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Brain and Nerve = Shinkei Kenkyu No... Dec 2020The number of super-aged people over 80 years has increased with the life expectancy; however, studies on their psychiatric disorders are lacking. The characteristics of...
The number of super-aged people over 80 years has increased with the life expectancy; however, studies on their psychiatric disorders are lacking. The characteristics of psychiatric disorders in the elderly are often complicated by physical diseases and organic changes in the brain. Psychiatric symptoms change atypically and rapidly. In the oldest-old, it is difficult to hear about the present condition of the patient and the aging process complicates drug therapy. In this paper, I outlined the diagnosis, symptoms, and treatments of: 1. psychotic disorders in the oldest-old including (A) schizophrenia comprised of (i) schizophrenia in late life and (ii) late-onset schizophrenia, (B) delusional disorder, (C) catatonia, and (D) late-onset psychotic disorders (conventional diagnosis); 2. depression; 3. apathy; 4. anxiety disorder; and 5. somatoform disorder.
Topics: Aged; Aged, 80 and over; Brain; Humans; Psychotic Disorders; Schizophrenia
PubMed: 33293470
DOI: 10.11477/mf.1416201693 -
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 -
The Psychiatric Quarterly Dec 2020Many questions pertaining to delusional disorder (DD) remain unanswered. It is unclear what syndromes to include under this category of psychotic illness and when to... (Review)
Review
Many questions pertaining to delusional disorder (DD) remain unanswered. It is unclear what syndromes to include under this category of psychotic illness and when to treat with antidepressants, cognitive therapy, or antipsychotic medication. DD is associated with psychiatric comorbidity, especially depression, and rates of suicidal behavior are high when the two conditions co-exist. In this selective review, we present two instances of suicide in the context of DD, one illustrating risks for the somatic subtype and the second, risks for the persecutory subtype. The frequency of suicidal behaviour in these two subtypes of DD is estimated at 8-21%. The literature suggests a prominent role for social emotions (shame, humiliation) in the pathway leading to suicide. In addition, risk factors found in our two patients point to factors such as poverty, living alone, vulnerable risk periods, stigma, and lack of trust in mental health services. Building trust may be the most effective preventive measure.
Topics: Antidepressive Agents; Antipsychotic Agents; Delusions; Humans; Suicidal Ideation; Suicide
PubMed: 32761556
DOI: 10.1007/s11126-020-09802-w -
Psychiatry Research Feb 2020The prevailing nosological classification of body dysmorphic disorder (BDD) encompasses an optional specifier "with absent insight/delusional beliefs" for patients who... (Comparative Study)
Comparative Study
The prevailing nosological classification of body dysmorphic disorder (BDD) encompasses an optional specifier "with absent insight/delusional beliefs" for patients who hold high conviction of the veracity of their disorder-specific beliefs. Yet limited research has examined the explicit nature of delusional beliefs in BDD. The current study therefore aimed to compare themes of delusional ideation in BDD relative to schizophrenia (SCZ) and healthy controls (HCs). Participants had a primary diagnosis of BDD (n = 44) or SCZ (n = 55), or were HCs (n = 55) with no personal or immediate family history of a diagnosable mental health disorder. Assessment of multidimensional delusional ideation was based on the Peters Delusional Inventory (PDI). Results showed that BDD and SCZ groups endorsed significantly more items, and had significantly elevated preoccupation and conviction than the HC group. Only the SCZ group exhibited significantly elevated distress relative to HC participants. In addition, BDD (akin to SCZ) participants were more likely to endorse somatic (appearance-related), control and thought alienation themes than the HC group. These findings suggest that delusional beliefs in BDD may not be strictly appearance-related, but rather span broader themes. This conveys therapeutic implications in terms of designing and administering targeted treatments aimed at delusional thinking in BDD.
Topics: Adult; Body Dysmorphic Disorders; Cognition; Delusions; Female; Humans; Male; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Thinking
PubMed: 31785950
DOI: 10.1016/j.psychres.2019.112694 -
Industrial Psychiatry Journal 2022Delusional disorders are common psychiatric disorders, but a delusion of pregnancy is a rare condition. Four cases that presented at a single tertiary care psychiatry...
