Acute-onset psychosis induced by a therapeutic dose of parenteral hyoscine butylbromide: A case report

Anticholinergic medications are frequently prescribed for gastrointestinal and genitourinary spasms. Psychosis, when present, results from anticholinergic overdose or toxicity. In the literature, anticholinergic-induced psychosis at therapeutic doses in patients with normal cognition is extremely uncommon. Here, we describe the case of a 28-year-old female who presented with auditory and visual hallucinations, stereotypy, and agitation after receiving a single intramuscular injection of 20 mg hyoscine butylbromide for dysmenorrhea. Even though it is rare for a therapeutic dose of hyoscine butylbromide to cause psychosis, clinicians should maintain a high index of suspicion and be cautious when administering or prescribing anticholinergics.

As vozes dos usuários participantes de grupos de ouvidores de vozes / Voices of users participating in voice hearing groups / Voix d'utilisateurs participant à des groupes entendeurs de voix / Las voces de los usuarios que participan en grupos de oyentes de voz

O objetivo deste artigo é investigar as vivências e possíveis efeitos da participação em grupos de Ouvidores de Vozes. Trata-se de um estudo qualitativo com participantes acima de 18 anos, que concordaram em fazer parte do estudo e frequentaram os grupos por um período mínimo de três meses. Foram realizadas 14 entrevistas até obtenção de saturação em grupos de Centros de Atenção Psicossocial, em seguida transcritas e analisadas usando a hermenêutica Gadameriana. A análise evidenciou cinco núcleos argumentais: a chegada no grupo; modo de funcionamento; uso de medicamentos; sentidos e efeitos. Demonstrou-se que os grupos podem ser uma das estratégias de cuidado e recuperação dos indivíduos, permitindo com que as suas experiências sejam reconhecidas e ressignificadas, promovendo, além da melhora clínica, acolhimento, compartilhamento entre pares e socialização.

This qualitative study investigates the experiences and possible effects of taking part in Voice-hearing Groups. Participants over the age of 18 who agreed to participate and attended the groups for at least 3 months were included in the research. Fourteen interviews were carried out in groups at Psychosocial Support Centers until saturation, and then transcribed and analyzed using Gadamerian hermeneutics. The analysis highlighted five argument cores: arrival in the group; mode of operation; use of medication; and meanings and effects. Results shown that these groups can be a strategy for the care and recovery of individuals, allowing their experiences to be recognized and reframed, promoting clinical improvement, user embracement, sharing among peers, and socialization.

Cette étude qualitative examine les expériences vécues et les effets possibles de la participation à des groupes d'entendeurs de voix. Les participants âgés de plus de 18 ans qui ont accepté de participer et ont participé aux groupes pendant au moins trois mois. Quatorze entretiens ont été réalisés dans des centres de soutien psychosocial jusqu'à saturation, puis transcrits et analysés selon l'herméneutique gadamérienne. L'analyse a mise en évidence cinq noyaux thématiques: l'arrivée dans le groupe; le mode de fonctionnement; l'utilisation de médicaments; les significations et les effets. Les résults montrent que ces groupes peuvent constituer une stratégie de soins et de rétablissement pour les individus, permettant de reconnaître et de recadrer leurs expériences, favorisant l'amélioration clinique, l'adhésion des utilisateurs, le partage entre pairs et la socialisation.

El objetivo de este artículo es identificar las experiencias y los posibles efectos de la participación en los Grupos de Oyentes de Voces. Se trata de un estudio cualitativo con participantes mayores de 18 años, que aceptaron participar del estudio y asistieron al grupo durante al menos tres meses. Se realizaron 14 entrevistas hasta que se obtuvo la saturación en grupos de Centros de Apoyo Psicosocial, luego se las transcribieron y analizaron utilizando la hermenéutica gadameriana. El análisis mostró cinco focos de discusión: la llegada al grupo; el modo operativo; el uso de medicamentos; y los sentidos y efectos. En cuanto a los resultados, se ha demostrado que los grupos pueden ser una de las estrategias de atención y recuperación de los individuos, permitiendo que sus experiencias sean reconocidas y replanteadas, y promoviendo la acogida del usuario, el intercambio entre pares y la socialización, además de la mejora clínica.

