Sorry for the lack of updates everyone. I’ve got finals this week and Tiffany has been ridiculously busy with work, but once this week is over, we’ll try to get back to regularly scheduled updates.
Good luck with finals to those who still have to take them!
Fifth Disease (also known as slapped cheek syndrome) is a benign illness that develops following exposure to the virus Parvovirus B19. Individuals affected by Parvovirus B19 are contagious and can spread the virus to others through aerosol droplets and respiratory secretions.
Once exposed, symptoms generally present within 4-14 days. Typically, the first sign of fifth disease is the development of a rash on the face with well-defined edges that gives the appearance of a slapped cheek on one or both sides of the face. Shortly after development of the facial rash, lace-like or spider web rash will form on the arms, legs, and trunk. Symptoms typically last 1-2 weeks; however, some cases have been known to produce recurring symptoms for weeks following initial exposure.
Diagnosis: Fifth disease is often diagnosed based on the unique rash pattern that develops and is confirmed through blood tests. The disease is confirmed if the blood test detects the presence of pronormoblasts, Parvovirus B19, or the Parvovirus B19 antibodies.
Symptoms: The most prevalent symptom associated with fifth disease is rash which presents with a slapped cheek appearance on the face and a lace pattern on the arms, legs, and trunks. The rash may be preceded by nausea and vomiting as well as a low grade fever. Along with rash, the individual may also develop arthritis or acute anemia.
Treatment: Fifth disease generally does not require treatment and will resolve itself within three to four weeks of symptom onset. Acetaminophen may be suggested to help reduce fever and ease joint pain if present and prescription steroid may also be prescribed to reduce inflammation in the case of severe rash. Blood transfusion may also be required in the rare event that severe anemia develops.
Additional Information: Approximately 60% of adults will test positive for the presence of Parvovirus B19 as a result of exposure during childhood; however, nearly 20% of such individuals will never develop symptoms while others may display atypical symptoms which prevent accurate diagnosis.
Parvovirus B19 is specific to humans; however, other strains of the virus may affect felines and canines. These strains are species specific.
Progeria (Hutchinson-Gilford Progeria Syndrome) is an extremely rare genetic disorder that causes the affected individual to undergo advanced aging at an early age. The symptoms closely resemble aging and include wrinkles, hair loss, and delayed growth. Affected individuals have normal development up to 18 months and suddenly stop gaining weight and display stunted height. As the individual ages, Progeria becomes more severe with an average life expectancy of 12 years. Progeria occurs in about 1 birth per 8 million and it is estimated that there are only 35-45 cases in the world.
Progeria itself is caused by a mutation in the gene called LMNA which encodes the Lamin A protein. Lamin A functions in keeping the cytoskeleton of the nucleus together. In individuals with Progeria, the mutation causes the nucleus to become unstable and leads to premature aging.
The main cause of death is atherosclerosis (thickening of blood vessels) and frequently leads to a heart attack or stroke. Physically and genetically, children resemble the elderly. At a molecular level, the cells of patients with Progeria and the elderly have nearly identical cell disfunction. Current research on Progeria is not only leading to a cure, but also is giving insight into the aging process.
Diagnosis: Diagnosis of Progeria is based on the symptoms of Progeria. It can also be confirmed with a genetic test.
Symptoms: Symptoms include narrow and wrinkled face, baldness, short stature, small jaw, missing teeth, and dry, scaly skin. There are no cognitive defects.
Treatment: There is no cure for Progeria and thus no treatment. However, management of the cardiovascular defects is the most frequent treatment method.
Additional Information: Progeria is frequently show in the media. Movies like The Curious Case of Benjamin Button and Big are all based on Progeria.
Capgras Syndrome (also known as Capgras Delusional Theory) involves a rare delusional misidentification that leads an individual to believe a family member or very close friend has been replaced by an impostor that is identical in appearance. In severe cases, some individuals may even believe they have been replaced by an impostor when looking in the mirror.
