Paranoia Revisited

Paranoia is derived from the Greek word ‘para’ (besides) and ‘nous’(mind) and was used in ancient Greek literature to mean ‘out of mind’, i.e. of unsound mind or insane. This broad usage was revived in the eighteenth century. The word Paranoia, from which the modern adjective paranoid derived,  has a long and chequered history as old as the term Psychiatry is.
The first stage in the development of its use in modern psychiatry can best be dated to 1818 when Heinroth described delusional states as ‘disorders of intellect’ (Verrucktheit) not fundamentally involving the other faculties of the mind, feeling and will, although they recognized that some admixture was usually present...

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OPIOIDS

Opium , derived from the ripe seed capsule of the opium poppy (Papaver somniferum), has been used for its analgesic and euphoriant effects since antiquity, with Sumerian ideograms of about 4000 BC referring to the poppy as the ‘plant of joy'.
In the developed countries the opioid drug most frequently associated with abuse and dependence is heroin. Virtually all the opioid dependence and abuse seen clinically is associated with prototypical m-agonist opioids.

Obsessive Compulsive Spectrum Disorders

Ms A, a 34-year old, single white woman presented with a chief complaint of “I’m obsessed, and I have lots of compulsive behaviors.” Since age 15, she had been preoccupied with her nose, which she thought was huge, hideous, and horrendous looking.” Because of this concern, she sometimes missed school, avoided friends, and felt suicidal. She stated at times, she realized that her view of her appearance was “probably distorted,” but at other times, especially when she was around other people, she was “absolutely, 100% convinced” that her belief was correct. Ms A was also excessively concerned about germs. She washed her hands up to 50 times a day and avoided activities that she thought might lead to contamination. In addition, she reported a history of hair pulling, which in her 20’s had resulted in noticeable hair loss. The patient’s family history was notable for Tourette’s disorder in a brother.

Non-Alzheimer’s Dementia: An Update

Dementia is a common neurodegenerative disorder involving as many as 10% of those over age 65 and substantially shortens life expectancy. The prevalence of dementia in developed countries under the age of 60 years is very low (0.3–0.7%) and increases almost exponentially with age to 42-68% in those older than 95 years (Fratiglioni et al., 2000). The incidence of dementia is about 0.1% in persons aged 60-65 years and increases to 9% in the population older than 95 years (Fratiglioni et al., 2000). Although Alzheimer’s disease (AD) is the commonest type of dementia, several other types of dementias have been described which are collectively referred to as non-Alzheimer’s disease (non-AD) dementias (Table 1). AD, because of its prevalence, has become the prototypical dementia to which all other dementias are compared. However, in the past two decades, remarkable progress in the fields of molecular genetics, biochemistry, and biophysics have permitted better distinction of the ‘other’ dementias from AD and more refined discrimination among these non-AD dementias.

Newer Antiepileptics: A Review

In many patients with epilepsy, seizures can be controlled with the established antiepilepstic drugs (Brodie et al., 1996) but 25-30% of patients continue to have seizures despite optional therapy, and other have unacceptable side effects.  Thus there is clearly a need for additional drugs as well as formant.  Strategies for preventing epilepsy.  Mechanisms is that underline seizure processes constitute potential target areas for the development of new AEDS. New antiepileptics drugs (AEDS) are being developed using two complimentary strategies.  Animal models that roughly mania human used to serene new compounds for antiseizure activity.  Alternatively, new drugs are being developed with specific cellular or molecular targets believed to be important in seizure generation.

Newer Antidepressants

Depressive disorders afflict at least 20% of women and 12% of men at some time during their lives. By the year 2020 the global burden of depression is projected to rank second only to that of ischaemic heart disease (Murray et al. 1997). However, When correctly diagnosed and aggressively managed, depression is a highly treatable disease (Angst, 1992; Burvill, 1995; Cohen & Guthrie, 1997). Pharmacotherapy represents a first line option in the management of major depressive illness (Evais et al. 1997; Brugha & Bebbington, 1992. Hence, antidepressant drugs have become an indispensable tool in modem medicine.

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome (NMS) is a life threatening condition. A drop in its incidence as well as mortality has been attributed to increased awareness among the clinicians, early diagnosis and prompt treatment. Central dopamine blockade is considered to play the major role in pathogenesis, though a primary role of sympathoadrenal hyperactivity has also been described, along with various other theories including genetic theories. Apart from conventional neuroleptics, atypical antipsychotics, few antidepressants and many other medications have been considered to be the risk factors for NMS. Hyperthermia, altered mental status, rigidity and autonomic instability are the main clinical symptoms. It is often complicated by renal and respiratory failure. Supportive care is of utmost importance in its management, but bromocriptine, amantadine and dantrolene have been seen to hasten recovery.

Sustained Attention and Executive Functioning in remitted Adolescents with Bipolar Disorder

The concept of bipolar disorder grew out of Emil Kraepelin‘s classification of Manic depressive insanity, when differentiated it from Dementia Precocox. Kraepelin described manic depressive insanity as a cyclic illness that leads to dysfunction only during the illness period and has relatively better prognosis (Kraepelin, 1904). However, bipolar illness has been known since ancient times as description of mania like state can be found in the writings of Hippocrates...

Neurobiology of Obsessive Compulsive Disorder

Once considered a rare condition, Obsessive Compulsive Disorder (OCD) is now recognized as a severe and often chronically disabling illness affecting 1% to 3%of the world's population (1) Apart from the initially dominant psychodynamic and behavioural understanding, biological understanding of the disabling condition got impetus after the advent of successful clinical trials of OCD with clomipramine. In the past two decades, there has been a considerable advance in understanding the biological underpinnings of OCD with emergence of various hypothetical models. Some of the views have raised questions over existing beliefs, too. Thus, to have an insight into the risk, phenomenology, pathophysiology and treatment implications of OCD, there is a need to know the neurobiological mechanism mediating it.

