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PubMed1994

Case study of monosymptomatic delusion of unpleasant body odor with structural frontal abnormality.

We report a 63-year-old man with a monosymptomatic delusion of unpleasant body odor contracted at the age of 61 years, who believed that his body reeked of some type of paint. He had symmetrical atrophy in the bilateral frontal lobes of unknown etiology on MRI. Further, quantitative rCBF measurement with SPECT brain scan using 99mTc-HMPAO showed relative hypoperfusion localized in the bilateral frontal lobes. EEG, neurological and neuropsychological tests were all normal, including the WAIS-R and Wechsler Memory Scale tests. However, he showed poor results on the Wisconsin Card Sorting test, presumably on account of frontal dysfunction, attaining only two categories with frequent perseverative errors. Although it is undetermined whether the illness in this case can be classified as organic delusional syndrome or paranoid disorder according to DSM-III-R criteria, these results imply that delusions are associated with frontal lobe abnormality.

Atrophy↗
PubMed1993

Influencing and being influenced: the other side of 'bizarre delusions'. 1. Analysis of the concept.

The psychopathological validity of the current concept 'bizarre delusion' is questioned. A review of the literature reveals that the traditional category 'ego disorders'--though preferable to 'bizarre delusion'--is also biased, taking into account mainly 'passivity experiences' of the kind of 'Gemacht', eclipsing experiences of active influence on external reality. Although anecdotal records of activity experiences in schizophrenic psychoses have been reported since Kraepelin, any general systematization is lacking.

Delusions↗
PubMed1993

Delusions and hallucinations in schizophrenic patients.

The Scale for Assessment of Positive Symptoms was used to measure delusions and hallucinations in 115 DSM-III-R schizophrenics. Our factorial analysis of the hallucinations and delusions resulted in three factors with appropriate internal consistency and frequency: a Schneiderian delusional syndrome, an auditory hallucination syndrome, and a paranoid syndrome that tend to be present in schizophrenics with later onset. These results should be cautiously interpreted due to their cross-sectional nature and to the size of the sample which does not ensure the stability of the factors.

Acute Disease↗
PubMed1994

Localization and lateralization in the delusion of substitution. Capgras symptom and its variants.

Five hundred and seventy cases in 252 reports of the delusion of substitution yielded 200 cases with an organic contributor to the occurrence of the delusion. In 79 cases lateralization or localization could be determined, with lesions primarily in the left temporal or right frontal areas. Factors related to 'feature recognition', 'familiarity' and 'reduplication' could be found and are discussed in relation to the neurobehavioral features of the symptom.

Adolescent↗
PubMed1975

Persecutory delusions: a cybernetic model.

The authors propose a cybernetic model for the formation and maintenance of persecutory delusions. During the formation of persecutory ideation, the threat of loss of control over the self or others interacts with predictions of control from others. This interaction may result in feelings of alien control followed by persecutory explanations. Since the persecutory explanations provide the individual with a new goal of resisting others' influence in order to prevent being controlled, they reduce the threat of loss of self-control. This is how persecutory delusions are maintained.

Cybernetics↗
PubMed1988

A new and timely delusion: the complaint of having AIDS.

Delusions presented by patients with psychiatric disorders are often a combination of psychopathology and current events. The authors present three cases that document the delusion of having acquired immune deficiency syndrome (AIDS) in patients who were not members of high-risk groups but had psychiatric disorders. This clinical phenomenon raises psychodynamic issues as well as adds a new dimension to the controversy over AIDS testing.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Traditional Chinese religious beliefs and superstitions in delusions and hallucinations of Chinese schizophrenic patients.

Religious beliefs and superstitions have an important impact on the psychopathology of psychiatric patients. Traditional Chinese religious beliefs and superstitions, such as fortune telling, Buddhist gods, Taoist gods, historical heroic gods and ancestor worship, have important influence on subjective psychotic experiences, in particular delusions and hallucinations. By means of empirical phenomenological case narration, the writer shows that all these traditional Chinese religious beliefs and superstitions tend to affect the contents, manifestation and meaningfulness of delusion and hallucination. They also serve as a means to replace clients' self-identity. They appear in the form of a supernatural force to resolve all difficulties, cause of troubles and misfortune, stress and coping mechanisms.

