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PubMed1982

Delusions: when to confront the facts of life.

Research indicates that patients do not hold delusions with as fixed a certainty as has been believed. Confrontation with reality may have an important role in the evaluation and treatment of delusional patients. The authors suggest four factors that may help predict the value of reality confrontation in a given clinical situation: 1) how understandable the delusion is in the context of the patient's life, 2) the degree of conviction with which the patient holds the delusion, 3) the phase in development of the delusional beliefs, and 4) the diagnosis of the patient.

Adaptation, Psychological↗
PubMed1993

Correlation of severity of psychiatric patients' delusions with right hemispatial inattention (left-turning behavior).

Studies associate psychotic disorders with various forms of subtle inattention to the right hemispace (left-turning behavior). The authors examined the correlation between this dopamine-related sign and severity of delusions (presumably dopaminergic symptoms) in 20 psychotic patients. Delusions were significantly correlated with severity of left-turning bias, and this neurological sign accounted for 33% of the variance in severity of delusions.

Adolescent↗
PubMed1980

Religious delusions among Jews.

Though most previous publications described religious delusions only among Christians, a review of cases at Friends Hospital revealed that they are equally common among Jews. Five cases are given, four illustrating psychotic reactions to stress, one demonstrating that a religious experience does not necessarily result in psychosis. Content may come from either the Old or New Testaments. The Messiah delusion is discussed in more detail, with a historical example from the 17th century. Since persecution and other social stress leads to fantasies of a savior, Jewish people are now particularly vulnerable to Messianic delusions.

Adolescent↗
PubMed1983

The Capgras delusion: a critique of its psychodynamic theories.

The psychodynamic explanations for the Capgras delusion are reviewed. A critique is offered, showing how these theories fail to account for several important clinical phenomena found in patients with the Capgras delusion. A new psychodynamic theory is suggested that attempts to encompass all of the significant clinical phenomena. This hypothesis is based on findings in a series of fourteen schizophrenic patients with the typical delusion. The focus is on the patient's loss of a stable sense of identity. By the process of projection the patient ascribes his identity diffusion to those around him who are then seen as unreal impostors.

Capgras Syndrome↗
PubMed1998

Delusions in Alzheimer's disease: a review.

Alzheimer's disease is the leading cause of mental impairment in elderly people, accounting for a large proportion of admissions to nursing homes and assisted living homes. Psychiatric symptoms associated with Alzheimer's disease, although common, have not received much attention until recently. In this review the authors discuss in detail the association between Alzheimer's disease and delusions. Definitions of terms are followed by an overview of the classification, clinical epidemiology, etiology, treatment, and prognosis of delusions in Alzheimer's disease. The article concludes by highlighting some of the open questions regarding delusions in Alzheimer's disease.

Aged↗
PubMedDate not supplied

Monosymptomatic delusions of parasitosis associated with ischemic cerebrovascular disease.

Monosymptomatic delusion of infestation (parasitosis) occur in idiopathic psychoses but have rarely been observed in patients with neurologic or systemic illnesses. A patient was observed in whom the delusion occurred in the presence of demonstrable cerebrovascular disease. The delusional symptoms were contralateral to the principal site of ischemic injury. Delusions of infestation may reflect an acquired neurologic or metabolic disorder, and medical and neurologic evaluation should be pursued in elderly patients presenting with this syndrome.

Aged↗
PubMed1996

Risk of mortality and institutionalization in demented patients with delusions.

Delusions are a common symptom during the course of dementia. Despite their clinical relevance, however, it is still unclear whether they are of prognostic value. This longitudinal study involving, at baseline, 99 demented Alzheimer disease (AD) and multi-infarct dementia (MID) patients, investigates the risk of mortality and institutionalization at 2 years after discharge from a dementia unit in patients with and without delusions at baseline. Results indicate that the presence of delusions is a significant predictor of future institutionalization (odds ratio 3.6, confidence interval 1.3-9.6), even when confounding factors such as age, educational level, and severity of cognitive and functional impairment are statistically controlled. No significant impact on survival was found.

Aged↗
PubMed1996

The concept of 'delusion' in Spanish psychiatry.

The history of the concept of delusion can be used to explore the general history of psychiatry in Spain and assess the contribution of her most distinguished practitioners. As this paper shows, the latter have not been as creative as their fellow artists or writers. Nonetheless, the ideas on delusions that some of them formulated deserve attention. The history of Spanish psychiatry (qua science) can be divided into four historical periods. (1) The native origins (up to the end of the eighteenth century). (2) The introduction of European psypchiatry (nineteenth century). (3) The period of consolidation (first third of the twentieth century). (4) From the Civil War (1936-39) to the present. These four periods provide a framework within which theories about delusion can be explored. Aspects of these four stages have been dealt with in earlier papers.

Delusions↗
PubMed1986

The formation of maintenance of delusions: a Bayesian analysis.

This paper argues that recent research on normal-belief formation is relevant to our understanding of the establishment and maintenance of delusions. Bayesian theory provides a normative model of the way in which evidence relevant to normal beliefs may be evaluated: this makes it possible to classify delusional beliefs in terms of deviations from optimal Bayesian inference. Some hypothetical forms of deviation appear to correspond closely to cognitive processes observed in some groups of deluded patients. Theories of the precise nature of the abnormal judgemental processes also have implications for psychological approaches to treatment of deluded patients. The role of hallucinations in the formation and/or maintenance of delusions and the extent to which the distortions of cognitive processes associated with delusions are content-specific or mood-specific are also considered.

Cognition Disorders↗
PubMed1997

Risperidone in the treatment of delusions of infestation.

