Paranoid Research Articles

My Silence Says It All: A Case Report and Literature Review of Catatonia in First Episode Psychosis

Background: Catatonia is a severe psychomotor syndrome associated with various psychiatric disorders and medical conditions. While it is associated with multiple conditions, it is studied most in psychiatric patients. In Schizophrenia, for eg, rates have been found in the range of 1% to 50%. It can present as a symptom cluster of psychomotor and behavioral symptoms such as automatism, negativism, mutism, waxy flexibility, echolalia amongst others. Motor symptoms including catatonia can be seen in psychosis, but little literature exists specifically on first episode psychosis (FEP) presenting with the specific motor cluster of catatonia. Materials and Methods: In our poster, we will present a case of catatonia in FEP and will also review existing literature which alludes to the topic. Case Report: Mr. X is a 24-year-old male without prior medical or psychiatric history who presented to the emergency room in a catatonic state, with immobility, mutism, staring, catalepsy, rigidity, withdrawal and negativism. He was admitted for medical management and subsequently required transfer to inpatient psychiatry. On the psychiatric unit, even after resolution of catatonia, patient continued to elicit delusional thoughts, internal preoccupation and paranoid ideation. As of date of submission, he is still on the inpatient unit. Discussion: Studies have alluded to motor symptoms being present in first episode psychosis, although significant epidemiological information was unable to be found in the literature. Cuesta et al studied 100 antipsychotic-naive FEP patients undertaking extensive motor evaluation including symptoms of catatonia but also parkinsonism, dyskinesia, akathisia and neurological soft signs. Patients were followed up over the course of months and years to track how motor symptoms correlated with disease outcomes. It was observed that early catatonic signs and dyskinesia at drug-naive state were significantly associated with poor long-term psychosocial functioning. Having more data about motor signs, specifically catatonia in psychosis has implications for treatment. Benzodiazepine and Electroconvulsive Therapy (ECT) are first line treatments, however antipsychotic medication remains an area to be studied regarding risk versus benefits for alleviating psychotic symptoms, while possibly increasing the risk for Neuroleptic Malignant Syndrome (NMS). The data is also unclear on first or second generation antipsychotics, with conflicting reports showing efficacy and detrimental side effects for both classes. Conclusion: Further research into the etiology of catatonia is warranted as well as its relationship with other motor symptoms and action of neurotransmitters (GABA, Serotonin, Dopamine). This will have treatment implications as current first line treatment includes benzodiazepines and ECT; Treatment with antipsychotics remains controversial, with evidence supporting and negating its efficacy and possibility for inducing Neuroleptic Malignant Syndrome (NMS).

Experiential avoidance mediates the association between paranoid ideation and depressive symptoms in a sample from the general population

Psychotic experiences are prevalent in the general population and are associated with negative outcomes, including depressive symptoms. The mechanisms underlying this relationship remain unclear, but new insights could be obtained by exploring the role of transdiagnostic processes such as experiential avoidance, defined as a person's attempts or desires to suppress unwanted internal experiences like thoughts, emotions, memories, or bodily sensations. Studies analyzing the link between negative emotional states and psychotic experiences are scant. We explored the association between a specific kind of psychotic experience (paranoid ideation), experiential avoidance, and depressive, anxiety, and stress symptoms in a sample from the general population. We found that experiential avoidance partially mediates the associations between paranoid ideation and stress and anxiety symptoms and that it fully mediates the association between paranoid ideation and depressive symptoms. Our results suggest that the presence of paranoid ideation and the usage of experiential avoidance to cope with it are vulnerability factors associated with psychological distress.

