Biomedical subjects
Publications and source records attributed to A L Shaner.
A series of 154 patients suffering from the syndrome of intermetamorphosis or its variants is discussed in terms of this misidentification syndrome's historical, classification, diagnostic, and psychosocial aspects. One case is presented in detail.
Self-report and clinical assessment of substance use were compared with urine analysis results in 56 male patients consecutively admitted for inpatient psychiatric treatment. All subjects received DSM-III-R Axis I diagnosis and were classified into diagnostic groups. Urine samples were tested for cocaine, marijuana, opiates, phencyclidine (PCP), amphetamines, and barbiturates. Thirty-five of the 56 patients (62%) produced urine samples that were positive for at least 1 substance of abuse. Of this group, 15 patients (27% of total sample) denied substance use during the week prior to admission. In addition, the admitting physician did not identify intoxication in 23 of the 35 patients (66%) with positive urines. The admitting physician's assessment matched the patient's answers regarding recent substance use in 79 percent of the patients. This association was especially apparent with the 26 patients who denied recent substance use, all but one of whom received a drug-negative assessment from the admitting physician.
Misidentification syndromes have traditionally relied upon the patient's delusional explanation for their classification. Using 2 cases for illustration, a more systematic classification is proposed for misidentification syndromes. The revised nomenclature has potential use in future research of misidentification syndromes.
The relationship of a full range of psychiatric symptoms to EE was examined in 40 men with BPRS and SANS diagnoses of schizophrenia or schizoaffective disorder. Patients from high-EE families had significantly higher ratings of positive symptoms, anxious depression, and overall psychopathology, but not negative symptoms, than did those from low-EE families. In predicting relapses of schizophrenia, account may need to be taken of an interaction between subtle differences in symptoms and relatives' attitudes.
Analeptic-induced paranoid psychosis occasionally occurs in the treatment of narcolepsy. Two cases illustrate how analeptic abuse can contribute to the development of paranoid psychosis in narcolepsy and greatly complicate treatment.
Capgras syndrome is an often reported misidentification syndrome. In contrast, the syndrome of intermetamorphosis has been rarely reported. We describe three new cases of the syndrome of intermetamorphosis and propose a new nomenclature that may further systematic study of misidentification syndromes.