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Rinaldi F, Sacchetto S, Di Francia A, Siracusano A, Niolu C, di Michele F. The "Hysterical Psychosis" Dilemma: A Narrative Review. Psychopathology 2024:1-11. [PMID: 38442702 DOI: 10.1159/000536377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/20/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Hysteria in its most severe expression may reach psychotic manifestations. Such symptomatology has been occasionally described by various authors starting from the 19th century and defined as "hysterical psychosis" (HP) by Hollender and Hirsch in 1964. Currently, diagnostic psychiatric manuals such as DSM and ICD do not include the diagnosis of HP, although this term is commonly used in clinical practice. This raises a well-known problem with case definition due to an inconsistent use of terminology. SUMMARY Here, we propose a review of the literature that aims to highlight the clinical features of HP endorsed by the majority of authors, such as histrionic premorbid personality, acute reactive onset, short duration, altered state of consciousness, unstable delusions, typical hallucinations, labile mood, lack of flat affect. In the discussion, we focus on the differential diagnosis between HP and other diagnoses such as brief psychosis and schizophrenia, trying to point out aspects of distinction and continuity. KEY MESSAGES The debate about this nosographic entity still remains a huge dilemma and needs further contributions.
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Affiliation(s)
| | | | | | - Alberto Siracusano
- Psychiatry and Clinical Psychology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Cinzia Niolu
- Psychiatry and Clinical Psychology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
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Ogrizek A, Ros T, Ludot M, Moro MR, Hatchuel Y, Gomez NG, Radjack R, Felix A. Asserting a Functional Neurological Symptom Disorder with a Complementary Diagnostic Approach: A Brief Report. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1601. [PMID: 37892264 PMCID: PMC10605693 DOI: 10.3390/children10101601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/16/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023]
Abstract
INTRODUCTION Functional neurological symptom disorder (FNSD) is a common diagnosis among adolescents. However, we feel it is a difficult diagnosis to assess because of the diversity of its clinical manifestations, the rapid changes in its nosography over the years, and its common imbrication with established somatic diagnoses. We would like to illustrate this hypothesis through a case presentation and the original diagnostic process that emerged from it. METHODS We chose to present our diagnosis approach through the case of an 11-year-old boy who showed a progressive loss of motor and sensory function to the point of total dependency, and then suddenly switched between this state and a "normal" physical presentation, while deliriously claiming to be an angel. RESULTS All possible infectious, autoimmune, metabolic, and toxic disorders were ruled out. After the successive therapeutic failures of antidepressants and neuroleptics, FNSD was diagnosed. CONCLUSION The DSM-5-TR classification was insufficient to explain the full clinical picture and a complementary approach (biblical, psychoanalytical, and historical) was used to analyze the cause of this atypical presentation.
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Affiliation(s)
- Anais Ogrizek
- Department of Adult and Child Psychiatry, Martinique University Hospital, F-97200 Fort-de-France, France;
| | - Thomas Ros
- Department of Adult and Child Psychiatry, Martinique University Hospital, F-97200 Fort-de-France, France;
| | - Maude Ludot
- Department of Child Psychiatry, University of Paris, Hôpital Cochin, Maison de Solenn, F-75014 Paris, France; (M.L.); (M.-R.M.); (R.R.)
| | - Marie-Rose Moro
- Department of Child Psychiatry, University of Paris, Hôpital Cochin, Maison de Solenn, F-75014 Paris, France; (M.L.); (M.-R.M.); (R.R.)
| | - Yves Hatchuel
- Department of Pediatrics, Martinique University Hospital, F-97200 Fort-de-France, France; (Y.H.); (N.G.G.)
| | - Nicolas Garofalo Gomez
- Department of Pediatrics, Martinique University Hospital, F-97200 Fort-de-France, France; (Y.H.); (N.G.G.)
| | - Rahmeth Radjack
- Department of Child Psychiatry, University of Paris, Hôpital Cochin, Maison de Solenn, F-75014 Paris, France; (M.L.); (M.-R.M.); (R.R.)
| | - Arthur Felix
- Department of Pediatrics, Martinique University Hospital, F-97200 Fort-de-France, France; (Y.H.); (N.G.G.)
