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I M GOD with euthymic affect

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could some body please tell me the answer to the following which i was asked in the exam long case.

patient on clozapine....problems with mental health (possible schizophrenia) since 1991 with an index offence of arson.

went to special school as a child and had a traumatic childhood.

delusion/overvalued idea including that he is god/evil...

examiner said that it is grandiose delusion/idea so why his affect is euthymic?

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Incongruent affect, compliant with the diagnosis ofSchizophrenia.

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Dissociation of affect , is a well known phenomena. In chronic psychosis, patients can have well systematised , elaborate delusions which become encapsulated and does not affect mood or behaviour , a phenomena often referred to as ' double orientation' .

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affect cognition discrepancy could well be explained by intellectual capacity

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thnx guys.

i said that affect could have been neutralized because of chronicity....also possibilty of negative sx masking the affect....also residual sx of the illness.....and illness presenting in different ways in LD than general population

guess second in the list was a blunder :-X

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I don't think that the 2nd part was a blunder at all. I've seen this often in the people with LD that I work with.

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could be all of them??? 8-)

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thinking theyre god with euthymic effect..

that describes most of my friends most times.. or me even..

hmm..

strange how arrogance and cockiness is looked down upon in the uk. but considered a virtue or a good trait/attitude to have in a south asian country..

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Yes slarti but arrogance and cockiness is wrapped in a beutiful chocolate paper here in UK and takes the form of so called assertiveness and considered an asset.Having said that I admire and understand the qualities which have taken west leaps a head of South Asians.

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I don't agree that hypocrisy should be described as 'arrogance and cockiness is wrapped in a beutiful chocolate paper here in UK'. Besides I have seen many people with 'God' delusions terribly worried that they will be attacked by the devil, and hence their grandiosity is in the delusion not it's interpretation. my point being incongruity of affect should be quoted in the context not as an overall description.

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examiner said that it is grandiose delusion/idea so why his affect is euthymic?

because grandiose delusions are one symptom that symptom can occur separately to an elevated mood which is another symptom ie just because someone is grandiose doesn't mean they are manic.

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He was euthymic because he knew gods, like humans, can be euthymic most of the time. :)

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He was euthymic because he knew gods, like humans, can be euthymic most of the time. :)

Cool 8-)

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The LD appears to be a red herring, although occasionally you encounter 'wish fullfilment' scenarios in LD 'yes I am the best footballer in London'.These are wishes, not delusions.

Grandiose delusions can exist in schizophrenic or persistent delusional disorder states, without the mood component.An other possibility is that the mood may have 'got better' before the delusion.

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The LD appears to be a red herring, although occasionally you encounter 'wish fullfilment' scenarios in LD 'yes I am the best footballer in London'.These are wishes, not delusions.

Grandiose delusions can exist in schizophrenic or persistent delusional disorder states, without the mood component.An other possibility is that the mood may have 'got better' before the delusion.

Hi Evan,

The 'wish fulfillment' explanation is interesting. Is there any specific psychopathologic term for this or is it more of a psychological explanation?

This brings to mind an institutionalised LD px I had who was thought by some to be psychotic, as he would claim to be a policeman, security man etc. He liked to dress in a white shirt and black tie. He was generally euthymic, with no grandiose features. I did not think he was psychotic. In retrospect it could have been a 'wish fulfilment' scenario.

Can you refer me to any literature on this please, I'd like to get more info.

Thanks,

Justme

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