A Case of Neuromyelitis Optica Spectrum Disorder with Visual Hallucination-induced Severe Delirium / 日本プライマリ・ケア連合学会誌

Objective: Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disease of the central nervous system characterized by optic neuritis and myelitis. NMOSD is more prevalent in the elderly than multiple sclerosis. In particular, optic neuritis of NMOSD is common in the elderly.Methods and Results: We report an 82-year-old female patient with no medical history who presented with optic neuritis as the first attack of NMOSD. On day X−15, she developed horizontal hemianopia and was referred to our department. On admission, her visual acuity was hand motion. Cerebrospinal fluid suggested pleocytosis. Magnetic resonance imaging revealed a hyper-intense lesion on the optic chiasm and optic tract. Steroid pulse therapy was performed, but from the night, delirium with visual hallucinations developed. She refused drug administration, removed the intravenous administration route, and was unable to continue in-hospital treatment.Conclusion: NMOSD often develops in the elderly with optic neuritis, and in addition to steroid therapy, plasma exchange or immunoglobulin therapy is expected to improve the prognosis. However, in our case, treatment was discontinued due to marked delirium accompanied by visual hallucinations. Visual hallucinations are more likely to occur in elderly patients with visual impairment, and clinicians should be careful and manage hallucination-associated delirium.

Consideraciones sobre las condiciones neuropsiquiátricas del Quijote de la Mancha / Considerations about the Neuropsychiatry Conditions of Quixote of La Mancha

RESUMEN Don Quijote de la Mancha, el pintoresco personaje creado por Miguel de Cervantes Saavedra en su obra inmortal El Ingenioso Hidalgo Don Quijote de la Mancha, presenta varias condiciones neuropsiquiátricas que incluyen tremor, trastornos del sueño, síntomas neuropsiquiátricos, síncope, trastornos de la percepción y traumatismo craneoencefálico. A lo largo de la obra, se presentan episodios en los que se hacen evidentes los diferentes trastornos mencionados. El artículo hace un recuento de ellos a través de la novela y un análisis a la luz de los conocimientos actuales sobre dichas condiciones.

ABSTRACT Don Quixote of La Mancha, the picturesque character created by Miguel de Cervantes Saavedra in his immortal book The Ingenious Nobleman Sir Quixote of La Mancha, presents several neuropsychiatric conditions, including tremor, sleep disturbances, neuropsychiatric symptoms, syncope, perception disorders and traumatic brain injury. Throughout the masterpiece, there are episodes where the aforementioned disorders are evident. This paper makes a list of them and analyses them in the light of the current knowledge of those conditions.

Hearing voices: From the Experience Qualification to the Possibility of Care / Escutar (as) Vozes: Da Qualificação da Experiência à Possibilidade de Cuidado

Abstract This article aimed to analyze hearing voices experiences in patients of a Psychosocial Care Center. In this regard, ten people were interviewed. The qualitative method was used, with content analysis. Four categories were chosen: "origin" of voices, phenomenology of voices, coping strategies, and family support. Hallucinatory experiences have emerged in contexts of violence and isolation. Topographic variables of the voices indicate possibilities of understanding the phenomenon. The movement is a basic condition to deal with the experiences. Family support is key to cope with difficulties. It is necessary to qualify the auditory hallucination as a meaningful experience, which must be respected in any intervention that intends care.

Resumo Este artigo teve como objetivo analisar experiências de audição de vozes de pacientes de um Centro de Atenção Psicossocial. Para isso, foram entrevistadas dez pessoas. Foi utilizado o método qualitativo, com análise de conteúdo. Foram eleitas quatro categorias: "origem" das vozes, fenomenologia das vozes, estratégias de lida, e suporte familiar. Observou-se que as vivências alucinatórias surgiram em meio a contextos de violência e isolamento. Variáveis topográficas que constituem as vozes indicam possibilidades de compreender o fenômeno. Movimentar-se apresentou-se como condição básica para a lida com as experiências. O suporte familiar mostrou-se essencial para o enfrentamento das dificuldades. Conclui-se que é necessária uma qualificação da alucinação auditiva como experiência plena de sentido, a qual deve ser respeitada em qualquer intervenção que se proponha ao cuidado.

Screening for Charles Bonnet syndrome: Should the definition be reconsidered?