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Swan K, Speyer R, Scharitzer M, Farneti D, Brown T, Woisard V, Cordier R. Measuring what matters in healthcare: a practical guide to psychometric principles and instrument development. Front Psychol 2023; 14:1225850. [PMID: 37790221 PMCID: PMC10543275 DOI: 10.3389/fpsyg.2023.1225850] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
The provision of quality healthcare relies on scales and measures with robust evidence of their psychometric properties. Using measurement instruments with poor reliability, validity, or feasibility, or those that are not appropriate for the target diagnostic group or construct/dimension under consideration, may be unfavorable for patients, unproductive, and hinder empirical advancement. Resources from the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) group can assist in identifying and developing psychometrically sound measures. The COSMIN initiative is the only international, research-based practice taxonomy and methodological guidelines for measurement in healthcare. This manuscript aims to provide an accessible introduction to theories, principles and practices of psychometrics, instrument properties, and scale development, with applied examples from the COSMIN recommendations. It describes why measurement in healthcare is critical to good practice, explains the concepts of the latent variable and hypothetical construct and their importance in healthcare assessments, explores issues of flawed measurement and briefly explains key theories relevant to psychometrics. The paper also outlines a ten-step process to develop and validate a new measurement instrument, with examples drawn from a recently developed visuoperceptual measure for analysis of disordered swallowing to demonstrate key concepts and provides a guide for understanding properties of and terminology related to measurement instruments. This manuscript serves as a resource for healthcare clinicians, educators, and researchers who seek to develop and validate new measurement instruments or improve the properties of existing ones. It highlights the importance of using psychometrically sound measurement instruments to ensure high-quality healthcare assessments.
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Affiliation(s)
- Katina Swan
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- St. John of God Midland Public and Private Hospitals, St John of God Health Care, Perth, WA, Australia
- Department of Allied Health, The School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Renee Speyer
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- Department Special Needs Education, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, Netherlands
| | - Martina Scharitzer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Daniele Farneti
- Audiologic Phoniatric Service, Otorhinolaryngology Department, Infermi Hospital, AUSL Romagna, Rimini, Italy
| | - Ted Brown
- Department of Occupational Therapy, Faculty of Medicine, Nursing and Health Sciences, Monash University – Peninsula Campus, Frankston, VIC, Australia
| | | | - Reinie Cordier
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Dubova M, Goldstone RL. Carving joints into nature: reengineering scientific concepts in light of concept-laden evidence. Trends Cogn Sci 2023; 27:656-670. [PMID: 37173157 DOI: 10.1016/j.tics.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023]
Abstract
A new wave of proposals suggests that scientists must reassess scientific concepts in light of accumulated evidence. However, reengineering scientific concepts in light of data is challenging because scientific concepts affect the evidence itself in multiple ways. Among other possible influences, concepts (i) prime scientists to overemphasize within-concept similarities and between-concept differences; (ii) lead scientists to measure conceptually relevant dimensions more accurately; (iii) serve as units of scientific experimentation, communication, and theory-building; and (iv) affect the phenomena themselves. When looking for improved ways to carve nature at its joints, scholars must take the concept-laden nature of evidence into account to avoid entering a vicious circle of concept-evidence mutual substantiation.
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Affiliation(s)
- Marina Dubova
- Cognitive Science Program, Indiana University, 1101 E. 10th Street, Bloomington, IN 47405, USA.
| | - Robert L Goldstone
- Cognitive Science Program, Indiana University, 1101 E. 10th Street, Bloomington, IN 47405, USA; Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th Street, Bloomington, IN 47405, USA
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Johnson KK, Bennett C, Rochani H. Significant Improvement of Somatic Symptom Disorder With Brief Psychoeducational Intervention by PMHNP in Primary Care. J Am Psychiatr Nurses Assoc 2022; 28:171-180. [PMID: 32964788 DOI: 10.1177/1078390320960524] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Patients with somatic symptom disorders (SSD) are prevalent in primary care, urgent care, and emergency rooms and present with reduced quality of life, increased disability, and suicidality . Criteria for SSD include (1) somatic symptoms that cause distress and disrupt life; (2) concurrent physical illness with thoughts and feelings that are disproportionate to the seriousness of the illness; and (3) distress which is persistent and causes suffering. The frequency of SSD in the general population is 5% to 7%; however, in primary care, it is 5% to 35% . Because patients present with anxiety, depression, and/or pain, providers are flummoxed when diagnostic findings do not match symptom intensity. The purpose of this project was to provide an intervention for patients with SSD and measure its effectiveness on their somatic symptoms. METHOD This study provided a single-session, 30-minute psychoeducational intervention for patients to explain brain pathways for pain and the body's response to stress, including scientific benefits of exercise and healthy diet. Patients were asked questions using the motivational interviewing technique OARS (open-ended question, affirmation, reflection, summary) and were encouraged to talk about their concerns. The study used a pre- and post-intervention visual analogue scale and a self-reported Patient Health Questionnaire-15 both before and 3 weeks post-intervention. RESULTS Measurements showed significant symptom improvement immediately after the intervention with sustained improvement 3 weeks post-intervention. CONCLUSIONS This intervention demonstrates an effective treatment for this insidious illness, which plagues up to 35% of patients in primary care.
