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Schizophrenia Bulletin Mar 2024
Topics: Humans; Delusions; Paranoid Disorders; Schizophrenia, Paranoid
PubMed: 38309718
DOI: 10.1093/schbul/sbae012 -
The American Journal of Case Reports Sep 2023BACKGROUND Many patients with dementia with Lewy bodies (DLB) experience cholinesterase inhibitor- and antipsychotic-resistant psychosis. The new second-generation...
BACKGROUND Many patients with dementia with Lewy bodies (DLB) experience cholinesterase inhibitor- and antipsychotic-resistant psychosis. The new second-generation antipsychotic pimavanserin has been used with some success in the treatment of psychosis in other forms of dementia, including Alzheimer disease and Parkinson disease dementia. It is possible that pimavanserin may also be useful in the treatment of psychosis in DLB. We sought to describe the disease course and treatment of psychosis in 4 patients with DLB who were prescribed pimavanserin after other medications failed to reduce the frequency or severity of hallucinations and delusions. CASE REPORT This is a case series of 4 male patients (ages 56 to 74 at the beginning of the reports) who developed DLB and psychosis (eg, visual illusions, visual and olfactory hallucinations, and paranoid delusions). All 4 patients were prescribed cholinesterase inhibitors (eg, donepezil or rivastigmine) prior to pimavanserin, and only 1 patient experienced improved psychosis while on cholinesterase inhibitors. All 3 patients who were prescribed first-generation antipsychotics (eg, haloperidol) or traditional second-generation antipsychotics (eg, olanzapine, risperidone, or quetiapine) experienced initial or lasting side effects with no improvement of psychosis. Conversely, all 4 patients tolerated pimavanserin well, and 3 of the 4 patients experienced significant improvement of psychosis (eg, fewer hallucinations, fewer delusions, reduced paranoia, and/or reduced distress or agitation related to hallucinations and delusions) when prescribed pimavanserin. CONCLUSIONS This case series suggests that pimavanserin is tolerable in older males with DLB and that it may be useful for the reduction of distressful hallucinations, delusions, and paranoia in patients with DLB.
Topics: Humans; Male; Aged; Antipsychotic Agents; Lewy Body Disease; Dementia; Cholinesterase Inhibitors; Parkinson Disease; Psychotic Disorders; Hallucinations; Piperidines; Urea
PubMed: 37775968
DOI: 10.12659/AJCR.939806 -
Cureus Oct 2023Our review paper delves into the intricate and multifaceted realm of cannibalism, with a focused exploration of its manifestations in Wendigo psychosis. We aim to... (Review)
Review
Our review paper delves into the intricate and multifaceted realm of cannibalism, with a focused exploration of its manifestations in Wendigo psychosis. We aim to explore the implications of cannibalism within the realms of psychiatry, anthropology, psychology, and sociology by navigating the complexities of cultural beliefs, psychological underpinnings, historical contexts, and contemporary significance surrounding cannibalism. Cannibalism is deeply ingrained in the cultural and mythological heritage of Algonquian-speaking tribes; it is closely associated with the symbolic figure of the Wendigo. The Wendigo serves as a warning about the potential loss of one's humanity in dire circumstances like starvation. Wendigo psychosis, characterized by psychiatric manifestations such as paranoia, anxiety, hallucinations, and cannibalistic urges, often emerges as a result of a fusion of cultural narratives and psychological vulnerabilities. This may provide an outlet for individuals experiencing internal distress. Historical records show that instances of Wendigo psychosis and cannibalism were more prevalent during periods of extreme scarcity and famine among Algonquian tribes, but they can also manifest in non-famine contexts. Cannibalism assumes diverse forms and meanings across various cultures, encompassing ritualistic, sacrificial, or survival cannibalism. Acknowledging these nuances is paramount to avoiding perpetuating harmful stereotypes and to appreciating the significance of these practices within specific cultures. Engaging in discussions about cannibalism necessitates cultural sensitivity and respect for diverse cultural practices and beliefs to foster open dialogue and enhance cross-cultural understanding. Although cannibalism is often associated with psychiatric disorders, it is not exclusively rooted in mental illness. Factors like substance abuse, antisocial traits, and environmental upbringing can also contribute to cannibalistic acts. In some cases, cannibalism may be linked to survival instincts stemming from trauma and abuse. Therefore, it is vital to distinguish between various forms of cannibalism and understand their underlying motivations. Analyzing cannibalistic fantasies from a psychoanalytic perspective involves exploring mechanisms such as melancholia and oral fixation, shedding light on the psychological underpinnings of these thoughts and urges. Moreover, the influence of media portrayals of cannibalism on public perceptions cannot be underestimated. Sensationalism and romanticization in popular culture can distort our understanding of the motivations and mental states of individuals involved in cannibalistic acts. In essence, cannibalism remains an intriguing and multidimensional topic deeply entrenched in cultural narratives and psychological complexities. A comprehensive understanding necessitates a multidisciplinary approach, taking into account how historical context, cultural beliefs, psychological experiences, and societal dimensions shape human behavior and our comprehension of the human condition. To navigate this complex subject with sensitivity and respect, it is essential to recognize the diverse manifestations and motivations behind cannibalistic behavior, whether in the context of Wendigo psychosis or other cultural practices.
