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PubMed1997

[Aqueductal stenosis and hydrocephalus in a psychotic adolescent].

Examination of a 14-year-old male who was admitted to an inpatient unit with an acute paranoid syndrome yielded serious organic findings: macroencephaly, head tilted to one side, strabismus, neurological deficits, hydroencephaly and an expressive speech disorder. The personal and family history revealed a disturbance of motor development since infancy and psychiatric illness in the immediate family. The medication and the surgical procedure selected--endoscopic third ventriculostomy--are described and the difficult differential diagnosis is discussed.

Adolescent↗
PubMed1983

[Family picture studies in patients with paranoid psychoses].

Among the first-degree relatives of 77 patients with delusional functional psychoses the authors found 13 schizophrenics (3.10%), 8 manic-depressives (1.91%) and 14 cases with atypical psychoses (3.34%), following ICD-9 criteria. These figures were compared with the figures in the literature on the genetics of paranoid schizophrenics and nonschizophrenic paranoids, regarding the different composition of the samples. Subdivision of the original 77 patients, using the concept of the axial syndromes, was able to form two homogeneous subgroups of first-degree relatives: one with a schizophrenia prevalence of 6.52% (uncorrected) and without any manic-depressive secondary cases (endogenomorphic-schizophrenic axial syndrome) and another with a manic-depressive illness (MDI) prevalence of 6.58% (uncorrected) without any secondary cases with schizophrenia or atypical psychosis. The first-degree relatives of the patients with an 'organomorphic' axial syndrome (usually excluded in other studies) had an increased rate of manic-depressive secondary cases (3.57%, uncorrected) and the highest rate of atypical psychosis (7.14%) without any schizophrenics, according to the etiopathogenetic heterogeneity of this group. 37 of the 77 patients were not assignable to any of the axial syndromes. In the first-degree relatives of these patients--best comparable to Kendler's criteria for 'delusional disorder'--an increased rate of schizophrenics and atypical psychoses was found (3.59 and 3.08%, uncorrected); the figures for MDI were within normal limits. Our results suggest that the axial syndromes are a useful diagnostic instrument in identifying--from the genetic standpoint--in part very homogeneous subgroups. This allows the conclusion that they are indicators for hypothetical basic disturbances.

Adolescent↗
PubMed1991

Cannabis psychosis following bhang ingestion.

The purpose of this preliminary investigation is to systematically characterize the signs and symptoms of cannabis psychosis in individuals who presented for psychiatric treatment in Pakistan after ingestion of bhang; a beverage containing cannabis. In order to control for the behavioral effects of cannabis alone, symptoms produced by bhang ingestion among non-patients consuming the same beverage were compared with those symptoms found among psychotic patients. Patients differed from controls in that a higher proportion of patients were found to be chronic users of bhang, and had a past history of psychotic episodes. Presenting symptoms of bhang-induced psychosis found in patients included grandiosity, excitement, hostility, uncooperativeness, disorientation, hallucinatory behavior and unusual thought content. Neuroleptic treatment successfully attenuated psychotic symptoms within five days of the initiation of the episode. The presenting symptoms of bhang-induced psychosis are consistent with a brief mania-like disorder with paranoid psychotic features, and cognitive dysfunction. Several etiologic hypotheses are proposed.

Administration, Oral↗
PubMed1986

Conversion without hysteria: a case report and review of the literature.

The term 'conversion' implies a correlation between conversion symptoms, hysteria, and hysterical personality. A clinical case of conversion related to chronic post-traumatic disorder, with paranoid features, was successfully treated by anti-psychotic drugs; it illustrates the non-specific nature of conversion symptoms. Mechanic's concept of 'illness behaviour' is a frame-work that meets the need for a broader understanding of conversion symptoms.

Aged↗
PubMed1997

The delusional parent: family and multisystemic issues.

OBJECTIVES: To examine the dilemmas for children, family, and mental health professionals posed by the presence of a delusional parent in a family, including someone with induced psychotic disorder (IPD); to identify frequently unrecognized problems; and to propose practical suggestions for professionals. METHOD: The pertinent literature on the effects of delusional parents on children, families, and professionals is reviewed. By way of 3 case vignettes, the dilemmas are identified and discussed. RESULTS: Delusional disorders are underdiagnosed, resulting in poor anticipation of their implications. Unanticipated family factors, such as "pursuit of isolation" and the related heightened risk of violence, contribute to the failure of professional interventions, which has been described as "therapeutic systems paralysis." CONCLUSIONS: These cases are complex, often requiring multisystemic involvement to reduce the risks of flight. violence, psychosis, posttraumatic stress disorder, and other psychiatric sequelae to children and other family members. The critical features of the innovative collaboration ("therapeutic consensus") required between professionals for successful therapeutic interventions with these families are described.

Adolescent↗