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Comprehensive Psychiatry Apr 2021Two of Europe's most influential psychopathologists at the start of the twentieth century (Eugen Bleuler and Karl Jaspers) pointed out the fact that patients rarely act... (Review)
Review
OBJECTIVES
Two of Europe's most influential psychopathologists at the start of the twentieth century (Eugen Bleuler and Karl Jaspers) pointed out the fact that patients rarely act according to their delusions. This study proposes an investigation of how this issue is addressed in psychopathological literature.
METHODS
This article offers a critical review of psychopathological literature which focuses on the influence of delusional ideation on behaviour.
RESULTS
Phenomenological psychiatry has relied on the paradox pointed out by Bleuler and Jaspers to emphasize disorders of self-experience in psychosis whereas analytical philosophy of delusion has focused on the psychological status of delusion, regarded as belief, certainty, or imagination. The empirical studies conducted during the past three decades - which were devoted to acting on delusion - focused on violent and safety-seeking behaviours. These studies have shown that these behavioural disorders are motivated by an emotional outburst (anger and/or fear) rather than by delusional content.
CONCLUSION
Delusional inconsequentiality can be clarified by conceptual research in phenomenological psychiatry and analytical philosophy, even though its role in the psychopathological processes has not yet been clearly identified or conceptualised. Empirical psychopathology on acting on delusion confirms the delusional inconsequentiality, but only implicitly, by highlighting the role of affectivity (rather than beliefs) in delusional actions. Given the major implications of better understanding this phenomenon, in terms of psychopathology and clinical practices, we suggest considering delusional inconsequentiality as a promising concept which could guide further research in contemporary psychopathology.
Topics: Delusions; Humans; Psychiatry; Psychopathology; Psychotic Disorders; Thinking
PubMed: 33581447
DOI: 10.1016/j.comppsych.2021.152230 -
Dementia and Neurocognitive Disorders Jun 2020Neurobehavioral symptoms of dementia (NBSD) are very common and are significant symptoms of the illness, contributing most to caregiver burdens and often resulting in... (Review)
Review
Neurobehavioral symptoms of dementia (NBSD) are very common and are significant symptoms of the illness, contributing most to caregiver burdens and often resulting in premature institutionalization of the person with dementia. The main symptoms of NBSD are anxiety, depression, delusions, and hallucinations. NBSD produce significant problems for both patients and caregivers. The pathophysiology of NBSD is determined by genetic, structural, or environmental factors. Therefore, treatment of NBSD requires continuous and organic cooperation between patients, caregivers, social environments, and doctors. Therefore, it is important for neurologists, who mainly view NBSD for dementia patients, to increase their understanding of these more comprehensive areas as well as the latest insights and treatments to help patients and caregivers.
PubMed: 32602280
DOI: 10.12779/dnd.2020.19.2.54 -
Frontiers in Psychiatry 2022Empathetic tendencies (i.e., perspective taking and empathic concern) are a key factor in interpersonal relationships, which may be impacted by emotion regulation (i.e.,...
Empathetic tendencies (i.e., perspective taking and empathic concern) are a key factor in interpersonal relationships, which may be impacted by emotion regulation (i.e., reappraisal and suppression) and mental health symptoms, such as psychotic-like experiences. However, it is unclear if certain psychotic-like experiences, such as delusion-proneness, are still associated with reduced empathetic tendencies after accounting for emotion regulation style and dimensions of psychopathology that are often comorbid. In the current study, linear models tested these associations in a transdiagnostic community sample ( = 128), using the Interpersonal Reactivity Index (IRI), Emotion Regulation Questionnaire, and the Peter's Delusion Inventory. Results indicated that perspective taking was positively associated with reappraisal and negatively associated with delusion-proneness, after controlling for age, sex, race, intelligence, and symptoms of anxiety and depression. A significant change in supported the addition of delusion-proneness in this model. Specificity analyses demonstrated perspective taking was also negatively associated with suppression, but this relationship did not remain after accounting for the effects of reappraisal and delusion-proneness. Additional specificity analyses found no association between empathic concern and reappraisal or delusion-proneness but replicated previous findings that empathic concern was negatively associated with suppression. Taken together, delusion-proneness accounts for unique variance in perspective taking, which can inform future experimental research and may have important implications for psychosocial interventions.
