Brahma rakshasa grahonmada: Borderline personality disorder?/tourette syndrome – plus?

Abstract

Brahma rakshasa grahonmada (BRG) is one among 18 types of bhootonmada (psychiatric problems caused by the affl iction of evil spirits or super natural powers or extraterrestrial forces or idiopathic). Acharya Charaka and Vagbhata have described this condition. The present study aims at better understanding of BRG and its clinical signifi cance. BRG is characterized by Haasa nritya priyam (engaged in jocularity and dancing/euphoria/mania/hypomania), aakroshinam (verbal abuse), pradhaavinam (hyperactivity/pacing/running), deva dvija bhishak dveshinam (negativistic, defi ant, disobedient, hostile behavior toward authority figures) mantra veda shastra abhidayinam (religious obsessions/praying compulsions), kaashta shastraadhibhi aatmaanam ghnantam (self-injurious behavior), Chhidra prahaarinam and vaidya randhraanveshinam (exploding nature/aggressiveness/assaulting/low frustration tolerance/rage attacks), “bho” shabda vaadinam(making sounds like “bho”/vocal tics), parusham (lack of empathy/cruelty), raudra cheshtam (hostile/antisocial behavior), sheeghra gaaminam (hyperactivity/pacing/running/impulsivity), etc., features. These features of BRG show similarity with various psychiatric/neuropsychiatric conditions such as borderline personality disorder (BPD), disruptive behavior disorders (DBDs) which include oppositional defi ant disorder and conduct disorder and Tourette syndrome (TS)-plus (comorbid condition of TS with attention-defi cit hyperactivity disorder [ADHD], obsessive-compulsive disorder [OCD], and other behavioral disorders). BRG is similar to BPD or TS-Plus (TS + ADHD + OCD+DBD).