hallucinations

幻觉
  • 文章类型: Journal Article
    显著性假说认为,显著性分配中的畸变最终导致幻觉和不寻常的信念,精神分裂症的“阳性症状”。这方面的证据来自对潜伏抑制(LI)的研究,指事先接触刺激会阻碍学习刺激与结果之间的关系的现象。
    本文回顾了所有已发表的研究LI与精神分裂症和分裂型之间关系的研究。
    当代文献表明,LI在精神分裂症患者和在分裂型测量上高度负荷的患者中都减弱,精神分裂症的多维衍生物。这表明这些个体比健康对照者对刺激赋予更大的显着性,并且在分裂型测量上得分较低的人,分别。然而,一些困惑限制了这些结论。对精神分裂症患者的研究受到精神药物混淆作用的限制,样本的特殊解析,因变量的变化,缺乏统计能力。此外,LI范式受到学习无关性的混杂效应的限制,条件性抑制,负启动,和新颖的弹出式效果。
    这篇综述最后建议研究人员开发新的范式,克服这些限制,以评估显著性假说的预测。
    UNASSIGNED: The Salience Hypothesis posits that aberrations in the assignment of salience culminate in hallucinations and unusual beliefs, the \"positive symptoms\" of schizophrenia. Evidence for this comes from studies on latent inhibition (LI), referring to the phenomenon that prior exposure to a stimulus impedes learning about the relationship between that stimulus and an outcome.
    UNASSIGNED: This article reviewed all published studies examining the relationship between LI and both schizophrenia and schizotypy.
    UNASSIGNED: Contemporary literature suggests that LI is attenuated in both people with schizophrenia and those loading highly on measures of schizotypy, the multidimensional derivative of schizophrenia. This suggests that these individuals assign greater salience to stimuli than healthy controls and people scoring low on measures of schizotypy, respectively. However, several confounds limit these conclusions. Studies on people with schizophrenia are limited by the confounding effects of psychotropic medications, idiosyncratic parsing of samples, variation in dependent variables, and lack of statistical power. Moreover, LI paradigms are limited by the confounding effects of learned irrelevance, conditioned inhibition, negative priming, and novel pop-out effects.
    UNASSIGNED: This review concludes with the recommendation that researchers develop novel paradigms that overcome these limitations to evaluate the predictions of the Salience Hypothesis.
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  • 文章类型: Journal Article
    背景:听觉言语幻觉(AVHs)是各种心理状况的重要症状,经常受到侮辱和误解。超越传统心理,心理治疗和精神病学方法,最近的研究转移集中在通过社区观点和由此产生的污名化理解AVHs。这种研究方法对于更好地支持和理解AVHs至关重要,然而,它仍然缺乏严格和共享的方法来研究和减少污名化。
    方法:我们的研究,意大利“PsicoVoice”项目的一部分,旨在调查关于AVHs的社区话语,以观察它们是否以及在多大程度上是污名化过程的驱动因素。让268名参与者参与AVHs的直接(听众)和间接(如亲属和专业人士)经验,该研究使用MADIT分析了54,320个实例的语料库:一种定性和定量的文本分析方法。MADIT允许对叙述中的修辞论证结构进行创新研究,制作一个指数,用于衡量围绕AVH的叙述“对人们互动的实际影响”。
    结果:分析显示,整体社区话语主要由绝对和个人信仰驱动的方式形成。这种传递感觉的方式,即使使用不必要的判断性词语,有助于为患有AVH的个体创造污名化的环境,巩固由个人意见主导的静态表示,并减少更细致入微的可能性,关于AVHs的不同互动。
    结论:该研究的发现强调了解决社区话语中叙事结构的重要性。通过干预这些叙述,有可能转向不太污名化的AVH社会建构。因此,本文最后利用结果提供了一些关于如何产生这些干预措施的见解。这种方法可能会显著影响社区如何理解和与经历AVH的个人互动,促进更具包容性和支持性的环境和干预措施。
    BACKGROUND: Auditory verbal hallucinations (AVHs) are a significant symptom of various psychological conditions, often stigmatized and misunderstood. Moving beyond traditional psychological, psychotherapeutic and psychiatric approaches, recent research shifts focus on understanding AVHs through community perspectives and the resulting stigmatization. This research approach is crucial for better support and understanding of AVHs, however it still suffers from the lack of a rigorous and shared methodology for studying and reducing stigma.
