DOCSLIB.ORG

The Psychopathology of Delusion of Control According to Subjective Experience

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Psychopathology of Delusion of Control According to Subjective Experience rev colomb psiquiat. 2018;47(4):221–228 www.elsevier.es/rcp Original article The Psychopathology of Delusion of Control According to Subjective Experience Marco Fierro a,∗, Ana María Hernández a, John Malcolm b a Fundación Universitaria Sanitas, Bogotá, Colombia b York University, Toronto, Canadá article info abstract Article history: Background: Delusion of control, including thought insertion, occurs in 20% of patients Received 5 November 2016 with schizophrenia. However little is known of its psychopathology, and studies involving Accepted 20 February 2017 patients are scarce. Available online 1 April 2017 Aims: To explore the subjective experience of patients with delusion of control and to pro- pose a psychopathological explanation based on empirical evidence. Keywords: Methods: Qualitative exploratory study of 7 patients (6 with schizophrenia and 1 with Delusion schizophreniform disorder). A phenomenologically-oriented semi-structured interview was Delusion of control used. Alien control Results: Delusion of control is not an isolated and pure symptom; it is always immersed in the Thought insertion context of a persecutory delusion and other psychiatric symptoms. The patient experiences Schizophrenia partial control, i.e. the control is never complete. In all cases, it is possible to trace the history Phenomenology of the narrative formation of delusion of control from its origins in persecutory delusions Subjective experience and other concomitant symptoms. Conclusions: The delusion of control is a narrative resulting from the joint presence of a per- secutory delusion and other psychiatric symptoms. For the patient, the delusion of control is the narrative of the elaborate expression of the meaning of the anomalous experience. Delusion of control is a narrative variety of persecutory delusion. © 2017 Asociacion´ Colombiana de Psiquiatrıa.´ Published by Elsevier Espana,˜ S.L.U. All rights reserved. La psicopatología del delirio de control según la experiencia subjetiva resumen Palabras clave: Introducción: El delirio de control, incluida la inserción de pensamientos, se presenta en el Delirio 20% de los pacientes con esquizofrenia. Sin embargo, se conoce poco de su psicopatología Delirio de control y los estudios que implican a pacientes son escasos. ∗ Corresponding author. E-mail address: Marcofi[email protected] (M. Fierro). https://doi.org/10.1016/j.rcp.2017.02.004 0034-7450/© 2017 Asociacion´ Colombiana de Psiquiatrıa.´ Published by Elsevier Espana,˜ S.L.U. All rights reserved. 222 rev colomb psiquiat. 2018;47(4):221–228 Control alienígena Objetivo: A partir de una serie de casos clínicos, explorar la experiencia subjetiva de Inserción de pensamientos pacientes con delirio de control y proponer una explicación psicopatológica con base en Esquizofrenia elementos empíricos. Fenomenología Métodos: Estudio exploratorio de tipo cualitativo con 7 pacientes (6 con esquizofreniay1con Experiencia subjetiva trastorno esquizofreniforme). Se utilizó una entrevista semiestructurada de orientación fenomenológica. Resultados: El delirio de control no se presenta como síntoma aislado y puro, siempre está inmerso en el contexto de un delirio persecutorio y otros síntomas psiquiátricos. El control vivido por el paciente es parcial, nunca total. En todos los casos fue posible rastrear la historia de la constitución narrativa del delirio de control a partir del delirio persecutorio y los otros síntomas concomitantes. El delirio de control es la narrativa que expresa de manera más elaborada el sentido que la experiencia tiene para el paciente. Conclusiones: El delirio de control es una narrativa derivada de la concomitancia de un delirio persecutorio y otros síntomas psiquiátricos. Es la narrativa que expresa de manera más elaborada el sentido que tiene la experiencia anómala para el paciente. El delirio de control es una variedad narrativa del delirio persecutorio. © 2017 Asociacion´ Colombiana de Psiquiatrıa.´ Publicado por Elsevier Espana,˜ S.L.U. Todos los derechos reservados. produced by someone else.6–8 The model has been revised and Introduction expanded, but has not changed substantially.9 The agency theory identifies the main problem as an Delusion of control has different names, including delusion altered sense of agency. This sense is defined as the experi- of passivity, passivity experience, and passivity phenomenon. ence, or the pre-reflective sense, that I am the cause or agent According to the patient’s narrative, his thoughts, emotions, of the movements of my body, or that it is I who is executing perceptions or actions are under the control of a different bodily movements.10 agent: either another person, a spirit, a machine, or unknown The concept of agency has been extended to thoughts, forces. Sometimes the patient states that the operator of con- perceptions, emotions, but has faced serious conceptual trol is installed inside his body, which leads to the narrative of and pragmatic problems when applied to these mental being