Case Report on Paranoid Schizophrenia with Capgras Syndrome

Paranoid is the most common delusion in people living with schizophrenia spectrum disorders which are present in about half of all people seeking treatment for a psychotic disorder. Schizophrenia is a persistent mental illness characterized by a wide range of symptoms, including delusions, hallucinations, disorganized speech or behavior, and cognitive impairment. Capgras syndrome is a form of the delusional belief in which a person has been replaced by an imposter. It can be seen in mental disorders as well as in central nervous system diseases in the form of neurodegenerative and non- neurodegenerative diseases The Capgras Syndrome is not an unusual condition, but an infrequent one which is possibly often unnoticed. A 48- years- old woman was admitted in female psychiatric ward with known case of paranoid schizophrenia with capgras syndrome. In the present case, the treatment approach was mainly somatic therapy i.e. psychopharmacotherapy, Electro convulsive Therapy (ECT) and psychological therapy. Psychiatric nurses have to play an important role to identify the symptoms and they should think critically, take action immediately to provide care to such type of patients.

Concentration of Circulating Cell-Free DNA in the Peripheral Blood Plasma of Patients with Acute Endogenous and Exogenous Etiology Psychoses

Introduction: cell-free plasma DNA (cfDNA) is used as a marker refl ecting the level of apoptosis in the human body under stress. Acute psychosis caused by endogenous (schizophrenia) and exogenous (alcohol intoxication) factors in the patient’s body is associated with oxidative stress. Presumably, cfDNA concentration in the blood plasma of patients with acute psychoses of endogenous and exogenous etiology is increased. The purpose of the study: comparative analysis of the cfDNA concentration in the blood plasma of treated and untreated patients with paranoid schizophrenia during the disease exacerbation, patients with alcoholic psychosis and healthy volunteers. Patients and methods: the concentration of cfDNA was determined in the blood plasma samples of 476 people: control group (n = 95); patients with schizophrenia in the acute stage of the disease (n = 334); patients with alcoholic psychosis (n = 47). Results: the concentrations of cfDNA in the plasma of patients with schizophrenia (median 931 ng/ml) is 2.2 times higher than in the control group (median 428 ng/ml) and 1.8 times higher than in the patients with alcoholic psychosis (504 ng/ml). For the patients with schizophrenia with high PANSS, we found the highest values of the cfDNA concentration in the blood plasma during psychosis, which indicates a more pronounced systemic process, which is accompanied by the cell death level increase. Conclusions: the concentration of cfDNA in the blood plasma could be used as a biochemical marker that refl ects the severity of the schizophrenia patient’ state upon admission to the hospital.

On the markers for schizophrenia

Summary. The study of various markers indicating an imbalance in both the neurotransmitter and immune systems observed in patients with schizophrenia is currently of great scientific and practical interest. These studies allow us to deepen knowledge about the etiology and pathogenesis of schizophrenic spectrum disorders, to facili-tate the classification and conduct of differential diagnosis in complex diagnostic cases. The article presents the results of laboratory studies of DMT-1, CD4, CD20, CD34 and dopamine in 24 people suffering from paranoid schizophrenia, and 14 healthy individuals. The aim of the study was to determine DMT-1, CD4, CD20, CD34 and dopamine as possible markers for the diagnosis of schizophrenia using the minimally invasive method.Materials and methods: Buccal epithelium was taken in 2 groups of patients suffering from paranoid schizophrenia receiving and not receiving therapy with psychotropic drugs. The third group consisted of healthy volunteers. The samples were studied by the immunocytochemical method followed by visualization using scanning laser confocal microscopy and morphometric analysis.Results and discussion: : It was revealed that the markers studied were found to be associated with the nature of mental disorder, but not with the influence of psychotropic drugs used in it. Conclusion: The results of this study may indicate the possibility of minimally invasive diagnosis of schizophrenia using this method; however, the authors note that the results of the study should be considered preliminary. It is necessary to expand the number of patients and compare them with groups of patients suffering from other mental disorders, which is certainly important for assessing the adequacy of the proposed method and the possibility of its use in differential diagnosis.

Association Between Residence And Disease Incidences In The Dr. Soetomo Hospital Psychiatric Clinic

Background; The increasing mental disorders prevalence adds countries’ burdens. One of the mental disorder’s risks is residence. There is no research about the relationship between residence and ten most psychiatric diseases in Surabaya. Objective; This research aims to study the relationship between residence and ten most diseases in Dr. Soetomo hospital psychiatric clinic. Methods; This research method using observational-analytic design with a cross-sectional approach in Dr. Soetomo hospital psychiatric clinic. Data were taken from medical records based on inclusion and exclusion criteria. The research used a chi-square test with 95%CI. Results: The dominant districts where research subjects lived were education-related psychiatric examinations in Semampir, paranoid schizophrenia in Sawahan, mental disorders due to brain damage in Sawahan, moderate depressive episodes in Gubeng, MMR in Kenjeran, activity and behavior disorders in Sawahan, hebefrenic schizophrenia in Tambaksari, family-related psychiatric examinations in Tambaksari, atypical autism in Sukomanunggal and Semampir, MADD in Tambaksari. Distribution of patients’ residence based on five regions of Surabaya was East Surabaya as the dominant residence of paranoid schizophrenia, moderate depressive episodes, hebefrenic schizophrenia, atypical autism, MADD; North Surabaya as the dominaNt residence of education-related psychiatric examinations, MMR; South Surabaya as the dominant residence of paranoid schizophrenia, mental disorders due to brain damage, activity and behavior disorders, family-related psychiatric examinations. Chi-square test showed a significant relationship between residence and ten most diseases. Conclusion; There is a significant (goodness of fit) relationship between residence and ten most diseases in Dr. Soetomo hospital psychiatric clinic. Keywords: Mental disorders, Residence, Surabaya City

