A 65-year-old woman believes that she is already dead. Similar delusions are reported in which of the following diseases?
E. Cotard’s syndrome is severe depression with nihilistic and hypochondriacal delusions tinged with grandiosity and a negative attitude. It is not related to delusional misidentification. Cotard’s syndrome is seen in schizophrenia, though more commonly in depressive psychosis. It is generally seen in elderly people and is also reported in organic lesions and migraine.
Reference:
Mr Spencer is a loving and caring husband of Martha. When Martha is pregnant, Mr Spencer develops symptoms of bloating, pelvic pain, and morning sickness.
The main psychopathology in the above presentation is:
A. Couvade syndrome describes a sympathetic pregnancy that affects husbands (rarely other family members) during their wives’ pregnancies. It is most frequent between 3 and 9 months of a spouse’s pregnancy. It is a conversion symptom and not delusional as the husband does not believe he is pregnant! Pseudocyesis is a condition where a woman experiences clinical signs of pregnancy without being pregnant, and she may become fully convinced of being pregnant.
A 72-year-old lady complains of being infested with body lice. Her dermatologist could not find any signs of infestation but she insists that she could feel the lice moving on her skin and brings a matchbox full of skin scrapings for examination.
Which of the following descriptions is most appropriate?
E. Delusional infestation (Ekbom’s syndrome) is a delusion of parasitic (macroscopic) infestation with classical matchbox sign. An old lady comes to clinic with a match box of skin scrapings, as evidence for the parasite that infests her, causing itching. This can predate the onset of dementia. It may or may not be associated with a somatic tactile hallucination. It is not the same as compulsive skin picking, where the psychopathology is one of compulsion and not delusion. In factitious dermatitis, patients seek medical attention without obvious monetary gain in order to be in a patient role. They induce skin lesions using chemicals or medicinal products in order to ‘become a patient’. This lady is not having somatization where multiple, non-specific somatic (mostly pain) symptoms are present.
Which of the following is not a delusional misidentification?
B. The various misidentification syndromes are:
Which of the following is FALSE with respect to Doppelganger?
D. Doppelganger is also known as double phenomenon – it is the awareness of one’s existence as being both outside and inside oneself. It is cognitive and ideational, as opposed to autoscopy which is perceptual. It can occur in the absence of mental illness too. It is not related to delusional misidentification syndromes where there is pathology of familiarity.
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