اثر بخشی درمان شناختی رفتاری واحدپردازه‌ای بر سوگیری تعبیر چهره و ترس از ارزیابی منفی در دانشجویان دارای خصیصه پارانوئید

The purpose of this research was to investigate the effectiveness of Modular Cognitive-‎Behavioral Therapy on facial expression bias and fear of negative evaluation in paranoid ‎students. The research method was quasi-experimental with pre-test-post-test with control group.‎‏ ‏The research community was composed of all students referring to the counseling center of kashmar University of Medical Sciences in the year 2017-16, who were diagnosed according to ‎Multidimensional Clinical Questionnaire-3 and DSM-‎‏5‏‎ criteria with paranoid attribution disorder ‎‎(According to statistics obtained from the center 60 people)‎‏.‏‎ Of these, 20 students with paranoid ‎characteristics were selected through purposeful sampling and were randomly assigned to ‎experimental and control groups. The experimental group received 16 sessions of Modular ‎Cognitive-Behavioral Therapy (HRT), Chuppita and did not receive interventional ‎control.Multidimensional Clinical Questionnaire and Objective Fear Scale , were completed ‎before and after the intervention by both groups. The collected data were analyzed by SPSS-22 ‎software and inferential statistics of covariance analysis. The results of analysis of covariance ‎showed that by eliminating the effect of pre-test scores on facial expression bias and fear of ‎negative evaluation as a scattering variable, the main effect of Modular cognitive-behavioral ‎therapy on facial expression bias and fear of negative evaluation in post-test is significant ‎‎(P‎‏>‏‎0/05). Therefore, Modular cognitive behavioral therapy can be used as an effective method to ‎reduce interpretation bias and fear of negative evaluation of people with paranoid traits.‎

Analysis of psychological status and effect of psychological intervention in quarantined population during the epidemic of SARS-CoV-2.

During outbreaks of the coronavirus disease 2019 (COVID-19), many countries adopted quarantine to slow the spread of the virus of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Quarantine will cause isolation from families, friends, and the public, which consequently leads to serious psychological pressure with potentially long-lasting effects on the quarantined population. Experience of specific practices to improve the psychological status of the mandatory quarantined population was limited. The aim of this study was to investigate the psychological impact of mandatory quarantine, and evaluate the effect of psychological intervention on the quarantined population.We conducted a prospective cohort study to assess and manage the psychological status of a mandatory quarantined population in Beijing, China. A total of 638 individuals completed 2 questionnaires and were enrolled in this study, of which 372 participants accepted designed psychological intervention while other 266 participants refused it. The SCL-90 questionnaire was used to evaluate the psychological status and its change before and after the intervention. The differences of SCL-90 factor scores between participants and the national norm group were assessed by 2 samples t test. While the SCL-90 factor scores before and after intervention were compared with 2 paired samples t test.Compared with the Chinese norms of SCL-90, the participants had higher SCL-90 factor scores in most items of the SCL-90 inventory. The SCL-90 factor scores of participants with psychological intervention significantly decreased in somatization, obsessive-compulsive, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism. In contrast, most factor scores of the SCL-90 inventory changed little without statistical significance in participants without psychological intervention.Psychological problems should be emphasized in the quarantined individuals and professional psychological intervention was a feasible approach to improve the psychological status of the mandatory quarantined population in the epidemic of SARS-CoV-2.

Severe anorexia and weight loss induced by tacrolimus in kidney transplant recipients

Common neuropsychiatric complications of tacrolimus include tremors, fatigue, headache, sleep disorders, paranoid reactions, and anxiety. Other, more serious complications include encephalopathy, convulsions, confusion, and coma. To our knowledge, however, severe weight loss by anorexia has not been reported as a neuropsychiatric adverse effect of tacrolimus given to adult kidney transplant recipients. In this article we present two cases of severe anorexia and weight loss associated with tacrolimus that appeared to reverse with cyclosporine.

Investigation of the effect of COVID-19 pandemic on employees' psychological symptoms and nutritional habits