Psychopathological conditions and somatic consequences of a suicide attempt with a corrosive substance in a patient suffering from long-lasting paranoid schizophrenia - a case study

Background: Schizophrenia is a chronic mental illness that affects 20 million people worldwide. Patients diagnosed with paranoid schizophrenia are characterized by cognitive deficits and the so-called negative symptoms, which significantly lower their quality of life and have implications for their independence and ability to fulfill various social roles. Aim: This study aims to present the case of a 49-year-old woman who has been suffering from schizophrenia for a long time and, due to a psychotic exacerbation with delusions and auditory hallucinations in the form of ordering voices, attempted suicide by ingesting a highly corrosive chemical agent used for unblocking pipes (the so-called “mole”). Case report: The patient was admitted to the 1st Department of Psychiatry, Psychotherapy and Early Intervention of SPSK 1 in Lublin for psychiatric treatment, after being transferred from the SPSK 1 Surgery Clinic, where she was initially admitted after the suicide attempt. Discussion: The psychotic exacerbation in the patient could have resulted from sensory deprivation due to her feeling of loneliness and deep social isolation.

The Importance of Family Support in Successful Treatment Adherence of Schizophrenic Patient

Background: Schizophrenia is a treatable disease but requires patient’s high adherence to treatment. Family support of a schizophrenic patient plays an important role in encouraging the patient to continue his treatment. This report aims to enhance the importance of family support of schizophrenic patient in patient’s adherence to achieve a good mental health for all family member.Case: A hospitalized male paranoid schizophrenic patient who was admitted and observed in Dr. Soetomo General Hospital from September 15th-25th, 2020. Patient came to the hospital with chief complaint could not stop talking (rambling) since 1 day before admission. Patient could neither eat nor sleep for that day. Patient relapsed after stopping taking medication from the psychiatrist.Discussions: The patient in this case suffered a relapse of his paranoid schizophrenia because he stopped taking medication. Lack of support from family is the most important factor in a schizophrenia patient. Psychoeducation to patient’s family about schizophrenia and the importance of medication would be a great help for patient’s adherence to treatment.Conclusions: Schizophrenia needs a long-life treatment. High adherence to treatment could improve schizophrenia’s symptoms and prevent relapse. Family support is important to make sure the patient keeps taking his medicine regularly.

Incongruence of neurophysiological manifestations as reflection of disturbances in synaptic pruning of the cortex in paranoid schizophrenia

Current study provides a comprehensive analysis of neurophysiological and molecular genetic data concerning the etiology of hallucinatory-paranoid syndrome in schizophrenia. The level of cortical excitation and inhibition was determined by analysis of event-related potential (ERP) parameters: latency and amplitude of intermediate (P200) and late (P300, N400) ERP components. The results showed the impossibility to determine the level of different cortical areas activation during perceiving stimuli of different significance in patients with hallucinatory-paranoid syndrome due to unidirectional shift of both ERP parameters to significant stimuli. The observed simultaneous increase of both amplitude and latency of these components in frontal regions is associated with an excessive number of aberrant synapses, and a decrease in the central regions is associated with synaptic deficit, this is due to disturbances in synaptic pruning of the cortex. Thus, the inhomogeneity of number and quality of synapses in central and frontal cortical areas was revealed, caused by inhomogeneity of their elimination process, which may be an essential condition for hallucinatory-paranoid syndrome emergence. An epigenetic analysis was also performed to assess the methylation level of gene expressing an extracellular matrix protein and playing a key role in neural connections distribution in ontogenesis. The detected epigenetic disorders in form of demethylation of RELN gene cause pathological synaptic pruning and elimination diversity in different brain areas.

When does schizophrenia really begin? - A case report confirming the neurodevelopmental theory of schizophrenia

Introduction: According to the neurodevelopmental theory, schizophrenia is a cognitive-behavioral manifestation of the non-physiological development of the CNS, which was caused by the interaction of genetic and environmental factors during its formation. Aim, material and methodology: The aim of this article is to present a clinical case in which exposure to numerous adverse environmental factors in the pre and postnatal period could cause the development of schizophrenia in adulthood. The analysis of the clinical case and the medical records of a patient diagnosed with paranoid schizophrenia, suffering from numerous perinatal complications, was performed. Case report: A woman, 23 years old, unmarried, studying at post-secondary school - archivistics. Currently, psychiatrically hospitalized for the second time. A patient from the first, twin, fraternal pregnancy. The delivery took place by caesarean section, complicated. In the APGAR scale, she scored 4 points in the 1st minute, and 6 points in the 3rd minute. By day 30, the patient had experienced preterm retinopathy, viral infection, salmonella, jaundice and anemia. In the second month of her life, she was treated with surgery due to intestinal obstruction. Psychomotor development was disturbed. At 9 years of age, there was a retinal detachment. Until the end of junior high school, she was educated in a special school for the visually impaired. Conclusions: The neurodevelopmental theory assumes that the increased risk of developing schizophrenia is associated with unfavorable factors in the developmental period. Identifying the causes underlying the development of the disease is a key step towards prevention, more efficient diagnosis, and improvement of the effectiveness of treatment of patients suffering from this disease.