Induced erotomania by online romance fraud - a novel form of de Clérambault's syndrome.

BACKGROUND: Although the impact of internet usage on mental health is extensively documented, there is a notable scarcity of reports in the literature concerning internet-induced erotomania. Erotomania is a rare and likely underdiagnosed delusional disorder. It is characterized by an irrational belief held by the affected persons that someone of higher socioeconomic status harbor romantic feelings toward them. Here, we describe the psychopathology of erotomanic delusion induced by online romantic fraud in a female patient. Employing this case as a focal point, we illuminate novel aspects of erotomania that warrant attention and examination. CASE PRESENTATION: We present a compelling case involving a 70-year-old married Caucasian woman diagnosed with medically controlled persistent depressive disorder for several years. The intricacies of her condition became evident as she became deeply engrossed in online profiles featuring the image of a renowned musician, inadvertently falling victim to an online romantic fraud. Subsequently, this distressing experience triggered the emergence of erotomanic delusions and a suicide attempt. The patient's history reveals an array of medical conditions and stressful life events, contributing to her vulnerability. The diagnosis of erotomanic delusional disorder, dysthymia, and mild cognitive impairment with cerebral vascular background was established. Treatment involved her previous antidepressant with low-dose risperidone, alongside supportive individual and group therapy. Her delusion showed remission four weeks later, prompting her discharge for outpatient follow-up. Although she retained some false beliefs, the intensity of the symptoms had notably diminished and her functionality improved. CONCLUSION: This case underscores the complex interplay between mental health, online activities, and the consequences of delusions, including suicidal thoughts, shedding light on the need for a comprehensive approach in addressing such challenging psychiatric scenarios.

Efficacy of repetitive transcranial magnetic stimulation (rTMS) adjunctive therapy for major depressive disorder (MDD) after two antidepressant treatment failures: meta-analysis of randomized sham-controlled trials.

BACKGROUND: Several meta-analyses demonstrated the efficacy of unilateral High-Frequency Left-sided (HFL) repetitive Transcranial Magnetic Stimulation (rTMS) for individuals with Major Depressive Disorder (MDD); however, results are contradictory due to heterogeneity of the included studies. METHODS: A systematic literature review (SLR) of English language articles published since 2000 was performed in March 2022 on PubMed and Scopus databases. Empirical evidence on the relative efficacy of rTMS treatment compared with standard pharmacotherapy in Treatment-Resistant Depression (TRD) were extracted. Random effects models were used to assess the effects of rTMS on response and remission rates. RESULTS: 19 randomized double-blinded sham-controlled studies were included for quantitative analysis for response (n = 854 patients) and 9 studies for remission (n = 551 patients). The risk ratio (RR) for response and remission are 2.25 and 2.78, respectively for patients after two treatment failures using rTMS as add-on treatment compared to standard pharmacotherapy. Cochrane's Q test showed no significant heterogeneity. No publication bias was detected. CONCLUSIONS: rTMS is significantly more effective than sham rTMS in TRD in response and remission outcomes and may be beneficial as an adjunctive treatment in patients with MDD after two treatment failures. This finding is consistent with previous meta-analyses; however, the effect size was smaller than in the formerly published literature.

[Questions and challenges in the diagnostics of gender identity disorder. Review and case vignettes].

Professionals working in the field of psychiatry have recently been increasingly encountering patients seeking help who define themselves as transsexual. Gender identity and gender self-expression of transsexual people do not match their biological sex, and they also feel an intense desire and urge to change their officially registered gender at birth and their physical appearance - even by using hormone therapy or surgery. In their case, the diagnosis of gender identity disorder as a disease category enables the use of medical interventions and health services necessary for transition. At the same time, the diagnosis is complicated by the fact that there is currently no specific psychodiagnostic procedure suitable for the clear identification of gender identity disorder, and gender incongruence can also appear as a symptom of many other mental disorders. Therefore, careful differential diagnosis is essential to establish a well-founded diagnosis, with the help of this literature review that summarizes other mental illnesses with similar symptoms as well as the more common comorbid pathologies.

Repetitive transcranial magnetic stimulation may be a cost-effective alternative to antidepressant therapy after two treatment failures in patients with major depressive disorder.