Purpose: Charles Bonnet syndrome (CBS) is a condition in which individuals with visual impairment (VI) and with no cognitive deficits experience visual hallucinations, typically with no other sensory hallucinations. Although few isolated case reports of CBS from India have been published, the prevalence for CBS in India is largely unknown. The primary aim of this study was to estimate CBS prevalence in patients with vision impairment visiting a tertiary eye care center. Methods: The study was conducted in two phases. In phase 1, patients with VI, age ?40 years with presenting visual acuity worse than 20/63 were enrolled. In phase 2, patients with presenting visual acuity worse than 20/63 and/or with binocular visual field loss, age ?18 years were recruited. A CBS survey was administered only to those who passed a screening test for cognition impairment. Results: A total of 218 patients were screened (phase 1 = 113 and phase 2 = 105). Two-hundred ten patients (mean age ± standard deviation = 49.2 ± 17.3 years, males = 139) were found eligible to complete the CBS survey. Fourteen patients were found to have visual hallucinations. In addition, three other patients had visual hallucinations with associated auditory input to the visual imagery. All patients had complete insight about their hallucinations. Conclusion: Depending on the inclusion criteria, we found the prevalence for CBS in patients with VI to vary between 6.7% to 8.1% (if including patients with auditory input). More investigation is needed to assess the associated role of other sensory inputs (e.g. auditory) with the visual imagery experienced in CBS.

Schizophrenia and Corollary Discharge: A Neuroscientific Overview and Translational Implications

Corollary discharge mechanism refers to the suppression of sensory consequences of self-generated actions; a process that serves to distinguish between self and non-self based on discrimination of origination of action. It explains, say for example, why we cannot tickle ourselves. This review discusses how corollary discharge model is an essential neural integration mechanism central to the motor functioning of animal kingdom. In this article, research conducted in the field of corollary discharge has been reviewed to understand the neuroanatomical and neurophysiological basis of corollary discharge and gain insight into the biochemical basis of its dysfunction. This review article also explores the role of corollary discharge and its dysfunction in the presentation of symptoms of schizophrenia, discussing the findings from corollary discharge studies on schizophrenia population. Lastly, the link between schizophrenia psychopathology and corollary discharge dysfunction has been highlighted, and an attempt has been made to establish a case for correction of corollary discharge deficit in schizophrenia through neuromodulation.

Musical Hallucination Caused by Ceftazidime in a Woman with a Hearing Impairment

Musical hallucinations remain a poorly understood clinical phenomenon, possibly because these types of hallucination have multiple causes and are rarely the focus of published reports. Here, the case of a 51-year-old female patient with a hearing impairment who developed musical hallucinations during treatment with ceftazidime, a third-generation cephalosporin, is presented. She responded to the discontinuation of ceftazidime and the initiation of low-dose olanzapine treatment. Musical hallucinations associated with ceftazidime are very rare, and the mechanisms underlying its occurrence remain unknown. Further studies will be necessary to determine the pathophysiology of adverse psychiatric reactions associated with ceftazidime.

A psychotic experience during adolescence: reasoning about differential diagnosis. case report

ABSTRACT CONTEXT: The aim of the present clinical review was to illustrate the diagnostic difficulty associated with psychotic experiences during adolescence, in the light of the multiplicity of circumstances interplaying during this period. It was also intended to illustrate the observation that not all hallucinations occur in the context of a declared psychotic disorder. Case Report: The patient was a 16-year-old adolescent girl who came to the Emergency Department of Coimbra Pediatric Hospital. On admission, she displayed mood and sensory perception disorders, with a bizarre gait abnormality. A diagnosis of conversion disorder was finally suggested, in accordance with the International Classification of Diseases, 10th edition. CONCLUSIONS: Conversive hallucinations are rare in the psychiatric literature. This diagnostic hypothesis only gained consistency over a long period of follow-up within a child and adolescent psychiatry outpatient service, which was fundamental for appropriate diagnostic clarification. The authors discuss psychotic experiences that can arise from a neurotic setting and share the reasoning that was constructed in relation to the differential diagnosis. The psychogenesis and phenomenology of this young patient's conversive hallucinations and the therapeutic strategies adopted over the course of the follow-up are also discussed.

Síndrome de Bonnet na Oftalmologia: revisão de literatura / Bonnet's syndrome in ophthalmology: literature review

RESUMO Com o aumento da longevidade e da qualidade de vida da população, o número de pessoas com baixa visão pela senilidade tende a crescer. A síndrome de Charles Bonnet (SCB) foi citada no século XVIII por Bonnet, quando seu avô, psicologicamente saudável e cego por catarata, citava visões de homens, mulheres, pássaros e construções. O principal fator de risco é visão diminuída. Algumas doenças oftalmológicas podem estar envolvidas como catarata ou uso de algumas medicações. Apesar de ser conhecida, é pouco diagnosticada por neurologistas, oftalmologistas e psiquiatras. Até o momento não existe um consenso no tratamento da síndrome de Charles Bonnet.

