8 years and the duration of treatment with PD medications (range, 2 months to 18.5 years varied. At the onset of OS, cognition was preserved in most patients. 42 of 47 patients had other psychiatric disorders in addition to OS, and 5 patients had isolated OS. Persecutory or other paranoid delusions developed in 34 patients with OS. OS was associated with PD medication in 25 of 26 patients, especially in patients, used the dopamine agonists. The dose of the PD medication associated with OS was decreased or these drugs were withdrawn to facilitate the treatment of OS. In most patients, OS disappeared or the severity of OS was reduced. OS is infrequent in patients with PD, but is likely to be easily detected because OS is commonly accompanied by persistent paranoid and sexual delusions. When clinicians encounter such patients, the withdrawal or reduction of dopamine agonists should be attempted, and if necessary, additional treatment with clozapine is recommended.

[Psychotic experiences in the course of alcohol withdrawal symptoms: locus of control among patients with and without delirium and analysis of subjective experiences in delirium].

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Kokoszka, Andrzej; Laskowska, Marta; Mikuła, Joanna

2011-01-01

The comparison of the locus of control in groups of patients hospitalised due to alcohol withdrawal with and without delirium and analysis of psychotic experiences of patients with delirium. 25 patients with alcohol withdrawal with delirium and 25 without delirium took part in the study. They filled-in the Internal-External (I-E) Locus of Control Scale by Rotter; Multidimensional Health Locus of Control (MHLC) scale; the group with delirium also did the Psychopathological Symptoms Inventory, by Bizoń et al. The mean score in I-E Locus of Control Scale in the group with delirium was more external than in the group without delirium (M = 13.28; SD = 2.762 versus M = 11.64; SD = 2.612; t(48) = -2.157; p = 0.036). Group with delirium had also lower mean score in the dimension of internal control in MHLC, than the group without delirium (M = 24.8; SD = 6.149 versus M = 26.8; SD = 4.648; t(48) = 1.99; p = 0.04). There were no statistically significant differences between the groups in the other subscales. The auditory and visual hallucinations were most common among patients with delirium (84%, 80% respectively, as well as delusions of taking part in not existing events (92%) and persecutory delusions (80%). Psychotic experiences influenced behaviour in nearly 50% of the cases. A more external locus of control may be one of the factors contributing to the development of alcohol delirium. The content of psychotic experiences seems to have impact on the behaviour of many patients with alcohol delirium.

Bimanual coupling paradigm as an effective tool to investigate productive behaviors in motor and body awareness impairments

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Francesca eGarbarini

2013-11-01

Full Text Available When humans move simultaneously both hands strong coupling effects arise and neither of the two hands is able to perform independent actions. It has been suggested that such motor constraints are tightly linked to action representation rather than to movement execution. Hence, bimanual tasks can represent an ideal experimental tool to investigate internal motor representations in those neurological conditions in which the movement of one hand is impaired. Indeed, any effect on the ‘moving’ (healthy hand would be caused by the constraints imposed by the ongoing motor program of the ‘impaired’ hand. Here, we review recent studies that successfully utilized the above-mentioned paradigms to investigate some types of productive motor behaviors in stroke patients. Specifically, bimanual tasks have been employed in left hemiplegic patients who report illusory movements of their contralesional limbs (anosognosia for hemiplegia. They have also been administered to patients affected by a specific monothematic delusion of body ownership, namely the belief that another person’s arm and his/her voluntary action belong to them. In summary, the reviewed studies show that bimanual tasks are a simple and valuable experimental method apt to reveal information about the motor programs of a paralyzed limb. Therefore, it can be used to objectively examine the cognitive processes underpinning motor programming in patients with different delusions of motor behavior. Additionally, it also sheds light on the mechanisms subserving bimanual coordination in the intact brain suggesting that action representation might be sufficient to produce these effects.

Can virtual reality reduce reality distortion? Impact of performance feedback on symptom change in schizophrenia patients.

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Moritz, Steffen; Voigt, Miriam; Köther, Ulf; Leighton, Lucy; Kjahili, Besiane; Babur, Zehra; Jungclaussen, David; Veckenstedt, Ruth; Grzella, Karsten

2014-06-01

There is emerging evidence that the induction of doubt can reduce positive symptoms in patients with schizophrenia. Based on prior investigations indicating that brief psychological interventions may attenuate core aspects of delusions, we set up a proof of concept study using a virtual reality experiment. We explored whether feedback for false judgments positively influences delusion severity. A total of 33 patients with schizophrenia participated in the experiment. Following a short practice trial, patients were instructed to navigate through a virtual street on two occasions (noise versus no noise), where they met six different pedestrians in each condition. Subsequently, patients were asked to recollect the pedestrians and their corresponding facial affect in a recognition task graded for confidence. Before and after the experiment, the Paranoia Checklist (frequency subscale) was administered. The Paranoia Checklist score declined significantly from pre to post at a medium effect size. We split the sample into those with some improvement versus those that either showed no improvement, or worsened. Improvement was associated with lower confidence ratings (both during the experiment, particularly for incorrect responses, and according to retrospect assessment). No control condition, unclear if improvement is sustained. The study tentatively suggests that a brief virtual reality experiment involving error feedback may ameliorate delusional ideas. Randomized controlled trials and dismantling studies are now needed to substantiate the findings and to pinpoint the underlying therapeutic mechanisms, for example error feedback or fostering attenuation of confidence judgments in the face of incomplete evidence. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Chinese version of the Psychotic Symptom Rating Scales: psychometric properties in recent-onset and chronic psychosis.

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Chien, Wai-Tong; Lee, Isabella Yuet-Ming; Wang, Li-Qun

2017-01-01

The purpose of this study was to test the reliability, validity, and factor structure of a Chinese version of the Psychotic Symptom Rating Scale (PSYRATS) in 198 and 202 adult patients with recent-onset and chronic psychosis, respectively. The PSYRATS has been translated into different language versions and has been validated for clinical and research use mainly in chronic psychotic patients but not in recent-onset psychosis patients or in Chinese populations. The psychometric analysis of the translated Chinese version included assessment of its content validity, semantic equivalence, interrater and test-retest reliability, reproducibility, sensitivity to changes in psychotic symptoms, internal consistency, concurrent validity (compared to a valid psychotic symptom scale), and factor structure. The Chinese version demonstrated very satisfactory content validity as rated by an expert panel, good semantic equivalence with the original version, and high interrater and test-retest (at 2-week interval) reliability. It also indicated very good reproducibility of and sensitivity to changes in psychotic symptoms in line with the symptom severity measured with the Positive and Negative Syndrome Scale (PANSS). The scale consisted of four factors for the hallucination subscale and two factors for the delusion subscale, explaining about 80% of the total variance of the construct, indicating satisfactory correlations between the hallucination and delusion factors themselves, between items, factors, subscales, and overall scale, and between factors and relevant item and subscale scores of the PANSS. The Chinese version of the PSYRATS is a reliable and valid instrument to measure symptom severity in Chinese psychotic patients complementary to other existing measures mainly in English language.

Associations of cerebrovascular metabolism genotypes with neuropsychiatric symptoms and age at onset of Alzheimer’s disease dementia

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Fabricio F. de Oliveira

Full Text Available Objective: To study associations of cerebrovascular metabolism genotypes and haplotypes with age at Alzheimer’s disease dementia (AD onset and with neuropsychiatric symptoms according to each dementia stage. Methods: Consecutive outpatients with late-onset AD were assessed for age at dementia onset and Neuropsychiatric Inventory scores according to Clinical Dementia Rating scores, apolipoprotein E gene (APOE haplotypes, angiotensin-converting enzyme gene (ACE variants rs1800764 and rs4291, low-density lipoprotein cholesterol receptor gene (LDLR variants rs11669576 and rs5930, cholesteryl ester transfer protein gene (CETP variants I422V and TaqIB, and liver X receptor beta gene (NR1H2 polymorphism rs2695121. Results: Considering 201 patients, only APOE-ɛ4 carriers had earlier dementia onset in multiple correlations, as well as less apathy, more delusions, and more aberrant motor behavior. Both ACE polymorphisms were associated with less intense frontally mediated behaviors. Regarding LDLR variants, carriers of the A allele of rs11669576 had less anxiety and more aberrant motor behavior, whereas carriers of the A allele of rs5930 had less delusions, less anxiety, more apathy, and more irritability. CETP variants that included G alleles of I422V and TaqIB were mostly associated with less intense frontally mediated behaviors, while severely impaired carriers of the T allele of rs2695121 had more anxiety and more aberrant motor behavior. Conclusion: Though only APOE haplotypes affected AD onset, cerebrovascular metabolism genotypes were associated with differences in several neuropsychiatric manifestations of AD.

Symptoms of psychosis in schizophrenia, schizoaffective disorder, and bipolar disorder: A comparison of African Americans and Caucasians in the Genomic Psychiatry Cohort.

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Perlman, Greg; Kotov, Roman; Fu, Jinmiao; Bromet, Evelyn J; Fochtmann, Laura J; Medeiros, Helena; Pato, Michele T; Pato, Carlos N

2016-06-01

Several studies have reported differences between African Americans and Caucasians in relative proportion of psychotic symptoms and disorders, but whether this reflects racial bias in the assessment of psychosis is unclear. The purpose of this study was to examine the distribution of psychotic symptoms and potential bias in symptoms assessed via semi-structured interview using a cohort of 3,389 African American and 5,692 Caucasian participants who were diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder. In this cohort, the diagnosis of schizophrenia was relatively more common, and the diagnosis of bipolar disorder and schizoaffective disorder-bipolar type was less relatively common, among African Americans than Caucasians. With regard to symptoms, relatively more African Americans than Caucasians endorsed hallucinations and delusions symptoms, and this pattern was striking among cases diagnosed with bipolar disorder and schizoaffective-bipolar disorder. In contrast, the relative endorsement of psychotic symptoms was more similar among cases diagnosed with schizophrenia and schizoaffective disorder-depressed type. Differential item function analysis revealed that African Americans with mild psychosis over-endorsed "hallucinations in any modality" and under-endorsed "widespread delusions" relative to Caucasians. Other symptoms did not show evidence of racial bias. Thus, racial bias in assessment of psychotic symptoms does not appear to explain differences in the proportion of symptoms between Caucasians and African Americans. Rather, this may reflect ascertainment bias, perhaps indicative of a disparity in access to services, or differential exposure to risk factors for psychosis by race. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Cotard's syndrome: Two case reports and a brief review of literature.

