1/9. Severe gamma-hydroxybutyrate withdrawal: a case report and literature review.We report a case of gamma-hydroxybutyrate (GHB) withdrawal resulting in severe agitation, mental status changes, elevated blood pressure, and tachycardia hours after stopping chronic use of GHB. The patient admitted to substantial GHB abuse on a daily basis for 2.5 years. Previous attempts at cessation reportedly resulted in diaphoresis, tremors, and agitation. The patient's symptoms, negative polypharmacy history, and negative urine and blood toxicological analysis for alcohol, benzodiazepines, sedative-hypnotics, or other substances suggested the diagnosis of GHB withdrawal. Later analysis of a patient drug sample confirmed the presence of GHB. The patient required 507 mg of lorazepam and 120 mg of diazepam over 90 h to control agitation. This is one of the few reported cases of GHB withdrawal and one of the most severe. Given the increasing use of GHB, more cases of severe GHB withdrawal should be anticipated.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
2/9. poisoning with Boophane disticha: a forensic case.Scales from the bulb are traditionally used as wound dressing after circumcision and as general wound dressing. Concoctions of the bulb taken orally cause sedation, analgesia, visual hallucinations, irrational behaviour, coma or death. A man ingested 150 ml of a concoction to see who placed a spell on him. He started to hallucinate, thinking that somebody was attacking him. He pulled his gun and fired shots randomly, killing one person and injuring others. A gas chromatograph/mass spectrometer was used to analyze a sample of the concoction. The sample contained buphandrin, buphanine and crinamidine (alkaloids) and eugenol. Buphanine has a pharmacological action similar to that of hyoscine and, when ingested in toxic quantities, leads to excitement, agitation, hallucinations and coma. eugenol is a volatile oil with analgesic properties. Although itcould not be proved that the concoction was only from Boophane disticha, the components were similar to those found in Amaryllidaceae to which Boophane belongs. The man's behaviour could be ascribed to the ingestion of compounds found in B. disticha.- - - - - - - - - - ranking = 2keywords = sample (Clic here for more details about this article) |
3/9. Fiery tongues and mystical motivations: glossolalia in a forensic population is associated with mania and sexual/religious delusions.Comparisons are made between a nonrandom sample of 18 glossolalists and 130 non-glossolalists admitted to a maximum-security forensic hospital. The glossolalic mentally disordered offender exhibited a predominance of diagnoses in the manic spectrum, and was typically psychotic. The delusions, hallucinations, and crimes were predominately of a religious and sexual nature. Glossolalist perpetrators tended to be female. We review the extant research on glossolalia in both normal and clinical samples. and integrate our findings, the first study of glossolalia in a forensic setting.- - - - - - - - - - ranking = 2keywords = sample (Clic here for more details about this article) |
4/9. sleep paralysis among Cambodian refugees: association with PTSD diagnosis and severity.Among Cambodian refugees attending a psychiatric clinic (n=100), 49% (49/100) had at least one episode of sleep paralysis (SP) in the previous 12 months. The annual and monthly SP prevalences were much higher in posttraumatic stress disorder (PTSD) than in non-PTSD patients. Among the PTSD patients, 65% (30/46) had monthly episodes of SP versus 14.85% (8/54) among non-PTSD patients (chi2[2, n=100]=26.78, P<.001). Moreover, patients with SP in the last month (n=30) versus those without SP had much higher PTSD severity scores. In the entire sample (n=100), the PTSD severity scores correlated significantly with the rate of SP in the last month. During SP, Cambodian refugees usually hallucinated an approaching figure (90%, 44/49). The rate of SP-associated and post-SP panic attacks was high, indicating the great distress caused by the phenomenon. SP seems to be a core aspect of the Cambodian refugee's response to trauma. When treating Cambodian refugees, and traumatized refugees in general, clinicians should assess for its presence.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
5/9. Musical hallucinations. A historical and clinical study.A sample of 46 subjects experiencing musical hallucinations was analysed - 10 new cases in addition to 36 culled from the literature. When compared with controls, it was found that musical hallucinations are far more common in females, and that age, deafness, and brain disease affecting the non-dominant hemisphere play an important role in their development. Psychiatric illness and personality factors were found to be unimportant.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