possessed. phenomena.11,12 After all, it is common to experience emo- At other times, the patient is convinced that his thoughts tions difficult to control, uncomfortable memories that one and some other mental phenomena are not his own, but would like to forget return over and over again, and it is not inserted by someone else, which is known as “thought inser- unusual for unwanted intrusive thoughts to continue popping tion.” into consciousness.13 This type of delusion has been considered characteristic of Another theory postulates that the patient finds certain 1,2 schizophrenia, but not exclusive or specific of it. Although it mental contents much too repulsive. By not tolerating them occurs in 1 in 5 patients with the disease, little is known of its as his own, he externalizes them and feels as if they were 3 psychopathology. Research about it is scarce, and explanation inserted. In this way, he copes with this negative charge.3 4 of its origin and permanence are unsatisfactory. It has also been argued that delusion of control originates The conviction expressed in the delusion of control is con- in an alteration in the intentionality of thought, feeling and trary to common sense. It is very difficult to imagine what it is action, which can be traced back to the prodromal stage of like to be in that state. Thought insertion has raised interest schizophrenia.14 in philosophers who have tried to explain it in various ways, It has been proposed that delusions constitute an expla- offering different answers to the following questions: Do peo- nation of certain experiences. They are rational responses to ple with thought insertion own the alien thoughts? Do they anomalous experiences. The subject suffering from a delusion experience a sense of agency towards the alien thoughts? Do develops his beliefs in the same way that the non-delusional 5 they endorse the content of the alien thoughts? subject does, but he has strange and unusual experiences that There are several theories about delusion of control. The do not occur in daily life.15–18 In the delusion of control, there best known theory suggests that the brain normally monitors is an anomalous experience that is explained by the patient 3 aspects of actions: a) the action in response to current exter- with the belief that his thoughts and actions are not his own nal stimulation; b) the voluntary action appropriate to current but originate from someone else. goals (willed intention), and c) the action which was actually A variation of the last explanation states that the process executed. In delusion of control, there is a disruption of cog- begins with an anomalous experience leading to cogni- nitive systems in charge of monitoring voluntary action and tive processing in order to make sense of that experience, its execution. This discrepancy gives rise to the experience but under conditions where prefrontal control and moni- of voluntary actions as if they were not the patient’s own but toring mechanisms are reduced. The attenuation of usual rev colomb psiquiat. 2018;47(4):221–228 223 constraints exercised by prefrontal cortex leads to explana- • Persecutory delusion: ‘they are persecuting me’, ‘they are tions that do not conform to conventional beliefs, but are seen doing witchery to me’, ‘they know my thoughts’. as plausible to the patient.19 • Grandiose delusion: ‘I am rich’, ‘I am the president’, ‘I am A phenomenologically-oriented theory, called “theory of famous’, ‘I am beautiful’, ‘I am god’. anomalous affective experience”,20,21 proposes that the nar- • Nihilist delusion: ‘I am dead’, ‘everyone else is dead’, ‘the ratives identified as delusions by the psychiatrist correspond world ended’, ‘I am rotten inside’. to linguistic elaborations that give meaning and make com- • Mystical delusion: ‘I’ve found the human ideal state’, ‘I’ve prehensible to himself and others the underlying anomalous found wisdom’, ‘I want to share this state of enlightenment affective or somatic experiences. Based on the predominant with humanity’. subjective experience, it is possible to identify five types • Somatic delusion: ‘I have a vacuum inside my head’, ‘an of delusion: persecutory, grandiose, nihilistic, mystical, and electric stream goes up and down all over my body’. somatic.22 According to the theory of the anomalous affective expe- According to this theory, delusions are constituted in rience, delusion of control emerges in the context of a 3 stages. This is not a voluntary, circumscribed to thought, and persecutory delusion, but the concurrent presence of alter- explicitly reflective process. Instead, it is rather involuntary, ations in the experience of self and/or somatic hallucinations implicit, and affective at first. The stages are: are also necessary. Amid the deep fear and distrustful char- acteristics of persecutory delusion, the subject feels different, 1. Irruption of an anomalous affective experience. as if he were not the same, as another person, or with some- 2. Implementation of a specific cognitive style. thing strange inside. The meaning that emerges and allows 3. Formation of a narrative that gives meaning to the experi- the patient to understand his experience is that of being pos- ence.
