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Violence Associated with Somatic Delusions
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) characterizes delusional disorder (DD) by the presence of delusions for longer than one month, without bizarre behavior or functional impairment. According to Kaplan and Saddock, the lifetime prevalence of DD (all subty...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199142/ https://www.ncbi.nlm.nih.gov/pubmed/30364849 http://dx.doi.org/10.7759/cureus.3186 |
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author | Virani, Sanya A Sobotka, John Brainch, Navjot Bazzi, Lama |
author_facet | Virani, Sanya A Sobotka, John Brainch, Navjot Bazzi, Lama |
author_sort | Virani, Sanya A |
collection | PubMed |
description | The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) characterizes delusional disorder (DD) by the presence of delusions for longer than one month, without bizarre behavior or functional impairment. According to Kaplan and Saddock, the lifetime prevalence of DD (all subtypes) is about 0.2%. The persecutory subtype of delusional disorder (DD-PS) is the most common and the somatic subtype (DD-SS) is exceedingly rare. We aim to describe two cases of patients with somatic delusions, both presenting as imminently dangerous and threatening. We also discuss one case that resulted from our extensive literature review where somatic delusions were implicated in elevating a mass shooter’s violence risk. Both patients whose cases are presented were involuntarily hospitalized after their doctors called 911 to report that they were being threatened by a weapon. These patients had no established psychiatric diagnoses and were evaluated thoroughly and diagnosed with DD-SS. Both perceived that their physicians were indifferent to their needs and cited their frustration as the trigger for planning attacks on the doctors. Unlike PS, SS is not traditionally described as increasing danger or risk of violence, and thorough risk assessments are not usually performed in DD-SS. We demonstrate that formal psychiatric violence risk assessments remain a useful tool to methodically stratify and effectively address risk, even in patients we do not typically expect to demonstrate premeditated violence. |
format | Online Article Text |
id | pubmed-6199142 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-61991422018-10-24 Violence Associated with Somatic Delusions Virani, Sanya A Sobotka, John Brainch, Navjot Bazzi, Lama Cureus Family/General Practice The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) characterizes delusional disorder (DD) by the presence of delusions for longer than one month, without bizarre behavior or functional impairment. According to Kaplan and Saddock, the lifetime prevalence of DD (all subtypes) is about 0.2%. The persecutory subtype of delusional disorder (DD-PS) is the most common and the somatic subtype (DD-SS) is exceedingly rare. We aim to describe two cases of patients with somatic delusions, both presenting as imminently dangerous and threatening. We also discuss one case that resulted from our extensive literature review where somatic delusions were implicated in elevating a mass shooter’s violence risk. Both patients whose cases are presented were involuntarily hospitalized after their doctors called 911 to report that they were being threatened by a weapon. These patients had no established psychiatric diagnoses and were evaluated thoroughly and diagnosed with DD-SS. Both perceived that their physicians were indifferent to their needs and cited their frustration as the trigger for planning attacks on the doctors. Unlike PS, SS is not traditionally described as increasing danger or risk of violence, and thorough risk assessments are not usually performed in DD-SS. We demonstrate that formal psychiatric violence risk assessments remain a useful tool to methodically stratify and effectively address risk, even in patients we do not typically expect to demonstrate premeditated violence. Cureus 2018-08-22 /pmc/articles/PMC6199142/ /pubmed/30364849 http://dx.doi.org/10.7759/cureus.3186 Text en Copyright © 2018, Virani et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Family/General Practice Virani, Sanya A Sobotka, John Brainch, Navjot Bazzi, Lama Violence Associated with Somatic Delusions |
title | Violence Associated with Somatic Delusions |
title_full | Violence Associated with Somatic Delusions |
title_fullStr | Violence Associated with Somatic Delusions |
title_full_unstemmed | Violence Associated with Somatic Delusions |
title_short | Violence Associated with Somatic Delusions |
title_sort | violence associated with somatic delusions |
topic | Family/General Practice |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199142/ https://www.ncbi.nlm.nih.gov/pubmed/30364849 http://dx.doi.org/10.7759/cureus.3186 |
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