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PubMed1991

Alzheimer's disease with delusions and hallucinations: neuropsychological and electroencephalographic correlates.

We longitudinally evaluated the neuropsychological functions, rate of progression, and waking EEG findings in 17 patients with probable Alzheimer's disease (AD) with delusions and hallucinations, and compared them with those of matched AD patients without delusions and hallucinations. AD patients with delusions and hallucinations had a more rapid rate of decline, as measured by the Mini-Mental State Examination, a specific defect in receptive language, and a greater frequency of aggression and hostility. Visual EEG analysis showed that these patients had a significantly greater proportion of moderately abnormal EEGs, and spectral analysis confirmed the increased amount of delta and theta activity. These data demonstrate that AD patients with delusions and hallucinations have a greater degree of cerebral dysfunction and a relatively focal neuropsychological defect, which may indicate a localized pathologic abnormality.

Aged↗
PubMed1994

A SPECT study of delusions in Alzheimer's disease.

Although delusions are a frequent finding in patients with Alzheimer's disease (AD), their mechanism is not well known. We carried out Tc 99m HMPAO single-photon emission computed tomography studies in 16 AD patients with delusions and 29 AD patients without delusions comparable in age, years of education, duration of illness, and severity of dementia. Although we found no significant between-group differences in performance on neuropsychological tasks, AD patients with delusions had significantly lower mean cerebral blood flow in both the left and right temporal lobes.

Aged↗
PubMed2004

Positivity in illness: self-delusion or existential growth?

OBJECTIVES: This study investigated the relationship between a measure of positivity in illness, the Silver Lining Questionnaire (SLQ), and measures of personality and spirituality/religious beliefs as a way of determining whether positivity in illness is a delusion or existential growth. METHOD: This is a cross-sectional study comparing response to the SLQ, to the Eysenck Personality Questionnaire (EPQ-R), breathlessness, illness type, and spiritual and religious beliefs in a final total sample of 194 respiratory outpatients. RESULTS: The SLQ was associated positively with extraversion (r =.16, p<.05), unrelated to neuroticism (r =.11, n.s.) and repression (r =.10, n.s.) and was positively associated with spiritual and religious beliefs, F(2; 187) = 7.12, p < 001, as predicted by the existential growth but not the delusion interpretation. There was no relationship between positivity and age, r(194) =.09, n.s., or between positivity and gender t(192) = -1.27, n.s., and nor were there relationships with type of illness, F(4, 188) = 2.17, n.s., or breathlessness, F (5, 173) = 0.42, n.s. CONCLUSIONS: The results suggest that positivity in illness is associated with existential growth, though the cross-sectional nature of the study precludes a conclusion of causal direction. The non-significant correlation between the SLQ and neuroticism is in the opposite direction predicted by the delusion explanation, but the non-significant relationship between the SLQ and repression is in the predicted direction. We cannot rule out the possibility that some positivity is delusion.

Adaptation, Psychological↗
PubMed2003

Sexual and physical abuse during childhood and adulthood as predictors of hallucinations, delusions and thought disorder.

In light of recent studies indicating a relationship between child abuse and the positive symptoms of schizophrenia, this study investigated the hypotheses that childhood sexual and physical abuse are related to hallucinations, delusions, and thought disorder in adults, and that those relationships are greater in those who have suffered abuse during adulthood as well as childhood. In 200 community mental-health-centre clients, the clinically evaluated symptomatology of the 92 clients whose files documented sexual or physical abuse at some point in their lives was compared with that of the 108 for whom no abuse was documented. In the 60 patients for whom child abuse was documented, hallucinations (including all six subtypes), but not delusions, thought disorder or negative symptoms, were significantly more common than in the non-abused group. Adult sexual assault was related to hallucinations, delusions, and thought disorder. In linear regression analysis, a combination of child abuse and adult abuse predicted hallucinations, delusions, and thought disorder. However, child abuse was a significant predictor of auditory and tactile hallucinations, even in the absence of adult abuse. Possible psychological and neurobiological pathways from abuse to symptoms are discussed, along with research and clinical implications.

Adolescent↗
PubMed1991

Delusions of substitution and diabetes mellitus.

A male patient with chronic paranoid schizophrenia developed delusions of substitution that were of abrupt onset and short duration. This coincided with the detection of diabetes mellitus. Over the next three years, despite being on continuous moderate dose neuroleptic treatment the re-emergence and resolution of delusions of substitution varied with the control of his diabetic status. A selective review of reports on organic contributors to delusions of substitution is presented. It is suggested that the abruptly appearing, short lasting delusions of substitution may be more likely to have a known organic contributor.

Blood Glucose↗
PubMed1975

Universal and cultural features in the delusions of a black urban group.