Background: It is anticipated that the fear caused by the possible consequences of Covid-19 virus transmission and the sense of restraint caused by control applications such as quarantine may affect individuals', especially employees' psychological parameters and change their habits. Objectives: The aim of this study is explaining the effect of pandemic conditions and precautionary practices on the psychological parameters and nutritional habits of employees. Methods: In this direction, The SCL-90-R test, which was applied to 400 office workers before the pandemic, was reapplied during the pandemic period and the differences between the psychological symptoms were evaluated statistically. In addition, a mini questionnaire was applied on the change of daily nutritional habits after the pandemic. Results: In the period of pandemic compared to before the pandemic;a definite statistical difference was determined in somatization, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid, and general symptom index symptoms. In addition, an acceptable difference was found for the increase in symptoms of paranoid ideation and obsessive-compulsive, and there was no statistical difference only in symptoms of hostility and psychoticism. In addition, it was found that the majority of the participants experienced a change in their daily eating methods. Conclusion: The increase in almost all of the psychological parameters is not evidence of psychological diseases. However, according to the average results, the parameters closest to evaluation as a problem comply with the observed behaviors in pandemic conditions. The change in nutrition methods is also thought to be a reflection of the psychological factors that changed during the pandemic period. © 2021 Mattioli 1885. All rights reserved.

A Case of Psychosis Due to Acute Hypocalcemia From Hypoparathyroidism

A 61-year-old female with past medical history of depression, hypoparathyroidism (hypoPtH), and hypothyroidism had disappeared from her home and was found wandering a few hours away with persecutory delusions, visual and auditory hallucinations. Serum calcium (Ca) was 6.3 mg/dL (range 8.6–10.2), albumin 3.7 g/dL (range 3.5–5.2) and ionized Ca 0.89 mmol/L (range 1.12–1.30). She was admitted and treated with Ca and calcitriol. Work-up for altered mental status was negative except for hypocalcemia (hypoCa) and scattered bilateral basal ganglia calcifications (BGC) with cortical and subcortical frontal lobe calcifications on CT. Psychiatry diagnosed delirium due to hypoCa. Acute psychosis resolved once Ca levels improved. Diagnosis of idiopathic hypoPtH was in 1997. Her regimen included Ca citrate 1500mg daily and 10 mcg of Forteo twice daily. She had skipped her medications for at least 2 days prior to presentation.Her medical records revealed that she was seen for severe depression, progressive gait abnormalities, slowed movements, and imbalance, in 2015. CT scan and MRI brain showed BGC. Her son gave a history of multiple admissions for psychosis, violence, delusions with agitation, and wandering at times when the patient was hypoCa, which was diagnosed as schizophrenia. Neuropsychiatric disturbances are commonly associated with hypercalcemia. Review of literature found a few case reports of psychosis and hypoPtH 1,2 BGC is common in hypoPtH. Psychotic symptoms due to BGC include auditory hallucinations, delusions of influence, paranoid states, and complex perceptual distortions.3,5 HypoCa is associated with cognitive impairment. Neurological manifestations tend to improve with Ca correction, but psychiatric symptoms do not improve substantially.4,5 Further studies are needed in hypoPtH with BGC to appropriately diagnose organic psychosis. This is important in management of the vicious cycle of psychiatric illness leading to noncompliance resulting in psychosis. Prevention of BGC will play a key role.

Cushing’s Disease Presenting With Severe Weight Loss, Anorexia and Refractory Psychotic Depression

Abstract Introduction: In this paper we report an unusual case of Cushing’s disease presenting with psychotic depression, paranoia, anorexia leading to severe weight loss culminating in 18% of her body weight. Case: A 22 year old female admitted with first episode psychosis to her local hospital displaying psychotic depressive symptoms, low mood, severe anorexia and mood congruent delusions regarding food contamination. Clinical manifestations of Cushing’s were recognised: cushingoid facies, facial plethora, hirsutism with striae and proximal myopathy. The degree of weight loss (70kg to 57kg) and paranoid ideation surrounding food necessitated caloric supplementation parenterally. Laboratory indices notable for hypokalaemia of 2.7nmol/l, male range testosterone level of 10.7nmol/l, DHEAS>27.1umol and suppressed gonadotrophins. Urine Free Cortisol was >25 times normal. Late night salivary cortisol was 13.4nmol/L(<2.6nmol/L). ACTH was raised at 74.0pg/ml in keeping ACTH dependent Cushing’s. MRI pituitary showed a bulky pituitary. CRF testing and Inferior Petrosal Sinus Sampling both indicated pituitary dependent Cushing’s disease. Following Metyrapone therapy and nutritional treatment the patient condition improved. She proceeded to transphenoidal pituitary exploration. Intraoperatively a very soft central lesion was excised and neuropathology confirmed a corticotroph adenoma. Post-operative morning cortisol at day 3 was 31nmol/l indicating early remission. 3 months post-operative there was remarkable improvement in mood, weight, cessation of anti-psychotics with normal diet and return of menses. She remained severely hypocortisolaemic 6 months post-op Conclusion: Cushing’s disease may present with severe psychiatric manifestation and significant weight loss. Clinicians need to be vigilant of psychosis as the primary presentation of Cushing’s disease.

