Pub Date : 2024-01-01DOI: 10.1097/HRP.0000000000000388
Jan Dirk Blom, Rosemarij J B van Veen, Emma H C van Rooijen, Christina W Slotema
Abstract: Sexual hallucinations are little known, yet often extremely burdening, phenomena. In this systematic review, we summarize what is known about their phenomenology, prevalence, etiopathology, ensuing distress, and treatment options. Sexual hallucinations can be experienced as genital or orgasmic sensations, although other sensory modalities can also be involved. With the notable exception of orgasmic auras in the context of epilepsy, sexual hallucinations tend to be distressing and embarrassing in nature. Our analysis of 79 studies (together describing 390 patients) indicates that sexual hallucinations are more frequent in women than in men, with a sex ratio of 1.4:1, and that they are most prevalent in schizophrenia spectrum disorders, with rates ranging from 1.4% in recently admitted patients to 44% in chronically hospitalized patients. Other underlying conditions include epilepsy, the incubus phenomenon (possibly the most prevalent cause in the general population, associated with sleep paralysis), narcolepsy, and sedative use. As regards the sedative context, we found more medicolegal than purely medical cases, which sadly underlines that not all sexually explicit sensations experienced in anesthesia practice are indeed hallucinations. In the absence of evidence-based treatment protocols for sexual hallucinations, practice-based guidelines tend to focus on the underlying condition. Further research is needed, especially in the fields of substance abuse, posttraumatic stress disorder, and borderline personality disorder, where only anecdotal information on sexual hallucinations is available. Moreover, awareness of sexual hallucinations among health professionals needs to be improved in order to facilitate counseling, diagnosis, and treatment.
{"title":"The Diagnostic Spectrum of Sexual Hallucinations.","authors":"Jan Dirk Blom, Rosemarij J B van Veen, Emma H C van Rooijen, Christina W Slotema","doi":"10.1097/HRP.0000000000000388","DOIUrl":"10.1097/HRP.0000000000000388","url":null,"abstract":"<p><strong>Abstract: </strong>Sexual hallucinations are little known, yet often extremely burdening, phenomena. In this systematic review, we summarize what is known about their phenomenology, prevalence, etiopathology, ensuing distress, and treatment options. Sexual hallucinations can be experienced as genital or orgasmic sensations, although other sensory modalities can also be involved. With the notable exception of orgasmic auras in the context of epilepsy, sexual hallucinations tend to be distressing and embarrassing in nature. Our analysis of 79 studies (together describing 390 patients) indicates that sexual hallucinations are more frequent in women than in men, with a sex ratio of 1.4:1, and that they are most prevalent in schizophrenia spectrum disorders, with rates ranging from 1.4% in recently admitted patients to 44% in chronically hospitalized patients. Other underlying conditions include epilepsy, the incubus phenomenon (possibly the most prevalent cause in the general population, associated with sleep paralysis), narcolepsy, and sedative use. As regards the sedative context, we found more medicolegal than purely medical cases, which sadly underlines that not all sexually explicit sensations experienced in anesthesia practice are indeed hallucinations. In the absence of evidence-based treatment protocols for sexual hallucinations, practice-based guidelines tend to focus on the underlying condition. Further research is needed, especially in the fields of substance abuse, posttraumatic stress disorder, and borderline personality disorder, where only anecdotal information on sexual hallucinations is available. Moreover, awareness of sexual hallucinations among health professionals needs to be improved in order to facilitate counseling, diagnosis, and treatment.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"32 1","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-10-24DOI: 10.1097/HRP.0000000000000385
Christian R Hardoy, Jonathan H Shipley, Eric N Kramer, Robert M McCarron
{"title":"Mental Health Is Heart Health: Adjusting Clinical Guidelines for Depression After Myocardial Infarction.","authors":"Christian R Hardoy, Jonathan H Shipley, Eric N Kramer, Robert M McCarron","doi":"10.1097/HRP.0000000000000385","DOIUrl":"10.1097/HRP.0000000000000385","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":" ","pages":"287-292"},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49690190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-10-13DOI: 10.1097/HRP.0000000000000381
Emmy Masur Patterson, Jacqueline Lim, Paul Fuchs, Joshua R Smith, Alexandra Moussa-Tooks, Heather Burrell Ward
{"title":"Use of First-Generation Antipsychotics in an Adolescent Male with Catatonic Schizophrenia.","authors":"Emmy Masur Patterson, Jacqueline Lim, Paul Fuchs, Joshua R Smith, Alexandra Moussa-Tooks, Heather Burrell Ward","doi":"10.1097/HRP.0000000000000381","DOIUrl":"10.1097/HRP.0000000000000381","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":" ","pages":"267-273"},"PeriodicalIF":2.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41199329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/HRP.0000000000000384
Miryam Yusufov, William F Pirl, Ilana M Braun, Timothy Sannes, R Kathryn McHugh
Learning objectives after participating in this cme activity, the psychiatrist should be better able to: • Outline the risk factors involved with opioid accessibility in patients receiving treatment for cancer.• Identify factors to address in order to mitigate risk for opioid misuse during cancer care.