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Grover, Sandeep; Aneja, Jitender; Mahajan, Sonali; Varma, Sannidhya

2014-11-01

Cotard's syndrome is a rare neuropsychiatric condition in which the patient denies existence of one's own body to the extent of delusions of immortality. One of the consequences of Cotard's syndrome is self-starvation because of negation of existence of self. Although Cotard's syndrome has been reported to be associated with various organic conditions and other forms of psychopathology, it is less often reported to be seen in patients with catatonia. In this report we present two cases of Cotard's syndrome, both of whom had associated self-starvation and nutritional deficiencies and one of whom had associated catatonia.

Kālacakra: Shortlies Considerations on Time

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Adrián Muñoz

2013-05-01

Full Text Available This paper calls for a comparative reading of both the Buddhist conception of time and a branch of Western phenomenology. With special emphasis on the Madhyamaka Buddhist school, it discusses the way in which fugacity and impermanence are similarly discussed by French philosopher Gaston Bachelard in his L’intuition de l’instant. In both cases, the stress lies on the fact that duration is but a mental construct lacking true, absolute reality, while at the same time the human being is subjected to hopes of transcendence which, in turn, engender disillusion and delusion.

The role of social media networks in psychotic disorders: a case report.

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Krishna, Nithin; Fischer, Bernard A; Miller, Moshe; Register-Brown, Kelly; Patchan, Kathleen; Hackman, Ann

2013-01-01

We report the case of a young man diagnosed with schizophrenia who presented with stalking behaviors that may have been caused by problematic use or participation in social media networks (SMN). We review the possible role of SMN in the formation of his romantic delusion and offer suggestions for clinicians around incorporation of SMN questions into assessments. It is imperative to identify populations at risk of SMN-related stalking behaviors to stratify mental health resources and interventions. Additional studies are needed to further clarify the role of SMN in psychotic disorders. Copyright © 2013 Elsevier Inc. All rights reserved.

The Capgras syndrome in paranoid schizophrenia.

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Silva, J A; Leong, G B

1992-01-01

Capgras syndrome is characterized by a delusion of impostors who are thought to be physically similar but psychologically distinct from the misidentified person. This syndrome is generally thought to be relatively rare. Most of our knowledge about Capgras syndrome derives from single case studies and small series of cases usually from diagnostically heterogeneous groups. In this article, a series of 31 patients suffering from both paranoid schizophrenia and Capgras syndrome is described. Issues pertaining to the phenomenology of Capgras syndrome, the possible relation between Capgras syndrome and other delusional misidentification syndromes, and a neurobiological hypothesis aimed at explaining Capgras syndrome are discussed.

Wernicke-Korsakoff Syndrome as a Consequence of Delusional Food Refusal: A Case Study.

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Hargrave, David D; Schroeder, Ryan W; Heinrichs, Robin J; Baade, Lyle E

2015-12-01

Wernicke-Korsakoff syndrome is caused by thiamine (vitamin B1) deficiency, typically resulting from malnutrition secondary to chronic alcohol abuse. Less often, other conditions can lead to malnutrition and Wernicke-Korsakoff syndrome. We describe a 35-year-old man who developed Wernicke-Korsakoff syndrome with a typical neurologic and neuropsychological presentation after somatic delusions led him to refuse to eat. Cases like his serve to heighten awareness of the interplay between psychiatric and neurologic conditions, their sometimes atypical pathogenesis, and the value to primary care providers of consulting with psychiatrists, neurologists, and neuropsychologists when managing patients with possible Wernicke-Korsakoff syndrome.

Complete self-mutilation of male genitals as a severe form of psychiatric manifestation of HIV: A case report with review of literature

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Sriharsha Bokka

2016-01-01

Full Text Available Genital self-mutilation (GSM is a rare event that is commonly associated with psychotic disorders. However, such injuries have also been reported in nonpsychotic patients as a result of either bizarre autoerotic acts and attempts at crude sex-change operation by transsexuals or secondary complex religious beliefs and delusions regarding sexual guilt. We report a case of GSM in a human immunodeficiency virus (HIV-positive individual who not only severed his penis, scrotum, and testes completely as a result of internal conflict and frustration but also refused any further treatment toward reconstruction owing to his guilt.

Are University Students Really Customers? When Illusion May Lead to Delusion for All!

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Svensson, Goran; Wood, Greg

2007-01-01

Purpose: The marketing concept is an idea that has been adopted in non-marketing contexts, such as the relationships between universities and their students. This paper aims to posit that marketing metaphors are inappropriate to describe the student-university relationship. Design/methodology/approach: The authors provide a conceptual discussion…

Illusions and delusions: relating experimentally-induced false memories to anomalous experiences and ideas

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Philip R Corlett

2009-11-01

Full Text Available The salience hypothesis of psychosis rests on a simple but profound observation that subtle alterations in the way that we perceive and experience stimuli have important consequences for how important these stimuli become for us, how much they draw our attention, how they embed themselves in our memory and, ultimately, how they shape our beliefs. We put forward the idea that a classical memory illusion – the Deese-Roediger-McDermott (DRM effect – offers a useful way of exploring processes related to such aberrant belief formation. The illusion occurs when, as a consequence of its relationship to previous stimuli, a stimulus is asserted to be remembered even when has not been previously presented. Such illusory familiarity is thought to be generated by the surprising fluency with which the stimulus is processed. In this respect, the illusion relates directly to the salience hypothesis and may share common cognitive underpinnings with aberrations of perception and attribution that are found in psychosis. In this paper, we explore the theoretical importance of this experimentally-induced illusion in relation to the salience model of psychosis. We present data showing that, in healthy volunteers, the illusion relates directly to self reported anomalies of experience and magical thinking. We discuss this finding in terms of the salience hypothesis and of a broader Bayesian framework of perception and cognition which emphasizes the salience both of predictable and unpredictable experiences..

[From querulous neurosis to querulous delusion: the psychopathological aspects of persistent dysfunctional complaining].

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Tewarie, P R M; van der Zwaard, R

2016-01-01

The clinical concept of querulous behaviour is used only sporadically in modern psychiatry, although the concept seems to be just as clinical relevant as it was many years ago. The extension of the right to complain has played a role in the acceptance of querulous behaviour. Judicial bodies and other government organisations are being kept busier than ever because people who feel they have been denied justice became entangled in interminable litigation. Gradually, querulous behaviour causes the initial sense of injustice to disappear and querulous patients are damaged economically, socially and personally and experience suffering and function less efficiently. To describe the history, clinical features, differential diagnosis, possible psychodynamic hypotheses and possible ways of treating querulous behaviour. We studied the literature using PubMed, PsychInfo, Google and Google Scholar. There seems to be a spectrum with fluent transitions from normal complaining behaviour, querulous behaviour which is based on a paranoid, narcissistic or obsessive-compulsive personality structure, to severe pathologies like a delusional disorder. There is little evidence that pharmacotherapy or psychotherapy is effective. Nevertheless, there are opportunities for administering psychiatric treatment in order to alleviate the loss and suffering for the patients and their next-of-kin. Querulous behaviour is an old clinical concept that still has relevance today for the individual patient, complaints officers and society in general. Our current diagnostic systems provide sufficient opportunities for diagnosing patients correctly. Patients may be best served by judicial mediation at an early stage, combined with psychiatric treatment aimed at controlling emotions and restricting harmful behaviour.

Prediction error, ketamine and psychosis: An updated model.

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Corlett, Philip R; Honey, Garry D; Fletcher, Paul C

2016-11-01

In 2007, we proposed an explanation of delusion formation as aberrant prediction error-driven associative learning. Further, we argued that the NMDA receptor antagonist ketamine provided a good model for this process. Subsequently, we validated the model in patients with psychosis, relating aberrant prediction error signals to delusion severity. During the ensuing period, we have developed these ideas, drawing on the simple principle that brains build a model of the world and refine it by minimising prediction errors, as well as using it to guide perceptual inferences. While previously we focused on the prediction error signal per se, an updated view takes into account its precision, as well as the precision of prior expectations. With this expanded perspective, we see several possible routes to psychotic symptoms - which may explain the heterogeneity of psychotic illness, as well as the fact that other drugs, with different pharmacological actions, can produce psychotomimetic effects. In this article, we review the basic principles of this model and highlight specific ways in which prediction errors can be perturbed, in particular considering the reliability and uncertainty of predictions. The expanded model explains hallucinations as perturbations of the uncertainty mediated balance between expectation and prediction error. Here, expectations dominate and create perceptions by suppressing or ignoring actual inputs. Negative symptoms may arise due to poor reliability of predictions in service of action. By mapping from biology to belief and perception, the account proffers new explanations of psychosis. However, challenges remain. We attempt to address some of these concerns and suggest future directions, incorporating other symptoms into the model, building towards better understanding of psychosis. © The Author(s) 2016.

Recall of threat material is modulated by self or other referencing in people with high or low levels of non-clinical paranoia.