ABSTRACT With the increase of longevity and the quality of life, the number of people with low vision due to senility tends to grow up. Charles Bonnet's syndrome (SCB) was cited in the XVIII century by Bonnet, when his grandfather blinded by cataracts and psychologically healthy cites visions of men, women, birds, and buildings. The main risk factor is low vision. Several ocular diseases may be involved as cataract or use of some medications. Although known, it is poorly diagnosed by neurologists, ophthalmologists and psychiatrists. To date there is no consensus on the treatment of Charles Bonnet's syndrome.

Sesgo atribucional en pacientes psiquiátricos, religiosos y un grupo control en el juicio de la experiencia alucinatoria: la tarea del White Christmas test / Attributional Biases in Psychiatric Patients, a Religious, and a Control Group in the Assessment of a Hallucinatory Experience: The "White Christmas Test"

RESUMEN El objetivo de este estudio es evaluar la experiencia alucinatoria auditiva en una muestra clínica de pacientes con historial psiquiátrico (p. ej., esquizofrénicos), practicantes religiosos (p. ej., cristianos evangélicos devotos) y un grupo control (sin trastorno mental y no religiosos devotos). La muestra estuvo integrada por individuos de ambos sexos. La muestra de pacientes se reclutó en 2 hospitales psiquiátricos de la Ciudad Autónoma de Buenos Aires, un grupo de practicantes religiosos (cristianos devotos) en un culto evangélico y un grupo de control no religioso y carente de síntomas psiquiátricos previos. Se aplicó el Cuestionario de Experiencias Alucinatorias y el Oxford-Liverpool Inventory Feelings and Experiences, y luego se administró el White Christmas Test, que evalúa el grado de la imaginería auditiva vívida con base en una versión del paradigma de detección de serial, en que el sujeto cree escuchar un tema musical en el trasfondo de un ruido blanco. Los pacientes mostraron mayor sesgo atribucional que los evangélicos y el grupo control, pero además los religiosos también tendieron a mostrar mayor sesgo (aunque en menor grado) que el grupo control. Además, los pacientes tendieron a mostrar más esquizotipia y experiencias alucinatorias que los evangélicos y el grupo control, pero sorprendentemente el grupo control mostró mayor esquizotipia negativa que el grupo religioso, lo cual indica que las prácticas religiosas podrían contribuir a disminuir los efectos negativos de la esquizotipia.

ABSTRACT The aim of this study was to evaluate the auditory hallucinatory experience in a clinical sample of patients with psychiatric symptoms (e.g. Schizophrenia), a religious group (eg. Christians) and a "control" group (with no mental disorder and non-religious). The sample consisted of individuals of both sexes. The patient sample was recruited in two psychiatric hospitals of Buenos Aires City, the religious from an evangelical cult, and people with no religious beliefs or previous psychiatric symptoms (control group). The Hallucinatory Experiences Questionnaire and the Oxford-Liverpool Inventory Feelings and Experiences were the measurement tools used. The White Christmas Test was also administered in order to assess the degree of vivid imagery hearing based on a version of signal detection paradigm in which the subjects think that they hear a song in the background of white noise. The results showed that patients showed greater attributional bias (compared with evangelicals and the control group), but the religious group also tended to show greater bias (although less) than the control group. In addition, patients tended to show greater schizotypal and hallucinatory experiences compared with the evangelicals and the control group, but surprisingly, the control group showed higher negative schizotypy than the religious group, which indicates that religious practices could help reduce the negative effects of schizotypy.

Aproximación al concepto de esquizofrenia: de la psiquiatría al psicoanálisis / Approach to the concept of schizophrenia: from psychiatry to psychoanalysis

El presente trabajo tiene como propósito interrogar el concepto de esquizofrenia tanto en el campo de la psiquiatría como en el del psicoanálisis. Comenzaremos revisitando a los autores predominantes y las teorizaciones de Freud y Lacan en torno de la esquizofrenia. Luego, compararemos los abordajes que se han hecho a partir de la década de los años cincuenta con los avances en psicofarmacología y en ciencias neurobiológicas. Analizaremos en particular el lugar que han tenido las alucinaciones auditivitas en el tratamiento de los distintos autores. Por último, nos interesará cotejar las diferencias y similitudes prescriptas por los distintos abordajes. Este rastreo se da en el marco de un proyecto de investigación guiado por los avances de las técnicas de neuroi- mágenes aplicadas a los fenómenos de alucinaciones auditivas en la esquizofrenia. Orientados por dichas coordenadas, arribamos a algunas conclusiones que nos permiten caracterizar el campo problemático delimitado por el cruce inter-discursivo.

