scholarly journals Folie a Deux: Shared Psychotic Disorder in a Medical Unit

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Saumya Bhutani ◽  
Damir Huremovic
Keyword(s):  
Psychotic Disorder ◽  
Clinical Characteristics ◽  
Psychotic Disorders ◽  
Medical Setting ◽  
Typically Develop ◽  
Medical Unit ◽  
Or Groups ◽  
Close Relationship ◽  
Socially Isolated ◽  
Shared Psychotic Disorder

Introduction. A shared psychotic disorder is a system of delusions shared by two or more individuals. Shared psychotic disorders typically develop in pairs or groups with a close relationship who are socially isolated. The function and affect of those inflicted with shared psychotic disorders usually remain intact. For these reasons, a shared psychotic disorder is seldom identified, diagnosed, and treated. This case describes a shared psychotic disorder incidentally discovered in a medical unit. Case. The patient was a 47-year-old woman with no known past psychiatric history who had been medically admitted for gastroenteritis. On the day of discharge, a psychiatric consult was requested for “paranoia and bizarre behavior.” The patient was seen making statements that she needed security and the FBI to escort her as she left the hospital. Another person in the patient’s room was discovered to be the patient’s mother who had been staying with her in the hospital. Evaluation of the patient along with observation of her mother revealed that the two shared a complex system of delusions revealing a diagnosis of shared psychotic disorder. Discussion. A shared psychotic disorder is a unique psychiatric diagnosis. It may be even rarer to diagnose in the inpatient medical setting because multiple individuals from a shared system are typically not seen. In this case, the patient and her mother had multiple clinical characteristics of a shared psychotic disorder, including an enmeshed relationship and social isolation. The treatment for shared psychotic disorders involves separation of the individuals and pharmacotherapy with antipsychotics. This case also presented a unique ethical dilemma as the psychiatric team was called to evaluate a patient and found a patient and another individual to have symptoms. Conclusion. A shared psychotic disorder is important to consider on the differential when cases of psychosis with delusional systems are seen on medical floors.

scholarly journals Folie a deux

2015 ◽  
Vol 53 (200) ◽  
pp. 295-297
Author(s):  
Pratikshya Chalise ◽  
Sandip Subedi ◽  
Pawan Sharma
Keyword(s):  
Case Report ◽  
Psychiatric Disorder ◽  
Psychotic Disorder ◽  
Delusional Disorder ◽  
The Other ◽  
Review Of Literature ◽  
Close Relationship ◽  
Folie À Deux ◽  
Shared Psychotic Disorder ◽  
Folie A Deux

Shared psychotic disorderis a rare psychiatric disorder. It is defined when a primary psychotic person imposes his/her delusional beliefs to the other person usually in a close relationship. Occurrence of this disorder among family members and close friends has been described. However, its exact incidence and prevalence is not known. Since such case has not been reported in Nepal to best of our knowledge, we present a case of shared delusional disorder along with brief review of literature. This case report describes a case of common shared persecutory delusion in husband and wife. Keywords: folie a deux; shared psychotic disorder.

scholarly journals T241. INCIDENCE AND SOCIO-DEMOGRAPHIC/CLINICAL CHARACTERISTICS OF PSYCHOTIC DISORDERS IN INDIA, NIGERIA AND TRINIDAD: PRELIMINARY BASELINE FINDINGS FROM INTREPID II

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S324-S324
Author(s):  
Tessa Roberts ◽  
Craig Morgan ◽  
Oye Gureje ◽  
Gerard Hutchinson ◽  
Rangaswamy Thara ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Tamil Nadu ◽  
Clinical Characteristics ◽  
Psychotic Disorders ◽  
Service Providers ◽  
Age Of Onset ◽  
Professional Services ◽  
Available N ◽  
Populations At Risk ◽  
Catchment Areas

