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There is uncertainty about whether delusion formation in Alzheimer’s disease (AD) can be explained by false memories. “Metamemory,” the ability to self-evaluate memory and identify memory errors, is impaired in people with delusions in schizophrenia. Our objective was to investigate whether false memory and metamemory were associated with delusions in AD. Participants with mild AD, with and without delusions, completed a computerized word recognition task and a metamemory measure. Group differences were compared using independent-samples t-tests or Mann Whitney tests. Significant findings were explored through binary logistic regression modeling. Participants with delusions (n = 10) gave more high confidence responses, significantly so for correct responses; percentage of high confidence correct responses for those with delusions (mean (SD)) was 69.7% (31.0%) and for those without (n = 14) was 43.5% (29.9%); t22 = -2.09, p = .049. This remained significant when sex was included in regression modeling; for each 1.0% increase in high confidence correct responses, participants were 5.4% more likely to have delusions (Exp(β) 1.054, 95% CI 1.007–1.105, p = .025). Findings provide tentative support for a link between metamemory and delusions in AD. This should be explored in a larger sample as it has potential implications for treatment. [ABSTRACT FROM AUTHOR]

Because of the stigma surrounding patients with substance use disorder (SUD) and difficulties with follow-up, data on outcomes is limited. We explore real-world data from a prospectively collected database to determine characteristics that contribute to the completion of acute treatment. Our cohort consisted of data from 1039 patients treated at a single facility. Success was defined as successful discharge from the program. Failure was defined as relapse or signing out against medical advice during treatment. We examined 43 distinct features collected at time of treatment using multivariate analysis. In the total cohort and both sexes, longer length of stay (p ≤ 0.01) was linked to treatment failure. When we examined the cohort by sex, variables associated with success and failure differed between groups. Among females, goal-directed thinking (p ≤ 0.05) correlated with treatment success. Taking unnecessary risks (p < 0.05), having a detailed suicide plan (p ≤ 0.001), and constricted thinking (p ≤ 0.01) predicted treatment failure. In males, prior arrest for driving under the influence (p ≤ 0.05), and presence of phobias, paranoias, and delusions (p ≤ 0.05) were associated with treatment failure. Identifying patients prone to acute therapy failure may guide more personalized treatment, thereby increasing success rates. When considering SUD treatments for patients, we must stratify based on patient characteristics. [ABSTRACT FROM AUTHOR]

Jean-Martin Charcot (1825–1893) showed little interest in mental disorders, the domain of nineteenth-century alienists. But hallucinations are not confined to the field of psychiatry, and Charcot, who had once tested the hallucinogenic effects of hashish in his youth, went on to describe hallucinations in the course of various neurological conditions as just another semiological element. Most of his or his disciples’ writings on hallucinations can be found in his work on hysteria. Hallucinations and delusions were part of “grand hysteria” and occurred at the end of the attack (third or fourth phase). Hypnosis or chemical agents could also induce hallucinations. Charcot and his disciples did not go so far as to emphasize the importance of hallucinations when they evoked past trauma, especially sexual trauma. Charcot’s materialistic orientation led him and his disciples—especially D. M. Bourneville (1840–1909), G. Gilles de la Tourette (1857–1904), and the neurologist and artist P. Richer (1849–1833)—to seek hysteria in artistic representations of “possessed women” and in the visions of nuns and mystics. Finally, Charcot recognized the importance of hallucinations in neurological semiology, by means of precise and relevant observations scattered throughout his work. Preoccupied with linking hysteria to neurology, Charcot only scratched the surface of the possible significance of hallucinations in this context, paving the way for the work of his students Pierre Janet (1859–1947) and Sigmund Freud (1856–1939). [ABSTRACT FROM AUTHOR]

This commentary on Adam Pautz's excellent book, Perception, explores the consequences of "spatial illusionism," the view that the spatial properties presented in experience aren't instantiated in the extra-mental world. First, I consider whether spatial illusionism entails that our ordinary beliefs about the physical world are mostly false. I then argue that spatial illusionism threatens to undermine two arguments Pautz's defends in Perception: his argument that sense data theory is incompatible with physicalism, and his central argument against the internal physical state view of perception. [ABSTRACT FROM AUTHOR]

A growing number of studies in both the scientific and the philosophical literature have drawn on a Bayesian predictive processing framework to account for the formation of delusions. The key here is that delusions form because of disrupted prediction error signalling. Parrott's recent critique argues that the framework is incomplete in two respects: (i) it leaves unclear why delusional hypotheses are selected over none at all, or over more plausible alternatives; and (ii) it leaves unclear how exactly it is that delusional hypotheses are generated in the first place. In this paper, we defend the framework's explanatory power by way of showing how it can go a long way in helping disentangle these concerns. We take up each of them in turn. As for the first, our argument turns on two claims: (a) believing nothing, although possible in principle, may not be a viable procedure in the circumstances; and (b) alternative hypotheses may be rendered unavailable for selection, due to aberrant prediction errors. As for the second concern, we distinguish three ways in which delusional hypotheses may be initially acquired, all of which are based on experience broadly construed. [ABSTRACT FROM AUTHOR]

This article explores a literary tradition situated at the intersection of scientific reports, memoirs, and creative writing, termed “clinical narrative.” This genre offers a profound approach to the painful aspects of conscious experience, particularly the phenomenological states associated with mental illness and brain disease, seen as unsettling landscapes of phenomenal experience. Through case studies providing multifaceted viewpoints – first-person, second-person, and third-person perspectives – we argue that clinical narratives are valuable resources for a transepistemic study of consciousness. By examining clinical conundrums such as somatic and nihilistic delusions, and anosognosia, we highlight the importance of detailed phenomenological, hermeneutic, and narrative accounts while acknowledging the significance of subpersonal, mechanistic models from cognitive and affective neuroscience. The tradition embodies the tension between the diverse perspectives in the field of mental health, including stories that directly challenge the medical discourse. However, the narrative arts can act as mediators or even peacemakers, by fostering an understanding between the opposing views. Stories are open to multiple interpretations, preserving the diversity of discourses on human meaning and avoiding the imposition of monolithic versions of our humanness. [ABSTRACT FROM AUTHOR]

