Out-of-body experiences (OBEs) are hallucinatory visual experiences that involve seeing the physical body placed in an external visual space. Many psychiatric disorders, brain dysfunctions, pharmacological agents, and altered psychological states are reportedly associated with these phenomena. OBEs have been linked to various brain lesions, particularly in the parietal and temporal regions, psychiatric disorders, severe emotional states like a near-death experience, substance use, migraine, and epilepsy, but very few have been reported in dissociative identity disorder. In this report, we present the case of a 15-year-old male patient who described a strange experience where he found himself to be floating outside his own body while he visualized his own body from a third-person perspective. On further evaluation, a diagnosis of dissociative identity disorder and dissociative fugue was formulated. The patient showed improvement after undergoing abreaction, hypnosis, and relaxation training along with supportive psychotherapy. Dissociative disorders occur due to an internal conflict between ego and self, when a person is unable to successfully repress a traumatic experience, or when a repressed memory or experience comes out of the cocooned barrier, leading to an altered state of perception and self-experience, which is described by the patient as OBE. This report presents a scarce differential in the context of psychiatric illness, which might be helpful in the formulation of approaches toward management in cases of such OBE, making it a strange yet intriguing addition to the literature.
Letter to the Editor response on lithium. He was also given olanzapine 15 mg and PRN lorazepam. His affective symptoms reduced significantly after four weeks (YMRS-9, serum lithium-1.1 mmol/L), with less robust improvement in hypergraphia and philosophical talks. He gradually improved on medication, with the resumption of vocation.
Background: Therehas been plethora of research regarding cannabis use disorder but very few studies reported demographic and phenomenological differences of acute psychosis with cannabis use to those of acute psychosis without cannabis use. This study attempted to evaluate the demographic and phenomenology differences between two groups of patients presenting with acute psychosis with cannabis use and acute psychosis without cannabis use. Material & Method: Two group of patients recruited for study were 'Cases with Cannabis' and 'control without Cannabis' presenting with acute psychosis with preceding cannabis use and second one presenting with acute psychosis without preceding cannabis use in outpatient department of psychiatry, M.Y hospital, Indore Assessment done using rating scales. Results: Acute psychosis with cannabis wascharacterizedby primarily polymorphic clinical picture with predominance of positive and mood symptoms both in clear and disturbed sensorium. Acute psychosis without cannabis was characterized by mixed positive and negative symptoms in clear sensorium.In 'Cases with cannabis' group 96.7% were males and 3.3% were females,mean age was higher (33.7%) than control (27.7%) group. Conclusion: Acute psychosis with cannabis is characterized by primarily polymorphic clinical picture with predominance of positive and mood symptoms both in clear and disturbed sensorium. Acute psychosis without cannabis is characterized by mixed positive and negative symptoms. General symptoms of psychosis were also more in acute psychosis without cannabis.
Background: Dementia affected about 46 million people in 2015and this number will roughly triple within the next 40 years. In 2011 Alzheimer's Disease International argue that dementia has become one of the most urgent health and social care challenges of the 21st century and its potential effect on economies around the world is attracting global attention. Predicting dementia in the early stages would be essential for better treatment before significant brain damage occurs. Current difficulty is the lack of specific biomarkers. In some previous studies electroencephalography (EEG) have shown the capability to identify dementia early and even classify the degree of its severity at a lower cost for mass screening. The aim and objective of this study was to EEG changes in vascular dementia and Alzheimer's Disease Related Dementias (ADRD) or dementia where no cause is identifiable, to measure severity of dementia by using DSR scale in different subjects and to correlate DSRS with EEG findings.Methods: Study sample was the 40 patients in each three groups- Dementia patients without any known cause of dementia or Alzheimer's Disease Related Dementias (ADRD), Vascular dementia (VaD) patients and Controls (age and sex matched subjects scoring more than the cut of score on dementia Scale). Written informed consent will be taken after explaining the objectives and procedure of study in detail. EEG were recorded in eyes closed, on intermittent photic stimulation and hyperventilation, only eyes closed data was used in study and these data were entered in excel sheet and analyzed using SPSS Software, appropriate statistical test was applied wherever necessary.Results: Participants with VaD have theta waves while ADRD group have delta waves preponderance as compare to control.Conclusions: EEG can have additive value in diagnosing VaD as well as it alone can be helpful in differentiating healthy individuals from dementia patients.
