Scene from Sssssss (1973).
“When Dr. Stoner needs a new research assistant for his herpetological research, he recruits David Blake from the local college. Oh, and he turns him into a snake for sh*ts and giggles.”
Movie Review by Jason Grey
Horror movies where people turn into snakes are relatively common (30 by one count), but clinical reports of delusional transmogrification into snakes are quite rare. This is in contrast to clinical lycanthropy, the delusion of turning into a wolf.
What follows are two frightening tales of unresolved mental illness, minimal followup, and oversharing (plus mistaking an April Fool's joke for a real finding).
THERE ARE NO ACTUAL PICTURES OF SNAKES in this post [an important note for snake phobics].
The first case of ophidianthropy was described by Kattimani et al. (2010):
A 24 year young girl presented to us with complaints that she had died 15 days before and that in her stead she had been turned into a live snake. At times she would try to bite others claiming that she was a snake. ... We showed her photos of snakes and when she was made to face the large mirror she failed to identify herself as her real human self and described herself as snake. She described having snake skin covering her and that her entire body was that of snake except for her spirit inside. ... She was distressed that others did not understand or share her conviction. She felt hopeless that nothing could make her turn into real self. She made suicidal gestures and attempted to hang herself twice on the ward...
The initial diagnosis was severe depressive disorder with psychotic features. A series of drug trials was unsuccessful (Prozac and four different antipsychotics), and a course of 10 ECT sessions had no lasting effect on her delusions. The authors couldn't decide whether the patient should be formally diagnosed with schizophrenia or a more general psychotic illness. Her most recent treatment regime (escitalopram plus quetiapine) was also a failure because the snake delusion persisted.
“Our next plan is to employ supportive psychotherapy in combination with pharmacotherapy,” said the authors (but we never find out what happened to her). Not a positive outcome...
Scene from Sssssss (1973).
Ophidiantrophy with paranoid schizophrenia, cannabis use, bestiality, and history of epilepsy
The second case is even more bizarre, with a laundry list of delusions and syndromes (Mondal, 2014):
A 23 year old, married, Hindu male, with past history of ... seizures..., personal history of non pathological consumption of bhang and alcohol for the last nine years and one incident of illicit sexual intercourse with a buffalo at the age of 18 years presented ... with the chief complains of muttering, fearfulness, wandering tendency ... and hearing of voices inaudible to others for the last one month. ... he sat cross legged with hands folded in a typical posture resembling the hood of a snake. ... The patient said that he inhaled the breath of a snake passing by him following which he changed into a snake. Though he had a human figure, he could feel himself poisonous inside and to have grown a fang on the lower set of his teeth. He also had the urge to bite others but somehow controlled the desire. He said that he was not comfortable with humans then but would be happy on seeing a snake, identifying it belonging to his species. ... He says that he was converted back to a human being by the help of a parrot, which took away his snake fangs by inhaling his breath and by a cat who ate up his snake flesh once when he was lying on the ground. ... the patient also had thought alienation phenomena in the form of thought blocking, thought withdrawal and thought broadcasting, delusion of persecution, delusion of reference, delusion of infidelity [Othello syndrome], the Fregoli delusion, bizarre delusion, nihilistic delusion [Cotard's syndrome], somatic passivity, somatic hallucinations, made act [?], third person auditory hallucinations, derealization and depersonalisation. He was diagnosed as a case of paranoid schizophrenia as per ICD 10.
Wow.
He was was given the antipsychotic haloperidol while being treated as an inpatient for 10 days. Some of his symptoms improved but others did not. “Long term follow up is not available.”
The discussion of this case is a bit... terrifying:
Lycanthropy encompasses two aspects, the first one consisting of primary lupine delusions and associated behavioural deviations termed as lycomania, and the second aspect being a psychosomatic problem called as lycosomatization (Kydd et al., 1991).