PubMed: 36226099
DOI: 10.3389/fpsyt.2022.992757 -
CNS Spectrums Feb 2022Dementia-related psychosis (DRP) is prevalent across dementias and typically manifests as delusions and/or hallucinations. The mechanisms underlying psychosis in... (Review)
Review
Dementia-related psychosis (DRP) is prevalent across dementias and typically manifests as delusions and/or hallucinations. The mechanisms underlying psychosis in dementia are unknown; however, neurobiological and pharmacological evidence has implicated multiple signaling pathways and brain regions. Despite differences in dementia pathology, the neurobiology underlying psychosis appears to involve dysregulation of a cortical and limbic pathway involving serotonergic, gamma-aminobutyric acid ergic, glutamatergic, and dopaminergic signaling. Thus, an imbalance in cortical and mesolimbic excitatory tone may drive symptoms of psychosis. Delusions and hallucinations may result from (1) hyperactivation of pyramidal neurons within the visual cortex, causing visual hallucinations and (2) hyperactivation of the mesolimbic pathway, causing both delusions and hallucinations. Modulation of the 5-HT2A receptor may mitigate hyperactivity at both psychosis-associated pathways. Pimavanserin, an atypical antipsychotic, is a selective serotonin inverse agonist/antagonist at 5-HT2A receptors. Pimavanserin may prove beneficial in treating the hallucinations and delusions of DRP without worsening cognitive or motor function.
Topics: Dementia; Hallucinations; Humans; Parkinson Disease; Piperidines; Psychotic Disorders; Urea
PubMed: 32811586
DOI: 10.1017/S1092852920001765 -
CMAJ : Canadian Medical Association... Aug 2019
Topics: Brain; Capgras Syndrome; Delusions; Humans; Neuropsychological Tests
PubMed: 31387959
DOI: 10.1503/cmaj.190048 -
Respiration; International Review of... 2022Rates of antimicrobial resistance are increasing globally while the pipeline of new antibiotics is drying up, putting patients with disease caused by drug-resistant... (Review)
Review
Rates of antimicrobial resistance are increasing globally while the pipeline of new antibiotics is drying up, putting patients with disease caused by drug-resistant bacteria at increased risk of complications and death. The growing costs for diagnosis and management of drug resistance threaten tuberculosis control where the disease is endemic and resources limited. Bacteriophages are viruses that attack bacteria. Phage preparations served as anti-infective agents long before antibiotics were discovered. Though small in size, phages are the most abundant and diverse biological entity on earth. Phages have co-evolved with their hosts and possess all the tools needed to infect and kill bacteria, independent of drug resistance. Modern biotechnology has improved our understanding of the biology of phages and their possible uses. Phage preparations are available to treat meat, fruit, vegetables, and dairy products against parasites or to prevent contamination with human pathogens, such as Listeria monocytogenes, Escherichia coli, or Staphylococcus aureus. Such phage-treated products are considered fit for human consumption. A number of recent case reports describe in great detail the successful treatment of highly drug-resistant infections with individualized phage preparations. Formal clinical trials with standardized products are slowly emerging. With its highly conserved genome and relative paucity of natural phage defence mechanisms Mycobacterium tuberculosis appears to be a suitable target for phage treatment. A phage cocktail with diverse and strictly lytic phages that kill all lineages of M. tuberculosis, and can be propagated on Mycobacterium smegmatis, has been assembled and is available for the evaluation of optimal dosage and suitable routes of administration for tuberculosis in humans. Phage treatment can be expected to be safe and active on extracellular organisms, but phage penetration to intracellular and granulomatous environments as well as synergistic effects with antibiotics are important questions to address during further evaluation.