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Affiliation(s)
- Kim K Johnson
- Kim K. Johnson, DNP, PMHNP-BC, NP-C, RN, School of Nursing, Middle Georgia State University, Macon, GA, USA
| | - Carole Bennett
- Carole Bennett, PhD, APRN, PMHCS-BC, Waters College of Health Professions, Georgia Southern University, Statesboro, GA, USA
| | - Haresh Rochani
- Haresh Rochani, DrPH, MPH, MBBS, Biostatistics, K. E. Peace Center for Biostatistics, Georgia Southern University, Statesboro, GA, USA
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Tsagkaris C, Matiashova L, Romash I, Papadakis M, Tymkiv I, Blyzniuk M, Trompoukis C. HYSTERICAL APNEA IN THE WORK OF GALEN (CA 129 - 199 AD): GENDER EQUITY IN THE HISTORY OF PSYCHOSOMATIC MEDICINE. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1920-1923. [PMID: 36089880 DOI: 10.36740/wlek202208118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: To presents clinical, epidemiological and pathophysiological aspects of the disease described by Galenos of Pergamon during the 2nd century AD and discusses its implications on contemporary discourse on gender equity and gender - based discrimination. PATIENTS AND METHODS Materials and methods: The authors searched original medical texts written in Greek language and attributed to Galenos for records related to hysterical apnea. CONCLUSION Conclusions: Galen attempted to interpret hysterical apnea by combining clinical and epidemiological observations with anatomical and functional lesions. His approach denounced the anatomically unsound notion of the wandering womb and availed the knowledge of his period in a rational manner. Investigating gender - related aspects of contemporary psychosomatic conditions related to fertility and pregnancy can help address gender - based discrimination in modern societies.
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Affiliation(s)
| | - Lolita Matiashova
- L.T. MALA NIT NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KHARKIV, UKRAINE
| | - Iryna Romash
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | | | - Iryna Tymkiv
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Mariya Blyzniuk
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
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Bingham PM. The Smile Sign. Pediatr Neurol 2021; 120:59-60. [PMID: 34020113 DOI: 10.1016/j.pediatrneurol.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Peter M Bingham
- Vermont Children's Hospital, Larner College of Medicine Department of Neurosciences, University of Vermont Medical Center, Burlington, Vermont.
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Fang Z, Li Y, Xie L, Cheng M, Ma J, Li T, Li X, Jiang L. Characteristics and outcomes of children with dissociative (conversion) disorders in western China: a retrospective study. BMC Psychiatry 2021; 21:31. [PMID: 33435924 PMCID: PMC7802240 DOI: 10.1186/s12888-021-03045-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/06/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Dissociative (conversion) disorder in children is a complex biopsychosocial disorder with high rates of medical and psychiatric comorbidities. We sought to identify the characteristics and outcomes of children with dissociative (conversion) disorders in western China. METHODS We conducted a retrospective cohort study of 66 children admitted with dissociative (conversion) disorders from January 2017 to July 2019, and analyzed their clinical characteristics, socio-cultural environmental variables, and personality and psychiatric/psychological characteristics. Binary logistic regression was used to analyze the variables associated with clinical efficacy. RESULTS Of these 66 patients, 38 (57.6%) were male and 28 (42.4%) were female, 46 (69.7%) had an antecedent stressor, 30 (45.5%) were left-behind adolescents, and 16 (24.2%) were from single-parent families. In addition, 30 patients (45.5%) were not close to their parents, 38 patients (59.4%) had an introverted personality, and 34 (53.1%) had unstable emotions. Thirteen families (19.7%) were uncooperative with the treatment. Patients who had cormorbid anxiety or depression exhibited significantly lower cognitive ability (P < 0.01). Logistic regression found that better treatment outcomes were positively associated with having a close relationship with parents, parental cooperation with treatment, and having a father with a lower level of education (i.e., less than junior college or higher). CONCLUSIONS The characteristics and outcomes of children with dissociative (conversion) disorders are related to socio-cultural environmental variables and psychiatric/psychological factors. Timely recognition and effective treatment of dissociative (conversion) disorders are important.