Conflicting views as to the form and content of delusions among African psychotics, notably the influence of cultural factors in the preliterate, led us to devote special attention to this area in a recent study of Bantu psychiatric patients. Our sample was drawn chiefly from Baragwanath Hospital serving the South Western Townships of Johannesburg, and smaller samples were drawn from mental hospitals, mental health society clinics, an old age home, and a middle class township in the Witwatersrand area. The degree of systematization and fixity of delusions in the sample as a whole, and in schizophrenia and manic-depressive psychosis in particular, were assessed. On the side of delusion content, cultural features such as witchcraft, animals as instruments of witchcraft, familiars, and ancestor worship are described. In conclusion, the relationship of cultural content of delusion to class, education and income are evaluated, with special attention to the influence of an early tribal background in our urban professional group, as illuminating the general issue reflected in our title.

Adult↗
PubMed1992

[The hypochondriacal delusion].

Hypochondriacal delusions are not bound to a specific mental disorder, but occur in the whole spectrum of psychoses. In spite of the implicitly wrong conception of reality, the significance of these delusions as an attempt to express, interpret and cope with mental illness should not be neglected if an approach to the patient's own experience is sought. On the one hand, hypochondriacal delusions are based on altered body perceptions in mental illness, characterized by primary local or general dysaesthesias to the point of depersonalisation, or caused secondarily by the patient's increased attention to his own body. This alienated bodily experience is named in (lay) medical terms by the delusional hypochondriac. On the other hand, "illness" with its manifold cultural and psychological meanings stands as a polyvalent metaphor for the incomprehensible alteration of the patient's self-experience in general: thus, the feeling of exposure to external attacks, of guilt, sinfulness, shame, loss of self-esteem or even the experience of a disruption of personality may find their expression in the hypochondriacal delusion.

Adult↗
PubMed1991

[Current status of late onset delusion in the elderly].

In the field of chronic delusions, authors make synthesis of the delusion with late emergence in the elderly. This delusion is at once replaced in the history of its nosographic position, then defined in its presentation. The question of its refer with depression and its place in the limits of dementia are approached. Authors outline the importance of biological, psychological and sociological factors in induction of this particular delusion to clarify the means for its management.

Aged↗
PubMed1991

[Delusions of parasitosis--report of 94 cases].

The present article describes 94 patients (34 male and 60 female) with delusions of parasitosis, admitted to our dermatology clinic between 1978 and 1989. The female to male ratio was to one under the age of 45, and 1:2.1 over 45. The mean age of onset in males was 46.4 years, and in females, 52.8. In nine patients (6 male and 3 female), the delusions began shortly after their retirement, while in seven (1 male and 6 female) after separation from their families. The ratio of the number of patients living alone to that of patients living with their families was one to two, three times higher than that of the general population (1:6). About half of the patients had no skin lesions, while half the rest had excoriations. Three had eczematous lesions caused by the application of insecticides. In 58 patients, the creatures of delusion were mites. Most patients complained of some kind of cutaneous sensations of the skin, such as itching, tickling and prickling, while only two complained of auditory sensations. The color of creatures of delusion was black or white. Folie á deux was observed in 23 groups and affected both sexes.

Adult↗
PubMed1990

[Delusions of poisoning in schizophrenia with Kandinsky-Clérambault syndrome (clinical and forensic-psychiatric evaluation)].

The author related the results of analyzing 273 patients suffering from attack-like progressive schizophrenia with the Kandinsky-Clérambault syndrome, who committed socially dangerous actions and were subjected to compulsory treatment. Out of the 273 patients, only 57 (20.5%) had a combination of the manifestations of the Kandinsky-Clérambault syndrome and delusion of poisoning. The establishment of delusion of poisoning was in a close relationship and in parallel to the formation of the Kandinsky-Clérambault syndrome. The formation of delusion of poisoning went on the basis of the 4 psychopathological phenomena: senestopathy, gustatory and olfactory hallucinations, acoustic pseudohallucinations. Delusion of poisoning acquires the greatest criminogenic importance when it is formed on the basis of senestopathies and acoustic pseudohallucinations; it is of the least importance when formed on the basis of gustatory and olfactory hallucinations.

Adolescent↗
PubMed1982

Delusions of infestation treated by pimozide: a double-blind crossover clinical study.

Eleven patients with delusions of infestation were treated with pimozide using a double-blind crossover technique. Ten out of 11 patients improved. The investigation showed significant relief of itch and delusions during pimozide treatment. Brief Psychiatric Rating Scale (BPRS) points decreased significantly. Adverse effects were few by 2 patients showed dose-related depressive reactions during treatment. Pimozide treatment of patients with delusions of infestation should be entrusted to dermatologists, because these patients with delusions differ from most patients attending psychiatric clinics in that they have a monosymptomatic hypochondriacal psychosis.

Acari↗
PubMed1981

[Relationship of delusions to attempted suicide and suicide].

