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Case-Based Differential Diagnostic Mental Health Evaluation for Adults
Published in Kunsook S. Bernstein, Robert Kaplan, Psychiatric Mental Health Assessment and Diagnosis of Adults for Advanced Practice Mental Health Nurses, 2023
Kunsook S. Bernstein, Robert Kaplan
The following are guidelines to assist the APMHN to effectively assess schizophrenic clients who exhibit one or both of the two most common major positive symptoms of schizophrenia: hallucinations (perceptual disturbances) and delusions (thought disturbances).Assessment of Hallucinations
Movement disorders
Published in Henry J. Woodford, Essential Geriatrics, 2022
The assessment of people with suspected movement disorders requires a careful history plus neurological, including gait and cognitive, examination. Medication history may reveal potentially causative agents (see page 190). Previous stroke and vascular risk factors may suggest a vascular aetiology. Some conditions have a genetic component and a family history should be sought. Movement disorders are commonly associated with depression and cognitive impairment and so screening for these problems is appropriate. Enquiry should be made about related complications, including bladder and bowel problems. These may be part of an autonomic disturbance, which could also include postural hypotension, urinary incontinence and male impotence. Disturbed sleep patterns, including rapid eye movement (REM) sleep disorder, may be associated. Hallucinations can be a feature of some movement disorders or occur secondary to medications. The timing of the occurrence of gait problems and falls within the illness can give clues to the diagnosis. Other symptoms and signs may be detected according to the suspected condition, as discussed later.
Changes in behaviour and emotions
Published in Marjolein de Vugt, Janet Carter, Understanding Young Onset Dementia, 2021
Joany Millenaar, Marjolein de Vugt
NPS related to psychosis include hallucinations, delusions and nighttime disturbances. A hallucination is an experience of something that is not really there. Hallucinations can occur for all the senses, though visual hallucinations (seeing things that are not really there) are the most common type of hallucination experienced by people with dementia. Visual hallucinations can be simple as seeing flashing lights or colours or more complex as seeing animals, people or bizarre situations. Someone with delusions is convinced of certain ideas that are not based on reality. The person with dementia often starts making accusations against the people around them (paranoia). For example, they think that they are robbed and accuse relatives of stealing their lost belongings. They may also accuse their partner of being unfaithful or of being an impostor. These false accusations can be hurtful and distressing. Hallucinations and delusions seem to be less common in people with YOD compared to people with late onset dementia (LOD) (van Vliet et al., 2012).
Bilateral Vision Loss and Visual Hallucinations in Subacute Sclerosing Panencephalitis: A Case Report
Published in Neuro-Ophthalmology, 2023
Ravi Uniyal, Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Shweta Pandey, Imran Rizvi, Amita Jain, Nidhi Tejan, Rupesh Singh kirar
This patient also developed visual hallucinations. Simple visual hallucinations occur due to hyperactivity or irritation of the primary visual cortex, while complex visual hallucinations can occur due to the involvement of visual association cortices.5 Visual hallucinations can be associated with various psychiatric, neurologic, and ophthalmologic conditions. In patients with severe vision loss, visual deafferentation may cause cortical release phenomenon, in the form of visual hallucinations, which is typically known as Charles Bonnet syndrome (CBS).5 CBS can be associated with vision loss due to any cause. Visual hallucinations in CBS tend to involve people, animals, faces, and even inanimate objects.5 The appearance of visual hallucinations in this patient can be explained by CBS secondary to vision loss; however, the occurrence of seizures suggests that brain parenchyma per se is also contributory.
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2022
David A. Bellows, John J. Chen, Hui-Chen Cheng, Panitha Jindahra, Peter W. MacIntosh, Collin McClelland, Michael S. Vaphiades, Xiaojun Zhang
Visual hallucinations are frequently encountered in clinical practice. It is critical for neurologists, particularly those in training, to develop a systematic approach for evaluating patients presenting with such unique and often perplexing symptoms. Here, the authors present the case of a 48-year-old woman who developed vivid visual hallucinations after receiving nivolumab, an immune checkpoint inhibitor (ICI), for melanoma. The authors discuss the broad differential diagnosis for visual hallucinations and how the history and examination can guide one’s evaluation. This patient was diagnosed with ICI-associated optic neuritis and Charles Bonnet syndrome (CBS). Highlights of the paper are the table on the differential diagnosis of visual hallucinations and the fact that the patient in question had relativity good central visual acuity of 20/50 with her right eye and 20/25 with her left eye but still experienced CBS. Also of interest is the discussion of the optic neuritis work-up and ICI-associated optic neuritis.
Psychological symptoms and intensity of partner violence: A study of women attending an anti-violence center in Italy
Published in Health Care for Women International, 2022
Patrizia Romito, Maria-Chiara Feresin, Federica Bastiani, Marie-Josèphe Saurel-Cubizolles
Other researchers have found links between violence and PTSD (including nightmares and panic attacks) (Coker et al., 2002; Mechanic et al., 2008), with a dose–response effect (Basile et al., 2004; Chandra et al., 2009; Ferrari et al., 2014), but only a few researchers considered psychotic symptoms. Boyda et al. (2014) and Shevlin et al. (2013) found strong associations between some types of IPV and auditory hallucinations. We believe that from a clinical perspective, having data on distinct symptoms is useful to help women recognize the effect of the context of life on their psychological wellbeing. Auditory hallucinations can be alarming for those who experience them. Out-reach messages from authoritative sources such as the British National Health Service present hallucinations as a sign of mental illness, without mentioning the possible association with aggression, threats, manipulation, or constant fear occurring in real life (NHS, 2019). For these reasons, we think that the links between this symptom and the intensity of partner violence should be discussed with women victims of IPV and with the professionals who work with them.