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Cureus Feb 2024Kratom is a plant extract readily available for purchase in the USA. It is known to produce both stimulant and opioid-related effects, predisposing it to abuse. The...
Kratom is a plant extract readily available for purchase in the USA. It is known to produce both stimulant and opioid-related effects, predisposing it to abuse. The long-term effects of kratom are poorly understood. In rare cases, serious side effects have been reported. Here, we report a case of a patient with a history of bipolar type schizoaffective disorder presenting with acute onset paranoia and delusions. The patient had been hospitalized seven times previously with psychotic symptoms, with no reported history of paranoid delusional thought content in previous admissions. It was discovered that the patient had been ingesting increasingly large quantities of kratom in the weeks leading up to the admission. It is believed that kratom may be responsible for the novel symptoms contributing to the patient's acute psychiatric decompensation.
PubMed: 38524086
DOI: 10.7759/cureus.54626 -
BMC Psychiatry Mar 2024Although the impact of internet usage on mental health is extensively documented, there is a notable scarcity of reports in the literature concerning internet-induced...
BACKGROUND
Although the impact of internet usage on mental health is extensively documented, there is a notable scarcity of reports in the literature concerning internet-induced erotomania. Erotomania is a rare and likely underdiagnosed delusional disorder. It is characterized by an irrational belief held by the affected persons that someone of higher socioeconomic status harbor romantic feelings toward them. Here, we describe the psychopathology of erotomanic delusion induced by online romantic fraud in a female patient. Employing this case as a focal point, we illuminate novel aspects of erotomania that warrant attention and examination.
CASE PRESENTATION
We present a compelling case involving a 70-year-old married Caucasian woman diagnosed with medically controlled persistent depressive disorder for several years. The intricacies of her condition became evident as she became deeply engrossed in online profiles featuring the image of a renowned musician, inadvertently falling victim to an online romantic fraud. Subsequently, this distressing experience triggered the emergence of erotomanic delusions and a suicide attempt. The patient's history reveals an array of medical conditions and stressful life events, contributing to her vulnerability. The diagnosis of erotomanic delusional disorder, dysthymia, and mild cognitive impairment with cerebral vascular background was established. Treatment involved her previous antidepressant with low-dose risperidone, alongside supportive individual and group therapy. Her delusion showed remission four weeks later, prompting her discharge for outpatient follow-up. Although she retained some false beliefs, the intensity of the symptoms had notably diminished and her functionality improved.
CONCLUSION
This case underscores the complex interplay between mental health, online activities, and the consequences of delusions, including suicidal thoughts, shedding light on the need for a comprehensive approach in addressing such challenging psychiatric scenarios.
Topics: Humans; Female; Aged; Delusions; Depressive Disorder; Emotions; Cognitive Dysfunction; Suicide, Attempted
PubMed: 38509502
DOI: 10.1186/s12888-024-05667-6 -
Visualizing threat and trustworthiness prior beliefs in face perception in high versus low paranoia.Schizophrenia (Heidelberg, Germany) Mar 2024Predictive processing accounts of psychosis conceptualize delusions as overly strong learned expectations (prior beliefs) that shape cognition and perception. Paranoia,...
Predictive processing accounts of psychosis conceptualize delusions as overly strong learned expectations (prior beliefs) that shape cognition and perception. Paranoia, the most prevalent form of delusions, involves threat prior beliefs that are inherently social. Here, we investigated whether paranoia is related to overly strong threat prior beliefs in face perception. Participants with subclinical levels of high (n = 109) versus low (n = 111) paranoia viewed face stimuli paired with written descriptions of threatening versus trustworthy behaviors, thereby activating their threat versus trustworthiness prior beliefs. Subsequently, they completed an established social-psychological reverse correlation image classification (RCIC) paradigm. This paradigm used participants' responses to randomly varying face stimuli to generate individual classification images (ICIs) that intend to visualize either facial prior belief (threat vs. trust). An independent sample (n = 76) rated these ICIs as more threatening in the threat compared to the trust condition, validating the causal effect of prior beliefs on face perception. Contrary to expectations derived from predictive processing accounts, there was no evidence for a main effect of paranoia. This finding suggests that paranoia was not related to stronger threat prior beliefs that directly affected face perception, challenging the assumption that paranoid beliefs operate on a perceptual level.