Load more

Recommended publications
  • Paranoid – Suspicious; Argumentative; Paranoid; Continually on The
    Disorder Gathering 34, 36, 49 Answer Keys A N S W E R K E Y, Disorder Gathering 34 1. Avital Agoraphobia – 2. Ewelina Alcoholism – 3. Martyna Anorexia – 4. Clarissa Bipolar Personality Disorder –. 5. Lysette Bulimia – 6. Kev, Annabelle Co-Dependant Relationship – 7. Archer Cognitive Distortions / all-of-nothing thinking (Splitting) – 8. Josephine Cognitive Distortions / Mental Filter – 9. Mendel Cognitive Distortions / Disqualifying the Positive – 10. Melvira Cognitive Disorder / Labeling and Mislabeling – 11. Liat Cognitive Disorder / Personalization – 12. Noa Cognitive Disorder / Narcissistic Rage – 13. Regev Delusional Disorder – 14. Connor Dependant Relationship – 15. Moira Dissociative Amnesia / Psychogenic Amnesia – (*Jason Bourne character) 16. Eylam Dissociative Fugue / Psychogenic Fugue – 17. Amit Dissociative Identity Disorder / Multiple Personality Disorder – 18. Liam Echolalia – 19. Dax Factitous Disorder – 20. Lorna Neurotic Fear of the Future – 21. Ciaran Ganser Syndrome – 22. Jean-Pierre Korsakoff’s Syndrome – 23. Ivor Neurotic Paranoia – 24. Tucker Persecutory Delusions / Querulant Delusions – 25. Lewis Post-Traumatic Stress Disorder – 26. Abdul Proprioception – 27. Alisa Repressed Memories – 28. Kirk Schizophrenia – 29. Trevor Self-Victimization – 30. Jerome Shame-based Personality – 31. Aimee Stockholm Syndrome – 32. Delphine Taijin kyofusho (Japanese culture-specific syndrome) – 33. Lyndon Tourette’s Syndrome – 34. Adar Social phobias – A N S W E R K E Y, Disorder Gathering 36 Adjustment Disorder – BERKELEY Apotemnophilia
    [Show full text]
  • DCF Pamphlet 155-2: Appendix 3
    DCF Pamphlet 155-2: Appendix 3 Appendix 3: The table below shows the ICD9 codes that are acceptable in the Substance Abuse and Mental Health Information System (SAMHIS). This replaces all previous versions of allowable ICD9 codes used in the Substance Abuse and Mental Health Information System. The following are the codes and their meaning. STATUS: 0 = Inactive, code is not usable, 1 = Active, this will show in SAMHIS. PROGRAM CODE: N = Not Active, M = Mental Health Code, S = Substance Abuse Code B = Behavioral Health (can be used for either a mental health or substance abuse diagnosis) NOTE: Codes with ‘N’ (Not Active) in the Program Code are for historical purposes only. ICD9 PROGRAM Code STATUS DESCRIPTION CODE 095.7 0 SYPHILIS OF TENDON/BURSA N 196.8 0 MAL NEO LYMPH NODE-MULT N 259.9 0 ENDOCRINE DISORDER NOS N 269.0 0 DEFICIENCY OF VITAMIN K N 289.9 0 BLOOD DISEASE NOS N 290 0 Senile and presenile organic psychotic conditions N 290.0 0 SENILE DEMENTIA UNCOMP N 290.1 0 Presenile dementia N 290.10 0 PRESENILE DEMENTIA N 290.11 0 PRESENILE DELIRIUM N 290.12 0 PRESENILE DELUSION M 290.13 0 PRESENILE DEPRESSION M 290.2 0 Senile dementia with delusional or depressive feat M 290.20 0 SENILE DELUSION M 290.21 0 SENILE DEPRESSIVE M 290.3 0 SENILE DELIRIUM N 290.4 0 Arteriosclerotic dementia N 290.40 0 ARTERIOSCLER DEMENT NOS N 290.41 0 ARTERIOSCLER DELIRIUM N 290.42 0 ARTERIOSCLER DELUSION M 290.43 0 ARTERIOSCLER DEPRESSIVE M 290.8 0 SENILE PSYCHOSIS NEC N 290.9 0 SENILE PSYCHOT COND NOS N 291 1 Alcohol psychoses S 291.0 1 DELIRIUM TREMENS
    [Show full text]
  • The Effect of Delusion and Hallucination Types on Treatment
    Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2016;29:29-35 Research / Araştırma DOI: 10.5350/DAJPN2016290103 The Effect of Delusion and Esin Evren Kilicaslan1, Guler Acar2, Sevgin Eksioglu2, Sermin Kesebir3, Hallucination Types on Ertan Tezcan4 1Izmir Katip Celebi University, Ataturk Training and Treatment Response in Research Hospital, Department of Psychiatry, Izmir - Turkey 2Istanbul Erenkoy Mental Health Training and Research Schizophrenia and Hospital, Istanbul - Turkey 3Uskudar University, Istanbul Neuropsychiatry Hospital, Istanbul - Turkey Schizoaffective Disorder 4Istanbul Beykent University, Department of Psychology, Istanbul - Turkey ABSTRACT The effect of delusion and hallucination types on treatment response in schizophrenia and schizoaffective disorder Objective: While there are numerous studies investigating what kind of variables, including socio- demographic and cultural ones, affect the delusion types, not many studies can be found that investigate the impact of delusion types on treatment response. Our study aimed at researching the effect of delusion and hallucination types on treatment response in inpatients admitted with a diagnosis of schizophrenia or schizoaffective disorder. Method: The patient group included 116 consecutive inpatients diagnosed with schizophrenia and schizoaffective disorder according to DSM-IV-TR in a clinical interview. Delusions types were determined using the classification system developed by Gross and colleagues. The hallucinations were recorded as auditory, visual and auditory-visual. Response to treatment was assessed according to the difference in the Positive and Negative Syndrome Scale (PANSS) scores at admission and discharge and the duration of hospitalization. Results: Studying the effect of delusion types on response to treatment, it has been found that for patients with religious and grandiose delusions, statistically the duration of hospitalization is significantly longer than for other patients.
    [Show full text]
  • Psychotic Symptoms in Post Traumatic Stress Disorder: a Case Illustration and Literature Review
    CASE REPORT SA Psych Rev 2003;6: 21-24 Psychotic symptoms in post traumatic stress disorder: a case illustration and literature review Adekola O Alao, Laura Leso, Mantosh J Dewan, Erika B Johnson Department of Psychiatry, State University of New York, Syracuse, NY, USA ABSTRACT Posttraumatic stress disorder (PTSD) is a condition being increasingly recognized. The diagnosis is based on the re-experiencing of a traumatic event. There have been reports of the presence of psychotic symptoms in some cases of PTSD. This may represent in- creased severity or a different diagnostic clinical entity. It has also been suggested that psychotic symptoms may be over-represented in the Hispanic population. In this manuscript, we describe a case to illustrate this relationship and we review the current literature on the relationship of psychotic symptoms among PTSD patients. The implications regarding diagnosis, treatment, and prognosis are discussed. Keywords: Psychosis; PTSD; Trauma; Hallucinations; Delusions; Posttraumatic stress disorder. INTRODUCTION the best of our knowledge is the first report of psychotic symp- Posttraumatic stress disorder (PTSD) is a psychiatric illness for- toms in a non-veteran adult with PTSD. mally recognized with the publication of the third edition of the Diagnostic and Statistical Manual of the American Psychiatric CASE ILLUSTRATION Association in 1980.1 Re-experiencing of traumatic events as A 37 year-old gentleman was admitted to a state university hos- recurrent unpleasant images, nightmares, and intrusive feelings pital inpatient setting after alerting his wife of his suicidal is a core characteristic of PTSD.2 Most PTSD research has oc- thoughts and intent to slit his throat with a kitchen knife.