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Affiliation(s)
- Zhixu Fang
- grid.488412.3Department of Neurology, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014 China ,grid.419897.a0000 0004 0369 313XMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China ,grid.488412.3National Clinical Research Center for Child Health and Disorders, Chongqing, 400014 China ,grid.507984.7China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China ,grid.488412.3Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yuhang Li
- grid.488412.3Department of Neurology, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014 China ,grid.419897.a0000 0004 0369 313XMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China ,grid.488412.3National Clinical Research Center for Child Health and Disorders, Chongqing, 400014 China ,grid.507984.7China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China ,grid.488412.3Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Lingling Xie
- grid.488412.3Department of Neurology, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014 China ,grid.419897.a0000 0004 0369 313XMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China ,grid.488412.3National Clinical Research Center for Child Health and Disorders, Chongqing, 400014 China ,grid.507984.7China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China ,grid.488412.3Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Min Cheng
- grid.488412.3Department of Neurology, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014 China ,grid.419897.a0000 0004 0369 313XMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China ,grid.488412.3National Clinical Research Center for Child Health and Disorders, Chongqing, 400014 China ,grid.507984.7China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China ,grid.488412.3Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jiannan Ma
- grid.488412.3Department of Neurology, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014 China ,grid.419897.a0000 0004 0369 313XMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China ,grid.488412.3National Clinical Research Center for Child Health and Disorders, Chongqing, 400014 China ,grid.507984.7China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China ,grid.488412.3Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Tingsong Li
- grid.488412.3Department of Neurology, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014 China ,grid.419897.a0000 0004 0369 313XMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China ,grid.488412.3National Clinical Research Center for Child Health and Disorders, Chongqing, 400014 China ,grid.507984.7China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China ,grid.488412.3Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiujuan Li
- grid.488412.3Department of Neurology, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014 China ,grid.419897.a0000 0004 0369 313XMinistry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China ,grid.488412.3National Clinical Research Center for Child Health and Disorders, Chongqing, 400014 China ,grid.507984.7China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China ,grid.488412.3Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014, China. .,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China. .,National Clinical Research Center for Child Health and Disorders, Chongqing, 400014, China. .,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China. .,Chongqing Key Laboratory of Pediatrics, Chongqing, China.
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Tomić A, Ječmenica Lukić M, Petrović I, Svetel M, Dragašević Mišković N, Kresojević N, Marković V, Kostić VS. Changes of Phenotypic Pattern in Functional Movement Disorders: A Prospective Cohort Study. Front Neurol 2020; 11:582215. [PMID: 33250849 PMCID: PMC7674825 DOI: 10.3389/fneur.2020.582215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction: Functional movement disorders (FMD) refer to a group of movement disorders that present with clinical characteristics incongruent to those due to established pathophysiologic processes, as for example in the case of neurodegeneration or lesions. The aim of this study was to assess clinical features that contribute to the specific phenotypic presentations and disease course of FMD. Methods: The study consisted of 100 patients with FMD treated at Clinic for Neurology, Clinical Center of Serbia, who were longitudinally observed. Comprehensive clinical and psychiatric assessment was performed at the baseline, when initial FMD phenotype was defined. Follow-up assessment of phenotypic pattern over the time and clinical course was done after 3.2 ± 2.5 years at average. Results: We showed that 48% of FMD patients were prone to changes of phenotypic pattern during the disease course. Dystonia had tendency to remains as single and unchanged phenotype over the time (68.2%), while patients initially presented with Tremor, Gait disorder, Parkinsonism and Mixed phenotype were more susceptible to developing additional symptoms (62.5, 50, and 100%, respectively). Higher levels of somatoform experiences (p = 0.033, Exp(B) = 1.082) and higher motor severity (p = 0.040, Exp(B) = 1.082) at baseline assessment were associated with an increased likelihood of further enriching of FMD phenotype with additional functional symptoms. Also, these patients more frequently reported pain, and had higher scores on majority of applied psychiatric scales, together with more frequent presence of major depressive disorder. Conclusion: Results from this prospective study suggested tendency for progression and enrichment of functional symptoms in FMD patients over time. Besides functional core symptoms, other key psychological and physical features (like pain or multiple somatisations) were quite relevant for chronicity and significant dysability of FMD patients.