    METHODS: Our study, part of the Italian \"PsicoVoice\" project, aims to investigate community discourses on AVHs, in order to observe whether and to what extent they are drivers of stigmatisation processes. Engaging 268 participants with direct (hearers) and indirect (such as relatives and professionals) experiences of AVHs, the research analyzes a corpus of 54,320 instances using MADIT: a text analysis methodology which is both qualitative and quantitative. MADIT allows for an innovative examination of the rhetorical-argumentative structures within narratives, producing an index for measuring the narratives\' practical impact on people\' interactions around AVHs.
    RESULTS: The analysis revealed that the overall community discourses are predominantly shaped by absolute and personal belief-driven modalities. This way of conveying sense, even with non-necessarily-judgmental words, contributes to a stigmatizing environment for individuals with AVHs, cementing a static representation dominated by personal opinions and reducing the potential for more nuanced, diverse interactions about AVHs.
    CONCLUSIONS: The study\'s findings underscore the importance of addressing the narrative structures within community discourses. By intervening in these narratives, there is potential to shift towards a less stigmatizing social construction of AVHs. Thus, the article concludes using the results to provide some insights on how to generate these interventions. This approach could significantly impact how communities understand and interact with individuals experiencing AVHs, promoting more inclusive and supportive environments and interventions.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    此病例报告着重于发生神经系统创伤并导致重症监护(ICU)谵妄时患者和家庭成员可能会经历的情况。它是患者(A.B.)和配偶(R.G.B.)观点的个人账户,当患者(A.B)在ICU中22天后出现椎动脉动脉瘤和出血,并经历了重症监护病房(ICU)谵妄。本病例报告提供了患者和配偶关于谵妄的观点,即,A.B.无法辨别现实,失去记忆,妄想症和幻觉,代理和恢复,ICU后综合征,和创伤后应激障碍(PTSD)。神经外科医生的临床诊断为谵妄,治疗包括睡眠镇静和不间断睡眠。A.B.能够恢复意识,但经历了长达一年的创伤后应激障碍。家庭一致参与患者的谵妄护理至关重要。家庭成员护理和以家庭为中心的策略对未来的研究和医疗保健具有重要意义。
    This case report focuses on what patients and family members may experience when a neurological trauma transpires and resultant intensive care (ICU) delirium occurs. It is the personal account of the patient (A.B.) and spouse\'s (R.G.B.) perspectives when the patient (A.B) suffered a vertebral artery aneurysm and hemorrhage and experienced intensive care unit (ICU) delirium after being in the ICU for 22 days. This case report provides the patient\'s and spouse\'s perspectives regarding delirium, i.e., A.B.\'s inability to discern reality, loss of memory, paranoia and hallucinations, agency and recovery, post-ICU syndrome, and post-traumatic stress disorder (PTSD). Clinical diagnosis by the neurosurgeon indicated delirium, with treatment consisting of sleep sedation and uninterrupted sleep. A.B. was able to regain consciousness yet experienced post-traumatic stress disorder up to one year afterward. Consistent family participation in the patient\'s delirium care is crucial. Family member care and family-centered strategies are provided with implications for future research and health care.
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  • 文章类型: English Abstract
    OBJECTIVE: To develop a systematics of chronic delusional psychoses in schizophrenia and pathology of the schizophrenic spectrum that takes into account psychopathological structure (the mechanism of delusional formation) and the trajectories of the disease course (the ratio of negative/positive dimensions).