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Greer, J; Smailes, D; Spencer, H; Freeston, M; Dudley, R

2016-03-01

Biased processing of negatively valenced, and particularly threat-related material plays an important role in the development of paranoid thinking. This has been demonstrated by superior memory for threat-related information in patients with persecutory delusions and in non-clinical paranoia-prone participants. This study examined how emotional material was recalled having been encoded in relation to one self or to another person, in people high or low in paranoid ideation. It was predicted that people high in paranoia would recall more threat related material about others than people low in paranoia owing to being particularly alert to threats from other people. Participants who reported high (N = 30) or low (N = 30) levels of sub-clinical paranoid thinking were presented with a series of threat-related and positive words and were asked to process them in terms of the self, or in terms of a fictional character. As predicted, when words were processed in terms of another person, the high paranoia group recalled more threat-related words than positive words, but when words had been processed in terms of the self, recall of threat-related and positive words did not differ. In contrast, there was no interaction between word-valence and referent in the low paranoia group. These findings are drawn from an analogue sample. Replication in a sample of clinical participants who report persecutory delusions is required. People high in sub-clinical paranoid ideation recalled threat preferentially in relation to other people. Such information processing biases may help understand the development and maintenance of persecutory beliefs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neuropsychiatric Inventory data in a Belgian sample of elderly persons with and without dementia

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Squelard GP

2012-10-01

Full Text Available Gilles P Squelard,1 Pierre A Missotten,1 Louis Paquay,2 Jan A De Lepeleire,2 Frank JVM Buntinx,2 Ovide Fontaine,1 Stephane R Adam,1 Michel JD Ylieff11Clinical Psychology of Ageing, Qualidem Research Project, University of Liège (ULg, Liège, Belgium; 2KU Leuven, Department of Public Health and Primary Care, Leuven, BelgiumBackground/aims: This study assesses and compares prevalence of psychological and behavioral symptoms in a Belgian sample of people with and without dementia.Methods: A total of 228 persons older than 65 years with dementia and a group of 64 non-demented persons were assessed using the Neuropsychiatric Inventory (NPI in 2004.Results: Within the group without dementia, the most frequent symptoms were depression, agitation, and irritability. Within the group with dementia, the most common symptoms were depression, irritability, apathy, and agitation. Prevalence of delusions (P < 0.05, hallucinations (P < 0.05, anxiety (P < 0.05, agitation (P < 0.05, apathy (P < 0.01, aberrant motor behavior (P < 0.01, and eating disorders (P < 0.05 were significantly higher in the group with dementia.Conclusion: Depression, elation, irritability, disinhibition, and sleeping disorders are not specific to dementia. Agitation, apathy, anxiety, and delusions are more frequent in dementia but were not specific to the dementia group because their prevalence rates were close to 10% in the group without dementia. Hallucinations, aberrant motor behavior, and eating disorders are specific to dementia. The distinction between specific and nonspecific symptoms may be useful for etiological research on biological, psychological, and environmental factors.Keywords: behavior, behavior disorders, epidemiology, dementia, psychiatric symptoms, neuropsychiatry

Christianity and Schizophrenia Redux: An Empirical Study.

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Kéri, Szabolcs; Kelemen, Oguz

2016-04-09

This paper explores the relationship among schizophrenia, spirituality, and Christian religiosity. We interviewed 120 patients with schizophrenia and 120 control individuals (74.2 % of individuals with self-reported Christian religions). Patients with schizophrenia showed increases in positive spirituality and decreases in positive congregational support, as measured by the Brief Multidimensional Measure of Religiousness/Spirituality. There was no significant difference in Christian religiosity. Higher positive spirituality was predicted by more severe self-disorder, perceptual disorder, and positive clinical symptoms. Schizophrenia patients with religious delusions did not exhibit enhanced Christian beliefs and rituals. These results do not confirm the hypothesis of general hyper-religiosity in schizophrenia.

Cotard′s syndrome: Two case reports and a brief review of literature

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Sandeep Grover

2014-01-01

Full Text Available Cotard′s syndrome is a rare neuropsychiatric condition in which the patient denies existence of one′s own body to the extent of delusions of immortality. One of the consequences of Cotard′s syndrome is self-starvation because of negation of existence of self. Although Cotard′s syndrome has been reported to be associated with various organic conditions and other forms of psychopathology, it is less often reported to be seen in patients with catatonia. In this report we present two cases of Cotard′s syndrome, both of whom had associated self-starvation and nutritional deficiencies and one of whom had associated catatonia.

[The representation of madness in William Shakespeare's characters].

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Stompe, Thomas; Ritter, Kristina; Friedmann, Alexander

2006-08-01

Shakespeare is one of the great creators of human characters of the 16(th) century. Like for many of his contemporaries madness was a central topic of his work. The first part of this paper discusses the sociocultural environment and the semantic field of madness in the Elizabethan age, which forms the background for Shakespeare's characters. In the second part we try to analyze the clinical pictures of the fictive characters of Othello, Hamlet, Lear and Macbeth. While we find melancholy, delusions and hallucinations, other diseases such as schizophrenia are missing entirely. Schizophrenia only appears in the literature more than two hundred years later, in the beginning of modern age.

One patient with Sjogren’s syndrome presenting schizophrenia-like symptoms

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Lin CE

2016-03-01

Full Text Available Ching-En Lin1,2 1Department of Psychiatry, Taipei Tzu-Chi Hospital, Buddhist Medical Foundation, Taiwan, Republic of China; 2School of Medicine, Tzu-Chi University, Hualien, Taiwan, Republic of China Abstract: Comorbid depression in patients with Sjogren’s syndrome has been reported frequently, while comorbid psychosis in subjects with Sjogren’s syndrome has rarely been reported. Here we report a patient with Sjogren’s syndrome who presented with schizophrenia-like symptoms such as persecutory delusions and auditory hallucinations in contrast to her previous psychiatric presentations, which only included depression and anxiety. Keywords: mental illness, psychosis, Sjogren’s syndrome, schizophrenia

"Early Psychosis" as a mirror of biologist controversies in post-war German, Anglo-Saxon, and Soviet Psychiatry.

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Rzesnitzek, Lara

2013-01-01

The English term "early psychosis" was coined in the 1930s to refer to feelings of irritability, loss of concentration, hypochondriac ideas, moodiness, and lassitude that were seen to precede the onset of clear-cut hallucinations and delusions. The history of thinking about "early psychosis" under names such as "latent," "masked," "mild," "simple" or "sluggish" schizophrenia before World War II and afterwards on the different sides of the Wall and the Iron Curtain reveals "early psychosis" as a mirror of quite aged international biologist controversies that are still alive today and to the same extent as they are misunderstood, are influential in their implications in today's psychiatry.

Antenatal care--antenatal screening for fetal abnormality.

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Baston, Helen

2003-02-01

JOANNA IS NOW 24 WEEKS pregnant. She is feeling very well and finding that now her energy has returned, she is really enjoying being preganant. She still proudly shows her precious scan picture to interested friends and takes the occasional glance herself during quiet moments. Joanna, has a cousin, Susan, who has Down's syndrome. Susan is a happy and loving child who has brought a lot of joy, as well as heartache, to the extended family. Although Joanna has no delusions about the hard work and continuing care that her cousin requires, she would not herself contemplate terminating a pregnancy if her baby had the condition.

Humans, elephants, diamonds and gold: patterns of intentional design in Girolamo Cardano's natural philosophy.

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Giglioni, Guido

2014-01-01

Distancing himself from both Aristotelian and Epicurean models of natural change, and resisting delusions of anthropocentric grandeur, Cardano advanced a theory of teleology centred on the notion of non-human selfhood. In keeping with Plato, he argued that nature was ruled by the mind, meaning by "mind" a universal paragon of intelligibility instantiated through patterns of purposive action ("noetic" teleology). This allowed Cardano to defend a theory of natural finalism in which life was regarded as a primordial attribute of being, already in evidence in the most elementary forms of nature, whose main categories were ability to feign, self-interest, self-preservation and indefinite persistence.

History, Violence and Poetics: Saint-John Perse and René Char

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Nathan Bracher

1991-06-01

Full Text Available This essay explores the parallel yet opposite stances taken both personally and textually by Perse and Char with respect to drama of World War II. While Perse remained disdainfully aloof from public affairs after the defeat and proclaimed in his poetry his solidarity with all humanity, Char explicitly linked his writing to events, yet sought to create a human space removed from history's upheavals. Striving to transcend the vicissitudes of individual existence, Perse celebrates an epic vision of history that overlooks and even condones its violence. Focusing on the inconsistent, fragmentary nature of existence, Char prevents us from having any teleological delusions concerning war.

Shall we really say goodbye to first rank symptoms?

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Heinz, A; Voss, M; Lawrie, S M; Mishara, A; Bauer, M; Gallinat, J; Juckel, G; Lang, U; Rapp, M; Falkai, P; Strik, W; Krystal, J; Abi-Dargham, A; Galderisi, S

2016-09-01

First rank symptoms (FRS) of schizophrenia have been used for decades for diagnostic purposes. In the new version of the DSM-5, the American Psychiatric Association (APA) has abolished any further reference to FRS of schizophrenia and treats them like any other "criterion A" symptom (e.g. any kind of hallucination or delusion) with regard to their diagnostic implication. The ICD-10 is currently under revision and may follow suit. In this review, we discuss central points of criticism that are directed against the continuous use of first rank symptoms (FRS) to diagnose schizophrenia. We describe the specific circumstances in which Schneider articulated his approach to schizophrenia diagnosis and discuss the relevance of his approach today. Further, we discuss anthropological and phenomenological aspects of FRS and highlight the importance of self-disorder (as part of FRS) for the diagnosis of schizophrenia. Finally, we will conclude by suggesting that the theory and rationale behind the definition of FRS is still important for psychopathological as well as neurobiological approaches today. Results of a pivotal meta-analysis and other studies show relatively poor sensitivity, yet relatively high specificity for FRS as diagnostic marker for schizophrenia. Several methodological issues impede a systematic assessment of the usefulness of FRS in the diagnosis of schizophrenia. However, there is good evidence that FRS may still be useful to differentiate schizophrenia from somatic causes of psychotic states. This may be particularly important in countries or situations with little access to other diagnostic tests. FRS may thus still represent a useful aid for clinicians in the diagnostic process. In conclusion, we suggest to continue a tradition of careful clinical observation and fine-grained psychopathological assessment, including a focus on symptoms regarding self-disorders, which reflects a key aspect of psychosis. We suggest that the importance of FRS may indeed be

Psychotic-spectrum symptoms, cumulative adversity exposure and substance use among high-risk girls.