This brief report concerns a patient interaction in a busy South London Home Treatment Team (HTT) service, where a psychodynamically informed approach was applied to a presentation of psychosis in a crisis setting. We discuss the case in light of the psychodynamic theories on psychosis of Carl Jung and Richard Lucas. Our patient, a young man, had been under the HTT for an extended period of time due to an episode of psychosis that was not resolving. After initially struggling to build rapport, we adapted Lucas' and Jung's models of interacting with acutely psychotic patients to re-establish psychic rapport, which led to our patient agreeing to take the medication that finally pulled him out of this long-standing episode. We believe this case highlights the power of psychodynamic thinking even in acute, short-term settings where extensive psychodynamic intervention may not be appropriate or feasible. [ABSTRACT FROM AUTHOR]

This article reports on the qualitative findings of a mixed methods study that investigated primary school teachers' beliefs, practices and choices of resources for teaching written grammar. Qualitative data were collected from Primary teachers in Western Australia through semi-structured interviews (n = 10) and analysed thematically. Although all participating teachers reported that they saw the teaching of written grammar as important, it was found that they had insecure Pedagogical Content Knowledge about Grammar (PCKAG). This insecure knowledge base coincided with eclecticism in pedagogical practice and the choice and use of resources that were not optimal for building PCKAG, or for supporting best practices in the instruction of written grammar. [ABSTRACT FROM AUTHOR]

Individuals with schizophrenia are at increased risk for suicide, and the Demoralization Hypothesis states that non-delusional awareness of one's social, cognitive, or occupational deterioration elicits depression and hopelessness. Both depression and hopelessness are established risk factors for suicide and are features of schizophrenia. The present study investigated whether insight into one's schizophrenia yields suicidal ideation, specifically by way of thwarted belongingness and perceived burdensomeness, which are constructs related to demoralization and measured by the Interpersonal Needs Questionnaire (INQ). Three separate models explored the mediating role of INQ scores on suicidal ideation in 99 participants with schizophrenia. With suicidal ideation entered as the dependent variable and INQ scores entered as the mediator, the first model included insight as the independent variable, the second included cognitive functioning, and the third included cognitive deterioration post-illness-onset. Consistent with our hypothesis, INQ scores related to suicidal ideation (B =.03, SE =.01, p <.001). However, neither insight, cognitive functioning, nor cognitive deterioration predicted INQ scores or suicidal ideation. Additionally, INQ scores did not mediate relationships with suicidal, ideation. Although INQ scores led to increased suicidal ideation, neither insight into illness, current cognitive functioning, nor shift in functioning led to increased INQ scores. Implications are discussed, and future directions are proposed. [ABSTRACT FROM AUTHOR]

Delusions are usually depicted in one of two contrasting ways. They are either characterized as harmful and dysfunctional beliefs or as fostering engagement with the environment and sometimes even psychological wellbeing in the face of psychological or biological difficulties – something which, according to some accounts, would make them biologically adaptive. It is this “adaptive hypothesis” that I focus on in this paper, by empirically investigating the adaptiveness of delusions in a sample of people suffering from OCD. The paper shows that delusions in OCD entertain complex and heterogeneous relationships with psychological wellbeing and engagement with the environment, highlighting some future directions that clinical and philosophical research on the topic should take. [ABSTRACT FROM AUTHOR]

Koro is a delusion whereby a man believes his penis is shrinking into his abdomen and this may result in his death. This socially-transmitted non-neuropsychological delusional belief occurs (in epidemic form) in South-East and South Asia. We investigated whether the two-factor theory of delusion could be applied to epidemic Koro. We scrutinised the literature on epidemic Koro to isolate features relevant to the two questions that must be answered to provide a two-factor account: What could initially prompt the Koro delusional hypothesis? Why is this hypothesis adopted as a belief? We concluded that the Koro hypothesis is usually prompted by the surprising observation of actual penis shrinkage—but only if the man has access to background beliefs about Koro. Whether the hypothesis is then adopted as a belief will depend on individual factors such as prior belief in the Koro concept or limited formal education and sociocultural factors such as deference to culture, to media, or to rumours spread by word of mouth. Social transmission can influence how the first factor works and how the second factor works. The two-factor theory of delusion can be applied to a socially-transmitted delusion that occurs in epidemic form. [ABSTRACT FROM AUTHOR]

Introductions: Reduplicative paramnesia (RP) is a rare and poorly understood phenomenon in which a person believes the place they are in has been replicated and exists in two places at once. There is minimal extant theoretical work addressing possible cognitive mechanisms subtending RP. Method: We present a new case of RP and discuss the therapeutic and theoretical implications of this case for the management and understanding of this phenomenon. Using the hypothetico-deductive approach to a neuropsychological case, we examine the phenomenon in the light of one and two-factor approaches to understanding the genesis of delusions. Results: The individual discussed in this case showed some evidence of relatively efficient incorporation of new evidence (belief updating) despite concurrently maintaining a delusional belief system. Conclusion: This case raises novel challenges for the two-factor account of neurological delusions. [ABSTRACT FROM AUTHOR]

The article provides a summary of the book "What Makes Us Social?" by Uta Frith and Chris Frith. It highlights the authors' exploration of social cognitive neuroscience and its implications for mental disorders, particularly autism and schizophrenia. The summary also mentions the authors' discussion of other processes involved in social communication and interaction, the role of metacognition in learning and psychotic delusions, and the influence of culture on social cognition. It concludes by emphasizing the importance of social connections and kindness in our well-being and the significance of social cognition in understanding mental disorders. [Extracted from the article]

