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Industrial Psychiatry Journal Oct 2021Phenomenon of induced delusional disorder has a relatively long, controversial history of conceptualization. It is a rare entity and goes undiagnosed mostly as only the...
Phenomenon of induced delusional disorder has a relatively long, controversial history of conceptualization. It is a rare entity and goes undiagnosed mostly as only the primary partner is brought to clinical attention. We present a case series of induced delusional disorder with different presentations. For effective management, understanding the dynamics of relationship shared by the partners and addressing the biopsychosocial factors are crucial. Failure to adhere to treatment poses additional challenge in these cases.
PubMed: 34908705
DOI: 10.4103/0972-6748.328825 -
Revista Colombiana de Psiquiatria 2016Fratricide is the killing of one's own bother. It's a type of homicide rarely seen on psychiatric practice. This is still a theme which is poorly studied, and not well...
BACKGROUND
Fratricide is the killing of one's own bother. It's a type of homicide rarely seen on psychiatric practice. This is still a theme which is poorly studied, and not well understood by the scientific literature.
OBJECTIVE
To report a case of a men, with paranoid schizophrenia that murdered his own bother and had a psychiatric forensic evaluation to establish his penal responsibility.
METHODS
A psychiatric interview was carried out and the psychiatric diagnosis was established based on the interview and analysis of forensic and medical records, using the DSM-IV-TR criteria. Literature review was held about the theme.
RESULTS
The examinee was considered not guilty by reason of insanity, due to the presence of a mental disorder that affected her entire understanding and volition of the practiced act.
CONCLUSIONS
The study of such cases may illustrate and identify motivating factors related to homicidal behavior in individuals with severe mental disorders.
Topics: Brazil; Homicide; Humans; Insanity Defense; Male; Middle Aged; Schizophrenia, Paranoid; Schizophrenic Psychology
PubMed: 27132763
DOI: 10.1016/j.rcp.2015.09.002 -
Reumatologia Clinica 2017
Topics: Adult; Animals; Ascorbic Acid; Feeding Behavior; Gingivitis; Hemarthrosis; Humans; Knee Joint; Magnetic Resonance Imaging; Male; Malnutrition; Milk; Schizophrenia, Paranoid; Scurvy; Yogurt
PubMed: 28433625
DOI: 10.1016/j.reuma.2017.03.001 -
Der Nervenarzt May 2017Depressive delusion is the key symptom of psychotic depression also known as major depressive disorder with psychotic features (ICD-10: F 32.3). Delusional topics are... (Review)
Review
Depressive delusion is the key symptom of psychotic depression also known as major depressive disorder with psychotic features (ICD-10: F 32.3). Delusional topics are limited to guilt, impoverishment and hypochondria. Kurt Schneider described these as being the three primordial fears of human beings. Psychotic depression is distinguished by the particular severity and frequency of the episodes of illness as well as by increased suicidal tendencies. Although one in five patients with a major depression experiences psychotic symptoms, this condition is all too easily overlooked and the appropriate therapy is not initiated. Here we use case histories to illustrate some of the obstacles to diagnosis arising from the difficulty of identifying delusions hidden in a person's experience of depression, life history and personality. A targeted active exploration of these difficulties is significant taking into account the observable symptoms and not only the subjectively experienced symptoms. A phenomenological approach is chosen to explore the matter of depressive delusion and to investigate the interaction of delusion and affect and the special importance of anxiety for the genesis of delusion. In accordance with the current treatment recommendations and against this background, it is proposed that the pharmacological strategy should be supplemented by the use of benzodiazepines more often than has it has been in the past.
Topics: Antidepressive Agents; Benzodiazepines; Depression; Diagnosis, Differential; Evidence-Based Medicine; Germany; Humans; Practice Guidelines as Topic; Schizophrenia, Paranoid; Treatment Outcome
PubMed: 27357450
DOI: 10.1007/s00115-016-0149-2 -
Psychiatry, Psychology, and Law : An... 2022This study investigates the relationship of delusional disorder and its subtypes to criminal and violent behavior by comparing the sociodemographic and clinical...
This study investigates the relationship of delusional disorder and its subtypes to criminal and violent behavior by comparing the sociodemographic and clinical characteristics of patients with and without a criminal history and identifying predictors of crime. The records of 346 patients with a delusional disorder diagnosis were retrospectively evaluated using a sociodemographic data form, a crime violence rating scale and the Overt Aggression Scale (OAS). The results show that homicide and attempted homicide were committed more frequently by patients with jealous delusions, whereas verbal assault and crimes against the public were committed more frequently by patients with persecutory and other delusions. Patients with a criminal history had more hospital admissions and longer stays. Marital status, persecutory delusions, a high OAS score and older age were found to be associated with higher risk of crime. Clinical subtypes and sociodemographic characteristics seem to discriminate delusional disorder patients' risk of crime.
PubMed: 35903497
DOI: 10.1080/13218719.2021.1956386 -
Asian Journal of Psychiatry Aug 2023We conducted a retrospective chart review to examine the gender differences in young onset Persistent Delusional Disorder (PDD) subjects (N = 236) with onset of...
We conducted a retrospective chart review to examine the gender differences in young onset Persistent Delusional Disorder (PDD) subjects (N = 236) with onset of illness before the age of 30 years. Gender differences in marital and employment status were significant (p-0.001). Delusion of infidelity and erotomania were more common in females, while males had more body dysmorphic and persecutory delusions (X-20.45, p-0.009). Males had more substance dependence (X-21.31, p < 0.001), as well as a family history of substance abuse and PDD (X-18.5, p < 0.01). To conclude, gender differences in PDD comprised some psychopathology, co-morbidity, and family history among those with young onset PDD.