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Lansing, Amy E; Plante, Wendy Y; Fennema-Notestine, Christine; Golshan, Shahrokh; Beck, Audrey N

2018-02-01

Psychotic-spectrum symptoms are linked to trauma, substance/alcohol use (SAU), criminality/violence and poor functional outcomes, supporting the need for early detection in vulnerable populations. To better understand high-risk girls' mental health, we assessed: (1) psychotic-spectrum symptoms; (2) cumulative trauma, adversity and loss exposures (C-TALE) and adversity-indicators (symptoms, maladaptive coping, stressor-reactivity); and SAU risk-factors; and (3) relationships among psychotic-spectrum symptoms, adversity-indicators and SAU risk-factors. We administered the Structured Clinical Interviews for Psychotic Spectrum, and Trauma and Loss Spectrum to 158 adolescent delinquent girls. Girls' psychotic-spectrum profiles were similar to previously reported adult psychotic patients and characterized by typical symptoms (hallucinations/delusions, reported largely SAU-independent), interpersonal sensitivity, schizoid traits and paranoia (over-interpretation, anger over-reactivity, hypervigilance). Auditory/visual hallucinations (55.7%), delusions (92.4%), ideas of reference (96.8%) and adversity (90.0% ≥10/24 C-TALE-types) were common. Mean loss (4) and trauma (8) onset-age occurred before SAU-onset (12). Significant positive correlations were found among psychotic-spectrum symptoms, stressor-reactivity, C-TALE, adversity-indicators; and number of SAU-types; and a negative correlation occurred between psychotic-spectrum symptoms and earlier alcohol use onset. After controlling for number of SAU-types, stressor-reactivity and adversity-related numbing individually had the largest associations with total psychotic-spectrum symptoms (b = 2.6-4.3). Girls averaged more than 4 maladaptive coping strategies (e.g., 24.8% attempted suicide) in response to adversity, amplifying potential health-disparities. No racial/ethnic differences emerged on psychotic-spectrum symptoms. This symptom constellation during adolescence likely interferes with social and academic

Do emotions drive psychosis?

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João G. Ribeiro

2012-12-01

Full Text Available Introduction: How important is the emotional life of persons who manifest psychotic symptoms? Aims: The aim of this paper is to review evidence on a causal role for emotions in psychotic processes. Methods: Selective review of literature on affective symptoms in psychoses, on emotions in the production of psychotic symptoms and on dopaminergic models of psychosis. Results: Affective symptoms are relevant across psychoses. Persons with schizophrenia have high levels of emotional reactivity and the intensification of negative affects not only is associated with but also precedes the intensification of psychotic symptoms, which is evidence that negative emotions drive the course of psychotic symptoms. Negative self‑representations are central in psychotic processes and can be the link between negative emotions and psychosis. Evidence favours the notion that persecutory delusions are consistent with negative affects and self‑representations, while grandiose delusions are consistent with a defensive amplification of positive affects and self‑representations. Shame has been proposed as the core emotional experience of psychosis, one in which the self becomes vulnerable to the external world, which is consistent with persecutory experiences. Assaults on the self, under the form of hostility in the family environment and society, are strong predictors of relapse and development of schizophrenia. Assaults on the self which induce social defeat are also strong stimulants of mesolimbic dopaminergic pathways, whose hyperactivity is associated with acute psychotic episodes and the experience of “aberrant salience”, put forward as a dopaminergic model of psychosis. Conclusions: The “defeat of the self” emerges as a central link that binds the experience of negative emotions to the expression of psychotic symptoms and its psychological and neurobiological correlates. The hypothesis gains support that the emotions related to that defeat control

The impact of social stress on self-esteem and paranoid ideation.

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Kesting, Marie-Luise; Bredenpohl, Marcel; Klenke, Julia; Westermann, Stefan; Lincoln, Tania M

2013-03-01

Vulnerability-stress models propose that social stress triggers psychotic episodes in high risk individuals. Previous studies found not only stress but also a decrease in self-esteem to precede the formation of delusions. As evidence for causal conclusions has not been provided yet, the present study assessed the direct impact of social stress on paranoid beliefs using an experimental design and considered a decrease in self-esteem as a mediator and the proneness to psychosis and paranoia as moderators of the effect. A nonclinical population sample (n = 76) was randomly assigned to an experimental (EG) or a control group condition (CG). In the EG, participants were excluded during a virtual ball game (Cyberball) by the other two players and received a negative feedback after performing a test. The CG was included in the game and received a neutral feedback. Before and after the experimental conditions, emotions, self-esteem and paranoid beliefs were assessed using state-adapted questionnaires. After the social stress induction, the EG reported a higher increase in subclinical paranoid beliefs compared to the CG. The impact of social stress on paranoid ideation was mediated by a decrease in self-esteem and moderated by proneness to paranoia. Individuals who felt distressed by paranoid thoughts at baseline were more likely to react with an increase in paranoid ideation under social stress. The results need to be confirmed in a patient sample to draw conclusions about the processes involved in the formation of delusions in clinically relevant stages. The impact of social stress on symptom formation and self-esteem is discussed in terms of recent models of symptom formation and interventions in psychosis. Copyright © 2012 Elsevier Ltd. All rights reserved.

A randomized placebo-controlled trial of an omega-3 fatty acid and vitamins E+C in schizophrenia.

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Bentsen, H; Osnes, K; Refsum, H; Solberg, D K; Bøhmer, T

2013-12-17

Membrane lipid metabolism and redox regulation may be disturbed in schizophrenia. We examined the clinical effect of adding an omega-3 fatty acid and/or vitamins E+C to antipsychotics. It was hypothesized that lower baseline levels of polyunsaturated fatty acids (PUFAs) would predict more benefit from the add-on treatment. The trial had a multicenter, randomized, double-blind, placebo-controlled 2 × 2 factorial design. Patients aged 18-39 years with schizophrenia or related psychoses were consecutively included at admission to psychiatric departments in Norway. They received active or placebo ethyl-eicosapentaenoate (EPA) 2 g day⁻¹ and active or placebo vitamin E 364 mg day⁻¹+vitamin C 1000 mg day⁻¹ (vitamins) for 16 weeks. The main outcome measures were Positive and Negative Syndrome Scale (PANSS) total and subscales scores, analyzed by linear mixed models. Ninety-nine patients were included. At baseline, erythrocyte PUFA were measured in 97 subjects. Given separately, EPA and vitamins increased drop-out rates, whereas when combined they did not differ from placebo. In low PUFA patients, EPA alone impaired the course of total PANSS (Cohen's d=0.29; P=0.03) and psychotic symptoms (d=0.40; P=0.003), especially persecutory delusions (d=0.48; P=0.0004). Vitamins alone impaired the course of psychotic symptoms (d= 0.37; P=0.005), especially persecutory delusions (d=0.47; P=0.0005). Adding vitamins to EPA neutralized the detrimental effect on psychosis (interaction d=0.31; P=0.02). In high PUFA patients, there were no significant effects of trial drugs on PANSS scales. In conclusion, given separately during an acute episode, EPA and vitamins E+C induce psychotic symptoms in patients with low levels of PUFA. Combined, these agents seem safe.

Comparison of symptoms of delirium across various motoric subtypes.

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Grover, Sandeep; Sharma, Akhilesh; Aggarwal, Munish; Mattoo, Surendra K; Chakrabarti, Subho; Malhotra, Savita; Avasthi, Ajit; Kulhara, Parmanand; Basu, Debasish

2014-04-01

The aim of this study was to determine the correlation between delirium motor subtypes and other symptoms of delirium. Three hundred and twenty-one (n = 321) consecutive patients referred to consultation-liaison psychiatry services were evaluated on Delirium Rating scale-Revised-98 version and amended Delirium Motor Symptom Scale. Half of the patients had hyperactive subtype (n = 161; 50.15%) delirium. One-quarter of the study sample met the criteria for mixed subtype (n = 79; 24.61%), about one-fifth of the study sample met the criteria for hypoactive delirium subtype (n = 64; 19.93%), and only very few patients (n = 17; 5.29%) did not meet the required criteria for any of these three subtypes and were categorized as 'no subtype'. When the hyperactive and hypoactive subtypes were compared, significant differences were seen in the prevalence of perceptual disturbances, delusions, lability of affect, thought process abnormality, motor agitation and motor retardation. All the symptoms were more common in the hyperactive subtype except for thought process abnormality and motor retardation. Compared to hyperactive subtype, the mixed subtype had significantly higher prevalence of thought process abnormality and motor retardation. Significant differences emerged with regard to perceptual disturbances, delusions, lability of affect and motor agitation when comparing the patients with mixed subtype with those with hypoactive subtype. All these symptoms were found to be more common in the mixed subtype. No significant differences emerged for the cognitive symptoms as assessed on Delirium Rating scale-Revised-98 across the different motoric subtypes. Different motoric subtypes of delirium differ on non-cognitive symptoms. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

Reducing Delusional Conviction Through a Cognitive-Based Group Training Game: A Multicentre Randomised Controlled Trial

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Yasser eKhazaal

2015-04-01

Full Text Available AbstractObjective: Michael’s Game is a card game targeting the ability to generate alternative hypotheses to explain a given experience. The main objective was to evaluate the effect of MG on delusional conviction as measured by the primary study outcome: the change in scores on the conviction subscale of the Peters Delusions Inventory (PDI-21. Other variables of interest were the change in scores on the distress and preoccupation subscales of the PDI-21, the Brief Psychiatric Rating Scale, the Beck Cognitive Insight Scale, and belief flexibility assessed with the Maudsley Assessment of Delusions Schedule. Methods: We performed a parallel, assessor-blinded, randomised controlled superiority trial comparing treatment as usual plus participation in Michael’s Game (MG with treatment as usual plus being on a waiting list (TAU in a sample of adult outpatients with psychotic disorders and persistent positive psychotic symptoms at inclusion. Results: The 172 participants were randomised, with 86 included in each study arm. Assessments were performed at inclusion (T1: baseline, at 3 months (T2: post-treatment, and at 6 months after the second assessment (T3: follow-up. At T2, a positive treatment effect was observed on the primary outcome, the PDI-21 conviction subscale (p=0.005. At T3, a sustained effect was observed for the conviction subscale (p=0.002. Further effects were also observed at T3 on the PDI-21 distress (p=0.002 and preoccupation subscales (p=0.001, as well as on one of the MADS measures of belief flexibility (anything against the belief (p=0.001. Conclusions: The study demonstrated some significant beneficial effect of MG. http://www.controlled-trials.com/ISRCTN37178153/Funding: Swiss National Science Foundation Grant 32003B-121038

[Successful electroconvulsive therapy of Cotard syndrome with bitemporal hypoperfusion].

