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Jonathan G Leung, Brian A Palmer
One underrecognized adverse event of clozapine is the emergence or worsening of obsessive-compulsive symptoms (OCS). OCS, particularly violent thoughts, can be inaccurately described as psychosis and result in a misdiagnosis. We report a case of a 42-year-old man, initially diagnosed with schizoaffective, who was placed on clozapine for the management of "violent delusions." However, clozapine led to a worsening of these violent thoughts resulting in suicidal ideation and hospitalization. After exploration of the intrusive thoughts and noting these to be egodystonic, clearly disturbing, and time consuming, an alternative diagnosis of obsessive-compulsive disorder (OCD) was made...
2016: Case Reports in Psychiatry
Diogo Telles-Correia, Ana Lúcia Moreira, João S Gonçalves
Prior to the seventeenth century, the experiences we now name hallucinations were valued within a cultural context, they could bring meaning to the subject or the world. From mid-seventeenth to eighteenth centuries, they acquire a medical quality in mental and organic illnesses. However, the term was only fully integrated in psychiatry by Esquirol in the eighteenth-nineteenth centuries. By then, a controversy begins on whether hallucinations have a perceptual or intellectual origin. Esquirol favors the intellectual origin, describing them as an involuntary exercise of memory and imagination...
2015: Frontiers in Psychology
Joel Paris
BACKGROUND: Egosyntonic and egodystonic features describe differences between trait-based and state-based mental disorders. Many diagnoses, most particularly personality disorder (PD), show both features. These complex forms of psychopathology are an amalgam of traits and symptoms in which both egosyntonicity and egodystonicity can be present but vary in prominence. This distinction might help resolve the long-standing controversy as to whether PDs are best classified using dimensions or categories...
February 2015: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Michele Fornaro, Matteo Martino
Poor-insight obsessive-compulsive disorder (PI-OCD) is a severe form of OCD where the 'typically obsessive' features of intrusive, 'egodystonic' feelings and thoughts are absent. PI-OCD is difficult to treat, often requiring very high doses of serotonergic drugs as well as antipsychotic augmentation. When this occurs, unpleasant side effects as nausea are common, eventually further reducing compliance to medication and increasing the need for pharmacological alternatives. We present the case of a PI-OCD patient who developed severe nausea after response to off-label doses of the selective serotonin reuptake inhibitor (SSRI), fluoxetine...
2010: Annals of General Psychiatry
John R E Fox, Amy Harrison
OBJECTIVE: difficulties with anger and disgust have been highlighted within females with eating pathology (FEP). However, research has not investigated whether FEP experience greater levels of anger compared to controls or how these two emotions may interact in FEP. It was predicted that FEP would show significantly higher levels of state anger and this would also lead to a significant increase in disgust for FEP. METHOD: the experimental group (n = 25) had significant levels of eating pathology...
March 2008: Clinical Psychology & Psychotherapy
Albina Rodrigues Torres, Maria Cristina Pereira Lima
Epidemiological surveys are important because clinical samples are subject of several selection biases. Sociodemographic factors and clinical aspects of the morbid condition itself influence help seeking behaviors. Due to the egodystonic nature of obsessive-compulsive disorder, sufferers tend to hide their symptoms and avoid or delay treatment seeking. However, most of our current knowledge about obsessive-compulsive disorder is based on clinical samples, which do not represent the totality of cases. A conventional Medline, PsychoInfo and Lilacs review of epidemiological studies on obsessive-compulsive disorder from 1980 to 2004 was conducted, using the following keywords: "epidemiology", "obsessive-compulsive disorder", "populational surveys" and "prevalence"...
September 2005: Revista Brasileira de Psiquiatria
Frédéric Langlois, Robert Ladouceur, Gosselin Patrick, Mark H Freeston
This study examines whether illness intrusions can be distinguished from obsessional intrusions and worries. It also assesses the relationship between strategies, thought characteristics, and appraisal of illness intrusions. Two hundred and forty-three non-clinical participants identified an obsessive intrusive thought, a worry, and an illness intrusion. They evaluated each thought using items from the Cognitive Intrusions Questionnaire. The comparisons of intrusions showed that illness intrusions share characteristics of worries and obsessional intrusions, but also have their own characteristics...