PubMed: 38509135
DOI: 10.1038/s41537-024-00459-z -
Translational Psychiatry Mar 2024Automatically extracted measures of speech constitute a promising marker of psychosis as disorganized speech is associated with psychotic symptoms and predictive of...
Towards a scalable approach to assess speech organization across the psychosis-spectrum -online assessment in conjunction with automated transcription and extraction of speech measures.
Automatically extracted measures of speech constitute a promising marker of psychosis as disorganized speech is associated with psychotic symptoms and predictive of psychosis-onset. The potential of speech markers is, however, hampered by (i) lengthy assessments in laboratory settings and (ii) manual transcriptions. We investigated whether a short, scalable data collection (online) and processing (automated transcription) procedure would provide data of sufficient quality to extract previously validated speech measures. To evaluate the fit of our approach for purpose, we assessed speech in relation to psychotic-like experiences in the general population. Participants completed an 8-minute-long speech task online. Sample 1 included measures of psychometric schizotypy and delusional ideation (N = 446). Sample 2 included a low and high psychometric schizotypy group (N = 144). Recordings were transcribed both automatically and manually, and connectivity, semantic, and syntactic speech measures were extracted for both types of transcripts. 73%/86% participants in sample 1/2 completed the experiment. Nineteen out of 25 speech measures were strongly (r > 0.7) and significantly correlated between automated and manual transcripts in both samples. Amongst the 14 connectivity measures, 11 showed a significant relationship with delusional ideation. For the semantic and syntactic measures, On Topic score and the Frequency of personal pronouns were negatively correlated with both schizotypy and delusional ideation. Combined with demographic information, the speech markers could explain 11-14% of the variation of delusional ideation and schizotypy in Sample 1 and could discriminate between high-low schizotypy with high accuracy (0.72-0.70, AUC = 0.78-0.79) in Sample 2. The moderate to high retention rate, strong correlation of speech measures across manual and automated transcripts and sensitivity to psychotic-like experiences provides initial evidence that online collected speech in combination with automatic transcription is a feasible approach to increase accessibility and scalability of speech-based assessment of psychosis.
Topics: Humans; Speech; Psychotic Disorders; Schizotypal Personality Disorder
PubMed: 38509087
DOI: 10.1038/s41398-024-02851-w -
The Journal of International Medical... Mar 2024Shared psychotic disorder characterized by Capgras syndrome is an extremely rare condition. To our knowledge, there are only a few published papers on this condition....
Shared psychotic disorder characterized by Capgras syndrome is an extremely rare condition. To our knowledge, there are only a few published papers on this condition. This paper presents a case of shared Capgras syndrome in two sisters. The inducer was a younger sister with schizophrenia, who passed on her Capgras delusion to her older sister after the death of their father. After committing a violent offense caused by Capgras delusion, a court ordered the sisters' involuntary admission to a psychiatric hospital. After being separated and receiving antipsychotic treatment, the sisters showed substantial improvement. However, shortly after hospital discharge, they stopped taking their medication and disappeared. After 15 years, their mother died and shortly afterwards, the sisters were re-admitted for forensic psychiatric evaluation after another violent crime caused by Capgras delusion. Timely recognition, adequate treatment and maintaining a therapeutic alliance could contribute to a better clinical course and outcome of this disorder, and reduce the risk of violent behavior.
Topics: Humans; Female; Capgras Syndrome; Shared Paranoid Disorder; Antipsychotic Agents; Mothers; Violence
PubMed: 38477256
DOI: 10.1177/03000605241233526 -
Cureus Feb 2024Capgras syndrome is a psychotic illness characterized by an unshaken false belief in having a close family member replaced by an imposter when there is no evidence of...
Capgras syndrome is a psychotic illness characterized by an unshaken false belief in having a close family member replaced by an imposter when there is no evidence of such. The patient described in this case report is a 68-year-old Caucasian female who presented with Capgras syndrome in the context of chronic progressive multiple sclerosis (MS) following an acute COVID-19 illness. She was treated with quetiapine with full resolution of symptoms.
PubMed: 38465171
DOI: 10.7759/cureus.53924 -
Cureus Feb 2024Delusional infestation (DI) is characterized by delusions of being infested by small microorganisms or even inanimate objects without any medical or microbiological...