Objective: Hypertrophic Olivary Degeneration is a rare condition causing transneuronal degeneration of the inferior olivary nucleus. Symptoms manifest as progressively worsening palatal tremor, ataxia, and eye movement disturbances that plateau after several months. Though rarely documented in the literature of this specific condition, disconnection of the inferior olivary nucleus from the cerebellum, and cerebellar atrophy represent a pathway to developing subsequent cerebellar cognitive affective syndrome. The presented case documents the neuropsychological sequelae of a 39-year-old female with a history of hypertrophic olivary degeneration and symptoms of palatal tremor, opsoclonus myoclonus, ataxia, and delusions. Method: Review of the patient's medical records, interviews with the patient and her father, and a neuropsychological assessment battery were used to collect data. Review of currently published literature lent to case conceptualization. Results: Neuropsychological testing revealed deficits in executive functioning, attention, and language. An anomalous, fixed persecutory delusion was revealed. Conclusion: Hypertrophic olivary degeneration creates disconnection syndromes between the inferior olivary nucleus, red nucleus, and cerebellum. Late stages of the disorder cause atrophy of the inferior olivary nucleus and adjacent structures. While the motor sequela is well documented, the neuropsychological and psychiatric impact is infrequently discussed in existing literature. We present the first case to detail the neuropsychological sequelae of hypertrophic olivary degeneration and propose a mechanism for the development of cognitive impairment and psychotic features within this condition. [ABSTRACT FROM AUTHOR]

The article presents the discussion on trauma shatters an individual's foundational beliefs. Topics include examining the profound betrayal felt by Black scientists in academia due to systemic racism and drawing parallels to Newton's third law; and offers a starting list of recommendations for individuals and institutional leaders in higher education.

Research suggests a correlation between homelessness and the prevalence of distressing unusual experiences and beliefs. This study aimed to explore how previously homeless individuals make sense of distressing unusual experiences and beliefs, by hearing their stories. Narrative analysis was used to understand the stories of six previously homeless White British males who reported distressing unusual experiences and beliefs. Participants' stories involved a holistic and whole-life approach when making sense of distressing unusual beliefs and experiences. Plots included interpersonal experiences (trauma and abuse; loss; judgemental attitudes; fitting in and relational coping), and their intrapersonal consequences (physical wellbeing; substance use; spiritual, religious, and paranormal experiences; and safety, security, and stability). A holistic, psychosocial, and whole-life approach may be helpful to support homeless individuals to make sense of distressing unusual experiences and beliefs and their coping responses. It may also be helpful to consider the changing sense of power, agency and autonomy when hearing their stories. [ABSTRACT FROM AUTHOR]

In this paper I argue that a prominent account of doxastic responsibility, Epistemic Reasons-Responsiveness can be amended to avoid two problems with its treatment of delusions. I do so by appealing to Carolina Flores’ recent work on the evidence-responsiveness of delusions: by excluding what Flores calls masking factors from the mechanism of reasons-responsiveness, we are able to accommodate the possibility for individuals with delusions to be responsible for their belief. I conclude by motivating that this possibility is one we should care about. [ABSTRACT FROM AUTHOR]

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, we ask: "what meaning(s) can delusional utterances possibly have?". We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance "p" means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical "toolbox" used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. [ABSTRACT FROM AUTHOR]

In this paper, I will explore the irrationality of delusions through Wittgenstein's notion of objective certainty. I will propose that objective certainties are constitutive epistemic norms, and that the specific irrationality of delusions can be captured in terms of the conflict with such constitutive norms. At the same time, however, I will critically examine various recent proposals to understand delusions as the loss of objective certainties, or even in terms of alternative objective certainties. Against these accounts, I will argue that lost or alternative objective certainties cannot be used to understand delusional conflicts with constitutive norms, and that such lost or alternative certainties would even preclude attributing delusions to someone. Alternatively, I will argue that the proposed type of irrationality at stake in delusions implies that delusional speech has the form of avowals. [ABSTRACT FROM AUTHOR]

Anomalous strange-face illusions (SFIs) are produced when mirror gazing under a low level of face illumination. In contrast to past studies in which an observer's task was to pay attention to the reflected face and to perceive potential facial changes, the present research used a mirror gazing task (MGT) that instructed participants to fixate their gaze on a 4-mm hole in a glass mirror. The participants' eye-blink rates were thus measured without priming any facial changes. Twenty-one healthy young individuals participated in the MGT and a control panel-fixation task (staring at a hole in a gray non-reflective panel). The Revised Strange-Face Questionnaire (SFQ-R) indexed derealization (deformations of facial features; FD), depersonalization (bodily face detachment; BD), and dissociative identity (new or unknown identities; DI) scales. Mirror-fixation increased FD, BD, and DI scores compared to panel-fixation. In mirror-fixation, FD scores revealed fading specific to facial features, distinct from "classical" Troxler- and Brewster-fading. In mirror-fixation, eye-blink rates correlated negatively with FD scores. Panel-fixation produced low BD scores, and, in a few participants, face pareidolias as detected on FD scores. Females were more prone to early derealization and males to compartmentalization of a dissociative identity. SFQ-R may be a valuable instrument for measuring face-specific dissociation (FD, BD, DI) produced by MGT. Use of MGT and panel-fixation task for differential diagnoses between schizophrenia and dissociative identity disorder is discussed. [ABSTRACT FROM AUTHOR]

The severity of positive symptoms in schizophrenia is associated with poor prognosis. About one-third of schizophrenia patients partially respond to treatment with available antipsychotics. The purpose of the present manuscript is to provide an updated overview of novel pharmacotherapy targeting positive symptoms in schizophrenia. A comprehensive research on the main database sources (PubMed, PsychINFO, Isi Web of Knowledge, MEDLINE, and EMBASE) was performed to obtain original articles published till 31st January 2023 about new pharmacological strategies for the treatment of positive symptoms in schizophrenia. The most promising compounds include: lamotrigine, pro-cognitive-compounds (donepezil – in the short term, idazoxan and piracetam) and drugs acting partially or totally outside the Central Nervous System (CNS) (anti-inflammatory drugs: celecoxib, methotrexate; cardiovascular compounds: L-theanine, mononitrate isosorbide, propentofylline, sodium nitroprusside; metabolic regulators: diazoxide, allopurinol; others: bexarotene, raloxifene [in women]). The effectiveness of the latter compounds indicates that other biological systems, such as immunity or metabolism can be object of future research to identify pharmacological targets for positive symptoms of schizophrenia. Mirtazapine could be useful for treating negative symptoms without increasing the risk of a worsening of delusions/hallucinations. Nevertheless, the lack of replication of studies prevents to draw definitive conclusions and future studies are needed to confirm the findings presented in this overview. [ABSTRACT FROM AUTHOR]