The purpose of this paper is to discuss the concept of schizophrenia in the 'eld of psychiatry and psychoanalysis. We will begin by revisiting the prevailing authors and the theorizations of Freud and Lacan around schizophrenia. Then, we will compare the approaches that have been made since the decade of the 'fties with the advances in psychopharmacology and in the neurobiological sciences. We will analyze in particular the place that the auditory hallucinations have had in the treatment of the different authors. Finally, we will be interested in comparing the differences and similarities prescribed by the different approaches. This tracking occurs within the framework of a research project guided by the advances of neuroimaging techniques applied to the phenomena of auditory hallucinations in schizophrenia. Guided by these coordinates, we arrive at some conclusions that allow us to characterize the problematic 'eld delimited by the inter-discursive crossing.

Effect of olanzapine combined with repetitive transcranial magnetic stimulation in the treatment of schizophrenia with auditory hallucination / 中国基层医药

Objective To study the effect of olanzapine combined with repetitive transcranial magnetic stimulation(rTMS) in the treatment of phonism dominated schizophrenia.Methods From August 2015 to November 2016,112 patients with phonism based schizophrenia in Ningbo Kangning Hospital were selected in the research . According to the different treatment ,the patients were divided into observation group and control group ,with 56 cases in each group.The observation group was treated with olanzapine combined with rTMS chemotherapy ,the control group was treated with olanzapine.Before and after treatment,the positive and negative symptom scale ( PANSS) score, Wisconsin Card Sorting Test ( WCST) score of the two groups were observed.The clinical efficacy was compared between the two groups.Results Before treatment,there were no statistically significant differences in PANSS score and WCST score between the two groups ( all P＞0.05).After treatment for 1 week,2 weeks,4 weeks,the PANSS scores of the two groups were significantly lower than those before treatment (F＝170.710,106.028,28.530,30.328, 25.806,10.832,203.342,372.253,all P＜0.05).The PANSS scores decreased more significantly in the observation group.After treatment for 1,2,4 weeks,the scores of positive symptoms in the observation group were (25.95 ±3.50)points, (24.72 ±4.50)points and(16.51 ±2.70)points,respectively,which were significantly lower than those in the control group[(27.27 ±2.03)points,(27.80 ±5.37)points,(19.53 ±3.07)points](t＝2.441,3.290,5.528,all P＜0.05).After treatment for 1 week,2 weeks,4 weeks,the continuous response scores in the observation group were (45.62 ±5.41)points,(44.69 ±4.91) points,(35.89 ±3.30) points,respectively,which were significantly lower than those in the control group[(50.61 ±5.35)points,(46.80 ±5.14)points,(42.70 ±5.04)points](t＝4.908, 2.221,8.459,all P＜0.05).The scores of continuous errors in the observation group were (49.47 ±4.59) points, (46.53 ±6.05) points and (36.35 ±5.18) points,respectively,which were lower than those in the control group [(83.1 ±6.58)points,(81.85 ±6.70)points and (76.86 ±76.86)points](t＝31.369,29.279,38.464,all P＜0.05).After treatment for 1 week,2 weeks,the classification scores in the observation group were (4.21 ±2.03) points and (5.35 ±2.23) points,respectively,which were significantly higher than those in the control group [(3.35 ±1.24)points and (3.95 ±1.24)points] (t＝2.705,4.106,all P＜0.05).The effective rate was 91.0%in the observation group ,which was 89.2%in the control group,there was no statistically significant difference (χ2＝0.022,P＞0.05).Conclusion Olanzapine combined with rTMS is effective in the treatment of schizophrenia ,and olanzapine combined with rTMS is more effective in improving the cognitive ability of patients than olanzapine alone .

