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A transdiagnostic approach toA transdiagnostic approach to
Mikhail A.Vrubel, 1890
OUTLINEOUTLINE
Mikhail A.Vrubel, 1890
I. Levitan, 1899
Prevalences of hallucinations and delusions
PATIENT GROUPPATIENT GROUP PREVALENCEPREVALENCE SOURCESOURCE
schizophreniaschizophrenia 59% hallucinations 73% delusions 59% hallucinations 73% delusions Lecrubier et al. 2007 Lecrubier et al. 2007
bipolar disorderbipolar disorder 76% psychotic symptoms76% psychotic symptoms Tillman et al. 2008 Tillman et al. 2008
deliriumdelirium 86% hallucinations 43% delusions 86% hallucinations 43% delusions Perälä et al. 2010 Perälä et al. 2010
borderline personality disorderborderline personality disorder 50% psychotic symptoms50% psychotic symptoms Kingdon et al. 2010 Kingdon et al. 2010
narcolepsynarcolepsy 40% hallucinations 2% delusions 40% hallucinations 2% delusions Leu-Semenescu et a. 2011 Leu-Semenescu et a. 2011
Lewy body dementia Lewy body dementia 78% hallucinations 25% delusions 78% hallucinations 25% delusions Nagahama et al. 2007 Nagahama et al. 2007
anxiety disorderanxiety disorder 27% psychotic symptoms27% psychotic symptoms Wigman et al. 2012 Wigman et al. 2012
Parkinson's diseaseParkinson's disease 30% hallucinations 30% hallucinations 5% delusions 5% delusions Friedman et al. 2013 Friedman et al. 2013
Alzheimer's diseaseAlzheimer's disease 21% hallucinations 21% hallucinations 10% delusions 10% delusions Burghaus et al. 2012 Burghaus et al. 2012
multiple sclerosismultiple sclerosis 10% hallucinations 7% delusions10% hallucinations 7% delusions Diaz-Olavarietta et al. 1999 Diaz-Olavarietta et al. 1999
epilepsyepilepsy 25% psychotic symptoms25% psychotic symptoms Matsuura et al. 2003 Matsuura et al. 2003
post traumatic stress disorderpost traumatic stress disorder 12% psychotic symptoms12% psychotic symptoms Soosay et al. 2012 Soosay et al. 2012
visual acuity < 0.3visual acuity < 0.3 11% hallucinations11% hallucinations Teunisse et al. 1995 Teunisse et al. 1995
unipolar depressionunipolar depression 10% psychotic symptoms10% psychotic symptoms Quinlan et al. 1997 Quinlan et al. 1997
systemic lupus erythematosussystemic lupus erythematosus 6% psychotic symptoms6% psychotic symptoms Beltrao et al. 2013 Beltrao et al. 2013
mild-moderate hearing lossmild-moderate hearing loss 4% hallucinations4% hallucinations Teunisse et al. 2012 Teunisse et al. 2012
Diagnosis?Diagnosis?
Formele denkstoornissenFour subtypes that present across diagnoses
Subtype Perception AttentionReality Testing
Social Isolation
TraumaExcitability
Sensory Cortex
StriatalDopamine
Optimal Treatment
Hyper-dopaminergic
== =/=/ =/=/ =/=/ == Anti-psychotic Anti-psychotic medicationmedication
re-experiencing == == == == =/ =/ EMDREMDR
inattentive =/=/ =/=/ == == == =/=/ cholinesterase cholinesterase inhibitorsinhibitors
de-afferentiation
== == == == TMSTMS
Working with Domains Instead of DiagnosesWorking with Domains Instead of Diagnoses