While the cause of Capgras syndrome is still under debate, many researchers believe the condition is the result of combined neurological and cognitive abnormalities. Some believe the delusion may be rooted in a perceptual error due to a disconnect between the area of the brain used to process facial features for recognition and the emotional response elicited by the limbic system. Others believe the delusion is the result of the inability to update memories, which denies the brain the ability to process small changes in personal appearance from the last stored memory. Regardless of the cause, a loved one’s appearance appears both typical and unfamiliar at the same time; therefore, the delusion is created to explain the confusion created by the disconnect in perception or memory.
Capgras syndrome is often seen in conjunction with another psychological or neurologically based condition such as schizophrenia, dementia, or severe head trauma. Each new episode of misidentification can vary greatly from previous episodes because the delusions can be either acute or chronic with persistent or transient properties.
Diagnosis: A physician may perform an extensive medical history and laboratory tests to rule out drugs, medications, or a general medical condition as the cause of such delusions; however, there is no specific DSM IV diagnostic criteria used to evaluate Capgras syndrome.
Symptoms: Capgras syndrome is often identified by the presence of delusions and the belief that a the individual or a loved one has been replaced by an identical impostor.
Treatment: Capgras syndrome is often treated using psychotherapy and a mixture of psychiatric medications. Due to the rarity of Capgras delusions and the unique aspects of each individual’s condition, psychotherapy must be tailored to each case. On the other hand, drug therapy typically includes a mixture of antipsychotic medications and antidepressants. The antipsychotic medications curb the presence of delusions, hallucinations, anxiety, and agitation while the antidepressants help the individual cope with the emotional response to delusions.
Additional Information: The first case of Capgras Syndrome was described in 1923 by French psychiatrist Joseph Capgras when a female patient claimed her husband and other family members had been replaced doubles.
Capgras syndrome is more commonly seen in females than males (approximately 3:2).
Scrupulosity (also known as religious obsessive compulsive disorder) is a specific form of obsessive compulsive disorder in which the individual becomes overly concerned with religious or moral issues. Obsessive thoughts concerning religious pureness or the appropriateness of actions in accordance with religious guidelines generally leads to intense anxiety. In an effort to cope, the individual often turns to a number of physical or mental compulsions to help reduce or rid the anxious feeling. Unlike general obsessive compulsive disorder, those suffering from scrupulosity are generally unaware of the inappropriateness of their actions and often believe the obsessive-compulsive thoughts and actions are the core of their relationship with a chosen higher power.
Scrupulosity was first described in 1691 by John Moore; however, he termed the condition religious melancholy and claimed it caused individuals to fear their actions to such an extent that they felt unfit for acceptance from a higher power. Although this condition has been described throughout history, it has only come to be recognized by the medical profession in recent years. Due to the recent recognition, the prevalence rate is currently unknown.
Diagnosis: A physician may perform an extensive medical history and laboratory tests to rule out drugs, medications, or a general medical condition as the cause of such symptoms; however there is no specific set of diagnostic criteria for scrupulosity. In most cases, physicians rely on the DSM IV criteria for obsessive compulsive disorder paired with religious obsessive-compulsive specificity to make a diagnosis. The DSM IV criteria for obsessive compulsive disorder include:
It is important to note that because scrupulosity can be difficult to distinguish from a strong yet rational religious relationship from scrupulosity, the physician may need to make multiple contacts with the patient to confirm the diagnosis.
Symptoms: Scrupulosity is a form of religious form of obsessive compulsive disorder; therefore, the symptoms include both obsessions and compulsions. It is important to note that the obsession and compulsions are unique to each individual.
Obsessions may include:
Compulsions can include:
Treatment: Scrupulosity is also treated following the same guidelines for obsessive compulsive disorder. Exposure response and prevention, a form of cognitive-behavioral therapy, is generally the most effective and most prescribed form of treatment. This type of therapy requires that the patient confront the fears causing the anxiety while making a conscious effort to prevent themselves from performing the obsessive or compulsive escape actions. In addition, medications known as Selective Serotonin Reuptake Inhibitors (SSRIs) may be prescribed to help reduce symptoms. Finally, because scrupulosity has a religious basis, it may also be helpful for the individual to meet with religious leaders to discuss the source of their obsessions and compulsions and develop a healthier relationship with their higher power.
