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Psychoanalytic aspects of the fitness for duty psychological evaluation 1
Published in Jed A. Yalof, Anthony D. Bram, Psychoanalytic Assessment Applications for Different Settings, 2020
It is known that Delusional Disorder can occur in people who otherwise function in an acceptable manner. This was the case with Dr. Ether. Dr. Ether showed no history or evidence of other psychotic disorders, including bipolar disorder, schizophrenia, schizotypal personality disorder, neurocognitive disorders, and obsessive-compulsive disorder—all of which need to be ruled out for Delusional Disorder. Because of his encapsulated but persistent and apparently unfounded belief that his ex-spouse continued to love him, despite evidence to the contrary and upon which he acted out, suggested erotomania. He was diagnosed with Persecutory type because he believed his ex-wife’s previous husband, having falsified his death and assumed a new identity, was conspiring against both him and his ex-wife. His Alcohol Use Disorder was viewed as in sustained full remission, supported by a robust recovery program.
Disorders
Published in Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson, Pocket Prescriber Psychiatry, 2019
Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson
Some patients with FEP do not ultimately fit a diagnosis of a schizophreniform illness. For some, this is because they are suffering from an organic psychosis, which may be due to drugs, epilepsy, neurodegenerative disease or many other medical disorders. Delusional disorder is characterised by a persistent delusion without other prominent features of schizophrenia (inappropriate affect, hallucinations, thought disorder). Psychosis can also be a feature of mania and severe depression; these affective psychoses are covered in the sections on BPAD and Depression.
Clinical Theory and Skills EMIs
Published in Michael Reilly, Bangaru Raju, Extended Matching Items for the MRCPsych Part 1, 2018
Acute polymorphic psychotic disorder.Acute schizophrenia-like disorder.Delusional disorder.Induced delusional disorder.Paranoid schizophrenia.Schizoaffective disorder, depressive typeSchizoaffective disorder, manic type.Schizoid personality disorder.Schizotypal disorder.Simple schizophrenia.
An atypical progression of schizophrenia in an elderly woman
Published in Baylor University Medical Center Proceedings, 2021
Rukan Huq, Farhan Mithani, Stav Cullum, Ranjit Chacko
Since her formal diagnosis of schizophrenia at the age of 35, the patient has been relatively high functioning. The year before presentation she joined a weight loss and exercise program and intentionally lost 56 pounds. She lived alone and required little supervision with activities of daily living. However, she experienced several episodes of visual hallucinations, delusional parasitosis, and paranoid delusions associated with medication noncompliance intervals. Her most recent hospitalization resulted from a self-prescribed drug holiday where her delusional parasitosis intensified from flowers to dragons on her skin, leading to self-harming behaviors. At this time, she was only taking olanzapine, and her Montreal Cognitive Assessment score was 27. Differential diagnoses of delusional disorder, delirium, and schizoaffective disorder were considered, but due to lack of medical comorbidities and clinical findings consistent with these other differentials, schizophrenia was diagnosed.
‘Come share my world’ of ‘madness’: a systematic review of clinical, diagnostic and therapeutic aspects of folie à deux
Published in International Review of Psychiatry, 2020
Giulia Menculini, Pierfrancesco Maria Balducci, Patrizia Moretti, Alfonso Tortorella
Noteworthy, a high rate of comorbid psychopathology was evidenced in the secondaries and does not account for the definition of a delusional disorder transmitted to a healthy individual. In this context exposure to the primary could act as a psychosocial trigger for a ‘transient psychotic phenomenon’ in a subject who would have developed a psychotic episode in any case. The possibility of psychiatric comorbidity should be reconsidered in illness criteria, since it is absent in the original description (Patel et al., 2004). The broadening of criteria for defining shared psychotic disorder is also suggested by a certain variability in the diagnosis of the primary, with described cases of mood disorders as the main illness of inducers in several reports (Arnone et al., 2006; Kraya & Patrick, 1997; Vigo et al., 2019).
Mental Disorders, Personality Traits, and Grievance-Fueled Targeted Violence: The Evidence Base and Implications for Research and Practice
Published in Journal of Personality Assessment, 2018
Emily Corner, Paul Gill, Ronald Schouten, Frank Farnham
Early results of a pilot project in the United Kingdom involving police and mental health services, working together to liaise with mental health services and divert vulnerable individuals, suggest a significant minority of referrals had a diagnosed psychotic illness and a significant proportion had been known to mental health services but were not currently receiving a service. Irrespective of the individuals' pronounced ideology, one principal concern is to protect people and help them to alter their behavior to reduce the possibility of grievance-fueled violence and associated risks. In this regard, it is relevant that those with grievance-fueled violence have higher rates of psychosis, predominantly delusional disorder. In a jurisdiction where compulsory treatment can be applied for the sake of a person's health, rather than solely on the grounds of dangerousness, treating the mental illness and introducing individuals into a care pathway serves both the interests of public health and of public safety, without it being necessary to attempt to predict which individuals would have gone on to commit violent acts, if they had not been treated. This follows a population model, already used with the fixated in the United Kingdom, in which attention to reducing risk factors might prevent harmful events, without knowing which cases would have gone on, in the absence of intervention, to act violently. This model is based on prevention, not prediction. The medical analogy is with coronary heart disease, where treatment of risk factors in a population (e.g., high cholesterol, smoking, hypertension) will lower the risk of heart attacks without it being necessary to predict exactly which individuals would have gone on to have them, if treatment had not been provided. Practical attention to the range of risk factors in a given population, or subpopulation, might be a way forward in preventing lone actor violence, without it being necessary to complete the difficult and complex task of disaggregating the relative importance of each factor in a given case.