["ZOOM effect". The TV sign in patients with dementia: Is there an increased incidence during pandemia due to a rise in isolation and virtuality?] / "Efecto ZOOM". El signo de la TV en pacientes con demencia: ¿Hubo un aumento en la incidencia durante la pandemia debido al mayor aislamiento y la virtualidad?

Delusional misidentification syndromes are misperceptions of external stimuli with an associated belief or elaboration that is held with delusional intensity. In the TV sign patient believes that the observed television events are occurring in a real three-dimensional space. It is one of the very rare forms of delusional misidentification syndrome in patients withdementia.Wereport7patientswithcognitiveimpairmentcaseswhohavepresentedTVsignduringtheCOVID-19 pandemic. Two patients had Alzheimer's dementia type diagnosis, 1 atypical Alzheimer dementia, 1 vascular dementia and 3 of them had mixed etiology (2 Alzheimer dementia + vascular and 1 dementia with Lewy bodies + vascular). Three presented other psychotic symptoms and 1 patient also had Capgras syndrome. These 7 cases series raise the possibility of an increase incidence of TV sign in patients with dementia during pandemia triggered by the rise in expo- sure to screen devices and a social isolation during this period.

Evidence for an interrelated cluster of Hallucinatory experiences in the general population: an incidence study.

BACKGROUND: Although hallucinations have been studied in terms of prevalence and its associations with psychopathology and functional impairment, very little is known about sensory modalities other than auditory (i.e. haptic, visual and olfactory), as well the incidence of hallucinations, factors predicting incidence and subsequent course. METHODS: We examined the incidence, course and risk factors of hallucinatory experiences across different modalities in two unique prospective general population cohorts in the same country using similar methodology and with three interview waves, one over the period 1996-1999 (NEMESIS) and one over the period 2007-2015 (NEMESIS-2). RESULTS: In NEMESIS-2, the yearly incidence of self-reported visual hallucinations was highest (0.33%), followed by haptic hallucinations (0.31%), auditory hallucinations (0.26%) and olfactory hallucinations (0.23%). Rates in NEMESIS-1 were similar (respectively: 0.35%, 0.26%, 0.23%, 0.22%). The incidence of clinician-confirmed hallucinations was approximately 60% of the self-reported rate. The persistence rate of incident hallucinations was around 20-30%, increasing to 40-50% for prevalent hallucinations. Incident hallucinations in one modality were very strongly associated with occurrence in another modality (median OR = 59) and all modalities were strongly associated with delusional ideation (median OR = 21). Modalities were approximately equally strongly associated with the presence of any mental disorder (median OR = 4), functioning, indicators of help-seeking and established environmental risk factors for psychotic disorder. CONCLUSIONS: Hallucinations across different modalities are a clinically relevant feature of non-psychotic disorders and need to be studied in relation to each other and in relation to delusional ideation, as all appear to have a common underlying mechanism.

Estudio descriptivo de series de casos de trastorno delirante / Descriptive study of case series with delusional disorder

Objective: The objective of this study is to investigate the demographic, environmental, psychosocial and clinical characteristics in a group of patients with delusional disorder (DD). Methodology: Retrospective descriptive study of DD cases registered at Psychiatry and Mental Hygiene Clinic of Cordoba according to DSM-IV/V criteria was conducted. We obtained a sample of 261 DD patients who met the inclusion criteria. Data and variables collected were divided into 4 groups: I. Socio-demographic and general data; II. DD risk factors (personal and family); III. DD clinical picture and diagnosis (presentation, symptoms, disability, use of health care resources, treatment, and evolution). Results: The proportion of males versus females was of 1.12. Only 16.5 percent of patients could not read or write. At the first visit of the psychiatry clinic, 56.3 percent of the patients were married and about half of them shared home. About 16.9 percent of patients had a past history of alcohol consumption, and 2.3 percent consumed other drugs. The most frequent subtype with the persecutory with 129 cases (49.4 percent). The mean delay in psychiatric attention was 43.21 months; the minimum value with 27 months was observed in the somatic subtype and the maximum value with 70 months was observed in jealous subtype. Ideas of reference and of persecution were found in 83.9 percent and 82.0 percent respectively. Conclusions: It is necessary to conduct future prospective studies to investigate the risk factors associated with the DD.

