Form Of Hallucinations Research Articles

‘A Waking Dream’: John Ferriar, Keats, and Medical Re–Enchantment

ABSTRACT Blackwood’s Edinburgh Magazine published a famous demolition of John Keats’s poetry in August 1818. The same issue also announced its hostility to John Ferriar’s Essay towards a Theory of Apparitions (1813). Ferriar’s essay treated visionary experience as a form of hallucination, ‘a waking dream’ whose causes were not essentially different from other physical diseases. This lecture explores the intersecting trajectories of Keats and Ferriar – who died in 1815 just as the poet started his medical training at Guy’s – to suggest both responded to the emergent science of mind in the period not as a demystification but rather a re-enchantment of imaginative life.

The effects of treatment with pimavanserin on activities of daily living in patients with Parkinson's disease psychosis: a 16-week, single-arm, open-label study.

More than half of patients with Parkinson's disease will experience psychosis symptoms in the form of hallucinations or delusions at some point over the course of their disease. These symptoms can significantly impact patients' health-related quality of life, cognitive abilities, and activities of daily living (ADLs) and function. Clinical assessment of how psychosis impacts these measures is crucial; however, few studies have assessed this sufficiently, in part due to a lack of appropriate scales for comprehensively assessing function. The objective was to assess how symptoms of Parkinson's disease psychosis (PDP) impact ADLs and function, cognitive function, and health-related quality of life. To address this unmet need, we utilized a modified version of the Functional Status Questionnaire (mFSQ) to measure the impact of psychosis on ADLs and function in patients with PDP treated with pimavanserin, a US Food and Drug Administration-approved medication to treat hallucinations and delusions associated with PDP. Eligible patients entered a 16-week, single-arm, open-label study of oral pimavanserin (34 mg) taken once daily. The primary endpoint was change from baseline to Week 16 on the mFSQ. Secondary endpoints included the Movement Disorders Society-modified Unified Parkinson's Disease Rating Scale (MDS-UPDRS) I and II; Schwab and England ADL; Clinical Global Impression-Severity of Illness (CGI-S), Clinical Global Impression-Improvement (CGI-I), and Patient Global Impression-Improvement (PGI-I), and were also measured as change from baseline to Week 16 using mixed-effects model for repeated measures (MMRM) and least-squares mean (LSM). Our results in a proof-of-concept, 16-week, open-label clinical study in 29 patients demonstrated that an improvement in psychosis symptoms following treatment with pimavanserin was associated with improvements in multiple measures of ADLs and function. Notably, a significant improvement was found on the primary endpoint, change from baseline to Week 16 in mFSQ score [LSM [SE] 14.0 [2.50], n = 17; 95% CI (8.8, 19.3); p < 0.0001]. These findings highlight the potential for improvement in function with improvement of psychosis symptoms in patients with PDP and suggest that the mFSQ may be a measurement tool to evaluate the level of improvement in function. ClinicalTrials.gov Identifier: NCT04292223.

Treatment Compliance Education Strategy for Mentally Disordered Patients at the Bangunjaya Public Health Center, Tulungagung Regency

Mental disorders are a condition where a person has a pattern of behavior that is related to distress, which causes disturbances in their life system. People with mental disorders or what are usually called ODGJ will be accompanied by symptoms in the form of hallucinations, illusions and strange behavior, for example Catatonic or aggressive, ODGJ experience disorders in the form of behavioral disorders, thought disorders, and emotional disorders so that their function as humans will also experience obstacles. The aim of this research is to provide an overall picture of Treatment Compliance Education Strategy for Mentally Disordered Patients at the Bangunjaya Public Health Center, Tulungagung Regency. Design The research used USG method in this research. Referring to the problem, the author proposes an idea to optimize the delivery of education to the families of patients who visit the to carry out routine checks. Treatment compliance carried out at public health centers can be the right place to do this. With this education, it is hoped that knowledge will increase to always comply with the treatment being carried out.