    METHODS: The study sample was recruited from the large Moscow psychiatric hospital in 2019-2024 and included 126 patients (94 male, 32 female, mean age 36.5±12.1 years) hospitalized with ICD-10 diagnosis of paranoid schizophrenia (F20.00) or delusional disorder (F22). A clinical-psychopathological method was used.
    RESULTS: The study identifies three variants of paranoid domains, the typology of which takes into account both the psychopathological structure and the trajectories of their development, which determine the dominance of predominantly negative or positive symptoms throughout the disease: 1) psychosis with delusional interpretations and predominant orientation of symptoms towards the negative pole of the schizophrenia psychopathology (n=37, 29.4%); 2) psychosis with hallucinatory delusions and predominant direction of symptoms towards the positive pole of the schizophrenia psychopathology (n=50, 39.7%); and 3) «combined» hallucinatory-delusional psychosis with a simultaneous orientation of symptoms to the negative/positive poles of the schizophrenia psychopathology (n=39, 30.9%). Detailed phenomenological characteristics of each of the three presented variants are given.
    CONCLUSIONS: The developed three-component taxonomy confirms, on the model of chronic delusional psychoses appearing in schizophrenia and the pathology of the schizophrenia spectrum, the concept of simultaneous representation of two relatively independent domains determined by neurobiological processes in the schizophrenia psychopathology positive and negative disorders.
    UNASSIGNED: Разработка учитывающей психопатологическую структуру (механизм бредообразования) и вектор траекторий развития заболевания (соотношение негативных/позитивных дименсий) систематики хронических бредовых психозов при шизофрении и патологии шизофренического спектра.
    UNASSIGNED: Выборка исследования сформирована в 2019—2024 гг. на базе крупного психиатрического стационара Москвы и включает 126 пациентов (94 мужчины, 32 женщины, средний возраст 36,5±12,1 года), госпитализированных с диагнозом «параноидная шизофрения» (F20.00 в МКБ-10) либо «бредовое расстройство» (F22 в МКБ-10). Применялся клинико-психопатологический метод исследования.
    UNASSIGNED: В исследовании выделены три варианта параноидных образований, типология которых учитывает как психопатологическую структуру, так и траектории их развития, определяющие доминирование на протяжении заболевания преимущественно негативной либо позитивной симптоматики: психоз с интерпретативным бредом с преимущественной направленностью симптоматики к негативному полюсу психопатологического пространства шизофрении (n=37, 29,4%); психоз с галлюцинаторным бредом с преимущественной направленностью симптоматики к позитивному полюсу (n=50, 39,7%); «совмещенный» галлюцинаторно-бредовой психоз с симультанной направленностью симптоматики к негативным/позитивным полюсам психопатологического пространства шизофрении (n=39, 30,9%). Приведены детальные феноменологические характеристики каждого из трех представленных вариантов.
    UNASSIGNED: Разработанная трехкомпонентная систематика подтверждает на модели хронических бредовых психозов, концепт симультанной представленности в клиническом пространстве шизофрении двух обусловленных нейробиологическими процессами относительно независимых доменов — позитивных и негативных расстройств.
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  • 文章类型: Systematic Review
    目标:随着全球人口老龄化,痴呆症的患病率越来越高,到2050年,估计有1.53亿人患有痴呆症。高达70%的痴呆症患者经历痴呆症相关精神病(D-RP)。抗精神病药物与老年人的许多不良反应有关。这篇综述旨在评估非药物干预在管理D-RP方面的证据。
    方法:搜索Medline,EMBASE,WebofScience,CINAHL,PsycINFO,Cochrane纳入了评估非药物干预措施的随机对照试验。数据提取和质量评估由两名研究人员独立评估。使用荟萃分析汇总异质性干预措施。
    结果:共纳入18篇文章(n=2040名参与者),并分类为:sensor-,活动-,认知和多组分导向。荟萃分析显示,在减少幻觉或妄想方面没有显著影响,但以人为本的护理,认知康复,音乐疗法,机器人宠物在单一研究中显示出希望。
    结论:未来的干预措施应特别关注D-RP,因为这不是许多纳入文章的目的。
    OBJECTIVE: As populations age globally, there is an increasing prevalence of dementia, with an estimated 153 million living with dementia by 2050. Up to 70% of people with dementia experience dementia-related psychosis (D-RP). Antipsychotic medications are associated with many adverse effects in older people. This review aims to evaluate the evidence of non-pharmacological interventions in managing D-RP.
