Delusional Disorder and False Allegations of Child Sexual Abuse: A Case Report

Child sexual abuse is a public health problem worldwide. When a court carries out an investigation into cases of sexual abuse, they are likely to ask for a genital examination report from a forensic pathologist indicating whether they believe sexual abuse contact has occurred. Any suspicion about the sexual abuse of a child should be evaluated prudently. Nevertheless, the investigation of sexual abuse is sometimes undertaken according to misguided or unnecessary complaints from concerned parents suffering from mental illness.

Clinical evidence in the phenomenon of Alien Abduction

Purpose: Starting from the classic definition of “alien abduction”, the present research, starting from the study published in 2020 on the proposed clinical classification of this particular phenomenon, is aimed at confirming the theoretical assumption of psychopathological origin. Methods: Clinical interview, based on narrative-anamnestic and documentary evidence and the basis of the Perrotta Human Emotions Model (PHEM) concerning their emotional and perceptual-reactive experience, and administration of the battery of psychometric tests published in international scientific journals by the author of this work: 1) Perrotta Integrative Clinical Interviews (PICI-2), to investigate functional and dysfunctional personality traits; 2) Perrotta Individual Sexual Matrix Questionnaire (PSM-Q), to investigate the individual sexual matrix; 3) Perrotta Affective Dependence Questionnaire (PAD-Q), to investigate the profiles of affective and relational dependence; 4) Perrotta Human Defense Mechanisms Questionnaire (PDM-Q), to investigate the defence mechanisms of the Ego. Results: Preliminary results from the interviews and the anamnestic form would suggest that the phenomenon of alien abductions has a greater tendency to occur in the female group, in the adult and mature group (and tends to diminish but not disappear with advancing age) and in the group geographically originating in central-northern Italy (due to lower religious influences but greater openness to the typical contents of ufological and mystery narratives). Moreover, the subsequent results would lead us to deduce with almost total certainty, concerning the selected sample, that the phenomenon of alien abductions has an absolute prevalence in the believing population concerning the existence of paranormal phenomena per se, even in the absence of objective and/or scientific evidence. It is a phenomenon that is almost completely linked (110/112, 98.2%) to a medium-low or not fully educated cultural level. Based on the PICI-2 it emerged that the primary emerging disorder is alternatively the delusional disorder, the dissociative disorder and the narcissistic disorder; followed, as secondary disorders, by the delusional disorder (if it is not considered as primary disorder), the schizoid disorder, the borderline disorder, the obsessive disorder and the psychopathic disorder. The analysis of functional traits also reported the marked dysfunctional tendency of the classes referring to self-control, sensitivity, Ego-Es comparison, emotionality, ego stability, security and relational functionality, confirming here too the marked dysfunctional tendency of the clinical population. According to the PSM-Q, almost 2/3 of the participants (73/112, 65.2%) present a dysfunctional tendency to sexual behaviour and a marked tendency to chronicle feelings of shame in avoidance behaviour or hyposexuality. Furthermore, 100% of the sample of the population surveyed report having suffered significant or serious psychological or physical abuse at a young age, or intra-parental relational imbalances, or in any case a sexual upbringing that was not open and lacking in free communication. According to the PDM-Q, 27.7% (31/112) are affected by affective dependency, with greater emphasis on types I (neurotic), VI (covert narcissist), V (borderline) and III (histrionic), in that order of descent. Finally, the PDM-Q reveals the widespread psychopathological tendency of the functional ego framework for the mechanisms of isolation, denial, regression, reactive formation, denial, projection, removal, withdrawal, instinct, repression and idealisation. Conclusion: This research confirms the psychopathological nature of the alien abduction phenomenon, which deserves to be treated using a psychotherapeutic approach (preferably cognitive-behavioural and/or strategic) and possibly also pharmacological in serious cases, depending on the symptoms manifested and the severity of the morbid condition.

Dopamine, Serotonin, and Structure/Function Brain Defects as Biological Bases for Treatment Response in Delusional Disorder: A Systematic Review of Cases and Cohort Studies

Although blockade of dopamine receptors D2 and D3 appears to be the main mechanism of antipsychotic action, treatment response variability calls for an examination of other biological systems. Our aim is to systematically review reports of treatment response in delusional disorder (DD) in order to help determine its biological bases. Computerized searches of ClinicalTrials.gov, PubMed, and Scopus databases (from 1999 to September 2021) were systematically reviewed, in keeping with PRISMA directives. We used the search terms: (treat * OR therap * AND (delusional disorder)). We included all studies that explored the biological mechanisms of treatment response in DD, as diagnosed by ICD or DSM criteria. A total of 4344 records were initially retrieved, from which 14 papers were included: case reports, case series, and cohort studies. Findings point to (1) dopaminergic dysfunction (based on biochemical and genetic studies), (2) serotonergic dysfunction (based on partial agonism/antagonism of drugs), and (3) brain structure/function impairment, especially in the temporal and parietal lobes, as crucial factors in treatment response. Further studies with higher levels of evidence are needed to help clinicians determine treatment.

