Varieties of Inner Speech and Creative Potential

Inner speaking, the covert talking that goes on inside a person's mind, can shape creative thought. How the phenomenological properties and quality of inner speaking correlate with a person's creative potential, however, is an open scientific problem. To explore this, participants ( n = 267) filled in the revised Varieties of Inner Speech Questionnaire and the revised Launay Slade Hallucination Scale (auditory subscale), and performed three tests of creative potential: one divergent (Alternative Uses Test) and two convergent thinking tests (Compound Remote Associates Test, short Hagen Matrices Test). The results showed that a tendency to engage in condensed and evaluative/ critical inner speaking negatively correlated with convergent thinking ability; and the results pointed toward a potential negative correlation of auditory hallucination proneness with divergent and convergent thinking ability. No evidence was found for a correlation of the dialogicality, imagining of others’ voices, or positive/regulatory aspect of the participants day-to-day inner speech, with creative potential. Herewith, the presented study contributes novel insight into the relationship between the varieties of inner speech and creative potential.

Myxedema Psychosis after Levothyroxine Withdrawal in Radioactive Iodine Treatment of Differentiated Thyroid Cancer: A Case Report

Neuropsychiatric symptoms, especially acute psychosis (often referred to as myxedema madness or psychosis), are rare but possible clinical presentations of patients with hypothyroidism. A 42-year-old woman with papillary thyroid carcinoma and recent total thyroidectomy had developed flat affect, paranoid delusion, and visual and auditory hallucination during inpatient admission for elective radioactive iodine treatment. On admission, her history and physical exam did not reveal symptoms and signs of significant hypothyroidism. Other medical causes of acute psychosis were excluded, and the patient was immediately treated with thyroid hormone replacement therapy. Subsequently, her thyroid function normalized, and her psychotic symptoms gradually improved. Although there is a lack of classic signs and symptoms of hypothyroidism, myxedema madness should be recognized as one of the potentially treatable causes of acute psychosis.

Molecular mimicry of NMDA receptors may contribute to neuropsychiatric symptoms in severe COVID-19 cases

Approximately 30% of individuals with severe SARS-CoV-2 infections also develop neurological and psychiatric complaints. In rare cases, the occurrence of autoimmune encephalitis has been reported after SARS-CoV-2 infection. In this systematic review, we have identified eight SARS-CoV-2-associated cases of anti-NMDA receptor encephalitis. All had cerebrospinal fluid antibodies against the NMDA receptor and a recent onset of working memory deficits, altered mental status, or psychiatric symptoms, such as confusion, agitation, auditory hallucination, catatonia and speech dysfunction. All patients received high-dose steroid and immunoglobulin therapeutics and conditions improved in each case. These findings suggest that clinical attention should be paid to warning signs of autoimmune encephalitis in severe COVID-19 cases. If characteristic features of autoimmune encephalitis are present, autoantibody diagnostics should be performed and confirmed cases should be treated with immunotherapy to minimize neurological impairments.

Case Report: Magic Mushroom (Psilocybe Cubensis) Intoxication

Introduction. Psilocybe mushroom, or wi dely known as the magic mushroom is a variety of mushroom commonly consumed because of hallucinogenic traits it causes toward its consumer. This hallucinogenic effect is caused by Psilocybin, a hallucinogenic substance often found within Psilocybe mushroom. This substance affects mental state of the consumer and has similar effect to those of LSD and Mescaline. Aside from its effect to cause mental disturbance, consumption of this mushroom may cause acute renal injury which leads to a fatal and life -threatening situation. Case presentation. A case of Psilocybe intoxication had been reported in a 22 years old male with a confirmed history of consuming Psilocybe mushroom. Patient first came with a symptom of disorientation and restlessness. Patient also often shook his head off, laughed out, screamed, and continuously making bizarre movements. Psychiatric examination confirmed a sign of auditory hallucination, unstable mood, and stereotypical behavior experienced by the patient. Conclusion. An approach is needed in the form of a ph ysical examination and support that supports a prompt and precise diagnosis, as well as comprehensive management that focuses on the direct management of life-threatening symptoms and symptomatic treatment, taking into account the si gns and symptoms of life-threateningnephrotoxicity