Topics: Anti-Bacterial Agents; Bacteriophages; Delusions; Humans; Mycobacteriophages; Mycobacterium tuberculosis; Tuberculosis
PubMed: 34814151
DOI: 10.1159/000519870 -
Dermatology and Therapy Dec 2019Delusional parasitosis, also known as delusional infestation or Ekbom syndrome, is a relatively infrequent psychotic disorder characterized by an unwavering false belief... (Review)
Review
Delusional parasitosis, also known as delusional infestation or Ekbom syndrome, is a relatively infrequent psychotic disorder characterized by an unwavering false belief that there is a parasitic infestation of the skin, despite the absence of any medical evidence that could support this claim. Delusional parasitosis can be categorized into primary, secondary, and organic forms. Sometimes, close relatives also experience identical delusions. This phenomenon was reported to occur in 5-15% of cases, and is known as shared psychotic disorder-delusional parasitosis with folie à deux. Patients with delusional parasitosis frequently seek help from many physicians. Close multidisciplinary cooperation between clinicians is often key to shortening the time taken to diagnose this disorder. Initiation of psychopharmacological therapy is a challenge, as many patients refuse any psychiatric treatment because of the stigma associated with mental illness and because of their firm belief that they have a parasitic infestation, not a psychiatric condition. For many patients, a sense of a lack of understanding leads to isolation and the development of depression symptoms, which is why it is crucial to earn the trust of such patients while taking care of them.
PubMed: 31520344
DOI: 10.1007/s13555-019-00324-3 -
Ecology and Evolution Mar 2024During the last 50 years, a group of ecologists has repeatedly used Popper's falsificationism in normative claims concerning how research in ecology should be... (Review)
Review
During the last 50 years, a group of ecologists has repeatedly used Popper's falsificationism in normative claims concerning how research in ecology should be conducted and/or how ecology should be corrected. Other ecologists seem to be dissatisfied with these criticisms. Nevertheless, they have not provided systematic analyses of how and why the Popperian criticisms of ecology fail. I have two aims in this article First, I show how so-called Popperian ecologists have not only failed to use but have misused - if not abused - Popper in their criticisms of ecology. That is, the Popperian criticisms of ecology lack the justification the critics claim it has. Second, I claim that Popper's falsificationism is an unsuitable philosophy of science for ecology. In other words, ecology should not be criticized nor evaluated from the Popperian perspective in the first place.
PubMed: 38435009
DOI: 10.1002/ece3.11106 -
Neuroscience and Biobehavioral Reviews Mar 2022This study aimed to review the neurobiological and neuropsychological correlates of paranoid (persecutory delusions) and misidentification (misidentification delusions... (Review)
Review
This study aimed to review the neurobiological and neuropsychological correlates of paranoid (persecutory delusions) and misidentification (misidentification delusions and/or hallucinations) subtypes of psychosis in dementia, to establish if they represent distinct subphenotypes. Nine studies were eligible, all included patients with Alzheimer's disease. Greater global cognitive deficits and an accelerated global cognitive decline were observed in the misidentification subtype. Neuroimaging studies showed more marked volume loss in multiple regions in patients with the misidentification subtype, including those involved in object recognition and the processing of information on spatial and temporal context. A single study found greater impairment in visual sustained attention and object recognition in the misidentification subtype. The small number of studies and methodological heterogeneity limit interpretation of the findings. Nevertheless, these findings would tentatively suggest that there may be additional or accelerated pathological change in functional networks involved in visuoperceptual processing in the misidentification subtype. This should be further explored in prospective studies and the investigation extended to other forms of dementia, to gain a transdiagnostic perspective.
Topics: Alzheimer Disease; Delusions; Hallucinations; Humans; Prospective Studies; Psychotic Disorders
PubMed: 35032536
DOI: 10.1016/j.neubiorev.2022.104529