Background: Western literature full of extensively study the antidepressant prescription pattern at different settings. Recently in Indian context multicentre study and individual centers reported pattern of antidepressant uses for management of depression. With the time newer antidepressant approved, with better understanding of evidence based pathogenesis of illness influence the treatment patterns. Mental hospital setting is different that medical college setting at least for stigma related issue. The aim of the research work was to study the pattern of antidepressant prescription at mental hospital and medical college settings.Methods: Cross-sectional assessments were done at mental hospital and medical college centers. Subjects diagnosed as depressive episode as per ICD 10, age >18 year included in study. Total 105 treatment seeking subject included in study from both centers Data was collected on socio-demographic characteristics, Clinical profile and prescribed medication.Results: 49 subjects from mental hospital, 56 subjects from medical college included in study. Mean age of study sample 39.27±12.96 vs 37.49±14.90 years respectively at mental hospital and medical college centers. Escitalopram prescribed 83.7% subjects, 53.3 % subjects receive monotherapy. L methyl folate and atypical antipsychotics was most commonly adjunctive medication with antidepressants.Conclusions: In sociodemographic differences subjects attending mental hospital belong to lower socioeconomic status compare to subject attending mental hospitals. There were no significant differences in prescription pattern of antidepressant medication for treatment of depressive episode. Escitalopram most commonly prescribed antidepressant and L methyl folate and atypical antipsychotics was most commonly used adjuvant with antidepressant medications.
IntroductionRoad rage is a term used to describe driving usually extreme in nature. There seems to be a multifactorial relationship between the situational characteristics of an anger provoking road situation and the feelings of anger and road behaviour.ObjectivesTo examine driver anger with regards to various sociodemographic parameter.Methods282 participants completed an internet-based survey including sociodemographic profile, anger assessment while driving using the Deffenbacher Driver Anger Scale, details of the driving. Participants were recruited through networks of authors, institution. The survey was disseminated through social media applications and email by snowball sampling method.ResultsMean age of the sample was 26.1 years with age group 24-29 years making half of the population. Majority sample were males (62.1%), graduates (53.2%), professionals (45.7%), urban locality based, nuclear family type. People experienced greater anger on Defenbacher likert scale for the following situations, when Someone is driving very close to your rear bumper (mean= 3.09), Someone cuts in right in front of you on the motorway(mean= 3.44), Someone cuts in and takes the parking spot(mean= 3.19), Someone coming towards you does not dim headlights at night(mean= 3.26), driving behind a vehicle smoking badly or giving off fumes(mean= 3.38).ConclusionsThe results revealed a prevalence of high anger scores amongst Indian drivers. The rage didn’t vary significantly within gender, locality, type of vehicle, however the anger scores were significantly higher in younger population. Strategies targeting at driving safety and reducing road rage should be implemented by authorities with sensitization of the drivers.DisclosureNo significant relationships.
Lycanthropy is a rare variant of a delusional misidentification syndrome specifically reverse intermetamorphosis where patients believe that they are experiencing transformation or have transformed into an animal. A case report of this phenomenon is discussed. We report the lycanthropy phenomenon of a 25year-old male who believed himself to be transformed into a buffalo after bestiality along with developing obsessive-compulsive features. A case report along with a literature review forms the basis of discussion. Clinical lycanthropy has been reported with various neuropsychiatric conditions including primary psychotic and affective conditions, drug intoxication and withdrawal, cerebrovascular disease, traumatic brain injury, dementia, delirium, and seizures, but its association in the context of obsessivecompulsive and related disorders (OCRDs) is a very rare finding. A differential of OCRD should be given due importance and managed accordingly when dealing with lycanthropy, which may help in early identification and management.
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