A Nightmare’s Lullaby: Exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and review
Introduction Acute psychotic states characterized by clinical lability and dream-like qualities are a staple of classic psychopatology. An excessive focus on diagnostic criteria for bipolar or schizophrenia-spectrum disorders risks missing this particular set of patients; defined through their dyna...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822018272/type/journal_article |
| _version_ | 1797616262641090560 |
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| author | A. Compaired Sánchez |
| author_facet | A. Compaired Sánchez |
| author_sort | A. Compaired Sánchez |
| collection | DOAJ |
| description |
Introduction
Acute psychotic states characterized by clinical lability and dream-like qualities are a staple of classic psychopatology. An excessive focus on diagnostic criteria for bipolar or schizophrenia-spectrum disorders risks missing this particular set of patients; defined through their dynamic presentation as much as by any cluster of symptoms or types of course.
Objectives
To explore the concept and relevance of oneroid-like cyclic psychosis through a clinical case and review.
Methods
We report the case of a 37 year old woman with bipolar disorder (three previous instances of manic episodes with psychotic symptoms) and various gynecological issues that required hormone therapy. After a couple of days having difficulty sleeping, the patient developed a clinical picture consisting of wide and sudden oscillations between hyperactive and inhibited psychomotor activity, moods of dread and ecstasy, and states of disorganized thought and childlike activities with perplexity and mutism. Frequent behaviors as if experiencing visual alucinations and repeated allusions to feeling as if in a dream. These symptoms lasted for 2-3 weeks, after treatment with risperidone and lithium. A narrative review concerning the case was also performed.
Results
Kleist’s ‘innate instability’ permeates much of the previous literature. Similar entities highlight different issues closely related to various biological rhythms: atypical psychosis and epilepsy, puerperal psychosis and estrogen dysregulation, cyclic psychosis and sleep disorders, delirious mania and effectiveness of electro-convulsive-therapy, etc.
Conclusions
Our findings point to the clinical relevance of oneiroid cyclic psychosis as innate instability. Further studies on the role of biological rhythms and its repercussions on daily practice are required.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:38:38Z |
| format | Article |
| id | doaj.art-f57b478497834b4588d35b7dd4fb9031 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:38:38Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-f57b478497834b4588d35b7dd4fb90312023-11-17T05:09:03ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S709S70910.1192/j.eurpsy.2022.1827A Nightmare’s Lullaby: Exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and reviewA. Compaired Sánchez0Hospital Universitario Ramón y Cajal, Psychiatry, Madrid, Spain Introduction Acute psychotic states characterized by clinical lability and dream-like qualities are a staple of classic psychopatology. An excessive focus on diagnostic criteria for bipolar or schizophrenia-spectrum disorders risks missing this particular set of patients; defined through their dynamic presentation as much as by any cluster of symptoms or types of course. Objectives To explore the concept and relevance of oneroid-like cyclic psychosis through a clinical case and review. Methods We report the case of a 37 year old woman with bipolar disorder (three previous instances of manic episodes with psychotic symptoms) and various gynecological issues that required hormone therapy. After a couple of days having difficulty sleeping, the patient developed a clinical picture consisting of wide and sudden oscillations between hyperactive and inhibited psychomotor activity, moods of dread and ecstasy, and states of disorganized thought and childlike activities with perplexity and mutism. Frequent behaviors as if experiencing visual alucinations and repeated allusions to feeling as if in a dream. These symptoms lasted for 2-3 weeks, after treatment with risperidone and lithium. A narrative review concerning the case was also performed. Results Kleist’s ‘innate instability’ permeates much of the previous literature. Similar entities highlight different issues closely related to various biological rhythms: atypical psychosis and epilepsy, puerperal psychosis and estrogen dysregulation, cyclic psychosis and sleep disorders, delirious mania and effectiveness of electro-convulsive-therapy, etc. Conclusions Our findings point to the clinical relevance of oneiroid cyclic psychosis as innate instability. Further studies on the role of biological rhythms and its repercussions on daily practice are required. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822018272/type/journal_articleoneiroid syndromeMood disordersbiological-rhythm dysregulationcyclic psychosis |
| spellingShingle | A. Compaired Sánchez A Nightmare’s Lullaby: Exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and review European Psychiatry oneiroid syndrome Mood disorders biological-rhythm dysregulation cyclic psychosis |
| title | A Nightmare’s Lullaby: Exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and review |
| title_full | A Nightmare’s Lullaby: Exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and review |
| title_fullStr | A Nightmare’s Lullaby: Exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and review |
| title_full_unstemmed | A Nightmare’s Lullaby: Exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and review |
| title_short | A Nightmare’s Lullaby: Exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and review |
| title_sort | nightmare s lullaby exploring the concept and relevance of oneiroid cyclic psychosis through a clinical case and review |
| topic | oneiroid syndrome Mood disorders biological-rhythm dysregulation cyclic psychosis |
| url | https://www.cambridge.org/core/product/identifier/S0924933822018272/type/journal_article |
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