Late Onset First Episode Psychosis Emerging as Delusional Misidentification of Familiar Sacred Places During a Holy Pilgrimage: A Case Report and Literature Review

Background

The delusional misidentification syndromes (DMS) include a myriad of discrete but related syndromes, which have wide spectrum anomalies of familiarity. Several misidentification syndromes have been described in the psychiatric literature, the most common of these delusions are: the Capgras syndrome; the Fregoli syndrome; the syndrome of inter-metamorphosis; reduplicative paramnesia; and environmental reduplication.

Case Presentation

The reported case highlights the emergence of late onset first episode psychosis in a Middle Eastern 65-year-old female who has no previous psychiatric history. The nature of psychosis was mainly delusions of misidentification and persecution.

Discussion

DMS are relatively rare and occur predominantly in association with schizophrenia and affective psychosis. Between 25 and 40% are associated with organic conditions such as dementia, head injuries, brain tumors, and epilepsy. Only three cases of misidentification of sacred places have been reported previously in the literature. This case report is the first to present a DMS, emerging as a late onset first episode psychosis during the sacred journey of Hajj.

Clinical Implications

The reported case highlights the importance of early recognition and treatment of mental health conditions that may appear de novo during the Hajj sacred journey. Readily available psychiatric resources, psychotropic medications, and psycho-education may be pivotal in ensuring mental well-being of pilgrims, which is fundamental to maintain the mental capacity required for completing these journeys.

     

Modeling Unicorns and Dead Cats: Applying Bressan’s ML<Superscript><Emphasis Type="Italic">ν</Emphasis></Superscript> to the Necessary Properties of Non-existent Objects

Should objects count as necessarily having certain properties, despite their not having those properties when they do not exist? For example, should a cat that passes out of existence, and so no longer is a cat, nonetheless count as necessarily being a cat? In this essay I examine different ways of adapting Aldo Bressan’s ML ^ν so that it can accommodate an affirmative answer to these questions. Anil Gupta, in The Logic of Common Nouns, creates a number of languages that have a kinship with Bressan’s ML ^ν , three of which are also tailored to affirmatively answering these questions. After comparing their languages, I argue that metaphysicians and philosophers of language should prefer ML ^ν to Gupta’s languages in most applications because it can accommodate essential properties, like being a cat, while being more uniform and less cumbersome.     

Predictors of Diabetes Fatalism Among Arabs: A Cross-Sectional Study of Lebanese Adults with Type 2 Diabetes

Fatalism is a grounded cultural belief that is common among Arabs and is known to hinder self-care in chronic diseases including diabetes (Nabolsi and Carson in Scand J Caring Sci 25(4):716–724, 2011). The purpose of this study is to identify predictors of diabetes fatalism in this population. Data on 280 Lebanese patients with type 2 diabetes (mean age 58.24 ± 13.48 years; mean HbA1c 7.90 ± 1.90%; 53.76% females) recruited from one hospital in greater Beirut, Lebanon, and from the community using snowballing technique were examined. Multiple linear regression was used to assess the independent association between diabetes fatalism and demographic and patient characteristics. Age (β = ?.14, 95% CI ?.27, ?.002), BMI (β = .35, 95% CI .15; .54), level of education (β = ?3.98, 95% CI ?7.64; ?.32) and number of diabetes problems (β = ?5.03, 95% CI ?9.89; ?.18) were significantly associated with diabetes fatalism in the regression model. The combination of demographic and patient characteristics accounted for 14.5% of the variance in diabetes fatalism scores’ change. Patients with type 2 diabetes who exhibited more fatalistic attitudes were younger, of lower education levels, had higher BMI and had fewer diabetes comorbidities. Such findings are crucial for healthcare practitioners to identify fatalistic patients and to tailor culturally appropriate strategies in diabetes management. Further studies are warranted to explore other potential determinants of diabetes fatalism with larger sample and non-Lebanese Arabic population.     

Perception of Candomble Practitioners About Herbal Medicine and Health Promotion in Ceará, Brazil

Candomble, a Brazilian religion of African origin that worships Orishas, promotes “healing” assistance during its worship rituals using therapy with plants and beliefs. From its ancestry tradition, the respect and beware with nature are expressed. Therefore, the aim of this study is to investigate the perception of ethnoecology and health promotion among Candomble practitioners from a Candomble temple in the state of Ceará, Brazil. The ethnography was designed to allow greater immersion into the current mystique. This immersion results in the breaking of existing prejudices and admiration for their worldview. Thus, it can be observed that people seek Candomble to get rid of “bad” health difficulties, such as insomnia, depression, eyesight problems among others, which are commonly treated with herbal preparations, baths, and teas, using plants native to the region; however, their indications are not always in accordance with scientific evidence. In parallel with biomedicine, their hospitable and healthcare practices are considered by most as the equivalent to traditional healthcare actions, but greater recognition of biomedicine is necessary. Based on this perspective, the use of native plants in Candomble is examples of memory, hospitality, and humanization for the community wellness.     

