The phenomena of auditory hallucination as described by Indonesian people living with schizophrenia

This study was a phenomenological inquiry of the experience of auditory hallucinations as described by 13 Indonesian people diagnosed with schizophrenia. The interviewees included 6 men and 7 women and they were aged between 19 and 56 years. Four themes emerged from this study: feeling more like a robot than a human being; voices of contradiction - a point of confusion; tattered relationships and family disarray; and normalizing the presence of voices as part of everyday life. The findings of this study have the potential to contribute to new understandings of how people live with and manage auditory hallucinations and so enhance client-centered nursing care.

Interpretation, emotional reactions and daily life implications of hallucination-like experiences in clinical and nonclinical populations

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Automatic tracking, super-resolution and recognition of human faces from surveillance video

Identifying an individual from surveillance video is a difficult, time consuming and labour intensive process. The proposed system aims to streamline this process by filtering out unwanted scenes and enhancing an individual's face through super-resolution. An automatic face recognition system is then used to identify the subject or present the human operator with likely matches from a database. A person tracker is used to speed up the subject detection and super-resolution process by tracking moving subjects and cropping a region of interest around the subject's face to reduce the number and size of the image frames to be super-resolved respectively. In this paper, experiments have been conducted to demonstrate how the optical flow super-resolution method used improves surveillance imagery for visual inspection as well as automatic face recognition on an Eigenface and Elastic Bunch Graph Matching system. The optical flow based method has also been benchmarked against the ``hallucination'' algorithm, interpolation methods and the original low-resolution images. Results show that both super-resolution algorithms improved recognition rates significantly. Although the hallucination method resulted in slightly higher recognition rates, the optical flow method produced less artifacts and more visually correct images suitable for human consumption.

Super-resolved faces for improved face recognition from surveillance video advances in biometrics

Characteristics of surveillance video generally include low resolution and poor quality due to environmental, storage and processing limitations. It is extremely difficult for computers and human operators to identify individuals from these videos. To overcome this problem, super-resolution can be used in conjunction with an automated face recognition system to enhance the spatial resolution of video frames containing the subject and narrow down the number of manual verifications performed by the human operator by presenting a list of most likely candidates from the database. As the super-resolution reconstruction process is ill-posed, visual artifacts are often generated as a result. These artifacts can be visually distracting to humans and/or affect machine recognition algorithms. While it is intuitive that higher resolution should lead to improved recognition accuracy, the effects of super-resolution and such artifacts on face recognition performance have not been systematically studied. This paper aims to address this gap while illustrating that super-resolution allows more accurate identification of individuals from low-resolution surveillance footage. The proposed optical flow-based super-resolution method is benchmarked against Baker et al.’s hallucination and Schultz et al.’s super-resolution techniques on images from the Terrascope and XM2VTS databases. Ground truth and interpolated images were also tested to provide a baseline for comparison. Results show that a suitable super-resolution system can improve the discriminability of surveillance video and enhance face recognition accuracy. The experiments also show that Schultz et al.’s method fails when dealing surveillance footage due to its assumption of rigid objects in the scene. The hallucination and optical flow-based methods performed comparably, with the optical flow-based method producing less visually distracting artifacts that interfered with human recognition.