    [Show full text]
  • Quick Lesson About
    QUICK Delusional Disorder: Grandiose Type LESSON ABOUT Description/Etiology Delusional disorder is characterized by the presence for at least one month of delusions and the absence of other symptoms associated with psychotic, mood, or personality disorders that usually include delusions. Delusions are fixed beliefs that persist despite objective evidence that they are not true. Whether a particular belief is considered delusional varies from culture to culture; to be considered a delusion the belief cannot be accepted by members of the believer’s own culture or subculture. Delusions are categorized as either nonbizarre or bizarre. Nonbizarre delusions are beliefs that could conceivably be true (e.g., a life partner having an affair, being the object of unspoken love, being spied on by a government agency), whereas bizarre delusions have no possible basis in reality (e.g., having all of one’s organs replaced without surgery, being controlled by messages received from the CIA through a hat made of aluminum foil). The primary change in criteria for diagnosis of delusional disorder in the Diagnostic and Statistical Manual of Mental Health Disorders, fifth edition (DSM-5) from the fourth edition of the manual is the removal of the requirement that delusions are nonbizarre. The criteria for delusional disorder are delusions of at least one month’s duration; criterion A for schizophrenia has never been met (nonprominent hallucinations that are related to the theme of the delusion may be present); functioning is not noticeably impaired and behavior is not odd (except possibly for the direct impact and ramifications of the delusion); symptoms of mood disorders, if any, are brief relative to the duration of the delusion; and the delusion is not directly due to a general medical condition or the physiological effect of a substance.
    [Show full text]
  • Accurate Diagnosis of Primary Psychotic Disorders the Care Transitions Network
    Accurate Diagnosis of Primary Psychotic Disorders The Care Transitions Network National Council for Behavioral Health Montefiore Medical Center Northwell Health New York State Office of Mental Health Netsmart Technologies Objectives • By the completion of this webinar, participants should understand that the diagnoses of primary psychotic disorders will change early in the course of illness. • Participants will understand that when mood and psychotic symptoms overlap, diagnosis can further change over the patient’s lifetime. • Participants will be be able to use DSM-5 criteria to diagnose primary psychotic disorders and schizoaffective disorder. What diagnoses are on your differential? Think broadly. Differential should Include… • Schizophrenia • Schizophreniform Disorder • Brief Psychotic Disorder • Delusional Disorder • Other Specified Psychotic Disorder • Unspecified Psychotic Disorder Differential should exclude… Symptoms due to a medical condition or the effects of a medication or substance abuse Mood disorders with psychosis The timeline of psychotic symptoms is crucial for distinguishing between schizophrenia-spectrum disorders For psychotic disorders, the most accurate diagnosis can change as symptoms change over time Delusional Disorder Unspecified Psychotic Schizophreniform Schizophrenia Disorder Disorder Brief Psychotic Disorder JANUARY FEBRUARY MARCH APRIL MAY JUNE Symptoms resolve Brief Psychotic Disorder Symptoms Delusional Disorder resolve Schizophreniform Disorder Schizophrenia 6 month mark 1 month mark Also important for distinguishing schizophrenia-spectrum disorders are …..the psychotic symptom domains ….the frequency & severity of symptoms Schizophrenia Schizophrenia Negative Signs & Disorganized Signs 5 Symptoms Grossly Disorganized or Catatonic Behavior 4 Disorganized Speech 3 ≥ 2/5 key symptom domains Each present for a significant portion of time during a 1 month Positive Symptoms period. (Or less if successfully treated).
