Quixotic delirium, around the fourth centenary of the publication of the second part of Don Quixote de la Mancha: About a case

Abstract

Psychosis, understood as a judgment out of reality, is sometimes considered as a defensive mechanism in the face of an overflowing situation. However, beyond the pathological, given its fantastic nature, has also brought its form and content to art in its various manifestations. Thus, we bring up a similar case. A 51-year-old male, who has one brother with schizophrenia; in his childhood and adolescence excelled by an excellent academic performance, even won a national prize of Economy; and very scarce emotional ties outside the family environment. At the age of 23, during his stay in a foreign country after obtaining a scholarship in a world-renowned company, he presented disorganized behavior and thought, disinhibition, delusions of persecution, prejudice and referentiality; then, he was repatriated by his family to enter in a psychiatric center. After, he continued psychiatric monitoring irregularly, with no disease awareness and little therapeutic adherence. In his last decompensation, he shown a megalomaniacal delusion, he defined himself as “a living being, brother of all living beings, who fought to defend peace, justice and the good of mankind”. The last year, he had been helping economically the homeless, interceding before the authorities for strangers and needy people; he restored and prayed in temples of different religions. Furthermore, with a significant deterioration in their self-care and family life. In consequence, he required a third forced psychiatric admission. After two months, he received discharge for clinical improvement and treatment with injectable paliperidone. Eight months later, he continues to be monitored and markedly recovered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.