Case Report on Acute Transient Psychotic Disorder

Introduction: Acute and Transient Psychotic disorder (ATPD) is defined by the ICD-10 as hallucinations, delusions, and/or senseless or nonsensical speech having an acute [1]. The distinguishing characteristic of ATPD is its abrupt onset. Second, there are characteristic symptoms present, and third, there is related acute stress [2]. Clinical Findings: Sleep disturbance, aggressiveness, muttering to self, irritability, irrelevant talks and loss of appétit, hearing of voices not heard by others, suspiciousness, increased talkativeness, increased energy and fearfulness. Mental Status Examination: Conscious, dressed appropriately, well groomed, standing, eye to eye contact initiated, non cooperative, activity normal, and the mood is exhausted, frustrated, the affect is irritable, guarded, and the flow of speech rate is rapid with moderate volume and responsive quality, Thought-flight of thoughts is evident, as are perceptual abnormalities- auditory hallucination, impaired social judgment, and full denial of sickness. Outcome: After treatment, the patient shows improvement. Irritability has reduced, sleeping pattern is improved, self muttering has stopped, irrelevant talks are less, and aggressiveness is reduced. Conclusion: Patient was admitted to Psychiatric Ward with a known case of Bipolar Affective Disorder and after Mental Status Examination he is diagnosed as Acute Transient Psychotic Disorder with complain of Sleep disturbance, aggressiveness, muttering to self, irritability, irrelevant talks. He improved after receiving adequate treatment, and the treatment was continuously ongoing until my last date of care.

Shift of musical hallucinations to visual hallucinations after correction of the hearing deficit in a patient with Lewy body dementia: a case report

Background Musical hallucinations are a particular type of auditory hallucination in which the patient perceives instrumental music, musical sounds, or songs. Musical hallucinations are associated with acquired hearing loss, particularly within the elderly. Under conditions of reduced auditory sensory input, perception-bearing circuits are disinhibited and perceptual traces released, implying an interaction between peripheral sensory deficits and central factors related to brain dysfunction. Case presentation A 71-year-old Caucasian man with hearing loss complained of memory difficulties and resting tremor of the right upper limb in the previous 2 years. He already had difficulties in instrumental activities of daily life. Neurological examination showed Parkinsonian signs and hypoacusia. Neuropsychological examination identified deficits in executive functions and memory tests. Brain computerized tomography and nuclear magnetic resonance scans showed mild cortical and subcortical atrophy. The clinical diagnosis of possible dementia with Lewy bodies was established. Five years later, the patient began complaining of musical hallucinations. There had been no previous change in medication. An otorhinolaryngologist diagnosed age-related hearing loss and prescribed bilateral hearing aids. After using the hearing aids, the patient did not hear the songs any longer, only some tinnitus, described as a whistle. However, at the same time, the patient started experiencing visual hallucinations he never had before. Discussion To our knowledge, the immediate shift of hallucinations from one sensory modality to another sensory modality when perception is improved has not been previously described. This report emphasizes the interaction between brain pathology and sensory deficits for the genesis of hallucinations, and reinforces the theory that attention and control networks must couple properly to the default mode network, as well as integrate and select adequately peripheral signals to the somatosensory cortices, in order to keep a clear state of mind. Conclusion The clinician should bear in mind and let the patient know that improving one sensory modality to ameliorate hallucinations may sometimes paradoxically lead to hallucinations in a different sensory modality.

