ABSTRACT
Neurological diseases often manifest with psychiatric symptoms, profoundly impacting patients' well-being and treatment outcomes. This comprehensive review examines the psychiatric manifestations associated with Alzheimer's disease, frontotemporal dementia (FTD), Parkinson's disease, multiple sclerosis (MS), stroke, epilepsy, Huntington's disease, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI), and multiple system atrophy (MSA). Key psychiatric symptoms include agitation, depression, anxiety, apathy, hallucinations, impulsivity, and aggression across these diseases. In addition, ethical considerations in treating these symptoms are paramount, particularly regarding genetic testing implications, end-of-life discussions, informed consent, and equitable access to innovative treatments. Effective management necessitates interdisciplinary collaboration, personalized interventions, and a focus on patient autonomy. Understanding the psychiatric burden of neurological diseases is crucial for enhancing patients' quality of life. Further research is needed to elucidate underlying mechanisms and develop targeted interventions. This review underscores the importance of comprehensive assessment and ethical treatment practices to address psychiatric manifestations effectively.
ABSTRACT
Our review paper delves into the intricate and multifaceted realm of cannibalism, with a focused exploration of its manifestations in Wendigo psychosis. We aim to explore the implications of cannibalism within the realms of psychiatry, anthropology, psychology, and sociology by navigating the complexities of cultural beliefs, psychological underpinnings, historical contexts, and contemporary significance surrounding cannibalism. Cannibalism is deeply ingrained in the cultural and mythological heritage of Algonquian-speaking tribes; it is closely associated with the symbolic figure of the Wendigo. The Wendigo serves as a warning about the potential loss of one's humanity in dire circumstances like starvation. Wendigo psychosis, characterized by psychiatric manifestations such as paranoia, anxiety, hallucinations, and cannibalistic urges, often emerges as a result of a fusion of cultural narratives and psychological vulnerabilities. This may provide an outlet for individuals experiencing internal distress. Historical records show that instances of Wendigo psychosis and cannibalism were more prevalent during periods of extreme scarcity and famine among Algonquian tribes, but they can also manifest in non-famine contexts. Cannibalism assumes diverse forms and meanings across various cultures, encompassing ritualistic, sacrificial, or survival cannibalism. Acknowledging these nuances is paramount to avoiding perpetuating harmful stereotypes and to appreciating the significance of these practices within specific cultures. Engaging in discussions about cannibalism necessitates cultural sensitivity and respect for diverse cultural practices and beliefs to foster open dialogue and enhance cross-cultural understanding. Although cannibalism is often associated with psychiatric disorders, it is not exclusively rooted in mental illness. Factors like substance abuse, antisocial traits, and environmental upbringing can also contribute to cannibalistic acts. In some cases, cannibalism may be linked to survival instincts stemming from trauma and abuse. Therefore, it is vital to distinguish between various forms of cannibalism and understand their underlying motivations. Analyzing cannibalistic fantasies from a psychoanalytic perspective involves exploring mechanisms such as melancholia and oral fixation, shedding light on the psychological underpinnings of these thoughts and urges. Moreover, the influence of media portrayals of cannibalism on public perceptions cannot be underestimated. Sensationalism and romanticization in popular culture can distort our understanding of the motivations and mental states of individuals involved in cannibalistic acts. In essence, cannibalism remains an intriguing and multidimensional topic deeply entrenched in cultural narratives and psychological complexities. A comprehensive understanding necessitates a multidisciplinary approach, taking into account how historical context, cultural beliefs, psychological experiences, and societal dimensions shape human behavior and our comprehension of the human condition. To navigate this complex subject with sensitivity and respect, it is essential to recognize the diverse manifestations and motivations behind cannibalistic behavior, whether in the context of Wendigo psychosis or other cultural practices.
ABSTRACT
Although multiple myeloma (MM) can cause various neurological complications, direct central nervous system (CNS) involvement is exceedingly uncommon and poorly understood. There has been one other reported case in the literature of a patient presenting with psychosis prior to diagnosis of MM. We present a case of a 58-year-old female with no history of psychiatric illness who presented to a behavioral health inpatient unit with paranoid delusions, multisensory hallucinations, and disorganized behavior in the days preceding her MM diagnosis. Due to hypercalcemia and altered mental status, she was transferred to an inpatient medical unit for further medical workup. Imaging revealed a sternal mass and diffuse lytic lesions. MM was confirmed. Her psychotic symptoms improved after one cycle of chemotherapy and steroids, treatment with aripiprazole, and resolution of hypercalcemia. Unlike other case reports where mental status changes have been described as consequences of already diagnosed MM, this patient's psychotic symptoms manifested prior to her MM diagnosis. While the exact pathophysiological mechanisms remain unclear, this case highlights a potential link between the sudden onset of psychosis and underlying undiagnosed MM. Healthcare providers need to be aware of this rare clinical presentation of psychosis in conjunction with MM.