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Lohmann, T; Nishimura, K; Sabri, O; Klosterkötter, J

1996-05-01

A case study is presented to illustrate a rare condition described by Cotard as "délire de négation". The central symptom is a nihilistic delusion with denial of one's own existence of oneself and that of the external world. In the present case, the syndrome became manifest as an escalation of a recurrent depressive disorder late in life. After initial resistance to therapy, the syndrome was successfully treated with electroconvulsive therapy. For the first time, we report the regional cerebral blood flow measured by 99mTc-HMPAO-SPECT before and after therapy. Before treatment, significant bitemporal hypoperfusion relative to the cerebellum was found, which was no longer demonstrable on remission.

Self-mutilation of the nose in a schizophrenic patient with Cotard syndrome.

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Ghaffari-Nejad, Alireza; Kerdegari, Mohammad; Reihani-Kermani, Hamed

2007-10-01

Cotard syndrome is a rare condition, which its main symptom is nihilistic delusion. Self-mutilation of the nose is also a rare condition, which has not been seen in schizophrenic patients with Cotard syndrome. A single case is presented here. A 32-year-old woman who was diagnosed as having schizophrenia and believed that she was dead, cut the tip of her nose. She had no guilt feeling and described her act as a cosmetic surgery. We try to explain how various symptoms that seem to be very far from each other could exist side by side. Misinterpretation of her face is suggested to be the starting point in her complex symptoms.

Poetry or pathology? Jesuit hypochondria in early modern Naples.

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Haskell, Yasmin

2007-01-01

In their didactic poems on fishing and chocolate, both published in 1689, two Neapolitan Jesuits digressed to record and lament a devastating 'plague' of 'hypochondria'. The poetic plagues of Niccolò Giannettasio and Tommaso Strozzi have literary precedents in Lucretius, Vergil, and Fracastoro, but it will be argued that they also have a real, contemporary significance. Hypochondria was considered to be a serious (and epidemic) illness in the seventeenth century, with symptoms ranging from depression to delusions. Not only did our Jesuit poets claim to have suffered from it, but so did prominent members of the 'Accademia degl'Investiganti', a scientific society in Naples that was at odds with both the religious and medical establishments.

Morgellons disease?

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Accordino, Robert E; Engler, Danielle; Ginsburg, Iona H; Koo, John

2008-01-01

Morgellons disease, a pattern of dermatologic symptoms very similar, if not identical, to those of delusions of parasitosis, was first described many centuries ago, but has recently been given much attention on the internet and in the mass media. The present authors present a history of Morgellons disease, in addition to which they discuss the potential benefit of using this diagnostic term as a means of building trust and rapport with patients to maximize treatment benefit. The present authors also suggest "meeting the patient halfway" and creating a therapeutic alliance when providing dermatologic treatment by taking their cutaneous symptoms seriously enough to provide both topical ointments as well as antipsychotic medications, which can be therapeutic in these patients.

Characterization and evolution of dermal filaments from patients with Morgellons disease.

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Middelveen, Marianne J; Mayne, Peter J; Kahn, Douglas G; Stricker, Raphael B

2013-01-01

Morgellons disease is an emerging skin disease characterized by formation of dermal filaments associated with multisystemic symptoms and tick-borne illness. Some clinicians hypothesize that these often colorful dermal filaments are textile fibers, either self-implanted by patients or accidentally adhering to lesions, and conclude that patients with this disease have delusions of infestation. We present histological observations and electron microscopic imaging from representative Morgellons disease samples revealing that dermal filaments in these cases are keratin and collagen in composition and result from proliferation and activation of keratinocytes and fibroblasts in the epidermis. Spirochetes were detected in the dermatological specimens from our study patients, providing evidence that Morgellons disease is associated with an infectious process.

Spice/K2 drugs--more than innocent substitutes for marijuana.

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Zawilska, Jolanta B; Wojcieszak, Jakub

2014-03-01

Smokeable herbal mixtures containing synthetic agonists of cannabinoid receptors, known under brand names such as Spice, K2 and Kronic, represent a relatively new type of designer psychoactive drugs that has recently emerged on the recreational drug market. Although the Spice packages are labelled 'not for human consumption' or 'for aromatherapy only' and declared to be purely herbal, these herbal mixtures produce cannabis-like effects after smoking. This review surveys the current state of knowledge regarding the pharmacological properties of synthetic cannabimimetics and the prevalence and pattern of their use. Special emphasis is given to the negative consequences of using these products, including, among others, hallucinations, psychoses with delusions, seizures, cardiovascular symptoms and acute kidney injury.

Schizencephaly and Psychosis: A Rare Association

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Matias Carvalho Aguiar Melo

2013-01-01

Full Text Available Schizencephaly is a rare malformation of the central nervous system defined as a gray matter-lined cleft filled with cerebrospinal fluid that extends from the pial surface to the ventricle. Few cases of association with psychosis were reported in the scientific literature. We present a case of a 46-year-old woman, admitted into a psychiatric hospital with crises of psychomotor agitation, disorganized and erotized behavior, persecutory and self-reference delusions, and auditory and visual hallucinations. She also reported seizures since her childhood. A head CT scan revealed a large subarachnoid space communication with the adjacent lateral ventricle in the topography of occipital, temporal, and parietal lobes to the right, suggestive of schizencephaly.

‘Early Psychosis’ as a Mirror of Biologist Controversies in Post-WarGerman, Anglo-Saxon and Soviet Psychiatry

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Lara eRzesnitzek

2013-07-01

Full Text Available The English term ‘early psychosis’ was coined in the 1930s to refer to feelings of irritability, loss of concentration, hypochondriac ideas, moodiness and lassitude that were seen to precede the onset of clear-cut hallucinations and delusions. The history of thinking about ‘early psychosis’ under names such as ‘latent’, ‘masked’, ‘mild’, ‘simple’ or ‘sluggish’ schizophrenia before World War II and afterwards on the different sides of the Wall and the Iron Curtain reveals ‘early psychosis’ as a mirror of quite aged international biologist controversies that are still alive today and to the same extent as they are misunderstood, are influential in their implications in today’s psychiatry.

GABAergic Mechanisms in Schizophrenia

DEFF Research Database (Denmark)

de Jonge, Jeroen C; Vinkers, Christiaan H; Hulshoff Pol, Hilleke E

2017-01-01

Schizophrenia is a psychiatric disorder characterized by hallucinations, delusions, disorganized thinking, and impairments in cognitive functioning. Evidence from postmortem studies suggests that alterations in cortical γ-aminobutyric acid (GABAergic) neurons contribute to the clinical features...... of schizophrenia. In vivo measurement of brain GABA levels using magnetic resonance spectroscopy (MRS) offers the possibility to provide more insight into the relationship between problems in GABAergic neurotransmission and clinical symptoms of schizophrenia patients. This study reviews and links alterations...... in the GABA system in postmortem studies, animal models, and human studies in schizophrenia. Converging evidence implicates alterations in both presynaptic and postsynaptic components of GABAergic neurotransmission in schizophrenia, and GABA may thus play an important role in the pathophysiology...

A card game for the treatment of delusional ideas: A naturalistic pilot trial

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Benzakin Laetitia

2006-10-01

Full Text Available Abstract Background "Michael's game" is a card game which aims at familiarizing healthcare professionals and patients with cognitive behavioral therapy of psychotic symptoms. This naturalistic study tests the feasibility and the impact of the intervention in various naturalistic settings. Method Fifty five patients were recruited in seven centers. They were assessed in pre and post-test with the Peters Delusion Inventory – 21 items (PDI-21. Results Forty five patients completed the intervention significantly reducing their conviction and preoccupation scores on the PDI-21. Conclusion This pilot study supports the feasibility and effectiveness of "Michael's game" in naturalistic setting. Additional studies could validate the game in a controlled fashion.

PET findings in patients with chronic paranoid schizophrenia

International Nuclear Information System (INIS)

Uesugi, Hideji; Toyoda, Junzo; Iio, Masaaki.

1995-01-01

The regional cerebral blood flow (rCBF) of chronic schizophrenic patients with auditory hallucinations and paranoid delusions and normal controls was compared. The subjects were 5 male chronic inpatients (average age of 41.4 yrs, BPRS 29.3±15.0). Normal controls (6 males) were matched for age and sex. rCBF was determined by PET, based on the consecutive inhalation of 15 O-CO 2 . rCBF in the paranoid schizophrenics was significantly higher than that in normal controls in the temporal lobe and cerebellum (p<0.05). rCBF in paranoid schizophrenia showed a tendency to be higher in the frontal lobe, parietal lobe, caudate nucleus, parahippocampus and putamen, but not in the thalamus. (author)

PET findings in patients with chronic paranoid schizophrenia

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Uesugi, Hideji [National Center of Neurology and Psychiatry, Kodaira, Tokyo (Japan). National Center Hospital for Mental, Nervous and Muscular Disorders; Toyoda, Junzo; Iio, Masaaki

1995-07-01

The regional cerebral blood flow (rCBF) of chronic schizophrenic patients with auditory hallucinations and paranoid delusions and normal controls was compared. The subjects were 5 male chronic inpatients (average age of 41.4 yrs, BPRS 29.3{+-}15.0). Normal controls (6 males) were matched for age and sex. rCBF was determined by PET, based on the consecutive inhalation of {sup 15}O-CO{sub 2}. rCBF in the paranoid schizophrenics was significantly higher than that in normal controls in the temporal lobe and cerebellum (p<0.05). rCBF in paranoid schizophrenia showed a tendency to be higher in the frontal lobe, parietal lobe, caudate nucleus, parahippocampus and putamen, but not in the thalamus. (author).

Confirmatory Factor Analysis of the Delirium Rating Scale Revised-98 (DRS-R98).

