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Industrial Psychiatry Journal Oct 2021
PubMed: 34908740
DOI: 10.4103/0972-6748.328860 -
Current Topics in Behavioral... 2022Any attempt to compare the definitions of symptoms listed for "primary psychoses" with those adopted in studies of psychoses in patients with epilepsy (PWE) will...
Any attempt to compare the definitions of symptoms listed for "primary psychoses" with those adopted in studies of psychoses in patients with epilepsy (PWE) will encounter problems of heterogeneity within both conditions. In this manuscript, five psychotic illnesses listed in Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5), that is, brief psychotic illness, schizophreniform disorder, schizophrenia, delusional disorder, and schizoaffective disorder are compared with postictal (or periictal) and interictal psychotic disorders in PWE. After examining definitions of primary psychoses, definitions of psychoses adopted in the papers dealing with postictal and interictal psychoses are summarized. Further, diagnostic criteria of five types of psychotic disorders in PWE proposed in 2007 by Krishnamoorthy et al. are also discussed, which include postictal psychosis, comorbid schizophrenia, iatrogenic psychosis caused by antiepileptic drugs (AEDs) (AED-induced psychotic disorder: AIPD), and forced normalization. Evidently, a comparison between postictal psychosis and schizophrenia is pointless. Likewise, schizophrenia may not be an appropriate counterpart of forced normalization and AIPD, given their acute or subacute course.Based on these preliminary examinations, three questions are selected to compare primary psychoses and psychoses in PWE: Is postictal psychosis different from a brief psychotic disorder? Does epilepsy facilitate or prevent the development of psychosis or vice versa? Is interictal psychosis of epilepsy different from process schizophrenia? In conclusion, antagonism between psychosis and epileptic seizures in a later stage of active epilepsy seems not to be realized without reorganization of the nervous system promoted during an earlier stage. Both genetic predisposition and the summated effects of epileptic activity must be taken into consideration as part of a trial to explain interictal psychosis. Interictal psychosis is an aggregate of miscellaneous disorders, that is, co-morbid schizophrenia, AED-induced psychotic disorders, forced normalization, and "epileptic" interictal psychosis. Data are lacking to conclude whether differences exist between process schizophrenia and "epileptic" interictal psychosis in terms of negative symptoms, specific personal traits, and the "bizarre-ness" of delusory-hallucinatory contents. These discussions may shed light on the essence of process schizophrenia, thus allowing it stand out and receive increased focus.
Topics: Epilepsy; Hallucinations; Humans; Psychotic Disorders; Schizophrenia; Seizures
PubMed: 34426945
DOI: 10.1007/7854_2021_234 -
The Neuroscientist : a Review Journal... Feb 2021Delusions are irrational, tenacious, and incorrigible false beliefs that are the most common symptom of a range of brain disorders including schizophrenia, Alzheimer's,... (Review)
Review
Delusions are irrational, tenacious, and incorrigible false beliefs that are the most common symptom of a range of brain disorders including schizophrenia, Alzheimer's, and Parkinson's disease. In the case of schizophrenia and other primary delusional disorders, their appearance is often how the disorder is first detected and can be sufficient for diagnosis. At this time, not much is known about the brain dysfunctions leading to delusions, and hindering our understanding is that the complexity of the nature of delusions, and their very unique relevance to the human experience has hampered elucidation of their underlying neurobiology using either patients or animal models. Advances in neuroimaging along with improved psychiatric and cognitive modeling offers us a new opportunity to look with more investigative power into the deluded brain. In this article, based on data obtained from neuroimaging studies, we have attempted to draw a picture of the neural networks involved when delusion is present and evaluate whether different manifestations of delusions engage different regions of the brain.
Topics: Cerebral Cortex; Connectome; Delusions; Humans; Nerve Net; Schizophrenia, Paranoid; Ventral Striatum
PubMed: 32648532
DOI: 10.1177/1073858420936172 -
L'Encephale Feb 2021In total, 14% to 30 % of individuals with gambling disorder engage in illegal acts to finance such behavior. This clinical situation could be explained by higher...
OBJECTIVES
In total, 14% to 30 % of individuals with gambling disorder engage in illegal acts to finance such behavior. This clinical situation could be explained by higher gambling severity, associated substance use disorder, antisocial personality disorder and economic factors (debts, financial problems). The present work focuses, more broadly, on criminal responsibility of problematic gamblers.
METHODS
We will discuss this question through different typical situations that medical experts of criminal responsibility may have to face. We will address each of the following cases: 1) isolated problematic gambling; 2) problematic gambling associated with antisocial personality disorder; 3) problematic gambling associated with a manic episode; 4) problematic gambling associated with substance use disorders; and 5) problematic gambling associated wiht dopamine agonist treatment.
