What would you call this (anosognosia)?

[Ceke2002]

Person experiences a period of (what they describe as "severe") intermittent insomnia for several months with accompanying delusional thought processes and episodes of anxiety, person diagnoses themselves with Fatal Familial Insomnia, person clings to this diagnosis and argues its validity despite numerous people attempting to point out the blatantly obvious and the fact that they admit themselves they have a been given a diagnosis of Psychosis-NOS after spending several weeks in a Psychiatric hospital, have a previous history of adderall abuse, continued to abuse adderall upon release from hospital, and were readmitted back to hospital with symptoms of psychosis a further three times at least -- but they're still absolutely not psychotic, and the only reasonable explanation they can find for their symptoms is FFI.

Theoretically would this be considered a case of anosognosia, or something else? They have a number of videos uploaded on a video hosting site (obviously not going to link to them) and it's just fascinating to watch them tangentially rambling about their symptoms of psychosis, medications, drug abuse, hospital admissions, etc, and how they came to the conclusion they actually suffered from FFI instead (something about hearing bubbles in their thalamus).

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[splik]

if someone believes they have something with unshakable conviction for no logical reason despite evidence to the contrary that is a delusion. the good thing about fatal familial insomnia is that it's fatal. so i would just tell them, "well we'll know for sure when you're dead a few months from now".

anosognosia is a term used to describe the lack of insight into neurological impairments (for example unaware cannot move left side of body) and is typically associated with right parieto-temporal pathology. the term has been (wrongly in my view) co-opted by certain psychiatrists (ahem Torrey Fuller) as an argument to forcibly drug and deprive people with psychoses of their liberties. it is true that lack of insight is by definition always present in psychosis (you can't be psychotic if you know it - that is hearing voices is not a psychotic phenomena if you know you are hearing voices) and that this might have some neurobiological correlates but there are all sorts of other reasons why denial occurs in psychosis, particularly as this is more common at the onset of psychosis than later in the course.

 

[smalltownpsych]

Using amphetamines and can't sleep and has hallucinations. They call that "tweaking" here in the US. Also, denial is different from anosognosia.

 

[Ceke2002]

if someone believes they have something with unshakable conviction for no logical reason despite evidence to the contrary that is a delusion. the good thing about fatal familial insomnia is that it's fatal. so i would just tell them, "well we'll know for sure when you're dead a few months from now".

anosognosia is a term used to describe the lack of insight into neurological impairments (for example unaware cannot move left side of body) and is typically associated with right parieto-temporal pathology. the term has been (wrongly in my view) co-opted by certain psychiatrists (ahem Torrey Fuller) as an argument to forcibly drug and deprive people with psychoses of their liberties. it is true that lack of insight is by definition always present in psychosis (you can't be psychotic if you know it - that is hearing voices is not a psychotic phenomena if you know you are hearing voices) and that this might have some neurobiological correlates but there are all sorts of other reasons why denial occurs in psychosis, particularly as this is more common at the onset of psychosis than later in the course.

Thanks for qualifying the actual meaning of anosognosia, good to know . And yes the 'Fatal' part of Fatal Familial Insomnia is kind of a dead give away that you don't have it if you're still not only alive but functioning at least well enough to ramble into a video camera -- which is why I couldn't stop laughing for several minutes when someone just straight up and asked "Yo dude, you dead yet?"

 

[Ceke2002]

Using amphetamines and can't sleep and has hallucinations. They call that "tweaking" here in the US. Also, denial is different from anosognosia.

Yeah he's definitely tweaking in the videos, it's pretty obvious. And now I know the actual (and not co-opted) meaning of the word anosognosia I can see how this is possibly a mixture of delusion and denial about their (actual) illness. I must admit though I don't get how someone could be that in denial about being diagnosed with something like Psychosis-NOS, that their preferred alternative is FFI.

 

[deleted343839]

The term anosognosia is also used in the context of dementia. For instance, it's very common for a person with dementia to genuinely believe that they are still capable of complex tasks (like balancing a checkbook, driving, etc.) that they are no longer able to perform. Denial is also not unusual in milder forms of dementia/cognitive impairment. When there is an underlying neurological disease process, distinguishing the two can be tricky at times.

The case you mentioned is... less ambiguous.

 

[Ceke2002]

The term anosognosia is also used in the context of dementia. For instance, it's very common for a person with dementia to genuinely believe that they are still capable of complex tasks (like balancing a checkbook, driving, etc.) that they are no longer able to perform. Denial is also not unusual in milder forms of dementia/cognitive impairment. When there is an underlying neurological disease process, distinguishing the two can be tricky at times.

The case you mentioned is... less ambiguous.

I know my Dad believed he was still capable of driving, and was going to have his licence returned to him any day now, pretty much right up until the end of his life. Even with anti-psychotic medication, which did bring a cessation of the psychotic type symptoms at least for a time, he also still didn't seem to retroactively develop any insight into the fact that Jesus wasn't actually hanging in a tree, and no the next door neighbours weren't beaming porno movies into my parent's back yard (he had Vascular Dementia with Lewy Bodies).

 

[Armadillos]

(you can't be psychotic if you know it - that is hearing voices is not a psychotic phenomena if you know you are hearing voices

Could you expand on this? Does this mean that if you asked a patient if they are currently hearing voices and they say yes that means they can't be psychotic?