Schizophrenia Of the Main Character In Fear Of Rain Movie Directed By Castille Landon

Literature is something that cannot be separated from people's lives, and films are one of the most popular forms of literary works today. Mental health is an important focus in everyone's life, to maintain and maintain sanity for a better life. This study discusses mental health problems, namely schizophrenia, with films as research objects. The purpose of this study was to find out the early symptoms of schizophrenia, the impact of schizophrenia, and the role of parents in responding to children with schizophrenia. This research uses descriptive qualitative method where the data collected is in the form of words, pictures and not numbers. Schizophrenia has two types of initial symptoms, namely positive symptoms and negative symptoms. In "FEAR OF RAIN" movie, the writer found that the character Rain (1). experiences positive symptoms, such as hallucinations and delusions. (2). The impact of schizophrenia makes it difficult for Rain to adapt to her family, friends and environment, because relapse can pose serious risks such. (3). In the film, the role of parents is very important like Rain parent’s who always accompany and support Rain in every difficult time. This shows how important the role of parents is in the condition of children with schizophrenia.The conclusion is that in Fear of Rain movie the main character experiences early symptoms in the form of hallucinations and delusions that cause Rain to experience excessive anxiety and aggressive behavior.

Automatic Detection of Inconsistencies and Hierarchical Topic Classification for Open-Domain Chatbots

Current State-of-the-Art (SotA) chatbots are able to produce high-quality sentences, handling different conversation topics and larger interaction times. Unfortunately, the generated responses depend greatly on the data on which they have been trained, the specific dialogue history and current turn used for guiding the response, the internal decoding mechanisms, and ranking strategies, among others. Therefore, it may happen that for semantically similar questions asked by users, the chatbot may provide a different answer, which can be considered as a form of hallucination or producing confusion in long-term interactions. In this research paper, we propose a novel methodology consisting of two main phases: (a) hierarchical automatic detection of topics and subtopics in dialogue interactions using a zero-shot learning approach, and (b) detecting inconsistent answers using k-means and the Silhouette coefficient. To evaluate the efficacy of topic and subtopic detection, we use a subset of the DailyDialog dataset and real dialogue interactions gathered during the Alexa Socialbot Grand Challenge 5 (SGC5). The proposed approach enables the detection of up to 18 different topics and 102 subtopics. For the purpose of detecting inconsistencies, we manually generate multiple paraphrased questions and employ several pre-trained SotA chatbot models to generate responses. Our experimental results demonstrate a weighted F-1 value of 0.34 for topic detection, a weighted F-1 value of 0.78 for subtopic detection in DailyDialog, then 81% and 62% accuracy for topic and subtopic classification in SGC5, respectively. Finally, to predict the number of different responses, we obtained a mean squared error (MSE) of 3.4 when testing smaller generative models and 4.9 in recent large language models.

EEG Microstate Dynamics Associated with Dream-Like Experiences During the Transition to Sleep

Consciousness always requires some representational content; that is, one can only be conscious about something. However, the presence of conscious experience (awareness) alone does not determine whether its content is in line with the external and physical world. Dreams, apart from certain forms of hallucinations, typically consist of non-veridical percepts, which are not recognized as false, but rather considered real. This type of experiences have been described as a state of dissociation between phenomenal and reflective awareness. Interestingly, during the transition to sleep, reflective awareness seems to break down before phenomenal awareness as conscious experience does not immediately fade with reduced wakefulness but is rather characterized by the occurrence of uncontrolled thinking and perceptual images, together with a reduced ability to recognize the internal origin of the experience. Relative deactivation of the frontoparietal and preserved activity in parieto-occipital networks has been suggested to account for dream-like experiences during the transition to sleep. We tested this hypothesis by investigating subjective reports of conscious experience and large-scale brain networks using EEG microstates in 45 healthy young subjects during the transition to sleep. We observed an inverse relationship between cognitive effects and physiological activation; dream-like experiences were associated with an increased presence of a microstate with sources in the superior and middle frontal gyrus and precuneus. Additionally, the presence of a microstate associated with higher-order visual areas was decreased. The observed inverse relationship might therefore indicate a disengagement of cognitive control systems that is mediated by specific, inhibitory EEG microstates.

SCHIZOPHRENIA AND PSEUDOBULBAR AFFECT DISORDER IN THE FILM SCRIPT JOKER

This study deals with schizophrenia, pseudobulbar affect (PBA) and negative responses of the community experienced by the main character of the Joker 2019 film, Arthur Fleck and the public's response to his illness. schizophrenia is a condition in which a person cannot distinguish between the real world and the world of fantasy or hallucination; while pseudobulbar affect (PBA) is a condition characterized by uncontrollable laughing or crying.Descriptive qualitative method to reveal the social features is applied to get relevant and precise data concerning the discussion based on the clinical psychology theory. Cinematography by listening to every scene in the film, showing Arthur Fleck's illness and the public's response to his illness is then used for the data collection procedures. The results show that the main character has got schizophrenia in the form of hallucination and pseudobulbar affect (PBA) in the form of inability to control his laughter and at the same time it is also found that the community gives negative responses upon the mental illness of the main character.