Sobre alucinação e realidade: a psicose na CID-10, DSM-IV-TR e DSM-V e o contraponto psicanalítico / À propos de l'hallucination et la réalité: la psychose dans la CID-10, DSM-IV-TR et DSM-V et la et le contrepoint psychanalytique / Acerca de la alucinación y la realidad: la psicosis en la CID-10, DSM-IV-TR y DSM-V y el contrapunto psicoanalítico / Regarding hallucination and reality: the psychosis in ICD-10, DSM-IV-TR, and DSM-V and the psychoanalytic counterpoint

A psicose é um dos poucos termos da psicopatologia clássica e da psicanálise que permanece nos sistemas classificatórios atuais, como o DSM (Manual Diagnóstico Estatístico de Transtornos Mentais) e a CID (Classificação Internacional de Doenças), o que nos dá condições para investigarmos as diversas maneiras de pensar o sofrimento psíquico. Desse modo, analisamos criticamente como o DSM-IV-TR, a sua atual edição (DSM-V) e a CID-10 definem e utilizam o termo 'psicose'. A apropriação desse conceito ampara-se em definição meramente descritiva como estratégia de recusa ao debate etiológico. A alucinação, um dos critérios para a classificação dos transtornos psicóticos, é definida partindo-se de realismo ingênuo em que a realidade é tomada objetivamente como um dado. Assim, apresentamos o contraponto psicanalítico para essa apropriação: a psicanálise aponta para a relevância da estruturação simbólica dos fenômenos perceptivos e para a realidade como construção subjetiva.

La psychose est l'un des rares termes de psychopathologie et de la psychanalyse classique qui restent dans les systèmes de classification actuels, tels que le Manuel diagnostique et statistique des troubles mentaux (DSM) et la Classification internationale des maladies (CID), qui nous donne les conditions pour enquêter sur les différents façons de penser la détresse psychologique. Ainsi, nous verrons comment le DSM-IV-TR, son numéro actuel (DSM-V) et la CID-10 définissent et utilisent le terme psychose. L'appropriation de ce concept se prend comme une définition purement descriptive de refus de stratégie de débat étiologique. L'hallucination, l'un des critères pour la classification des ' roubles psychotiques' est définie à partir d'un réalisme naïf où la réalité est prise comme une donnée objective. Ainsi, nous présentons le contrepoint psychanalytique de cette appropriation: les points psychanalyse à la pertinence de la structuration symbolique des phénomènes de perception et la réalité comme une construction subjective.

La psicosis es uno de los pocos términos de la psicopatología clásica y el psicoanálisis que permanecen en los sistemas de clasificación actuales, tales como el Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM) y la Clasificación Internacional de Enfermedades (CID), que nos da las condiciones para investigar las distintas formas de pensar sobre la angustia psicológica. Por lo tanto, se discute cómo el DSM-IV-TR, su edición actual (DSM-V) y el CID-10 definen y utilizan el término psicosis. La apropiación de este concepto mantiene a sí misma como una definición puramente descriptiva de la negativa a la estrategia de debate etiológico. La alucinación, uno de los criterios para la clasificación de los trastornos psicóticos se define empezando con un realismo ingenuo donde la realidad se toma como un hecho objetivamente. Por lo tanto, presentamos el contrapunto psicoanalítica a esa apropiación: puntos psicoanálisis a la relevancia de la estructuración simbólica de los fenómenos de percepción y la realidad como una construcción subjetiva.

Abstract Psychosis is one of the few terms in classical psychopathology and psychoanalysis that remain in the current classification systems, such as the DSM (Diagnostic and Statistical Manual of Mental Disorders) and the ICD (International Classification of Diseases), which allows to investigate the various ways of thinking about psychological distress. We discuss how the DSM-IV-TR, its current edition (DSM-V), and the ICD-10 define and use the term psychosis. The appropriation of this concept is based on a merely descriptive definition, as a refusal strategy towards etiological discussion. Hallucination, one of the criteria for the classification of psychotic disorders is defined with a naive realism in which reality is taken as an objective construction. We present the psychoanalytic counterpoint to such appropriation: psychoanalysis points to the relevance of the symbolic structuring of perceptual phenomena and reality as a subjective construction.

A Case Of Psychotic Disorder Due To Dengue Fever

This case reported highlighted psychotic disorder due to dengue fever is rare. Hence we describe a case which clearly presented with psychotic symptoms during the illness. Methods: We reported a case of psychotic disorder due to dengue fever who presented with psychotic symptoms of auditory and visual hallucination, and persecutory delusion, which had significant temporal correlation with dengue fever symptoms. There were no neurological deficits noted, no altered sensorium and cognitive impairment during the episode. He has no past and family history of mental illness and there was no evidence of encephalitis and metabolic disturbances. Results: Our case suggests that prominent psychotic symptoms can occur during an episode of dengue fever, which remitted when one recovering from dengue fever. Conclusion: We demonstrated that patients who presented with the acute onset of psychosis accompanied by symptoms of viral fever should be screened for dengue fever, particularly if the person lived in or visited the area where dengue fever is endemic. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX.