Paranoia and Grandiosity in the General Population: Differential Associations With Putative Causal Factors.

Worry, negative self-beliefs, and sleep disturbance have been identified as contributory factors to the onset, maintenance, and severity of paranoia. We tested the specificity of these contributory factors to paranoia compared to grandiosity, a different type of delusional ideation. Data were used from 814 adults from the Nathan Kline Institute-Rockland (NKI-Rockland) study, a general population dataset. Paranoid and grandiose delusional ideation was assessed using the Peters Delusions Inventory (PDI-21) and correlated with self-reported worry (n = 228), negative self-beliefs (n = 485), and sleep quality (n = 655). Correlations were compared using Fisher's r-to-z transform to examine whether the magnitude of relationships differed by delusion type. Paranoia was significantly associated with worry, negative self-belief, and sleep quality. Grandiosity demonstrated significantly weaker relationships with worry and negative self-beliefs. Relationships with sleep quality were similar. We replicate previous reports that worry, negative self-beliefs and sleep quality are associated with paranoid ideation in the general population. We extend these findings by demonstrating that these contributory factors, particularly worry and negative self-beliefs, are associated with paranoid ideation to a greater extent than grandiosity. This suggests a degree of specificity of contributory factors to different types of delusional thinking, supporting the pursuit of specific psychological models and treatments for each delusion type.

The Fear of Being Laughed at, Social Anxiety, and Paranoid Ideation: A Multilevel Confirmatory Factor Analysis of Multitrait-Multimethod Data.

The GELOPH-15 is a self-report measure that assesses individual differences in the fear of being laughed at (i.e., gelotophobia), a relatively understudied but important trait that is closely related to social anxiety. Using a multitrait-multimethod (MTMM) approach, the convergent and discriminant validity of the GELOPH-15 scale was examined based on 217 self- and 651 peer ratings (of three close acquaintances per target) of the traits gelotophobia, social anxiety, and paranoid ideation. Participants completed the Spanish versions of the GELOPH-15, the Social Interaction Anxiety Scale, and the Paranoia Scale. Applying MTMM models of multilevel confirmatory factor analyses (ML-CFA-MTMM) revealed relatively high associations between the self- and peer ratings, supporting the convergent validity of the GELOPH-15. Discriminant validity analyses confirmed the expected relationship patterns of gelotophobia with social anxiety and paranoid ideation (i.e., strong, but not perfect associations). The results showed that the ML-CFA-MTMM models might be a useful tool for analyzing the convergent and discriminant validity based on self- and peer ratings.

