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Perspectives in Psychiatric Care Jan 2020To explore and synthesize literature related to the nursing process addressing the focus "Delusion". (Review)
Review
PURPOSE
To explore and synthesize literature related to the nursing process addressing the focus "Delusion".
DESIGN AND METHODS
This literature review is integrated with a scoping study framework. From the total 252 papers found, 39 were selected.
FINDINGS
Relevant data and diagnostic activities, hypothetic nursing diagnoses, and interventions addressing the focus "Delusion" were identified.
PRACTICE IMPLICATIONS
This literature review allowed the development of a clinical data model addressing the focus "Delusion", based on the steps of the nursing process identified. This clinical data model may contribute towards improving nursing clinical decision-making and nursing care quality in relation to a client suffering from delusion as well as producing more reliable nursing-sensitive indicators.
Topics: Clinical Decision-Making; Delusions; Humans; Nursing Process; Primary Care Nursing
PubMed: 31355471
DOI: 10.1111/ppc.12401 -
International Review of Psychiatry... 2020Ekbom's syndrome represents a relatively uncommon neuropsychiatric condition characterized by the recurrent and bizarre fixed delusional belief to be infested by small... (Review)
Review
Ekbom's syndrome represents a relatively uncommon neuropsychiatric condition characterized by the recurrent and bizarre fixed delusional belief to be infested by small organisms or even unanimated materials ('Morgellons disease'), without any objective evidence of infestation/parasitosis. The condition, mainly diagnosed in a nonpsychiatric setting, is supposed to be largely underestimated and, hence, undermanaged. The present comprehensive review aims at investigating Ekbom's syndrome, from a historical, epidemiological, clinical and therapeutic perspective, by providing diagnostic-treatment strategies in managing this condition in routine psychiatric clinical settings. The prototypical patient is a middle-aged woman (or a younger subject in those cases in which substance and/or alcohol abuse is implicated), often single, divorced or widowed (loneliness component and social withdrawal), who has already consulted several specialists due to skin lesions associated with a firm and delusional belief to be infested. The identification and diagnosis are challenging due to poor patient's insight, poor knowledge and collaboration between specialists and differential diagnoses to be considered before asking for a psychiatric referral. Management and treatment strategies mainly derive from isolated case reports or observational studies with a small sample size. Further randomized clinical trials should be performed to evaluate the efficacy of newer antipsychotic drugs, including long-acting injectable formulations.
Topics: Antipsychotic Agents; Delusions; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Loneliness; Referral and Consultation; Social Isolation; Syndrome
PubMed: 32436416
DOI: 10.1080/09540261.2020.1757306 -
Medical Oncology (Northwood, London,... Jul 2023Cancer treatment is one of the most challenging topics in medical sciences. Different methods such as chemotherapy, tumor surgery, and immune checkpoint inhibitors... (Review)
Review
Cancer treatment is one of the most challenging topics in medical sciences. Different methods such as chemotherapy, tumor surgery, and immune checkpoint inhibitors therapy (ICIs) are potential approaches to treating cancer and killing tumor cells, but clinical studies have shown that they have been successful for a limited group of patients. Using viruses as a treatment can be considered as an effective treatment in the field of medicine. This is considered as a potential treatment, especially in comparison to chemotherapy, which has severe side effects related to the immune system. Most oncolytic viruses (OVs) have the potential to multiply in cancer cells, which are more than normal cells in malignant tissue and can induce immune responses. Therefore, tons of efforts and research have been started on the utilization of OVs as a treatment for cancer and have shown promising in treating cancers with less side effects. In this article, we have gathered studies about oncolytic viruses and their effectiveness in cancer treatment.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Omid Salahi] Last name [Ardekani], Author 2 Given name: [Mohammad Mehdi] Last name [Fazeli], Author 3 Given name: [Nillofar Asadi] Last name [Jemezghani]. Also, kindly confirm the details in the metadata are correct.Confirmed.
Topics: Humans; Oncolytic Viruses; Oncolytic Virotherapy; Delusions; Neoplasms; Treatment Outcome; Drug-Related Side Effects and Adverse Reactions
PubMed: 37458862
DOI: 10.1007/s12032-023-02106-6 -
Psychopathology 2022The aim of the present study is to investigate the relationship between personality, trait affectivity, and severity of delusions in patients with delusional disorder...