Kydd, O.U., Major, A., Minor, C (1991). A really neat, squeaky-clean isolation and characterization of two lycanthropogens from nearly subhuman populations of Homo sapiens. J. Ultratough Molec. Biochem. 101: 3521-3532. [this is obviously a fake citation]
Endogenous lycanthropogens responsible for lycomania are lupinone and buldogone which differ by only one carbon atom in their ring structure; their plasma level having a lunar periodicity with peak level during the week of full moon. Lycosomatization likely depends on the simultaneous secretion of suprathreshold levels of both lupinone and the peptide lycanthrokinin, a second mediator, reported to be secreted by the pineal gland, that “initiates and maintains the lycanthropic process” (Davis et al., 1992). Thus, secretion of lupinone without lycanthrokinin results in only lycomania. In our patient these molecular changes were not investigated.
oh my god, the paper by Davis et al. on the Psychopharmacology of Lycanthropy (and "endogenous lycanthropogens") was published in the April 1, 1992 issue of the Canadian Medical Association Journal. There is no such thing as lupinone and buldogone.
Fig. 1 (Davis et al., 1992): Structural formulas of endogenous lycanthropogens.
I know the authors are non-native English speakers, but where was the peer review for the Asian Journal of Psychiatry?? We might as well return to the review for Sssssss, which was more thorough.
THE MORGUE:
David Blake - Our hapless victim. David is a college student who gets recruited by Dr. Stoner to help out at his farm, and be his latest test subject. He's a nice guy, and there really is not much to say about him, as he's pretty bland until he starts growing scales.
Dr. Carl Stoner - The villain of our piece. He's a snake researcher looking for new grant money, and a new test subject. He actually means well enough, and is looking to advance humanity, but in classic horror movie fashion, he plays God and things go too far.
Kristine Stoner - The doctor's daughter, who is also interested in snakes. Especially David's. She's smart, and kind, and again a bit of a blank slate beyond those traits. Loyal to a fault with her father.
Dr. Daniels - A minor character, but Stoner's chief rival, and the man who holds the purse strings. The two doctors have an antagonistic relationship, but there seems to be an undercurrent of past friendship as well, overshadowed by Daniels' position. Or I'm reading too much into things.
Sssssss has a score of 13% on Rotten Tomatoes. We don't have a similar rating system for journal articles, but there's always PubMed Commons and PubPeer...
Further Reading
People Who Change into Snakes in Movies - from California Herps
Snake me up before you go-go: An unusual case of ophidianthropy - by Dr Mark Griffiths
Psychopharmacology of Lycanthropy
Werewolves of London, Ontario
References
Davis WM, Wellwuff HG, Garew L, Kydd OU. (1992). Psychopharmacology of lycanthropy. CMAJ Apr 1;146(7):1191-7.
Kattimani S, Menon V, Srivastava MK, Mukharjee A. (2010). Ophidianthropy: the case of a woman who ‘Turned into a Snake’. Psychiatry On-Line.
Mondal, G., Nizamie, S., Mukherjee, N., Tikka, S., & Jaiswal, B. (2014). The ‘snake’ man: Ophidianthropy in a case of schizophrenia, along with literature review, Asian Journal of Psychiatry, 12, 148-149 DOI: 10.1016/j.ajp.2014.10.002
hello
ReplyDeletealthough the kydd article is a treasure, and that the authors from CIP cited it is awesome, I don't know what the post as a whole was trying to say (full disclosure:I know every single one of the authors on the first paper personally)
If you're referring to the general issue of people trying to carve out spaces in terms of psychopathology, may I refer you to http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775058/ which has another one?
My point is, there is no harm in it, even if no good will come of it. though that's the sad state of psychopathology research. :-(
Thanks for your comment. The initial point of the post was to describe two cases of a rare and bizarre syndrome for Halloween. The Neurocritic has a long history of such posts. For instance, (Every Day Is) Halloween has a list of horror-related posts from 2006-2012. I've also written specifically about clinical lycanthropy, including the Kydd paper (see Further Reading).
ReplyDeleteThen it became apparent that these case reports of ophidianthropy had little (if any) peer review.
Perhaps you know something I don't... perhaps Mondal et al. were pranking us as well. I assumed that wasn't the case. So why report the buffalo incident? Why cite an April Fool's joke (and a fake paper contained therein) in an Elsevier journal? I thought this said something about the state of publishing, and as you said "the sad state of psychopathology research." Given that a presumably real patient was described and then discussed in the context of completely made-up science, I did think that was harmful.