PENGARUH PERILKU REMAJA TERHADAP KESIAPAN MENARCHE DI SMP NEGERI 1 BARUMUN TENGAH KABUPATEN PADANG LAWAS TAHUN 2020

The youth group in the world is estimated at 1.2 billion (18%). Female puberty is marked by the arrival of menstruation for the first time (Menarche). Menarche in adolescent girls usually occurs in the age range of 10-16 years. Changes in young women have a tendency neoritis at puberty many experience inner conflict from the arrival of the first menstruation that can cause pathological behavior, including anxiety in the form of phobias, excessive interest in guilt or guilt that is very extreme which then transforms into a paranoid reaction. How is the influence of behavior, knowledge, attitudes, and actions of young women towards readiness to face Menarche in SMP Negeri 1 Barumun Tengah. This type of quantitative research with cross sectional approach. The study was conducted at SMP Negeri 1 Barumun Tengah starting from February-April 2020 with a total sample of 56 students. The results of this study can be known that the variable of knowledge influences the readiness of students in facing Menarche with p = 0.001. While the attitude and action variables are not influential on the readiness of students in the face of Menarche. Students with neutral knowledge were not ready to face Menarche by 84.7%. It is expected that students of SMP N 1 Barumun Tengah to improve their behavior regarding the readiness to face menstruation by asking questions such as mothers or midwives so that their behavior will be good in the face of menarce. Teachers are expected to provide counseling guidance to help with menstrual problems so that they are ready to face menstruation more mature and better.

Modern health worries and idiopathic environmental intolerance attributed to electromagnetic fields are associated with paranoid ideation

ObjectiveParanoid ideation is assumed to characterize worries about possible harmful effects of modern technologies (MHWs) and idiopathic environmental intolerances (IEIs), such as IEI attributed to electromagnetic fields (IEI-EMF). Empirical evidence on these associations is scarce. MethodsIn a cross-sectional on-line survey, participants of a community sample (n = 700; mean age: 28.4 ± 12.0; 434 females) completed the Somatosensory Amplification Scale, the Modern Health Worries Scale, and the Paranoid Ideation scale of the Symptom Checklist 90 Revised. They were considered IEI-EMF if (1) they categorized themselves so, (2) they had experienced symptoms that they attributed to the exposure to electromagnetic fields, and (3) the condition impacted their everyday functioning. ResultsParanoid ideation was significantly positively associated with MHWs (standardized β = 0.150, p < .001) even after controlling for socio-demographic variables and somatosensory amplification tendency, an indicator of somatic symptom distress. Also, paranoid ideation explained significant variability in IEI-EMF (OR = 1.090, 95% CI: 1.006–1.180, p = .035) even after statistically controlling for socio-demographic variables and somatosensory amplification. ConclusionsParanoid ideation was found to be associated with MHWs and IEI-EMF. This association appears independent of general somatic symptom distress in both cases. This might partly explain the temporal stability of these constructs.

Coronavirus Awareness and Mental Health: Clinical Symptoms and Attitudes Toward Seeking Professional Psychological Help.

The current study analyzed the relationship between Coronavirus (COVID-19) Awareness, mental health, and willingness to seek professional psychological help. This was made through a quantitative approach, using online questionnaires to collect data from 855 subjects. The questionnaires included the Brief Symptom Inventory (BSI-53) to measure mental health indicators, the Attitudes Toward Seeking Professional Psychological Help Scale–Short Form, and the Coronavirus Awareness Scale-10 (CAS-10). An Exploratory Factor Analysis suggests that three factors underlie the CAS-10: Coronavirus Concern, Exaggerated Perception, and Immunity Perception. Results indicate a significant positive correlation between Coronavirus Concern and both general anxiety and phobic anxiety symptoms. Immunity Perception is positively related to paranoid ideation and psychotic symptoms. A Mediation Analysis determined that Coronavirus Concern has a significant positive direct effect on Openness to Seeking Psychological Treatment (OSPT), while Exaggerated Perception and Immunity Perception scores have significant direct negative effects on the Value and Need in Seeking Treatment (VNST) scores. Indirectly, the relationship between Coronavirus Concern and OPST is significantly mediated by anxiety symptoms. Similar results were found for the VNST subscale. There is a negative significant effect of Immunity Perception over OSPT mediated by Paranoid Ideation. However, the overall model only achieved small r2 coefficients for the OSPT (0.060) and VNST (0.095) scores. Comparisons in Coronavirus Awareness between sex, age, and the presence of children and older adults at home were also made. These results are discussed regarding their practical implications for mental health providers and policymakers.