Jan Sawka’s Screen Play

In 1982 the Polish American artist Jan Sawka executed an extraordinary painting, 15 Strange Things on the Clean Morning Sky. Contradicting the title, the sky depicted is covered with sketches and cryptic writing. This suggests a common hallucinatory experience had by pilots navigating an empty sky, the ganzfeld effect. When vision encounters any undifferentiated field, such as total darkness, it will create something to see, in the form of hallucinations. Maurice Merleau-Ponty has asserted that hallucination is an integral part of visual perception: it is a kind of preseeing, which Jacques Lacan calls the screen. For Lacan, the screen is a “locus of mediation” between actual perceptions and the expectations or models that shape our seeing; it works without any conscious awareness on our part. This is not so with the “15 strange things” of Sawka’s title: small, framed images in a dusky cluster near the top of the painting. Their subjects reflect three modes in which conscious thought is conceived out of the torrent of visual impressions: diagrams, words, and clouds. Sawka plays with the screen in various ways, making it visible in other works of his. His preoccupation with the nature of seeing is not confined to images from the material world but has implications as well for memory, fiction, and painting itself—since a canvas is also a screen.

Hearing Voices: A Corporeal Expression of Trauma in Margaret Atwood’s Lady Oracle

The study aims at giving the clinical symptom “Hearing Voices” a literary conceptualization through an analytical reading of Margaret Atwood’s Lady Oracle (1976). Shedding light on the synergy between the body, the voice, and trauma, the study specifically examines how the protagonist’s childhood trauma returns through the cracks of her consciousness in a form of hallucinations and hearing ghost voices in adulthood. The study also aims to explore how Atwood problematizes the notion of hearing voices to project her protagonist’s inner world. The ensuing discussion utilizes Sigmund Freud’s theorization on trauma’s embodiment through corporeality, as well as Cathy Caruth’s emphasis on the manifestation of trauma through both the voice and the body. Also relevant is Laura Di Prete’s focus on the interplay between embodied voices and speaking bodies. Keywords: Childhood memories; Corporeality of trauma; Hearing voices; Margaret Atwood,;Lady Oracle.

W1. CHARACTERIZING FOXP2 EFFECTS ON CLINICAL PHENOTYPES IN ADULTS WITH ADHD

Psychotic experiences (PE) are forms of hallucinations and delusions neither reaching the intensity and functional impairment required to be regarded as full psychotic symptoms nor a psychotic disorder. Here we investigated the ability to predict PE using multiple models (regressions, mediation and moderation) using polygenic risk score for psychotic experiences (PE-PRS), polygenic risk score for schizophrenia (SCZ-PRS), and polyenvironmental risk score (PERS) in youth from a Brazilian sample. The scores were not able to predict outcome, either when both scores were combined (PERS + PE-PRS and PERS + SCZ-PRS) or separately. Our results show that there is no association between PE and PRS or PERS among adolescents in our Brazilian sample. The lack of association may be a result of the absence of better representativeness regarding genetic and environmental factors of our population.

TH2. CAFFEINE-RELATED GENES INFLUENCE ANXIETY DISORDERS IN CHILDREN AND ADULTS WITH ADHD

Psychotic experiences (PE) are forms of hallucinations and delusions neither reaching the intensity and functional impairment required to be regarded as full psychotic symptoms nor a psychotic disorder. Here we investigated the ability to predict PE using multiple models (regressions, mediation and moderation) using polygenic risk score for psychotic experiences (PE-PRS), polygenic risk score for schizophrenia (SCZ-PRS), and polyenvironmental risk score (PERS) in youth from a Brazilian sample. The scores were not able to predict outcome, either when both scores were combined (PERS + PE-PRS and PERS + SCZ-PRS) or separately. Our results show that there is no association between PE and PRS or PERS among adolescents in our Brazilian sample. The lack of association may be a result of the absence of better representativeness regarding genetic and environmental factors of our population.

