Psychosis or ‘the loss of touch with reality’ is present in several mental health conditions such as bipolar disorder, major depressive disorder, and schizophrenia. The primary symptoms of psychosis include delusions, hallucinations, disorganized behavior, and other negative symptoms.
Schizophrenia, often considered the classic psychotic disorder, represents the complex as well as heterogenetic nature of psychotic symptoms. Earlier, when schizophrenia was not diagnosed according to DSM-5, five subtypes, including paranoid, disorganized, catatonic, undifferentiated, and residual, were used to diagnose it.
In recent years, several rare clinical syndromes have been defined that represent different symptoms of psychotic disorder.
1) Cotard’s Syndrome
Cotard’s Syndrome, a rare disorder, is named after the French neurologist Jules Cotard (1840-1889). People afflicted with Cotard’s Syndrome believe themselves to be already dead, not existing, are putrefying, or their body has lost the blood or internal organs, and their flesh is rotting. Initially, the term used by Cotard was ‘délire des negations’ to define this condition. He believed it to be a form of the depressive condition instead of a type of delusion. Berrios and Luque supported his view.
While the DSM does not enlist Cotard’s Syndrome, ‘nihilistic delusions’ are enlisted. Cotard’s Syndrome is a misunderstood condition that can be treated with antidepressants, antipsychotic drugs, and Electroconvulsive Therapy (ECT). People who have Coatrd’s Syndrome often experience depression and suicidal thoughts.
2) Capgras Syndrome
Capgras syndrome is also named for a French physician, Joseph Capgras (1873-1950). People who have Capgras Syndrome believe their close family members, including parents, spouses, or friends to be replaced by an imposter. It generally manifests in people who have paranoid schizophrenia, Alzheimer’s disease, epilepsy, traumatic brain injury, and neurodegenerative diseases, including Lewy Body Dementia. Capgras syndrome is also not listed in the DSM. Though the exact cause of Capgras syndrome is not yet known, it can be generally treated through a combination of psychotherapy and antipsychotic drugs.
3) Folie à Deux (Shared Psychotic Disorder)
‘Folie à deux’ in French means 'madness of two’ is a rare psychiatric condition in which two people in close proximity experience delusions and hallucinations. Folie à deux was recently termed as ‘Shared Psychotic Disorder.’ There are pieces of evidence that prove that social isolation is a major contributing factor in the development of Shared psychotic disorder. However, it is also believed that the second individual who adopts the psychiatric condition from the primary individual is more likely to have symptoms of underlying Dependent Personality Disorder. The earlier versions of the DSM enlisted Shared Psychotic Disorder as a distinct psychotic disorder. However, DSM-5 no longer separates it from delusional disorders. Both the affected individuals who meet the criteria are diagnosed with delusional disorder.
4) Apotemnophilia
Apotemnophilia is also known as ‘Body integrity dysphoria.’ People who have Apotemnophilia experience a strong urge to cut off their limbs. Scientists have blamed neurological damage to the right parietal lobe of the brain for causing this disorder. Generally, Behavioral therapy and Aversion therapy (to reduce self-harm) are used to treat apotemnophilia. But a patient with apotemnophilia often tries to avoid or resist treatment.
5) Alien hand syndrome
People with Alien hand syndrome believe their limbs are not their own and that they have no control over it. People who have Alien hand syndrome often complain that their hands do not follow their commands and tried to choke them. Some patients also reported scratching their hands until it starts bleeding.
The generally accepted explanation of this mental health condition is damage to the corpus callosum, the bridge that connects the left and the right side of the brain. It usually manifests in people who have Alzheimer’s disease or Creutzfeldt-Jakob Disease. Or people who had brain surgery in which the left and right hemispheres of the brain were separated. Currently, there are no known treatments available for alien hand syndrome.
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