Exacerbation of Psychosis by Misinterpretation of Physical Symptoms

Reeves, Roy R.; Torres, Rafael A.

doi:10.1097/01.smj.0000078686.34109.11

Cited by 18 publications

(10 citation statements)

References 8 publications

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“…Delusional disorders are thought to be stable in their course and less than 25% progress to schizophrenia [5]. Impaired or altered processing of perceptual disturbances is common in people suffering from psychotic disorders [6]. Although studies have found a genetic predisposition in those suffering from schizophrenia spectrum disorders and have shown a familial inheritance pattern the same is not true for delusional disorders [5].…”

Section: Introductionmentioning

confidence: 79%

Schizophrenia with Somatic Delusions: A Case Report

Korenis¹

2015

J Psychiatry

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Journal of Psychiatry AbstractSchizophrenia is a mental illness that affects approximately 1% of the general population. Symptoms most commonly include auditory hallucinations, several types of delusions, disorganization in speech and behavior, formal thought disorder, and negative symptoms including poverty of speech, thought or motivation. Of the delusional symptoms, somatic delusions-those that pertain to the body-are rather rare. Somatic delusions are defined as fixed false beliefs that one's bodily function or appearance is grossly abnormal. They are a poorly understood psychiatric symptom and pose a significant clinical challenge to clinicians. Studies indicate that only one third of this patient population has a positive treatment outcome with resolution of symptoms. While challenges exist in treating patients when they present with somatic delusions alone, it becomes far more difficult when somatic delusions present in patients with schizophrenia. Physical symptoms such as pain or discomfort are often incorrectly perceived or misinterpreted by psychotic patients. Often medical conditions are overshadowed by psychosis and may get undiagnosed or overlooked which could potentially result in fatal errors for patients. While little has been written about patients with true delusions that are somatic in nature, somatic delusions, specifically somatic delusions associated with schizophrenia are particularly under reported in the literature. Here, we describe the case of a 40-year-old Hispanic-American patient with established chronic schizophrenia. From her initial presentation to the hospital, she exhibited and perseverated on a number of somatic delusions about her body including her bones being "twisted" around one another, delusions of pregnancy and abortion, and her normally-functioning arm being broken. This paper will also explore treatment challenges posed by these complicated patients. In addition, a review of potential cultural influences as well as the economic burden that such patients place on the health care sector by their numerous emergency room and office visits will be discussed.

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Section: Introductionmentioning

confidence: 79%

Schizophrenia with Somatic Delusions: A Case Report

Korenis¹

2015

J Psychiatry

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“…In addition, we wanted to explore the relevance of affective reactivity to a more internal stimulus as well, specifically physical discomfort. Physical discomfort may be misinterpreted by individuals with psychotic experiences (Reeves and Torres, 2003), who therefore may show increased affective response to this stimulus.…”

Section: Introductionmentioning

confidence: 99%

Affective reactivity to daily life stress: Relationship to positive psychotic and depressive symptoms in a general population sample

Booij

Snippe

Jeronimus

et al. 2018

Journal of Affective Disorders

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“…Furthermore, impaired processing of perceptual information may lead to physical symptoms being misperceived by patients and clinicians. A series of cases were recently reported in which somatic symptoms occurred in psychotic patients and worsened their psychosis, but only later were recognized as physical problems [26]. Physicians often regard psychotic individuals as unpredictable and limit their clinical contact.…”

Section: Laboratory Testsmentioning

confidence: 98%

Psychotic symptoms in patients with medical disorders

Patkar

Mago²,

Masand³

2004

Curr Psychiatry Rep

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Psychotic symptoms frequently occur in patients with comorbid medical disorders and present a diagnostic and treatment challenge. They may be a part of an independent psychiatric illness associated with the underlying medical condition or induced by substance use or medications. The presence of psychotic symptoms can contribute to misdiagnosis or complicate the management of the comorbid medical illness. Psychiatrists must be familiar with the assessment and management of psychotic disorders in patients with comorbid medical disorders. Medications that may be used to treat psychosis include antipsychotic agents, benzodiazepines, or possibly certain anticonvulsants. Selecting the appropriate medication requires knowledge of the pharmacokinetics of different agents and their side effect profile. Understanding the neuropsychiatric effects of medications and drug-drug interactions may help in preventing psychotic symptoms.

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Exacerbation of Psychosis by Misinterpretation of Physical Symptoms

Cited by 18 publications

References 8 publications

Schizophrenia with Somatic Delusions: A Case Report

Schizophrenia with Somatic Delusions: A Case Report

Affective reactivity to daily life stress: Relationship to positive psychotic and depressive symptoms in a general population sample

Psychotic symptoms in patients with medical disorders

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