When clinicians adopt the standard 16–26 session maximum suggested by CBTp efficacy research, clients with long-term medication resistant psychosis may receive an inadequate dose of therapy. Building engagement and trust can take significantly longer for clients who have been given a stigmatizing medical explanation for their difficulties. We present a case study of successful long-term CBTp consisting of 200 sessions over a 6-year period. Supervision aided the recovery process over the last 2 years of therapy. A client with a 30-year history of medication resistant persecutory delusions, voices, stigma and prominent negative symptoms gradually formed a working alliance with the therapist. A CBT formulation emphasizing activating the adaptive mode led to later targeted work to reduce distress and social avoidance and address underlying trauma. Social recovery was achieved with increased independence and enhanced creativity. A commentary is provided by a senior clinician from a psychodynamic perspective. Clients with long-term medication resistant psychosis often need an increased number of CBT sessions but can still recover. Ongoing supportive supervision prevents early discharge and a failure to achieve a recovery trajectory. We should not accept that medication resistant clients are CBT resistant following a brief course of therapy. [ABSTRACT FROM AUTHOR]

Introduction: Although delusions in Parkinson's disease (PD) are rare, when they occur they frequently take the form of "Othello syndrome": the irrational belief that a spouse or partner is being unfaithful. Hitherto dismissed as either a by-product of dopamine therapy or cognitive impairment, there are still no convincing theoretical accounts to explain why only some patients fall prey to this delusion, or why it persists despite clear disconfirmatory evidence. Methods: We discuss the limitations of existing explanations of this delusion, namely hyperdopaminergia-induced anomalous perceptual experiences and cognitive impairment, before describing how Bayesian predictive processing accounts can provide a more comprehensive explanation by foregrounding the importance of prior experience and its impact upon computation of probability. We illustrate this new conceptualisation with three case vignettes. Results: We suggest that in those with prior experience of romantic betrayal, hyperdominergic-induced aberrant prediction errors enable anomalous perceptual experiences to accrue greater prominence, which is then maintained through Bayes-optimal inferencing to confirm cognitive distortions, eliciting and shaping this dangerous delusion. Conclusions: We propose the first comprehensive mechanistic account of Othello syndrome in PD and discuss implications for clinical interventions. [ABSTRACT FROM AUTHOR]

We aimed to evaluate whether the content of eating/body image-related beliefs in individuals with anorexia nervosa (AN) was associated with important aspects of eating disorder (ED) psychopathology. Females with AN completed assessments within 96 hours of admission to an inpatient medical stabilization program. Study staff administered the Brown Assessment of Beliefs Scale and participants completed self-report measures. We derived belief content domains using an inductive approach and examined associations between beliefs and clinical variables. The following belief categories emerged (% with a belief in that category): body image beliefs (64%), food beliefs (30%), body function beliefs (20%), rejection of illness beliefs (12%), morality beliefs (10%), and control beliefs (6%). No one belief domain was significantly associated with greater delusional intensity. However, findings indicate that greater delusionality was generally associated with worse ED psychopathology. [ABSTRACT FROM AUTHOR]

The DSM-5 and other psychiatric texts define delusions as fixed beliefs that are unamenable to change. However, many fixed beliefs are considered culturally or socially normative, and may even serve an important function in unifying groups and communities. The clinical definition of delusions does not take into account the potential social function of fixed beliefs, which may be a key factor in distinguishing fixed beliefs that are beneficial from those that are pathological. This article proposes that including a social dimension in our definition and understanding of delusions may facilitate clinical distinctions between normative fixed beliefs and clinically relevant delusions. [ABSTRACT FROM AUTHOR]

This article aims to describe the time trend in number of dual diagnosis patients treated in the psychiatric system in Denmark from 2000 to 2017. We calculated the share of patients with dual diagnosis, number of dual diagnosis contacts, number of unique individuals with dual diagnosis as well as number of new patients with dual diagnosis among patients in psychiatric treatment, i.e. among inpatients, outpatients and patients in emergency departments. In order to calculate this, we merged data from the National Patient Register (NPR), the National Registry of Alcohol Treatment, the National treatment registry for substance use, the National Prescription Registry and the Danish National Health Service register in the period from 2000 to 2017. We found an overall increase in patients with dual diagnosis in psychiatric treatment in Denmark from 2000 to 2017. We further detected an increase in the age and sex-standardized number of patients with dual diagnosis in treatment over time, however most markedly for outpatients. Further, inclusion of data from other sources of data than the NPR dramatically increased the number of patients that could be identified as dual diagnosis patients. Using these data, almost half of all male inpatients could be identified as dual diagnosis while the share was more than 40% for patients with schizophrenia, schizotypal and delusional disorders (F2) and patients with personality disorders (F6). The increase of individual diagnosis patients necessitates action at different levels. This includes improvement of preventive measures as well as improvement of treatment for this underserved group. [ABSTRACT FROM AUTHOR]