Asian People↗
PubMed1995

Delusions of infestation during delirium in a patient with restless legs syndrome.

A case is described in which delusions of infestation developed during delirium secondary to pneumonia in a patient with restless legs syndrome (RLS). This case demonstrates how tactile sensations may precede and give rise to delusional misinterpretations. Since RLS is relatively common in elderly people and may be due to a treatable cause such as iron deficiency, it is worth considering this syndrome in patients with delusions of infestation.

Aged↗
PubMed2005

Logics of delusion.

Delusion represents an exceptional test case for the principal categories of common sense and philosophical thought, such as 'reason', 'truth' and 'reality'. Via an engagement with the legacy of Freud and the most discussed results of twentieth-century psychiatry, my aim will be to analyse its paradoxical forms and to shed light on the logics that underlie and orient its specific modalities of temporalization, conceptualization and argumentation. Delusion, then, has traditionally been presented as synonymous with irrationality (absurdity, groundlessness, error, chaos), whereas by contrast its mirror image, reason, has been defined in terms of evidence, demonstrability, truth and order. I will analyse and contrast their paradoxical definitions.

Delusions↗
PubMed1981

Solitary psychosis--three cases of monosymptomatic delusion of alimentary stench treated with behavioural psychotherapy.

Three cases of monosymptomatic delusion of alimentary stench are described. Each patient was referred for behaviour therapy as a last resort, after extensive medical investigation for halitosis or flatulence and failure of other psychiatric treatment. Two of the patients showed clinical improvement after treatment, sustained at follow-up. Monosymptomatic delusion is now a treatable condition and is important to diagnosis.

Adult↗
PubMed1988

Dangerous delusions. Violence and the misidentification syndromes.

Among the mentally ill, those with well-developed delusions are more likely to commit violent crimes against persons than those with chronic, undifferentiated psychoses. Reports of violence associated with delusional misidentification are reviewed and four patients described who were either perpetrators or victims of assaults as a consequence of the syndromes of Frégoli, Intermetamorphosis, Subjective Doubles and Capgras. The cases illustrate the multiplicity of factors which have to be taken into consideration in order to predict whether an individual will act in a violent manner on these delusions.

Adult↗
PubMed1988

A century of delusions in south west Scotland.

Two groups of patients admitted to psychiatric hospital in Dumfries were studied, drawn from the periods 1880-1889 and 1970-1979. Feighner criteria were applied to make three diagnostic categories - depression, mania and schizophrenia - and the occurrence and content of delusions were noted for each. A significant decline in the prevalence of delusional depressive illness was found between the two periods, and a similar trend was noted for delusional manic illness. In contrast, the prevalence of delusional schizophrenic illness was stable. This decline is taken to reflect a change in the phenomenology of affective illness since last century in South West Scotland. The content of delusions is also discussed.

Adult↗
PubMed1994

The defensive function of persecutory delusions. Evidence from attribution tasks.

Abnormalities of 'social' reasoning were investigated in patients suffering from persecutory delusions and in matched depressed and normal controls using transparent (obvious) and opaque (unobvious) tests of attributional style. Whereas depressed and normal subjects yielded similar causal inferences for both attributional measures, the deluded subjects showed a marked shift in internality, attributing negative outcomes to external causes on the transparent Attributional Style Questionnaire but, on the more opaque Pragmatic Inference Task, attributing negative outcomes to internal causes and thus showing a cognitive style resembling that of the depressed group. This finding, interpreted in terms of explicit versus implicit judgements, supports the hypothesis that delusions function as a defence against underlying feelings of low self-esteem.

Adult↗
PubMed2000

Obsessive-compulsive disorder and delusions revisited.

BACKGROUND: The concept of fixed, unshakeable (delusional) beliefs within the context of obsessive-compulsive disorder (OCD) is one that has received varying amounts of attention in the literature, and has not yet received universal acknowledgement. There are good grounds for including these cases within the diagnostic concepts of OCD, with significant implications for clinical management. AIMS: To present cases with unusual OCD, in order to re-evaluate the issue of delusions and OCD. METHOD: The cases of five subjects with delusions in the course of obsessive-compulsive disorder are presented to illustrate 'delusional' OCD. The management and outcome of these cases are discussed. RESULTS: Fixity and bizarreness of beliefs in OCD occur on a continuum from 'none' to 'delusional intensity' and may fluctuate within subjects. CONCLUSIONS: The idea that these cases may represent a form of OCD has implications for management, as, if this is correct, they should be able to respond to appropriate behavioural and/or pharmacological strategies used in OCD.