Dysbindin (DTNBP1) variants are associated with hallucinations in schizophrenia

BACKGROUND: Dystrobrevin binding protein 1 (DTNBP1) is a schizophrenia susceptibility gene involved with neurotransmission regulation (especially dopamine and glutamate) and neurodevelopment. The gene is known to be associated with cognitive deficit phenotypes within schizophrenia. In our previous studies, DTNBP1 was found associated not only with schizophrenia but with other psychiatric disorders including psychotic depression, post-traumatic stress disorder, nicotine dependence and opiate dependence. These findings suggest that DNTBP1 may be involved in pathways that lead to multiple psychiatric phenotypes. In this study, we explored the association between DTNBP1 SNPs (single nucleotide polymorphisms) and multiple psychiatric phenotypes included in the Diagnostic Interview of Psychosis (DIP). METHODS: Five DTNBP1 SNPs, rs17470454, rs1997679, rs4236167, rs9370822 and rs9370823, were genotyped in 235 schizophrenia subjects screened for various phenotypes in the domains of depression, mania, hallucinations, delusions, subjective thought disorder, behaviour and affect, and speech disorder. SNP-phenotype association was determined with ANOVA under general, dominant/recessive and over-dominance models. RESULTS: Post hoc tests determined that SNP rs1997679 was associated with visual hallucination; SNP rs4236167 was associated with general auditory hallucination as well as specific features including non-verbal, abusive and third-person form auditory hallucinations; and SNP rs9370822 was associated with visual and olfactory hallucinations. SNPs that survived correction for multiple testing were rs4236167 for third-person and abusive form auditory hallucinations; and rs9370822 for olfactory hallucinations. CONCLUSION: These data suggest that DTNBP1 is likely to play a role in development of auditory related, visual and olfactory hallucinations which is consistent with evidence of DTNBP1 activity in the auditory processing regions, in visual processing and in the regulation of glutamate and dopamine activity

Physostigmine for promethazine poisoning

Experience suggests that the central anticholinergic action of promethazine is a major element in the toxic effects following overdosage. Physostigmine seems to be a direct antidote at doses within the safe therapeutic range; side-effects, if they become a problem, can be treated with intravenous atropine.

Linking Attention to Learning, Expectation, Competition, and Consciousness

The concept of attention has been used in many senses, often without clarifying how or why attention works as it does. Attention, like consciousness, is often described in a disembodied way. The present article summarizes neural models and supportive data and how attention is linked to processes of learning, expectation, competition, and consciousness. A key them is that attention modulates cortical self-organization and stability. Perceptual and cognitive neocortex is organized into six main cell layers, with characteristic sub-lamina. Attention is part of unified design of bottom-up, horizontal, and top-down interactions among indentified cells in laminar cortical circuits. Neural models clarify how attention may be allocated during processes of visual perception, learning and search; auditory streaming and speech perception; movement target selection during sensory-motor control; mental imagery and fantasy; and hallucination during mental disorders, among other processes.

A new comparator account of auditory verbal hallucinations: how motor prediction can plausibly contribute to the sense of agency for inner speech

The comparator account holds that processes of motor prediction contribute to the sense of agency by attenuating incoming sensory information and that disruptions to this process contribute to misattributions of agency in schizophrenia. Over the last 25 years this simple and powerful model has gained widespread support not only as it relates to bodily actions but also as an account of misattributions of agency for inner speech, potentially explaining the etiology of auditory verbal hallucination (AVH). In this paper we provide a detailed analysis of the traditional comparator account for inner speech, pointing out serious problems with the specification of inner speech on which it is based and highlighting inconsistencies in the interpretation of the electrophysiological evidence commonly cited in its favor. In light of these analyses we propose a new comparator account of misattributed inner speech. The new account follows leading models of motor imagery in proposing that inner speech is not attenuated by motor prediction, but rather derived directly from it. We describe how failures of motor prediction would therefore directly affect the phenomenology of inner speech and trigger a mismatch in the comparison between motor prediction and motor intention, contributing to abnormal feelings of agency. We argue that the new account fits with the emerging phenomenological evidence that AVHs are both distinct from ordinary inner speech and heterogeneous. Finally, we explore the possibility that the new comparator account may extend to explain disruptions across a range of imagistic modalities, and outline avenues for future research.