Clinical evidence in the phenomenon of Demonic Possession

Purpose: Starting from the classic definition of “demonic possession” (as a psychophysical condition in which a person becomes the victim of a supernatural being of demonic origin), the present research, starting from the study published in 2019 on the proposed clinical classification of this particular phenomenon, is aimed at confirming the theoretical assumption of psychopathological origin, refuting the assumptions of the most significant analytical orientations, such as the ethnopsychiatric, the socio-anthropological, the cultural, the religious and the esoteric, to reaffirm the accuracy of the theoretical approach of the multifactorial model proposed in the previous research. Methods: Clinical interview, based on narrative-anamnestic and documentary evidence and the basis of the Perrotta Human Emotions Model (PHEM) concerning their emotional and perceptual-reactive experience, and administration of the battery of psychometric tests published in international scientific journals by the author of this work: 1) Perrotta Integrative Clinical Interviews (PICI-2), to investigate functional and dysfunctional personality traits; 2) Perrotta Individual Sexual Matrix Questionnaire (PSM-Q), to investigate the individual sexual matrix; 3) Perrotta Affective Dependence Questionnaire (PAD-Q), to investigate the profiles of affective and relational dependence; 4) Perrotta Human Defense Mechanisms Questionnaire (PDM-Q), to investigate the defence mechanisms of the Ego. Results: The preliminary results of the interviews and the anamnestic form would suggest that the phenomenon of demonic possession has a greater tendency to manifest itself in the female group, in the juvenile group (and tends to decrease but not to disappear with the advancement of age) and in the group geographically originating in the centre-south of Italy (due to greater religious influences, popular beliefs and ancestral fideistic representations). Moreover, the subsequent findings would lead to deduce with almost total certainty, concerning the selected sample, that the phenomenon of demonic possession has an absolute prevalence in the believing population, faithful or in any case trusting in the existence of paranormal phenomena per se, even in the absence of objective and/or scientific evidence. Based on the PICI-2 it emerged that the primary emerging disorder turns out to be alternatively the delusional disorder, the dissociative disorder and the obsessive disorder; followed, as secondary disorders, by the delusional disorder (if it is not considered as primary disorder), the schizoid disorder, the borderline disorder and the psychopathic disorder. Even the analysis of functional traits has reported the marked dysfunctional tendency of the classes that refer to self-control, sensitivity, Ego-ID comparison, emotionality, ego stability, security and relational functionality, reaffirming here too the marked dysfunctional tendency of the clinical population. According to the PSM-Q, more than 1/4 of participants present a lack of acceptance of their sexual orientation and a marked tendency to chronicle feelings of shame into dysfunctional sexual behaviours of avoidance or hypersexuality. Still, nine in ten reports having experienced severe psychological or physical abuse at a young age, or intraparental relational imbalance, or otherwise a sexual upbringing that was not open and lacked free communication. According to the PDM-Q, 37.2% are affected by affective dependence, with a greater emphasis on types I (neurotic), V (borderline), III (histrionic), and VII (psychotic) in that order of descent. Finally, the PDM-Q reveals the widespread psychopathological tendency of the ego function framework for the mechanisms of isolation, denial, regression, reactive formation, denial, projection, removal, withdrawal, instinct, repression, and idealization. Conclusions: The present research demonstrates beyond any reasonable doubt the psychopathological nature of the phenomenon of demonic possession, which deserves to be treated pharmacologically and with a psychotherapeutic approach (preferably cognitive-behavioural and/or strategic), according to the symptoms manifested and the severity of the morbid condition.

Same Gender Erotomania: When the Psychiatrist Became the Delusional Theme—A Case Report and Literature Review

Erotomania is a rare subtype of delusional disorder, whereby the affected person believes that another individual, usually someone with higher socio-economic status, is in love with them despite having little or no contact. To the best of our knowledge, this is the first published case of same gender erotomania, involving a 28-year-old single lady and a 42-year-old divorcee towards a female psychiatrist. We aimed to share the challenges experienced by the managing psychiatrist as she inopportunely became the theme of her patients’ delusion. We also reviewed and discussed recent literature on erotomania to create awareness among psychiatrists towards this rare psychiatric condition.