Matricide and schizophrenia- psychopathological, psychodynamic, and forensic aspects: a case report.

Matricide is the murder of a mother by her son or daughter, a form of homicide rarely seen in psychiatric practice. A narrative review was conducted on the relationship between matricide and schizophrenia, followed by a case report in Brazil of a schizophrenic patient who murdered his mother and was submitted to forensic psychiatric assessment for criminal liability. The article discusses psychopathological, psychodynamic, and forensic aspects related to the case. The observation of ambivalent and conflictive relations between schizophrenic individuals and their mothers suggests the need for family-level interventions to resolve the understandable occurrence of emotional conflicts, which can serve as stimuli that trigger the murder.

Cessation of dangerousness status in Brasília, Brazil: An analysis of 144 reports from Federal District Medical Examiner's Office in the last 10 years.

The aim of this study is to evaluate factors related to cessation of dangerousness of individuals under safety measures, through the study of psychiatric reports. This is a cross-sectional study, conducted through a retrospective analysis of expert psychiatric dangerousness cessation reports issued by the Federal District Coroner's Office, Brasília, Brazil. By examining official files, information was extracted from the reports (socio-demographic data, clinical characteristics, type of crime, historical characteristics and the search for items related to risk assessment present in instruments such as Historical, Clinical and Risk Management [HCR-20], Psychopathy Checklist - Revised [PCL-R], Two-Tiered Violence Risk Scale [TTV], Short-Term Assessment of Risk and Treatability [START] and others) and submitted to statistical analysis and then compared to other studies on the subject. The items most considered by the experts were those referring to PCL-R, START and the "non static" part of HCR-20 and TTV. For the non-cessation of dangerousness, we've found: absence of remorse, fragile behavioral control, early behavioral problems, juvenile delinquency. For the cessation of dangerousness, we've found: presence of social skills, balanced emotional state, presence of social support, adherence to rules, good coping strategies, involvement with treatment and adherence. The systematization and standardization of forensic psychiatric reports needs to be established and the use of risk assessment instruments are essential to support better decisions by the experts.

Dementia or psychosis precipitated by social isolation? A brief case report in COVID-19 pandemic times.

BACKGROUND: The year 2020 was marked by the pandemic of COVID-19, which abruptly changed the ways of dealing with viral infections and social relationships. Cognitive, emotional, and neurological effects due to infection with this condition, as well as several health damages, are due to social isolation. AIM: To recognize the consequences of and reasons behind forced social isolation and related psychosis symptoms. METHOD: This is a case report of a healthy 70-year-old female patient who began to experience paranoid delusions and auditory hallucinations after adopting strict measures that abruptly impacted her routine of activities outside the home, by confining herself at home overnight. The patient has agreed to the publication anonymously and signed an informed consent. RESULTS: The patient required rapid and home treatment with risperidone antipsychotics, and eventually had a total remission of symptoms. The suspicion of dementia or another organic cause was investigated and has so far been ruled out. DISCUSSION AND CONCLUSIONS: It is suggested that the situation was triggered by abrupt and unorganized social isolation during the pandemic. A literature review on the subject was carried out, finding pertinent information about psychosis, social isolation due to COVID-19, and the case described. The patient will follow a careful follow-up with a plan for withdrawal of antipsychotic medication after 6 asymptomatic months with monitoring of demented prodrome. It is necessary to study more about this topic and promote planning in case of a need to adopt extreme measures, such as isolation and lockdown.

Prevalence of Capgras syndrome in Alzheimer's patients: A systematic review and meta-analysis.