Additional Information: Although the prevalence rate of scrupulosity is unknown, there are large regional differences in the percentage of patients who suffer from general obsessive compulsive disorder couples with religious obsessions or compulsions. Rates are reported to range from less than 7% in the U.K and Singapore to 40-60% in traditional Muslim and orthodox Jewish populations.
Scrupulosity is thought to have a Roman Catholic origin but it is seen in a variety of religious affiliations.
Some sufferers of scrupulosity believe they suffer from obsession without compulsion; however, some compulsions can be entirely mental (e.g. attempting to cancel potentially blasphemous thoughts with pure thoughts).
Argyria is a condition that causes the skin of the affected to become blue or blue-grey following an accumulation of silver or silver containing compounds in the body. This condition is seen in humans, as well as other animals, and is generally the result of prolonged contact or ingestion of a silver containing material.
Argyria can be wide-spread and cover the entire body or it can be localized to a specific region of the body. Reports of generalized argyria are most common in individuals having occupations requiring long-term exposure to silver compounds such as silver mining, silver refining, production of silverware, production of electroplating solutions, or photographic processing. In addition, long-term use if silver containing medications, such mucous membrane irrigates and colloidal silver dietary supplements, have been associated with generalized argyria development. Localized argyria is more commonly associated with surgical and dental procedures involving the use of silver sutures or processes that rely on the use of silver needles such as acupuncture or body piercing.
While the most prominent sign of argyria is a blueish skin discoloration, continued silver exposure can lead to severe medical complications including persistent bronchitis, loss of coordination, grand mal seizures, respiratory paralysis, and poisoning by silver.
Diagnosis: A physician will often review the individual’s medical history and inquire about possible occupational, environmental, or dietary exposure to silver or silver containing compounds. A skin biopsy may also be performed to determine if the skin discoloration is the result of silver accumulation.
Symptoms: A generalized or localized blue to blue-grey discoloration of the skin following exposure to silver or silver containing compounds.
Treatment: Few cures exist for argyria so most physicians focus on prevention through the use of appropriate personal protective equipment when working with silver compounds. When prevention fails, the most common treatments aim to limit or eliminate exposure to silver and silver containing compounds. While these treatments generally stop the progression of the condition, few are able to help minimize the blueish discoloration and restore skin to the original pigmentation. A topical hydroquinone ointment may be prescribed by a physician and laser surgeries may help reduce the skin discoloration while use of sunscreen will prevent the discoloration from darkening.
Additional Information: The average human contains about 1 milligram of silver in the body but signs of argyria can be seen when the body contains as little as 4 grams of silver. The symptoms associated with argyria are often most pronounced when the body contains 20-40 grams of silver.
A condition known as methemoglobinemia may also lead to blueish skin discoloration; however, this is the result of chronic tissue hypoxemia rather than an accumulation of silver product.
http://www.youtube.com/watch?v=ahihGKZC5Kk&feature=player_embedded
Body dysmorphic disorder (BDD) is a psychological disorder that causes the affected person to become excessively concerned about a perceived defect in his or her body image. The flaw is either very minor or often imaged. Affected people typically feel ashamed and struggle going out in public because they don’t want to be seen by people. The affected preson can become worried over a single feature (weight, hair, teeth, etc), a combination of many physical attributes, or their general appearance. The disorder becomes so extreme that anxiety and distress result impairing occupational or social functioning.
The causes are typically thought to be a combination of psychological, biological, and environmental factors from one’s past that heavily affect oneself. The media is also closely associated with the cause due to the necessity of aesthetic beauty. People with BDD do not think that they look betters than others, but feel that their defect is irrevocably ugly and shouldn’t be seen or patient. Symptoms usually begin in late childhood near puberty and can be present throughout their life
BDD is a chronic disorder and can worsen if left untreated. It is estimated that 1-2% of the global population suffer from BDD. While thought to be only present in women, the disorder affects men and women equally. The suicide rate for people affected by BDD is 45 times higher than the United States population. The rate is double that of depression and three times as much with those affected by bipolar disorder. Thoughts of suicide are very common at 80% in most patients with BDD.