    METHODS: The search of Medline, EMBASE, Web of Science, CINAHL, PsycINFO, and Cochrane included randomised controlled trials that evaluated non-pharmacological interventions. Data extraction and assessment of quality were assessed independently by two researchers. Heterogenous interventions were pooled using meta-analysis.
    RESULTS: A total of 18 articles (n = 2040 participants) were included and categorised into: sensory-, activity-, cognitive- and multi-component-orientated. Meta-analyses showed no significant impact in reducing hallucinations or delusions but person-centred care, cognitive rehabilitation, music therapy, and robot pets showed promise in single studies.
    CONCLUSIONS: Future interventions should be developed and evaluated with a specific focus on D-RP as this was not the aim for many of the included articles.
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  • 文章类型: Journal Article
    背景:路易体病(LBD)的视觉幻觉(VH)现象学是异质的,包括轻微的现象(通过,存在,幻觉)和复杂的幻觉。涉及的神经底物和机制尚不清楚。在这里,我们调查了与次要(MVH)和复杂VH(CVH)相关的灰质(GM)改变。
    方法:具有VH和健康对照(HC-n=20)的LBD患者(n=28)接受MRI检查。我们管理了东北视觉幻觉访谈(NEVHI),评估VH现象学的半结构化访谈,持续时间和频率。VH聚集在MVH和CVH中,并作为患者的特征进行治疗。首先,我们比较了LBD和HC的GM体积。然后,进行多元回归以揭示与持续时间相关的改变,MVH和CVH的频率和严重程度,包括相反的VH结构域,颅内总容积(TIV)和MMSE作为干扰回归因子。
    结果:我们发现双侧梭状回(FG)的GM体积减少,与HC相比,LBD的左后扣带回和右额下回。我们还发现,左侧FG的CVH持续时间与GM体积呈负相关。我们没有发现与MVH现象学有任何关联。
    结论:LBD患者在腹侧视觉流中表现出GM改变,与HC相比,默认模式网络和抑制区域。尽管LBD与HC的比较并非特定于VH,在先前的研究中,所确定的区域与VH有关,提示它们可能代表促成VH的网络中功能改变的结构标志.当测试与VH现象学的关联时,我们没有发现与MVH相关的GM改变.这些现象可能与结构改变无关,而与视觉网络中的功能改变无关。相反,CVH与FG中GM的降低有关。FG中的萎缩可能导致维持CVH持续时间的该区域的自发激活,考虑VH内容(D\‘Antonio等人。,2022年)。这些改变可能代表了LBD中VH的易感条件。根据hodotopic模型,VH现象学可能有助于识别所涉及的大脑区域,并可能揭示VH状态下发生的皮质区域/网络功能障碍的底物(ffytche等人。,2008).
    BACKGROUND: Visual hallucinations (VH) phenomenology in Lewy Body Disease (LBD) is heterogenous, including minor phenomena (passage, presence, illusions) and complex hallucinations. Neural substrates and mechanisms involved are still unclear. Here we investigated grey matter (GM) alterations associated with minor (MVH) and complex VH (CVH).