PubMed: 38034155
DOI: 10.7759/cureus.47962 -
Cureus Feb 2024This comprehensive review explores the intricate relationship between security technologies and mental health. Security technologies, including physical security,... (Review)
Review
This comprehensive review explores the intricate relationship between security technologies and mental health. Security technologies, including physical security, cybersecurity, and surveillance measures, are integral components of our modern world, designed to protect individuals, organizations, and society from various threats. While they are vital in enhancing safety, they also have profound implications for mental well-being. The review delves into the positive impacts of security technologies, including their capacity to enhance personal safety, reduce anxiety and fear, and instill a sense of security. However, it also reveals the negative consequences, such as privacy invasion, surveillance-related stress, paranoia, and ethical concerns, which can erode mental health. User perception and trust are central to understanding how individuals experience security technologies. The review emphasizes the importance of ethical guidelines, user education, and technological advancements in mitigating negative impacts. By embracing an ethical-by-design approach, empowering users, and promoting public awareness, a balanced equilibrium between security and mental health can be achieved. The conclusion highlights the significance of ongoing research and interdisciplinary collaboration to navigate this intricate relationship effectively. By prioritizing ethical considerations and fostering a dialogue that values security and individual well-being, we can ensure a safer and more mentally healthy future in our technologically interconnected world.
PubMed: 38455776
DOI: 10.7759/cureus.53664 -
BMC Psychiatry Nov 2023The nature of the relationship between Internet Gaming Disorder (IGD) and psychosis is unclear so far. There is evidence that greater time spent in playing video games...
BACKGROUND
The nature of the relationship between Internet Gaming Disorder (IGD) and psychosis is unclear so far. There is evidence that greater time spent in playing video games may expose players to both insomnia and a toxic online environment with widespread cyberbullying. These two possible consequences of IGD may, in turn, be associated with greater psychotic experiences (PE). Based on this theoretical framework, the present study proposed to contribute the body of the knowledge in this area, by testing the possible indirect effects of insomnia severity, cyber-victimization and cyberbullying in the cross-sectional association between IGD and PE in a sample of Tunisian university students.
METHOD
We conducted a cross-sectional study over 4 months (February-May 2022). The Arabic versions of the Brief Symptom Inventory, the Internet Gaming disorder-20 Test, the Insomnia Severity Index, and the Revised Cyber Bullying Inventory-II were administered to a total of 851 students (mean age = 21.26 ± 1.68 years, 53.7% females).
RESULTS
We found that 25% of students were at risk of IGD, and 1.8% had an IGD. The results of the mediation analysis showed that insomnia severity fully mediated the association between IGD and paranoid ideation. Higher IGD was significantly associated with more insomnia severity, which was, in turn, significantly associated with more paranoid ideation. Cyberbullying partly mediated the association between IGD and psychoticism. Higher IGD scores were significantly associated with more cyberbullying, which was, in turn, significantly associated with more psychoticism. Finally, greater IGD was significantly and directly associated with higher psychoticism.
CONCLUSION
Our findings suggest that insomnia and cyberbullying may be regarded as potential targets for youth mental health promotion, as well as community-focused prevention and early intervention in psychosis. More particular attention should be devoted to the huge potential for engaging in cyberbullying among online gamers. Sleep deprivation should be prevented, assessed and treated in heavy gamers.
Topics: Adolescent; Female; Humans; Young Adult; Adult; Male; Sleep Initiation and Maintenance Disorders; Cyberbullying; Cross-Sectional Studies; Internet Addiction Disorder; Behavior, Addictive; Video Games; Internet
PubMed: 37978468
DOI: 10.1186/s12888-023-05363-x -
Psychopharmacology Jan 2024Paranoia is a common symptom of psychotic disorders but is also present on a spectrum of severity in the general population. Although paranoia is associated with an...
