Oneiroid syndrome

It is characterised by vivid scenic hallucinations, catatonic symptoms (ranging from stupor to agitation), delusions, and kaleidoscopic psychopathological experiences.

[2] Potential causes include: Despite its distinct clinical presentation, oneiroid syndrome is not widely recognised in contemporary psychiatric diagnostic systems such as the DSM-5.

[4] The term "oneiroid syndrome", while generally known to European and Russian psychiatrists, remains largely unfamiliar in the United States.

[5] Key features include conflicting emotions, contradictory thoughts, and actions, as well as a profound sense of dramatic changes in reality.

[5] Individuals with oneiroid syndrome typically recognise the perceived phenomena as belonging to alternate realms or dimensions inaccessible to ordinary people, rather than to the tangible, external world.

Disorientation regarding time and place is common, accompanied by a "double awareness," where the patient simultaneously perceives themselves as being in their current physical location (e.g., a psychiatric hospital) while also engaging in the fantastical narrative.

Distortions of time are frequent, with patients describing experiences spanning years, even millennia, often involving themes such as death, resurrection, and cloning.

[2] Early signs include sleep disturbances and escalating anxiety, which rapidly progress to confusion and vivid derealisation.

[5] This state serves as the foundation for unsystematic and fragmented delusions, often accompanied by strong emotional responses such as amazement or ecstasy.

[5] During episodes of severe consciousness disruption, patients may very rarely develop hyperthermia, which can lead to increasing cerebral oedema and impaired cardiac function.

This condition, referred to as "febrile schizophrenia" in Russia and "lethal catatonia" in Western literature, is a critical medical emergency.

A transition to amential syndrome (characterised by severe confusion and disorientation) or mental fog is considered an unfavourable prognostic sign.