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Thurber, Steven; Kishi, Yasuhiro; Trzepacz, Paula T; Franco, Jose G; Meagher, David J; Lee, Yanghyun; Kim, Jeong-Lan; Furlanetto, Leticia M; Negreiros, Daniel; Huang, Ming-Chyi; Chen, Chun-Hsin; Kean, Jacob; Leonard, Maeve

2015-01-01

Principal components analysis applied to the Delirium Rating Scale-Revised-98 contributes to understanding the delirium construct. Using a multisite pooled international delirium database, the authors applied confirmatory factor analysis to Delirium Rating Scale-Revised-98 scores from 859 adult patients evaluated by delirium experts (delirium, N=516; nondelirium, N=343). Confirmatory factor analysis found all diagnostic features and core symptoms (cognitive, language, thought process, sleep-wake cycle, motor retardation), except motor agitation, loaded onto factor 1. Motor agitation loaded onto factor 2 with noncore symptoms (delusions, affective lability, and perceptual disturbances). Factor 1 loading supports delirium as a single construct, but when accompanied by psychosis, motor agitation's role may not be solely as a circadian activity indicator.

Focus on psychosis

Science.gov (United States)

Gaebel, Wolfgang; Zielasek, Jürgen

2015-01-01

The concept of psychosis has been shaped by traditions in the concepts of mental disorders during the last 170 years. The term “psychosis” still lacks a unified definition, but denotes a clinical construct composed of several symptoms. Delusions, hallucinations, and thought disorders are the core clinical features. The search for a common denominator of psychotic symptoms points toward combinations of neuropsychological mechanisms resulting in reality distortion. To advance the elucidation of the causes and the pathophysiology of the symptoms of psychosis, a deconstruction of the term into its component symptoms is therefore warranted. Current research is dealing with the delineation from “normality”, the genetic underpinnings, and the causes and pathophysiology of the symptoms of psychosis. PMID:25987859

Super analog computer for evaluating the safety of buried radioactive waste

International Nuclear Information System (INIS)

Cohen, B.L.

1980-01-01

It is argued that the past use of digital computer programs for evaluating the safety of buried radioactive waste has been largely wasteful and dangerously delusive. It is suggested to use actual rocks as the analog of buried waste. The problem of comparable rates of leaching of radioactive waste and of natural rock is discussed. Two examples are given of the use of natural rock as an ''analog computer'': one for high-level radioactive waste, and one for low-level radioactive waste. Digital computers have not contributed anything to two crucial questions: Can shafts be securely sealed. Does the heat crack the rock or have important effects on its chemistry. 4 refs

Revelation, delusion or disillusion: subjective interpretation of religious and spiritual experiences in bipolar disorder

NARCIS (Netherlands)

Ouwehand, E.; Wong, K.; Boeije, H.R.; Braam, A.W.

2014-01-01

The objective of this study is to explore the interpretation of religious and spiritual experiences during mania, depression and recovery, from the perspective of bipolar clients and to inquire into their expectations of treatment in relation to these experiences. For this purpose, a qualitative

Revelation, delusion or disillusion : subjective interpretation of religious and spiritual experiences in bipolar disorder

NARCIS (Netherlands)

Ouwehand, Eva; Wong, Kwok; Boeije, Hennie; Braam, Arjan

2014-01-01

The objective of this study is to explore the interpretation of religious and spiritual experiences during mania, depression and recovery, from the perspective of bipolar clients and to inquire into their expectations of treatment in relation to these experiences. For this purpose, a qualitative

Revelation, delusion or disillusion: subjective interpretation of religious and spiritual experiences in bipolar disorder.

NARCIS (Netherlands)

Ouwehand, E.; Wong, K.; Boeije, H.; Braam, A.

2014-01-01

The objective of this study is to explore the interpretation of religious and spiritual experiences during mania, depression and recovery, from the perspective of bipolar clients and to inquire into their expectations of treatment in relation to these experiences. For this purpose, a qualitative

Comorbidity of narcolepsy and schizophrenia in an adolescent patient

Directory of Open Access Journals (Sweden)

Mu-Hong Chen

2014-11-01

Full Text Available A 13-year-old boy suffered from hypersomnia, fragmented nighttime sleep, and cataplexy since age 10 years, and then developed prominent psychotic symptoms (i.e., auditory and visual hallucination, hallucinatory behavior, delusions of reference, and misidentification that occurred persistently during the wakeful and consciously clear period when he was aged 12 years. The child underwent additional medical evaluation and testing, and comorbidity of narcolepsy and schizophrenia was diagnosed. The child's psychotic symptoms and narcolepsy improved significantly upon treatment with methylphenidate 30 mg, olanzapine 25 mg, and haloperidol 10 mg. In this case, the child's symptomology of narcolepsy and schizophrenia and the dilemma of the use of antipsychotics and psychostimulants are representative examples of the diagnostic and therapeutic challenges in adolescent psychiatry.

Reasoning, emotions, and delusional conviction in psychosis.

Science.gov (United States)

Garety, Philippa A; Freeman, Daniel; Jolley, Suzanne; Dunn, Graham; Bebbington, Paul E; Fowler, David G; Kuipers, Elizabeth; Dudley, Robert

2005-08-01

The aim of the study was to elucidate the factors contributing to the severity and persistence of delusional conviction. One hundred participants with current delusions, recruited for a treatment trial of psychological therapy (PRP trial), were assessed at baseline on measures of reasoning, emotions, and dimensions of delusional experience. Reasoning biases (belief inflexibility, jumping to conclusions, and extreme responding) were found to be present in one half of the sample. The hypothesis was confirmed that reasoning biases would be related to delusional conviction. There was evidence that belief inflexibility mediated the relationship between jumping to conclusions and delusional conviction. Emotional states were not associated with the reasoning processes investigated. Anxiety, but not depression, made an independent contribution to delusional conviction. Copyright (c) 2005 APA, all rights reserved.

[Delusional jealousy and obsessive love--causes and forms].

Science.gov (United States)

Bogerts, Bernhard

2005-02-10

Obsessive love and delusional jealousy as persistent mental disorders, are well-known but rare psychiatric conditions, the prevalence of which is estimated to be less than 0.1%. Delusional jealousy should not be confused with exaggerated "pathological" jealousy, which is characterized by excessive suspicion and possessiveness on the part of individuals who, as a rule, suffer from considerably disordered self-esteem. As a paranoid development, delusional jealousy occurs in particular among male chronic alcoholics. As in all delusional disorders, trivial events are evaluated with unshakeable certainty as proof of the correctness of the delusive notion. Obsessive love is seen predominantly in women. In the differential diagnosis, other mental disorders such as schizophrenia, manic or organic brain syndrome must be excluded.

Disruption of Conscious Access in Schizophrenia.

Science.gov (United States)

Berkovitch, Lucie; Dehaene, Stanislas; Gaillard, Raphaël

2017-11-01

Schizophrenia is a severe and complex psychiatric disorder resulting in delusions, hallucinations, and cognitive impairments. Across a variety of paradigms, an elevated threshold for conscious perception has been repeatedly observed in persons with schizophrenia. Remarkably, even subtle measures of subliminal processing appear to be preserved. We argue here that the dissociation between impaired conscious access and intact unconscious processing may be due to a specific disruption of top-down attentional amplification. This proposal is compatible with the neurophysiological disturbances observed in schizophrenia, including dysconnectivity, abnormal neural oscillations, and glutamatergic and cholinergic dysregulation. Therefore, placing impaired conscious access as a central feature of schizophrenia can help researchers develop a coherent and parsimonious pathophysiological framework of the disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

Delusional parasitosis--study of 3 cases.

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Hanumantha K

1994-10-01

Full Text Available Delusional disorder-somatic (parasitosis type is a rare psychiatric disorder which poses a challenge to diagnostic and therapeutic skills. Pimozide, a highly specific dopamine blocker has shown promising results in the 3 cases illustrated here. These cases were seen over a period of 3 years. All the three patients believed that an insect has entered through the ear and is burrowing tracts/laying multiple eggs. They approached the ENT surgeons or neurosurgeon with a fear that their brain will be invaded. On psychiatric evaluation, no past or present history of major psychiatric illness was found. Premorbid personalities were well adjusted. Only for two patients, acute moderate stressors were detected. Delusions disappeared by the end of 2 wks but therapy was continued for 5 months.

Implicit and explicit self-schema in active deluded, remitted deluded, and depressed patients.

Science.gov (United States)

Vázquez, Carmelo; Diez-Alegría, Cristina; Hernández-Lloreda, María J; Moreno, Marta Nieto

2008-12-01

The main objective of this study was to analyze the hypothesis that patients with persecutory delusions would show a depressive-type self-concept when assessed with implicit measures of self-schema (i.e., a free recall test of self-relevant adjectives) but would show a normal self-concept when assessed with explicit measures (i.e., a self-concept questionnaire and a task requiring endorsement of self-relevant adjectives). The sample consisted of 136 participants (40 acute deluded participants, 25 remitted deluded participants, 35 depressed patients and 36 normal controls). Our results revealed that both groups of deluded participants showed no significant discrepancy between explicit and implicit measures of self-concept. These findings do not support the hypothesis of an implicit negative cognitive schema in persecutory deluded participants.

Ownership illusions in patients with body delusions: Different neural profiles of visual capture and disownership.

Science.gov (United States)

Martinaud, Olivier; Besharati, Sahba; Jenkinson, Paul M; Fotopoulou, Aikaterini

2017-02-01

The various neurocognitive processes contributing to the sense of body ownership have been investigated extensively in healthy participants, but studies in neurological patients can shed unique light into such phenomena. Here, we aimed to investigate whether visual capture by a fake hand (without any synchronous or asynchronous tactile stimulation) affects body ownership in a group of hemiplegic patients with or without disturbed sensation of limb ownership (DSO) following damage to the right hemisphere. We recruited 31 consecutive patients, including seven patients with DSO. The majority of our patients (64.5% overall and up to 86% of the patients with DSO) experienced strong feelings of ownership over a rubber hand within 15 sec following mere visual exposure, which correlated with the degree of proprioceptive deficits across groups and in the DSO group. Using voxel-based lesion-symptom mapping analysis, we were able to identify lesions associated with this pathological visual capture effect in a selective fronto-parietal network, including significant voxels (p < .05) in the frontal operculum and the inferior frontal gyrus. By contrast, lesions associated with DSO involved more posterior lesions, including the right temporoparietal junction and a large area of the supramarginal gyrus, and to a lesser degree the middle frontal gyrus. Thus, this study suggests that our sense of ownership includes dissociable mechanisms of multisensory integration. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Neuropsychiatric Model of Biological and Psychological Processes in the Remission of Delusions and Auditory Hallucinations

NARCIS (Netherlands)

van der Gaag, M.

