Misidentification syndrome, facial misrecognition, and dysmorphic symptoms.
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Adult↗
Biomedical subjects
G B Leong
Publications and source records attributed to G B Leong.
The Capgras syndrome in paranoid schizophrenia.
Capgras syndrome is characterized by a delusion of impostors who are thought to be physically similar but psychologically distinct from the misidentified person. This syndrome is generally thought to be relatively rare. Most of our knowledge about Capgras syndrome derives from single case studies and small series of cases usually from diagnostically heterogeneous groups. In this article, a series of 31 patients suffering from both paranoid schizophrenia and Capgras syndrome is described. Issues pertaining to the phenomenology of Capgras syndrome, the possible relation between Capgras syndrome and other delusional misidentification syndromes, and a neurobiological hypothesis aimed at explaining Capgras syndrome are discussed.
Adult↗
The psychotherapist as witness for the prosecution: the criminalization of Tarasoff.
The "duty to protect" doctrine heralded by the Tarasoff decision seeks to prevent physical harm to third parties by psychiatric patients. Recent court cases have mandated the testimony of a criminal defendant's psychotherapist both about the Tarasoff warning itself and about confidential treatment information that was associated with the warning. One court further ruled that some clinical sessions were not psychotherapy and therefore were not afforded the protection of psychotherapist-patient privilege. The continuing erosion of confidentiality has resulted in psychiatrists and other mental health professionals becoming prosecution witnesses at the criminal trials of their own patients.
California↗
Evolving misidentification syndromes and facial recognition deficits.
In this paper, the authors report the case of a 33 year old man with several misidentification delusions involving the self. Evidence suggests that one type of misidentification delusion may evolve into another type. Neuropsychological testing further suggests that misidentification delusions may be associated with subtle abnormalities in facial recognition abilities and with non dominant cerebral compromise.
Adult↗
A psychiatric study of persons charged with arson.
A total of 29 court-referred individuals charged with arson were psychiatrically studied. From this pre-trial cohort from a large heterogeneous urban population base, a higher rate of psychosis was found than in other recent studies. However, consistent with these studies was the rarity of the diagnosis of pyromania. An important finding of this study was the substantial number of fires set by individuals who are homeless mentally disordered or substance abusing, or both.
Adult↗
A case of Capgras-Fregoli syndrome.
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Adult↗
The dangerousness of persons with misidentification syndromes.
The central feature of misidentification syndromes is the presence of a delusion in which either the identity of the self or other persons is misrecognized. Recent psychiatric case reports have noted the dangerousness posed by persons with misidentification delusions. The authors report on a series of 29 individuals whose delusional misidentification was associated with aggressive behaviors. Important parameters which may assist in defining this sample of dangerous delusional misidentification syndrome persons are discussed.
Adult↗
Dangerousness of the delusional misidentification of children.
Misidentification syndromes have been studied from a variety of perspectives, including phenomenological, biological, and nosological approaches. More recently, misidentification syndromes have been studied from a psychiatric-legal perspective, especially with regards to the problem of dangerousness. Capgras syndrome and other syndromes of misidentification can lead to hostile mood and subsequent physical violence. Little attention has so far been devoted to children as the objects of the psychotic person's misidentification delusion(s). We provide a review of cases from the anglophonic literature that have children as the misidentified objects, add three new cases, and then discuss the relationship between misidentification and potential harm to these children.
Adult↗
The death penalty and Bernard Diamond's approach to forensic psychiatry.
Bernard Diamond would testify only for the defense in criminal cases, but only if the whole psychiatric truth would be introduced during a trial and the facts of the case supported the defense position. Otherwise, he would refuse to participate. Although few other forensic psychiatrists have personal or professional ethical concerns regarding ever participating for the prosecution, many more have such problems in capital cases. Bernard Diamond's approach to forensic psychiatry should be considered at least as an option by those opposed to the death penalty. Bias in capital cases is not a persuasive reason to withdraw from involvement if the forensic psychiatrist remains honest.
Capital Punishment↗
The physician as erotomanic object.
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Adult↗
Misidentification syndrome and male pseudocyesis.
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Adult↗
Posttraumatic stress disorder in burn patients.
Posttraumatic stress disorder can occur in burn patients and may delay a patient's recovery. We have described the case of such a patient whose posthospital course was complicated by an untreated, coexisting PTSD.
Accidents, Occupational↗
The syndrome of intermetamorphosis.
A series of 154 patients suffering from the syndrome of intermetamorphosis or its variants is discussed in terms of this misidentification syndrome's historical, classification, diagnostic, and psychosocial aspects. One case is presented in detail.
Adult↗
Transdermal nicotine and smoking behavior in psychiatric patients.
The authors used a double-blind crossover design to observe the effect of transdermally administered nicotine on the smoking behavior of 13 psychiatric patients who were not trying to stop smoking. The patients smoked significantly fewer cigarettes while receiving nicotine than while receiving placebo. These data suggest that transdermally administered nicotine can be a useful adjunct in treating nicotine-addicted psychiatric patients in a non-smoking environment.
Administration, Cutaneous↗
Delusion of fetal duplication in a Capgras patient.
A case of Capgras syndrome in a pregnant patient is described. In addition to perceiving living family members as impostors, she believed that there was a double or twin of her fetus. She conceptualized her "twins" differently than the way she viewed doubles of family members. Her fetus may represent the youngest "person" to have been duplicated. The relationship of Capgras syndrome to misidentification phenomena is discussed.
Adult↗
Legal and ethical issues in electroconvulsive therapy.
The use of electroconvulsive therapy (ECT) today has become mired in legal regulations. Obtaining a valid informed consent prior to administering ECT is the duty of the treating psychiatrist; failure to obtain such consent is the most common area of professional liability. The trend of increased judicial scrutiny of ECT has generated both clinical and ethical dilemmas, especially in the context of the emerging concept of the right to effective treatment.
Electroconvulsive Therapy↗
Opinions by AAPL forensic psychiatrists on controversial ethical guidelines: a survey.
A survey was conducted of a sample of AAPL members to determine their opinions on the inclusion of controversial ethical guidelines for forensic psychiatry. Members appear to appreciate the need to consider traditional Hippocratic values as at least one consideration in their functioning as forensic psychiatrists. They appear to balance their duties to an evaluee with duties to society and the legal system and to appreciate the responsibilities of multiple agency. Support was shown for interpreting ambiguities in AAPL's current guidelines in the directions indicated by most of this survey's proposed guidelines.
Attitude of Health Personnel↗
The Tarasoff dilemma in criminal court.
The duty to protect, or Tarasoff duty, has been conceptualized as arising solely in the context of a clinical setting. A recent California Supreme Court ruling in People v. Clark adds legal, clinical, and ethical dilemmas to the oftentimes contentious Tarasoff issue. Though the Tarasoff issue is but a minor legal point in Clark, a possible consequence of Clark is that a Tarasoff warning could be deemed nonconfidential and admissible in a criminal trial. Psychotherapists could therefore be testifying in criminal courts as prosecution witnesses. While the possibility of a chilling effect on patients' disclosure of violent ideation in the context of psychotherapy first caused apprehension after the California Supreme Court's 1976 decision in Tarasoff v. Regents of the University of California, this same Court's ruling in People v. Clark some 14 years later may ensure that this fear finally becomes realized.
Adult↗