Topics: Male; Female; Humans; Adult; Delusions; Schizophrenia, Paranoid; Sex Factors; Retrospective Studies; Comorbidity; Substance-Related Disorders
PubMed: 37270876
DOI: 10.1016/j.ajp.2023.103653 -
Case Reports in Dermatological Medicine 2020Isotretinoin, an active form of vitamin A, is the drug of last resort for the treatment of severe acne. Depression, suicidal ideation, and psychosis are among the most...
Isotretinoin, an active form of vitamin A, is the drug of last resort for the treatment of severe acne. Depression, suicidal ideation, and psychosis are among the most well-documented psychiatric side effects. Here, we report a case of isotretinoin-induced psychosis, which was diagnosed as delusional disorder somatic subtype, in a young male in the absence of any prodromal symptoms, previous psychiatric history, or family history of mental illness. The onset of psychosis was in the context of a dosage increase from 40 mg/day to 80 mg/day. Isotretinoin was discontinued, and the patient showed improvement on low-dose quetiapine.
PubMed: 32774942
DOI: 10.1155/2020/8853167 -
Current Pharmaceutical Design 2022Adherence to medication regimens is of great importance in psychiatry because drugs sometimes need to be taken for long durations in order to maintain health and... (Review)
Review
BACKGROUND
Adherence to medication regimens is of great importance in psychiatry because drugs sometimes need to be taken for long durations in order to maintain health and function.
OBJECTIVE
This study aimed to review influences on adherence to antipsychotic medications, the treatment of choice for the delusional disorder (DD), and to focus on adherence in women with DD.
METHODS
This is a non-systematic narrative review of papers published since 2000 using PubMed and Google Scholar, focusing on women with DD and medication adherence.
RESULTS
Several factors have been identified as exerting influence on adherence in women with persistent delusional symptoms who are treated with antipsychotics. Personality features, intensity of delusion, perception of adverse effects, and cognitive impairment are patient factors. Clinical time spent with the patient, clarity of communication, and regular drug monitoring are responsibilities of the health provider. Factors that neither patient nor clinician can control are the social determinants of health, such as poverty, easy access to healthcare, and cultural variables.
CONCLUSION
There has been little investigation of factors that influence adherence in the target population, e.g., women with DD. Preliminary results of this literature search indicate that solutions from outside the field of DD may apply to this population. Overall, a solid therapeutic alliance appears to be the best hedge against nonadherence.
Topics: Antipsychotic Agents; Female; Humans; Medication Adherence; Schizophrenia, Paranoid
PubMed: 35272589
DOI: 10.2174/1381612828666220310151625 -
Annals of the New York Academy of... Nov 2015A growing body of evidence suggests that reasoning in humans relies on a number of related processes whose neural loci are largely lateralized to one hemisphere or the... (Review)
Review
A growing body of evidence suggests that reasoning in humans relies on a number of related processes whose neural loci are largely lateralized to one hemisphere or the other. A recent review of this evidence concluded that the patterns of lateralization observed are organized according to two complementary tendencies. The left hemisphere attempts to reduce uncertainty by drawing inferences or creating explanations, even at the cost of ignoring conflicting evidence or generating implausible explanations. Conversely, the right hemisphere aims to reduce conflict by rejecting or refining explanations that are no longer tenable in the face of new evidence. In healthy adults, the hemispheres work together to achieve a balance between certainty and consistency, and a wealth of neuropsychological research supports the notion that upsetting this balance results in various failures in reasoning, including delusions. However, support for this model from the neuroimaging literature is mixed. Here, we examine the evidence for this framework from multiple research domains, including an activation likelihood estimation analysis of functional magnetic resonance imaging studies of reasoning. Our results suggest a need to either revise this model as it applies to healthy adults or to develop better tools for assessing lateralization in these individuals.
Topics: Brain Mapping; Cerebrum; Functional Laterality; Humans; Likelihood Functions; Schizophrenia, Paranoid; Split-Brain Procedure
PubMed: 26426534
DOI: 10.1111/nyas.12940 -
Schizophrenia Research Sep 2018Clozapine has been shown to be the most efficacious therapy for treatment resistant schizophrenia, estimated at one third of all schizophrenia cases. There is... (Review)
Review
Clozapine has been shown to be the most efficacious therapy for treatment resistant schizophrenia, estimated at one third of all schizophrenia cases. There is significant morbidity and mortality associated with clozapine including risk of agranulocytosis, aspiration pneumonia, bowel ischemia, myocarditis, seizures, and weight gain. Here we present a case of a 62-year-old man with chronic paranoid schizophrenia refractory to numerous antipsychotics who was started on clozapine therapy during an acute inpatient psychiatric admission. Within three weeks of starting clozapine, the patient developed flu-like symptoms, pleuritic chest pain, and was sent to a medical hospital for evaluation. After transfer, the patient had a rapidly deteriorating course with newly developed congestive heart failure, acute respiratory failure requiring intubation, and cardiovascular collapse requiring vasopressors. The patient expired within two days of transfer and four days after initial symptoms developed. The underlying etiology in this case is likely clozapine induced myocarditis leading to rapid cardiovascular collapse and death. Mortality with clozapine induced myocarditis has been estimated up to 24%. Given that 90% of clozapine cardiotoxic sequelae are seen in the first month post-initiation, more rigorous post-initiation surveillance is recommended for the first four weeks of clozapine with weekly cardiac enzymes (troponins, creatinine kinase-MB), EKG, and acute inflammatory markers (C-reactive protein, and erythrocyte sedimentation rate).
Topics: Antipsychotic Agents; Clozapine; Fatal Outcome; Humans; Male; Middle Aged; Myocarditis; Schizophrenia, Paranoid
PubMed: 29503232
DOI: 10.1016/j.schres.2018.02.058