scholarly journals Psychosis and Dandy-Walker syndrome: a case report and review of the literature

2021 ◽  
Vol 34 (2) ◽  
pp. e100254
Author(s):  
Alejandro Porras Segovia ◽  
Margarita Guerrero-Jiménez ◽  
Carmen Maura Carrillo de Albornoz Calahorro ◽  
Luis Gutierrez-Rojas
Keyword(s):  
Fourth Ventricle ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Review Of The Literature ◽  
Mild Intellectual Disability ◽  
Cystic Dilatation ◽  
Violent Behaviour ◽  
Persecutory Delusions ◽  
Brain Malformations ◽  
Vermian Hypoplasia

Dandy-Walker syndrome (DWS) is a group of brain malformations which sometimes present with psychotic symptoms. We present the case of a patient diagnosed with Dandy-Walker variant who presented with schizophrenia-like psychosis. A man in his 30s was admitted to an acute psychiatric unit presenting with persecutory delusions, auditory hallucinations and violent behaviour. The MRI performed showed the typical alterations of Dandy-Walker variant: vermian hypoplasia and cystic dilatation of the fourth ventricle. He also suffered from mild intellectual disability. After being treated with olanzapine 10 mg/d for a month, his psychotic symptoms greatly improved and he was discharged. In conclusion, DWS may cause psychosis through a dysfunction in the circuit connecting prefrontal, thalamic and cerebellar areas. The association between these two conditions may contribute to the understanding of the aetiopathogenesis of schizophrenia.

scholarly journals Supersensitivity Psychosis and Its Response to Asenapine in a Patient with Delusional Disorder

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Ravi Philip Rajkumar
Keyword(s):  
Atypical Antipsychotics ◽  
Antipsychotic Agents ◽  
Delusional Disorder ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Typical Antipsychotic ◽  
Persecutory Delusions ◽  
Established Treatment

Supersensitivity psychosis is a recognized complication of long-term antipsychotic treatment, in which patients develop new or reemergent psychotic symptoms, generally accompanied by dyskinetic movements, due to prolonged dopamine receptor blockade and resultant supersensitivity. Though it is most closely associated with schizophrenia and the use of typical antipsychotic agents, it has also been documented in patients with other diagnoses, and in those receiving atypical antipsychotics. There is no established treatment for this condition. In this paper, we describe a patient with persistent delusional disorder, jealous type, who developed a supersensitivity psychosis characterized by persecutory delusions, auditory hallucinations, and thought insertion in association with mild tardive dyskinesia. These symptoms resolved completely following six weeks of treatment with the second-generation antipsychotic asenapine, 20 mg/day. The mechanisms and implications of the patient’s symptomatology and response are discussed.

scholarly journals De Novo Partial 13q22-q34 Trisomy with Typical Neurological and Immunological Findings: A Case Report with New Genetic Insights

2020 ◽  
Vol 11 (1) ◽  
pp. 21
Author(s):  
Claudia Brogna ◽  
Valentina Milano ◽  
Barbara Brogna ◽  
Lara Cristiano ◽  
Giuseppe Rovere ◽  
...  
Keyword(s):  
Case Report ◽  
De Novo ◽  
Partial Trisomy ◽  
Cerebral Vasculitis ◽  
Radiological Findings ◽  
Cerebral Lesions ◽  
Brain Malformations ◽  
Vermian Hypoplasia ◽  
Callosal Dysgenesis ◽  
First Time

The partial trisomy 13q encompasses an extensive variability of phenotypic and radiological findings including leukoencephalopathy and brain malformations such as holoprosencephaly, callosal dysgenesis, hippocampal hypoplasia, olfactory hypoplasia, and vermian hypoplasia. We report for the first time a case of a 23-year-old patient affected by de novo partial 13q22.1q34 trisomy (41.7 Mb, 72,365,975-114,077,122x3) presenting with hemiparesis related to both ischemic and haemorrhagic cerebral lesions compatible with cerebral vasculitis due to a possible combination of genetic and immunological interaction.