6/9. Clinical correlates of septum pellucidum cavities: an unusual association with psychosis.Cavities in the septum pellucidum are widely regarded as incidental findings of little clinical importance. The prevalence of such cava on computerized tomography in a mixed sample of 22000 neurological and psychiatric patients is found to be 0.15%. A statistical association between this anomaly and a referral diagnosis of functional psychosis is reported, and 6 cases are described. These cases were male and characterized by an early history of developmental delay, with lifelong disturbances of emotion and behaviour prior to the onset in early adulthood of an atypical schizophrenia-like psychosis with disorders of speech and movement. It is suggested that septal cavities may signal an underlying abnormality of function relevant to the pathogenesis of these illnesses.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
7/9. hallucinations in patients admitted to a geriatric psychiatry service: review of 42 cases.Although hallucinatory experiences may be relatively common among the elderly, isolated, and infirm, their frequency has been the subject of little research. Patient records of admissions to a 12-bed geriatric psychiatry service over three and a half years were reviewed for documented presence of hallucinatory symptoms. hallucinations were documented in 15 per cent of the cases. Although acute and chronic brain syndromes and schizophrenic disorders were disproportionately represented in the hallucinating sample, affective disorders were also represented. A significant number of persons in this sample were single and had been living alone prior to admission and were described by family members or others as having "independent" or "reclusive" personality styles. In the majority of cases there was no history of psychiatric illness, and the individuals were distressed by the hallucinatory experiences. Symptom management is discussed in the context of factors that appear to affect occurrences and types of hallucinations and the responses to hallucinations in elderly patients.- - - - - - - - - - ranking = 2keywords = sample (Clic here for more details about this article) |
8/9. erythropoietin and visual hallucinations in patients on dialysis.The authors encountered five patients who first had visual hallucinations while taking erythropoietin. Since this association had not previously been reported, the authors studied a convenience sample of dialysis patients at two institutions to determine the incidence of visual hallucinations in patients on erythropoietin and possible associated risk factors. Eleven percent of the patients had visual hallucinations at one institution with no other factor than erythropoietin as a probable cause and 2% at the other. Significant risk factors for hallucinations included diabetic retinopathy or cataracts (chi 2 = 4.59, df = 1, P = 0.032) and older age (t = 2.24, df = 123, P = 0.27). A multivariate analysis comparing visual hallucinations, eye pathology, and age showed that eye pathology was close to the trend level of significance but that age maintained significance as a risk factor. The visual hallucinations occurred in response to the administration of erythropoietin and appeared to vary in relation to dose. Similarities between the syndrome of visual hallucinations in dialysis patients taking erythropoietin and the syndrome of visual hallucinations in dialysis patients taking erythropoietin and the Charles Bonnet syndrome are discussed.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
9/9. Hallucinosis in idiopathic Parkinson's disease.BACKGROUND: Hallucinosis is a complication of the treatment of idiopathic Parkinson's disease commonly thought to afflict older, chronically medicated, cognitively impaired patients. However, patients with idiopathic Parkinson's disease of short duration experiencing hallucinosis on relatively low doses of dopaminergic medication have been found. The aim, therefore, was to investigate the homogeneity of a population of patients with idiopathic Parkinson's disease and hallucinosis. methods: The clinical, demographic, and cognitive correlates of hallucinosis were investigated in a sample of 129 patients with idiopathic Parkinson's disease. RESULTS: There were two subgroups of patients with idiopathic Parkinson's disease experiencing hallucinosis. In patients with a disease duration of five years or less, hallucinosis was associated with rapid progression of the motor component of the disease but not cognitive impairment. In patients with idiopathic Parkinson's disease of longer than five years duration, hallucinosis was associated with postural instability, global cognitive impairment, and lack of depressive affect. In all patients with idiopathic Parkinson's disease, hallucinosis was more prevalent when they were treated with a direct acting dopamine receptor agonist. Hallucinosis was not associated with age at onset of idiopathic Parkinson's disease or dosage of dopaminergic medication. CONCLUSION: Hallucinosis in idiopathic Parkinson's disease is heterogeneous, falling into two groups. The difference in the pathophysiological basis of hallucinosis in these two groups of patients is discussed.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |