Case report: Clinical lycanthropy in Huntington's disease

We describe the case of a patient diagnosed with Huntington's disease (HD), who, following a two-year history of anxiety with obsessional preoccupations, developed psychosis with clinical lycanthropy: a prominent delusional idea that he was a werewolf. Although there was no benefit from various antidepressants and antipsychotics, there was remarkable improvement of his symptoms following prescription of Clozapine. His choreiform movement disorder also improved as his mental state settled. Although some reported cases of clinical lycanthropy are related to neurological conditions, this is the first case in a patient with HD. We also discuss the relevance of cultural and personal factors in the expression of a delusion that incorporates disgust, and the potential role of somatosensory aberrations and misidentification of self.

[1]  J. Mallet,et al.  Clinical Lycanthropy, Neurobiology, Culture: A Systematic Review , 2021, Frontiers in Psychiatry.

[2]  C. Galletly,et al.  Clozapine treatment for Huntington’s disease psychosis , 2021, The Australian and New Zealand journal of psychiatry.

[3]  J. Mallet,et al.  The neurobiological hypotheses on Clinical Lycanthropy , 2020, Psychiatry Research.

[4]  S. Aggarwal,et al.  Management of neuropsychiatric symptoms in Huntington's disease (HD) with clozapine: A case report. , 2020, Asian journal of psychiatry.

[5]  Naeema Majothi,et al.  Treatment of psychosis in Huntington's disease with clozapine , 2020, Progress in Neurology and Psychiatry.

[6]  Lei Yuan,et al.  Topography of Reward and Aversion Encoding in the Mesolimbic Dopaminergic System , 2019, The Journal of Neuroscience.

[7]  Brett Trost,et al.  Length of Uninterrupted CAG, Independent of Polyglutamine Size, Results in Increased Somatic Instability, Hastening Onset of Huntington Disease. , 2019, American journal of human genetics.

[8]  Anina N. Rich,et al.  Moral Violations and the Experience of Disgust and Anger , 2018, Front. Behav. Neurosci..

[9]  P. McColgan,et al.  Huntington's disease: a clinical review , 2018, European journal of neurology.

[10]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[11]  T. Woodward,et al.  Dopamine, cognitive biases and assessment of certainty: A neurocognitive model of delusions. , 2017, Clinical psychology review.

[12]  J. Blom When doctors cry wolf: a systematic review of the literature on clinical lycanthropy , 2014, History of Psychiatry.

[13]  Nellie Georgiou-Karistianis,et al.  Structural MRI in Huntington's disease and recommendations for its potential use in clinical trials , 2013, Neuroscience & Biobehavioral Reviews.

[14]  B. Landwehrmeyer,et al.  Factor analysis of behavioural symptoms in Huntington’s disease , 2010, Journal of Neurology, Neurosurgery & Psychiatry.

[15]  R. V. D. Mast,et al.  Psychopathology in verified Huntington's disease gene carriers. , 2007, The Journal of neuropsychiatry and clinical neurosciences.

[16]  Ivanei E. Bramati,et al.  The Moral Affiliations of Disgust: A Functional MRI Study , 2005, Cognitive and behavioral neurology : official journal of the Society for Behavioral and Cognitive Neurology.

[17]  R. Cochrane,et al.  Effect of Culture and Environment on the Phenomenology of Delusions and Hallucinations , 2002, The International journal of social psychiatry.

[18]  M. Phillips,et al.  Disgust – the forgotten emotion of psychiatry , 1998, British Journal of Psychiatry.

[19]  R. Roos,et al.  Clozapine versus placebo in Huntington’s disease: a double blind randomised comparative study , 1997, Journal of neurology, neurosurgery, and psychiatry.

[20]  J. R. Harding,et al.  Delusional misidentification of the self. , 1995, British journal of hospital medicine.

[21]  U. Bonuccelli,et al.  Clozapine in Huntington's chorea , 1994, Neurology.

[22]  Kwang-iel Kim,et al.  Schizophrenic Delusions Among Koreans, Korean-Chinese and Chinese: a Transcultural Study , 1993, The International journal of social psychiatry.

[23]  T. Fahy Lycanthropy: A Review , 1989, Journal of the Royal Society of Medicine.

[24]  P. Keck,et al.  Lycanthropy: alive and well in the twentieth century , 1988, Psychological Medicine.

[25]  D. Millard St Christopher and the Lunar Disc of Anubis , 1987 .

[26]  R. Ritner Anubis and the Lunar Disc , 1985 .

[27]  G. Fraedrich,et al.  Juvenile recurrent respiratory papillomatosis: Still a mystery disease with difficult management , 2007, Head & neck.

[28]  Rita Pal,et al.  Pain on Injection of MCT/LCT Preparations of Propofol and Etomidate: A Double-blind Randomised Comparative Study , 2019, JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH.

[29]  Rajeet Shrestha Clinical lycanthropy: delusional misidentification of the "self". , 2014, The Journal of neuropsychiatry and clinical neurosciences.

[30]  D. C. Henckel,et al.  Case report. , 1995, Journal.

[31]  M. Bartels,et al.  Comparison of schizophrenic delusions between Japan and Germany. , 1993, Psychopathology.

[32]  M. Drake Medical and neuropsychiatric aspects of lycanthropy , 1992, The Journal of medical humanities.