Gang Membership and Mental Health During the Transition to Adulthood

There is an increasing understanding that mental health may be a collateral consequence of joining a gang. The objective of the present study is to assess the effect of gang joining on a set of diverse mental health outcomes that include depression, anxiety, hostility, and paranoid ideation. To reduce bias in our comparisons, we balance gang-joiner and gang-abstainer groups by applying the entropy balancing algorithm to longitudinal data from the Pathways to Desistance study. The results indicate that joining a gang is implicated in poor outcomes for all four measures of mental health considered in our analysis. The observed associations persist both at the first and second wave after joining a gang. To understand more comprehensively both the short- and long-term consequences of gang joining, scholars of crime and justice must expand their focus to include mental health—not solely as a predictor of group offending but also as its consequence. Future studies should also consider mental health in the context of gang desistance.

Visual function and psychological variables in alcohol dependency syndrome

ABSTRACT Introduction: Alcohol Dependence Syndrome (ADS) is defined as excessive alcohol consumption accompanied by psychological, physical, social, and economic disorders. Alcohol consumption affects motor and proprioceptive functions, decreasing motor and cognitive functions and causing attention deficits. We aim to evaluate visual function and attention, and psychological profiles in consumer and abstainer ADS patients.Methods: This quantitative, descriptive, cross-sectional and correlational study evaluates visual function in a sample of ADS patients. The Portuguese version of the Brief Symptom Inventory was used to assess patients’ psychological status. The orthoptic examination protocol for visual function consisted of 11 standardized tests: VA for distance and near, ocular movements, near convergence and accommodation point, cover and prismatic cover tests, fusional vergence for distance and near, near stereoacuity, chromatic vision, contrast sensitivity and visual attention.Results: The sample included 176 patients. 121 were consumers and 55 were abstainers, aged between 31 and 72. The most affected parameters of visual function were visual acuity (80.39%), contrast sensitivity (67.50%), convergence at distance (66.44%) and near stereopsis (62.75%). Visual function was impacted in both groups. Regarding psychological status, consumers had higher averages for the Depression subscale, followed by Paranoid Ideation and Obsession. Abstainers had the highest averages in the Obsession subscale, followed by Paranoid Ideation and Depression. Statistically significant differences existed between the groups in the subscales for depression (p=.046) and paranoid ideation (p =.042).Conclusion: Changes in visual function and attention, as well as psychopathological function, should be considered in the rehabilitation of ADS patients.

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.

Spice related catatonia and its treatment: The case study

IntroductionSynthetic Cannabinoids were recognized as drugs of abuse since 2008, they are sold under various names (Kush, K2, Spice).ObjectivesThe Patient N., 17 years old male was admitted to the hospital with a first-time psychotic episode. He is fond of extreme sports (ski jumping, gymnastic and acrobatic elements).MethodsThe patient was fully examined.ResultsThen he was taken to the admission department. About a week before admission he fell, injuring his leg and head. After that he did not sleep, became excited, aggressive, “said strange things”. During the admission patient showed disorganized behavior, agitation, paranoid ideation, beliefs that others were inserting thoughts into his head (“thought insertion”) and that his thoughts could be read by others (“thought broadcasting”), imperative “voices”, bizarre delusional thoughts. The UDT showed positive K2 analysis. The patient was prescribed Diazepam, Zuclopenthixol, Valproic acid. No improvement observed. Haloperidol was prescribed next day. Then Haloperodol was changed to Quetiapine, and after 10 days of treatment no improvement was observed. The patient started to show catatonia symptoms such as elective mutism, mild rigidity, signs of cog-wheeling or clasp-knife rigidity. He experienced anxiety, fear, did not take care of himself. Every day he started to be aggressive, impulsive, started to experience auditory hallucinations. Due to that fact it was decided to prescribe Haloperidol, Chlorpromazine, Phenazepame, Diphenhydramine.That treatment improved behavior.ConclusionsThus, the intensive treatment with antipsychotic medications in combination with benzodiazepines and diphenhydramine is much more preferable for the management of the cases of oneiroid catatonia due to the usage of Spice.