The aim of the present study is to investigate the relationship between personality, trait affectivity, and severity of delusions in patients with delusional disorder (DD). Thirty-two outpatients affected by DD were administered the Structured Interview for DSM-IV-TR Personality Disorders (SIDP-IV), the Pathological Narcissism Inventory (PNI), the Positive and Negative Affect Schedule (PANAS), and the Psychotic Symptom Rating Scale (PSYRATS). We analyzed the prevalence of personality disorder in our sample of patients with DD and studied the correlations between the severity of delusions and the different affective variables. Finally, we obtained a multivariate explanatory model of the severity of the delusions. The severity of delusions was directly associated with "grandiose fantasy" item of narcissistic personality and inversely related with the feelings of shame, fear, and guilt. In the multivariate model, the feeling of shame was the only independent variable capable of accounting for the severity of delusions that, in DD patients, would lie on an affective core of shame.
Topics: Delusions; Humans; Narcissism; Personality Disorders; Schizophrenia, Paranoid; Shame
PubMed: 35272292
DOI: 10.1159/000522344 -
Cognitive Neuropsychiatry Jul 2021: Delusions demand an explanation in terms of their neural, psychological, and sociological mechanisms. We must bridge these levels of explanation in order to understand...
: Delusions demand an explanation in terms of their neural, psychological, and sociological mechanisms. We must bridge these levels of explanation in order to understand and ultimately treat delusions. To this end, debates continue as to the number of contributing factors, how those factors interact, and their underlying computational mechanisms.: One popular family of models suggests that two separate insults are necessary, a problem with perception and an independent problem with belief. In particular, new work proposes that the belief problem entails a bias against disconfirmatory evidence - yielding the characteristic fixity of delusions. Here, we evaluate that claim, as well as explanations of delusions more broadly.: We suggest that such a bias may not explain enough of the variance in belief updating in delusional participants, and, more fundamentally, it might rule out specific accounts of delusions, since, such a bias might prevent them from forming in the first place, under particular assumptions about cognitive architectures.: We suggest conceptualising delusions as an evolving uncertainty driven negotiation between beliefs and evidence, in which initial formation is fuelled by unexpected uncertainty, but, once formed, the delusion engenders new expectations about uncertainty that tune down updating but also facilitate the elastic assimilation of contradictory evidence.
Topics: Delusions; Humans; Uncertainty
PubMed: 34102951
DOI: 10.1080/13546805.2021.1938984 -
MMW Fortschritte Der Medizin Feb 2021
Review
Topics: Cues; Delusions; Electric Stimulation; Eyebrows; Humans; Narcissism
PubMed: 33591507
DOI: 10.1007/s15006-021-9650-z -
Journal of Psychosomatic Obstetrics and... Mar 2022Delusions of pregnancy are associated with functional impairment and psychological distress. Previous works have focused on characterizing their etiology and identifying... (Review)
Review
PURPOSE
Delusions of pregnancy are associated with functional impairment and psychological distress. Previous works have focused on characterizing their etiology and identifying contributory social and cultural factors. The purpose of this review is to give an overview of the literature on medical or surgical comorbidities associated with delusions of pregnancy.
METHODS
We searched Google Scholar, PubMed, and PsycInfo using the terms "pregnancy delusion," "delusional pregnancy," "pseudocyesis", and "false/pseudo/phantom/spurious pregnancy" to identify all published cases of delusional pregnancies. We included cases in which medical or surgical factors might have contributed to the delusion. We extracted the following information from selected case reports: patient age, psychiatric diagnoses, medications, medical comorbidities, somatic complaints, treatment, and outcome.
RESULTS
We found that 23 of 140 cases (16.4%) were potentially influenced by concomitant medical or surgical conditions including gallstones, abdominal tumors, hyperprolactinemia, constipation, a tubal cyst, and esophageal achalasia. Medical or surgical treatment was pursued in 15 of these 23 cases, followed by mitigation of the delusion in ten cases.
CONCLUSIONS
We emphasize the importance of a thorough workup including physical and gynecological examinations in patients presenting with a delusion of pregnancy. Clinicians should recognize and overcome potential barriers to undertaking comprehensive assessments in order to prevent delays in management and treatment of underlying medical or surgical conditions.
