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Healthcare (Basel, Switzerland) Feb 2024Tokophobia is regarded as the intensive fear of childbirth that some pregnant women have. However, little is known about the psychopathological details of tokophobia...
Tokophobia is regarded as the intensive fear of childbirth that some pregnant women have. However, little is known about the psychopathological details of tokophobia (fear of childbirth). Between 2020 and 2021, a total of 10 pregnant women (nine nulliparae and one multipara) with a strong fear of childbirth were referred by obstetricians. Semi-structured psychopathological interviews were conducted, and two cases were judged to have obsession, three an overvalued idea, and one secondary delusion. Three were characterised by both obsession and overvalued idea and one by both obsession and secondary delusion. In total, six cases had features of an overvalued idea. All of the participants except one had a lifetime history of a specific phobia. In addition, their history included social phobia in two cases, panic disorder in one case, obsessive-compulsive disorder (other than tokophobia) in two cases, depressive disorder in two cases, bipolar disorder in two cases, and PTSD in six cases. To conclude, this study showed that tokophobia was not a phobic disorder but a kind of overvalued idea that requires specific assessment and treatment.
PubMed: 38470630
DOI: 10.3390/healthcare12050519 -
The British Journal of Psychiatry : the... Apr 2024Felt presence is a widely occurring experience, but remains under-recognised in clinical and research practice. To contribute to a wider recognition of the phenomenon,...
Felt presence is a widely occurring experience, but remains under-recognised in clinical and research practice. To contribute to a wider recognition of the phenomenon, we aimed to assess the presentation of felt presence in a large population sample ( = 10 447) and explore its relation to key risk factors for psychosis. In our sample 1.6% reported experiencing felt presence in the past month. Felt presence was associated with visual and tactile hallucinations and delusion-like thinking; it was also associated with past occurrence of adverse events, loneliness and poor sleep. The occurrence of felt presence may function as a marker for general hallucination proneness.
Topics: Humans; Emotions; Hallucinations; Psychotic Disorders; Risk Factors
PubMed: 38470304
DOI: 10.1192/bjp.2024.7 -
Cureus Mar 2024The present study aimed to examine clinical differences between subjects with early-onset (<21 years) and adult-onset (>30 years) bipolar I disorder, in particular, in...
BACKGROUND
The present study aimed to examine clinical differences between subjects with early-onset (<21 years) and adult-onset (>30 years) bipolar I disorder, in particular, in relation to anxiety comorbidity.
METHOD
Subjects were selected from a cohort of 161 consecutive patients with bipolar disorder type I as diagnosed by the Structured Clinical Interview for DSM Disorder (SCID-I). Clinical characteristics and axis I comorbidity were compared between those whose illness first emerged before the age of 21 years (n=58) and those whose first episode occurred after the age of 30 years (n=27). Psychopathology was assessed using the 18-item version of the Brief Psychiatric Rating Scale (BPRS). The frequency of delusions, hallucinations, and formal thought disorders was evaluated with the SCID-I. Overall, social and occupational functioning was assessed by the Global Assessment of Functioning (GAF).
RESULTS
Most subjects with early-onset bipolar disorder were males, had panic disorder and substance abuse comorbidity, longer duration of illness, exhibited mood-incongruent delusions, and presented with a mixed episode at onset more frequently than the later adult-onset subjects. Mixed mania at the first episode of illness and lifetime panic disorder comorbidity predicted mixed polarity at the first hospitalization episode in the early-onset subjects.
CONCLUSIONS
Overall, early age at onset seems to delineate a distinct bipolar I disorder subtype characterized by a greater likelihood of mixed episodes, lifetime panic disorder comorbidity, and schizophrenia-like delusions.
PubMed: 38463410
DOI: 10.7759/cureus.55803 -
Annals of Medicine and Surgery (2012) Mar 2024Acute psychosis is a common brief psychiatric emergency period of delusions, hallucinations, disorganized thoughts and/or speech with or without psychomotor elements,...
INTRODUCTION AND IMPORTANCE
Acute psychosis is a common brief psychiatric emergency period of delusions, hallucinations, disorganized thoughts and/or speech with or without psychomotor elements, which is not commonly induced by isotretinoin therapy. Dermatologists should counsel the patient before starting the treatment with all new, uncommon side effects, especially neuropsychiatric manifestations before starting this medication.
CASE PRESENTATION
A 23-year-old male smoker with a known case of acne vulgaris recently started on isotretinoin for 2 weeks after which he developed abnormal hyperactive psychomotor activity. He was diagnosed with isoteritoin-induced acute psychosis based on clinical findings and exclusion, and valproic acid and olanzapine were initiated. The patient showed significant improvement.