Abstract: Most patients with advanced cancer receive treatment for related pain. Opioid accessibility, however, is a risk factor for misuse, which can present care challenges and quality-of-life concerns. There is a lack of consistent universal screening prior to initiation of opioid prescribing. One crucial issue in treating this population is adequately identifying and mitigating risk factors driving opioid misuse. Drawing on theory and research from addiction science, psychology, palliative care, and oncology, the presented conceptual framework suggests that risk factors for opioid misuse during cancer care can be stratified into historical, current, malleable, and unmalleable factors. The framework identifies necessary factors to address in order to mitigate risk for opioid misuse during cancer care, and offers key directions for future research.
{"title":"Toward a Psychological Model of Chemical Coping with Opioids in Cancer Care.","authors":"Miryam Yusufov, William F Pirl, Ilana M Braun, Timothy Sannes, R Kathryn McHugh","doi":"10.1097/HRP.0000000000000384","DOIUrl":"10.1097/HRP.0000000000000384","url":null,"abstract":"<p><strong>Learning objectives after participating in this cme activity, the psychiatrist should be better able to: </strong>• Outline the risk factors involved with opioid accessibility in patients receiving treatment for cancer.• Identify factors to address in order to mitigate risk for opioid misuse during cancer care.</p><p><strong>Abstract: </strong>Most patients with advanced cancer receive treatment for related pain. Opioid accessibility, however, is a risk factor for misuse, which can present care challenges and quality-of-life concerns. There is a lack of consistent universal screening prior to initiation of opioid prescribing. One crucial issue in treating this population is adequately identifying and mitigating risk factors driving opioid misuse. Drawing on theory and research from addiction science, psychology, palliative care, and oncology, the presented conceptual framework suggests that risk factors for opioid misuse during cancer care can be stratified into historical, current, malleable, and unmalleable factors. The framework identifies necessary factors to address in order to mitigate risk for opioid misuse during cancer care, and offers key directions for future research.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"31 6","pages":"259-266"},"PeriodicalIF":2.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1097/HRP.0000000000000382
Rachel Belfer, Alexandra Fields, Rafael Gonzalez-Alonso, Carolyn Sargent, Rubiahna L Vaughn, Aviva Caroff, Eric J Mariuma, Ketevan Amirkhanashvili, Runjhun Bhatia, Andrea Murez
{"title":"Exploring a Multidisciplinary Approach to Wernicke's Encephalopathy in Pregnancy.","authors":"Rachel Belfer, Alexandra Fields, Rafael Gonzalez-Alonso, Carolyn Sargent, Rubiahna L Vaughn, Aviva Caroff, Eric J Mariuma, Ketevan Amirkhanashvili, Runjhun Bhatia, Andrea Murez","doi":"10.1097/HRP.0000000000000382","DOIUrl":"10.1097/HRP.0000000000000382","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"31 6","pages":"274-280"},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-10-13DOI: 10.1097/HRP.0000000000000383
Jennifer Wang, Samir J Abu-Hamad, Michael Jennings, Kyle Blackburn, Diana M Robinson
{"title":"Hero or Antagonist: A Case Series on the Tolerability of Memantine as Salvage Therapy for Catatonia from Anti-NMDA Receptor Encephalitis.","authors":"Jennifer Wang, Samir J Abu-Hamad, Michael Jennings, Kyle Blackburn, Diana M Robinson","doi":"10.1097/HRP.0000000000000383","DOIUrl":"10.1097/HRP.0000000000000383","url":null,"abstract":"","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":" ","pages":"281-286"},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41199328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01Epub Date: 2023-07-28DOI: 10.1097/HRP.0000000000000375
Kati N Lake, Victoria M Wilkins, Elizabeth B Ford, Sharon J Parish, Reile M Slattery, Mark J Russ, Benjamin D Brody
CASE HISTORY Ms. A is a 23-year-old artist and food services worker with a history of bipolar 1 disorder. She was admitted to an inpatient psychiatric facility following a three-week history of unusual and disorganized behavior, including leaving rotting food in her bathtub for “storage,” decreased need for sleep, and sending large volumes of illogical messages to a high-profile artist whom she believed was in love with her. The police brought Ms. A to the emergency room (ER) after she became disruptive to her roommates in a shared living space.
{"title":"A 23-Year-Old Woman with Psychotic Mania and a Report of Sexual Violence During a Psychiatric Hospitalization.","authors":"Kati N Lake, Victoria M Wilkins, Elizabeth B Ford, Sharon J Parish, Reile M Slattery, Mark J Russ, Benjamin D Brody","doi":"10.1097/HRP.0000000000000375","DOIUrl":"10.1097/HRP.0000000000000375","url":null,"abstract":"CASE HISTORY Ms. A is a 23-year-old artist and food services worker with a history of bipolar 1 disorder. She was admitted to an inpatient psychiatric facility following a three-week history of unusual and disorganized behavior, including leaving rotting food in her bathtub for “storage,” decreased need for sleep, and sending large volumes of illogical messages to a high-profile artist whom she believed was in love with her. The police brought Ms. A to the emergency room (ER) after she became disruptive to her roommates in a shared living space.","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":"31 5","pages":"234-241"},"PeriodicalIF":3.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10218010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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