Topics: Delusions; Female; Humans; Mental Disorders; Pregnancy; Pregnancy Trimester, Third
PubMed: 32597281
DOI: 10.1080/0167482X.2020.1779696 -
International Journal of Dermatology May 2020Delusional infestation (DI) is a disorder in which patients express a firm, unwavering belief that they are infested with some type of organism but otherwise have a... (Review)
Review
Delusional infestation (DI) is a disorder in which patients express a firm, unwavering belief that they are infested with some type of organism but otherwise have a typical grasp on reality with relatively normal cognitive functioning. Although classified as a somatic delusional disorder, DI requires special consideration due to its complicated clinical presentation, requiring attention to several possible explanations for the symptoms the patients describe. The purpose of the current review is to first summarize the clinical background and features of the diagnosis then explore treatment options. DI is a rare disorder though has reported cases dating back to the 19th century and spanning across the globe. Patients often experience the disorder as secondary to a medical condition, including substance use/withdrawal. However, there have also been many reported cases of primary DI, occurring in the absence of any other psychiatric or medical disorder. Clinically, DI is a diagnosis of exclusion, where the physician must rule out other medical conditions, including genuine dermatological disorders or infestations, or contributions from medications or substances. Patients with the disorder more commonly present to nonpsychiatric healthcare providers, making it essential for all clinicians to be able to identify the disease. Treatment can include either first or second generation antipsychotics, but it is important to proceed tactfully in discourse with the patient, being careful to address patients in a straightforward manner without reinforcing or questioning the delusion and focusing conversation on what can be done for the symptoms. Future research can continue to evaluate pathophysiology underlying primary DI, which historically has been an under-studied topic.
Topics: Antipsychotic Agents; Delusions; Diagnosis, Differential; Ectoparasitic Infestations; Humans; Physician-Patient Relations; Rare Diseases
PubMed: 31773724
DOI: 10.1111/ijd.14709 -
Schizophrenia Research Jul 2022Delusions are rigid beliefs held with high certainty despite contradictory evidence. Notwithstanding decades of research, we still have a limited understanding of the... (Review)
Review
Delusions are rigid beliefs held with high certainty despite contradictory evidence. Notwithstanding decades of research, we still have a limited understanding of the computational and neurobiological alterations giving rise to delusions. In this review, we highlight a selection of recent work in computational psychiatry aimed at developing quantitative models of inference and its alterations, with the goal of providing an explanatory account for the form of delusional beliefs in psychosis. First, we assess and evaluate the experimental paradigms most often used to study inferential alterations in delusions. Based on our review of the literature and theoretical considerations, we contend that classic draws-to-decision paradigms are not well-suited to isolate inferential processes, further arguing that the commonly cited 'jumping-to-conclusion' bias may reflect neither delusion-specific nor inferential alterations. Second, we discuss several enhancements to standard paradigms that show promise in more effectively isolating inferential processes and delusion-related alterations therein. We further draw on our recent work to build an argument for a specific failure mode for delusions consisting of prior overweighting in high-level causal inferences about partially observable hidden states. Finally, we assess plausible neurobiological implementations for this candidate failure mode of delusional beliefs and outline promising future directions in this area.
Topics: Delusions; Humans; Psychotic Disorders
PubMed: 33676820
DOI: 10.1016/j.schres.2021.01.023 -
Schizophrenia Research Feb 2020The presence of delusions is considered a key feature of psychosis, but despite the psychopathological centrality of the concept of delusion, its definition and... (Review)
Review
The presence of delusions is considered a key feature of psychosis, but despite the psychopathological centrality of the concept of delusion, its definition and comprehension is a matter of continuing debate. In recent years studies showing that delusions are common in the general population have accumulated and challenged the way we perceive psychotic illness. In this systematic review, we examine the basis of the psychosis continuum-hypothesis, by reviewing a representative section of the original literature that report measures of delusional ideation in the general population, focusing specifically on methodology. Three online databases were systematically searched for relevant studies. After applying criteria of inclusion and exclusion, 17 articles were included for comprehensive review. Estimates of the distribution of delusions in the general population vary substantially, as does the mode of assessment. The methodology relies with few exceptions exclusively on self-report and fully structured interview by lay person. We conclude that measures of delusions in the general population should be interpreted cautiously due to inherent difficulties in methodology. Hypothesizing a continuum of delusion between normality and full-blown psychosis is deemed premature based on the reviewed studies.
Topics: Delusions; Humans; Psychopathology; Psychotic Disorders; Self Report; Thinking
PubMed: 31836260
DOI: 10.1016/j.schres.2019.10.043