Psychopathology and treatment of Prader-Willi syndrome in adulthood: About a clinical case

IntroductionPrader-Willi syndrome is a congenital disease caused by a genetic alteration of chromosome 15, described by doctors Prader, Labhart and Willi in 1956. It’s a rare disease (prevalence 2.8/100,000) and it occurs equally in both sexes and in all races. This disorder produces changes in hypothalamic function that can lead to muscle hypotonia, short stature, a compulsion to eat, and a lack of satiety. At the psychopathological level, the clinic is very varied, being mainly important the psychomotor retardation in different degrees and behavioral problems;especially in the behavioral phenotype. Affective and psychotic symptoms are also frequent.ObjectivesPsychopathology and treatment analysis through a clinical case.Methods40-year-old patient undergoing mental health follow-up since adolescence with a diagnosis of paranoid personality disorder. No medical history of interest. He was admitted to the hospitalization unit for serious behavioral alterations in a context of probable paranoid ideation towards the neighborhood. In the psychopathological examination, marked cognitive rigidity, high impulsivity and very low tolerance to frustration stand out, showing a hostile and defiant attitude. Poorly structured paranoid ideation. Presents obsessive-compulsive behaviors (scratching). Hyperphagia and obesity.ResultsPsychometric assessment (Waiss-IV): total IQ 61 (mild mental retardation). Genetics:deletion 15 q11-q13 of chromosome 15), confirms Prader-Willi diagnosis. Remission of behavioral disorders, suspiciousness and heteroaggressive behaviors with treatment with monthly depot paliperidone (150 mg).ConclusionsKnowledge of the clinical and morphological characteristics of this syndrome would allow an early diagnosis and treat its possible complications as soon as possible. Antipsychotic treatment is effective in the management of behavioral and psychotic symptoms.DisclosureNo significant relationships.

Borderline personality disorder and psychotic symptoms. Report of two cases

IntroductionDSM-V includes near-psychotic symptoms as new criteria in borderline personality disorder (BPD). This change makes more difficult the differential diagnosis between considering psychotic symptoms as part of the BPD or as part of a comorbid psychotic disorder.ObjectivesRecognize the difficulty of the differential diagnosis in clinical practice between BPD and comorbid diagnosis of BPD with psychotic disorders, and how it can affect the patient’s outcome.MethodsPatients’ data is obtained from medical history and psychiatric interviews carried out during their hospitalizations.Results32 year-old female patient with previous diagnosis of BPD, psychotic episodes and cannabis abuse, was admitted due to paranoid ideation and aggressiveness, with massive borderline defense mechanisms (frequent displays of anger, high impulsivity, low frustration tolerance, self-destructive behavior…). Psychotic symptoms ceased two weeks after admission, and considering the patient’s individual characteristic it was believed BPD fitted more with this clinical case, although different psychotic disorders were considered. 30 year-old female patient began intensive psychiatric treatment with previous diagnosis of BPD, psychotic disorder and cannabis abuse. It was observed that the paranoid ideation and bodily experiences she suffered lasted months and were characterized by a strong belief. These two reasons were put into consideration when it was decided to judge this clinical case as a comorbid diagnosis of BPD with a psychotic disorder.ConclusionsIt is necessary to assess the difficulty of the differential diagnosis in these patients, and offer them specialized treatment depending on the diagnosis, as it can affect the patient’s outcome.DisclosureNo significant relationships.

Coping styles, dysfunctional schemes and psychopathological symptoms related to emotional dependence on the aggressor partner

Coping styles, dysfunctional schemes and psychopathological symptoms could be factors of vulnerability that increase the probability that a person develops emotional dependence on an aggressive partner. Delimiting the risk factors is fundamental for its prevention and treatment. Consequently, the main objectives of the present study were to analyze the relationship between the above-mentioned factors, as well as the mediating role of the first three in the relationship between emotional dependence and received violence. The sample was made up of 657 women from the clinical and general population, with ages ranging from 18 to 66 years of age (M= 23.38, SD= 8.24). The results reflected the predominance of inadequate coping styles, such as desiderative thinking, social isolation and self-critical, psychopathological symptoms of depression, anxiety, interpersonal sensibility, obsession-compulsion and paranoid ideation, as well as abandonment and subjugation schemes. These factors also explained part of the relationship between emotional dependence and staying in violent relationships.