Polyenvironmental and polygenic risk scores and the emergence of psychotic experiences in adolescents

Psychotic experiences (PE) are forms of hallucinations and delusions neither reaching the intensity and functional impairment required to be regarded as full psychotic symptoms nor a psychotic disorder. Here we investigated the ability to predict PE using multiple models (regressions, mediation and moderation) using polygenic risk score for psychotic experiences (PE-PRS), polygenic risk score for schizophrenia (SCZ-PRS), and polyenvironmental risk score (PERS) in youth from a Brazilian sample. The scores were not able to predict outcome, either when both scores were combined (PERS + PE-PRS and PERS + SCZ-PRS) or separately. Our results show that there is no association between PE and PRS or PERS among adolescents in our Brazilian sample. The lack of association may be a result of the absence of better representativeness regarding genetic and environmental factors of our population.

Characteristics of hallucinatory-paranoid disorders in patients with vascular dementia of different stages of development

IntroductionThe most frequent and severe non-cognitive disorders in dementia are hallucinatory-paranoid disorders (HPD), which cause social dysfunction and financial burden of this pathology.ObjectivesTo study the features of HPD in vascular dementia (VD), an approach using clinical-psychopathological, psychometric, psychodiagnostic and mathematical-statistical methods was used.MethodsThe study was based on the examination of 75 patients with HPD in VD and 63 patients with VD without HPD.ResultsIn patients with VD in the middle stage of development in the structure of clinical manifestations was dominated by frequent paranoid and paranoid disorders (in 75.6% of patients, p &lt;0.05) with a systemic delusional plot (in 70.1% of patients, p &lt;0.01) material damage, robbery, theft (in 26.8% of patients, p &lt;0.01), relationships (in 21.9% of patients, p &lt;0.01) and jealousy (in 17.1% of patients, p &lt;0, 01), which ran in the form of paranoid delusional disorder (63.4%), acute paranoia (12.2%) and hallucinations (24.4%). In patients with VD in the late stage of development, the clinical and psychopathological structure of GPR was characterized by a predominance of frequent, hallucinatory disorders (82.4% of patients, p &lt;0.01) in the form of healthy (23.5%, p &lt;0.1), tactile (20.6%, p &lt;0.01) and auditory (26.5%, p &lt;0.5) hallucinations, which took the form of hallucinations (44.2%, p &lt;0.05), confusion (61.5 %, p &lt;0.05) and paranoid delusional disorder (17.6%, p &lt;0.01).ConclusionsThe study of the clinical and psychopathological structure of HPD in patients with dementia of different stages of development revealed their dependence on the stage of development of the pathological process.

Auditory Hallucination in Hearing Loss Patient: A Case Report

Hallucination occurs in different modalities (olfactory, tactile, gustatory, visual, and auditory). Auditoryhallucination is the most common among them. It is a form of hallucination that involves perceiving soundswithout external auditory stimulus. It is most common among people with psychotic disorder (schizoprenia).It is also seen in people with hearing impairment. Hallucinations may also be present in 10–15% of normalhealthy individuals. This case study discuss about an adult female of 88 years who reported with a complaintof auditory hallucination for the past 2 years and focuses on the rehabilitation provided and highlights theuse of amplification devices on tinnitus and similar disorders.

