“That's not my arm”: A hypnotic analogue of somatoparaphrenia

Introduction. “Instrumental hypnosis” allows researchers to model clinical symptoms in the laboratory, creating “virtual patients” with reversible disturbances in, for example, perception, action, memory, or belief. We used hypnosis to temporarily recreate somatoparaphrenia, a delusional belief that one's own limb belongs to someone else.

Methods. We compared a “Fully Formed” somatoparaphrenia suggestion with a “Factor 1 + Factor 2” suggestion that attempted to generate the delusional belief from analogues of its hypothesised underlying factors (i.e., paralysis plus disrupted critical belief evaluation). We tested and then challenged subjects’ responses to these suggestions.

Results. Although many hypnotic subjects experienced temporary paralysis, only a minority claimed their arm did not belong to them. Notably, the Fully Formed suggestion was more successful in recreating features of somatoparaphrenia than the Factor 1 + Factor 2 suggestion. In response to the challenges, some of those who developed temporary somatoparaphrenia maintained their belief throughout the hypnosis session.

Conclusions. We discuss these findings in terms of the “two-factor” theory of delusions and we highlight the advantages versus disadvantages of using hypnosis to explore such delusional beliefs in the laboratory.     

Recurrent postictal depression with cotard delusion

Depression is a common occurrence among epileptic patients and constitutes, alongwith anxiety disorders, the most frequent psychiatric condition in these patients. However, little work is done in the area of post-ictal depression especially in children with epilepsy. Here, the authors report an adolescent boy who developed recurrent depression associated with Cotard’s delusion following complex partial seizure at the age of 7 years. Trial of antidepressant drug and lithium worsened the clinical picture but ultimately he responded well to carbamazepine. This case is unique in its presentation due to recurrent depression itself is rare at this age and secondly rarity of onset of Cotard delusion in prepubertal phase. This case also showed that postictal depression is biological process rather than psychological and social reaction. Prompt identification and management of underlying cause would definitely prevent further complication and would also prevent the child from exposing unnecessary with various pharmacological treatments     

试析老年痴呆患者的被窃妄想

目的了解老年痴呆患者被窃妄想的临床特征。方法将83例老年痴呆患者按有无嫉妒妄想分为两组,并就痴呆严重度、类型、伴随症状等进行对照分析。结果被窃妄想在老年痴呆患者中的发生率较高（56．％）;痴呆严重程度轻于无被窃妄想者;被窃妄想在阿尔茨海默病（AD）中的发生率高于血管性痴呆（VD）;有被窃妄想者伴有较多嫉妒妄想（P均〈0．05）。结论被窃妄想可能是老年痴呆较敏感的临床症状之一,尤其对轻度AD的诊断有一定意义。     

躁狂症与精神分裂症妄想特征比较

目的：比较躁狂症与精神分裂症妄想特征及病理机制的差异。方法：用自编妄想特征调查表对躁狂症和精神分裂症患者各56例的妄想特征进行比较。结果：精神分裂症最多见的被害、关系妄想；躁狂症患者最多见夸大妄想，其次为被害、关系妄想。两者的持续时间，隐蔽性、协调性、稳定性以及伴随症状均有差异。结论：精神分裂症与躁狂症患者妄想特征及病理心理机制可能不同。     

96例精神分裂症患者自尊感与妄想症状的相关性分析

目的通过分析精神分裂症患者妄想症状与自尊和缺陷感之间的关系,明确自尊和缺陷感对妄想症状出现的影响,为精神分裂症患者的早期干预提供理论依据和为康复期认知心理治疗指明方向。方法运用PAN—SS、SES、FIS、SAS、SDS对120例精神分裂症患者进行评定。结果完成评定的患者共96例,其中56例存在明确的妄想（为研究组）,40例未发现有妄想（为对照组）。两组的SES、FIS得分存在显著性差异（P〈0．01）。妄想的出现与自尊感、缺陷感明显相关（P〈0．01）。结论精神分裂症患者的低自尊和高缺陷感是影响患者妄想症状出现和加重的重要因素。     

Changes in nitric oxide level and superoxide dismutase activity during antimanic treatment

