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Diagnostics of End-World delusion with religious content (EWDRC) is relevant due to its insufficient exploration, difficulty in differential diagnostics and social danger of the delusional behavior.
Objectives
To develop a typology based on psychopathological and phenomenological features.
Methods
Sixty patients with EWDRC were examined. Psychopathological and statistical methods were applied.
Results
Study of EWDRC found heterogeneity of clinical appearances. Two different types were identified: apocalyptic and eschatological. The apocalyptic type (51 patients, 85%) was characterized by prevalence of End-World ideas in an acute sensual delusion. Due to heterogeneity of delusion’s dynamics two subtypes were identified: - Subtype 1 (31 patients, 61%) was characterized with long period of development (changes in the stages) of different delusion’s types: delusion of perception, importance, staging, and the antagonistic one. Psychotic symptoms were quickly reduced with antipsychotic therapy. - Subtype 2 (20 patients, 39%) was characterized with rapid development of delusion’s stages up to oneiro-catatonic states which were hardly jugulated. Eschatological type (9 patients, 15%) was characterized by the systematized interpretive delusion with individual interpretation of apocalyptic signs. These states evolved within mixed forms of schizophrenia.
Conclusions
The analysis of EWDRC revealed the apocalyptic type’s acute course. Patients with the apocalyptic type have a premonition of upcoming End-World, and feel themselves engaged in it. The eschatological type is based on the systematized interpretive End-World delusion with “confirmations” found in everyday life. The results showed the high risk of the delusional behavior in patients with EWDRC which requires careful approach to the diagnostics and treatment of these conditions.
Diagnostics of Apocalyptic variant of end-world Delusion with Religious Content (ADRC) in schizophrenia is related with insufficient exploration and recognizability, despite the severity of the state, social risks and resistance to psychopharmacotherapy.
Objectives
To define psychopathological and phenomenological features of ADRC in schizophrenia, to identify the clinical dynamics of delusional disorders due to specifics of the delusional behavior, and to develop diagnostic and prognostic criteria.
Methods
28 patients with ADRC in schizophrenia were examined (ICD-10: F20.0, F20.01, F20.02). Clinical-psychopathological and statistical methods were applied.
Results
Delusional ideas of end-world, Apocalyptic variant, occurred in the structure of affective-delusional state (acute sensual delusion with fantastic content). Two types of ADRC were identified: with the predominance of acute sensory delusions of perception and with the predominance of visual-figurative delusions of the imagination. These types differed in the severity and depth of psychotic manifestations and in the specifics of a delusion formation, were characterized by the mono- or polythematic delusional disorders.
Conclusions
Cases of ADRC differ both in the clinical-psychopathological specifics of delusional constructions, and in the socio-behavioral aspect. Among these cases, there is a high risk of delusional destructive behavior, with auto-aggressive, suicidal attempts and hetero-aggressive behavior. In cases with ADRC the strong persistence of delusional pseudo-religious beliefs occurs, with the refusal of any medical and psychological assistance, as well as implication of socially dangerous acts associated with the spread of delusional ideas and their induction of religiously inclined persons, which leads to the emergence of pathological pseudoreligiosity (distortion of traditional canonical religious views).
Disclosure
No significant relationships.
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