    METHODS: LBD patients (n = 28) with VH and Healthy controls (HC-n = 20) underwent MRI. We administered the North East Visual Hallucinations Interview (NEVHI), a semi-structured interview assessing the phenomenology of VH, their duration and frequency. VH were clustered in MVH and CVH and treated as a patient\'s trait. First we compared GM volume of LBD and HC. Then, multiple regressions were performed to disclose alterations associated with the duration, frequency and severity of MVH and CVH, including the opposite VH domain, total intracranial volume (TIV) and MMSE as nuisance regressors.
    RESULTS: We found a decreased GM volume in the bilateral fusiform gyrus (FG), in the left posterior cingulate and in the right inferior frontal gyrus in LBD compared to HC. We also found that CVH duration was negatively associated with GM volume in the left FG. We did not find any association with MVH phenomenology.
    CONCLUSIONS: LBD patients showed GM alterations in ventral-visual-stream, default-mode-network and inhibitory regions compared to HC. Although the LBD versus HC comparison is not specific to VH, the regions identified have been implicated in VH in previous studies suggesting they may represent structural hallmarks of functional alterations in networks contributing to VH. When the association with VH phenomenology was tested, we did not find GM alterations associated with MVH. It is likely that these phenomena might be not associated with structural alterations but with functional alterations within visual networks. CVH were instead associated with decreased GM in FG. The atrophy in the FG may lead to a spontaneous activation of this region that sustain CVH duration, accounting for VH content (D\'Antonio et al., 2022). These alterations may represent the predisposing condition to VH in LBD. According to the hodotopic model, VH phenomenology may help identify brain regions implicated and might reveal the substrates for cortical region/network dysfunctions occurring during VH state (ffytche et al., 2008).
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  • 多发性硬化症(MS)是一种神经系统疾病,伴有神经元物质脱髓鞘,尤其是白质,有多个发作发生在时间上。它与多种神经和精神后遗症有关。抑郁症和其他情感症状通常与MS有关。先前的研究还表明,精神病症状也可能与MS同时发生。
    准备了住院病房患者的病例报告。随后,基于三个数据库的系统评价和荟萃分析(PRISMA)首选报告项目模型,对文献进行了系统的文献综述.搜索词包括(MS或多发性硬化症)和(精神病或精神分裂症或分裂情感障碍或精神病或幻觉或妄想)。
    文献综述导致在PubMed上最初发现了2711首热门歌曲,在PsycINFO上点击了1276次,在Embase上有5429次命中。一些患者在较早的年龄被诊断为MS,而精神病发作较晚。而有些人最初被诊断为精神病(或精神分裂症),然后是MS。观察到的精神病症状包括迫害妄想,缺乏洞察力,参考的妄想,幻听,宏伟的妄想,和被动。常用的抗精神病药包括利培酮,奥氮平,喹硫平,和阿立哌唑.MS患者中同时发生的精神病的存在强调了对症状进行全面评估的必要性。
    这个案例强调了进行磁共振成像(MRI)大脑的重要性,不仅是对最初发作的精神病,而且对病程相对稳定的患者的任何突然变化也是如此。此外,精神病会影响MS的治疗依从性,使识别和管理它变得更加重要。
    UNASSIGNED: Multiple sclerosis (MS) is a neurological disorder with demyelination of neuronal matter, especially of white matter, with multiple episodes occurring temporally. It has been associated with multiple neurological and psychiatric sequelae. Depression and other affective symptoms are commonly associated with MS. Previous research has also suggested that psychotic symptoms may co-occur with MS as well.
    UNASSIGNED: A case report was prepared on the patient admitted to the inpatient unit. Subsequently, a systematic literature review of literature was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model on three databases. Search terms included (MS OR multiple sclerosis) AND (Psychosis OR schizophrenia OR schizoaffective disorder OR psychotic OR hallucination OR delusion).
