Set-Up Madness: A Review

@#Psychosis can be defined as a mental disorder in which a person’s thoughts, affective response, ability to recognize reality, and ability to communicate and relate to others are sufficiently impaired to grossly interfere with his or her capacity to deal with reality. The classical characteristics of psychosis are impaired reality testing, hallucinations, delusions, and illusions. While factitious disorder and malingering are usually acknowledged as contrived psychiatric conditions for acquisition of interior or exterior profits, respectively, another alternative, also, exists that though is not manufactured individually, is enforced peripherally. Such cases, which are usually referred by the judge’s ruling, for evaluation and treatment, are more important than comparable simulated or genuine mental conditions, because incorrect diagnosis, or careless, cagily, and guarded validation of preliminary diagnosis that has been issued in the authorized or emergency department, can seriously endanger the individual’s civil rights, while it should not be overlooked that incorrect diagnosis is a kind of malpractice that may harm an individual awfully. In the present article the clinical picture of the said situation, in addition to some case histories, and recommendable hints for differential diagnosis between different types of psychoses, has been discussed.

Behavioral Variant Frontotemporal Dementia Phenocopy Syndrome / 정신신체의학

OBJECTIVES: The aim of this study was to draw attention toward so called ‘behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome’, which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. METHODS: English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as ‘frontotemporal’, ‘phenocopy’ and ‘behavioral’, and reviewed. Besides, two clinical vignettes were described. RESULTS: Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. CONCLUSIONS: Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.