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Affiliation(s)
| | | | | | | | | | | | | | - Vladimir S. Kostić
- Clinical Centre of Serbia, Faculty of Medicine, Clinic for Neurology, University of Belgrade, Belgrade, Serbia
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Caporaso E, Oliver D, Rusher M. A Pregnant Woman with Hyperemesis Gravidarum Admitted to the Psychiatric Ward. Psychiatr Ann 2020. [DOI: 10.3928/00485713-20200903-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Phillips W. La Envidia: An Illness Manifest at the Level of the Community Body. ANTHROPOLOGY OF CONSCIOUSNESS 2020. [DOI: 10.1111/anoc.12126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Wendy Phillips
- Goddard College and California Institute of Integral Studies
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Abstract
PURPOSE OF REVIEW The nomenclature and classification of somatoform disorders have undergone revisions in the fifth edition of the Diagnostic and Statistical Manual (DSM 5) and the upcoming eleventh edition of the International Classification of Diseases (ICD-11). The present review describes the changes that have evolved and highlight the possible challenges. RECENT FINDINGS Bodily distress disorders replace the term somatoform disorders. The emphasis on the symptoms to be medically unexplained has been removed. The need to have a certain number of symptoms associated with different organ systems has made way to the presence of one or more distressing bodily symptoms. The focus on psychological aspects like excessive attention, thoughts, and behaviors associated with bodily symptoms have been added to make it a more diagnosis of inclusion rather than exclusion. An additional qualifier of severity has been added, which highlights the importance of impairment associated with these symptoms. SUMMARY The diagnostic criteria for bodily distress disorders is a step towards making the diagnostic criteria clinically useful and appears to be applicable across the healthcare settings. However, the ability to discern this diagnosis with the newly revised classification of chronic pain and the possibility of over psychologizing the medical disorders need to be researched.
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Canan F, North CS. The Association between General and Pathological Dissociation and Disaster-Related Psychopathology in Directly Exposed Survivors. Psychiatry 2020; 83:292-305. [PMID: 32069180 DOI: 10.1080/00332747.2020.1716440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: Dissociation and trauma have a well-documented relationship, and dissociation is assumed to result from trauma exposure. If trauma generates dissociative psychopathology, it should be observed after exposure to disaster and be associated with disaster-related psychopathology. Few studies have focused specifically on dissociation as an outcome of disaster trauma. This study examined dissociation and its association with disaster-related psychopathology in survivors of five different disasters. Methods: In the first 6 postdisaster months, directly exposed survivors (N = 216) of mass shootings, floods, or a firestorm completed structured diagnostic interviews providing lifetime predisaster and postdisaster prevalent/incident psychiatric diagnoses and the Dissociative Experiences Scale (DES) 1-3 years after baseline. Results: DES scores were very low; only 1% met the DES Taxon signifying pathological dissociation. In multivariate models including predisaster lifetime major depression, lifetime panic disorder, lifetime generalized anxiety disorder, and lifetime alcohol use disorder; disaster-related PTSD; and number of incident somatoform symptoms as independent covariates, predisaster lifetime major depression and alcohol use disorder were independently associated with both general (DES score) and pathological (DES Taxon) dissociation, and postdisaster incident somatization symptoms were also associated with general dissociation, but postdisaster psychopathology including disaster-related PTSD was not associated with general or pathological dissociation. Conclusions: Neither general nor pathological dissociation was independently associated with disaster-related PTSD or other incident psychopathology. The only psychiatric disorders associated with dissociation were present before the disasters. Coupled with the low dissociation rates, these findings indicate that dissociation does not appear to be a mental health outcome of disaster trauma.
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Sapkota RP, Brunet A, Kirmayer LJ. Characteristics of Adolescents Affected by Mass Psychogenic Illness Outbreaks in Schools in Nepal: A Case-Control Study. Front Psychiatry 2020; 11:493094. [PMID: 33312130 PMCID: PMC7704439 DOI: 10.3389/fpsyt.2020.493094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/23/2020] [Indexed: 12/05/2022] Open
Abstract
This paper presents the first systematic case-control study of correlates of mass psychogenic illness (MPI) in an adolescent school population. MPI is generally construed as a dissociative phenomenon spread by social contagion to individuals who are prone to dissociation. We sought to test if the correlates of dissociative experiences most commonly proposed in the literature could predict caseness among students affected by episodes of mass psychogenic illness occurring in schools in Nepal. We assessed 194 cases and 190 controls (N = 384) of ages 11-18 years from 12 public schools. Cases and controls were comparable on all demographic variables, except for family configuration, with nuclear families more common among those affected. In bivariate comparisons, caseness was associated with childhood physical neglect and abuse, as well as living in nuclear families, peritraumatic dissociation, dissociative tendencies, and depressive and post-traumatic stress symptoms. Hypnotizability emerged as the strongest correlate of psychogenic illness among the cognitive and personality trait variables. However, in multivariable logistic regression, the correlates of dissociation did not predict caseness, suggesting that they do not adequately account for the phenomenon of mass psychogenic illness. An ad-hoc Classification and Regression Trees analysis showed that if an adolescent was highly hypnotizable and reported high rates of peritraumatic dissociative experiences, then there was a 73% probability of being a case in a mass psychogenic illness episode. Future studies involving other psychological, social and cultural factors, as well as school- and family-related factors are needed to understand the correlates of mass psychogenic illness and guide prevention and intervention.