Caregivers play a key role in supporting older Mexican Americans, who are less likely to enter nursing facilities than other racial/ethnic groups in the US. However, there is little research on how Neuropsychiatric symptoms (NPS) affect relationship quality between caregivers and care recipients. Using data from the 2015 wave of the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (n = 416) study of older (age 85+) Mexican Americans, we examined relationship quality and NPS with ordered logistic regression. Relationship quality was measured using positive (enjoyment, appreciation) and negative (nerves, argue) assessments. NPS were categorized into hyperactivity, affective, and psychosis symptoms. Hyperactivity symptoms were associated with appreciation, arguing, and nerves. Psychosis symptoms were associated with arguing and nerves. Spousal caregivers were more likely to report arguing and nerves and less likely to report feeling appreciated. Enjoyment assessments were not associated with NPS. Relationship quality is related to behavioral changes in late life. Mexican American caregivers negatively evaluate their relationships, not in response to care tasks per se, but when the older person exhibits behavioral problems. The relationship between NPS and negative relationship assessments may be due to unanticipated behavior changes in late life and stigma around psychiatric symptomatology. [ABSTRACT FROM AUTHOR]

Erotomania (de Clérambault's syndrome) refers to the delusional belief that another person, usually socially unreachable, is in love with the holder of the delusion. The occurrence of erotomania in Frontotemporal Dementia has rarely been reported. We present the unique case of a 59-year-old woman with a strong family history of early-onset dementia in whom erotomania was the initial manifestation that led to a diagnosis of definite Behavioral Variant of Frontotemporal Dementia with a pathogenic missense mutation in the MAPT gene. Based on this case, we propose a hypothetical model for developing erotomania in patients with FTD. [ABSTRACT FROM AUTHOR]

The content of auditory hallucinations (AHs) and delusions is malleable and reflects the social environment and the local culture. COVID-19 is a significant new feature of the social environment, yet research has not yet determined how the phenomenology of psychosis has changed since the COVID-19 outbreak. Adult patients (N = 17) receiving care within an acute inpatient psychiatric care setting in Boston were recruited to participate in an hour-long Zoom interview about their psychosis phenomenology and the potential impact of COVID-19. Thematic analysis of interview data found that for many, ideas about COVID-19 were present in the content of their AHs and shaped their paranoid ideation. Some felt that the frequency and loudness of the AHs had increased. However, not all participants spoke in ways that suggested the virus had affected their experience. Results demonstrate that COVID-19 influenced the content of psychosis for many, but the effect of COVID-19 on psychosis was not uniform. The increased social isolation, financial insecurity, and socio-political climate of the period also seemed to negatively impact individuals with psychosis. Understanding how COVID-19 specifically has influenced psychosis helps to illustrate how societal and external factors may shape this experience. [ABSTRACT FROM AUTHOR]

Dementia due to Parkinson's disease and Alzheimer's disease are associated with behavioural and psychological symptoms, including psychosis. Long-term management presents a challenge for health care providers and caregivers. Symptoms of psychosis include hallucinations and delusions; if untreated, these can lead to institutionalisation, decreased quality of life, and significant patient and caregiver distress. A critical step in the effective management of dementia-related psychosis (DRP) is the identification and diagnosis of affected patients. The lack of a standardised diagnostic approach presents a barrier to treatment and there are no consensus guidelines for DRP. Furthermore, there are no approved therapies for the treatment of DRP. Antipsychotic medications are often prescribed off-label, even though some are associated with an increased risk of adverse events or mortality. We present currently available screening tools and guidelines for the diagnosis and treatment of Parkinson's disease psychosis and DRP in the context of what is needed for effective management of psychosis. We present currently available screening tools and guidelines for Parkinson's disease psychosis and dementia-related psychosis, and discuss the unmet need for simple clinical diagnostic tools and treatment guidelines. The identification of psychosis is variable across different settings and specialties, without a unified approach to screening, definition, or diagnosis. Currently used tools for defining and assessing psychosis in a research setting are usually too cumbersome for everyday clinical practice. The development of a standardised set of diagnostic criteria would provide clinicians the opportunity to improve the detection, treatment, and quality of life of patients and their caregivers. [ABSTRACT FROM AUTHOR]

Death anxiety has been implicated in the development and continuation of various psychiatric conditions, although few studies have focused on the relationship between death anxiety and psychosis. The present study investigated whether this relationship extends to positive schizotypy, thus exploring death anxiety as a risk factor along a psychosis continuum. The study also explored whether the relationship is moderated by maladaptive coping. Relationships between death anxiety, maladaptive coping and positive schizotypy were investigated in a non-clinical sample (N = 61). As hypothesised, hierarchical regression analysis showed that death anxiety significantly predicted positive schizotypy. Furthermore, this relationship was moderated by maladaptive coping. That is, there was a significantly stronger positive association between death anxiety and positive schizotypy at higher versus lower levels of maladaptive coping. These novel findings indicate that a relationship between death anxiety and psychosis may exist along a psychosis continuum; and this is especially pronounced for those who more often engage in maladaptive coping strategies. The findings are discussed within the framework of Terror Management Theory. Future experimental research is required to inform an accurate model of the role of death anxiety in the development of psychosis, thereby guiding effective interventions for those at risk. [ABSTRACT FROM AUTHOR]

Over the last decade or so, several researchers have considered the predictive processing framework (PPF) to be a useful perspective from which to shed some much-needed light on the mechanisms behind psychosis. Most approaches to psychosis within PPF come down to the idea of the "atypical" brain generating inaccurate hypotheses that the "typical" brain does not generate, either due to a systematic top-down processing bias or more general precision weighting breakdown. Strong at explaining common individual symptoms of psychosis, such approaches face some issues when we look at a more general clinical picture. In this paper, we propose an update on the current accounts of psychosis based on the realization that a neurotypical brain constantly generates non-actual, de-coupled, counterfactual hypotheses as part of healthy cognition. We suggest that what is going on in psychosis, at least in some cases, is not so much a generation of erroneous hypotheses, but rather an inability to correctly use the counterfactual ones. This updated view casts "accurate" cognition as more fragile and delicate, but also closes the gap between psychosis and typical cognition. [ABSTRACT FROM AUTHOR]

