An Overview Of Delusions In Schizoaffective Disorder From Homoeopathic Materia Medica And Repertory

Dr. Yashasvi shakdvipiya¹, Dr Noopur kumari², Dr Darshana Dabhi ³
Asst.Prof.¹
MD(Hom.)(PGR) ^{2, 3}
Dept. of Repertory
Dr.M.P.K.Homoeopathic Medical College, Hospital & Research Centre
Homoeopathy University, Jaipur-302029

Abstract: This article is a venture to extrapolate delusions and its related psychological delusions in schizoaffective disorders from homoeopathic materia medica and repertory. It is a prospective analytical study to augment the precursory knowledge of practitioners as well as students.

Keywords: Schizoaffective disorders, Schizophrenia,Delusion, Hallucination, Homoeopathy, Kent’s repertory, materia medica.

Introduction: Emotions impart the substantial driving force to an individual. In a healthy condition there is a perfect balance between the mind and body. A distracted mind is the result of some form of bodily discomfort. When such bodily discomfort tends to menace the reliability of a person, an exaggerated emotional response results in the ‘anxiety state’. Persons readily get disturbed when they found a sufficient gap between their expectations and the actuality. This sense of perception is often suppressed at the conscious level and thereby facilitates deceitful expressions. The intellect determines the capacities of an individual; the emotions determine their free expression.¹The affections are pre-eminently deranged, the intellect sphere is only secondarily changed.² The term ‘schizoaffective disorder’ is implied when schizophrenia and affective disorder coexist in equal measure.³ It is formed from 2 words i.e.”schizo-” refers to the psychotic symptoms of schizophrenia that affect a person’s thinking, sense of self, and perceptions and the word “-effective” refers to extreme shifts in mood, energy, and behaviour.⁴ Schizophrenia is a psychosis characterized by delusions, hallucinations and lack of insight. ³A delusion is a false belief that specify an abnormality in the affected person’s content of thought. The false belief is not accounted for by the person’s cultural or religious background or his or her level of intelligence. The key feature of a delusion is the degree to which the person is convinced that the belief is true. A person with a delusion will hold firmly to the belief regardless of evidence to the contrary.⁵ Delusions can be (a) persecutory- such as a conviction that others are out to get one (b) hypochondriacal- such as an unfounded conviction that one has cancer (c) grandiose- such a belief that one has special powers or status (d) nihilistic- my head is missing, I have nobody. Hallucinations are perceptions without external stimuli they can occur in any sensory modality, most commonly visual or auditory.³The most commonest delusion that can be found in schizoaffective disorder is the false belief that they are a particular historical figure or that somebody is plotting against them or controlling them.⁴ These persons can be found saying that they are being sent by God for a mission.⁶ The changes in the mood of a person become more prominent in adolescence or young adulthood. People with this condition often have difficulty functioning at school, at work, and in social settings. Disordered thinking and concentration, inappropriate emotional responses, erratic speech and behavior, and difficulty with personal hygiene and everyday tasks are also common.⁴

Rubrics related to Schizoaffective disorder as reflected in Kent’s repertory ⁷ 

(I) Rubrics pertaining to schizophrenic state

• MIND – DELUSIONS, – bewitched, thinks he is – cann-i.
• MIND – DELUSIONS, – Christ, thinks himself to be – cann-i.
• MIND – DELUSIONS, – conspiracies – against him, there were – lach. plb.
• MIND – DELUSIONS, – divine, thinks he is – cann-i. stram.
• MIND – DELUSIONS, – emperor, – thought himself an – cann-i.
• MIND – DELUSIONS, – God, – is the object of God’s vengeance – kali-br.
• MIND – DELUSIONS, – God, – that he is in communication with – verat.
• MIND – DELUSIONS, – influence, is under a powerful – cere-b.
• MIND – DELUSIONS, – juggler, thinks himself a –
• MIND – DELUSIONS, – noble, thinks he is a – phos.
• MIND – DELUSIONS, – separated from the world, that he is –
• MIND – DELUSIONS, – sorrow, thinks everyone he meets has a secret – cann-i.
• MIND – DELUSIONS, – superhuman, – control, under, is – anac. Lach.Naja Thuj.
• MIND – DELUSIONS, – superhuman, is- cann-i.
• MIND – DELUSIONS, – transferred – to another world – cann-i.
• MIND – DELUSIONS, – vengeance, thinks he is singled out for Divine – KALI-BR.