CLINICAL DISCUSSION
Acute psychosis is a new, unfamiliar side effect presenting after initiation of isotretinoin therapy in young adults who were previously healthy. The mechanism is not well known but is thought to result from a decrease in the adult's neurogenesis or alterations in exposure of the serotonergic neurotransmitter system.
CONCLUSION
Isotretinoin is commonly used nowadays for treating young adults. Patients and their families should be counselled about all the psychiatric side effects. Antipsychotics and antiepileptics with mood stabilizers may improve the acute status for patients with isotertoin-induced psychosis.
PubMed: 38463077
DOI: 10.1097/MS9.0000000000001726 -
International Journal of Law and... 2024A psychotically motivated act or an act committed under impaired insight and control of action in the midst of an acute psychosis is the standard for lack of criminal... (Review)
Review
A psychotically motivated act or an act committed under impaired insight and control of action in the midst of an acute psychosis is the standard for lack of criminal responsibility. There is now increasing evidence that positive symptoms, particularly in the form of hallucinations and delusions, in trauma-related disorders and borderline personality disorder (BPD) are comparable to positive symptoms in psychotic disorders, posing a challenge for differential diagnosis and forensic assessment of the relevance of positive symptoms to insight and self-control. Due to the indistinguishability of the phenomena, there is both a risk of misdiagnosis of a psychotic disorder and also trivialization with the use of pseudo-hallucinations or quasi-psychotic labels. Essential phenomenological differences that may be helpful in forensic assessments are the usually preserved reality testing in trauma-related disorders and BPD, as well as differences in psychopathological symptom constellations. Because of these differences relevant to forensic assessments, it seems useful to distinguish trauma-related disorders and BPD with positive symptoms from psychotic disorders.
Topics: Humans; Borderline Personality Disorder; Dissociative Disorders; Forensic Psychiatry; Psychotic Disorders; Diagnosis, Differential; Hallucinations; Delusions; Trauma and Stressor Related Disorders
PubMed: 38460238
DOI: 10.1016/j.ijlp.2024.101973 -
Actas Espanolas de Psiquiatria Feb 2024Stroke survivors usually present physical and neuropsychiatric complications. Post-stroke psychosis (PSPsy) is a particularly neglected sequel despite its disruptive...
INTRODUCTION
Stroke survivors usually present physical and neuropsychiatric complications. Post-stroke psychosis (PSPsy) is a particularly neglected sequel despite its disruptive nature.
OBJECTIVES
To present a case of early emerging neuropsychiatric symptoms following a left posterior cerebral artery (PCA) stroke. To review and discuss PSPsy clinical manifestations, pathophysiology, and clinical outcomes.
CLINICAL CASE
A previously autonomous 68-year-old woman with vascular risk factors and depressive disorder presented to the emergency department with a 5-day history of disorientation, motor aphasia, and right hypoesthesia. Computer tomography revealed a left PCA stroke. She was started on acetylsalicylic acid and rosuvastatin and discharged the next day. Afterward, the patient developed a depressive mood, emotional lability, periods of confusion, delusions of persecution, guilt and unworthiness, auditory hallucinations, and suicide ideation. She was admitted to a psychiatric hospital and started on risperidone with a good response, being discharged after 15 days with the resolution of psychiatric symptoms.
CONCLUSIONS
PSPsy is more common after right hemisphere lesions and usually develops after some months. Nevertheless, our patient presented PSPsy following an ischemic event of the left PCA, with neuropsychiatric symptomatology dominating the clinic since the beginning. The involvement of the retrosplenial cortex or its connections was likely important for this atypical presentation. Due to the lack of guidelines on approaching PSPsy, most patients are treated with the same strategies used for non-stroke patients. A better comprehension of the anatomical basis underlining the symptomatology in these patients could deepen the understanding of psychosis and psychotic disorders.
Topics: Aged; Female; Humans; Hallucinations; Infarction, Posterior Cerebral Artery; Personality Disorders; Posterior Cerebral Artery; Psychotic Disorders
PubMed: 38454893
DOI: No ID Found -
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 -
BMC Neurology Mar 2024Neuropsychiatric symptoms and delusions are highly prevalent among people with dementia. However, multiple roots of neurobiological bases and shared neural basis of...
BACKGROUND
Neuropsychiatric symptoms and delusions are highly prevalent among people with dementia. However, multiple roots of neurobiological bases and shared neural basis of delusion and cognitive function remain to be characterized. By utilizing a fine-grained multivariable approach, we investigated distinct neuroanatomical correlates of delusion symptoms across a large population of dementing illnesses.