Delusional disorders are common psychiatric disorders, but a delusion of pregnancy is a rare condition. Four cases that presented at a single tertiary care psychiatry center with delusion of pregnancy as a part of different psychological disorders are illustrated here. These cases were seen over a period of 6 months and had varied presentations and associated psychopathologies. Three of the four patients showed rapid recovery to treatment, but one patient was lost to follow-up. The heterogeneity in the presentation, sociodemographic profile of the patients and even in the symptom profile and response to treatment in this condition is highlighted and discussed in this case series.
PubMed: 36419711
DOI: 10.4103/ipj.ipj_166_21 -
Frontiers in Psychiatry 2022The hierarchy of evidence coming from evidence-based medicine favors meta-analyses and randomized controlled trials over observational studies and clinical cases....
BACKGROUND
The hierarchy of evidence coming from evidence-based medicine favors meta-analyses and randomized controlled trials over observational studies and clinical cases. Nonetheless, in the field of psychiatry, where conditions are much more complex, additional evidence coming from real-world clinical practice is necessary to complement data from these gold standards. Thus, in this systematic review, the aim is to summarize the evidence coming from clinical case reports regarding cariprazine, a third-generation antipsychotic drug that has been approved for the treatment of schizophrenia and bipolar I disorder with manic, depressive or mixed features in adults.
METHODS
A systematic review was performed using Embase and Pubmed databases searching for English-language cases published in peer-reviewed journals between 2000 January and 2021 September with the following search terms: (cariprazin OR "rgh-188" OR rgh188 OR vraylar OR reagila) AND ("case report" OR "case report"/de OR "case stud" OR "case study"/de OR "case seri").
RESULTS
After the removal of duplicates, 49 articles were retrieved via the search, from which 22 were suitable for this review. These 22 articles encompassed 38 cases from which 71% described patients with schizophrenia, 16% patients with psychotic disorders, 5% patients with mood disorder and 8% described patients with other disorders such as Wernicke-Korsakoff syndrome, borderline personality disorder and obsessive-compulsive disorder with paranoid schizophrenia. The median age of patients was 31, and half of them were female. The majority of patients (76%) started cariprazine with 1.5 mg/day, and the most common maintenance dose was 4.5 mg/day (34%) and 3.0 mg/day (29%).
CONCLUSION
Cariprazine was found to be safe and effective in a wide range of psychiatric conditions with different symptom profiles from acute psychotic symptoms through addiction to negative and cognitive symptoms. The results are in-line with the established evidence from clinical trials, however, they also show how cariprazine can be successfully utilized for treating certain symptoms irrespective of the indication.
PubMed: 35370825
DOI: 10.3389/fpsyt.2022.827744 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2023To unite within the framework of a single clinical entity (based on the model of hypochondriacal paranoia) phenomena of the somatopsychotic and hypochondriacal range,...
OBJECTIVE
To unite within the framework of a single clinical entity (based on the model of hypochondriacal paranoia) phenomena of the somatopsychotic and hypochondriacal range, which, in accordance with modern systematics, are classified as various categories of psychosomatic, affective disorders and personality disorders.
MATERIAL AND METHODS
The sample for analysis consisted of 29 patients (with the diagnosis of delusional disorder (ICD-10; F22.0 in ICD-10), 10 men (34.5%) and 19 women (64.5%), the average age was 42.9±19.9 years; men - 10 nab. (34.5%), women - 19 nab. (64.5%). The average duration of the disease iswas 9.4±8.5 years. The psychopathological method was used as the main one.
RESULTS
The article forms an alternative concept of somatic paranoia based on the model of hypochondriacal paranoia. The fundamental difference between the construct of somatic paranoia is an obligate connection between somatopsychic and ideational disorders. Somatopsychic (coenesthesiopathic) symptoms do not exist as an independent (equivalent to the structure of somatic clinical syndromes) dimensions and are formed exclusively with the participation of ideational phenomena.
CONCLUSION
In accordance with the presented concept, coenesthesiopathic symptoms within the framework of somatic paranoia act as a somatic equivalent of delusional disorders.