CLINIC AND COMPLICATIONS OF COVID-19 CORONAVIRUS DISEASE WITH PATHOGENESIS ELEMENTS

The longer the COVID−19 coronavirus pandemic lasts, the more information about its clinical manifestations is accumulated. The incubation period of COVID−19 ranges from 2 to 14 days, rarely up to 3 weeks, but in a significant number of cases an infection is not accompanied with the appearance of clinical symptoms. Currently, the following variants of the clinical course of COVID−19 can be identified as follows: viral load; subclinical; slight; uncomplicated with damage to only the upper respiratory tract; mild pneumonia, severe pneumonia, acute respiratory distress syndrome, etc. The clinical course of COVID−19 depends on the severity, the criteria of which are the intoxication manifestation, the degree of fever and the dominant syndrome. Mild / moderate forms are manifested by frequent increase in body temperature up to 38 ° C, respiratory symptoms, headache, myalgias, palpitations and general malaise. Patients stop distinguishing smells and feel the taste of food. Approximately from the 7th to the 9th days of the disease there are problems with breathing, which indicates the impairment of the lower respiratory tract and the beginning of the second phase of the disease, and its course is regarded as severe. Severe forms of the disease can also be manifested by impaired coordination of movements, slurred speech. In 1 to 4 % of patients there is developed the psychosis in the form of hallucinations. In the elderly, COVID−19 may be accompanied by delirium, lowering blood pressure. The risks of adverse disease are associated with somatic diseases: cardiovascular and nervous systems, respiratory tract, hormonal disorders, etc. Otitis, sinusitis, sepsis, bronchopulmonary infection, thrombosis, myocarditis etc. can be the complications of COVID−19. Computer tomography is an instrumental test that demonstrates the damage of lungs with coronavirus and allows to assess its severity. Key words: coronavirus infection, COVID−19, clinical variants, severity, pneumonia, acute respiratory distress syndrome.

Acquisition of visual priors and induced hallucinations in chronic schizophrenia.

Prominent theories suggest that symptoms of schizophrenia stem from learning deficiencies resulting in distorted internal models of the world. To test these theories further, we used a visual statistical learning task known to induce rapid implicit learning of the stimulus statistics. In this task, participants are presented with a field of coherently moving dots and are asked to report the presented direction of the dots (estimation task), and whether they saw any dots or not (detection task). Two of the directions were more frequently presented than the others. In controls, the implicit acquisition of the stimuli statistics influences their perception in two ways: (i) motion directions are perceived as being more similar to the most frequently presented directions than they really are (estimation biases); and (ii) in the absence of stimuli, participants sometimes report perceiving the most frequently presented directions (a form of hallucinations). Such behaviour is consistent with probabilistic inference, i.e. combining learnt perceptual priors with sensory evidence. We investigated whether patients with chronic, stable, treated schizophrenia (n = 20) differ from controls (n = 23) in the acquisition of the perceptual priors and/or their influence on perception. We found that although patients were slower than controls, they showed comparable acquisition of perceptual priors, approximating the stimulus statistics. This suggests that patients have no statistical learning deficits in our task. This may reflect our patients' relative wellbeing on antipsychotic medication. Intriguingly, however, patients experienced significantly fewer (P = 0.016) hallucinations of the most frequently presented directions than controls when the stimulus was absent or when it was very weak (prior-based lapse estimations). This suggests that prior expectations had less influence on patients' perception than on controls when stimuli were absent or below perceptual threshold.

The study of mRNA Expression of Dopamine Receptors D2 and D3 in Schizophrenic Patients

Schizophrenia is a severe mental disorder affecting behavior, thought and emotions in the form of hallucinations, delusions and cognitive impairment. Dopamine system is implicated in the pathogenesis of schizophrenia through dopamine receptors expression in the brain. The aim of this work is to evaluate the role of mRNA expression of dopamine receptors D2 and D3 in the diagnosis of schizophrenia. Thirty-five schizophrenic patients and fifteen age and gender matched healthy controls were included in this study. Serum lipid profiles were determined by enzymatic colorimetric method while the determination of dopamine receptors D2 and D3 mRNA expression was performed by real time q PCR technique. There was significant statistical decrease of HDL-c and increase of LDL-c in patients compared to control group, while Cholesterol and TAG showed no significant statistical difference between the two groups. There was significant increase of the mRNA expression of dopamine receptors D2 and D3 genes in the blood of the patients compared to control group (p value= 0.001 and < 0.001 respectively). From this study, it could be concluded that Dopamine receptors D2 and D3 mRNA expression in the blood might be used as diagnostic markers of schizophrenia, revealing the importance of dopamine receptors antagonist as antipsychotics. Key words : Schizophrenia, dopamine D2 receptors, dopamine D3 receptors, mRNA expression.