Oxidant nitric oxide (NO) and antioxidant superoxide dismutase (SOD) have been implicated to play a role in the pathogenesis of bipolar disorders. This is the first prospective study aimed to evaluate NO levels and SOD activity in bipolar disorder (type I manic episode) (BD-ME). 29 inpatient subjects with BD-ME and 30 healthy controls were included. Serum NO levels and SOD activity have been studied at 1st (NO [1st] and SOD [1st] respectively) and 30th days (NO [30th] and SOD [30th] respectively) after treatment. The clinical outcome was measured by Bech-Rafaelson Mania Scale (BRMS). The mean NO [1st] (p<.001) and NO [30th] levels (p<.001) were higher than controls, but SOD [1st] (p<.001) and SOD [30th] (p<.001) activities in BD-ME were lower than controls. SOD(1) activity was higher than SOD [30th] (p<.001), while there was no significance in comparison between NO [1st] and NO [30th] (p>.05). SOD [30th] activity is negatively correlated with the number of previous manic attacks and NO [1st] was negatively correlated with sleep item score of BRMS at first day. Also there was a significant correlation between NO [1st] levels and with the existence of a delusion. NO and SOD appear to play a role in the pathophysiological events occurring in BD, especially in BD-ME. This study for the first time showed the possible role of NO on sleep and the generation of delusions in the pathophysiology of BD. In the light of literature, induced glutamate pathway might be responsible for delusions in BD. The results of this research need further investigation to understand the oxidative vs antioxidative process in BD.     

The Relationship between Exercise and Psychotic Symptoms in College Students: A Cross-Sectional Analysis

An increasing number of studies have suggested that increased physical activity is associated with less mental illness. However, therelationship between exercise and psychotic experiences (PEs) is still unknown. The purpose of this study was to explore therelationship between exercise and PEs in college students in the United States. Data from the Health Mind Survey (2020–2021round) were analyzed. Respondents included 137,916 college students who were asked about exercise and PEs (lifetimepsychotic experiences, delusions, and hallucinations). A multivariate logistic regression analysis was used to investigate therelationship between exercise and PEs while controlling for demographic characteristics. There was a significant correlationbetween exercise and PEs among college students. Compared to students who exercised less than one hour per week, studentswho exercised five or more hours per week had fewer lifetime psychotic experiences. This same finding obtained for both maleand female college students. The findings from the present study indicate that exercising for five or more hours each week ismost correlated with decreased PEs among college students. However, experimental studies are required to extend and confirmour findings and determine the causality of this relationship.     

How psychotic-like are paranormal beliefs?

Background and objectives

Paranormal beliefs and Psychotic-like Experiences (PLE) are phenotypically similar and can occur in individuals with psychosis but also in the general population; however the relationship of these experiences for psychosis risk is largely unclear. This study investigates the association of PLE and paranormal beliefs with psychological distress.

Methods

Five hundred and three young adults completed measures of paranormal beliefs (Beliefs in the Paranormal Scale), psychological distress (General Health Questionnaire), delusion (Peters et al. Delusions Inventory), and hallucination (Launay-Slade Hallucination Scale) proneness.

Results

The frequency and intensity of PLE was higher in believers in the paranormal compared to non-believers, however psychological distress levels were comparable. Regression findings confirmed that paranormal beliefs were predicted by delusion and hallucination-proneness but not psychological distress.

Limitations

The use of a cross-sectional design in a specific young adult population makes the findings exploratory and in need of replication with longitudinal studies.

Conclusions

The predictive value of paranormal beliefs and experiences for psychosis may be limited; appraisal or the belief emotional salience rather than the belief per se may be more relevant risk factors to predict psychotic risk.     

Délires paranoïaques,dangerosités et homicides

“Are you threatening to kill me?”, asks the psychiatrist. “It's not a threat, it's a promise!”, replies the paranoiac patient. In just a few short words, this exchange raises the issue of a dangerous, potentially homicidal nature linked to paranoia. This mental disorder is such that it severely complicates interpersonal relationships. Its mechanisms and delusional themes often cause paranoiac individuals – male or female – to have difficult, tense, conflictual and even violent relationships both inside and outside of the family. These difficult relationships can sometimes lead to serious non-lethal attacks or, more exceptionally, single or multiple homicides that have frequent precursory warning signs. The motives for homicides committed by paranoiacs are linked to the themes of their delusions: persecution, prejudice, jealousy, filiation, erotomania, betrayal, etc. The therapeutic alliance, frequently difficult to set up and maintain, makes healthcare treatment difficult for dangerous paranoiac individuals. Ideally, this treatment is based on two key approaches: medicinal treatment and psychotherapy. When these people are not considered to be criminally responsible for the acts that they have committed they are forced to receive care.