Effect of Marriage on Pre-existing Psychoses: A Convenient or Futile Solution for Severe Mental Disorders?

Marriage can be defined as the state of being united as spouses in a consensual and contractual relationship recognized by law. The general population generally believes marriage to be a solution to mental illnesses. It can be agreed that mental disorders and marital issues have some relation. Parents of patients with psychoses expect that marriage is the solution to the illness and often approach doctors and seek validation about the success of the marriage of their mentally ill child, which is a guarantee no doctor can give in even normal circumstances. Evidence on sexual functioning in patients of psychosis is limited and needs further understanding. Studies show about 60%–70% women of the schizophrenia spectrum and illness to experience sexual difficulties. Based on available information, sexual dysfunction in population with psychosis can be attributed to a variety of psychosocial factors, ranging from the psychotic symptoms in itself to social stigma and institutionalization and also due to the antipsychotic treatment. Despite the decline in sexual activity and quality of life in general, it is very rarely addressed by both the treating doctor and by the patient themselves hence creating a lacuna in the patient’s care and availability of information regarding the illness’ pathophysiology. Patients become noncompliant with medications due to this undesirable effect and hence it requires to be given more attention during treatment. It was also found that paranoid type of schizophrenia patient had lower chances of separation than patients with other types of schizophrenia. The risk of relapse in cases with later age of onset of the disease, lower education, a positive family history of psychosis or a lower income increased more than other populations.

Capgras-féle tünettel összefüggő szülőgyilkosságok. Két eset bemutatása

Capgras symptom is characterized by the delusional belief that a person significant to the patient has been replaced by a ‘double’ or ‘impostor’. Capgras symptom was discussed to be associated with violent behavior. We report here the cases of two male patients with schizophrenia paranoid type, where parricide was connected to Capgras delusion. It is important to emphasize that in our observed cases, non-adherence played an essential role in the development of violent behavior, parricide. Orv Hetil. 2019; 160(42): 1673–1676.

Psychotherapy Process Research in Schizophrenia Paranoid Type: The Investigation of Delusion Formation through the Evaluation of In-Session Events

The study aimed to investigate delusion formation in paranoid type schizophrenia through the evaluation of the relation between specific in-session events and the session outcome. Six transcripts of integrative psychotherapy sessions -three with good and three with bad outcome- of an individual suffering from paranoid type schizophrenic symptoms were evaluated by five raters in order: a) to locate the in-session events related to delusion formation and b) to explore the relation of these events to a number of mechanisms postulated to be involved in delusion formation, utilizing the newly developed Scale for the In-session Investigation of Delusion Formation. Although, no significant differences were found in the total number of the in-session events counted in the sessions with good and bad outcome, the evaluations obtained by the raters were found to be affected by the patient’s general decrease in psychopathological symptoms due to a significant parallel reduction of anxiety and delusions in paranoid type schizophrenia.

The peculiarity of Experiencing Body by Patients in Schizophrenia

IntroductionBy the present, the study of corporeality as a psychological phenomenon in schizophrenia has had a lack of attention. At the focus of works, there have been mainly psychopathological phenomena: cenestopathies, visceral hallucinations and body scheme disturbances. There is an evidence of the necessity for psychological investigations: the execution of radical changes in appearance, a frequent turning to plastic surgery, dysfunctional wearing and transsexuality.ObjectivesThe experimental group consisted of 23 patients in schizophrenia of paranoid type (F 20.00). The control group consisted of 27 healthy subjects.AimIt is to study the peculiarity of experiencing their own body by patients in schizophrenia.MethodsThere are projective techniques, such as: “A Picture of Me”, “Verbal Self-Portrait”, ‘A Picture of Inner Body” and the psychosemantic test “Classification of Sensations”.ResultsThere are statistically significant differences (P < 0.005) found between the groups:– patients with schizophrenia are characterized for their deficit of experiencing their body. It does not refer to “Myself” and is deinvidualized. The body does not serve as a physical presentation of the subject in a social world;– a wary attitude is observed in relation to body displays in the form of inner body sensations with a minor (than in norm) awareness relatively to the inner arrangement of their own body. This causes the increase of the quantity of intraceptive sensations categorized by patients in schizophrenia as unhealthy or a threat.ConclusionThe above-mentioned peculiar features of corporeality in schizophrenia make it a source of negative experiences.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Political abuse and forensic psychiatry in communist Romania