Abstract Background The incidence, presentation, and course of psychotic disorders are highly variable across populations. A recent review noted a lack of evidence from low- and middle-income countries in the global South, where around 85% of the world’s population lives. Robust population-based data from these contexts are needed to better understand the sources of variation in psychotic disorders. INTREPID II is a multi-country programme comprising incidence, case-control, and follow-up studies of psychotic disorders in three diverse catchment areas with populations at risk of ~ 500,000 in Tamil Nadu (India), Oyo state (Nigeria), and northern Trinidad. Here, using baseline data from the initial 15 months, we present findings on variations in incidence and clinical presentation. Methods Baseline recruitment and assessment is ongoing. In each site individuals with an untreated psychotic disorder are identified through a comprehensive case detection system that includes professional, folk, and popular sectors. Inclusion criteria are age of 18–64, resident in catchment area, presence of a ICD-10 psychotic disorder, and no more than one continuous month of treatment with antipsychotic medication prior to the start of case identification. At baseline, detailed data on demographic and clinical characteristics and putative risk factors are collected using established tools. Results In the first 15 months, we identified 614 cases (199 in India, 92 in Nigeria, and 264 in Trinidad). There was wide variation in where cases were identified: In India, 9% via professional services and 91% via the popular sector (i.e., in the community); In Nigeria, 33% via professional services and 63% via the folk sector (traditional and religious service providers); In Trinidad, 98% via professional services. Further, there were notable variations in incidence and sociodemographic and clinical characteristics. Age-adjusted rates were highest in Trinidad (men: 47.1, 95% CI 39.8–55.4; women: 38.7, 95% CI 32.0–46.3) compared with India (men: 23.0, 95% CI 18.4–28.4; women: 30.2, 95% CI 24.9–36.4) and Nigeria (men: 13.0, 95% CI 9.5–17.2; women: 12.4, 95% CI 9.0–16.6). The proportion with age of onset before 29 years was higher in Trinidad (74%) compared to Nigeria (45%) and India (36%). Among those on whom full data are currently available (n, 327), more in Nigeria were assigned a diagnosis of schizophrenia (63%) than in India (46%) and Trinidad (42%). Median duration of untreated psychosis was was longer in India (5.1 years, IQR 1.9–13.6) than in Nigeria (1.5 years, IQR 0.1–4.1) and Trinidad (2.6 years, IQR 0.3–15.2). However, an insidious onset (i.e., gradual emergence of symptoms over several months) was more common in Trinidad (50% of cases) than in India (28%) and Nigeria (14%). Education levels were lower in India (31% completed secondary education or higher) than in Nigeria (74%) or Trinidad (68%). However, the proportion of cases who were married or in a steady relationship was similar in all sites (India: 42%, Nigeria: 38%, Trinidad: 38%), as was the proportion who were unemployed (India: 48%, Nigeria: 55%, Trinidad: 51%). Discussion In initial analyses, we found evidence that the incidence and presentation of psychoses varied by site, findings that both further highlight the heterogeneity of psychoses across contexts and challenge assumptions about the basic epidemiology based on findings from the global North. For example, the data from our India site suggest higher rates among women and a later age of onset than commonly supposed. Our findings also show that many people with psychotic disorders in these settings are untreated for long periods, indicating an urgent need to develop more accessible services.

Shared Psychotic Disorder: A Critical Review of the Literature

1995 ◽  
Vol 40 (7) ◽  
pp. 389-395 ◽  
Author(s):  
M Silveira José ◽  
V Seeman Mary
Keyword(s):  
Social Isolation ◽  
Psychotic Disorder ◽  
Case Reports ◽  
Married Couples ◽  
Equal Frequency ◽  
Dsm Iv ◽  
Males And Females ◽  
Socially Isolated ◽  
The Relationship ◽  
Shared Psychotic Disorder

Objective To search the literature to reassess the concept of shared psychotic disorder (SPD) using modern nosology and current biopsychosocial formulation. Method Analyzing published case reports from 1942 through to 1993 that meet DSM-IV criteria for SPD according to patient age, sex, nature and duration of the relationship with the “primary”, length of exposure to primary's psychosis, family psychiatric history, comorbidity, social isolation of the dyad, presence of hallucinations, delusional type, and the diagnosis of the primary. Results Findings revealed: 1. males and females were affected with equal frequency; 2. there was equal prevalence in younger and older patients; 3. the majority of shared psychoses (90.2%) were equally distributed among married couples, siblings, and parent-child dyads; 4. comorbid dementia, depression, and mental retardation were common; 5. hallucinations were common; 6. the majority of dyads (67.3%) were socially isolated. Conclusions SPD probably occurs in premorbidly disposed individuals in the context of social isolation which is shared with a psychotic person.