Organic Delusions: Phenomenology, Anatomical Correlations, and Review

1985 ◽  
Vol 146 (2) ◽  
pp. 184-197 ◽  
Author(s):  
Jeffrey L. Cummings
Keyword(s):  
Basal Ganglia ◽  
Prospective Study ◽  
Limbic System ◽  
Systematic Study ◽  
False Beliefs ◽  
Review Of The Literature ◽  
Persecutory Delusions ◽  
Study Review ◽  
A Prospective Study ◽  
Reduplicative Paramnesia

SummaryOrganic delusions are common, but have received little systematic study. Review of the literature reveals that they occur most commonly in toxicmetabolic processes and in disorders affecting the limbic system and basal ganglia. A prospective study of 20 consecutive patients with organic delusions revealed four general types of false beliefs: simple persecutory delusions, complex persecutory delusions, grandiose delusions, and those associated with specific neurological defects (anosognosia, reduplicative paramnesia). Simple delusions responded best to treatment, and complex delusions were more resistent. Acting on delusional beliefs was not unusual, and treatment of the delusions was an important aspect of management of the patient.

scholarly journals Violent behaviour in schizophrenia

2005 ◽  
Vol 187 (5) ◽  
pp. 426-430 ◽  
Author(s):  
Jan Vevera ◽  
Alan Hubbard ◽  
Arnošt Veselý ◽  
Hana Papežová
Keyword(s):  
Logistic Regression ◽  
Substance Misuse ◽  
Overt Aggression ◽  
Psychotic Symptoms ◽  
Violent Behaviour ◽  
Stable Conditions ◽  
Dsm Iv ◽  
Available Information ◽  
Overt Aggression Scale ◽  
Over Time

BackgroundA number of studies have reported increased violence in patients with schizophrenia.AimsTo determine the prevalence of violence among those with schizophrenia in samples from 1949, 1969, 1989 and 2000 in Prague (Czech Republic) and to examine trends in this behaviour.MethodRecords from 404 patients meeting DSM–IV criteria for schizophrenia were screened for violence (defined as 3 points on the Modified Overt Aggression Scale) from the first observed psychotic symptoms until the time of latest available information.ResultsLogistic regression revealed a marginally significant increase in violence only inthe 2000 cohort. Overall, violence was associated with schizophrenia in 41.8% of men and 32.7% of women, with no association between substance misuse and violence.ConclusionsThe violence rate found in our sample is expected to remain stable over time under stable conditions. Substance misuse is not the leading cause of violence among those with schizophrenia.

scholarly journals High-dose olanzapine in treatment resistant schizophrenia. A case report and literature review

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S115-S115
Author(s):  
Ciara Clarke ◽  
Clodagh Rushe ◽  
Fintan Byrne
Keyword(s):  
Case Report ◽  
Literature Review ◽  
The Body ◽  
Psychotic Symptoms ◽  
High Dose ◽  
Extensive Literature ◽  
Treatment Resistant ◽  
Persecutory Delusions ◽  
Full Resolution ◽  
One Year

ObjectiveWe report a case of a 58-year-old gentleman who was hospitalised intermittently for one year due to treatment resistant schizophrenia. Prior to hospitalisation he had been prescribed standard antipsychotics for decades without full resolution of positive psychotic symptoms. During his final admission lasting six months he was guarded, suspicious, irritable, constantly paced the corridor and displayed thought block and paranoid persecutory delusions. He would not enter the assessment room or allow any blood or ECG monitoring, however, he was compliant with oral medication. He was successfully treated with high dose olanzapine (40mg/day) and was discharged to the community. The aim of this study is to bring awareness and add to the body of evidence for the use of high-dose olanzapine in patients with treatment resistant schizophrenia in whom a trial of clozapine is not possible.Case reportThe patient gave written consent for this case report to be written and presented. An extensive literature review was performed and key papers were identified. Discussion focuses on the key areas in the literature.DiscussionThis case demonstrates that high-dose olanzapine can be used effectively as an alternative to clozapine in treatment resistant schizophrenia.ConclusionThis case highlights the need for further evaluation of high-dose olanzapine as an alternative to clozapine in patients with treatment-resistant schizophrenia.