La fonction du phénomène élémentaire dans la clinique infantile / A função do fenômeno elementar na clínica infantil

Dans le présent article, nous proposons une réflexion concernant le phénomène élémentaire dans la clinique infantile. Phénomène de déréalisation, surgissement d'un bruitage à caractère xénopathique, le phénomène élémentaire ne relève pas de l'expérience du compagnon imaginaire. Partant de l'hypothèse que la violence de son émergence intempestive témoigne de l'incidence sur le corps d'une inscription élémentaire des traces de la langue maternelle, nous déplierons, à partir d'un fragment clinique, extrait d'une cure d'enfant, la spécificité clinique de ce phénomène. Écho psychique du bruissement originaire de la langue maternelle, il surgit sous forme d'hallucination à des moments critiques de la structuration du fonctionnement psychique chez l'enfant. Néanmoins, le phénomène élémentaire, en raison de son caractère furtif et de la plasticité du psychisme infantile, peut passer inaperçu.

No presente artigo, propomos uma reflexão concernente ao fenômeno elementar na clínica infantil. Fenômeno de desrealização, surgimento de um efeito sonoro de caráter xenopático, o fenômeno elementar não vem da experiência do companheiro imaginário. Partindo da hipótese de que a violência de sua emergência intempestiva é testemunho da incidência no corpo de uma inscrição elementar dos traços da língua materna, desenvolveremos, através de um fragmento clínico extraído da cura psicanalítica de criança, a especificidade clínica desse fenômeno. Eco psíquico do efeito sonoro originário da língua materna, ele surge sob forma de alucinação em momentos críticos da estruturação do funcionamento psíquico na criança. Entretanto, o fenômeno elementar, em razão de seu caráter fugidio e da plasticidade do psiquismo infantil pode passar despercebido.

Brazilian National Anthem presenting as musical hallucination: A case report with 9-year follow-up / Hino Nacional Brasileiro apresentando-se como alucinação musical: relato de caso com 9 anos de acompanhamento

ABSTRACT Musical hallucination is a type of complex auditory hallucination. Possible etiologies are deafness, psychiatric disorders such as schizophrenia, major depression, use of medication and stress, besides neurologic diseases including epilepsy, stroke and cancer. Uncommon etiologies encompass infectious diseases, metabolic disorders, and sensory deprivation. Although musical hallucinations have a major impact on patients' lives, they have been undervalued and understudied in the literature. We report a case of a 79-year-old woman with musical hallucination (hearing a sung National anthem) without cognitive impairment or hearing loss. The patient had preserved insight of her complaint and responded well to neuroleptics.

RESUMO A alucinação musical é o um tipo de alucinação auditiva complexa. As etiologias possíveis são a perda auditiva, transtornos psiquiátricos tais como a esquizofrenia, depressão maior, uso de medicações e estresse, condições neurológicas como a epilepsia, acidente vascular encefálico e neoplasias. Etiologias menos frequentes englobam doenças infecciosas, metabólicas e endócrinas e privação sensorial. Apesar das alucinações musicais causarem grandes repercussões na vida dos pacientes sempre foram pouco valorizadas e estudadas na literatura. Relatamos o caso de uma senhora de 79 anos com alucinação musical (ouvia o hino nacional cantado), sem déficit cognitivo ou perda auditiva. A paciente tinha insight de seu problema e respondeu bem ao tratamento com neurolépticos.

O mau cheiro como estratégia de sobrevivência / Stench as a survival strategy / La puanteur comme une stratégie de survie / El hedor como estrategia de supervivencia / Der Gestank als Überlebensstrategie

O presente trabalho tem como base a narrativa de um atendimento clínico, no qual a paciente procura análise, pois todos os seus relacionamentos amorosos fracassavam causando-lhe intenso sofrimento. Ao longo dos atendimentos ela diz saber o porquê desses fracassos: ela fede. Formulamos a hipótese clínica de que o mau cheiro se insere na economia psíquica da paciente como um mecanismo de defesa e, tomando o conceito de narcisismo como norteador, discutimos o papel da alucinação olfativa na sustentação psíquica da paciente.