    [Show full text]
  • Sleep Disturbances in Patients with Persistent Delusions: Prevalence, Clinical Associations, and Therapeutic Strategies
    Review Sleep Disturbances in Patients with Persistent Delusions: Prevalence, Clinical Associations, and Therapeutic Strategies Alexandre González-Rodríguez 1 , Javier Labad 2 and Mary V. Seeman 3,* 1 Department of Mental Health, Parc Tauli University Hospital, Autonomous University of Barcelona (UAB), I3PT, Sabadell, 08280 Barcelona, Spain; [email protected] 2 Department of Psychiatry, Hospital of Mataró, Consorci Sanitari del Maresme, Institut d’Investigació i Innovació Parc Tauli (I3PT), CIBERSAM, Mataró, 08304 Barcelona, Spain; [email protected] 3 Department of Psychiatry, University of Toronto, #605 260 Heath St. West, Toronto, ON M5T 1R8, Canada * Correspondence: [email protected] Received: 1 September 2020; Accepted: 12 October 2020; Published: 16 October 2020 Abstract: Sleep disturbances accompany almost all mental illnesses, either because sound sleep and mental well-being share similar requisites, or because mental problems lead to sleep problems, or vice versa. The aim of this narrative review was to examine sleep in patients with delusions, particularly in those diagnosed with delusional disorder. We did this in sequence, first for psychiatric illness in general, then for psychotic illnesses where delusions are prevalent symptoms, and then for delusional disorder. The review also looked at the effect on sleep parameters of individual symptoms commonly seen in delusional disorder (paranoia, cognitive distortions, suicidal thoughts) and searched the evidence base for indications of antipsychotic drug effects on sleep. It subsequently evaluated the influence of sleep therapies on psychotic symptoms, particularly delusions. The review’s findings are clinically important. Delusional symptoms and sleep quality influence one another reciprocally. Effective treatment of sleep problems is of potential benefit to patients with persistent delusions, but may be difficult to implement in the absence of an established therapeutic relationship and an appropriate pharmacologic regimen.
    [Show full text]
  • Traumatic Shame Memories and Development of Paranoid Ideations
    University of Texas at Tyler Scholar Works at UT Tyler Psychology and Counseling Theses Psychology and Counseling Summer 8-24-2020 Traumatic Shame Memories and Development of Paranoid Ideations Anwesha Maitra University of Texas at Tyler Follow this and additional works at: https://scholarworks.uttyler.edu/psychology_grad Part of the Clinical Psychology Commons, Counseling Commons, and the Psychiatry and Psychology Commons Recommended Citation Maitra, Anwesha, "Traumatic Shame Memories and Development of Paranoid Ideations" (2020). Psychology and Counseling Theses. Paper 11. http://hdl.handle.net/10950/2665 This Thesis is brought to you for free and open access by the Psychology and Counseling at Scholar Works at UT Tyler. It has been accepted for inclusion in Psychology and Counseling Theses by an authorized administrator of Scholar Works at UT Tyler. For more information, please contact [email protected]. TRAUMATIC SHAME MEMORIES AND DEVELOPMENT OF PARANOID IDEATIONS by ANWESHA MAITRA A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Clinical Psychology Department of Psychology and Counseling Dennis Combs, Ph. D., Committee Chair College of Education and Psychology The University of Texas at Tyler August 2020 The University of Texas at Tyler Tyler, Texas This is to certify that the Master's Thesis of ANWESHA MAITRA has been approved for the thesis requirement on July 15th, 2020 for the Clinical Psychology, M.S Degree Approvals: Thesis Chair: Dennis Combs, Ph.D. Member: Sarah Sass, Ph.D. Member: Eric Stocks, Ph.D. Chair, Department of Psychology © Copyright by Anwesha Maitra 2020 All rights reserved Acknowledgement I would like to thank my professors Dr.
    [Show full text]
  • A Study of Prevalence & Pattern of Psychotic Features in Patients With
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 6 Ser.6 (June. 2021), PP 44-51 www.iosrjournals.org A Study of Prevalence & Pattern of Psychotic Features in Patients with Bipolar Mood Disorder Riddhi M. Thacker1, Chirag A. Kundalia2, Mukesh J. Samani3 1, 2, 3 = Department of Psychiatry, P.D.U Govt. Medical College & Hospital, Rajkot. Abstract: Background: Mood disorders are best considered as syndromes consisting of cluster of sign and symptoms that represent a marked departure from a person’s habitual functioning and tend to recur, often in periodic or cyclical fashion. Manic and mixed episodes represent the hallmark of what was once termed ‘Manic-depressive psychosis’ and is currently termed Bipolar I Disorder. Psychotic features are especially prevalent phenotype in Bipolar Disorder and it generally represents a more severe form of illness. Depending upon their appropriateness to the mood, can be mood-congruent or mood-incongruent and can be present in both manic and depressive phase. Impact of psychotic features on the natural history of Bipolar Disorder is determined by multiple factors like age at onset, life events, familiality, etc and can also affect the outcome. Aim and Objectives: 1. To evaluate prevalence and pattern of psychotic features in patients with Bipolar Mood Disorder during the active phase of the current episode. 2. To assess correlation of various socio- demographic factors, age at onset of illness and family history of psychiatric illness with presence of psychotic features in Bipolar Mood Disorder.3. To study relationship between presence of psychotic features and severity of mood symptoms.