The Broadest Necessity

In this paper the logic of broad necessity is explored. Definitions of what it means for one modality to be broader than another are formulated, and it is proven, in the context of higher-order logic, that there is a broadest necessity, settling one of the central questions of this investigation. It is shown, moreover, that it is possible to give a reductive analysis of this necessity in extensional language (using truth functional connectives and quantifiers). This relates more generally to a conjecture that it is not possible to define intensional connectives from extensional notions. This conjecture is formulated precisely in higher-order logic, and concrete cases in which it fails are examined. The paper ends with a discussion of the logic of broad necessity. It is shown that the logic of broad necessity is a normal modal logic between S4 and Triv, and that it is consistent with a natural axiomatic system of higher-order logic that it is exactly S4. Some philosophical reasons to think that the logic of broad necessity does not include the S5 principle are given.     

Healthcare in Pali Buddhism

This article addresses an apparent paradox found in Pali Buddhist literature: while the “uncompounded” (asa?khata) is valued over and above what is “compounded” (sa?khata), the texts also encourage careful attention to relative (or, physical) health. The mind is the laboratory and the object of a thorough work meant to lead to final liberation from mental affliction and from the cycle of existence, whereas the body is perceived as impure, limited, and intrinsically unsatisfactory. Nonetheless, a disciple of the Buddha is supposed to take care of his/her own and others’ physical wellbeing, and monastic equipment includes a set of medicines. “Ultimate health” is the final goal, but conventional healthcare supports the path to nibbāna and represents a value per se. The present article will explore the intricate connection between these two dimensions.     

Perceived Perfectionism from God Scale: Development and Initial Evidence

In this study, the Perceived Perfectionism from God Scale (PPGS) was developed with Latter-day Saints (Mormons) across two samples. Sample 1 (N = 421) was used for EFA to select items for the Perceived Standards from God (5 items) and the Perceived Discrepancy from God (5 items) subscales. Sample 2 (N = 420) was used for CFA and cross-validated the 2-factor oblique model as well as a bifactor model. Perceived Standards from God scores had Cronbach alphas ranging from .73 to .78, and Perceived Discrepancy from God scores had Cronbach alphas ranging from .82 to .84. Standards from God scores were positively correlated with positive affect, whereas Discrepancy from God scores was positively correlated with negative affect, shame and guilt. Moreover, these two PPGS subscale scores added significant incremental variances in predicting associated variables over and above corresponding personal perfectionism scores.     

Perspective of Islamic Self: Rethinking Ibn al-Qayyim’s Three-Heart Model from the Scope of Dynamical Social Psychology

The present article proposes the perspective of Islamic self (PIS), which is guided by three core principles. First, the Islamic self is shaped by the God’s predicament: The life test. Second, the structure of the self and its spiritual virtues represent means to succeed the life test. Third, the complex dynamics of the self can be mathematically formalized into a parsimonious framework. Specifically, the PIS considers the self as a dynamical system characterized by the emergence of self-organized stable and unstable patterns taking the form of positive (“illuminating heart”) or negative (“darkened heart”) dynamics.     

“For Every Illness There is a Cure”: Attitudes and Beliefs of Moroccan Muslim Women Regarding Health,Illness and Medicine

In order to provide adequate health care, it is important to be well aware of the views and attitudes of the health seeker regarding health, illness and medicine. In the Belgian context, the views of Muslim women, particularly of middle-aged and elderly Moroccan women, have been understudied. The aim of this article is twofold. First, we seek to bring forward the attitudes and beliefs of middle-aged and elderly Moroccan Muslim women living in Antwerp (Belgium) towards health, illness and medicine. Second, we seek to explore which role religion plays in their views and attitudes regarding health, illness and medicine. Qualitative empirical research was conducted with a sample of middle-aged and elderly Moroccan Muslim women living in Antwerp (Belgium) (n = 30) and with experts in the field (n = 15). In-depth interviews and participant observations were conducted to reveal their perceptions regarding health, illness and medicine. This study reveals that religion plays a crucial role in how Muslim women perceive and deal with illness. Theological considerations that centre on God’s omnipotence, the belief in the afterlife and religious virtues take up a central position. A holistic approach is adopted in the search for healing, i.e. an interplay between calling upon medicine and turning to God. Religious beliefs seem to be a powerful source in coping with illness.