DATE: December 29, 2024 at 12:01PM
SOURCE: PSYCHOLOGY TODAY

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DATE: December 29, 2024 at 12:00PM
SOURCE: PSYPOST.ORG

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TITLE: Psychiatrists detail strange case of woman haunted by mysterious “possessions” for seven years

URL: psypost.org/psychiatrists-deta…

What happens when cultural beliefs intersect with psychiatric conditions? A case study from Cureus sheds light on a rare disorder known as trance and possession disorder, experienced by a 55-year-old woman in rural India. Her episodes of altered consciousness, perceived as possession, were ultimately linked to an underlying mood disorder known as dysthymia. The report, authored by psychiatrists from Jawaharlal Nehru Medical College in India, sheds light on the complexity of diagnosing and treating psychiatric conditions influenced by cultural factors.

Trance and possession disorder is a rare psychiatric phenomenon characterized by altered states of consciousness. In a trance state, individuals experience a temporary shift in awareness, often accompanied by behaviors or speech they cannot control. Possession states, however, are marked by the replacement of the individual’s sense of self with another identity, which might be perceived as a deity, a spirit, or even an animal. These episodes are deeply influenced by cultural and social factors, often manifesting in ways that reflect local beliefs and practices.

During these episodes, individuals may exhibit behaviors such as speaking in unfamiliar voices, making uncharacteristic gestures, or appearing unresponsive to their surroundings. Despite the dramatic presentation, these episodes are typically transient and may be triggered by emotional stress, unresolved conflicts, or social and environmental pressures. The condition is recognized under different names in psychiatric classifications, emphasizing the importance of cultural context in its diagnosis and interpretation.

Dysthymia, now often referred to as persistent depressive disorder, is a chronic form of depression characterized by a persistently low mood. Unlike major depression, its symptoms are less severe but last much longer, often for years. People with dysthymia might experience fatigue, low self-esteem, difficulty concentrating, and feelings of hopelessness. Though these symptoms are less acute, their prolonged nature can significantly impair an individual’s quality of life.

Dysthymia often coexists with other mental health conditions, exacerbating their symptoms. In the case study, the patient’s dysthymia likely heightened her vulnerability to the trance and possession episodes, creating a feedback loop where each condition influenced the other.

The patient in this case was a 55-year-old woman from Maharashtra, India. A homemaker from a lower socioeconomic background, she was brought to the psychiatric clinic by her daughter due to ongoing symptoms of low mood, headaches, social withdrawal, and difficulty managing daily tasks. These symptoms were compounded by episodes during which the patient would speak in a different voice, act out of character, and exhibit behaviors consistent with possession. These episodes, lasting up to two hours, had been occurring for seven years.

Her family initially sought the help of faith healers, a common response in many rural and traditional communities, which delayed medical intervention. When she finally presented at the clinic, a comprehensive medical evaluation was conducted. Blood tests, neurological examinations, and imaging studies, including magnetic resonance imaging (MRI) and electroencephalography (EEG), ruled out underlying physical conditions such as brain tumors or seizure disorders. The patient’s longstanding history of depressive symptoms, dating back to adolescence, provided further insight into the underlying causes of her condition.

Treatment combined medication and psychotherapy. The patient was prescribed escitalopram, an antidepressant aimed at alleviating her dysthymic symptoms. Weekly psychotherapy sessions addressed her emotional struggles and the link between her mood disorder and trance episodes. Over several months, her depressive symptoms improved, and the trance episodes became less frequent and intense. This outcome highlighted the value of treating both conditions holistically rather than focusing on them in isolation.

“If our patient’s prior psychiatric diagnosis of dysthymia had been recognized and treated appropriately, the trance episodes may not have occurred in the first place. Diagnosing TPD [trance and possession disorder] poses several challenges and limitations due to the complex interplay of cultural, spiritual, psychiatric, and socioeconomic factors. Therefore, early diagnosis and treatment are crucial to enhance the patient’s general functioning and quality of life,” the study authors concluded.

While case studies offer valuable insights into rare and complex conditions, they have inherent limitations. They focus on individual experiences, which may not be representative of broader populations. The findings cannot be generalized to all individuals with trance and possession disorder or dysthymia, and cultural factors unique to the patient’s background may limit the applicability of the observations to other settings.

Despite these limitations, case studies remain indispensable in advancing medical knowledge. They often shed light on unusual presentations of conditions and guide clinicians in understanding how different factors—biological, psychological, and social—interact in a single patient. In this case, the detailed narrative helps bridge the gap between clinical practice and cultural sensitivity, emphasizing the need for holistic approaches in mental health care.

The study, “Trance and Possession Disorder With Underlying Dysthymia: A Case Report,” was authored by Yatika Chadha, Ragini Patil, Saket Toshniwal, and Nayan Sinha.

URL: psypost.org/psychiatrists-deta…

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DATE: December 28, 2024 at 07:00PM
SOURCE: Consortium Psychiatricum

TITLE: The Mental Health of Refugees and Forcibly Displaced People: A Narrative Review

URL: consortium-psy.com/jour/articl…

BACKGROUND: One of the pressing global issues today is the matter of refugees and forcibly displaced people migration. Refugee or forcibly displaced status has a significant impact on a person's mental health, with a high risk of developing depression, anxiety, post-traumatic stress disorder and psychotic disorders.

AIM: To conduct a literature review and evaluate the mental health status of refugees and forcibly displaced people due to military action

METHODS: The search of literature was conducted without any restrictions on the publication date, with a focus on articles from the past two decades. The search was conducted in the Google Scholar and PubMed databases using the following keywords and phrases: “migration”, “migrants”, “refugees”, “forcibly displaced people”, “mental health”, “mental disorder”, “psychiatric disorders”. This analysis included studies that discussed and evaluated the social, psychological, and clinical aspects of migration. The review included original research and meta-analyses published in English, Russian, and Spanish. Descriptive analysis was applied to summarize the results.