INTER AKSI AGAMA DAN BUDAYA

EMPIRISMA ◽  
2018 ◽  
Vol 27 (1) ◽  
Author(s):  
Mohammad Arif Dan Yuli Darwati
Keyword(s):  
Human Life ◽  
Belief System ◽  
Cultural Interaction ◽  
Cultural Economic ◽  
Modern Period ◽  
Or Groups ◽  
Close Relationship ◽  
History Of ◽  
The Relationship ◽  
Determining Factor

This paper will try to explain the relationship between religion and culture. These two topics are the most important items that are inseparable in the history of human civilization from the classical to the modern period. Religion is ahuman belief system that is related to God. If the rule comes from God, then it cannot be said to be a culture, because it is not human creation, but God’s creation that is absolute. Religion is interpreted as part of the life (culture) ofindividuals or groups, each of which has the authority to understand religion and apply it. With the characteristics as indicated by Fazlur Rahman, wherever religion is located, it is hoped that it can provide guidance on values or moralsfor all activities of human life, whether social, cultural, economic or political. Not infrequently also religion becomes a determining factor in the adhesive process of social cultural interaction of the community as well as unifying thenation. Culture and religion are something different but can influence each other so that new cultures or mixing of cultures emerge. The opinion of Endang Saifudin Anshari who said in his writing that religion and culture do notinclude each other, in principle one is not part of the other and each consists of itself. Between them, of course, they are closely related like us, we see in everyday life and human life. As also seen in the close relationship between husband and wife who can give birth to a son but the husband is not part of the wife, and vice versa. Religion and culture are two different things but cannot be separated. The existence of a religion will be greatly influenced and affect thepractice of a religion in question. And conversely, a culture will be greatly influenced by the beliefs of the society in which culture develops. Therefore religion is not only an individual problem but religion is also a social affair whichultimately religious people are not only able to give birth to individual piety but also must be able to give birth to social piety.Key words: Interaction, Religion, Culture,

scholarly journals Dysregulation of complement and coagulation pathways: emerging mechanisms in the development of psychosis

2021 ◽  
Author(s):  
Meike Heurich ◽  
Melanie Föcking ◽  
David Mongan ◽  
Gerard Cagney ◽  
David R. Cotter
Keyword(s):  
High Risk ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Clinical Symptoms ◽  
First Episode Psychosis ◽  
Specific Protein ◽  
First Episode ◽  
Clinical High Risk ◽  
Blood Proteins ◽  
Episode Psychosis

AbstractEarly identification and treatment significantly improve clinical outcomes of psychotic disorders. Recent studies identified protein components of the complement and coagulation systems as key pathways implicated in psychosis. These specific protein alterations are integral to the inflammatory response and can begin years before the onset of clinical symptoms of psychotic disorder. Critically, they have recently been shown to predict the transition from clinical high risk to first-episode psychosis, enabling stratification of individuals who are most likely to transition to psychotic disorder from those who are not. This reinforces the concept that the psychosis spectrum is likely a central nervous system manifestation of systemic changes and highlights the need to investigate plasma proteins as diagnostic or prognostic biomarkers and pathophysiological mediators. In this review, we integrate evidence of alterations in proteins belonging to the complement and coagulation protein systems, including the coagulation, anticoagulation, and fibrinolytic pathways and their dysregulation in psychosis, into a consolidated mechanism that could be integral to the progression and manifestation of psychosis. We consolidate the findings of altered blood proteins relevant for progression to psychotic disorders, using data from longitudinal studies of the general population in addition to clinical high-risk (CHR) individuals transitioning to psychotic disorder. These are compared to markers identified from first-episode psychosis and schizophrenia as well as other psychosis spectrum disorders. We propose the novel hypothesis that altered complement and coagulation plasma levels enhance their pathways’ activating capacities, while low levels observed in key regulatory components contribute to excessive activation observed in patients. This hypothesis will require future testing through a range of experimental paradigms, and if upheld, complement and coagulation pathways or specific proteins could be useful diagnostic or prognostic tools and targets for early intervention and preventive strategies.