Psychiatry was often used for political reasons in the second half of the 20th century, especially in the former communist countries. According to the global initiative on psychiatry, political abuse of psychiatry is defined as the incorrect usage of diagnoses, treatments, or psychiatry admissions in order to limits fundamental rights of persons or population groups in certain countries. Most studies regarding political abuse as a repressive measure analysed it in either USSR or China. Romania is one of the countries from the former communist block in which psychiatry was proven to be used as a form of repression against political dissidents. One of the psychiatry “tools” used against political dissidents was the widespread usage of mandatory, non-voluntary admissions. They were seen as preventive measures, whose purpose was to prevent an individual to act antisocially. The purpose of this article is to analyse the characteristics of the patients that were non-voluntarily admitted in psychiatry hospitals, based on studies published by the forensic psychiatry researchers in the communist period. The main conclusions of this study are: (1) the presence of a disproportionate number of patients admitted with schizophrenia, especially the paranoid type; (2) patients that performed acts against the state were more often diagnosed with schizophrenia; (3) patients that performed acts against the state were more often considered to have no judicial responsibility; (4) the non-voluntary admission/treatment were more often removed for crimes against persons, and less often in crimes against the state.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Perceived Stigma in Patients with Schizophrenia and Caregivers in Songklanagarind Hospital: Cross-Sectional Study

Objective: To study the perceived level of stigma in patients with schizophrenia and caregivers. Material and Method: This was a cross-sectional study. The researchers collected all data of patients with schizophrenia and caregivers in the psychiatric out-patient unit in Songklanagarind Hospital from May 2015 to March 2016. A self-administered questionnaire was used. Demographics and level of perception of stigma data were analyzed using descriptive statistics and presented in the form of a percentage, mean, and standard deviation.Results: One hundred seventy-one patients with schizophrenia participated. Eighty-nine patients were female (52.0%); the average age was 42.3 years [standard deviation (S.D.)=13.4]; duration of illness was 15 years (S.D.=11.4). Most patients were Buddhist (84.2%), unemployed (38.0%), paranoid type (68.4%). One hundred seventy-one caregivers participated. The average age was 51.2 years (S.D.=13.4). Most caregivers were female (71.9%), Buddhist (86.0%), a parent of patient (40.4%). Average duration of care was 12.7 years (S.D.=9.3). The study found that the patients perceived a low level of stigma (62.0%). Only 1.8% of patients perceived a high level of stigma. The caregivers also perceived a low level of stigma (62.0%). Only 0.6% of caregivers perceived a high level of stigma.Conclusion: Most patients with schizophrenia and caregivers perceived a low level of stigma.

Olanzapine as a possible replacement choice for paliperidone-induced Pisa syndrome: a case report

Objective: The aim of this paper is to present a case of paliperidone-induced Pisa syndrome and provide treatment experience. Method: The case report is combined with a review of the literature. Results: A 37-year-old man had been diagnosed with paranoid-type schizophrenia for about 10 years. He received three-month treatment of paliperidone extended release (ER) at 6 mg per day, but showed a progressively Pisa-like physical position. We initially added an anticholinergic drug, but saw no improvement. The paliperidone ER was replaced by olanzapine at 10 mg per day, and the Pisa-like symptom improved after 1 month of the drug replacement. Conclusions: We propose olanzapine as a possible replacement choice for patients with paliperidone-related Pisa syndrome.