L'écriture comme intensité : la vision métaphorique à travers l'oeuvre de Reinaldo Arenas

En observant le foisonnement de métaphores de la lumière et de la vision dans l’œuvre de Reinaldo Arenas – l’accentuation de la couleur, l’éblouissement, la brûlure et le dédoublement – cette thèse s’interroge sur la vision de l’écriture formulée dans et à partir de ces images, et sur les implications de cette vision. Constatant à travers cette réflexion l’inscription à même le langage des images de la lumière et de la vision – de la réflexion à la clarté, en passant par l’image et la lucidité – cette thèse délibère, à travers l’œuvre de Reinaldo Arenas et celle de Jorge Luis Borges, sur une définition de l’écriture comme intensité, notion et image empruntées au registre du sensible par le détour de la physique. Le premier chapitre s’intéresse à la couleur comme phénomène de la vision, du sensible, de l’affect et de la nuance, ainsi qu’à la métaphore de la cécité abordée par Borges et par Paul de Man comme phénomène de la lecture, points d’entrée à une réflexion sur l’écriture. Le second chapitre aborde la notion d’éblouissement en tant qu’intensité de la lumière et temporalité de la prise de conscience lucide, définissant ainsi une vision du temps et les affinités entre la temporalité de l’écriture et celle de l’image poétique. Le troisième chapitre, réitérant la question de la relation au temps – historique et narratif –, réaffirme les inflexions du langage en fonction de la lumière, c’est-à-dire la relation entre l’aspect « lumineux » du langage, l’intensité de la lumière et l’intensité de l’écriture (entendue comme écriture littéraire), en explorant le seuil (la destruction par le feu) mis en lumière par l’image du phénix, figure mythique et littéraire de la transformation des images, selon la définition de l’imagination proposée par Gaston Bachelard. Enfin, la double conclusion (une conclusion en deux parties, ou deux conclusions réfléchies l’une dans l’autre), relie les images poétiques de la lumière évoquées et leurs implications en examinant la portée d’une vision de l’écriture comme intensité. Cette idée est élaborée à travers l’image finale du double, figure littéraire constitutive et omniprésente à la fois chez Arenas et chez Borges, image non seulement de la relation entre le personnage et son double (qui relève de l’hallucination ou de l’imagination, images, encore une fois, de la vision), mais aussi de la relation entre l’auteur et le texte, le lecteur et le texte, l’écriture et le temps. La double conclusion vise le dédoublement et redoublement comme figures de l’intensité dans l’écriture. Le lien entre la vision métaphorique et l’écriture comme intensité est donc articulé par la métaphore, telle qu’entendue par Borges, élargie à l’image poétique dans la perspective de Gaston Bachelard ; elle s’appuie sur la vision de la littérature pensée et écrite par Arenas. La réflexion est double : dans le texte et sur le texte, au plan poétique et au plan d’une réflexion sur l’écriture d’Arenas ; sur l’écriture et, implicitement, sur la littérature.

La psicosis: un acercamiento desde la teoría de Wilfred Bion

Este texto pretende hacer un acercamiento a la definición de la psicosis a partir de la revisión de la obra de Wilfred Bion. Para esto es necesario abarcar algunos conceptos de los psicoanalistas Sigmund Freud y Melanie Klein, como los son el yo y algunos mecanismos de defensa como la identificación proyectiva y la escisión. Se presentaran las conceptualizaciones pertinentes, para ser integradas a la teoría del pensamiento con el fin de lograr una definición de la psicosis a la luz de los planteamientos de Bion. También se ilustrarán los elementos definidos y la integración de los mismos, a través de viñetas de casos clínicos seleccionados para este fin. Finalmente se corroborará la pertinencia de la teoría bioniana en la clínica contemporánea

Acute psychotic disorders induced by topiramate: report of two cases

Relatamos dois pacientes epilépticos que manifestaram quadro psicótico agudo induzido por topiramato (TPM). Um paciente apresentou agitação psicomotora grave, heteroagressividade, alucinações auditivas e visuais, e delírios de conteúdo paranóide e místico. O outro paciente apresentou agitação psicomotora, despersonalização, desrealização, ansiedade intensa e delírio de que estava perdendo a memória. Ambos os pacientes foram conduzidos ao serviço de emergência e, após a interrupção do TPM em um deles e redução da droga em outro, houve remissão total dos sintomas psicóticos sem necessidade de medicação antipsicótica. Alertamos os clínicos para o risco de surgimento de sintomas psicóticos em pacientes em uso do TPM.

