Vol 7, No 1 (2026)

BACKGROUND: Chronic and recurrent dermatophytosis (CRD) might affect mental health morbidity as well as the quality of life of patients, although it has not been conclusively proven.

AIM: To study the quality of life and mental health burden in patients with CRD as compared to those presenting with first-episode superficial dermatophytic infection (SDI).

METHODS: The study included patients aged over 18 years with CRD or with first-episode SDI. Quality of life was assessed using the Dermatology Life Quality Index (DLQI), mental health morbidity — using the 12-item General Health Questionnaire (GHQ12) and the Hospital Anxiety and Depression Scale (HADS) defined as the HADS-A (anxiety) and the HADS-D (depression).

RESULTS: A total of 166 patients were examined: 104 with CRD and 62 with first-episode SDI. CRD patients had significantly poorer quality of life, especially in the “extremely large score category” as compared with SDI. The DLQI domains of “symptoms and feelings” and “daily activities” were the worst affected (in all cases p< 0.05). In multivariate logistic regression analysis, body surface area involvement and HADS-A emerged as significant predictors of CRD.

CONCLUSION: CRD patients had greater deterioration in mental health (HADS-A) as compared to patients with first-episode superficial dermatophytosis.

BACKGROUND: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition with a globally increasing prevalence. Early detection is crucial for effective intervention, yet current diagnostic methods often result in delays. Emerging research suggests that prenatal biomarkers, including structural anomalies detectable via ultrasound, may offer opportunities for earlier identification.

AIM: To synthesize current evidence on prenatal ultrasound-detectable anomalies associated with ASD and assess their potential as early predictors.

METHODS: A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar for studies published between 2007 and 2025. Keywords included “autism spectrum disorder”, “prenatal ultrasound”, “fetal anomalies”, “preeclampsia”, “neurodevelopment” and “biomarkers”. Priority was given to recent and high-quality studies, including systematic reviews and large cohort analyses. The selected articles were read in full, and their key findings were summarized in a narrative form. The synthesis focused on describing the scope of the existing evidence, the prenatal ultrasound findings reported in relation to ASD, and on highlighting recurrent patterns or notable differences between studies.

RESULTS: Several studies report associations between ASD and prenatal anomalies such as ventriculomegaly, increased biparietal diameter, hyperechogenic kidneys, and congenital heart defects. However, these findings are not specific to ASD and show inconsistent predictive performance. Sensitivity and specificity vary widely across studies, and ethical concerns about overdiagnosis and disparities in access to care persist.

CONCLUSION: Prenatal ultrasound may contribute to early ASD risk identification but lacks the accuracy required for standalone diagnosis. Integrating ultrasound findings with genetic and postnatal data, along with standardized protocols and further research, is essential to improve its predictive value and clinical application.

BACKGROUND: Illness anxiety disorder, also known as hypochondriasis, is characterized by excessive worry about having or developing a serious medical condition and has rarely been associated with delusional disorder.

CASE SERIES PRESENTATION: Two middle-aged patients with illness anxiety disorder gradually developed somatic-type delusional disorder. The first, a 45-year-old woman, had a two-and-a-half-year history of health-related fears involving her throat — an ulcer for six months, a cyst for one year and a tumor for one year. She initially showed improvement with fluoxetine over two months, but after discontinuing the medication for three months, developed a fixed delusion that she had throat cancer, accompanied by aggression and poor self-care. She responded to risperidone within three weeks, though symptoms relapsed after discontinuing the treatment at six months. The second patient, a 45-year-old man with anxious traits and a family history of psychosis, had a five-year history of concerns about having a gastric ulcer and liver failure despite repeated normal medical evaluations. He subsequently developed a delusional conviction of liver failure for three months and showed improvement within two weeks with cariprazine treatment. He remained stable for four months but relapsed after stopping the treatment. Upon restarting cariprazine, he achieved sustained remission for six months.

CONCLUSION: The factors leading to the transition of illness anxiety-related ideas into delusions require further study in the context of poor treatment adherence. It is equally important to distinguish delusional disorder from hypochondriasis, particularly in patients with poor or absent insight.

This article introduces the Bipolar Tensile Model, a neurosemiotic and integrative framework for understanding Autism Spectrum Disorder (ASD). The model reinterprets ASD not as a collection of deficits, but as the outcome of an unresolved tension between two complementary hemispheric cognitive modalities: symbolic-sequential and corporeal-perceptual. In typical development, these modalities are dynamically harmonized through an extended interhemispheric network, comprising the Default Mode Network, major cerebral commissures (corpus callosum, anterior and hippocampal), and the cerebellum.

In ASD, the instability of this mediating system disrupts proprioceptive integration and generates polarized cognitive configurations, such as operational rigidity, sensory disorganization, and repetitive behaviors. Proprioception is understood not as a peripheral sensory channel, but as a semiotic regulator of interhemispheric coherence and embodied self-awareness.

Drawing on a narrative synthesis of clinical, neuropsychological, and neurophysiological literature — and supported by representative clinical cases — the model highlights how interhemispheric disconnection and proprioceptive instability interact to shape atypical developmental patterns. It proposes compensatory adaptation, including local hyperconnectivity and symbolic overcompensation, as central mechanisms in the formation of ASD profiles.

By integrating insights from semiotics, systems neuroscience, and embodied cognition, the Bipolar Tensile Model provides new perspectives on diagnosis, clinical interpretation, and individualized therapeutic approaches, with particular attention to the early identification of proprioceptive dysfunction and the design of integrative rehabilitation protocols.