Diagnosis: According to the DSM IV, in order to be diagnosed with BDD, a person must fulfill the following:
A psychiatrist or physician may analyze the symptoms and rule out other social disorders.
Symptoms: Symptoms include preoccupation with physical appearance, frequent examination of self in a mirror or avoiding mirrors, belief that others hone in on your negative characteristic, avoidiance of social situations, depression, anxiety, and weight loss.
Treatment: Cognitive behavior therapy is one of the most effective ways of relieving BDD. Serotonin containing drugs may also benefit the patient. A combined regiment of therapy and anti-depressants have seen the most results.
Additional Information: Many people on tumblr have contacted us and asked us to do this disorder. Please, and I emphasize this, if you think you might have BDD, get professional help. It is a very real disorder and one that should not be ignored.
As always, a few documentaries about BDD:
Dissociative fugue (also known as a fugue state or psychogenic fugue) is a rare psychiatric disorder with an estimated lifetime prevalence of only 0.2%. An episode of dissociative fugue often begins when an individual experiences a traumatic event such as being the victim of an assault, witnessing a violent crime, or surviving a natural disaster. Following the event, the individual is thought to dissociate from his identity and detach himself from the current surroundings in an attempt to cope with the trauma. The dissociation and detachment often draws the individual to abruptly flee to a new or unfamiliar location, experience a temporary yet reversible form of amnesia affecting his personal identity, and partially or completely adopt a new identity. Those experiencing a dissociative fugue episode often spontaneously revert from the fugue state identity to their pre-fugue identity which can lead to intense confusion and extreme distress.
Diagnosis: In many cases, dissociative fugue receives a retroactive diagnosis after an individual has spontaneously reverted from the fugue state identity to their pre-fugue identity. A physician may then review past patient history and perform a physical examination to exclude medications, illicit drug use, or a neurological condition as the cause of the reversible amnesia. A psychological examination may also be performed. Laboratory tests may be used to rule out other disorders; however, there are no specific physiological or biochemical tests used to indicate dissociative fugue.
Treatment: The goal of treatment is to help the individual cope with the event that triggered the fugue state; therefore, psychotherapy and cognitive therapy are used conjunction with psychiatric mediations. While no medication specifically treats dissociative identity disorder, it can be used curb the anxiety and depression that may result from fugue episode. In addition, creative therapies such as art or music therapy may be used to help the patient express his emotions toward the event that led to the fugue episode or those toward the fugue episode itself. Finally, hypnosis may be performed once the individual has reverted from the fugue state to the pre-fugue identity to gather information about the individual’s fugue identity and actions performed during the fugue episode. While not directly involving the treated individual, family therapy can be used to educate those close to the individual about causes of dissociative fugue and the warning signs of recurrence.
Symptoms: The primary symptoms of dissociative fugue are often a sense of confusion related to personal identity and recent activities as well as distress resulting from the sudden presence of unfamiliar locations and objects with no recollection of their significance. In addition to these symptoms, individuals suffering from dissociative fugue also abruptly travel away from home, experience reversible amnesia of personal identity, and display partial or complete adoption of a new identity.
Additional Information: Dissociative fugue episodes typically lasts less than one month; however, some cases have been known to last only hours while other cases have been reported to last decades.
Television shows such as Breaking Bad, Doctor Who, and Buffy the Vampire Slayer make reference to dissociative fugue episodes.
Huntington’s disease is a neurodegenerative genetic that greatly affects muscle coordination and cognition. The nerve cells in the brain slowly breakdown and atrophy. Huntington’s disease affects the striatum of the brain as well as the hippocampus, purkinje cells, and the cerebellum.
Huntington’s is an autosomal dominant genetic disease that results from a defect on chromosome #4. The defect causes a repeat in a CAG sequence on the DNA to occur many more times than normal. In person without Huntington’s, the CAG sequence is repeated 10 to 35 times. In an individual with Huntington’s disease, the repeat can be repeated 36-120 times. The repeated sequence is expanded as it is passed through one generation to the next, lengthening the sequence in each offspring. Therefore, the disease becomes progressively juvenile. If one parent has Huntington’s, the child has a 50% chance of having the disease as well.
