PS381; Unusual Disorders and Differences

Anti-NMDA Receptor Encephalitis

• Immune system attacks on NMDA receptors in the brain

• NMDA receptors are found throughout the brain

• Symptoms -- Confusion, seizures, delusions, hallucinations, catatonia

Causes and Diagnosis

• Autoimmune

• Tumors -- Often in the ovaries

• Herpesviral encephalitis

• May be wrongly diagnosed with schizophrenia

• Diagnosis through finding blood related antibodies in the cerebrospinal fluid

Locked-In Syndrome

• Paralysis of all motor muscles except those that control blinking and eye movement up and down

• Conscious but unable to talk or move

• Appears in a come, may be thought to be brain-dead

• Can be caused by stroke in the brain stem

Cotard’s Delusion

• Believe they are dead or parts of their body have disappeared

• Associate with brain damage due to many potential causes:

  • Infections, schizophrenia, schizoaffective disorder, tumor, dementia, stroke, injury, M.S., Parkinson’s disease

Capgras Syndrome

• Person believes that a loved one has been replaced by an imposter

Fregoli Delusion

• Person believes that a loved one is disguising themselves as other people

Folie et Deux

• 2 or more people share delusional beliefs

• “Shared psychotic disorder”

• Involves one person who has illness affecting other person who come to share beliefs

Paraphrenia

• Not in DSM

• Paranoid Delusions

• Hallucinations -- Usually auditory

• Onset 60 years old

• More common in women, those living alone, those with sensory loss

• Schizoid or paranoid personality features

• Associated with tumors and strokes

Delusional Disorder

• Erotomania

• Grandiose

• Somatic

• Jealous

• Persecutory

• Mixed Typle

Body Integrity Disorder/Dysphoria

• Person wants to have a disability

• Amputations, paralysis, blindness, deafness

• Begins in childhood

Intermittent Explosive Disorder

• Verbal or physical aggression 2x week for at least 3 months

• Physical assault with injury to animals or other people or property damage 3 or more times in a year

• Behaviour is not disproportionate

• Not due to mental disorder, medical conditions, substance abuse

Moral Problem

• Challenges to sense of right or wrong, or sense of goodness about the self, others, or institutions

Religious or Spiritual Problems

• Loss or questioning of faith or spiritual values that are not necessarily related to an organized religious institution

Misophonia

• Reduced tolerance for certain sounds

• Irritated, annoyed, disgusted, angered, or enraged when hearing certain sounds

• Sympathetic nervous system activation -- fight or flight

• Distressed by their reactions, fell they have little control over response

• Respond by avoiding, leaving, asking person to stop, and aggressive behaviour

• More common in females

Charles Bonnet Syndrome

• Visual hallucinations in people with visual impairment, due to macular degeneration

• Temporary or lifelong

• Not considered a mental health condition

Blindsight

• Occurs in those who have cortical blindness

  • Some have ability to dodge obstacles and respond to movement and emotional faces

• Extra pathway from eyes to superior colliculus to amygdala

  • SC directs eye movement, head movement in turning in the direction of stimuli, reaching amygdala

Adjustment Disorder

• Used when person is having difficulty adjusting to an event, circumstance, etc

• Do not meet criteria for PTSD or ASD or any other diagnosis