    [Show full text]
  • Is Faith Delusion?
    Is Faith Delusion? Professor Andrew Sims It has been claimed that God is a delusion. I plan to examine that proposition from the standpoint of psychopathology. Delusion has now become a psychiatric word. Although in the past, the word delusion could refer to being fooled or cheated 1, in modern speech it always implies a suspicion of psychiatric illness. It has been appropriated by psychiatry and invariably implies a psychiatric diagnosis. If I am deluded, then I am necessarily mentally ill. In English law, delusion has been the cardinal feature of insanity for the last 200 years 2. It is a mitigating circumstance and can convey diminished responsibility. It is, therefore, within our professional competence as psychiatrists to say what is, and is not, delusion. I have had the temerity to entitle this, ‘Is faith delusion?’ as if I could answer that question for all faiths and, therefore, know about all religions and philosophies. Of course, this is not so, but there is a dilemma here; the person who can state, objectively, ‘religion is, or says…’ , in doing so, puts himself outside religion, and all religion, each faith, can only be truly known from inside. I therefore hope that the disadvantage of not being able to speak for all religions is outweighed by knowing well the subjective experience of one type of believer. Are all people with religious belief, a priori, suffering from mental illness? Sigmund Freud in 'Moses and Monotheism’ stated that belief in a single God is delusional 3. His contemporary, William James, was somewhat more circumspect and considered that spiritual and psychotic experiences were broadly distinguishable 4.
    [Show full text]
  • The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic Criteria for Research
    The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic criteria for research World Health Organization Geneva The World Health Organization is a specialized agency of the United Nations with primary responsibility for international health matters and public health. Through this organization, which was created in 1948, the health professions of some 180 countries exchange their knowledge and experience with the aim of making possible the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. By means of direct technical cooperation with its Member States, and by stimulating such cooperation among them, WHO promotes the development of comprehensive health services, the prevention and control of diseases, the improvement of environmental conditions, the development of human resources for health, the coordination and development of biomedical and health services research, and the planning and implementation of health programmes. These broad fields of endeavour encompass a wide variety of activities, such as developing systems of primary health care that reach the whole population of Member countries; promoting the health of mothers and children; combating malnutrition; controlling malaria and other communicable diseases including tuberculosis and leprosy; coordinating the global strategy for the prevention and control of AIDS; having achieved the eradication of smallpox, promoting mass immunization against a number of other
    [Show full text]
  • Mood Disorders Agenda
    Mood Disorders Agenda • Statistics on MDD • Mood Disorders • Major Depressive Disorder • Bipolar • Schizophrenia • Other Mood Disorders Statistics The National Institute of Mental Health (NIMH) conservatively estimates the total costs associated with serious mental illness, those disorders that are severely debilitating and affect about 6 percent of the adult population, to be in excess of $300 billion per year. This estimate is based on 2002 data from the Substance Abuse and Mental Health Services Administration (SAMHSA) , the Social Security Administration , and findings from the NIMH-funded National Comorbidity Survey – Replication (NCS-R) The prevalence of a major mood disorder (Depression, BPD) in a given year in the Medicare population is only ~5% but the lifetime prevalence of a major mood disorder is ~20%.1 1According to the NIH the one year prevalence of a major depressive episode (not BPD) is anywhere from 5-16% depending on the patient’s age with younger patients having a higher prevalence in any given year. Since the diagnosis of “Major Depression in Remission” considers the lifetime prevalence the figure most likely exceeds 20% for all mood disorders combined. Major Depressive Disorder (MDD) According to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) , five or more of the symptoms listed below must be present during the same 2-week time period that represents changes in functioning. At least one symptom is either a depressed mood or loss of interest. Depressed mood most of the day,
    [Show full text]