OBJECTIVE: The aim of this study is to describe the efficacy and safety of risperidone, in the treatment of delusions of infestation. METHOD: The authors present a three-case series in which risperidone was used to treat delusions of infestation. RESULTS: All three patients responded to risperidone and experienced no extrapyramidal side effects. Two of our patients had failed treatment with haloperidol and another had failed treatment with pimozide. CONCLUSION: Risperidone was an effective and safe treatment in three cases of delusions of infestation. It is possible that 5-HT2 antagonism is essential for therapeutic benefit in this condition.

Adult↗
PubMed1976

Cultural aspects of delusions: a psychiatric study of Egypt.

This paper deals with the cultural elements of the delusions of a sample of Egyptian psychiatric patients. After examination of clinical records, interviewing psychiatrists and reviewing literature, the author reaches the conclusion that the content of the patient's delusion varies directly in relation to his social class. For most of the low class men and women, the delusional symptoms, either megalomaniac or persecutory were fantasied in terms of the cultural religious institutions. Middle and upper class patients, however, much more frequently "secularized" their restitutive narcissistic and self esteem delusions in terms of science and class conception of power.

Adolescent↗
PubMed2002

[Hallucinations, delusions, and nocturnal events in 152 Parkinson's patients: a regional survey].

Parkinson's disease cannot be reduced to its motor symptoms. Psychological and behavioral disorders often accompany its development. Our study was conducted in June 1999 among 36 neurologists practicing in hospital or private clinic settings in the Poitou-Charentes area. Neurologists were requested to record hallucinations, delusions and nocturnal events observed in Parkinson's patients. A total of 152 reports were collected from 17 physicians. Fifty-three percent of the patients attended hospital clinics and 47p.100; were seen at the physician's office. Hallucinations were recorded in 23.1p.100; of the patients. The risk of hallucination symptoms was higher among patients seen at hospital clinics and who had more advanced disease. Only 7.2p.100; of the patients reported delusions, most often of a persecution type. Nocturnal events affected 49.3p.100; of the patients. The appearance of such symptoms was highly related to Hoehn and Yahr stage and was more frequent in hospital patients. Hallucinations, delusions, and nocturnal events affect patients with advanced Parkinson's disease, associated with long-term L-dopa treatment. Eighty-three percent of the patients had such symptoms and most of them used L-dopa. This long-term treatment is linked to these three symptoms. Hallucinations were increasingly reported for patients with increasing long-term medication with dopaminergic agonists. Nocturnal events, for patients on L-dopa, were associated with advanced disease, long-term treatment with L-dopa, and hospitalization. Psychic and behavioral disorders appear frequently in Parkinson's disease patients and are inter-related. Physicians should be aware of the relationship with treatment to avoid aggravation.

Aged↗
PubMed1975

[Present status of research on delusions].

Regarding the definition of the concept of delusion it is stated that up to now delusions can be diagnosed only with the aid of phenomenological intuition. The decisive criterion is the high subjective certainty in the sense of an elimination of the possibility of chance coincidences without any narrowing of affect. The current hypotheses are presented, concerning the choice of theme, the acute elimination of chance without narrowing of affect, the persistence of certainty and incorrigibility. The relationship between age at the onset of the illness and the choice of the illness and the choice of theme are discussed in the light of my own findings. Reasons emerge to believe that, depending on the respective cultural setting, certain age specific themes can play a role in the formation of the content of delusions. The acute subjective certainty, as well as the incorrigibility are linked with organic or endogenous syndromes.

Age Factors↗
PubMed2004

Delusions, substance abuse, and serious violence.

The objective of the study was to learn how delusions, substance abuse, and violence are related. The sample was 90 hospitalized patients with adequate descriptions of mental status when violent. Data sources were risk assessment based on record review and patient and staff interviews. The data include history of violence and substance abuse, diagnosis, and demographic and legal status. Delusions were definitely or questionably present in 73.3 percent and absent in 26.7 percent of violent episodes; 83.5 percent of delusionally violent patients had a history of substance abuse. These results support the importance of substance abuse in relation to violence by psychiatric patients. Delusions alone were infrequently related to violence, but when present appeared almost always to drive the violent behavior.

Adult↗
PubMedDate not supplied

Delusion as psychopathological metaphor.

The equivocity of the term delusion has led to it being considered a mere artifact. In this study, its meaning is considered as a psychopathological metaphor to be able to consider the relationships of man with the distorted reality. To do so, the meaning of the concept of man must be adequately understood, and based on this, observe the relationships that man establishes with reality. This relationship is always an aspiration to truth, although not exclusively as judicative as is usually understood. From this time, a series of apparently unconnected and rare psychopathological phenomena can be joined in view of the essentially veritative relationship. This relationship has been subjected to serious and deep philosophical considerations during the XX century and has left its mark on the psychopathological concept of delusion. This equivocity of delusion, finally dependent on a psychopathology that is understood in regards to an unsatisfactory idea of man, may be explained based on a better and more purified psycholopathological practice that is up-dated in regards to concepts of subjectivity and truth.

Delusions↗
PubMed2006

Delusion of oral parasitosis in a patient with major depressive disorder.

Delusion of parasitosis is a rare condition in which the patient has a strong conviction that he or she is infested by small organisms. The condition may exist as an isolated phenomenon, or may occur in association with other psychiatric syndromes. We report a single case of a rare form of this phenomenon. A middle-aged woman who met forth edition of diagnostic and statistical manual of mental disorders criteria for major depressive disorder with psychotic features is described. She had delusions of oral parasitosis. She felt lizards and small organisms in her mouth. To the best of our knowledge, there has been only one previous report of delusions of oral parasitosis to date. We discuss the interesting aspects of this case.

Adult↗