A patient with schizophrenia denied his original name, referred to himself by a female name, and believed he had a female body, consistent with reverse intermetamorphosis, a subtype of delusional misidentification of the self. He also experienced Capgras delusion involving his parents and described being controlled by an external agent who bore his original name. These symptoms suggest that a marked disruption of the sense of agency, along with delusional compensatory mechanisms, may contribute to profound psychological changes in the self. Bodily alterations and comorbid Capgras delusion may further disturb the sense of self, with a delusional agent dominating the original sense of agency and generating a unified self centered on that agent.
For patients with panic disorder or social anxiety disorder, adding mindfulness-based cognitive therapy (MBCT) to usual care costs about JPY 13,885 more per patient over 8 weeks but improves anxiety symptoms and quality of life. The incremental cost per quality-adjusted life year (QALY) was JPY 1,566,357, well below Japan's willingness-to-pay threshold of JPY 5,000,000, giving a 77.5% probability of being cost-effective. MBCT reduced state anxiety by 10.13 points and trait anxiety by 12.00 points on the STAI. Sensitivity analyses confirmed the findings were robust.
A feasibility randomized controlled trial compares augmented mindfulness-based cognitive therapy (MBCT) with follow-up sessions to augmented MBCT without follow-up sessions for adults aged 20–65 with panic disorder, agoraphobia, or social anxiety disorder that has not remitted after at least 4 weeks of usual treatment. The 8-week MBCT program includes a 10-month follow-up period. Primary outcomes are inclusion rate, dropout rate, attendance rate, and clinical measures at 8 weeks and 5, 8, and 12 months. Recruitment began in January 2020 and 43 participants were enrolled by January 2021; data collection is expected to finish by May 2022. The study is limited by mixed intervention delivery modes and lack of a pharmacotherapy-alone arm.