    UNASSIGNED: The literature review led to an initial discovery of 2711 hits on PubMed, 1276 hits on PsycINFO, and 5429 hits on Embase. Some patients were diagnosed with MS at an earlier age with a later onset of psychosis, while some were initially diagnosed with psychosis (or schizophrenia) first and subsequently with MS. Psychotic symptoms observed included persecutory delusions, lack of insight, delusions of reference, auditory hallucinations, grandiose delusions, and passivity. The commonly prescribed antipsychotics included risperidone, olanzapine, quetiapine, and aripiprazole. The presence of co-occurring psychosis in MS patients underscores the need for a comprehensive evaluation of symptoms.
    UNASSIGNED: This case highlights the importance of conducting a magnetic resonance imaging (MRI) brain not only for initial onset psychosis but also for any sudden changes in patients who have had a relatively stable course. Moreover, psychosis can affect treatment adherence in MS, making it all the more critical to identify and manage it promptly.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    精神病的症状,以妄想和幻觉为特征,通常是痴呆症患者所经历的。完成了一项系统评价,以确定与痴呆症患者的参考标准相比,评估精神病症状的工具。还确定了报告精神病工具之间相关值的文章。
    搜索概念精神病,痴呆症,诊断准确性用于搜索MEDLINE,PsycINFO,和Embase。符合主要目标的文章描述了一种评估精神病症状的工具,妄想,或者痴呆症患者的幻觉,精神病诊断评估的参考标准形式,以及精神病工具的诊断准确性结果。次要客观文章报道了痴呆症患者的两种或多种精神病工具之间的相关性值。
    一项研究达到了主要目标,并描述了神经精神量表(NPI)和哥伦比亚大学精神病理学量表在识别精神病症状方面的敏感性和特异性。幻觉,和妄想。NPI和CUSPAD在识别精神病症状方面的敏感性分别为83%和90%,分别。符合次要目标的9项研究描述了11种独特的工具,并检查了用于评估痴呆症患者精神病症状的工具的相关程度。
    在一项研究中将NPI和CUSPAD确定为精神病工具,已根据痴呆症患者的精神病评估参考标准进行了评估。存在各种评估痴呆症患者精神病症状负担的工具,但现有工具的诊断准确性仍未得到充分研究。需要对痴呆症患者使用的所有精神病工具的比较实用性和诊断准确性进行进一步研究。
    UNASSIGNED: Symptoms of psychosis, characterized by delusions and hallucinations, are commonly experienced by persons living with dementia. A systematic review was completed to identify tools to evaluate symptoms of psychosis compared to a reference standard in persons with dementia. Articles reporting correlation values between psychosis tools were also identified.
    UNASSIGNED: The search concepts psychosis, dementia, and diagnostic accuracy were used to search MEDLINE, PsycINFO, and Embase. Included articles meeting the primary objective described a tool to assess symptoms of psychosis, delusions, or hallucinations in persons with dementia, a reference standard form of diagnostic assessment for psychosis, and diagnostic accuracy outcomes for the psychosis tool. Secondary objective articles reported correlation values between two or more psychosis tools in persons with dementia.
    UNASSIGNED: One study met the primary objective and described the sensitivity and specificity of the Neuropsychiatric Inventory (NPI) and Columbia University Scale for Psychopathology in Alzheimer\'s Disease (CUSPAD) in identifying symptoms of psychosis, hallucinations, and delusions. The sensitivity of the NPI and CUSPAD in identifying symptoms of psychosis was 83 and 90%, respectively. Nine studies meeting the secondary objective described eleven unique tools and examined the degree to which tools used to assess psychotic symptoms in persons with dementia were related.
    UNASSIGNED: The NPI and CUSPAD were identified in a single study as psychosis tools that have been evaluated against a reference standard of psychosis assessment in persons with dementia. Various tools to assess the burden of psychotic symptoms in persons with dementia exist, but the diagnostic accuracy of existing tools remains understudied. Further research on the comparative utility and diagnostic accuracy is required for all psychosis tools used with persons with dementia.
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