This article is a contribution to the psychopathology of communication. Using the communication model of orienting behavior the pathological phenomena of delusion, suicide attempt and suicide are dealt with in a communication-theoretical framework. On this basis, the relationship of delusion to suicide attempts and to suicides is examined. The results are that delusion and suicide attempt are subject to a communicative principle, whereas suicide is subject to an anticommunicative principle. Our numerous observations that the act of suicide leading to death is never carried out in a state of delusion are interpreted within the framework of the communication model presented here.

Adult↗
PubMed1980

[The logic of delusions].

The author attempts to uncover the logic behind the various delusion phenomena. Starting from the hypothesis that the paranoic interprets certain I-thou relations exclusively as auto-reference, a new conceptualization of the notion of 'auto-reference' is proposed. On the basis of a reformulated Freudian structure model, auto-reference (id) is defined as physical self-reference. With the aid of a many-valued (transclassical) logic it is shown that delusion phenomena represent mirror-like mappings of certain physical structures of the paranoic. The formal treatment of delusion structures should therefore directly indicate the composition of certain organic structures, especially brain structures, of the paranoic. As this paper tries to show, progress in delusion research can only be achieved by interdisciplinary cooperation.

Delusions↗
PubMed1995

Pathogenesis of delusions.

This overview of attempts to shed light on the pathogenesis of delusions provides a sense of promise, because we are grappling with the right problems, and reasons for both optimism and skepticism. Optimism is justified because some of the approaches have yielded empirical support and can be tested profitably in research. Skepticism is warranted because we remain unclear about precisely what delusions are; and we have as yet no means of identifying them with a laboratory test. Hence, we must rely on the problematic nature of clinical observation of the inner experiences of patients to make progress. The different mechanisms proposed still require considerable testing, but scrutiny of current results suggests that anomalous experience as a stimulus for delusion formation has been better documented than proposals invoking disordered reasoning or motivational deviances. Nevertheless, no view is as yet established, and each may have some relevance to solving the delusion puzzle.

Delusions↗
PubMedDate not supplied

[The influence of environment complexity and individual's reactivity on the genesis of schizophrenic delusions and on the differences in their content].

The present paper tries to answer two questions: 1. Is there a connection between the occurrence of delusions in paranoid schizophrenics and the lack of them in healthy people, and the complexity of their environment and the level of their reactivity? 2. Is there a connection between the differentiation of the delusion's content, and the level of reactivity of the examined schizophrenics? Examined were 26 paranoid schizophrenics (13 with delusions of grandeur and 13 with delusions of persecution) and 26 healthy people.

Adult↗
PubMedDate not supplied

[The pathogenesis of persecutory delusions in the light of the attribution theory].

Among the present pathogenetic hypotheses of delusions the cognitive model based on the attribution theory presents interesting assumptions. The attribution theory describes the ways in which we explain causes of events and human behaviour from the point of view of common sense psychology, as well as biases found in explaining everyday events, known as attribution errors. One of them is self-serving bias, which protects self-esteem and distorts attribution processes. Kaney, Bentall and co-workers revealed the defensive attributional style in the patients with persecutory delusions and after empirical research they suggested that delusions are the extreme forms of self-serving bias. After presenting the studies of Kaney-Bentall the authors of the article express their doubts regarding attributional hypothesis of persecutory delusions.

Delusions↗
PubMed1996

[Psychotherapy of delusions].

Psychotherapy of delusion is usually considered far from promising. However, patients with delusional problems require some of psychotherapy if they fail to respond to pharmacological treatment, particularly if their behaviour and wellbeing are severely disturbed. Case reports indicate that at least delusional social behaviour, but also general cognitive styles, can be influenced outside of delusional perception and the delusional work of systematization. Diagnostic assessment for psychotherapy of deluded patients should clarify: the affective charge of the delusion; the degree of fixation; and its compensatory function for impeding disorganization. The expressive function of the delusion may help the therapist to pay attention to the patient's most important and unresolved life themes, even if they cannot be addressed at the beginning of the therapy. In the acute phase this knowledge can help to disactualize the theme; in the post-acute phase it can help to reflect on the further destiny of the blocked development expressed in the theme, be it by grief or by promoting it to more adequate striving. Based on those theories of delusion which have a practical impact and illustrated by case vignettes, proposals are made on how to deal psychotherapeutically with the pre-predicative statement of delusional belief, how to support disactualization of the delusional theme, how to help the patient with self-presentation, and how to support more flexible decentered cognitive styles.

Cognitive Behavioral Therapy↗
PubMed1997

Violent behaviors associated with the antichrist delusion.

Delusions involving the antichrist concept have been occasionally reported. Some cases of the antichrist delusion have been associated with violent behavior. In this article we describe the case of a man who suffered from a chronic antichrist delusion and who also displayed repeated and serious violent behaviors. We also discuss the role of the antichrist delusion as well as other psychotic symptoms in the genesis of violence in the present case.

Adult↗