Adolescent↗
PubMed2003

Self-discrepancies, attentional bias and persecutory delusions.

BACKGROUND: Persecutory delusions appear to involve abnormal attentional biases to threat-related information, particularly information related to the self. The present study aimed to investigate attentional biases to different types of perceived threat and changes in self-perception in response to exposure to such threat-related material. METHOD: Discrepancies between actual self, ideal self and perceived others' self-representations were assessed in three groups of participants; 13 people experiencing persecutory delusions, 11 people in a psychiatric comparison group, and 13 in a non-psychiatric comparison group. An adaptation of the emotional Stroop task was then used as an experimental manipulation of attentional bias to five different types of threat (sociotropic, autonomic, physical, ego threats from others, and self-directed ego threats). Self-discrepancies were then again assessed. RESULTS: Before administration of the emotional Stroop task, there were no significant differences between the groups in terms of their self-actual:self-ideal and self-actual:other-actual discrepancies. However, after the administration of the Stroop task, significant differences between the clinical groups were observed, mirroring significant reductions in self-actual:self-ideal discrepancies and significant increases in self-actual:other-actual discrepancies in the paranoid participants. CONCLUSIONS: This paper is novel in repeating the assessment of self-discrepancies after the processing of threat-related information. These findings are consistent with Bentall, Kinderman, and Kaney's (1994) model of paranoid ideation and findings reported by Kinderman and Bentall (2000).

Adult↗
PubMed2006

Personalizing and externalizing biases in deluded and depressed patients: are attributional biases a stable and specific characteristic of delusions?

OBJECTIVES: The purpose of this study was to explore whether explicit and implicit attributional styles of delusional patients were associated to their clinical state, and whether attributions biases are specific to delusional psychopathology or also appear in other disorders (i.e. depression). DESIGN AND METHODS: A cross-sectional design was used. The sample consisted of 136 participants (40 acute deluded participants, 25 remitted deluded participants, 35 depressed patients and 36 normal controls). The Internal, Personal and Situational Attributions Questionnaire (IPSAQ) and the Pragmatic Inferential Test (PIT) were used to assess explicit and implicit attributional style, respectively. RESULTS: All participants, with the exception of the depressed patients group, showed an externalizing bias (EB) for negative events. Although both acute and remitted deluded patients showed a similar overall pattern of explicit attributions, the personalizing bias (PB) was significantly greater in the acute group. The magnitude of this bias, which was also found in the depressed patients, was significantly related to the patient's degree of severity, as assessed by the total BPRS score (r=.45, p<.001). The results on the implicit attributions were more equivocal, perhaps due the low reliability of the PIT. CONCLUSIONS: Attributional biases seem to be a stable characteristic of delusions. Yet, the PB might be a rather unspecific characteristic that varies with the degree of the severity of psychopathology. The implications of these findings for understanding the role of attributional biases in depression and delusion formation are discussed.

Acute Disease↗
PubMed1999

Persecutory delusions and autobiographical memory.

OBJECTIVES: It was hypothesized that people with persecutory delusions, such as depressed people, would experience difficulty when attempting to generate specific autobiographical memories. DESIGN: 20 deluded participants, 20 depressed patients and 20 normal controls were compared on an autobiographical memory test. METHODS: Participants attempted to recall memories to positive and negative cue words. Independent raters classified responses as specific, general, imaginary or unscorable. Over-general memories were further classified as extended or categorical. RESULTS: Deluded participants recalled significantly more general (especially categorical) memories and fewer specific memories than the normal control subjects. Depressed participants showed little evidence of over-general memories, although they showed faster recall latencies to negative than to positive cues. CONCLUSIONS: People with paranoid delusions show information processing features similar to those previously reported in people with depression. The possible contribution of adverse experiences to over-general autobiographical recall is discussed.

Adult↗