June 2004: Behaviour Research and Therapy
C H Abdo, A Hounie, M de Tubino Scanavino, E C Miguel
OBJECTIVE: There have been reports of obsessive-compulsive disorder (OCD) patients with comorbid paraphilias. In this paper, two cases of comorbidity between OCD and transvestism are reported with the aim of discussing possible explanations for this association. METHOD: Longitudinal case studies of two patients with OCD and tranvestism according to the DSM-IV were assessed using semi-structured interviews. RESULTS: Both patients presented with OCD and comorbid transvestism with different clinical features and treatment response...
June 2001: Acta Psychiatrica Scandinavica
F Langlois, M H Freeston, R Ladouceur
Worry is the central characteristic of Generalized Anxiety Disorder (GAD) and obsessions are a central feature of Obsessive-Compulsive Disorder (OCD). There are strong similarities between these disorders: repetitive cognitive intrusions, negative emotions, difficulty dismissing the intrusion and finally, loss of mental control. Direct comparisons between obsessions and worries are almost non-existent in the literature but key distinctions have been proposed. The study attempted to specify the differences between obsessive intrusive thoughts and worry in a nonclinical population across a series of variables drawn from current models (appraisal, general descriptors and emotional reactions)...
February 2000: Behaviour Research and Therapy
D E Vybornykh
The authors examined 16 patients with ischemic heart disease who had psychogenic disorders with ideas of rationalization of therapy. Paranoial personality disorders (paranoial psychopathy) was diagnosed in 11 patients, pseudopsychopathy in residual schizophrenia in 5 patients. The patients had either a fanatic idea of creating new methods of self-therapy and an autoaggressive behavior (performing some dangerous manipulations, usage of non-medicamentous substances, etc.). The premorbid state of such patients was characterized by inclination to paranoial reactions and a special predisposition to them combined with an egodystonic attitude to corporal manifestations...
1998: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
C Glickauf-Hughes
It is the premise of this article, that at least in some instances, narcissistic and masochistic characters may develop from different role assignments in the same family (i.e., families with narcissistic dynamics). It is hypothesized that the child who later becomes narcissistic becomes assigned the role of the good child, remains merged with the mother, and becomes her ego-ideal. In contrast, the mother projects the egodystonic aspects of herself onto the child who becomes scapegoated, more willful, and defiant and eventually masochistic...
June 1997: American Journal of Psychoanalysis
C Crépault
After having defined the terminology, the author attempts to identify homosexuality through the sexual individuation process and to trace its different ontogenic inconsistencies. A typology based on non conformity of gender and the heterophobia is suggested. Two clinical case examples will be given to further illustrate the sexoanalytic treatment of egodystonic homosexuality.
January 1994: Contraception, Fertilité, Sexualité
R Plutchik, H R Conte, T B Karasu, P Buckley
The paper is concerned with the integration of psychodynamic theory with psychometric theory in order to find meaningful ways to measure psychodynamic variables. Four reasons are suggested for the use of self-report tests in psychotherapy research. These include the need for reliable measuring instruments, cost-efficient methods of data collection, and the progressive refinement of "fuzzy" concepts through the process of test construction. A three-stage approach to outpatient assessment is presented which is called sequential psychodiagnostic evaluation...
1988: Hillside Journal of Clinical Psychiatry
M Hillbrand, H Foster, M Hirt
The availability of psychosocial treatment for sex offenders is influenced to a considerable extent by the process of adjudication. Convicted rapists are usually incarcerated, and thus receive treatment in a high-structure setting. Convicted child molesters are usually paroled and receive treatment in the low-structure setting of outpatient psychotherapy. In the present study, three types of sex offenders (child molesters, child rapists, and adult rapists) were compared to examine the validity of the match between type of sex offender and type of treatment modality...
February 1990: Archives of Sexual Behavior
J L Cummings, K Cunningham
Two patients with Huntington's disease (HD) and obsessive-compulsive disorder (OCD) are reported. The OCD was manifested by repetitive, stereotyped, complex, egodystonic behaviors that were disabling. These cases and other neurological syndromes with OCD (Gilles de la Tourette syndrome, neuroacanthocytosis, postencephalitic parkinsonism, caudate infarction, carbon monoxide poisoning, manganese intoxication, anoxia, progressive supranuclear palsy, Sydenham's chorea, and frontal lobe lesions) indicate that the frontal lobe, caudate nucleus, and globus pallidus are members of a complex circuit that plays a key role in mediating the symptoms of OCD...
February 1, 1992: Biological Psychiatry
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