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Paper 4: Answers
Published in Sabina Burza, Beata Mougey, Srinivas Perecherla, Nakul Talwar, Practice Examination Papers for the MRCPsych Part 1, 2018
Sabina Burza, Beata Mougey, Srinivas Perecherla, Nakul Talwar
False. Formication, seen in cocaine intoxication and alcohol withdrawal, is a type of superficial tactile hallucination in which there is a sensation of tiny animals or insects crawling over the body or just underneath the skin. It is often associated with delusions of infestation. (13: p. 107)
Neuroacupuncture for Central Nervous System Disorders
Published in Len Wisneski, The Scientific Basis of Integrative Health, 2017
Len Wisneski, Jason Jishun Hao, Linda Lingzhi Hao
Restless legs syndrome is a neurological movement disorder characterized by abnormal sensations in the legs, and an uncontrollable urge to move them in order to relieve these unpleasant feelings. The sensations are often described as paresthesia, pruritus, discomfort, or a sensation similar to insects crawling under the skin (formication).
MRCPsych Paper A1 Mock Examination 5: Answers
Published in Melvyn WB Zhang, Cyrus SH Ho, Roger Ho, Ian H Treasaden, Basant K Puri, Get Through, 2016
Melvyn WB Zhang, Cyrus SH Ho, Roger CM Ho, Ian H Treasaden, Basant K Puri
Explanation: Formication is the sensation of insects crawling under the skin and is a form of haptic (tactile) hallucination. Haptic hallucinations are superficial sensations on or under the skin in the absence of a real stimulus. Option (e), visceral hallucination, on the other hand, is a deep sensation involving inner organs without any real stimuli.
The Koo-Brownstone staging system as a tool to assist in the management of patients with a possible diagnosis of dermatological delusions: an experts suggestion
Published in Journal of Dermatological Treatment, 2022
The first stage is ‘Formication Only’, which means that there is no ideation of parasitosis and the patient only complains of crawling, biting, stinging sensations. The second stage is ‘Overvalued Ideation’ where these patients become more worried about the erroneous ideation of a parasitic infestation but still have enough insight to be often apologetic that they are so preoccupied with these symptoms. The third stage is ‘Pre-Delusional’, which is defined as a patient who initially appears delusional but, after developing a strong rapport with the provider, proves able to consider alternative explanations for their symptoms. The fourth stage is ‘Delusional’ which is where the patient is not open-minded at all and cannot tolerate alternative explanations. Many delusional patients are still willing to consider pharmacotherapy, if it is presented as a ‘trial and error’ approach and is deliberately not linked to any psychiatric terminology. The fifth stage is ‘Terminal Delusion’. These patients are only interested in the validation of their parasitic ideations and is also almost impossible to get them to accept pharmacotherapy unless the medication kills their ‘parasites’.
Choosing the appropriate pharmacotherapy for Morgellons disease: an expert perspective
Published in Expert Opinion on Pharmacotherapy, 2022
Esther A. Balogh, Katherine G. Beuerlein, Steven R. Feldman
Because many prescription drugs and illicit substances, such as stimulants used in ADHD management and cocaine, can cause or worsen feelings of formication, physicians should consider screening for and encourage reduction of stimulants and other psychoactive substances in their MD patients. In a study of 147 patients with DI by the Mayo Clinic, 24% of the patients had a history of illicit drug use, while 8 patients were taking prescribed medications that may bring about delusional states such as amphetamine and dextroamphetamine, methylphenidate, ciprofloxacin, and levodopa [21]. In the CDC’s pivotal 2012 study on MD’s etiology, in a case series of 41 patients, 24% had a past history of drug or alcohol abuse, and 50% of the patients had at least one drug (amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, opiates, or propoxyphene) detected through hair sampling. High rates of drug abuse in this patient population have also been our clinical experience [2]. Because discussion of the use of illicit substances with patients and its potential contribution to their delusional disorder can be a sensitive topic, one potential route for discussion could emphasize that certain drugs make some patients a ‘petri dish’ for infestation and that reducing the use of these drugs may be necessary to ‘get the infestation under control.’ The complexity of managing patients who are on multiple drugs with psychoactive effects may be another reason to involve a psychiatrist in the management of these patients and their treatment regimens.
Emotion regulation processes and middle-aged Japanese women’s health
Published in Climacteric, 2021
K. Hashiguchi, S. Yoshikawa, T. Muto
The Kupperman Kohnenki Shogai Index (KKSI)24 is a validated version of the Kupperman Index25 modified for Japanese women. It includes 17 items comprising 11 categories: vasomotor, paresthesia, insomnia, nervousness, melancholia, vertigo, weakness, arthralgia and myalgia, headaches, palpitations, and formication. Each item is rated on a 5-point scale, from 0 (none) to 4 (severe). Of all categories, the severity grade of vasomotor is given the greatest weight, namely 4; paresthesia, insomnia, and nervousness are weighted with a factor of 2; while the remaining symptoms have a factor of 1. Possible scores range from 0 to 51 points. Higher scores indicate higher menopausal symptoms. In the current study, the KKSI demonstrated good internal consistency (Cronbach’s α = 0.92).