2006-01-01

This selective review combines cognitive models and biological models of psychosis into a tentative integrated neuropsychiatric model. The aim of the model is to understand better, how pharmacotherapy and cognitive-behavior therapy come forward as partners in the treatment of psychosis and play

Delusions of expertise: the high standard of proof needed to demonstrate skills at horserace handicapping.

Science.gov (United States)

Browne, Matthew; Rockloff, Matthew J; Blaszcynski, Alex; Allcock, Clive; Windross, Allen

2015-03-01

Gamblers who participate in skill-oriented games (such as poker and sports-betting) are motivated to win over the long-term, and some monitor their betting outcomes to evaluate their performance and proficiency. In this study of Australian off-track horserace betting, we investigated which levels of sustained returns would be required to establish evidence of skill/expertise. We modelled a random strategy to simulate 'naïve' play, in which equal bets were placed on randomly selected horses using a representative sample of 211 weekend races. Results from a Monte Carlo simulation yielded a distribution of return-on-investments for varying number of bets (N), showing surprising volatility, even after a large number of repeated bets. After adjusting for the house advantage, a gambler would have to place over 10,000 bets in individual races with net returns exceeding 9 % to be reasonably considered an expert punter (α = .05). Moreover, a record of fewer bets would require even greater returns for demonstrating expertise. As such, validated expertise is likely to be rare among race bettors. We argue that the counter-intuitively high threshold for demonstrating expertise by tracking historical performance is likely to exacerbate known cognitive biases in self-evaluation of expertise.

Thought insertion as a self-disturbance: An integration of predictive coding and phenomenological approaches

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Philipp Sterzer

2016-10-01

Full Text Available Current theories in the framework of hierarchical predictive coding propose that positive symptoms of schizophrenia, such as delusions and hallucinations, arise from an alteration in Bayesian inference, the term inference referring to a process by which learned predictions are used to infer probable causes of sensory data. However, for one particularly striking and frequent symptom of schizophrenia, thought insertion, no plausible account has been proposed in terms of the predictive-coding framework. Here we propose that thought insertion is due to an altered experience of thoughts as coming from nowhere, as is already indicated by the early 20th century phenomenological accounts by the early Heidelberg School of psychiatry. These accounts identified thought insertion as one of the self-disturbances (from German: Ichstörungen of schizophrenia and used mescaline as a model-psychosis in healthy individuals to explore the possible mechanisms. The early Heidelberg School (Gruhle, Mayer-Gross, Beringer first named and defined the self-disturbances, and proposed that thought insertion involves a disruption of the inner connectedness of thoughts and experiences, and a becoming sensory of those thoughts experienced as inserted. This account offers a novel way to integrate the phenomenology of thought insertion with the predictive coding framework. We argue that the altered experience of thoughts may be caused by a reduced precision of context-dependent predictions, relative to sensory precision. According to the principles of Bayesian inference, this reduced precision leads to increased prediction-error signals evoked by the neural activity that encodes thoughts. Thus, in analogy with the prediction-error related aberrant salience of external events that has been proposed previously, internal events such as thoughts (including volitions, emotions and memories can also be associated with increased prediction-error signaling and are thus imbued with

Phenomenology of Schizophrenia and the Representativeness of Modern Diagnostic Criteria.

Science.gov (United States)

Kendler, Kenneth S

2016-10-01

This article aims to determine the degree to which modern operationalized diagnostic criteria for schizophrenia reflect the main clinical features of the disorder as described historically by diagnostic experts. Amazon.com, the National Library of Medicine, and Forgottenbooks.com were searched for articles written or translated into English from 1900 to 1960. Clinical descriptions of schizophrenia or dementia praecox appearing in 16 textbooks or review articles published between 1899 and 1956 were reviewed and compared with the criteria for schizophrenia from 6 modern US operationalized diagnostic systems. Twenty prominent symptoms and signs were reported by 5 or more authors. A strong association was seen between the frequency with which the symptoms/signs were reported and the likelihood of their presence in modern diagnostic systems. Of these 20 symptoms/signs, 3 (thought disorder, delusions, and hallucinations) were included in all diagnostic systems and were among the 4 most frequently reported. Three symptoms/signs were added then kept in subsequent criteria: emotional blunting, changes in volition, and changes in social life. Three symptoms/signs were added but then dropped: bizarre delusions, passivity symptoms, and mood incongruity. Eleven symptoms/signs were never included in any diagnostic system. Compared with historical authors, modern criteria favored symptoms over signs. Odd movements and postures, noted by 16 of 18 historical authors, were absent from all modern criteria. DSM-5 criteria contain 6 of the 20 historically noted symptoms/signs. Although modern operationalized criteria for schizophrenia reflect symptoms and signs commonly reported by historical experts, many clinical features emphasized by these experts are absent from modern criteria. This is not necessarily problematic as diagnostic criteria are meant to index rather than thoroughly describe syndromes. However, the lack of correspondence in schizophrenia between historically important

METAPHYSICAL REVOLUTION OF DESCARTES AND TRANSFORMATION OF THE ANTHROPOLOGICAL PROJECT

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Anatolii M. Malivskyi

2015-05-01

Full Text Available The purpose is to reveal and comprehend forms of influence metaphysical' revolution for a way of interpretation of the anthropological project by Descartes on the basis of investigations of modern dekartes's researchers, that is the recognition of a fundamental role of metaphysics. Methodology. As methodological base modern investigations of dekartes's researchers accenting a fundamental role of metaphysics and expediency of unbiassed judgment of heritage of the great thinker are used. The scientific novelty. The transformation of the anthropological project is outlined as manifestation of metaphysical revolution. It is about a transcendencecy of naive anthropology (as an embodiment of reductive mindset, that is interpretations of human nature as its corporality and transition to metaphysical anthropology which consists in upholding of unconditional priority of human thinking as associated with God. As result of transition concentration of attention on intense human nature, that is at tension between sensuality and intelligence, aspiration to truth and tendency to delusion, between Life and Nothing, etc. Conclusions. The appeal to the incomplete anthropological project of Descartes on the basis of innovative researches allows proving the thesis about influence of metaphysical revolution on a way of its interpretation. The main forms of oriented to science ideals of naive anthropology, trust in evidence of the senses, atheism, interpretation of science as the main form of detection rationality of human nature, which Descartes tends constructively to overcome in the text of "meditation", are highlighted. During creation of metaphysical anthropology the attention of the thinker is drawn by the fact of impossibility of comprehension of human nature by means of natural-science rationality and expediency of the appeal to metaphysics. The subject of attention of the thinker is the tension between sensuality and intelligence, need

Short- and long-term follow-up of intensive care unit patients after sedation with isoflurane and midazolam--a pilot study.

Science.gov (United States)

Sackey, Peter V; Martling, Claes-Roland; Carlswärd, Christine; Sundin, Orjan; Radell, Peter J

2008-03-01

To compare memories from the intensive care unit (ICU) and short- and long-term psychological morbidity in patients after sedation with intravenous midazolam or inhaled isoflurane. Prospective long-term follow-up after randomized controlled trial. General ICU at Karolinska University Hospital, Solna, Stockholm. Forty patients in need of sedation during ventilator treatment. Patients were randomized to receive isoflurane or midazolam for goal-directed sedation until extubation or for a maximum of 96 hrs. For short-term follow-up, doctors', nurses', and physiotherapists' notes from the 4 days following exposure to the study drugs were reviewed for words indicating adequate or pathologic cognitive and psychological recovery. For long-term follow-up, all 6-month survivors received questionnaires including the ICU Memory Tool (ICU-MT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), and Well-Being Index. Additionally, several screening questions for previous posttraumatic stress symptoms were included. In the short term follow-up, no significant differences were found between groups. In the long-term follow-up, a trend toward fewer hallucinations/delusions after isoflurane sedation than after midazolam (two of ten isoflurane patients vs. five of seven midazolam patients) was found (p = .06). None of the five solely isoflurane-sedated patients reported hallucinations/delusions from the ICU. There was no difference in groups in long-term psychological morbidity as measured with HADS and IES. Memories of negative feelings in the ICU (ICU-MT) were associated with high HADS and IES scores (Fisher's exact test, p = .02 and p = .01, respectively). Sedation of ICU patients with isoflurane may result in fewer delusional memories or hallucinations from the ICU compared with more commonly used intravenous sedation. Memories of negative feelings from the ICU were associated with symptoms of depression or anxiety or symptoms indicating posttraumatic stress

Attribution style as a factor in psychosis and symptom resolution.