METHODS
In this study, 750 older adults with mild cognitive impairment and Alzheimer's disease completed brain structural imaging and neuropsychological assessment. We utilized principal component analysis followed by varimax rotation to identify the distinct multivariate correlates of cortical thinning patterns. Five of the cognitive domains were assessed whether the general cognitive abilities mediate the association between cortical thickness and delusion.
RESULTS
The result showed that distributed thickness patterns of temporal and ventral insular cortex (component 2), inferior and lateral prefrontal cortex (component 1), and somatosensory-visual cortex (component 5) showed negative correlations with delusions. Subsequent mediation analysis showed that component 1 and 2, which comprises inferior frontal, anterior insula, and superior temporal regional thickness accounted for delusion largely through lower cognitive functions. Specifically, executive control function assessed with the Trail Making Test mediated the relationship between two cortical thickness patterns and delusions.
DISCUSSION
Our findings suggest that multiple distinct subsets of brain regions underlie the delusions among older adults with cognitive impairment. Moreover, a neural loss may affect the occurrence of delusion in dementia largely due to impaired general cognitive abilities.
Topics: Humans; Aged; Alzheimer Disease; Delusions; Cognitive Dysfunction; Cognition; Brain
PubMed: 38448803
DOI: 10.1186/s12883-024-03568-5 -
Journal of Multidisciplinary Healthcare 2024Historically, humanity has suffered and endured deadly pandemics of varying mortality rates. Irrefutably, research shows that the outbreak of pandemics is flooded by... (Review)
Review
Historically, humanity has suffered and endured deadly pandemics of varying mortality rates. Irrefutably, research shows that the outbreak of pandemics is flooded by mythical and fallacious information among the public, hence stifling the prevention, treatment, and management of diseases. This paper focused on comparing selected aspects of the two pandemics, that is, HIV/AIDS and Coronavirus. This comparative analysis is important for drawing informative lessons for effective response and management of pandemics in the future. Through a literature review analysis, the paper established that both pandemics have more similarities than distinctions. The etiology and epidemiology of the diseases assume a similar cascading trajectory; the public health information about the diseases is characterized by myths, conspiracy theories, illusions, and delusions from the public. The myths associated with pandemics prevail around causation, disease transmission, and cure. The pandemics present economic paradoxes, though arguably the negatives outdo the positives. There is a need for the governments and international health custodians to be richly prepared for the pandemics in the future. This implies having special budgetary allocations for possible pandemic outbreaks, investing in vaccine development and disease surveillance, and training and skilling personnel in all social-health-related sectors.
PubMed: 38445068
DOI: 10.2147/JMDH.S440243 -
ELife Mar 2024In children, psychotic-like experiences (PLEs) are related to risk of psychosis, schizophrenia, and other mental disorders. Maladaptive cognitive functioning, influenced...
In children, psychotic-like experiences (PLEs) are related to risk of psychosis, schizophrenia, and other mental disorders. Maladaptive cognitive functioning, influenced by genetic and environmental factors, is hypothesized to mediate the relationship between these factors and childhood PLEs. Using large-scale longitudinal data, we tested the relationships of genetic and environmental factors (such as familial and neighborhood environment) with cognitive intelligence and their relationships with current and future PLEs in children. We leveraged large-scale multimodal data of 6,602 children from the Adolescent Brain and Cognitive Development Study. Linear mixed model and a novel structural equation modeling (SEM) method that allows estimation of both components and factors were used to estimate the joint effects of cognitive phenotypes polygenic scores (PGSs), familial and neighborhood socioeconomic status (SES), and supportive environment on NIH Toolbox cognitive intelligence and PLEs. We adjusted for ethnicity (genetically defined), schizophrenia PGS, and additionally unobserved confounders (using computational confound modeling). Our findings indicate that lower cognitive intelligence and higher PLEs are significantly associated with lower PGSs for cognitive phenotypes, lower familial SES, lower neighborhood SES, and less supportive environments. Specifically, cognitive intelligence mediates the effects of these factors on PLEs, with supportive parenting and positive school environments showing the strongest impact on reducing PLEs. This study underscores the influence of genetic and environmental factors on PLEs through their effects on cognitive intelligence. Our findings have policy implications in that improving school and family environments and promoting local economic development may enhance cognitive and mental health in children.
Topics: Adolescent; Child; Humans; Mental Disorders; Psychotic Disorders; Mental Health; Cognition; Intelligence
PubMed: 38441539
DOI: 10.7554/eLife.88117