Basal ganglia calcification and psychosis in 22q11.2 deletion syndrome.

Intracerebral calcifications are a facultative symptom of hypoparathyreoidism in 22q11.2 deletion syndrome (22qDS). We describe a patient with 22qDS, basal ganglia calcification (BGC) and psychotic symptoms and discuss the etiological connection of BGC with psychiatric symptoms. Future work needs to determine the prevalence of BGC in 22qDS and psychiatric disorders.

Lycanthropy--psychopathological and psychodynamical aspects.

OBJECTIVE: The imagination of being transformed into an animal or being an animal is called lycanthropy. The phenomenon is presented and psychodynamical aspects are discussed. METHOD: A literature review forms the base of this discussion of a psychopathological phenomenon. RESULTS: The lycanthropic symptomatology represents a spectrum of continuity of developmental and culture-dependent normal behaviour via partial forms to the complete picture of lycanthropy. It is observed in different mental disorders. CONCLUSION: Lycanthropy is interpreted by the authors as a delusion in the sense of the self-identity disorder defined by Scharfetter. It is mainly found in affective and schizophrenic disorders but can be a symptom of other psychiatric disorders as well. Psychodynamically this kind of delusion can be interpreted as an attempt to project suppressed affects, especially with aggressive or sexual content, into the figure of an animal. Psychotherapy and/or neuroleptic medication can be effective.

[Koro--discussing a transcultural psychopathological phenomenon]. / Koro--Erörterung eines transkulturell psychopathologischen Phänomens.

Koro describes a psychopathological phenomenon mainly found in Asia. It is the syndrome of an assumption of male genital shrinking. This idea is rarely described in Western culture. Inspired by a current case report--a patient, suffering from schizophrenia described Koro-like symptoms--we will discuss Koro on the basis of a literature review in its transcultural psychiatric context.

The development of a clinical syndrome of asymptomatic pancreatitis and eosinophilia after treatment with clozapine in schizophrenia: implications for clinical care, recognition and management.

Clozapine, the first atypical antipsychotic, is indicated for the treatment of therapy-resistant schizophrenia. It needs to be monitored closely because of its well-known potential side-effects, especially agranulocytosis. We present a case of a middle-aged woman with chronic schizophrenia, who was treated with clozapine and developed a clinical syndrome of asymptomatic pancreatitis and eosinophilia within the fifth week of treatment. Asymptomatic pancreatitis has rarely been reported up to now and is not recognized as a typical side-effect of clozapine. In our opinion, pancreatic enzymes should be monitored especially in the first 6 weeks of clozapine treatment.

[Erotomania and Frégoli syndrome. A case report]. / Liebeswahn und Frégoli-Syndrom. Eine Kasuistik.

A case report of a female schizophrenic patient is presented who showed a coincidence of erotomania and Frégoli syndrome with some interesting symptom constellations only rarely mentioned in the literature. Organic and psychodynamic factors were found in the etiopathogenesis of this disorder. A combination of psychotherapy and neuroleptic therapy was partly successful.

[Unplanned discharge in a psychiatric day clinic - argument for an individualized approach]. / Behandlungsabbruch in der psychiatrischen Tagesklinik - Plädoyer für eine differenzierte Betrachtungsweise.

OBJECTIVE: Drop-outs, respectively unplanned discharges in psychiatric therapy are often explained by so-called lack of insight into the disease or difficult circumstances of admission. We were interested in the question how often drop outs are noticed in a voluntarily day clinic setting where nearly all psychiatric diseases are treated. METHOD: The charts of all patients discharged in 1998 (n = 65) were screened referring to their mode of discharge. RESULTS: 31 patients (47.7 %) regularly ended their treatment. An unplanned discharge was registered with 34 patients (52.3 %). CONCLUSIONS: The statistically relevant term of drop-out does not appear to be the right one to deal with the individual treatment situation and the motivation for the limitation of treatment. A typology of prematurely ended therapies is developed.

[Lycanthropy-zooanthropism--discussion of a psychopathological phenomenon]. / Lykanthropie/Zooanthropismus--Erörterung eines psychopathologischen Phänomens.

The belief to be transformed into an animal is named Lycanthropy. "Zooanthropismus" is the German equivalent. Three case reports raised the question how this phenomenon, in our cases to be transformed into a frog, a bee or a wolf/dog, can be interpreted in a psychopathological and diagnostic regard. Is it pathognomonic for a special disease? With the three case reports and a survey of the literature this paper deals with Lycanthropy trying to put this perhaps neglected topic back into the focus of psychiatric interest and place it in psychopathology.