Reactivation of Latent Toxoplasmosis in a Schizophrenia Patient: A Case Report

Schizophrenia is a serious mental disorder characterized by chronic relapsing episodes of psychosis. The disease is multifactorial, where infections, genetic vulnerability and environmental factors are involved in the development of the illness. Toxoplasma gondii is one of the parasites that has long been known associated with schizophrenia in many studies. To date, there is growing evidence of association between T. gondii infections and schizophrenia. Herein we report a rare case of reactivated toxoplasmosis in a schizophrenia individual. This patient was incidentally diagnosed with reactivated T. gondii infection. He denied any symptoms of toxoplasmosis but experienced a mild psychiatric auditory hallucination. Serology test for T. gondii immunoglobulin antibodies measured a high positive IgG titer (135.9 IU/ml) and negative for IgM. Interestingly, nested PCR exhibited a positive result for the type I strain of T. gondii dense granular (GRA) 7 gene (GRA7). This case highlights the detection of probable reactivation of toxoplasmosis in an immunocompetent schizophrenic patient without psychiatric treatment-resistant and remains asymptomatic for toxoplasmosis. Both serology and molecular tools have been a helpful aid in establishing the diagnosis. Nonetheless, early detection as in this case may aid the patient management in the future.

Co-design of avatars to embody auditory hallucinations of patients with schizophrenia

Auditory hallucinations are common and distressing symptoms of the schizophrenia disease. It is commonly treated with pharmacological approaches but, unfortunately, such an approach is not effective in all patients. In the cases in which the use of antipsychotic drugs is not possible or not recommended, psychotherapeutic interventions are used to help patients gain power and control against hearing voices. Recently, virtual reality technologies have been incorporated to this type of therapies. A virtual representation of their voice (avatar) is created in a controlled computer-based environment, and the patient is encouraged to confront it. Unfortunately, the software tools used in these therapies are not described in depth and, even more important, to the best of our knowledge, their usability, utility and intention to use by therapists, and patients have not been evaluated enough. The involvement of end users in the software development is beneficial in obtaining useful and usable tools. Hence, the two contributions of this paper are (1) the description of an avatar creation system and the main technical details of the configuration of auditory hallucination avatars, and (2) its evaluation from both the therapists’ and the patients’ viewpoints. The evaluation does not only focus on usability, but also assesses the acceptance of the technology as an important indicator of the future use of a new technological tool. Moreover, the most important results, the lessons learned and the main limitations of our study are discussed.

Auditory Hallucinations: A Phenomenological Study

Background: Auditory hallucinations are common feature in psychotic disorder and have also given diagnostic importance. These hallucinations can be rated on different dimensions both quantitatively and qualitatively, so here comes phenomenological aspect. Study of phenomenological aspects may lead to more understanding about them and further can help in management of distressing auditory hallucinations. Aims and Objectives: The aims and objectives of the current study was as follows- 1. To explore the phenomenology of auditory hallucination in schizophrenia spectrum disorder. 2. To find out clinical correlation of auditory hallucination with other psychotic symptoms. 3. To find out factor structure of PSYRATS (Psychotic Symptom Rating Scale) and their correlation with PANSS and its subscales. Materials and Methods: One hundred patients, who had schizophrenia spectrum diagnoses attending general hospital psychiatry unit in India having auditory verbal hallucination (AVH) in last seven days were studied. Phenomenology was assessed by using Psychotic Symptoms Rating Scale (PSYRATS) and Positive and Negative Syndrome Scale (PANSS). Pearson correlation for the psychotic symptoms, Dimensions of psychotic symptoms on PSYRATS were explored by principal component analysis. Results: In study 82% patients had schizophrenia. More than one third patients heard voices continuously, in more than two-third patients voices were coming from outside head only, had no control over them, and had same loudness as one’s own voice. One third patients had AVH (Auditory Verbal Hallucinations) with all negative content, 19% had AVH commanding nature. 79% had delusions, 96% had hallucinatory behavior. Bipolar index showed dominance of positive symptoms. 80% reported depression. On principal component analysis three factors found, all three factors were positively correlated with positive subscale and total PANSS score. None of three factors were correlated with negative subscale of PANSS. Conclusion: In this study of AVH phenomenology among schizophrenia spectrum disorders, most dimensions of AVH correlated well with one another. On principal component analysis three factor structure of PSYRATS was found.