scholarly journals Clinical characteristics and sociodemographic features of psychotic major depression

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Meng-qi Wang ◽  
Ran-ran Wang ◽  
Yu Hao ◽  
Wei-feng Xiong ◽  
Ling Han ◽  
...  
Keyword(s):  
Family History ◽  
Major Depression ◽  
Clinical Characteristics ◽  
Missing Values ◽  
Psychotic Disorders ◽  
Mental Health Center ◽  
Psychiatric Diseases ◽  
First Onset ◽  
History Of ◽  
Psychotic Major Depression

Abstract Background Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research. Methods This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method. Results PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019–2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168–1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492–0.741), were more often divorced (OR 3.087, 95% CI 1.168–10.096), had a younger age of onset (OR 0.934, 95% CI 0.914–0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492–0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267–0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD. Conclusions PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.

Amphetamine use and psychiatric admissions: a 10-year perspective

2021 ◽  
pp. 103985622110142
Author(s):  
Jai Nathani ◽  
Richard W Morris ◽  
Nicholas Glozier ◽  
Grant Sara
Keyword(s):  
Cohort Study ◽  
Psychotic Disorder ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Service Use ◽  
Psychotic Disorders ◽  
Multivariate Tests ◽  
Psychiatric Admissions ◽  
Amphetamine Treatment ◽  
Amphetamine Use

Objective: We aimed to (i) describe the 10-year trend in admissions associated with amphetamine use, (ii) describe the distinguishing characteristics of people with an amphetamine-related diagnosis (ARD) and (iii) examine predictors of repeated admissions among people with an ARD. Method: We conducted a retrospective cohort study. We (i) counted the number of admissions with an ARD and evaluated any trends, and using univariate and multivariate tests, (ii) compared those who had an ARD with those who did not and (iii) compared those with an ARD who had one, two to four, and five or more admissions. Results: Admissions associated with amphetamine use increased between 2009 and 2015. Those with an ARD had significant differences in demographics, diagnosis and pattern of service use relative to those without an ARD. Amongst those with an ARD, a higher number of admissions was positively associated with a schizophrenia diagnosis but inversely associated with a transient psychotic disorder diagnosis. Conclusions: The increase in admissions associated with amphetamine use indicates that people with an ARD posed major demands on inpatient services. Targeting amphetamine treatment to those with psychotic disorders, both schizophrenia and transient psychotic disorders, may reduce hospital-related costs and re-admissions.

Frontal Lobe Epilepsy Presenting as a Psychotic Disorder With Delusions and Hallucinations: A Case Study

CNS Spectrums ◽  
1999 ◽  
Vol 4 (9) ◽  
pp. 64-66,82 ◽  
Author(s):  
Bonnie J. Ramsey
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Frontal Lobe ◽  
Psychotic Disorder ◽  
Temporal Lobe ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Frontal Lobe Epilepsy ◽  
Unique Case ◽  
Frontal Lobe Seizures

AbstractAlthough psychotic symptoms are a recognized manifestation of epilepsy, these are more often associated with seizures of the temporal lobe type. While 10% of children with temporal lobe epilepsy develop a psychotic disorder by adulthood, the literature does not report any cases of psychotic disorders associated with frontal lobe seizures in children. This article presents a unique case of a girl whose frontal lobe seizures were associated with delusional psychotic symptoms. Once her seizure disorder was identified through electroencephalography (EEG) and appropriate anticonvulsant therapy was initiated, her associated psychotic symptoms resolved.

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