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Affiliation(s)
- Ram P Sapkota
- Research Centre of the Douglas Hospital, Department of Psychiatry, McGill University, Montreal, QC, Canada.,Division of Social and Transcultural Psychiatry, Global Mental Health Program, McGill University, Montreal, QC, Canada
| | - Alain Brunet
- Research Centre of the Douglas Hospital, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Laurence J Kirmayer
- Division of Social and Transcultural Psychiatry, Global Mental Health Program, McGill University, Montreal, QC, Canada.,Culture and Mental Health Research Unit, Institute of Community & Family Psychiatry, Jewish Genera Hospital and Lady Davis Institute, Montreal, QC, Canada
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15
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Canan F, North CS. Dissociation and disasters: A systematic review. World J Psychiatry 2019; 9:83-98. [PMID: 31649861 PMCID: PMC6811731 DOI: 10.5498/wjp.v9.i6.83] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/03/2019] [Accepted: 08/21/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dissociation, which is defined as the failure to associate consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior into an integrated whole, has long been assumed to be generated by trauma. If dissociation is a product of trauma exposure, then dissociation would be a major mental health outcome observed in studies of disaster survivors. Although some studies have examined dissociation in disasters, no systematic literature reviews have been conducted to date on the topic.
AIM To systematically evaluate the literature on the association between disaster and dissociation to determine the prevalence and incidence of dissociation after exposure to disaster and further examine their relationship.
METHODS EMBASE, Medline, and PsychINFO were searched from inception to January 1, 2019 to identify studies examining dissociative disorders or symptoms related to a disaster in adult or child disaster survivors and disaster responders. Studies of military conflicts and war, articles not in English, and those with samples of 30 or more participants were excluded. Search terms used were “disaster*” and dissociation (“dissociat*,” “multiple personality,” “fugue,” “psychogenic amnesia,” “derealization,” and “depersonalization”). Reference lists of identified articles were scrutinized to identify studies for additional articles.
RESULTS The final number of articles in the review was 53, including 36 articles with samples of adults aged 18 and above, 5 of children/adolescents under age 18, and 12 of disaster workers. Included articles studied several types of disasters that occurred between 1989 and 2017, more than one-third (38%) from the United States. Only two studies had a primary aim to investigate dissociation in relation to disaster and none reported data on dissociative disorders. All of the studies used self-report symptom scales; none used structured interviews providing full diagnostic assessment of dissociative disorders or other psychopathology. Several studies mixed exposed and unexposed samples or did not differentiate outcomes between exposure groups. Studies examining associations between dissociation and disaster exposure have been inconclusive. The majority (75%) of the studies compared dissociation with posttraumatic stress, with inconsistent findings. Dissociation was found to be associated with a wide range of other psychiatric disorders, symptoms, and negative emotional, cognitive, and functional states.
CONCLUSION The studies reviewed had serious methodological limitations including problems with measurement of psychopathology, sampling, and generation of unwarranted conclusions, precluding conclusions that dissociation is an established outcome of disaster.
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Affiliation(s)
- Fatih Canan
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX 75390, United States
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Carol S North
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX 75390, United States
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
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Abstract
Constantly shifting cultural views influence public perceptions of psychiatric diagnoses, sometimes accommodated by changes in diagnostic terminology. Evolving scientific knowledge of the era is at times used to justify and support mental illnesses. Too often, however, remasked nomenclatures fail to alter social stigma, in part because political arguments are used. Scientific validations of variant behaviors as symptoms with a pathologic status are unfortunately overshadowed. Examples of cultural bias effects on recurring diagnostic challenges illustrate a need for scientific validation. Renaming fails to improve stigma or diagnostic clarity. For example, neurasthenia, or nervous exhaustion, was attributed to fast-paced urban life through the late 1970s. Its symptoms are now largely, to no real advantage, retitled as chronic fatigue syndrome. Diagnoses like "hysteria" have evolved into histrionic personality disorder and somatoform spectrum disorders, although less as a result of demonic possession or a "wandering uterus." Decriminalized and depathologized homosexuality remains a political football, where religious "sin" conceptualizations have not been displaced by studies documenting healthy adjustments among groups with diverse sexual orientations and preferences. Each of these remains severely socially stigmatized. The pseudoscience of "drapetomania," once used to rationalize and pathologize a slave's freedom, is perceived now as psychiatric incarcerations of mentally healthy individuals, more commonly in totalitarian regimes-a politicization of stigma. Research reviews and funding efforts need to emphasize a sound basis for individuals caught in perpetuated diagnostic challenges, not remedied by simple shifts in nomenclature.