BACKGROUND: The cost-effectiveness of treatment strategies for patients with Major Depressive Disorder (MDD) who have not responded to two adequate treatments with antidepressants (TRD) are still unclear. The aim of this analysis was to evaluate the cost-effectiveness of add-on repetitive Transcranial Magnetic Stimulation (rTMS) compared with standard treatment. METHODS: A Markov-model simulated clinical events over one year from the perspective of healthcare payer. Third- and fourth-line treatment pathways (augmentation, antidepressant switch or combination, and Electro-Convulsive Therapy (ECT)) were defined based on medical practice guidelines. Transition probabilities were derived from a recent meta-analysis and scientific publications. Resource utilization and cost estimates were based on the patient-level database of a large university hospital. RESULTS: Incremental Quality-Adjusted Life Years (QALYs) and costs were 0.053 and 785 €, respectively, corresponding to an Incremental Cost-Effectiveness Ratio (ICER) of 14,670 € per QALY. The difference in cost between standard treatment and rTMS is explained by the rTMS sessions used in acute (€660) and maintenance (€57/month) treatments, partly offset by lower hospital costs due to higher remission rates in the rTMS arm. Key parameters driving the ICER were incremental utility of remission, unit cost of rTMS treatment and remission rate. At a threshold of €22,243 add-on rTMS is a cost-effective alternative to pharmacotherapy. Evidence on long-term effectiveness is not yet available, so results are estimated for a one-year period. CONCLUSION: Not only does rTMS treatment have beneficial clinical effects compared with drug therapy in TRD, but it also appears to offer good value-for-money, especially in centres with larger numbers of patients where unit costs can be kept low.

[Attila József - psychoanalysis - Hungarian literary history. Interview with the 70-year-old Antal Bókay].

No abstract available.

[The role of socialisation in psychosexual development].

INTRODUCTION: In the recent research and interpretation of the genetical-biological and environmental-social factors shaping psychosexual development, in addition to scientific arguments, more and more ideological and political aspect have received unfortunate emphasis. OBJECTIVE: Since the literature investigating the development of gender identity and gender orientation has not only increased, but also polarized, it is timely to look at the scientific exchange of ideas and debates among the differing positions. METHOD: Exploring the significance of genetic, biological and social factors involved in the development of gender identity and gender orientation based on international literature data. RESULTS: Based on the current state of science it can be concluded that, in addition to the indisputably marked genetic-biological factors, education and social patterns, as well as the extremely complex environmental and media-related influence with its variable intensity and diverse emotional content also play a significant role in the psychosexual development. This is supported, among other observations, by the data indicating that homoerotic behavior is more common in people raised by same-sex couples. CONCLUSION: As psychosexual development is determined jointly by both genetic-biological and social factors (like education, media etc), belonging to a sexual minority group is not a choice, not the result of a personal decision. Therefore, any kind of discrimination in this regard is unacceptable. Further scientific studies are necessary to answer a large number of questions that still remain open.

[Chronophrenia - a new delusion described by Bertalan Petho].

In 1985 Bertalan Petho enriched psychiatric literature by the description of a new delusion. The essence of chronophrenia is the delusion, that the patient has already lived through this life once. The phenomenon is a persis - tant delusion, that differs from the experi-ences of déja vu and déja vecu. The present article introduces the publication of Petho and interprets it in the light of research on time-sense in schizophrenia. The similarity of chrono-phrenia and the idea of Eternal Return by Nietzsche is also discussed.

["Why not?" - The medical diagnoses of Michel Foucault].

No abstract available.

[The Hipnoword application in clinical practice - an interview with Erika Somogyi M.D., psychotherapiest].

No abstract available.

[The psychoanalysis of Harold F. Searles and nonhumanism].

No abstract available.

["Praecox-Gefühl". A brief look].

No abstract available.

Aggression expression among League of Legends and Fortnite players - a brief report.

BACKGROUND AND AIMS: Our primary goal was to determine and compare the anger expression strategies used by players of the two most popular online games, League of Legends and Fortnite Battle Royale, as well as those used by non-gamers. METHODS: The study sample was comprised of 450 subjects, of whom 338 were males and 112 females. The sample was further divided into four groups: 1. Non-gamers; 2. League of Legends gamers; 3. Fortnite gamers; and 4. League of Legends and Fortnite gamers. Anger attributes were measured using the validated Hungarian version of the 20-item Anger Expression Scale (Oláh 1987; Spielberger, 1985). Multinomial Logistic Regression was used to analyze the role of age and gender of the subjects to predict whether subjects were non-gamers or gamers. Subjects were further assessed by employing the Anger Expression Scale, which determines Anger-In (turning anger inwards or suppressing anger) and Anger-Out (expressing anger outwardly) profiles of individuals. The Anger-In and Anger-Out variables were added to the model. RESULTS: Compared to League of Legends gamers, Fortnite gamers had a more passive (Anger-In) anger expression strategy. Fortnite and League of Legends gamers possessed a more passive anger expression strategy relative to nongamers. DISCUSSION AND CONCLUSION: Further research is needed to determine whether the games themselves have a determining influence on the gamers anger expression strategy, or whether the gamers personality and anger expression strategy predisposed them to choose one game over the other.