Topics: Male; Humans; Female; Young Adult; Adult; Middle Aged; Paranoid Disorders; Psychophysiologic Disorders; Personality Disorders; International Classification of Diseases; Syndrome; Delusions
PubMed: 37141123
DOI: 10.17116/jnevro20231230426 -
Fortschritte Der Neurologie-Psychiatrie Mar 2020Distinguishing between melancholic and non-melancholic depression is still of significant importance in the classification and differentiation of depressive disorders.... (Review)
Review
Distinguishing between melancholic and non-melancholic depression is still of significant importance in the classification and differentiation of depressive disorders. Melancholy appears to be a psychopathological and biologically based entity which can be described as a disorder of drive and which finds its extreme culmination in depressive delusion. Its pathogenesis ranges from the melancholic predisposed personality, mostly of the Typus melancholicus, over psychomotor inhibition and depersonalization, to depressive delusion. Delusion arises from the fear that the realization of basic human values, such as one's existence for important others or ideals, health and livelihood has become hopeless. A clear understanding of the nature and pathogenesis of melancholic delusional depression not only facilitates the diagnostic process, and the empathic assistance to the patient, but also has direct consequences for an appropriate treatment of this disorder.
Topics: Delusions; Depression; Depressive Disorder; Humans; Personality; Personality Inventory
PubMed: 31378852
DOI: 10.1055/a-0957-3226 -
The Journal of Dermatological Treatment Mar 2022Delusional infestation (DI) is a rare delusional disorder in which individuals have a false belief that they are infested with bugs, parasites, or insects, despite the... (Review)
Review
BACKGROUND
Delusional infestation (DI) is a rare delusional disorder in which individuals have a false belief that they are infested with bugs, parasites, or insects, despite the lack of medical evidence that such an infestation exists. Data on the effectiveness of antipsychotics for DI are limited.
METHODS
We conducted a systematic review using EMBASE, MEDLINE, PsycINFO, and Cochrane Central Register of Controlled Trials from inception of the databases up until July 20, 2018. Studies examining typical or atypical antipsychotics for primary DI were included.
RESULTS
A total of 51 relevant articles were identified, primarily case reports/series. Overall response was favorable for both typical and atypical antipsychotics, but there was no strong evidence to suggest that any one antipsychotic agent was preferable to other agents. Pimozide (1-16 mg/day) and risperidone (0.5-8 mg/day) were the most commonly studied typical and atypical antipsychotics, respectively. Inconsistent reporting of treatment outcomes and variability in study designs limited the overall evaluation of the data.
CONCLUSIONS
There remains a lack of sound data supporting the effectiveness of antipsychotic treatment for primary DI. Further research is required to establish more definitive conclusions about the relative clinical utility of antipsychotic agents for DI.
Topics: Antipsychotic Agents; Humans; Risperidone; Treatment Outcome
PubMed: 32658556
DOI: 10.1080/09546634.2020.1795061 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2021To define psychopathological and phenomenological characteristics of the apocalyptic variant of end-world delusion with religious content (EWDRC) in schizophrenia, to...
OBJECTIVE
To define psychopathological and phenomenological characteristics of the apocalyptic variant of end-world delusion with religious content (EWDRC) in schizophrenia, to identify features of clinical dynamics of delusional disorders and their interaction with delusional behavior of patients.
MATERIAL AND METHODS
A total of 28 patients with schizophrenia (F20.01, F20.02 according to ICD-10) and EWDRC were examined. Clinical-psychopathological and follow-up methods were used.
RESULTS
The development of the end-world delusional ideas occurred in unstructured affective-delusional disorder with acute sensual delusion. Two types of EWDRC were differentiated: with predominance of perception delusion or picturesque delusion. These types differed by acuity and massiveness of psychotic symptomatology, the mono- or polythematic character of delusional disorders, affect type, as well as by the duration and intensity of the development of delusional stages, and in their phenomenological specifics.
CONCLUSION
Delusional ideas of the end of the world in schizophrenic patients develop in the structure of the syndrome of acute sensory delusions with a predominance of delusions of perception (type I) or visual-figurative delusions of the imagination (type II), which have different duration, degree of dominance and depth of psychopathological disorders.
Topics: Delusions; Humans; International Classification of Diseases; Psychopathology; Psychotic Disorders; Schizophrenia
PubMed: 34693683
DOI: 10.17116/jnevro20211210917