 

 (II) Rubrics pertaining to the affective state 

• MIND – CAPRICIOUSNESS- agar. alum. am-c. arn. Ars. asaf. aur-m. bar-c. Bell. brom. BRY. calc. calc-s. cann-i. canth. caps. carb-an. carbn-s. CHAM. chin. chinin-ar. cimic. CINA Coff. croc. dig. dros. Dulc.grat. hep. ign. IP. kali-ar. KALI-C. kreos. lach. led. lyc. mag-m. merc. nit-ac. nux-m. nux-v. op. par. phos. Puls. raph. Rheum. rhod. sarr. sec. sil. spong. STAPH. stram. Sulph. thuj. viol-t. zinc.
• MIND – GESTURES, makes – pulls hair of bystanders –
• MIND – GESTURES, makes – ridiculous or foolish- Bell . croc. Cupr. HYOS. ign. kali-p. Lach.. merc. Mosch. Nux-m .op. Sep. Stram. verat.
• MIND – MIRTH, hilarity, liveliness, etc. – alternating, lachrymose mood, with – sadness, with- cann-i. caust. croc. ferr. hell. nat-c. nit-ac. petr. plat. sep. tarent. zinc.
• MIND – MOOD, – changeable, variable,etc.- Agn. Aloe Alum. ambr. anac. ant-t. Apis. arg-met. Arg-n. arn. Ars. ars-i. asaf. asar. Aur. aur-m. Bar-c. Bell. bism. Borx. bov. bry. Bufo. Calc. calc-s. cann-s. caps. carb-an. carbn-s. carl. caust. Chin. Cocc. con. Croc. Cupr. cycl. Dig. dros. Ferr. ferr-ar. gels. graph. hyos. IGN. iod. Kali-c. kali-p. kali-s. lac-c. lach. lachn. LYC. Mag-c. meny. Merc. mez. morph. nat-c. nat-m. nit-ac. NUX-M. op. Petr. phel. Phos. plan. Plat. Psor. PULS. ran-b. rat. sabad. sanic. SARS. seneg. Sep.sil. spig. spong. stann. staph. Stram. sulph. Sul-ac. tarent. thuj. Tub. Valer. verat. verb. ZINC.
• MIND – PULL, desires to pull – one’s hair – BELL. Lil-t.tarent.
• MIND- SPEECH, babbling–confused – bry. calc. Cann-s. Caust. Crot-c. crot-h. Gels. Hyos. Lach. lyc.med. mosch. Nat-m. .nux-m. sec. stram. thuj.
• MIND – SPEECH, babbling– foolish – Bell. HYOS. Lach. merl. Nux-m. .par. phos. Stram. tab.
• MIND – SPEECH, babbling – incoherent- Agar. amyg. Anac. Arg-n. ars. Bapt. Bell. BRY. cact. calad. Camph. CANN-I. carbn-s. cham. chel. chlol. Crot-h. cub. cupr. cycl. dulc. ether. Gels. hep. hydr-ac. HYOS. kali-bi. kali-br. kali-c. kali-p. LACH. merc. Morph. Nux-m..op. par. Ph-ac. PHOS. plb. RHUS-T. STRAM. Sulph. tanac. vip. visc. zinc.
• MIND – SPEECH, babbling – prattling – aloe. Anac. BRY. HYOS. nux-v. op. plb. Stram.. tarax.
• MIND – SPEECH, babbling – unintelligible- ars. BELL. euph. HYOS. lyc. Merc. Naja. nux-v. Ph-ac. Sec. sil. STRAM. tab.

Discussion:

Group of medicines for Schizoaffective disorder from rubrics as discussed:

Reflection of Schizoaffective disorder through symptoms of materia medica

Belladonna:  The patient who is constitutionally belladonna is prone to hallucinations or visions and psychic phenomenon. Belladonna individuals often sense that they have the power of a magical or psychic kind even when they have not had direct evidence of it. They believed that they had power to heal others but had not tried to do so.⁸  All sorts of delusions and hallucinations are mingled with the acute mania ghosts, horrid monsters, strange things and deformed subjects.⁹ Patient lives in a world of his own, engrossed in spectres and visions and is oblivious to the surrounding realities. He is acutely alive and crazed by the flood of subjective visual impressions and fantastic illusions. Changeable temperament. ¹⁰

 Stramonium: The rage that the stramonium individual feels is often unfocused; the anger is not directed at any in particular. It appears as if they are “possessed” by a force that is entirely impersonal. ⁸ It is like an earthquake in its violence. Many of its delusions relate to being under attack in some way.⁹ The mind is in an uproar, cursing, tearing the clothes, violent speech, frenzy, erotomania, exposing of the person.  He sees animals, ghosts, angels, departed spirits, devils and knows that they are not real but later he is confident of it. ^9,10  Delusion about his identity; thinks himself to be tall, double as if a part is missing. Religious mania. ¹⁰

 Lachesis: They often imagine that they are being discriminated against or that the world, in general, is a dangerous place to live in.⁸ A woman imagines that her friends, husband and children are trying to damage her; that her friends are trying to put her in an insane asylum. Imagines her relatives are trying to poison her and she refuses to eat. Thinks she is somebody else and in the hands of a stronger power. She thinks her in under superhuman control. She is compelled to do things by spirits. She hears a command partly in her dreams, that she must carry out. Imagines she is pursued.^{7, 8} Imagines that she has stolen something, or that somebody thinks that she has stolen something, and fears the law. It is full of religious insanity.^{9, 10}  Suspicious; the nocturnal delusion of fire. ¹⁰