Delusional infestation (DI) is characterized by delusions of being infested by small microorganisms or even inanimate objects without any medical or microbiological evidence. The pathophysiology of DI is not well understood, and there are two types of DI: the primary form, where there is no underlying cause, and the secondary form, which is related to an associated psychiatric disorder, medical condition, or substance use. DI in Parkinson's disease (PD) is rarely reported, and most published cases are due to antiparkinsonian drugs. Piribedil is a dopaminergic agonist used for the symptomatic treatment of PD either as monotherapy or as adjuvant therapy with other antiparkinsonian treatments. We report the case of an 81-year-old man followed for PD at our institution who developed DI after piribedil dose escalation. When DI is secondary to an antiparkinsonian drug, the treatment of choice is based on withdrawing the implicated drug.
PubMed: 38449964
DOI: 10.7759/cureus.53631 -
Sleep Medicine Apr 2024Decreased sleep spindle activity in individuals with psychotic disorders is well studied, but its contribution to psychotic symptom formation is not well understood....
Decreased sleep spindle activity in individuals with psychotic disorders is well studied, but its contribution to psychotic symptom formation is not well understood. This study explored potential underlying mechanisms explaining the association between decreased sleep spindle activity and psychotic symptoms. To this end, we analysed the links between sleep spindle activity and psychotic experiences and probed for the mediating roles of attentional performance and perceptual distortions in a community sample of young adults (N = 70; 26.33 ± 4.84 years). Polysomnography was recorded during a 90-min daytime nap and duration, amplitude, and density from slow (10-13 Hz) and fast (13-16 Hz) spindles were extracted. Attentional performance was assessed via a test battery and with an antisaccadic eye movement task. Psychotic experiences (i.e., paranoid thoughts; hallucinatory experiences) and perceptual distortions (i.e., anomalous perceptions; sensory gating deficits) were assessed via self-report questionnaires. We conducted sequential mediation analyses with spindle activity as predictor, psychotic experiences as dependent variable, and attentional performance and perceptual distortions as mediators. We found reduced right central spindle amplitude to be associated with paranoid thoughts. Increased antisaccadic error rate was associated with anomalous perceptions and perceptual distortions were associated with psychotic experiences. We did not find significant mediation effects. The findings support the notion that reduced sleep spindle activity is involved in the formation of paranoid thoughts and that decreased antisaccadic performance is indicative of perceptual distortions as potential precursors for psychotic experiences. However, further research is needed to corroborate the proposed mediation hypothesis.
Topics: Young Adult; Humans; Perceptual Distortion; Sleep; Polysomnography; Psychotic Disorders; Attention; Electroencephalography
PubMed: 38422784
DOI: 10.1016/j.sleep.2024.02.023 -
International Journal of Molecular... Feb 2024Ekbom syndrome, also known as delusional parasitosis (DP) or delusional infestation, is an uncommon psychiatric disorder distinguished by an enduring conviction of... (Review)
Review
Ekbom syndrome, also known as delusional parasitosis (DP) or delusional infestation, is an uncommon psychiatric disorder distinguished by an enduring conviction of parasitic infestation, persisting notwithstanding the presence of medical evidence to the contrary. Primarily affecting middle-aged women, DP can manifest either as isolated psychological distress or as a component within a more intricate psychiatric framework, substantially influencing the quality of life for affected individuals. Its pathophysiological mechanism involves uncertain dopaminergic imbalances and dysfunction in the dopamine transporter system. Dermatologists often play a pivotal role in diagnosis, as patients first seek dermatological assessments of their signs and symptoms. However, DP frequently originates from underlying psychiatric disorders or medical variables, manifesting with neurological and infectious causative factors. The diagnostic complexity is attributed to patients' resolute convictions, leading to delayed psychiatric intervention. First-line DP treatment involves antipsychotics, with newer agents demonstrating promising prospects, but the lack of standardized protocols poses a significant therapeutic challenge. In this narrative review, both a comprehensive approach to this uncommon pathology and an update on the state of knowledge in this medical subfield focused on optimizing the management of DP are provided. The complexity of DP underlying its uncommon nature and the incomplete understanding of its pathophysiology highlight the need for further research through multicenter studies and multidisciplinary teams to enhance therapeutic efficacy and safety.
Topics: Middle Aged; Humans; Female; Quality of Life; Delusional Parasitosis; Antipsychotic Agents; Dopamine; Interdisciplinary Studies
PubMed: 38396826
DOI: 10.3390/ijms25042151