Evidence from treatment trials shows that the most effective pharmacological treatment for Psychotic Major Depression (PMD) is combined antidepressant and antipsychotic pharmacotherapy. This study investigates the use of antidepressant and antipsychotic treatment for PMD in clinical practice and examines how treatment profiles correlate with demographic and clinical symptoms. Anonymised electronic health records of 2,837 individuals with PMD were followed up for 12-months post-diagnosis in a historic open cohort design. The use of antidepressants and antipsychotics, alone or in combination, were described using frequency statistics. Demographic and clinical characteristics associated with each treatment were assessed using logistic regression analyses. Antidepressant and antipsychotic combination pharmacotherapy was the most used treatment for PMD with 69.9% users, compared to antidepressant monotherapy (10.9%) and antipsychotic monotherapy (10.3%). The remaining 8.9% of individuals did not receive antidepressant or antipsychotic treatment. The presence of delusions was strongly associated with the use of antipsychotics, both alone (odds ratio =3.99, 95% confidence intervals = 2.72–5.83, p<.001) and in combination with antidepressants (OR = 2.7, 95% CI = 2.09–3.67, p<.001), rather than antidepressant treatment alone. Combined antidepressant and antipsychotic pharmacotherapy is the most common treatment of PMD in clinical practice, showing that clinical practice is in line with evidence from treatment research. [ABSTRACT FROM AUTHOR]

Despite the persistent public health problem of positive psychotic symptoms, understanding of symptom specific prevalence rates, clinical correlates and service utilisation are sparse. The current study aimed to establish prevalence, clinical and service utilisation correlates of hallucinations and delusions in people accessing outpatient clinics in Tamil Nadu, India. Secondary patient data from outpatient clinics, over a 12-month period, in 2016, was used for analysis (N = 917). Based on the presence of positive psychotic symptoms (PPSx), the sample was divided into four groups for analysis- hallucinations-only (H), delusions-only (D), both hallucinations and delusions (HD) and neither PPSx (N-PPSx). Findings indicate that the most prevalent PPSx were hallucinations (10.7%) however, barriers to service utilisation and clinical correlates were associated predominantly with the D and the HD group; as was severe work impairment. Yet, this group was most likely to remain with psychiatric services. Lastly, diagnostic challenges were apparent within the sample. The study revealed that despite more barriers to service utilisation, persons with PPSx remain in contact with services. Yet prognosis remains only moderate at best, indicating other mediating and underlying factors impeding recovery may be interplaying and, therefore, a need for enhanced biopsychosocial approaches. [ABSTRACT FROM AUTHOR]

The etiology of Delusional Disorder is not well understood and could even be characterized as unknown. The intersection of childhood abuse, trauma and socio-economic factors in the causation of Delusional Disorder has not been acknowledged. Examining the impact of social media can lead to a theoretical reconsideration of Delusional Disorder as a paradoxical search for psychological acceptance through the formation of a pseudocommunity. [ABSTRACT FROM AUTHOR]

Cotard delusion—the delusional belief "I am dead"—is named after the French psychiatrist who first described it: Jules Cotard. Ramachandran and Blakeslee proposed that the idea "I am dead" comes to mind when a neuropathological condition has resulted in complete abolition of emotional responsivity to the world. The idea would arise as a putative explanation: if "I am dead" were true, there would be no emotional responsivity to the world. We scrutinised the literature on people who expressed the delusional belief "I am dead", looking for data on whether such patients are reported as entirely lacking in emotional responsivity. In numerous cases, patients with Cotard delusion are described as experiencing emotions including anxiety, fear, guilt, distress, euphoria and worry. We conclude that complete absence of emotional responsivity cannot be what prompts the delusional idea that one is dead. We propose that, in at least some cases, the idea "I am dead" comes to mind in response to symptoms of depersonalisation or derealisation, often present in cases of Cotard delusion, and give examples of Cotard patients with abnormalities in various neural areas that could be responsible for the presence of such symptoms. [ABSTRACT FROM AUTHOR]

Group norms are necessary for navigating the social world, but they also constrain how we think about individuals. This manuscript progresses in three parts, along the way integrating research from cognitive, developmental, and social psychology, as well as the broader social sciences, to present a theoretical perspective on how the tendency to interpret descriptive norms (i.e., what is) as prescriptive (i.e., what should be) is an early emerging bias to maintain the status quo. First, I define descriptive-to-prescriptive reasoning and review previous research on how it maintains the status quo. Second, I review a recent programme of research on the early development of descriptive-to-prescriptive reasoning. Third, I provide suggestions for future research, particularly in the domain of redirecting descriptive-to-prescriptive reasoning for good. Overall, I propose that descriptive-to-prescriptive reasoning biases children to keep groups in their place and prevent them from changing. Implications for stereotyping and group-based inequality are discussed. [ABSTRACT FROM AUTHOR]

Delusions are a core feature of psychosis and are thought to exist on a continuum from healthy individuals to clinical populations. This study examined the relationship between delusion-like experiences, using the Peters Delusional Inventory (PDI), and two aspects of personal worldview: core schemas (positive and negative views of the self and others) and locus of control (LOC). 258 healthy participants without a history of psychiatric illness completed an online survey assessing these constructs. Stepwise regression controlling for age and negative affect, revealed that negative self-schemas significantly predicted the presence of delusion–like experiences whilst negative schemas of others significantly predicted both the presence of delusion–like experiences and associated levels of distress and preoccupation. Positive schemas did not relate to delusions as measured by the PDI. Hierarchical regression demonstrated that LOC did not significantly predict delusion–like experiences. The findings highlight that negative schemas of others may be more critically related to delusional experiences than negative self-schemas. Replication in clinical samples is required, while some implications for future research and clinical interventions in prodromal psychosis are examined. [ABSTRACT FROM AUTHOR]

Between the early 1970s, when neoliberalism was in full swing and became the dominant rhetoric of the time, and the 2008 global economic crisis, capitalism as a result of its inherent nature entered a fundamental crisis with unavoidable consequences. Many in-depth analyses of the economic crisis from a Marxist viewpoint have revealed that in the area of wealth appropriation, capitalism has now exacerbated inequality to absurd levels. This is not to mention other challenging issues such as the parasitic nature of increasingly digitized finance capital, uncontrolled inflation leading to rampant financial deficits, the worsening ecological crisis with mounting environmental costs that erode profits, escalating political manipulation by monopoly capitalists, and the mounting by developed countries of inappropriate military interventions in the developing world, to name just a few. Today, the fundamental characteristics and specific manifestations of contemporary capitalism are exerting significant impacts on the process of building socialism worldwide. Faced with today's capitalism, China and Vietnam while exercising due caution must put forward and consistently highlight the need to examine the direction the system is taking. Thorough research on this subject is critical for a correct scientific understanding. [ABSTRACT FROM AUTHOR]

We aimed to examine the clinical features of psychotic symptoms preceding or concomitant to multiple sclerosis (MS) diagnosis. From the 1st to 10th of January 2020 a systematic review was conducted through an electronic search of different databases. Results were limited to English, French, German, Italian and Spanish language articles. We identified 599 titles, and included 32 cases from case-report and case series. One case report from our department was added. The mean age of first psychiatric symptoms was 25.8 ± 10.2 years, the mean age of MS diagnosis was 31.2 ± 10.7 years and the mean delay until MS diagnosis was 2.7 ± 3 years. Most reported symptoms were delusions (81%), auditory hallucinations (59%) and visual hallucinations (50%). Upon the MS diagnosis, immunosuppressive therapy was significantly more effective for psychotic symptoms than antipsychotics (OR = 9.0; 95%CI: 2.15-37; p = 0.002). Diffuse periventricular lesions were found in 95.6% of cases, with mostly temporal or frontal predominant lesions. In cases affected by predominant temporal lesions, 83% of cases presented visual hallucinations (p < 0.05). Poor response or resistance to antipsychotics treatment should alert clinicians on the need to consider a differential diagnosis. Considering the impact of delay in MS diagnosis further research regarding this subject is warranted. Insight into the occurrence of psychotic symptoms in multiple sclerosis (MS) is mainly limited to case reports and case series. Delay in MS management between initial psychotic symptoms and the MS diagnosis is 2.73 ± 3 years and 0.8 ± 1.2 years for patients presenting a first episode of psychosis. The resistance and poor response to antipsychotics found in most cases (75%) were associated with an excellent improvement (95%) of both psychiatric and neurologic symptoms with corticosteroids. Prospective studies are needed to investigate the spectrum of psychosis in MS. [ABSTRACT FROM AUTHOR]

This study investigates the relationship of delusional disorder and its subtypes to criminal and violent behavior by comparing the sociodemographic and clinical characteristics of patients with and without a criminal history and identifying predictors of crime. The records of 346 patients with a delusional disorder diagnosis were retrospectively evaluated using a sociodemographic data form, a crime violence rating scale and the Overt Aggression Scale (OAS). The results show that homicide and attempted homicide were committed more frequently by patients with jealous delusions, whereas verbal assault and crimes against the public were committed more frequently by patients with persecutory and other delusions. Patients with a criminal history had more hospital admissions and longer stays. Marital status, persecutory delusions, a high OAS score and older age were found to be associated with higher risk of crime. Clinical subtypes and sociodemographic characteristics seem to discriminate delusional disorder patients' risk of crime. [ABSTRACT FROM AUTHOR]

In the case of an innocence defense, when the criminal charges are acquitted, the person is viewed as not guilty, but in the situations that Bortolotti discusses, the beliefs remain irrational, and in vast majority of cases, the harms continue to outweigh the gains. In this way, Bortolotti's notion of epistemic innocence serves as a link to a broader and pre-modern idea of rationality, making it, in Taleb's words, "Lindy-compatible" (i.e., compatible with the Lindy effect: the older an idea is, the longer it is likely to survive in the future). Bortolotti also contextualizes her discussion of epistemic innocence within larger debates about rationality. In the law, innocence defense requires a high bar, while Bortolotti is interested in keeping the bar very low with regards to epistemic benefits. [Extracted from the article]

Using critical race theory (CRT), this article examines the ideology of privilege within White supremacy thought permeating the Administrative State. Through systems of privilege, the experiences of disadvantaged groups are masked by dominant narratives and used to validate status quo perspectives. To this point, privilege fuels the oppressive state of racial dominance, in American society, and is legitimized through the subtle language within the administrative practice. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of preventable death among adults diagnosed with schizophrenia spectrum disorders. Fewer studies have examined suicide thoughts and behaviors among community populations of adults with psychosis symptoms. The current study examined the relationships between psychosis symptomatology, depression, and suicide ideation and plan among a sample of adults in psychiatric emergency care. An Electronic Medical Record Search Engine was used to obtain data from Psychiatric Emergency Services (PES) of an academic healthcare system in the United States. Patients included 712 adults who presented to PES from 2013 to 2020 with one or more symptom of psychosis and either suicide ideation or a recent suicide attempt. Data were examined in SPSS27 using logistic regressions. Patients were twice as likely to experience suicidal ideation when hallucinations were present and eight times more likely when depression was present. Also, patients were twice as likely to have a suicide plan when hallucinations were present and three-times more likely when depression was present. Delusions did not significantly relate to suicide ideation or plan. Study findings suggest the importance of incorporating positive symptom evaluations into suicide risk assessments and the formulation of risk among patients with psychosis symptoms. [ABSTRACT FROM AUTHOR]

This commentary deals with the issue of alternative food and drink from the perspective of my work on such topics as disenchantment, enchantment, McDonaldization, nothing, prosumption, rationalisation and something. The conclusion is that the interests of, and pressure from, large-scale profit-making businesses will, to a large extent, undermine efforts to produce ‘true’ alternatives in food and drink. Those alternatives will survive on the margins in the developed world, but they will be more prevalent in the less developed world which is less attractive to those businesses, and therefore, the alternatives will be allowed to survive there. [ABSTRACT FROM PUBLISHER]

