Kandinsky–Clérambault syndrome with religious delusion of possession (KSRDP) in schizophrenia is insufficiently explored phenomenon. The syndrome characterized by significant severity of clinical state, high social risks and resistance to psychopharmacotherapy and requires the close attention.

To analyze psychopathological specifics of KSRDP and to identify the prognosis, dynamics of schizophrenia with KSRDP.

Thirty four patients (18 women; 16 men; the average age 28 ± 9,5 years) with schizophrenia (F20.0, F20.01, F20.02 according to ICD-10) were examined by psychopathological, psychometrical and statistical methods

The specifics of the syndrome is delusional belief in possession by demonic or divine ‘spiritual being’, invaded within the body. This possession is interpreted by patients as the totality of mind, body and soul control; and in several cases – as the appearance of a new identity. According to the “classical” Kandinsky–Clérambault syndrome, KSRDP accompanied by extensive psychic automatisms (ideational, cenestopathic, kinaesthetic), haptic and olfactory pseudo-hallucinations. Furthermore the specific hallucinations for KSRDP (Hallucinationen der Gemeingefühlsempfindun by von Krafft-Ebing, R.) are observed, which based on sensory-spatial imaginary sensations, with a clear localization in the field of a visceral sensitivity (as a material object with a certain shape, consistency, size, and weight).

In contrast with “classical” paranoid syndrome of Kandinsky–Clérambault when negative effect is usually perceived by patients as external influence, KSRDP is characterized by delusional idea of ‘spiritual being’s invasion inside the body, mind and soul to control the whole human’s existence. Patients with KSRDP require specific treatment and management due to the religious content of delusion.

No significant relationships.

Despite existing observations of religious delusions in epilepsy in classical psychiatric literature, such clinical cases are rare in current practice.

To reveal features of disease progression, interference of combined mental pathology, treatment specifics, markers of possible harmful behavior.

Psychopathological, Multichannel eyes closed resting EEG in interictal period.

Patient N, 39 years old, manifested her illness at age 13 with affective bipolar disorder; phases lasted several months each. From age 19, rare recurrent generalized convulsive paroxysms preceded by an aura; non-convulsive paroxysms were observed. The patient was uncritical of paroxysms and discontinued anticonvulsive therapy. At age 29 and 30 she suffered two psychotic attacks (lasting several weeks) with sensory delusions of meaning, staging, persecution, megalomaniacal ideas of apocalyptic content (ideas that she was responsible for possible outbreak of nuclear war, coming of the Apocalypse, her son was the antichrist). Delusional behavior (tried to take the naked infant out into the cold, throwing him out of the window). Anticonvulsive therapy accompanied by antipsychotic medications. Schizoaffective disorder and epilepsy diagnosed. From age 35, acute psychotic attacks with apocalyptic delirium preceded by the same aura lasted maximum one day, followed by partial amnesia. Epileptiform polyspikes (up to 150 μV) registered in the right temporal-central EEG leads.

Presence of religious delusion in combined schizoaffective disorder and epilepsy, requires special approach: combination of anticonvulsants and antipsychotics. Religiosity of patient should be taken into account as well.

No significant relationships.

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.

To develop a typology based on psychopathological and phenomenological features.

Sixty patients with EWDRC were examined. Psychopathological and statistical methods were applied.

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.

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.

No significant relationships.

The study of the premanifest stages of the first psychotic episode with religious delusion is relevant due to the lack of clarity in differentiating normal religiosity from pathological and, as a consequence, a relatively longer period of an untreated psychotic state, which negatively affects both the course of the disease and its outcomes. Another important factor is the high risk of antisocial, autoaggressive and suicidal behavior at different stages of the disease.

The aim of the study is to identify the conditions for the formation of religious delusion in adolescence and young adults, to analyze the correlations between religiosity at the pre-manifest stage and the subsequent manifest psychotic episode with religious delusions of different content.

The 57 male patients at a young age (16-25 years) with a manifest psychotic episode (F20, F25 according to ICD-10) with religious delusion (delusion of sin (21,6 %), delusion of demonic possession (29,4 %), antagonistic and messianic delusion (39,2 %), oneiroid with religious content (9,8 %)) were studied with the clinical-psychopathological, psychometric (PAS) methods. The religiosity of patients in premorbid was assessed with the Duke University Religion Index (DUREL) questionnaire.

Of greatest importance in the formation of psychotic episode with religious content is hereditary burden, premorbid personality structure, high scores on the PAS scale.

The presence or absence of religiosity in premorbid doesn’t matter to formation of psychotic episode with religious delusion.

No significant relationships.