Cannabis indica: This remedy relates to altered consciousness. Delusions that he has two existences or to be conscious of two states or to exist in two spheres incoherent speech, wonderful imagination and hallucinations. Exaltation of spirits with mirthfulness; feels as if calvarium were opening and shutting or being lifted and lowered into place. Visual clairvoyance.^{9, 10} Subconscious or dual nature state. Apparently under the control of the second self. Excessive loquacious; exuberance of spirits. Emotional excitement. Rapid change of mood. Can not realize own identity. ¹⁰

 Hyoscyamus niger: In advanced stages of pathology she may imagine that poison gas is being pumped into her house, or that CIA is watching her.⁸ Full of imaginations and hallucinations when asleep and when awake. They take on the delusion that they have sinned away their day of grace, they have done some awful things “she imagines that she has murdered, that she has done some dreadful thing.” Thinks he is in the wrong place, he is not at home. Sees persons who are not and who have not been present. Sometimes he will imagine the things are worms, vermins, rats, cats, mice. Imagines that he is pursued, that the people have all turned against him, that his friends are no longer his friends. He carries on a conversation with imaginary people. Talks as if he was talking to himself, but he really imagines that someone is sitting by his side to whom he is talking. Sometimes he talks to dead folks, recalls past events with those that have departed.⁹ Hyoscyamus is a perfect picture of mania in a quarrelsome and obscene character. Inclined to be unseemly and immodest in acts, gestures and expressions. Great hilarity; inclined to laugh at everything.¹⁰

 Conclusion:

Homoeopathic materia medica literature gives extensive pathogenetic drug picture which is related to the clinical picture of Schizoaffective disorder. Above discussed pictures of drugs are few to quote among these. Not only these remedies can be useful as a therapeutic choice in this disorder but also their further clinically verification may help to explore the effectiveness of homoeopathy in schizoaffective disorder along with standard treatment protocol.

References

1. Dhawale ML. Principles & practice of homoeopathy: homoeopathic philosophy & repertorization. New Delhi, India: B. Jain Publishers (P) Ltd.; 2014.
2. Patel RP. The art of case taking and practical repertorization in homoeopathy (how to use repertory). New Delhi: B Jain; 1999.
3. Ralston SH, Penman ID, Strachan MWJ, Hobson RP. Davidson’s principles and practice of medicine. Edinburgh: Churchill Livingstone/Elsevier; 2018.
4. Schizoaffective disorder – Genetics Home Reference – NIH [Internet]. U.S. National Library of Medicine. National Institutes of Health; [cited 2019Mar29]. Available from: https://ghr.nlm.nih.gov/condition/schizoaffective-disorder
5. Chaudhury S, Kiran C. Understanding delusions. Industrial Psychiatry Journal. 2009;18(1):3.
6. Mattingley DW, Koola MM. Association of Lyme Disease and Schizoaffective Disorder, Bipolar Type: Is it Inflammation Mediated? [Internet]. Indian journal of psychological medicine. Medknow Publications & Media Pvt Ltd; 2015 [cited 2019Mar29]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418265/
7. Kent JT, Kent CL. Repertory of the homoeopathic materia medica. Noida: B. Jain Publishers (P) Ltd.; 2016.
8. Bailey PM. Homoeopathic psychology. Personality profiles of the major constitutional remedies. New Delhi. B. Jain Publishers (P) Ltd.; 2016.
9. Kent JT. Lectures on homoeopathic materia medica. New Delhi. B. Jain Publishers (P) Ltd.; 2002
10. Boericke W. New manual of homoeopathic materia medica with repertory: including Indian drugs, nosodes, uncommon rare remedies, mother tinctures, relationships, sides of the body, drug affinities, & list of abbreviations. New Delhi: B. Jain Publishers; 2007.

About Authors
AUTHOR’S INFORMATION

1. Dr Yashasvi Shakdvipiya
   BHMS, MD(Hom.)
   Assistant Professor,
   Department of Repertory
   Homoeopathy University, Jaipur
   Email i.d- [email protected]
   Ph.no.- 9783318494
2. Noopur kumari
   BHMS, MD (Hom.) – Part 2
   Department of Repertory
   Homoeopathy University, Jaipur
   Former Senior Research Fellow (SRF)
   Central Council for Research in Homoeopathy (CCRH)
   Janakpuri, D- block, New Delhi
   Email i.d- [email protected]
   Ph. No. -8949241039
3. Darshana Dabhi
   BHMS, MD (Hom.) – Part 2
   Department of Repertory
   Dr M.P.K homeopathic Medical College Hospital & Research Centre
   Homoeopathy University, Jaipur
   Email id- [email protected]
   Phone no.- 6375297104