Objetivo: El objetivo de este estudio es conocer las características demográficas, ambientales, psicosociales y clínicas de un grupo de pacientes con trastorno delirante (TD). Metodología: Estudio epidemiológico descriptivo retrospectivo de Registro de Casos en el Dispensario de Psiquiatría e Higiene Mental de Córdoba sobre pacientes con TD según criterios DSM-IV-TR y DSM-V. Aquellos pacientes que cumplieron con los criterios de inclusión definidos constituyeron nuestra muestra final de 261 casos. Las variables recogidas fueron agrupadas con el orden siguiente: I. Variables de los datos sociodemográficos y generales; II. Variables de los Factores de riesgo del TD (familiares y personales); III. Variables del Cuadro Clínico y el Diagnóstico del TD (presentación, sintomatología delirante, funcionalidad y discapacidad, utilización de los recursos sanitarios, tratamiento, problemas psicosociales, evolución y curso). Resultados: La proporción hombres versus mujeres fue de 1,12. El 30 por ciento era analfabeto; el 56,3 por ciento se encontraba casado y el 58,2 por ciento convivían con la familia en el momento de realizar la primera consulta psiquiátrica. Un 16,9 por ciento consumió previamente alcohol y un 2,3 por ciento otras sustancias. El subtipo más numeroso fue el persecutorio con 129 casos (49,4 por ciento). Los valores medios de demora en la atención psiquiátrica fueron de 43,21 meses, el valor mínimo con 27 meses lo presentó el somático y el máximo el celotípico con 70 meses. Las ideas de referencia y de persecución se presentaron en el 83,9 por ciento y en el 82,0 por ciento de los casos respectivamente. Conclusiones: Son necesarios futuros estudios prospectivos para investigar los factores de riesgo del TD.

History of religious delusions and psychosocial functioning among Mexican patients with paranoid schizophrenia.

The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.

The continuum of psychotic symptoms in the general population: a cross-national study.

OBJECTIVE: To identify the cross-national prevalence of psychotic symptoms in the general population and to analyze their impact on health status. METHOD: The sample was composed of 256,445 subjects (55.9% women), from nationally representative samples of 52 countries worldwide participating in the World Health Organization's World Health Survey. Standardized and weighted prevalence of psychotic symptoms were calculated in addition to the impact on health status as assessed by functioning in multiple domains. RESULTS: Overall prevalences for specific symptoms ranged from 4.80% (SE = 0.14) for delusions of control to 8.37% (SE = 0.20) for delusions of reference and persecution. Prevalence figures varied greatly across countries. All symptoms of psychosis produced a significant decline in health status after controlling for potential confounders. There was a clear change in health impact between subjects not reporting any symptom and those reporting at least one symptom (effect size of 0.55). CONCLUSIONS: The prevalence of the presence of at least one psychotic symptom has a wide range worldwide varying as much as from 0.8% to 31.4%. Psychotic symptoms signal a problem of potential public health concern, independent of the presence of a full diagnosis of psychosis, as they are common and are related to a significant decrement in health status. The presence of at least one psychotic symptom is related to a significant poorer health status, with a regular linear decrement in health depending on the number of symptoms.

Dimensional correlates of poor insight in obsessive-compulsive disorder.

BACKGROUND: Cross-sectional studies have associated poor insight in patients with obsessive-compulsive disorder (OCD) with increased OCD symptom severity, earlier age of onset, comorbid depression, and treatment response. The goal of this current study was to examine the relationship between dimensions of OCD symptomatology and insight in a large clinical cohort of Brazilian patients with OCD. We hypothesized that poor insight would be associated with total symptom severity as well as with hoarding symptoms severity, specifically. METHODS: 824 outpatients underwent a detailed clinical assessment for OCD, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), the Brown Assessment of Beliefs Scale (BABS), a socio-demographic questionnaire, and the Structured Clinical Interview for axis I DSM-IV disorders (SCID-P). Tobit regression models were used to examine the association between level of insight and clinical variables of interest. RESULTS: Increased severity of current and worst-ever hoarding symptoms and higher rate of unemployment were associated with poor insight in OCD after controlling for current OCD severity, age and gender. Poor insight was also correlated with increased severity of current OCD symptoms. CONCLUSION: Hoarding and overall OCD severity were significantly but weakly associated with level of insight in OCD patients. Further studies should examine insight as a moderator and mediator of treatment response in OCD in both behavioral therapy and pharmacological trials. Behavioral techniques aimed at enhancing insight may be potentially beneficial in OCD, especially among patients with hoarding.