This article introduces to the dermatology provider two medications for the treatment of tardive dyskinesia (TD), which were the first medications approved by the US FDA specifically for the treatment of TD. In addition to describing these two new medications, this article will also provide a focused review of the pathogenesis of TD, as well as non-FDA-approved treatments, which have been tried prior to the advent of these medications. A PubMed search was conducted and articles were reviewed by the senior authors and included if they were relevant for dermatologists regarding etiology, symptoms, risk, and treatment of TD. One of the most widely accepted explanations of TD involves the concept of 'dopamine receptor hypersensitivity state.' There are several other less well substantiated proposed pathogenic pathways of TD. The clinical manifestation is characterized by involuntary movements. Prevention includes switching to a 2nd generation agent or using the lowest dose possible for the shortest amount of time. Two new FDA-approved medications for TD are also discussed and reviewed. TD now has FDA-approved medications for treatment. Now, there is even more reason for the dermatologist to have increased confidence when treating delusions of parasitosis (DOP) with antipsychotic agents. [ABSTRACT FROM AUTHOR]

Delusional mood is a well-recognized psychological state, often present in the prodromal stage of schizophrenia. Various phenomenological psychopathologists have proposed that delusional mood may not only precede but also contribute to the later formation of schizophrenic delusion. Hence, understanding experiential abnormalities involved with the delusional mood have been considered central for the understanding of schizophrenic delusion. Ranging from traditional and contemporary phenomenological and neurobiological accounts, it has been often mentioned that the peculiar affective saliency of the world experience may underpin the emergence of delusional mood. In this paper, I employ Edmund Husserl's account of affection and affective syntheses to clarify the nature of such an experience and illuminate how this experiential abnormality contributes to the emergence of the delusional mood. I conclude by relating the phenomenological account I advance here with a neurobiological account of aberrant salience hypothesis and chart out a possible way toward mutual enlightenment for both approaches. [ABSTRACT FROM AUTHOR]

The prevalence and associated factors related to psychotic symptoms in older adults are understudied. The objectives were to assess the prevalence, incidence and factors associated with psychotic symptoms in a representative Greek sample of community living older adults. The sample includes n = 1,904 residents of the cities of Larissa and Maroussi in Greece participating in the Hellenic Longitudinal Investigation of Aging and Diet study with available data at baseline and n = 947 individuals at the 3-year follow-up. Past-month presence of delusions and hallucinations was assessed on the grounds of the 17 symptoms of the Columbia University Scale for Psychopathology in Alzheimer's Disease and 14 symptoms of the Neuropsychiatric Inventory Questionnaire. A comprehensive neuropsychological assessment for probable diagnosis of dementia and physical comorbidity was carried out by neurologists. Penalized logistic regression analyses were used to assess the socio-economic and clinical factors associated with psychotic symptoms. Past-month prevalence of psychotic symptoms was 1.9% and 1.0% when excluding cases of dementia. The prevalence of any delusion and hallucination was 0.8% and 0.3% when excluding dementia. The incidence of psychotic symptoms without dementia was 1.3%. Recent widows and farmers/breeders/craftsmen, versus public servants/teachers/executives, had both six times the odds of experiencing psychotic symptoms without dementia. Hearing impairment and the number of health conditions also increased the odds while increased age was protective. Psychotic symptoms unrelated to dementia constitute a considerable mental health problem in old age. Paranoid delusions were the most prevalent. Socio-economic and health status factors are significant predictors of psychotic symptoms. [ABSTRACT FROM AUTHOR]

This study describes the person-centered experience and impact of symptoms and the treatment needs of dementia-related psychosis (DRP) from a patient and care partner perspective. Qualitative interviews and a quantitative survey were used to collect patient experience data from persons with DRP or their care partners. Sixteen participants (1 person with DRP, 15 care partners) completed the qualitative interview; 212 participants (26 persons with DRP, 186 care partners) completed the quantitative survey. The most commonly reported symptoms were visual hallucinations, auditory hallucinations, persecutory delusions, and distortion of senses. The most common impacts were difficulty differentiating what is real from what is not real, increased anxiety, and effects on personal relationships. Current treatments were less than moderately helpful, and the ability to distinguish what is real from what is not real and overall symptom improvement were described as the most important benefits of an ideal treatment. Patient experience data provide insights into urgent therapeutic needs of patients by describing the nature, frequency, and severity of symptoms and the impacts they have on individuals' lives. Patient experience data demonstrate an unmet need for treatments to reduce the symptoms and impacts of DRP. [ABSTRACT FROM AUTHOR]

Objectives: We examined the clinicodemographic and psychosocial factors that relate to the presentation and severity of delusions of theft among female patients with amnestic mild cognitive impairment (a-MCI) and Alzheimer's disease (AD). Methods: We enrolled a total of 177 female patients with a-MCI or AD, of whom 40 presented with delusions of theft. We compared the differences in clinicodemographic and psychosocial factors of the 40 patients (delusions of theft group) with 50 age- and Mini-Mental State Examination (MMSE)-matched controls without delusions (control group). Furthermore, we identified the factors associated with the presentation of delusions of theft using a general linear model (GLM). The severity of delusions of theft was calculated using the Neuropsychiatric Inventory Questionnaire, and correlations between the clinicodemographic and psychosocial factors were examined. Results: Between the two groups, the delusions of theft group had lower scores on the Physical Self-Maintenance Scale and instrumental activities of daily living (IADL) and higher scores on the Japanese version of the Zarit Caregiver Burden Interview (ZBI-J) than the control group. GLM analysis revealed that the IADL score was related to the presentation of delusions of theft. The severity of delusions of theft correlated with the MMSE and the ZBI-J scores in the delusions of theft group. Conclusions: The two groups had several differences regarding clinicodemographic and psychosocial factors. Furthermore, lower IADL scores were related to symptom presentation. Symptom severity correlated with cognitive functioning and caregiver burden. Clinical Implications: In the determination of treatment or care, differences in these factors should be considered. [ABSTRACT FROM AUTHOR]