Lunar cycle and psychiatric hospital admissions for schizophrenia: new findings from Henan province, China

Is there an association between the lunar phases and hospital admission for different episode types in bipolar disorder? A retrospective study in northern China

The effects of the moon on mental activities remain contentious. Few studies have investigated associations between lunar phases and different types of bipolar disorder (BD) episodes. In the current study, 7,452 patients with BD from three hospitals were enrolled. Patients were divided into two groups on the basis of episode types, and the effects of lunar phase were examined for each type. The cosinor analysis revealed moon-related rhythmicity in admissions for BD in a period of 14.75 days. There were fewer admissions around the new moon and the full moon. There was no significant difference between different groups in acrophase. There was possibly a temporal lag between the onset of BD and hospitalization. Thus, it is too early to draw firm conclusions about the impact of lunar phases on BD. Sleep might be a middle way from moon effect to admissions of BD. These results have implications for future disease prevention strategies and research.

Effect of meteorological factors and lunar phases on occurrence of psychogenic nonepileptic seizures

BACKGROUND

Psychogenicnonepilepticseizures (PNES) lack the abnormal electrographical discharges in electroencephalogram seen in epileptic seizures. The notion of the effects of meteorological factors and lunar phases onoccurrence of seizures in patients with PNES has been the subject of very few research studies and the available evidence in the literature is equivocal. In this study, we aimed to study the influence oflunarphases and meteorological factors on the frequency of PNES and its semiological categories.

METHODS

We retrospectively reviewed the medical records of patients discharged with a diagnosis of PNES from our epilepsy monitoring unit in a 3-year period. The 119 patients who met the inclusion criteria were categorized into hypermotor, hypomotor, or intact sensorium based on semiology of their seizures. The occurrence of PNES, in total and in each semiological category, was correlated with the daily average temperature, atmospheric pressure, and the 4 lunar phases.

RESULTS

There were 31.8% and 11.1% more-than-expected captured seizures when the average daily atmospheric pressure was lower or higher, respectively, of what is generally considered a comfortable atmospheric pressure. No consistent relation was found between the full moon phases and occurrence of PNES.

CONCLUSION

A significant association between atmospheric pressure and the occurrence of nonepileptic seizures was found, whereas no consistent increase in PNES was observed during the full moon phases. There is still an open debate about the effect of the lunar phases on human behavior and neurological disorders such as PNES.

Does lunar synodic cycle affect the rates of psychiatric hospitalizations and sentinel events?

The lunar synodic cycle is often believed to be associated with psychiatric emergencies and exacerbation in various countries, including India. However, the scientific literature regarding this matter is inconclusive. We aimed to evaluate the relationship between lunar cycle phase and admission rates plus occurrence of sentinel events in the psychiatric ward of a tertiary care general hospital in India. All admissions and transfer-ins (N = 780) to the Department of Psychiatry between August 1st, 2016 and July 31st, 2017 were evaluated from hospital records by a blinded author to obtain sentinel events, like requirement of physical restraint (PR) and chemical restraint (CR), occurring on full moon days (FM), new moon days (NM), and control days (CD). Statistical analysis was done by comparison of proportions. Significant positive differences were found when CR applied exclusively [p = .0008] on FM and NM days, and its frequency [p < .0001] in comparison to CD. Frequencies of parenteral [p = .0001] and per oral [p = .0064] modes of CR applied on FM and NM days showed significant positive results when compared with CD. Use of all restraints (PR plus CR) [p = .0017] and their frequencies [p < .0001] on FM and NM days were also positively significant. Sentinel events, such as use of restraints, especially chemical ones, in psychiatry in-patients are significantly more common during full moon and new moon phases.

Clinical Lycanthropy, Neurobiology, Culture: A Systematic Review

Background: Culture can affect psychiatric disorders. Clinical Lycanthropy is a rare syndrome, described since Antiquity, within which the patient has the delusional belief of turning into a wolf. Little is known on its clinical or therapeutic correlates. Methods: We conducted a systematic review (PRISMA) on PubMed and Google Scholar, until January 2021. Case reports, data on neurobiological hypotheses, and cultural aspects were included. Language was not restricted to English. Results: Forty-three cases of clinical lycanthropy and kynanthropy (delusion of dog transformation) were identified. Associated diagnoses were: schizophrenia, psychotic depression, bipolar disorder, and other psychotic disorders. Antipsychotic medication may be an efficient treatment for this rare transnosographic syndrome. In case of depression or mania, the treatment included antidepressants or mood regulators. The neuroscientific hypotheses include the conception of clinical lycanthropy as a cenesthopathy, as a delusional misidentification of the self-syndrome, as impairments of sensory integration, as impairments of the belief evaluation system, and right hemisphere anomalies. Interestingly, there is a clinical overlap between clinical lycanthropy and other delusional misidentification syndromes. Clinical lycanthropy may be a culture-bound syndrome that happens in the context of Western cultures, myths, and stories on werewolves, and today's exposure to these narratives on cultural media such as the internet and the series. We suggest the necessity of a cultural approach for these patients' clinical assessment, and a narrative and patient-centered care. Conclusions: Psychiatric transtheoretical reflections are needed for complementaristic neurobiological and cultural approaches of complex delusional syndromes such as clinical lycanthropy. Future research should include integrative frameworks.