The present paper is based on a clinical situation in which the patient seeks an analysis because all her love relationships failed causing intense suffering. Along the treatment she says that she knows why her relationships come to an end: She stinks. We formulate the clinical hypothesis that stench is inserted into the patient’s psychic economy as a defense mechanism and, taking the concept of narcissism as a guide, we discuss the role of the olfactory hallucination as a psychic support for the patient.

Ce travail est basé sur le récit d’une situation clinique dans lequel le patient cherche l’analyse a cause des echècs dans toutes ses relations amoureuses lui causant des souffrances intenses. Au cours des sessions, elle dit connaître la raison de cette condition: Elle pue. Nous formulons l’hypothèse clinique que l’odeur est insérée dans l’économie psychique du patient comme un mécanisme de défense et, en prenant le concept de narcissisme comme un guide, nous avons discuté du rôle de l’hallucination olfactive dans le soutien psychologique du patient.

El presente trabajo tiene como base la narrativa de un atendimiento clínico en lo qual la paciente busca a un análisis porque todos sus relacionamientos amorosos fallaban, generandole un gran sofrimiento. Al largo de los atendimientos ella dice saber la razón destos fracasos: ella huele mal. Hemos formulado la hipótesis clínica de que el holor malo está insertado en la economía psíquica de la paciente como un mecanismo de defensa, y tomando el concepto de narcisismo como rector, discutimos el rol de la alucinación olfativa en el sostén psíquico de la paciente.

Die vorliegende Arbeit hat als Grundlage den Bericht ueber eine klinischen Behandlung in der eine Patientie eine Analyse sucht weil alle ihre Liebesbeziehungen zerbrachen was ihr intensives Leid zufuegte. Im Zuge der Behandlung sagte sie sie wisse die Ursache dieser Fehlschlaege: sie stinkt.. Wir stellten die klinische Hypothese auf dass sich der schlechte Geruch in der “psychischen Oekonomie” der Patientin als Mechanismus der Verteidigung eingliedert und indem wir das Konzept des Narzismus als Ausrichtung nahmen, diskutierten wir die Rolle der Geruchshalluzination in der psychischen Haltung der Patientin.

Michel Henry: sense of self and hallucination / Michel Henry: sentimento de si e alucinação

In this paper we develop the thesis of the possibility of understanding human beings, starting from the phenomenality of their therapeutic needs. We bring the phenomenality of hallucination to the center of the debate. We show how, in Michel Henry, the phenomenality of sight, touch and anguish is, in all, comparable to the phenomenality of hallucination. From the starting point of this phenomenality we will understand human actions and thus, the essence of clinical practice.

Neste texto desenvolveu-se a tese da possibilidade da compreensão do humano a partir da fenomenalidade das suas necessidades terapêuticas. A fenomenalidade da alucinação é trazida para o centro do debate. Buscou-se mostrar como é que, em Michel Henry, a fenomenalidade da visão, do tato e da angústia é em tudo comparável com a fenomenalidade da alucinação. Será a partir dessa fenomenalidade que se compreenderá o agir humano e, com ela, a essência da clínica.

Conceptualization of Soliloquy in Patients with Schizophrenia / 신경정신의학

Soliloquy is a significant symptom in schizophrenia and is usually regarded as being related to auditory hallucination. Elucidation of the psychopathology of soliloquy is incomplete. Soliloquy is also a normal human behavior that has multidimensional functions such as guiding internal cognitive processes and managing social interaction. In the young, soliloquy appears as egocentric speech and arises before maturation of the third-person perspective. Soliloquy has been regarded as indicative of an intermediary stage during the transformation of social speech into internalized thinking. Every thought process retains a social dimension because language itself is based on intersubjectively shared meanings, and internal thinking originates from interpersonal communication. Thus, soliloquy can be seen as a kind of thought process that accentuates the social dimension. This approach may help in understanding soliloquy in normal and pathological situations. Soliloquy was actively discussed in the late nineteenth and early twentieth century in European psychiatry. Since then it has received less attention and has been neglected as an academic concern, except in child developmental theory. Recently however, soliloquy has attracted more attention among neuroscientific researchers. To attain an advanced understanding of soliloquy, it is necessary to integrate the early European perception of soliloquy with current developmental theory. In this paper, we review past literature on the conceptualization of soliloquy and integrate those concepts into an explanatory framework. In addition, a case series and a discussion of the applicability of the explanatory framework are presented. Our results may help provide an insight into the contemporary understanding of soliloquy.