Identificación de la ideación suicida en una población abierta / Identification of suicidal ideation in an open population

Tomando como muestra la población que asiste por cualquier motivo al Hospital Regional 1o. de Octubre, se aplicó un cuestionario en forma individual con el fin de investigar el grado de ideación suicida (SIS-Q), el cual explora los siguientes parámetros: 1) Trastornos del sueño, 2) trastornos del ánimo, 3) sentimientos de culpa y 4) minusvalía. La población se dividió en ocho grupos: I, sujetos con trastornos del sueño; II, con trastornos del ánimo; II, con sentimiento de culpabilidad; IV, con minusvalía; V, con trastornos del sueño y de la conducta; VI, con depresión; VII, con franca ideación suicida, y VIII, personas sin ninguna alteración. Se estudió una población total de 1,000 pacientes, de los cuales 675 (67.5 por ciento) correspondieron al sexo masculino y 325 (32.5 por ciento) al sexo femenino, cuya edad osciló entre 15 y 81 años, con una media de 48. Setenta y nueve de los sujetos encuestados (12.2 por ciento) presentaron franca ideación suicida, siendo 27 (4.1 por ciento) hombres y 52 (8.0 por ciento) mujeres, con predominio en el grupo de mujeres de 35.44 años, con 14 casos (17.7 por ciento), y la mayor frecuencia se presentó en hombre de 45-54 años con seis casos (7.5 por ciento). El 9.1 por ciento (59) de los encuestados tuvieron depresión, 21 (3.2 por ciento) hombres y 38 (5.9 por ciento) mujeres. Se encontró una mayor frecuencia en el grupo de mujeres de 35-44 añois, con 11 casos, y en varones de 45-54 años con seis casos (1.6 por ciento). Del grupo estudiado, 152 personas (23.6 por ciento) manifestaron trastornos del sueño, 51 (7.8 por ciento) hombres y 93 (15.6 por ciento) mujeres, en donde la edad que predominó en uno y otro sexo fue de 35-44 años; en el resto de la población, 60 (9.3 por ciento) casos cursaron con trastornos del ánimo, el 2.9 por ciento (19) presentó sentimiento de culpa y 11 (1.7 por ciento) minusvalía. Llamó la atención que de una población aparentemente sana se encuentra que 12.2 por ciento presenten franca ideación suicida y 9.16 por ciento cursen con criterios mayores para depresión, que es el factor más importante asociado al suicidio

Characteristics of freebase cocaine psychosis.

Psychosis was present in 29 percent of cocaine-disordered patients hospitalized in 1985 during an epidemic of freebase cocaine abuse in the Bahamas. Record reviews revealed that a variety of psychotic phenomenologic patterns were present. Prior major mental disorders and increased dosage of cocaine were more common among psychotic than non-psychotic patients. Violent behavior was common among cocaine patients, especially those with psychosis. We conclude that freebase cocaine psychosis is neither rare nor benign.

Characteristics of freebase cocaine psychosis

Psychosis was present in 29 percent of cocaine disordered patients hospitalized in 1985 during an epidemic of freebase cocaine abuse in the Bahamas. Record reviews revealed that a variety of psychotic phenomenologic patterns were presented. Prior major mental disorders and increased dosage of cocaine were more common among psychotic than non psychotic patients. Violent behaviour was common among cocaine patients, especially those with psychosis. We conclude that freebase cocaine psychosis is neither rare nor benign. (AU)

Schneider's First Rank Symptoms: an international and interethnic comparative study.

419 patients in Sri Lanka, 150 patients in U.K. and 172 patients in Canada who were suffering from "Functional Psychoses" were interviewed using the Present State Examination to elicit Schneider's First Rank Symptoms (FRS). Nationality and ethnicity were found to be significant variables associated with lower prevalence of FRS. Higher prevalence of cultural and subcultural beliefs among ethnic minorities may contribute towards this lower prevalence but a true reduction also appears to be present. Prevalence of some individual FRS also vary with ethnicity and nationality. Universally, FRS had a good discriminative value.