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Making readers care
Published in Rebecca A. Bitenc, Reconsidering Dementia Narratives, 2019
However, even this reversal of norms and normality undergoes a further twist in the house mother’s final address. Her discourse is full of contradictions. It exposes her cruelty, sardonic nature, and apparent megalomania. And yet, in the fashion of the court jester, the fool who also speaks truth, Johnson makes her a mouthpiece for criticising care home environments that are, in other ways, worse than or at least as bad as the one she manages. In contrast to the house mother’s theatrically and ‘over-the-top’ immoral acts of ‘care,’ the deplorable conditions in other institutions, she describes, seem plausible, even likely. At once self-absorbed and selfish, the house mother at times seems to show a real interest in her charges. It thus becomes difficult not to be at least partially persuaded by her argument. She draws an image of mental homes in which people are ‘put away … simply because they are old’ and where they are ‘stripped of their spectacles, false teeth/ everything personal to them’ (198). Her own ‘care,’ by contrast, provides her patients with ‘constant occupation, and/most important, a framework within which to establish/ – indeed, to possess – their own special personalities’ (198). However, her means of allowing these personalities expression consist in nurturing petty rivalries among the residents, or giving them reasons to complain.
Historical Terminology
Published in Michael Farrell, Psychosis Under Discussion, 2017
The expression ‘mania’ has been linked to many prefixes to describe the form that the frenzied interest or activity takes. ‘Monomania’ concerns a driving obsession for one subject, ‘mono’ being Greek for ‘single’. ‘Nymphomania’, deriving from the Greek ‘nymph’ meaning ‘bride’, refers to morbid and uncontrollable female sexual desire. From the Greek ‘dypsa’, meaning ‘thirst’, comes the expression ‘dypsomaniac’, someone craving alcohol. ‘Megalomania’ refers to delusions of grandeur. ‘Erotomania’ signifies a morbid feeling of desperate love. In ‘micromania’ (the Greek ‘micros’ means ‘small’), the individual is convinced that he or she, or part of him- or herself, is reduced in size. ‘Pyromania’, from ‘pyro’ meaning ‘fire’, refers to manic fire setting.
Neuropsychiatry in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
Placed in historical context, psychiatry and neurology have always been sinuously intertwined. Why would diseases of the mind differ from diseases of the brain? That was clearly obsessing many pioneering physicians in these specialties—and honestly, it still is. Attempts to establish a biologic foundation for psychiatry (scouting for abnormal neuroimaging and other biomarkers) continue to this day and, at first glance, would be far preferable to explaining psychiatric disorders fallaciously as a consequence of motherhood deprivation or some other traumatic event.1 The so-called “organic causes” of psychiatric disease (e.g., brain injury-induced mental disorders) obscured the clear dividing line between the two specialties because, for example, syphilis could invade the brain and spine, presenting with both paralysis and insanity. To be sure, there are at least two stories. One is the history of psychiatry seen through neurosyphilis (a disease of the brain eventually causing megalomania), and the other is the story of hysteria (a disease of the mind causing paralysis, blindness, and abnormal movements).2 At least in the United States, much of this dichotomy was a consequence of psychiatry ceding to psychoanalysis after Freud came on the scene. But there is no clear separation between psychodynamic principles explaining neurosis and neurobiology explaining psychosis, and splitting neurology and psychiatry is sort of artificial. Psychiatrists have understandably struggled with the diagnosis and classification of mental illness because of their inability to confirm anatomical abnormalities with MRI and autopsy. On the other hand, abnormally complex emotions cannot easily be localized in the brain. Some psychiatrists are convinced that much of what we see in the major psychosis entities is a chemical imbalance rather than a structural defect. Our understanding, however, is more primitive and inferential (drug X works, so it must be this neurotransmitter). A consequence of this reasoning could be that drugs are prescribed for dubious indications (i.e., something many of us would consider within the margins of a normal adaptive response). Psychiatry cannot be poles apart from neurology; this has become more apparent in the modern age, where we see well-known psychiatric disorders, such as malignant catatonic states, caused in some previously mentally healthy patients by a neuroimmunologic disorder that responds to immunosuppressive agents.
Perspectives on Recovery-Oriented Care in Mental Health Practices: Health Professionals Experiences
Published in Issues in Mental Health Nursing, 2023
Kim Jørgensen,, Mathias Søren Hansen,, Trine Groth,, Morten Hansen, Bengt Karlsson,
Not all users experience themselves as ill but experience, for example, pressure from relatives who wanted them admitted. It is predominantly experienced as a well-known challenge that many users do not see a purpose for hospitalisation and are not motivated to be admitted. This makes it more difficult to collaborate on the treatment and to motivate the user to participate in treatment and activities.I had a young man(patient) who was hospitalised for the first time. He had never been ill before but displayed very severe megalomaniac delusions. The family was shocked but involved. He was incredibly angry upon admission and did not want contact with family or any treatment, either medical or hospitalisation. There was a lot of coercion involved in terms of treatment and deprivation of liberty, but we achieved a very good relationship with him and re-established contact with the family (nurse).
The de Clérambault syndrome: more than just a delusional disorder?
Published in International Review of Psychiatry, 2020
Gaia Sampogna, Francesca Zinno, Vincenzo Giallonardo, Mario Luciano, Valeria Del Vecchio, Andrea Fiorillo
The ancient descriptions of erotomania syndrome can be found in the works by Hippocrates, Plutarch, and Galen. In the sixteenth century, the French physician Bartholomy Pardoux (1545–1611) in the book ‘Disease of the Mind’ differentiated between ‘insane love’ (erotomania) and ‘uterine furors’ (nymphomania). In 1623, Jacques Ferrand described clinical cases of patients affected by ‘maladie d’amour’ or ‘melancholie erotique’. In the early eighteenth century, erotomania was described as a general disease caused by unrequited love, while subsequently it was considered an excessive physical love (defined as nymphomania or satyriasis). Esquirol (1838) defined erotomania as a chronic mental disorder (namely ‘monomania’) characterised by an excessive love for an object, either known or imaginary. At that time, erotomania was conceptualised as a form of ‘partial madness’, being a disease of the imagination accompanied by an error of judgement. In 1921, Kraepelin coined the term ‘paranoic megalomania’, emphasising the delusional component of erotomania.
Treatment-related transient splenial lesion of the Corpus Callosum in patients with neuropsychiatric disorders: a literature overview with a case report
Published in Expert Opinion on Drug Safety, 2020
Giovanna Cirnigliaro, Ilaria Di Bernardo, Valentina Caricasole, Eleonora Piccoli, Barbara Scaramelli, Simone Pomati, Chiara Villa, Leonardo Pantoni, Bernardo Dell’Osso
A 26-year-old patient, known to our psychiatric service for six previous hospitalizations, was transferred from a psychiatric rehabilitation community to our inpatient unit after an aggressive act against an operator. Patient’s psychopathological onset dated back to the age of 22, when he developed megalomaniac and persecutory delusions in the context of a massive and protracted cannabinoid abuse. Starting from the first hospitalization, a therapy with Olanzapine and Valproic acid was administered. Between the subsequent hospitalizations, Valproic acid was self-suspended by the patient due to side effects. In addition, Olanzapine up to the maximum dosage of 20 mg/day was ineffective in keeping the patient free from psychotic exacerbations. Thus, it was associated with Haloperidol (up to 6 mg/day). During the sixth hospitalization, Olanzapine was replaced with Lurasidone, titrated to the dosage of 120 mg/day. The patient was then transferred to a psychiatric rehabilitation community, in order to strengthen the therapeutic compliance and better control his cannabinoid addiction.