RESULTS
Isolated problematic gambling, (not associated with any psychiatric or addictive disorder): it seems consensual that individuals committing infractions in this case are criminally responsible. However, impeded ability to action control and possible sentence attenuation could be discussed in case of severe gambling disorder. Problematic gambling associated with antisocial personality disorder: if the penal offence reports solely to personality disorder, criminal responsibility would be attributed. However, if illegal or violent acting is directly linked to co-cocurrent delusional symptoms, it could be a cause of criminal non-responsibility. Problematic gambling associated with manic episode: manic episode related offence could lead to negation of criminal responsibility, while a hypomanic episode may provide grounds for sentence reduction. Problematic gambling associated with substance use disorders: in France, addiction is not considered to remove nor to impede a person's ability to understand or control his actions and is excluded from criminal non-responsibility causes. However, substance induced delusional or confusional episodes could abolish a subject's discernment or his ability to control his actions yielding to penal non-responsibility. Problematic gambling associated with dopamine agonist treatment: Criminal responsibility for dopamine agonist induced gambling related illegal acts is still controversial. Nevertheless, people committing an infraction linked to associated dementia or dopamine agonist induced mania should be considered as criminally non-responsible.
CONCLUSIONS
Some clinical dimensions such as craving intensity, compulsivity, disorder's severity, volitional control might be forensic targets to assess criminal responsibility.
Topics: Behavior, Addictive; Criminals; Gambling; Humans; Personality Disorders; Social Behavior
PubMed: 32928533
DOI: 10.1016/j.encep.2020.04.018 -
Neuropsychiatric Disease and Treatment 2021Schizophrenia is a chronic relapsing and remitting disorder associated with significant impairments in social and vocational functioning and a shortened lifespan, and it...
Schizophrenia is a chronic relapsing and remitting disorder associated with significant impairments in social and vocational functioning and a shortened lifespan, and it is a disabling psychiatric brain syndrome whose phenotype is characterized by three core symptom domains: positive symptoms, such as delusions and hallucinations, negative symptoms, which include lack of motivation and social withdrawal, and cognitive impairment. Moreover, patients with schizophrenia have severe problems with personal and social relations which affect their quality of life. Antipsychotic medications in conjunction with psychosocial interventions can help patients achieve recovery. Here are described three clinical cases of schizophrenic patients treated with cariprazine for inadequate response to a previous treatment. The purpose of this clinical series is to give useful information for the use of cariprazine in clinical practice.
PubMed: 34285492
DOI: 10.2147/NDT.S315653 -
Journal of Psychiatric Research Dec 2020Firmly held beliefs that have a delusional quality are commonly experienced in those with schizophrenia spectrum disorders (SSD) and have been reported in those with...
Firmly held beliefs that have a delusional quality are commonly experienced in those with schizophrenia spectrum disorders (SSD) and have been reported in those with dissociative identity disorder (DID). However, no study to date has compared delusional belief content and characteristics between these diagnostic groups. This study examined delusional content, and the degree of conviction, preoccupation and distress associated with them in 50 participants with DID and 50 with an SSD exploring also dissociation and childhood trauma as predictors of delusional beliefs. Multivariate analysis of variance and linear regressions were conducted to explore differences between beliefs and characteristics and to examine their association with dissociation and childhood trauma. The SSD sample presented more self-referential delusional beliefs and characteristics compared to the DID group. Yet, the DID group had more mistrust delusional beliefs and characteristics in comparison to SSD participants. Mistrust beliefs were predicted by depersonalization/derealization in the DID sample, but did not predict any delusional belief in the SSD sample. The content of fixed beliefs differs between DID and SSD samples and in this study depersonalization/derealization experiences were related to mistrust beliefs but not to other delusional forms, and only in the DID sample.
Topics: Delusions; Dissociative Disorders; Dissociative Identity Disorder; Humans; Psychotic Disorders; Schizophrenia
PubMed: 33038656
DOI: 10.1016/j.jpsychires.2020.09.015 -
Healthcare (Basel, Switzerland) Sep 2022There is increasing evidence that individuals with psychosis are at increased risk for cardiovascular disease, diabetes, metabolic syndrome, and several other medical... (Review)
Review
BACKGROUND
There is increasing evidence that individuals with psychosis are at increased risk for cardiovascular disease, diabetes, metabolic syndrome, and several other medical comorbidities. In delusional disorder (DD), this is particularly so because of the relatively late onset age.
AIMS
The aim of this narrative review is to synthesize the literature on the necessity for medical collaboration between psychiatrists and other specialists.
METHODS
A non-systematic narrative review was carried out of papers addressing referrals and cooperation among specialists in the care of DD patients.