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17
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Walker LS. Commentary: Understanding Somatic Symptoms: From Dualism to Systems, Diagnosis to Dimensions, Clinical Judgement to Clinical Science. J Pediatr Psychol 2019; 44:862-867. [PMID: 31241136 DOI: 10.1093/jpepsy/jsz050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/24/2019] [Accepted: 05/15/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lynn S Walker
- Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center
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18
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Byrne A, O’Connor J, Wilson O’Raghallaigh J, MacHale S. Something torn or burst or unbearable: a psychoanalytically-informed exploration of the experience of somatic symptoms. PSYCHOANALYTIC PSYCHOTHERAPY 2019. [DOI: 10.1080/02668734.2019.1582085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A. Byrne
- School of Psychology, Trinity College, Dublin, Ireland
| | - J. O’Connor
- School of Psychology, Trinity College, Dublin, Ireland
| | | | - S. MacHale
- Liaison Psychiatry Service, Beaumont Hospital, Dublin, Ireland
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Anthrax Exposure, Belief in Exposure, and Postanthrax Symptoms Among Survivors of a Bioterrorist Attack on Capitol Hill. Disaster Med Public Health Prep 2018; 13:555-560. [PMID: 30417804 DOI: 10.1017/dmp.2018.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Following chemical, biological, radiological, and nuclear disasters, medically unexplained symptoms have been observed among unexposed persons. OBJECTIVES This study examined belief in exposure in relation to postdisaster symptoms in a volunteer sample of 137 congressional workers after the 2001 anthrax attacks on Capitol Hill. METHODS Postdisaster symptoms, belief in exposure, and actual exposure status were obtained through structured diagnostic interviews and self-reported presence in offices officially designated as exposed through environmental sampling. Multivariate models were tested for associations of number of postdisaster symptoms with exposure and belief in exposure, controlling for sex and use of antibiotics. RESULTS The sample was divided into 3 main subgroups: exposed, 41%; unexposed but believed they were exposed, 17%; and unexposed and did not believe that they were exposed, 42%. Nearly two-thirds (64%) of the volunteers reported experiencing symptoms after the anthrax attacks. Belief in anthrax exposure was significantly associated with the number of ear/nose/throat, musculoskeletal, and all physical symptoms. No significant associations were found between anthrax exposure and the number of postdisaster symptoms. CONCLUSIONS Given the high incidence of these symptoms, these data suggest that even in the absence of physical injury or illness, there may be surges in health care utilization. (Disaster Med Public Health Preparedness. 2019;13:555-560).
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Saltzman HM. What's in a Word? ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:709-710. [PMID: 29192409 DOI: 10.1007/s40596-017-0863-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 11/22/2017] [Indexed: 06/07/2023]
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Dinsdale NL, Crespi BJ. Revisiting the wandering womb: Oxytocin in endometriosis and bipolar disorder. Horm Behav 2017; 96:69-83. [PMID: 28919554 DOI: 10.1016/j.yhbeh.2017.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 09/07/2017] [Accepted: 09/09/2017] [Indexed: 12/23/2022]
Abstract
Hippocrates attributed women's high emotionality - hysteria - to a 'wandering womb'. Although hysteria diagnoses were abandoned along with the notion that displaced wombs cause emotional disturbance, recent research suggests that elevated levels of oxytocin occur in both bipolar disorder and endometriosis, a gynecological condition involving migration of endometrial tissue beyond the uterus. We propose and evaluate the hypothesis that elevated oxytocinergic system activity jointly contributes to bipolar disorder and endometriosis. First, we provide relevant background on endometriosis and bipolar disorder, and then we examine evidence for comorbidity between these conditions. We next: (1) review oxytocin's associations with personality traits, especially extraversion and openness, and how they overlap with bipolar spectrum traits; (2) describe evidence for higher oxytocinergic activity in both endometriosis and bipolar disorder; (3) examine altered hypothalamic-pituitary-gonadal axis functioning in both conditions; (4) describe data showing that medications that treat one condition can improve symptoms of the other; (5) discuss fitness-related impacts of endometriosis and bipolar disorder; and (6) review a pair of conditions, polycystic ovary syndrome and autism, that show evidence of involving reduced oxytocinergic activity, in direct contrast to endometriosis and bipolar disorder. Considered together, the bipolar spectrum and endometriosis appear to involve dysregulated high extremes of normally adaptive pleiotropy in the female oxytocin system, whereby elevated levels of oxytocinergic activity coordinate outgoing sociality with heightened fertility, apparently characterizing, overall, a faster life history. These findings should prompt a re-examination of how mind-body interactions, and the pleiotropic endocrine systems that underlie them, contribute to health and disease.