Toward an Explanation of the Genesis of Ketamine-Induced Perceptual Distortions and Hallucinatory States

The NMDA receptor (NMDAR) channel has been proposed to function as a coincidence-detection mechanism for afferent and reentrant signals, supporting conscious perception, learning, and memory formation. In this paper we discuss the genesis of distorted perceptual states induced by subanesthetic doses of ketamine, a well-known NMDA antagonist. NMDAR blockage has been suggested to perturb perceptual processing in sensory cortex, and also to decrease GABAergic inhibition in limbic areas (leading to an increase in dopamine excitability). We propose that perceptual distortions and hallucinations induced by ketamine blocking of NMDARs are generated by alternative signaling pathways, which include increase of excitability in frontal areas, and glutamate binding to AMPA in sensory cortex prompting Ca++ entry through voltage-dependent calcium channels (VDCCs). This mechanism supports the thesis that glutamate binding to AMPA and NMDARs at sensory cortex mediates most normal perception, while binding to AMPA and activating VDCCs mediates some types of altered perceptual states. We suggest that Ca++ metabolic activity in neurons at associative and sensory cortices is an important factor in the generation of both kinds of perceptual consciousness.

The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): Reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia

Background: Neuropsychiatric symptoms (NPS) affect almost all patients with dementia and are a major focus of study and treatment. Accurate assessment of NPS through valid, sensitive and reliable measures is crucial. Although current NPS measures have many strengths, they also have some limitations (e.g. acquisition of data is limited to informants or caregivers as respondents, limited depth of items specific to moderate dementia). Therefore, we developed a revised version of the NPI, known as the NPI-C. The NPI-C includes expanded domains and items, and a clinician-rating methodology. This study evaluated the reliability and convergent validity of the NPI-C at ten international sites (seven languages). Methods: Face validity for 78 new items was obtained through a Delphi panel. A total of 128 dyads (caregivers/patients) from three severity categories of dementia (mild = 58, moderate = 49, severe = 21) were interviewed separately by two trained raters using two rating methods: the original NPI interview and a clinician-rated method. Rater 1 also administered four additional, established measures: the Apathy Evaluation Scale, the Brief Psychiatric Rating Scale, the Cohen-Mansfield Agitation Index, and the Cornell Scale for Depression in Dementia. Intraclass correlations were used to determine inter-rater reliability. Pearson correlations between the four relevant NPI-C domains and their corresponding outside measures were used for convergent validity. Results: Inter-rater reliability was strong for most items. Convergent validity was moderate (apathy and agitation) to strong (hallucinations and delusions; agitation and aberrant vocalization; and depression) for clinician ratings in NPI-C domains. Conclusion: Overall, the NPI-C shows promise as a versatile tool which can accurately measure NPS and which uses a uniform scale system to facilitate data comparisons across studies. Copyright © 2010 International Psychogeriatric Association.

Analgésicos Tópicos

Background and objectives: Pain treatment involves the usage of common and opioid analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs) and adjuvant analgesics. Traditionally, these drugs are administered systemically or into the neuraxis. However, when analgesics are applied through these pathways, they are associated with significant side effects, which can hinder its use. Topical administration of analgesics is an alternative. The objective of this paper is to discuss topical analgesics, the mechanisms of action and clinical efficacy. Content: This is a review paper addressing the usage of the topical local anesthetics: capsaicin, clonidine, tricyclic antidepressants, ketamine, opioids and cannabinoids, discussing mechanism of action and effectiveness. Conclusions: Topical analgesics are promising as a strategy for pain treatment, as they are associated with lower incidence of side effects. The benefit of local anesthetics, NSAID's and capsaicin is well established. However, the efficacy of clonidine, tricyclic antidepressants, ketamine, opioids and cannabinoids is still questionable. Studies have shown that the multimodal approach is an alternative, but studies are needed to confirm this hypothesis. © 2012 Elsevier Editora Ltda.