Paranoia is a common symptom of psychotic disorders but is also present on a spectrum of severity in the general population. Although paranoia is associated with an increased tendency to perceive cohesion and conspiracy within groups, the mechanistic basis of this variation remains unclear. One potential avenue involves the brain's dopaminergic system, which is known to be altered in psychosis. In this study, we used large-N online samples to establish the association between trait paranoia and perceptions of cohesion and conspiracy. We further evaluated the role of dopamine on perceptions of cohesion and conspiracy using a double-blind, placebo-controlled laboratory experiment where participants received levodopa or a placebo control. Our results were mixed: group perceptions and perceptions of cohesion were higher among more paranoid individuals but were not altered under dopamine administration. We outline the potential reasons for these discrepancies and the broader implications for understanding paranoia in terms of dopamine dysregulation.
Topics: Humans; Dopamine; Paranoid Disorders; Perception; Psychotic Disorders; Double-Blind Method
PubMed: 37848635
DOI: 10.1007/s00213-023-06476-7 -
Schizophrenia Bulletin Nov 2023Auditory verbal hallucinations (AVH) are central features of schizophrenia (SZ). However, AVH also occur in a small percentage of the general population who do not have...
BACKGROUND AND HYPOTHESES
Auditory verbal hallucinations (AVH) are central features of schizophrenia (SZ). However, AVH also occur in a small percentage of the general population who do not have a need for care, termed nonclinical voice hearers (NCVH). We sought to determine the degree to which the experience of AVH was similar in NCVH and in people with schizophrenia (PSZ) and evaluate the degree to which NCVH shared other features of SZ such as delusional beliefs, cognitive impairment, and negative symptoms.
STUDY DESIGN
We recruited 76 people with a DSM-V diagnosis of SZ/schizoaffective disorder (PSZ; 49 with current AVH, 27 without), 48 NCVH, and 51 healthy controls. Participants received a broad battery of clinician-administered and self-report symptom assessments and a focused cognitive assessment.
STUDY RESULTS
The AVH of NCVH and PSZ shared very similar sensory features. NCVH experienced less distress, had greater control over their AVH, and, unlike PSZ, rarely heard 2 voices speaking to each other. NCVH demonstrated a wide range of deeply held unusual beliefs, but reported less paranoia, and fewer first-rank symptoms such as passivity and alterations in self-experience. NCVH showed no evidence of cognitive deficits or negative symptoms.
CONCLUSIONS
The AVH in NCVH and PSZ demonstrate important similarities as well as clear differences. Specific features, rather than the presence, of AVH appear to determine the need for care. NCVH do not share the cognitive and motivational deficits seen in PSZ. These results suggest that AVH and unusual beliefs can be separated from the broader phenotype of SZ.
Topics: Humans; Hallucinations; Psychotic Disorders; Schizophrenia; Voice; Cognition
PubMed: 37350507
DOI: 10.1093/schbul/sbad083 -
Psychological Medicine Jul 2023Persecutory fears build on feelings of vulnerability that arise from negative views of the self. Body image concerns have the potential to be a powerful driver of...
BACKGROUND
Persecutory fears build on feelings of vulnerability that arise from negative views of the self. Body image concerns have the potential to be a powerful driver of feelings of vulnerability. Body image concerns are likely raised in patients with psychosis given the frequent weight gain. We examined for the first-time body esteem - the self-evaluation of appearance - in relation to symptom and psychological correlates in patients with current persecutory delusions.
METHODS
One-hundred and fifteen patients with persecutory delusions in the context of non-affective psychosis completed assessments of body image, self-esteem, body mass index (BMI), psychiatric symptoms and well-being. Body esteem was also assessed in 200 individuals from the general population.
RESULTS
Levels of body esteem were much lower in patients with psychosis than non-clinical controls ( = 1.2, < 0.001). In patients, body esteem was lower in women than men, and in the overweight or obese BMI categories than the normal weight range. Body image concerns were associated with higher levels of depression ( = 0.55, < 0.001), negative self-beliefs ( -0.52, < 0.001), paranoia ( -0.25, = 0.006) and hallucinations ( -0.21, = 0.025). Body image concerns were associated with lower levels of psychological wellbeing ( 0.41, < 0.001), positive self-beliefs ( 0.40, < 0.001), quality of life ( 0.23, = 0.015) and overall health ( 0.31, = 0.001).
