Erotomania revisited: from Kraepelin to DSM-III-R

Article Abstract:

Erotomania has long been identified as a syndrome where an individual is under the delusion that another person loves him or her from afar. The sufferer typically constructs an elaborate delusion in which some other person, the object, is perceived as covertly communicating his or her affection. The delusion may include receiving secret messages through newspapers or the sending of telepathic signals. Erotomania is not necessarily associated with schizophrenia or other disorders. The victims of this condition are usually, but not always, women of modest socioeconomic backgrounds and the object is often an older, unobtainable man of some social prominence or higher economic status. The victim is totally convinced of the object's love and devotion in spite of the fact that the two may never have even met each other. The condition was first reported by the French psychiatrist de Clerambault in 1921, when he described five cases in detail. Emil Kraepelin also observed cases of erotomania (sometimes called Kraepelin's paranoia), identifying a clinically identical syndrome, and proposed a method of diagnosis, along with an examination of the various subtypes of this disorder. Erotomania has been included for the first time in the DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, third edition, revised) and can be found under the category of "Delusional (Paranoid) Disorder". The description of the disorder, its origin, and treatment remain almost identical to that of these two early investigators. Ironically, modern observations only reenforce conclusions which were reached almost 100 years ago. The origin of the disorder is most likely the result of unfulfilled narcissistic needs; the delusions are chronic but in time may be transferred to another individual or may decrease in intensity. The only effective treatment is enforced physical separation of the sufferer from the object. In addition, the use of neuroleptics, anti-psychotic drugs, has shown some success in relieving the symptoms of erotomania. However, these remedies may not always be effective and the general prognosis for this disorder is not good. The condition may last for many years, with the object suffering continual harassment and the patient exhibiting bizarre behavior.

Research, Identification and classification, Delusions, Psychology, Pathological, Psychopathology, Categorization (Psychology), Diagnostic and Statistical Manual of Mental Disorders (Book), de Clerambault, Gatian, Kraepelin, Emil

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CT scan abnormalities and outcome of chronic schizophrenia

Article Abstract:

Computed tomography (CT) is a diagnostic imaging technique in which images are generated by a computer using data from a scanning X-ray of the area of the body being examined. CT has been useful in characterizing some abnormalities of brain morphology associated with schizophrenia. This study examined the relationship between long-term outcome of schizophrenia and brain ventricle size and cortical atrophy as seen on CT scans. CT brain scans were performed on 21 patients that had been recently diagnosed with chronic schizophrenia. Scan results were used to determine the extent of atrophy of the cerebral cortex and cerebral ventricle size. Cerebral ventricle size was expressed as ventricle-to-brain ratio (VBR). Two years later, the patients were reexamined for long-term outcome of their schizophrenia by evaluating several areas of clinical and social functioning. Eighteen patients completed the study. VBR averaged 5.2, with four patients having abnormally large ventricles, based on a VBR of higher than 7.5. Moderate to severe cortical atrophy was seen in six patients and no or mild atrophy was seen in 11 patients. Ventricular enlargement was associated with a poorer employment score at follow-up. Cortical atrophy was associated with a poor result in five of six areas assessed at follow-up. The results indicated that cortical atrophy and ventricular enlargement are associated with a poorer long-term outcome in schizophrenic patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Abnormalities, CT imaging, CAT scans, Brain, Schizophrenia, Brain abnormalities

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