Nonconvulsive Status Epilepticus

For most clinicians, status epilepticus brings to mind a state of ongoing convulsions, often with marked morbidity and mortality. Less well recognized are ongoing epileptic seizures with little or no evidence of convulsion. Such states, often with mild or minimal obtundation, are some of the more difficult conditions to diagnose, especially early in their course. In January, 1888, Charcot in France made a connection between epileptic states and ongoing confusion In 1901, Gowers stated, that after epileptic fits, the patient may pass into a condition of mental automatism, in which various acts are performed in an apparently conscious manner, but of which no recollection is retained afterwards. It was not until the advent of EEG and Lennox's description in 1938 of his cousin who had continuous spike-wave activity that non-convulsive status epilepticus (NCSE) was demonstrated.

Multiple Personality Disorder: A Fact or Fiction

Multiple personality disorder (MPD) or Dissociative Identity Disorder (DID) is one of the most amazing and unusual mental conditions known. It is the ultimate dissociative disorder, chronic in nature and without proper treatment may become a lifelong process, though it may manifest itself differently over the lifetime of an individual (Kluft, 1985).  The existence of apparently separate and autonomous alter personalities, exchanging control over an individual’s behaviour, elicits intense fascination in some and protests and disbelief form others.  The existence of these entities raises questions about fundamental assumptions of the unity of personality and the structure of consciousness. The wide variety of symptoms commonly found in MPD includes most of the types of symptoms found in all of the psychiatric disorders combined.  Thus, to find out what is MPD a fact or fiction we will discuss various aspects of MPD/DID in some detail.

Neuropathology And Assessment Of Mild Cognitive Impairment (MCI)

Mild cognitive impairment (MCI) refers to a specific type of recent memory loss characterizing trouble remembering recently learned information or knowledge, forget appointments, difficulty in identifying familiar faces, may frequently misplace items and repeating the same questions. People who are experiencing forgetfulness and are concerned about MCI should undergo a medical evaluation. To an extent it will help us to rule out and treat potentially reversible conditions like disorders of the thyroid or parathyroid gland, intracranial space occupying processes, vitamin deficiencies, kidney and liver disorders, and emotional problems such as depression, which can also cause forgetfulness like MCI.

Life Events and Psychiatric Disorders

Researchers have long been interested in understanding how individuals and environments affect each other, primarily so as to describe and explain age – related behaviour and individual differences. One focus has been to study life events. A life event is indicative of or requires a significant change in the ongoing life patterns of the individual. According to Settersten and Mayer (1997), "A life event is a significant occurrence involving a relatively abrupt change that may produce serious and long lasting effects". It refers to the happening itself and not to the transitions that will occur because of the happenings.

Personal Values Questionnaire

The PVQ measures the importance individuals attach to three social values or conscious drivers of behaviour: Achievement, Affiliation and Power. A PVQ profile will describe the extent to which test-takers consciously rate these values. It offers illuminating information on what matters to an individual; where they are likely to invest their energies; whether they fir their chosen job role, and how then can improve this fit.

Kentucky Inventory of Mindfulness Skills (KIMS)

The Kentucky Inventory of Mindfulness Skills (KIMS) is a 39-item self-report measuring Mindfulness on four scales: i.Observing, ii.Describing, iii.Act With Awareness, and iv.Accept Without Judgment. It was developed at Kentucky University by Baer, Smith, & Allen in 2004. A short, 20-item version of it (KIMS-Short) was developed in Germany in 2011 and enables researchers to replicate the basic factor structure. However KIMS-Short shows the Observing subscale as comprising two different but strongly correlated factors depending on whether the observed stimuli are internal or external. Good support has been found for the model of four correlated factors, and the scales have been found to be both highly internally consistent and sensitive to change through Mindfulness-Based Cognitive Therapy.

Dialectical Behavior Therapy-Ways of Coping Checklist (DBT-WCCL)

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Distress Tolerance Scale

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Beck's Depression Inventory

The Beck Depression Inventory (BDI, BDI-II), created by Dr. Aaron T. Beck, is a 21-question multiple-choice self-report inventory, one of the most widely used instruments for measuring the severity of depression. Its development marked a shift among health care professionals, who had until then viewed depression from a psychodynamic perspective, instead of it being rooted in the patient's own thoughts.

The Rorschach Test

The Rorschach test (German pronunciation; also known as the Rorschach inkblot test, the Rorschach technique, or simply the inkblot test) is a psychological test in which subjects' perceptions of inkblots are recorded and then analyzed using psychological interpretation, complex algorithms, or both. Some psychologists use this test to examine a person's personality characteristics and emotional functioning. It has been employed to detect underlying thought disorder, especially in cases where patients are reluctant to describe their thinking processes openly. The test is named after its creator, Swiss psychologist Hermann Rorschach.

Yale Brown Obsessive Compulsive Scale (Y-BOCS)

The Yale–Brown Obsessive Compulsive Scale, sometimes referred to as Y-BOCS, is a test to rate the severity of obsessive–compulsive disorder (OCD) symptoms.
The scale, which was designed by Dr. Wayne Goodman and his colleagues, is used extensively in research and clinical practice to both determine severity of OCD and to monitor improvement during treatment. This scale, which measures obsessions separately from compulsions, specifically measures the severity of symptoms of obsessive–compulsive disorder without being biased towards the type of content of obsessions or compulsions present.