There are two types of Huntington’s: juvenile which appears in children and the much more common form, adult-onset Huntington’s which appears in an individual aged 30 to 40.
Huntington’s disease has become a target due to the ethical issues associated with it. Many question when an individual should be tested for the disease, if at all. Preimplantation genetic diagnosis has been used as a selective form of abortion. Some individuals who might have the disease may opt to not have the disease diagnosed.
Worldwide, 5-10 people out of 100,000 have the disease.
After the first onset of symptoms, an individual typically has a life span of twenty more years of life. Huntington’s has no cure and ultimately leads to death. Suicide is one of the greatest cause of fatalies in the disease with 7.3% with Huntington’s taking their own lives and up to 27% attempting suicide.
Diagnosis: A genetic counselor can determine if the child will have Huntington’s disease using genetic testing. The geneticist will look at the number of CAG repeats and determine the likelihood of the person developing Huntington’s in their life. In most cases, the affected individual will have an idea of when the symptoms will onset. A physical diagnosis that analyzes the symptoms of Huntington’s is also effective for most patients. Medical imaging of the brain can also show which areas of the brain have atrophied.
Symptoms: Huntington’s disease affects many parts of the body. Movement disorders can include involuntary jerking, sustained contraction of muscles, rigidity, diffulty with speech, posture problems, and difficulty swallowing. Cognitive disorders include difficulty with organization, emotional flexibility, lack of focus and reasonable thinking, and various other symptoms. Lastly, psychiatric disorders include sadness, unhappiness, social withdrawal, loss of interest, fatigue, feelings of guilt, reduced appetite, and reduced sex drive.
Treatment: There is no cure for Huntington’s disease. Some of the symptoms can be controlled with various antidepressants and other drugs that reduce the amount of involuntary muscle jerking.
Additional Information: Huntington’s disease has become prominent in different media sources and has appeared in Everwood, House, Private Practice, ER, and Scrubs.
Agoraphobia is severe anxiety disorder that is defined as the fear of wide open spaces, crowds, or uncontrollable social conditions. People that have agoraphobia have a difficult time feeling safe and comfortable in public places. The fear can be so intense that the person becomes trapped in their own home. Agoraphobia results from the fear of having a panic attack in a social situation with no means to leave. Public scrutiny and social pressure can also induce panic attacks and cause agoraphobia.
Agoraphobics will go to great lengths to avoid past places where panic attacks have occurred (malls, football games, etc). Many agoraphobics suffer temporary separation anxiety when familiar residents leave them alone temporarily. These conditions can also induce a panic attack.
Agoraphobia may also cause repressed memories to occur again leading to further anxiety issues. Agoraphobia, while typically thought of, not always associated with social embarrassment, because the agoraphobic becomes anxious and fears the onset of a panic attack in a public situation.
Approximately 3.2 million adults in the US are affected or 2.2% of the population. The age range is 18-54 and can onset earlier. Women are twice as likely to suffer from agoraphobia as men.
New research has looked into agoraphobia being caused by the dysfunction of the vestibular system and substance abuse, but no causal conclusion has been made.
Diagnosis: Mental health specialists usually look to see if agoraphobia has developed after the onset of a panic disorder. Usually, the presence of a panic disorder is enough to diagnose the patient, but formal diagnosis of agoraphobia without history of panic disorder is possible.
Symptoms: A major symptom and cause of agoraphobia is the onset of panic attacks. Panic attacks cause the the person to feel a period of intense fear and discomfort which also leads to shortness of breath, feelings of choking, chest pain, nausea, faintness, dizziness, and chills. Panic attacks can last 10-15 minutes, but rarely past 30 minutes. Additional symptoms include sense of helplessness, over-dependence on others, depression, and inability to leave your home.
Treatment: There are various treatments used to help overcome agoraphobia. Cognitive behavioral treatmetns are frequently common and include exposure therapy which allows one to slowly be exposed to the stressful location. Pharmaceutical drugs such as sertraline and benzodiazepines are also beneficial in reducing anxiety.
Additional Information:
As always, some documentaries about agoraphobia:
