BACKGROUND: This case series presents a unique manifestation of shared psychotic disorder “folie à trois” transmitted entirely through digital interactions. It is among the first documented clinical accounts demonstrating that immersive online alliances — without physical proximity — can serve as fertile ground for psychotic contagion. The report contributes to evolving psychiatric frameworks by highlighting the role of “virtual cohabitation” in shaping shared delusional systems. CASE SERIES PRESENTATION: Three young adult males from different cities in West Bengal developed a shared persecutory delusional system over three years of daily interaction within an online gaming guild. The inducer (Case A) presented with severe paranoia, digital surveillance delusions, and insomnia. Recipients (Cases B and C) displayed alignment with these beliefs, marked social withdrawal, and psychological dependency on the inducer. All patients were diagnosed with shared psychotic disorder. Interventions included second-generation antipsychotics (risperidone, olanzapine, aripiprazole), structured cognitive-behavioral therapy, digital hygiene protocols, and psychoeducation. Separation of digital communication among the triad facilitated therapeutic gains. All three demonstrated symptomatic improvement over 2–3 months, with partial restoration of social functioning. CONCLUSION: This case underscores that psychological proximity fostered through immersive digital platforms may suffice for the transmission of delusional beliefs. Clinicians must routinely explore virtual relationships and digital group identities as potential vectors of psycho-pathology. Early detection, digital boundary setting, and integrative therapy approaches are essential in managing such emerging presentations.
Objective This study aimed to evaluate the effectiveness and safety of Altibrain (R) in combination with standard Autism Spectrum Disorder (ASD) treatment compared to standard ASD treatment alone in individuals diagnosed with ASD. Method A randomized, open-label trial was conducted involving 120 participants aged 3 to 17 years, randomly assigned to either the Standard ASD Treatment group or the Altibrain (R) + Standard ASD Treatment group. Sixty patients were randomly allocated to each Standard ASD Treatment group or the Altibrain (R) + Standard ASD Treatment group. participant allocation was done by computer-generated randomization. Participants had confirmed ASD diagnoses based on DSM-IV or ICD-11 criteria and demonstrated moderate to severe core ASD symptoms. Informed consent was obtained from caregivers. A total number of 120 subjects were included, consisting of 71 male and 49 female patients. Participants received either standard ASD treatment alone or Altibrain (R) in addition to standard ASD treatment orally once daily for 24 weeks. A total of 7 study visits/24 weeks to analyze the intervention efficacy of the Standard ASD Treatment group or the Altibrain (R) + Standard ASD Treatment group. Primary outcomes included changes in core ASD symptoms measured by the Autism Diagnostic Observation Schedule (ADOS) and safety assessments. Secondary outcomes included alterations in social communication skills, reduction in repetitive behaviors, overall functional improvements, and safety and tolerability of Altibrain (R). Results Altibrain (R) significantly improved qualitative deficits in social interaction and repetitive behaviors compared to standard ASD treatment alone (p < 0.0001). The Altibrain (R) + Standard ASD Treatment group demonstrated significant improvements in social functioning, social awareness, cognition, communication, and motivation compared to the Standard ASD Treatment group (p < 0.0001). Additionally, Altibrain (R) showed superior efficacy in reducing hyperactivity/noncompliance, inappropriate speech, irritability, lethargy/social withdrawal, stereotypic behavior, and aberrant behavior compared to standard treatment alone (p < 0.0001). Additionally, Altibrain (R) exhibited a favorable safety profile as per the 4-week post-treatment safety follow-up. Conclusion Further research is warranted to confirm and expand upon these results, including longer-term studies with larger cohorts and investigations into underlying mechanisms. Overall, Altibrain (R) holds promise as a valuable therapeutic option for individuals with ASD and their families. Limitations of the study include neuroimaging and biomarkers analysis.
Background Heavy alcohol use is associated with an increased risk of Intracerebral Hemorrhage (ICH), but the relationship with lesser amounts of alcohol is uncertain. Tribals in East India have a higher prevalence of alcohol abuse. We assessed the dose-risk relationship between alcohol consumption and ICH and evaluated the intra-population variations of this risk. Methods In this case-control study, we recruited 510 patients with ICH. Cases were matched 1:1 with ICH-free controls. Alcohol consumption patterns were designated into groups - none, rare, moderate, intermediate, and heavy. The no-alcohol consumption category was used as reference to determine ICH risk. Results Rare and moderate alcohol consumption conferred a decreased risk of ICH (OR = 0.35, P value <0.001 and OR = 0.58, P value 0.008 respectively). Patients with heavy alcohol use were at a significantly higher risk (OR = 1.65, P value = 0.027). Subgroup analysis revealed similar risk profiles for rare and moderate consumption in both lobar and non-lobar ICH, whereas heavy alcohol conferred an increased risk only for non-lobar ICH. Heavy alcohol consumption was also associated with risk of ICH in tribals (OR = 3.24. P value = 0.04). Conclusion Rare and moderate alcohol consumption may have a protective effect on ICH risk whereas heavy alcohol use is associated with an increased risk, Further, tribal populations have an increased ICH risk with heavy alcohol use with no decrease in risk with rare or moderate use. This highlights the need for culturally tailored prevention strategies for these communities.