scholarly journals Persistent psychotic symptoms following COVID-19 infection

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Soon Tjin Lim ◽  
Benjamin Janaway ◽  
Harry Costello ◽  
Anand Trip ◽  
Gary Price
Keyword(s):  
Tumour Necrosis ◽  
Auditory Hallucinations ◽  
Tnf Alpha ◽  
Psychotic Symptoms ◽  
Resonance Imaging ◽  
Tnf Α ◽  
Cerebrospinal Fluid Examination ◽  
Brain Scan ◽  
Inflammatory State ◽  
Necrosis Factor

Summary To date, there have been no detailed reports of patients developing persistent psychotic symptoms following Coronavirus disease 2019 (COVID-19) infection. There have been reports of patients developing transient delirium (with and without hypoxia) after COVID-19 infection as well as other neurological manifestations. We report on a female patient who, post-COVID-19 infection, developed an initial delirium followed by persistent and florid psychotic symptoms consisting of persecutory delusion, complex visual and auditory hallucinations and Capgras phenomenon in the absence of hypoxia but elevated tumour necrosis factor (TNF)-α. The psychotic symptoms persisted for about 40 days. Her magnetic resonance imaging brain scan, electroencephalogram, cerebrospinal fluid examination and extensive autoimmune panel did not show any abnormalities. The cause of the psychotic symptoms in this patient were not ascertained but we propose either an inflammatory state, characterised by the patient's elevated TNF-alpha levels as a possible contributing mechanism for her psychosis in line with the proinflammatory changes observed in some cases of psychosis. Or, an alternative, but unproven, hypothesis is one of an antibody-mediated encephalitic event induced by viral infection.

scholarly journals A network analysis of post-traumatic stress and psychosis symptoms

2020 ◽  
pp. 1-8
Author(s):  
Amy Hardy ◽  
Ciaran O'Driscoll ◽  
Craig Steel ◽  
Mark van der Gaag ◽  
David van den Berg
Keyword(s):  
Traumatic Stress ◽  
Graphical Model ◽  
Mental Health Problems ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Stress Reactions ◽  
Post Traumatic Stress ◽  
Psychological Mechanisms ◽  
Stress Symptoms ◽  
Post Traumatic

Abstract Background Understanding the interplay between trauma-related psychological mechanisms and psychotic symptoms may improve the effectiveness of interventions for post-traumatic stress reactions in psychosis. Network theory assumes that mental health problems persist not because of a common latent variable, but from dynamic feedback loops between symptoms, thereby addressing the heterogeneous and overlapping nature of traumagenic and psychotic diagnoses. This is a proof-of-concept study examining interactions between post-traumatic stress symptoms, which were hypothesized to reflect trauma-related psychological mechanisms, and auditory hallucinations and delusions. Method Baseline data from two randomised controlled trials (N = 216) of trauma-focused therapy in people with post-traumatic stress symptoms (87.5% met diagnostic criteria for PTSD) and psychotic disorder were analysed. Reexperiencing, hyperarousal, avoidance, trauma-related beliefs, auditory hallucinations and delusional beliefs were used to estimate a Gaussian graphical model along with expected node influence and predictability (proportion of explained variance). Results Trauma-related beliefs had the largest direct influence on the network and, together with hypervigilance, were implicated in the shortest paths from flashbacks to delusions and auditory hallucinations. Conclusions These findings are in contrast to previous research suggesting a central role for re-experiencing, emotional numbing and interpersonal avoidance in psychosis. Trauma-related beliefs were the psychological mechanism most associated with psychotic symptoms, although not all relevant mechanisms were measured. This work demonstrates that investigating multiple putative mediators may clarify which processes are most relevant to trauma-related psychosis. Further research should use network modelling to investigate how the spectrum of traumatic stress reactions play a role in psychotic symptoms.