Birth experiences, trauma responses and self-concept in postpartum psychotic-like experiences

The frequency of psychotic-like experiences (PLEs) amongst new mothers is beginning to be explored but the mechanisms underlying such experiences are yet to be understood. First time mothers (N=10,000) receiving maternity care via the UK National Health Service were contacted postnatally via Emma's Diary, an online resource for mothers. Measures assessed birth experience, trauma appraisals, post-traumatic stress symptoms, adjustment to motherhood, self-concept clarity and PLEs (in the form of hallucinations and delusions). There was a 13.9% response rate (N=1393) and 1303 participants reported experiencing at least one PLE (93.5%). Three competing nested path models were analysed.A more negative birth experience directly predicted delusions, but not hallucinations. Trauma appraisals and poorer adjustment to motherhood indirectly predicted PLEs, via disturbed self-concept clarity. Post-traumatic stress symptoms directly predicted the occurrence of all PLEs.PLEs in first time mothers may be more common than previously thought. A key new understanding is that where new mothers have experienced birth as traumatic and are struggling with adjustment to their new role, this can link to disturbances in a coherent sense of self (self-concept clarity) and be an important predictor of PLEs. Understanding the development of PLEs in new mothers may be helpful in postnatal care, as would public health interventions aimed at reducing the sense of abnormality or stigma surrounding such experiences.

STUDI ANALISIS TERHADAP PENGGUNAAN TERAPI SPIRITUAL EMOTIONAL FREEDOM TECHIQUE (SEFT) YANG DAPAT DIGUNAKAN SEBAGAI TERAPI PADA KLIEN YANG MENGALAMI POST TRAUMATIC STRESS DISORDER (PTSD)

The experience of being victims or perpetrators or witnesses of traumatic experience can cause physical and emotional disorder (psychological) when this disorder lasted more than 4 weeks post trauma and diagnosed as Post Traumatic Stress Disorder (PTSD). Traumatic experience makes the life of the victim experiencing a decrease in quality of life due to having a lot of physical disorders such as shortness of breath, dizziness, loss of appetite, impaired cognitive form of daze, unable to forget, impaired concentration, emotions in the form of hallucinations, nightmares, irritability, impaired social and behavioral disorders (Varcarolis, 2006). A person categorized as sufferers of PTSD or traumatic incident suffered casualties when already experiencing disruption of emotions. This scientific masterpiece using descriptive method in the form of a literature study traced via Google Scholar, proquest and there are 13 articles accordingly. Therapy can be used as alternative SEFT psychotherapy to address emotions in people with PTSD or misbehaving emotion because of the traumatic experience. This therapy is a new method from EFT that have proved effective in the case of Viet Nam war veteran PTSD but this therapy is more effective because it included elements of spirituality. The principle of this therapy is to balance the body's energy in the 18-point energy meridians so that when the energy of the body back in balance then the negative emotions will disappear (Zainuddin, 2007). Therapy effective for addressing PTSD SEFT or emotional disorders who experience a traumatic experience because of this therapy because it is easy and relatively fast with high effectiveness

Twenty year multi-follow-up of different types of hallucinations in schizophrenia, schizoaffective disorder, bipolar disorder, and depression

Hallucinations are a salient feature of both psychotic and mood disorders. Currently there is a call for more research on the phenomenology of different forms of hallucinations, in a broader array of disorders, to further both theoretical knowledge and clinical utility. We investigated auditory, visual, and olfactory hallucinations at index hospitalization and auditory and visual hallucinations prospectively for 20years in 150 young patients, namely 51 schizophrenia, 25 schizoaffective, 28 bipolar, and 79 unipolar depression. For the index hospitalization, the data showed schizophrenia and schizoaffective patients had a greater rate of auditory and visual hallucinations than bipolar and depression patients. However, over the longitudinal trajectory of their illness, a greater percentage of schizophrenia patients had auditory and visual hallucinations than schizoaffective patients, as well as bipolar and depression patients. Also, in contrast to the initial period, schizoaffective patients did not differentiate themselves over the follow-up period from bipolar patients. Bipolar and depression patients did not significantly differ at index hospitalization or at follow-up. We found visual hallucinations differentiated the groups to a greater degree over the 20year course than did auditory hallucinations. These findings suggest the longitudinal course is more important for differentiating schizophrenia and schizoaffective disorder, whereas the initial years may be more useful to differentiate schizoaffective disorder from bipolar disorder. Furthermore, we found that the early presence of auditory hallucinations was associated with a reduced likelihood for a future period of recovery. No olfactory hallucinations were present at the index hospitalization in any patients. Over the course of 20years, a minority of schizophrenia patients presented with olfactory hallucinations, and very few schizoaffective and bipolar patients presented with olfactory hallucinations. This study underscores the importance of the longitudinal course of symptoms to understand the relationship between related disorders and recovery.