The association between Capgras syndrome and Alzheimer's disease has been reported in several studies, but its prevalence varies considerably in the literature, making it difficult to measure and manage this condition. OBJECTIVE: This study aims to estimate the prevalence of Capgras syndrome in patients with Alzheimer's disease through a systematic review, and to review etiological and pathophysiological aspects related to the syndrome. METHODS: A systematic review was conducted using the Medline, ISI, Cochrane, Scielo, Lilacs, and Embase databases. Two independent researchers carried out study selection, data extraction, and qualitative analysis by strictly following the same methodology. Disagreements were resolved by consensus. The meta-analysis was performed using the random effect model. RESULTS: 40 studies were identified, 8 of which were included in the present review. Overall, a total of 1,977 patients with Alzheimer's disease were analyzed, and the prevalence of Capgras syndrome in this group was 6% (CI: 95% I² 54% 4.0-8.0). CONCLUSION: The study found a significant prevalence of Capgras syndrome in patients with Alzheimer's disease. These findings point to the need for more studies on the topic to improve the management of these patients.

A associação da síndrome de Capgras com a doença de Alzheimer é relatada em diversos estudos, porém a sua prevalência varia consideravelmente entre bibliografias, dificultando a real mensuração e manejo desta patologia. OBJETIVO: O objetivo deste estudo foi estimar, através de uma revisão sistemática, a prevalência da síndrome de Capgras em pacientes com a doença de Alzheimer, bem como revisar os aspectos etiológicos e fisiopatológicos relacionados à síndrome. MÉTODOS: Uma revisão sistemática foi realizada utilizando-se as seguintes bases de dados: Medline, ISI, Cochrane, Scielo, Lilacs e Embase. A seleção dos estudos, extração de dados e análise qualitativa foi feita por dois pesquisadores de forma independente e seguindo rigorosamente a mesma metodologia, sendo as discordâncias resolvidas por consenso. A metanálise foi calculada utilizando-se modelo de efeito randômico. RESULTADOS: Foram recuperados 40 estudos, dos quais 8 foram incluídos na presente revisão. Considerando todos os estudos incluídos, 1977 pacientes com doença de Alzheimer foram analisados, sendo encontrada a prevalência da síndrome de Capgras dentre esses pacientes de 6% (IC: 95% I² 54% 4,0-8,0). CONCLUSÃO: A presente revisão encontrou uma prevalência significativa da síndrome de Capgras nos pacientes com doença de Alzheimer. Tal achado implica na necessidade de mais estudos visando melhorar o manejo desses pacientes.

Esophageal mucosal resection versus esophagectomy: a comparative study of surgical results in patients with advanced megaesophagus.

BACKGROUND: The surgical treatment of advanced megaesophagus has no consensus, being esophagectomy the more commonly used method. Since it has high morbimortality--inconvenient for benign disease -, in recent years an alternative has been introduced: the esophageal mucosal resection. AIM: To compare early and late results of the two techniques evaluating the operative time, length of ICU stay; postoperative hospitalization; total hospitalization; intra- and postoperative complication rates; mortality; and long-term results. METHODS: Were evaluated retrospectively 40 charts, 23 esophagectomies and 17 mucosectomies. In assessing postoperative results, interviews were conducted by using a specific questionnaire. RESULTS: Comparing the means of esophagectomy and mucosal resection, respectively, the data were: 1) surgical time--310.2 min and 279.7 min (p > 0.05); 2) length of stay in ICU--5 days and 2.53 days (p <0.05); 3) total time of hospitalization--24.25 days and 20.76 days (p> 0.05); 4) length of hospital stay after surgery--19.05 days and 14.94 days (p> 0.05); 5) presence of intraoperative complications--65% and 18% (p <0.05); 6) the presence of postoperative complications - 65% and 35% (p> 0.05). In the assessment of late postoperative score (range 0-10) esophagectomy (n = 5) obtained 8.8 points and 8.8 points also got mucosal resection (n = 5). CONCLUSIONS: Esophageal mucosal resection proved to be good alternative for surgical treatment of megaesophagus. It was advantageous in the immediate postoperative period by presenting a lower average time in operation, the total hospitalization, ICU staying and complications rate. In the late postoperative period, the result was excellent and good in both operations.