RESULTS: The literature review showed that global migration levels have reached a high point, and this trend continues due to the existing geopolitical conditions. Even limited and difficult-to-compare epidemiological data demonstrate that more than a quarter of migrants suffer from mental disorders. These primarily include depression, anxiety, and post-traumatic stress disorders. Apart from creating and exacerbating problems for the refugees and forcibly displaced people themselves, they also pose serious challenges to the social services and healthcare systems of refugee-hosting countries. The literature review demonstrated that forced displacement plays a role in the development of mental disorders, and also emphasizes the significance of several associated factors.

CONCLUSION: This review emphasizes the urgent need for standardizing screening methods for refugees and forcibly displaced people, creating unified approaches to diagnostic evaluation, as well as specialized training for mental health professionals. Large-scale programs are needed to support and implement sustainable global mental health measures in the countries affected by hostilities.

URL: consortium-psy.com/jour/articl…

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DATE: December 28, 2024 at 07:00PM
SOURCE: Consortium Psychiatricum

TITLE: Integrating Rational Emotive Behavior Therapy, Compassion-Focused Therapy with Cognitive Retraining in Traumatic Brain Injury: A Case Report

URL: consortium-psy.com/jour/articl…

BACKGROUND: This case report presents a novel approach to treating Traumatic Brain Injury (TBI) by integrating Rational Emotive Behavior Therapy (REBT), Compassion-Focused Therapy (CFT), and Cognitive Retraining (CR). It contributes to the literature by demonstrating the effectiveness of a comprehensive psychotherapeutic approach in managing complex TBI sequelae, particularly in the Indian context where such interventions are underrepresented.

CASE REPORT: A 34-year-old Indian female presented signs of emotional dysfunction, cognitive impairment, social maladaptation, shamefulness, and self-deprecation following a TBI sustained 10 years prior. A mental status examination and psychological assessments revealed cognitive deficits, emotional instability, and irrational beliefs, all related to her injury and recovery. The treatment plan integrated REBT, to address the irrational beliefs; CFT, to manage the sense of shame and the insistence to self-criticize; and CR, to improve cognitive functions. This approach was tailored to the patient’s cognitive limitations and cultural context. Interventions included challenging irrational beliefs, self-compassion imagery, and cognitive exercises adapted to her specific deficits. Outcomes were measured using the Subjective Units of Distress (SUD) scale and clinical observations. The patient showed improvements in emotional regulation, cognitive functioning, and overall quality of life, as evidenced by reduced subjective distress (SUD down from 90 to 58) and enhanced daily functioning.

CONCLUSION: This case demonstrates that an integrated psychotherapeutic approach combining REBT, CFT, and CR can effectively address the complex psychological and cognitive challenges of TBI patients. Tailoring interventions towards patient cognitive limitations and cultural context is crucial for a successful outcome. The case highlights the importance of incorporating diverse therapeutic modalities in TBI management, promoting a more holistic approach to recovery and enhancing the quality of life of TBI survivors.

URL: consortium-psy.com/jour/articl…

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DATE: December 28, 2024 at 07:00PM
SOURCE: Consortium Psychiatricum

TITLE: Dynamics of Clinical Manifestations and Social Functioning in Schizophrenia: A Non-interventional Observational Study of Paliperidone Palmitat Dosage Forms

URL: consortium-psy.com/jour/articl…

BACKGROUND: Over the past seven years, the use of long-acting forms of antipsychotic medication has significantly increased in Russia. Specifically, in Moscow, from 2016 to 2021, the proportion of prescribed injectable long-acting antipsychotics had increased more than sevenfold (from 3% to 23%). Studies have shown that the correct selection of target groups for such therapy can reduce the frequency of relapses requiring hospitalization, lower the costs of inpatient care, and shift the focus of therapy from multiple drug administrations to psychosocial work.

AIM: This study was aimed at evaluating changes over time in psychosocial functioning, as well as clinical and psychopathological manifestations, in patients with schizophrenia during early remission and while on therapy with different forms of paliperidone: oral paliperidone (OP), paliperidone palmitate administered once monthly (PP1M), and paliperidone palmitate administered once every three months (PP3M).

METHODS: The observational study included 155 patients: 54 patients who had been treated with another second-generation antipsychotic received OP, 50 patients who had been treated with another antipsychotic received PP1M injections, and 51 patients who had been in remission for four months after treatment with PP1M received PP3M. The duration of the follow-up period was 12 months. Assessment of personal and social functioning was conducted five times: before the start of treatment, and 3, 6, 9, and 12 months later.

RESULTS: Treatment in all groups led to a statistically significant reduction in the severity of positive symptoms (p <0.001). Hallucinations proved more susceptible to therapy (p <0.001), while persistent delusions showed greater treatment resistance. Significantly more patients in the PP1M and PP3M groups had completed the entire program (n=24; 48.0%, and n=30; 58.8%, respectively) compared to the OP group (n=11; 20.4%). The PP3M group demonstrated the highest treatment adherence, with the largest number of patients completing the study, and a similar rate of exacerbations or inadequate efficacy compared to the other groups.

CONCLUSION: Treatment with different forms of paliperidone provides a roughly equal pace reduction in the severity of schizophrenia, including positive and negative symptoms. The PP3M group had better adherence and the highest number of patients who fully completed the study.

URL: consortium-psy.com/jour/articl…

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