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Medford N, Sigala N. Case report: Clinical lycanthropy in Huntington's disease. Front Psychiatry 2023; 14:1089872. [PMID: 36778641 PMCID: PMC9911433 DOI: 10.3389/fpsyt.2023.1089872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023] Open
Abstract
We describe the case of a patient diagnosed with Huntington's disease (HD), who, following a two-year history of anxiety with obsessional preoccupations, developed psychosis with clinical lycanthropy: a prominent delusional idea that he was a werewolf. Although there was no benefit from various antidepressants and antipsychotics, there was remarkable improvement of his symptoms following prescription of Clozapine. His choreiform movement disorder also improved as his mental state settled. Although some reported cases of clinical lycanthropy are related to neurological conditions, this is the first case in a patient with HD. We also discuss the relevance of cultural and personal factors in the expression of a delusion that incorporates disgust, and the potential role of somatosensory aberrations and misidentification of self.
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Affiliation(s)
- Nick Medford
- Department of Neuropsychiatry, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Natasha Sigala
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
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Guessoum SB, Benoit L, Minassian S, Mallet J, Moro MR. Clinical Lycanthropy, Neurobiology, Culture: A Systematic Review. Front Psychiatry 2021; 12:718101. [PMID: 34707519 PMCID: PMC8542696 DOI: 10.3389/fpsyt.2021.718101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Sélim Benjamin Guessoum
- University Hospital Cochin, Greater Paris University Hospitals (AP-HP), Paris, France.,University of Paris, PCPP, Boulogne-Billancourt, France.,University Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France
| | - Laelia Benoit
- University Hospital Cochin, Greater Paris University Hospitals (AP-HP), Paris, France.,University Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France.,Yale School of Medicine (Child Study Center), Yale University, QUALab, New Haven, CT, United States
| | - Sevan Minassian
- University Hospital Cochin, Greater Paris University Hospitals (AP-HP), Paris, France
| | - Jasmina Mallet
- University Hospital Louis Mourier, Greater Paris University Hospitals (AP-HP), Paris, France.,Inserm UMR1266, Institute of Psychiatry and Neurosciences of Paris (IPNP), Paris, France
| | - Marie Rose Moro
- University Hospital Cochin, Greater Paris University Hospitals (AP-HP), Paris, France.,University of Paris, PCPP, Boulogne-Billancourt, France.,University Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France
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