RESULTS
Psychiatrists, the primary care providers for DD patients, depend on neurology to assess cognitive defects and rule out organic sources of delusions. Neurologists rely on psychiatry to help with patient adherence to treatment and the management of psychotropic drug side effects. Psychiatrists require ophthalmology/otolaryngology to treat sensory deficits that often precede delusions; reciprocally, psychiatric consults can help in instances of functional sensory impairment. Close collaboration with dermatologists is essential for treating delusional parasitosis and dysmorphophobia to ensure timely referrals to psychiatry.
CONCLUSIONS
This review offers many other examples from the literature of the extent of overlap among medical specialties in the evaluation and effective treatment of DD. Optimal patient care requires close collaboration among specialties.
PubMed: 36141341
DOI: 10.3390/healthcare10091729 -
Nursing Aug 2021Patients with delusional infestation, a rare psychiatric disorder, have a false and fixed belief that insects or other organisms are crawling in or on their skin. This...
Patients with delusional infestation, a rare psychiatric disorder, have a false and fixed belief that insects or other organisms are crawling in or on their skin. This article describes signs and symptoms, available treatments, and appropriate nursing interventions for patients with primary delusional infestation.
Topics: Humans; Mental Disorders; Nursing Assessment; Nursing Diagnosis; Risk Factors
PubMed: 34347755
DOI: 10.1097/01.NURSE.0000757152.58008.d1 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2022The neurophysiological objectification of intranosological differentiation of main clusters (schizoid/paranoid and hysterical/emotionally unstable) within the typology...
OBJECTIVE
The neurophysiological objectification of intranosological differentiation of main clusters (schizoid/paranoid and hysterical/emotionally unstable) within the typology of personality disorders (PD), as well as the differentiation of schizoid/paranoid PD and schizophrenia.
MATERIAL AND METHODS
Two groups of patients with PD participated in the study: PD1 - with schizoid/paranoid pattern (=16), and PD2 - with hysterical/emotionally unstable pattern (=18). The data were compared with the control group of healthy volunteers (=86) and the group of schizophrenic patients (Sz, =67). The analysis of four neurophysiological endophenotypes (measures of prepulse inhibition (PPI) of acoustic startle response and of P50 suppression, P300 amplitude, percentage of antisaccade errors) was carried out.
RESULTS
The decrease of PPI and P50 suppression (measures of sensorimotor and sensory gating) relative to the control group was found both for Sz (<0.01) and PD1 (<0.05) groups. The highest P300 amplitude was observed in the control group, while the lowest values were observed in the Sz group (<0.001); the values of PD1 and PD2 groups were intermediate. In all clinical groups percent of antisaccade errors was significantly higher compared to the control group (Sz - <0.001; PD1 - <0.05; PD2 - <0.01). However, the level of the fronto-central cortical activation during antisaccade performance (estimated by contingent negative variation amplitude) was significantly reduced only in the Sz group (<0.01), which is consistent with the concept of «hypofrontality» in schizophrenia. The changes associated with increased emotional reactivity were found in PD2 group only (P300 amplitude frontal maximum, asymmetry of error percent in antisaccade task).
CONCLUSION
The study showed that two personality patterns in PD patients are related to the individual specificity of functional brain networks.
Topics: Humans; Reflex, Startle; Personality Disorders; Schizophrenia; Endophenotypes; Neurophysiology
PubMed: 36440789
DOI: 10.17116/jnevro2022122111124 -
The Cochrane Database of Systematic... Dec 2019Primary delusional infestation (DI) is a primary psychiatric disorder characterised by delusions and abnormal tactile sensations. The pathophysiology is undecided and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Primary delusional infestation (DI) is a primary psychiatric disorder characterised by delusions and abnormal tactile sensations. The pathophysiology is undecided and treatment includes both pharmacological and non-pharmacological options. There is currently no Cochrane Review of the treatments used. Primary DI is a diagnosis often encountered by both dermatologists and psychiatrists, with a large associated disease burden.
OBJECTIVES
To evaluate the effectiveness of different treatments in primary delusional infestation (DI).
SEARCH METHODS
On 24 December 2014 and 19 March 2019, we searched the Cochrane Schizophrenia Group's Study-Based Register of Trials including registries of clinical trials.
SELECTION CRITERIA
Randomised controlled trials involving the treatment of adults with primary DI.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened and assessed studies for inclusion using pre-specified inclusion criteria.
MAIN RESULTS
We did not identify any studies for inclusion.
AUTHORS' CONCLUSIONS
Currently there is no evidence from RCTs available to compare treatment of primary DI with placebo. We cannot, therefore, make any conclusions regarding the effects of treatments (pharmacological or non-pharmacological) for primary DI. This lack of evidence for treatment of primary DI has implications for research and practice. Robust randomised trials are indicated.
Topics: Antipsychotic Agents; Humans; Psychotherapy; Randomized Controlled Trials as Topic; Schizophrenia, Paranoid; Self Concept
PubMed: 31821546
DOI: 10.1002/14651858.CD011326.pub2