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Affiliation(s)
- Natalie L Dinsdale
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, BC, Canada; Department of Psychology, 9 Campus Drive, 154 Arts, University of Saskatchewan, Saskatoon S7N 5A5, SK, Canada.
| | - Bernard J Crespi
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, BC, Canada.
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North CS, Surís AM. Advances in Psychiatric Diagnosis: Past, Present, and Future. Behav Sci (Basel) 2017; 7:bs7020027. [PMID: 28445399 PMCID: PMC5485457 DOI: 10.3390/bs7020027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 04/21/2017] [Accepted: 04/22/2017] [Indexed: 01/08/2023] Open
Abstract
This editorial examines controversies identified by the articles in this special issue, which explore psychopathology in the broad history of the classification of selected psychiatric disorders and syndromes over time through current American criteria. Psychiatric diagnosis has a long history of scientific investigation and application, with periods of rapid change, instability, and heated controversy associated with it. The articles in this issue examine the history of psychiatric nomenclature and explore current and future directions in psychiatric diagnosis through the various versions of accepted diagnostic criteria and accompanying research literature addressing the criteria. The articles seek to guide readers in appreciating the complexities of psychiatric diagnosis as the field of psychiatry pushes forward toward future advancements in diagnosis. Despite efforts of many scientists to advance a diagnostic classification system that incorporates neuroscience and genetics, it has been argued that it may be premature to attempt to move to a biologically-based classification system, because psychiatric disorders cannot yet be fully distinguished by any specific biological markers. For now, the symptom-based criteria that the field has been using continue to serve many essential purposes, including selection of the most effective treatment, communication about disease with colleagues, education about psychiatric illness, and support for ongoing research.
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Affiliation(s)
- Carol S North
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8828, USA.
- Metrocare Services, Dallas, TX 75247-4914, USA.
| | - Alina M Surís
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8828, USA.
- VA North Texas Health Care System, 4500 S. Lancaster Road, 151, Dallas, TX 75216, USA.
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Sallin K, Lagercrantz H, Evers K, Engström I, Hjern A, Petrovic P. Resignation Syndrome: Catatonia? Culture-Bound? Front Behav Neurosci 2016; 10:7. [PMID: 26858615 PMCID: PMC4731541 DOI: 10.3389/fnbeh.2016.00007] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/11/2016] [Indexed: 12/12/2022] Open
Abstract
Resignation syndrome (RS) designates a long-standing disorder predominately affecting psychologically traumatized children and adolescents in the midst of a strenuous and lengthy migration process. Typically a depressive onset is followed by gradual withdrawal progressing via stupor into a state that prompts tube feeding and is characterized by failure to respond even to painful stimuli. The patient is seemingly unconscious. Recovery ensues within months to years and is claimed to be dependent on the restoration of hope to the family. Descriptions of disorders resembling RS can be found in the literature and the condition is unlikely novel. Nevertheless, the magnitude and geographical distribution stand out. Several hundred cases have been reported exclusively in Sweden in the past decade prompting the Swedish National Board of Health and Welfare to recognize RS as a separate diagnostic entity. The currently prevailing stress hypothesis fails to account for the regional distribution and contributes little to treatment. Consequently, a re-evaluation of diagnostics and treatment is required. Psychogenic catatonia is proposed to supply the best fit with the clinical presentation. Treatment response, altered brain metabolism or preserved awareness would support this hypothesis. Epidemiological data suggests culture-bound beliefs and expectations to generate and direct symptom expression and we argue that culture-bound psychogenesis can accommodate the endemic distribution. Last, we review recent models of predictive coding indicating how expectation processes are crucially involved in the placebo and nocebo effect, delusions and conversion disorders. Building on this theoretical framework we propose a neurobiological model of RS in which the impact of overwhelming negative expectations are directly causative of the down-regulation of higher order and lower order behavioral systems in particularly vulnerable individuals.
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Affiliation(s)
- Karl Sallin
- Centre for Research Ethics and Bioethics (CRB), Uppsala UniversityUppsala, Sweden
- Department of Women’s and Children’s Health, Division of Neonatology, Karolinska InstituteSolna, Sweden
| | - Hugo Lagercrantz
- Department of Women’s and Children’s Health, Division of Neonatology, Karolinska InstituteSolna, Sweden
| | - Kathinka Evers
- Centre for Research Ethics and Bioethics (CRB), Uppsala UniversityUppsala, Sweden
| | - Ingemar Engström
- School of Health and Medical Sciences, Örebro UniversityÖrebro, Sweden
| | - Anders Hjern
- Centre for Health and Equity Studies (CHESS), Karolinska Institute and Stockholm UniversityStockholm, Sweden
| | - Predrag Petrovic
- Department of Clinical Neuroscience, Karolinska InstituteSolna, Sweden
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