In this paper the question of autonomy in delusional disorders is investigated using a phenomenological approach. I refer to the distinction between freedom of intentional action, and freedom of the will, and develop phenomenological descriptions of lived autonomy, taking into account the distinction between a pre-reflective and a reflective type. Drawing on a case report, I deliver finely-grained phenomenological descriptions of lived autonomy and experienced self-determination when acting on delusions. This analysis seeks to demonstrate that a person with delusions can be described as responsible for her behaviour on a 'framed' level (level of freedom of intentional action), even though she is not autonomous on a higher ('framing') level (level of freedom of the will), if, and only if, the goods of agency for herself and others are respected. In these cases the person with delusions is very nearly comparable to people in love, who are also not free to choose their convictions, and who could also be rightly held responsible for the behaviour flowing from their convictions.
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http://dx.doi.org/10.1186/1747-5341-8-14 | DOI Listing |
Cureus
November 2024
Psychiatry, Maudsley Health, Al Amal Psychiatric Hospital, Dubai, ARE.
Schizophrenia is a chronic psychiatric disorder marked by severe disturbances in thought, perception, and behavior. Long-acting injectable (LAI) antipsychotics, such as paliperidone, are widely used to promote sustained remission and ensure medication adherence, especially in patients prone to relapse. However, the COVID-19 pandemic has introduced unique challenges, with studies indicating that infections like COVID-19 may exacerbate psychiatric symptoms through neuroinflammatory pathways.
View Article and Find Full Text PDFNeuropsychiatr Dis Treat
October 2024
Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
Despite evidence of benefits beyond those of oral antipsychotics, long-acting injectable antipsychotics (LAIs) are underused in schizophrenia treatment. Underuse may be partially a result of misconceptions held by some healthcare professionals (HCPs) pertaining to LAIs. A panel of four experts convened between January 2022 and May 2022 to identify these misconceptions, and example cases or scenarios were created to illustrate common clinical situations relevant to these beliefs.
View Article and Find Full Text PDFCureus
August 2024
Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE.
Treatment-resistant schizophrenia (TRS) presents considerable challenges in contemporary psychiatric practice due to inadequate response to conventional antipsychotic treatments. Paliperidone, the primary active metabolite of risperidone, particularly in its long-acting injectable (LAI) form, has emerged as a promising option for TRS due to its consistent medication delivery, reducing symptom exacerbation and relapse associated with oral dosing fluctuations. This case report presents the clinical journey of a 42-year-old female diagnosed with schizophrenia at age 15.
View Article and Find Full Text PDFClin Psychol Eur
September 2023
Royal Holloway University of London, Egham Hill, Egham, United Kingdom.
Background: This report presents the single case of Jack, a 67-year-old referred to our Older Adult Community Mental Health Team (OA CMHT) for his distressing persecutory delusion and high levels of worry. Jack also reported learning difficulties and autistic traits, although neither were formally diagnosed.
Method: Ten sessions of worry intervention taken from The Feeling Safe Programme worry module were used to reduce Jack's time spent worrying and increase his engagement in meaningful activity.
Cureus
October 2023
Psychiatry, University of Galway, Galway, IRL.
This case describes delusions of vampirism among several other psychotic symptoms in a 15-year-old who has a diagnosis of schizophrenia, with these delusions first presenting when he was 13 years of age. Delusions of vampirism can be associated with a strong desire to suck human blood but these delusional beliefs were not acted upon here. This is the first report of delusions of vampirism in childhood to date.
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