Collectively, the reviewed articles form a coherent theory of dysfunctional emotion regulation in patients with BPD in the form of the fronto-limbic imbalance model, which is characterized by hypoactivity of the prefrontal region and hyperactivity of the limbic region. Thus, it appears that, compared to individuals without BPD, those with the diagnosis have a marked tendency to interpret their environment more negatively and to react with greater emotional intensity.
In this report, we present the case of a talented anorectic patient whose artistic expression of his anorexia gave us an exceptional insight into the pain he experienced. Based on his artwork, we designed an illustrated visual analogue scale (VAS) that allowed us to assess the control of the disease over his mind and thus the clinical progress from a psychotherapeutic point of view. By comparing the progression of the VAS with the Body Mass Index (BMI), we were able to identify the tipping point at which the patient regained control and provide targeted support to maintain it, perceived as very helpful by the patient. A VAS assessing anorexia's control over the mind is a simple and readily available tool that factors in the psychiatric background of the disease. It could be a good complement to the BMI as a clinical outcome parameter and should be further explored.
A 74-year-old woman was brought to the emergency department because of a cognitive decline in the past two months. She presented evidence of metabolic encephalopathy on physical examination. In laboratory investigations, the patient only had a slightly abnormal liver function without hyperammonemia. Computed tomography (CT) of the head and lumbar puncture were unremarkable. Magnetic resonance imaging of the brain revealed a symmetric T1-weighted hypersignal in the globus pallidus and cerebral peduncles, suggestive of a hepatic encephalopathy. CT scan of the abdomen and chest revealed an important portocaval shunt. Laxative medication and rifaximin were introduced with good outcome. Closure of the shunt was performed by the interventional radiology team.
Healthcare professionals take care of victims of excessive jealousy, but also deal with jealous people who suffer and want to change their behavior. Most of the time, patients do not come to us to talk specifically about jealousy, but the subject can be raised in appropriate contexts, for example following a violent incident (e.g., in the emergency department, traumatology, gynecology or pediatrics) during a consultation with a specialist on alcohol, psychiatry or geriatrics, at a family planning clinic, during a prenatal consultation or during couples therapy.
The intuition of a link between creativity and mental disorders is old, what is new now is the contribution of neuroscience. There seems to be a common vulnerability to mental disorders and creativity. Genetic studies confirm this link between madness and creativity, demonstrating the direct influences of genetic factors on creativity as opposed to the sharing of an environment. However, the development of creativity involves many other determinants. While creativity can sometimes be linked to mental disorders and thus due to psychopathological family factors, this is neither a prerequisite nor a necessary condition for the development of creativity.
Depersonalization/derealization disorder is an understudied debilitating condition characterized by subjective experiences of unreality, emotional numbness, and the feeling of the body being disconnected. Its etiology has been linked to emotional abuse and psychoactive substance abuse. The pathophysiology might involve dysfunction of the frontal, insula/limbic and the temporoparietal areas of the brain, amongst others. Most pharmacological and psychotherapeutic treatments do not lead to sufficient clinical improvement in patients. Alternative therapeutic approaches such as repetitive transcranial magnetic stimulation might be able to treat the condition but needs to be well researched first.
