Background Erotomania, also known as “de Clérambault’s Syndrome”, is a psychiatric syndrome characterized by the delusional belief that one is loved by another person of, generally of a higher social status. Erotomania has always been a target of attempts of conceptualization, and the utility of regarding Erotomania as an independent syndrome has been questioned to this day. Erotomania has a much higher prevalence in the female sex, and male Erotomania is a rare and probably underdiagnosed condition. Male Erotomania is only more prevalent in forensic samples, since male sex is one of the risk factors for violent behavior in this disorder. In this article, we aim to describe an uncommon case of Erotomania occurring in a male, hoping to add to literature and to reflect on the implications of the occurrence of Erotomania in men. By discussing the case in light of the different described clinical pictures, proposed diagnostic criteria and classifications, we also aim to contribute to the ongoing attempt to conceptualize this syndrome and to understand the pertinence of considering it an independent nosological entity. Case presentation We describe a case of Erotomania in a middle-aged Caucasian Portuguese male, with consecutive erotic delusions, followed by a classic turn to a persecutory delusion. The patient was admitted as an inpatient in a psychiatry unit and he was medicated with risperidone 3 mg and diazepam 3 mg daily. His persecutory delusion remitted a 4 days later, he gained insight and was discharged to follow-up as an outpatient. He retains his erotic delusional beliefs, but these are less intense, and has not presented further aggressive behavior. Conclusions We can conclude that it seems reasonable to retain the operative concept of Erotomania as a subtype of Persistent Delusional Disorder/Delusional Disorder, since cases fitting the classical descriptions of the syndrome have been reported, including the presented case. The diagnosis of Erotomania has implications in case management, treatment and prognosis, and missing it, especially in men, may culminate in violent situations that can have legal implications. The developed diagnostic criteria and classifications seem to retain use and should be kept in mind, in the sense that they facilitate making an important diagnosis.
IntroductionUrban living has consistently been associated with higher risk of developing schizophrenia when compared to rural living. Exposure to green space has been associated with better mental health outcomes and, more recently, childhood exposure to green space has been linked with lower rates of schizophrenia. The reasons for these findings remain unknown, although lower levels of pollution and psychological factors may play a role.ObjectivesWe aim to review the literature regarding exposure to green space and its relationship with the risk of developing schizophrenia.MethodsWe performed an updated review in the PubMed database using the terms “green space” and “schizophrenia”. The included articles were selected by title and abstract.ResultsGrowing up surrounded by non-urban environments is associated with lower schizophrenia rates. Upbringing in urban areas is associated with higher schizophrenia rates when compared with non-built-up areas. Schizophrenia risk seems to decrease with vegetation density in a dose-response relationship for urban and agricultural areas. Risk of schizophrenia has been found to be associated additively with green space exposure and genetic liability. No evidence for gene-environment interaction has been reported so far in this regard.ConclusionsExposure to green space during childhood appears to lower the risk of developing schizophrenia later in life and can be a preventive strategy. Further research in this area is needed.
IntroductionHuntington Disease (HD) is a genetic, progressive neurodegenerative disorder. Its clinical features include motor dysfunction, cognitive impairments, and psychiatric symptoms. The association between HD and suicide is well documented, and the risk of suicide in HD is higher than in patients with other neurological diseases.ObjectivesWe aim to review the literature regarding suicidal behaviour in HD.MethodsWe performed an updated review in the PubMed database using the terms “suicide”, “suicidal behaviour” and “Huntington Disease”. The included articles were selected by title and abstract.ResultsThe most relevant risk factors associated with suicidality in HD are depression, anxiety, and aggression, so the presence of psychiatric diagnoses should be closely monitored. No consistent results have been found regarding gender. Evidence for periods of elevated risk of suicidal behaviour in HD is mixed and the data on specific pharmacological interventions for alleviating suicidal ideation in HD is scarce.ConclusionsPatients with HD are at a high risk for suicide. This risk is further increased when a comorbid psychiatric disorder is present. It is important for the practicing psychiatrist to be aware of this association to correctly manage patients with HD, thus helping prevent suicidal behaviour.
IntroductionLying can be defined as stating a deliberate falsehood with the intent to deceive. It is part of our everyday life but it can be pathological, without motivation and a symptom of psychiatric illness. Although pathological lying has been debated for a century, it remains a controversial issue in Psychiatry.ObjectivesWe aim to perform a review regarding pathological lying and related issues.MethodsWe performed an updated review in the PubMed database and GoogleScholar using the terms “pathological lying”, “compulsive lying”, “mythomania” and “pseudologia fantastica”. The included articles were selected by title and abstract. We also consulted reference textbooks.ResultsWe described the difference between normal and pathological lying and debated the different types of pathological lying, such as compulsive lying, mythomania and pseudologia fantastica.ConclusionsRecognizing lying is crucial for a skilled patient interview and distinguishing between pathological and non pathological lying may be decisive for an accurate differential diagnosis.
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