Science.gov (United States)

Mizrahi, Romina; Addington, Jean; Remington, Gary; Kapur, Shitij

2008-09-01

Attribution (AT) style theory provides a framework for understanding the causal explanations that individuals give for their own behaviour and the behaviour of others. It has been suggested that patients with persecutory delusions excessively attribute hypothetical positive events to internal causes (self) and hypothetical negative events to external personal causes. Despite this, how AT associates with psychotic symptoms (not only persecutory delusions) and how it changes with the resolution of psychosis has never been investigated. We conducted a cross-sectional study to investigate how AT is associated with psychopathology and a longitudinal study to examine the change of AT during the first 6 weeks of antipsychotic treatment and the relationship with psychopathology improvement. 86 patients meeting DSM-IV criteria for schizophrenia and related psychotic disorders were included in the cross-sectional study, and 17 patients in the longitudinal study. The longitudinal group were free of antipsychotic drugs at baseline and followed for 6 weeks after being started on antipsychotic medication by their psychiatrist. We used the Internal, Personal and Situational Attributions Questionnaire (IPSAQ) as a measure of AT. Patients that tend to internalize (i.e. less self-serving bias), showed greater overall psychopathology, as measured by PANSS-Total (F(2,83)=6.59, p=0.002), with a trend toward significance for PANSS-Positive (F(2,83)=2.62 p=0.07). Longitudinally, having a low self-serving bias was associated with poorer response to antipsychotic treatment. Further, externalizing bias seems to change early on in treatment (F=9.65 df=1,15 p=0.007) and reach ceiling effects thereafter. AT is related to overall symptom severity, with internalizing style linked to higher global psychopathology. Antipsychotic treatment has little effect on AT, at least within 6 weeks of antipsychotic exposure, and only a modest effect is on EB which plateaus within 2 weeks. Finally

Suicidal changes in patients with first episode psychosis: clinical predictors of increasing suicidal tendency in the early treatment phase

DEFF Research Database (Denmark)

Madsen, Trine; Nordentoft, Merete

2012-01-01

significantly predicted developing a higher suicidal tendency, whereas a one-point increase score on delusions was preventive of this. Feeling hopeless was highly associated with suicide attempt in those with earlier suicide attempt. Conclusion: The risk of suicide attempt did not differ between patient groups......Aim: To identify predictors for developing a higher suicidal tendency during treatment of first-episode psychosis. Methods: In a prospective follow-up study, we examined clinical factors collected at treatment initiation as predictors for developing a higher suicidal tendency among patients...... in the first year of treatment of psychosis. Patients were grouped and ranked according to their highest suicidal tendency in the year before treatment: not suicidal, suicidal thoughts, suicidal plans or suicide attempt(s). Predictors for becoming more suicidal in the first year of treatment were examined...

Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient.

Science.gov (United States)

Morgado, Pedro; Ribeiro, Ricardo; Cerqueira, João J

2015-01-01

Introduction. Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method. We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Results. Although there are few descriptions of this syndrome in schizophrenia, patients usually present depressive mood and psychomotor retardation, features not seen in our patient. Loss of the sense of the inner self, present in schizophrenia, could explain patient's symptomatology but neurobiological bases of this syndrome remain unclear. Conclusion. Despite not being considered in actual classifications, Cotard syndrome is still relevant and psychiatric evaluation is critical to diagnosing and treating this condition in psychiatric patients.

Cotard's syndrome and delayed diagnosis in Kashmir, India

Science.gov (United States)

Wani, Zaid A; Khan, Abdul W; Baba, Aijaz A; Khan, Hayat A; Wani, Qurat-ul Ain; Taploo, Rayeesa

2008-01-01

Cotard's syndrome is a rare syndrome, characterized by the presence of nihilistic delusions. The syndrome is typically related to depression and is mostly found in middle-aged or older people. A few cases have been reported in young people with 90% of these being females. We present a case of a young pregnant woman suffering from Cotard's syndrome. This is the first report of this syndrome in a pregnant woman. The case was diagnosed late, due to lack of awareness of psychiatric problems in primary care physicians resulting in undue suffering, loss of precious time and resources for the patient. Besides highlighting the rare combination of pregnancy and Cotard's syndrome this report delineates the difficulties faced by patients with such symptoms in a low resource setting. PMID:18271948

Dopamine transporter gene polymorphism and psychiatric symptoms seen in schizophrenic patients at their first episode

Energy Technology Data Exchange (ETDEWEB)

Inada, Toshiya; Sugita, Tetsuyoshi; Dobashi, Izumi [National Institute of Mental Health, Chiba (Japan)] [and others

1996-07-26

To investigate the possible role of the dopamine transporter (DAT) gene in determining the phenotype in human subjects, allele frequencies for the 40-bp variable number of tandem repeats (VNTR) polymorphism at this site were compared between 117 Japanese normal controls and 118 schizophrenic patients, including six subgroups: early-onset, those with a family history, and those suffering from one of the following psychiatric symptoms at their first episode: delusion and hallucination; disorganization; bizarre behavior; and negative symptoms. No significant differences were observed between the group as a whole or any subgroup of schizophrenic patients and controls. The results indicate that VNTR polymorphism in the DAT gene is unlikely to be a major contributor to any of the psychiatric parameters examined in the present population of schizophrenic subjects. 12 refs., 1 fig., 2 tabs.

Phobias in Poetry: Coleridge′s Ancient Mariner

Science.gov (United States)

Singh, Satendra; Khetarpal, Abha

2012-01-01

The Rime of the Ancient Mariner was written by Coleridge and is a classic poetry about retribution, punishment, guilt, and curse. Religious beliefs and delusions can arise from neurologic lesions and anomalous experiences, suggesting that at least some religious beliefs can be pathological. Looking at the poem through the psychiatric and psychological domain, the symbolism, the narration and the entire setting of the poem represents Post Traumatic Stress Disorder. Mariner′s reactions are beautifully portrayed from the psychoanalytic point of view and the literary piece shows claustrophobia, stygiophobia, dikephobia, and poinephobia. The mental stress of a person under a crisis situation has remarkably been evoked in this poem. This incredible piece of art expresses how the realization of divine love within oneself has the power to heal pain and suffer. PMID:23162202

Ion transport in deep-sea sediments

International Nuclear Information System (INIS)

Heath, G.R.

1979-01-01

Initial assessment of the ability of deep-sea clays to contain nuclear waste is optimistic. Yet, the investigators have no delusions about the complexity of the natural geochemical system and the perturbations that may result from emplacement of thermally-hot waste cannisters. Even though they may never be able to predict the exact nature of all these perturbations, containment of the nuclides by the waste form/cannister system until most of the heat has decayed, and burial of the waste to a sufficient depth that the altered zone can be treated as a black box source of dissolved nuclides to the enclosing unperturbed sediment, encourage them to believe that ion migration in the deep seabed can be modeled accurately and that our preliminary estimates of migration rates are likely to be reasonably realistic

Recommending "Unstuck-Your Guide to the Seven-Stage Journey Out of Depression"

Institute of Scientific and Technical Information of China (English)

CHEN Ke-ji; CONG Wei-hong

2010-01-01

@@ Depression is a common disorder worldwide.In the West,depression is also called "the blues" informally.It is a psychological disorder characterized by an all-encompassing low mood.Slightly depressed people may behave normally,while experiencing feelings of pain at heart.In mild depression cases,people may feel gloomy or distressed,which is usually associated with memory impairment,insomnia,dreaminess,etc.People suffering from severe depression may be preoccupied with,or ruminate over,thoughts and feelings of worthlessness,inappropriate guilt,helplessness,hopelessness,hallucinations,or delusions,most often accompanied by recurrent thoughts of death,suicide attempt or a specific plan for committing suicide.With the intensifying pressure and a competition of modern society,many people become victims of depression.It brings great trouble and burden to patients,their families,and society.

The Relationship Between Depression And Positive Signs In Chronic Schizophrenia

Directory of Open Access Journals (Sweden)

Bahaoddini S S

2004-06-01

Full Text Available Background: The results of studies about relationship between depression and positive signs in schizophrenia are controversial and clarifying the nature of this association may be difficult. The aim of present study is to investigate relationship between depressive symptoms and positive signs, in acute phase of patients with chronic schizophrenia, who have been admitted in Roozbeh Hospital. Materials and Methods: Assessments were performed using the Beck depression Inventory for depression (subjectively and positive and negative syndrome scale (PANSS for psychotic symptoms. Results: The results demonstrated a significant correlation between depressive symptoms and positive signs in these patients. Also, a significant correlation existed between depression and these items: delusions, hallucinatory behavior, excitement, hostility. Conclusion: depressive symptoms and positive signs in schizophrenia may have a common underlying pathophysiological origin.

The Society Problems in the Modern Islamic Poetry

Directory of Open Access Journals (Sweden)

Anas H. Saeed

2013-06-01

Full Text Available This research addresses the problems faced by the modern communities in terms of its social milieu. It also tries to shed some light on the most prominent of these problems that are monitored by the modern Muslims poets in their poetries and poems. These societal challenges involve homelessness, poverty and hunger, delusion and confusion, freedom restriction and injustice; cruelty of the society, sadness and worry, depression, drug addiction as well as moral corruption and the exploitation of women. These poets put their hands on those risks and social ills as a prelude to offer solutions to them to provide a decent life for human being and to build new societies towards being more stable and secure; full of happiness; respect; freedom; justice and to live a prosperous carefree life.

Low dosage of aripiprazole induced neuroleptic malignant syndrome after interaction with other neuroleptic drugs

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Albino Petrone

2013-09-01

Full Text Available Aripiprazole is a 2nd generation antipsychotic medication, atypical neuroleptic used for treatment of schizophrenia improving symptoms such as hallucinations, delusions, and disorganized thinking. A potentially fatal symptom complex sometimes referred to as neuroleptic malignant syndrome (NMS has been reported in association with administration of antipsychotic drugs, including aripiprazole. Rare cases of NMS occurred during aripiprazole treatment in the worldwide clinical database. The disease is characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia. We report on a 63-year old woman with depression syndrome who developed neuroleptic malignant syndrome after twelve days of aripripazole 5 mg per day. Our case is added to the small number already described and suggests the need for caution when aripripazole is added to increase the effect of other antipsychotics.

Subconsciously opposed. Unbewusst dagegen. Zur Psychologie der Kernenergiekontroverse

Energy Technology Data Exchange (ETDEWEB)

Wuenschmann, A

1982-01-01

The book deals with the emotional aspects of the controversy on peaceful use of nucleon energy. It would be self-delusion to expect a near end of the nuclear discussion. Advocates and opponents confront each other almost beyond reconcilation, handly prepared to hear the opposite side's arguments. What is the reason. As C.F. von Weizsaecker remarked to the author: 'To understand a phenomenon like the present nuclear energy debate is hardly possible without recurring to psychology'. In this paperback an entirely new approach to the nuclear energy debate is opened. The book has found wide attention. As the 'Neue Zuercher Zeitung' wrote: 'The author's psychology analysis of the nuclear energy controversy and especially its interpretation based on Jung's depth psychology combine to form a terse survey of many phenomena not so far systematically studied'.