[An evaluation of a Hungarian questionnaire to assess childhood adversities: A pilot study].

BACKGROUND: Detection of childhood traumas is important both in clinical practice and in research. There is a pressing need for methods that are relatively simple but comprehensive, non-intrusive, and possess adequate psyc - ho metric properties. In this study we translated one of the most widely used and well-studied measure of childhood abuse and neglect and explored the psychometrical properties of this questionnaire. METHODS: The study was based on data from a clinical (N=171) and a normative (N=358) sample. In total 529 adults participated in the testing process. Beside the trauma questionnaire Parental Bonding Inventory, Impact of Events Scale and Dissociative Experiences Scale were administered. RESULTS: We examined the internal consistency of the translated trauma questionnaire. The Cronbach's a coefficients for the five subscales ranged from 0,639 to 0,934. Participants in the clinical sample reached higher scores on all trauma subscales except sexual abuse, than normative adults [PA: t (398)=-2,771; p=0,006; PN: t (398)=-5,990; p=0,000; EA: t (398)=-3,679; p=0,000; EN: t (398)=-4,759; p=0,000; total score: t (398)=-4,669; p=0,000]. Correlations among the trauma questionnaire total score and the scales of Parental Bonding Inventory indicating some medium effects (with maternal care: r=-0,661; p=0,000; with paternal care: r=-0,483; p=0,000). CONCLUSION: Our preliminary findings suggest that this trauma questionnaire is practical and facilitates the systema - tic evaluation of adverse early life events and maximizes the possibility of detecting childhood abuse and neglect.

Untreated depressive symptoms significantly worsen quality of life in old age and may lead to the misdiagnosis of dementia: a cross-sectional study.

BACKGROUND: Several studies demonstrated the role of depressive mood and cognitive impairment in the background of elevated mortality and decreased Quality of Life (QoL) in old age. Our aim was to assess depressive and cognitive symptoms among older people in order to determine if those are recognized and treated or not, to elucidate the association between them and to investigate their impact on QoL. METHODS: In the framework of the ICT4Life project self-administered questionnaires and clinical screening tools were used to assess QoL, depressive symptoms and cognitive functions of 60 older persons over the age of 65. RESULTS: Males found to be depressed (53.8 vs. 40.4%) and cognitively declined (53.8 vs. 48.9%) more frequently; and had higher scores on the depression (6.85 vs. 5.32) and lower on the QoL (47.38 vs. 50.19) scales. Depressed older persons had lower cognitive levels (24.39 vs. 21.52) and their QoL was significantly poorer (53.97 vs. 43.85) than that of the non-depressed subjects. Depressive symptoms were detected in almost half of the older adults (43.9%), and the majority (80.77%) did not receive antidepressant medication. CONCLUSIONS: Depressive and cognitive symptoms found to be common among older people, but were not recognized and treated in most cases. Close correlation between depression and cognitive impairment was also confirmed, as well as the key role of depression in the background of pseudo-dementia and QoL decline. Early recognition of depressive symptoms is important not only to treat the underlying mood disorder, but also to improve QoL of older persons.

The impact of depressive mood and cognitive impairment on quality of life of the elderly.

BACKGROUND: The quality of life (QOL) of the elderly can be influenced by numerous factors. We assessed QOL, cognitive functions, depression and clinical data in elderly aged 65 and over with the aim of analysing factors affecting their QOL. METHODS: Semi-structured interviews were conducted with elderly over the age of 65, and their QOL, cognitive functions and depressive symptoms were assessed by validated clinical tests and screening tools. RESULTS: The correlation between QOL scales and cognitive tests was not significant. In contrast, the results of depression scales showed significant negative correlation with the scores of the QOL scales. A better QOL was determined by lower age, lack of depressive symptoms, and higher scores in the QOL-AD (Alzheimer's disease) scale. Depressive mood has much more negative impact on the QOL of the elderly than cognitive impairment. CONCLUSIONS: Our results demonstrated a close correlation between QOL and depressive mood in the elderly. The early detection and effective management of affective and cognitive symptoms in the elderly can not only restore mental health but may also improve their QOL.

[Two early reports on delusional symptom formation by Camillo Reuter].

No abstract available.

[The neurological illnesses of Frida Kahlo].

No abstract available.

[The text "World" by I.L. and speculative realism].

No abstract available.

[Diogenes Syndrome - case reports].

No abstract avalilable.

[Catatonia in childhood and adolescence - a brief review and case report].

The authors overview the clinical, epidemiological, pathophysiological and therapeutic aspects of catatonia in childhood and adolescence. They deal with the recent changes of the nosological position of the phenomenon, and emphasize the importance of specific therapeutic interventions.