Course and symptom and functional correlates of passivity symptoms in schizophrenia: an 18-year multi-follow-up longitudinal study

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ellen S. Herbener ◽  
Martin Harrow
Keyword(s):  
Longitudinal Study ◽  
Schizoaffective Disorder ◽  
Similar Rate ◽  
Psychotic Symptoms ◽  
Work Functioning ◽  
Index Hospitalization ◽  
Persecutory Delusions ◽  
Work Impairment ◽  
Time Information

Abstract Background Change in the experience of oneself may lay the groundwork for the development of additional hallucinations and delusions in individuals with schizophrenia. However, to date, the course and symptom and functioning correlates of passivity symptoms (cf. thought insertion, thought withdrawal) have not been measured consistently over long periods of time. Information on the course and correlates of passivity symptoms is essential for developing models of their contribution to schizophrenic illness. Method Eighty-two individuals diagnosed with schizophrenia or schizoaffective disorder were recruited at an index hospitalization and reassessed at three or more follow-ups over the following 18 years. Results The results indicate that a small group of participants report passivity symptoms at all follow-ups, many reported passivity symptoms at some follow-ups, and the majority of individuals never reported passivity symptoms. The prevalence of passivity symptoms was similar to that for delusions of reference and persecutory delusions. Notably, when individuals did experience passivity symptoms, they also had a greater number of additional psychotic symptoms than individuals without passivity symptoms. Further, the presence of passivity symptoms was associated with work impairment at some assessments. Conclusions Passivity symptoms present episodically, at a similar rate as delusions of reference and persecutory delusions, and when present, they are associated with having a higher number of additional psychotic symptoms, as well as having some impact on work functioning. These results suggest that passivity symptoms may increase vulnerability to additional psychotic symptoms and greater work impairment.

scholarly journals Treatment-resistant psychotic symptoms and the 15q11.2 BP1–BP2 (Burnside-Butler) deletion syndrome: case report and review of the literature

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Martilias Farrell ◽  
Maya Lichtenstein ◽  
Matthew K. Harner ◽  
James J. Crowley ◽  
Dawn M. Filmyer ◽  
...  
Keyword(s):  
Case Report ◽  
Deletion Syndrome ◽  
Psychotic Symptoms ◽  
Review Of The Literature ◽  
Treatment Resistant

iMAgery focused psychological therapy for persecutory delusions in PSychosis (iMAPS): a multiple baseline experimental case series

2020 ◽  
Vol 48 (5) ◽  
pp. 530-545
Author(s):  
Christopher D.J. Taylor ◽  
Penny E. Bee ◽  
James Kelly ◽  
Richard Emsley ◽  
Gillian Haddock
Keyword(s):  
Case Series ◽  
First Episode Psychosis ◽  
Psychological Therapy ◽  
Multiple Baseline ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multiple Baseline Design ◽  
Persecutory Delusions ◽  
Baseline Design ◽  
Episode Psychosis

AbstractBackground:Many people with psychosis experience persecutory delusions and report negative schematic beliefs and intrusive mental images which may be maintaining factors for psychotic symptoms.Aims:This study examined the feasibility and acceptability of a new psychological therapy targeting schemas and images (iMAPS therapy).Method:The study used a randomised multiple baseline design. Participants with first episode psychosis were randomised using a multiple baseline design with 2–5 assessments. Six sessions of therapy, consisting of a combination of imagery techniques and imagery rescripting techniques, was used. In each session, participants completed a Mental Imagery in Psychosis Questionnaire (MIPQ) and imagery interview. Mood and delusional beliefs (PSYRATS) were also measured at each session.Results:Five participants with first episode psychosis completed the baseline visits and attended all therapy sessions. One participant declined the final assessment. Results demonstrated significant reductions in negative schematic beliefs, delusions, imagery distress and other measures of schema (YSQ, SMI). Although multiple baseline randomisation strengthens the study, it lacked a control arm and blind assessments.Conclusions:iMAPS appears a feasible and acceptable treatment for psychosis, and further evaluation is indicated.

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