CONCLUSIONS
Patients with current persecutory delusions have low body esteem. Body image concerns are associated with poorer physical and mental health, including more severe psychotic experiences. Improving body image for patients with psychosis is a plausible target of intervention, with the potential to result in a wide range of benefits.
Topics: Male; Humans; Female; Delusions; Body Image; Quality of Life; Psychotic Disorders; Paranoid Disorders
PubMed: 35387699
DOI: 10.1017/S0033291722000800 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Jul 2023Family risk factors are crucial to adolescent mental health. Few studies have investigated the complex relationship between family risk factors and adolescent mental...
OBJECTIVES
Family risk factors are crucial to adolescent mental health. Few studies have investigated the complex relationship between family risk factors and adolescent mental health. This study aims to investigate the complex relationship between family cumulative risk (FCR) and adolescent mental health, and to clarify the factors contributing to adolescent mental health problems.
METHODS
This study recruited 903 junior high school students and 991 senior high school students in Changsha, Hunan and was conducted through an offline computer-based questionnaire survey using the Middle School Student Mental Health Scale (MSSMHS) and the Family Cumulative Risk Questionnaire (FCRQ) to assess the mental health status and FCR factors, respectively. Statistical analyses were conducted to clarify the demographic factors influencing MSSMHS total and factor scores, and to analyze the relationship between FCRQ and MSSMHS total and factor scores.
RESULTS
Females exhibited more mental health problems than males in various MSSMHS factors (all <0.05); adolescents were prone to different mental health problems at different stages (junior high school first-grade vs. senior high school first-grade); senior high school first-grade students were more likely to experience academic pressure and maladjustment than junior high school first-grade students (<0.01), and junior high school first-grade students were more likely to exhibit obsessive, paranoia, and hostility symptoms than senior high school first-grade students (all <0.01); adolescents with low family intimacy and high family conflict reported more symptoms in every dimension of MSSMHS (all <0.05); adolecents with poor parent-child separation reported higher obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, academic pressure, maladjustment, emotional instability, and unbalanced mind than those with good parent-child separation (all <0.05).
CONCLUSIONS
Female, low family intimacy, high family conflict, and poor parent-child separation are risk factors of adolescent mental health problems. Higher-grade middle school students are prone to exhibit academic pressure and maladjustment, while lower-grade middle school students are prone to exhibit obsessive, paranoia, and hostility symptoms.
Topics: Male; Adolescent; Female; Humans; Mental Health; Anxiety; Anxiety Disorders; Risk Factors; Students
PubMed: 37724411
DOI: 10.11817/j.issn.1672-7347.2023.230065 -
BMC Psychiatry Nov 2023Suicidal thoughts, acts, plans and deaths are considerably more prevalent in people with non-affective psychosis, including schizophrenia, compared to the general...
BACKGROUND
Suicidal thoughts, acts, plans and deaths are considerably more prevalent in people with non-affective psychosis, including schizophrenia, compared to the general population. Social isolation and interpersonal difficulties have been implicated in pathways which underpin suicidal experiences in people with severe mental health problems. However, the interactions between psychotic experiences, such as hallucinations and paranoia, suicidal experiences, and the presence, and indeed, absence of interpersonal relationships is poorly understood and insufficiently explored. The current study sought to contribute to this understanding.
METHODS
An inductive thematic analysis was conducted on transcripts of 22, individual, semi-structured interviews with adult participants who had both non-affective psychosis and recent suicidal experiences. A purposive sampling strategy was used. Trustworthiness of the analysis was assured with researcher triangulation.
RESULTS
Participants relayed both positive and negative experiences of interpersonal relationships. A novel conceptual model is presented reflecting a highly complex interplay between a range of different suicidal experiences, psychosis, and aspects of interpersonal relationships. Three themes fed into this interplay, depicting dynamics between perceptions of i. not mattering and mattering, ii. becoming disconnected from other people, and iii. constraints versus freedom associated with sharing suicidal and psychotic experiences with others.
CONCLUSION
This study revealed a detailed insight into ways in which interpersonal relationships are perceived to interact with psychotic and suicidal experiences in ways that can be both beneficial and challenging. This is important from scientific and clinical perspectives for understanding the complex pathways involved in suicidal experiences.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT03114917), 14 April 2017. ISRCTN (reference ISRCTN17776666 .); 5 June 2017). Registration was recorded prior to participant recruitment commencing.
Topics: Adult; Humans; Suicidal Ideation; Psychotic Disorders; Interpersonal Relations; Schizophrenia; Hallucinations
PubMed: 38001403
DOI: 10.1186/s12888-023-05164-2