From Kid to K-9: A Case of Benzodiazepine Withdrawal-Induced Zoopsic Intermetamorphosis (2649)
Bibliographic record
Abstract
Objective: NA Background: Intermetamorphosis is a type of misidentification syndrome characterized by the belief that an individual has been transformed into another ( Pryse-Phillips, 2003 ). Zoopsic intermetamorphosis can be considered to occur when the illusion of an individual is transformed into an animal. Few hallucinations have been identified following withdrawal from benzodiazepines ( Seens & Hirsch, 2018 ), but zoopsic intermetamorphosis has yet to be described. Design/Methods: Case Report: A 39-year-old right-handed male began experiencing visual hallucinations of his son three days following discontinuation of 4 mg per day of alprazolam. The patient entered his bathroom with the belief that his son was taking a bath, which was confirmed with a hallucination of the six-year-old; however, as the patient reached his son, the boy transformed into a dog and began wagging his tail. Results: Abnormalities in Neurological Examination: Cranial nerves IX and X: uvula deviated to the left. Motor: drift test with right abductor digiti minimi sign. Cerebellar: finger-to-nose dysmetria bilaterally. Low amplitude, high frequency tremor on extension (upper extremities). Reflexes: 0 branchioradialis, 1+ biceps, 0 triceps, 0 quadriceps femoris, 1+ right ankle jerk, and 0 left ankle jerk. Beck’s Depression Inventory Type II: 27 (definite depression). Beck’s Anxiety Inventory: 27 (severe). Conclusions: The mechanism for benzodiazepine withdrawal-induced metamorphosis is unknown. Possibly benzodiazepine withdrawal leads to a reduction in gamma-aminobutyric acid with associated disinhibition phenomenon and thus positive symptoms occur. While metamorphosis has been described with occipital/occipitotemporal lobe lesions ( Pryse-Phillips, 2003 ), no such pathology was noted in this patient. In those who undergo benzodiazepine withdrawal, query as to metamorphosis is warranted. Alternatively, in those presenting with metamorphosis, investigation into benzodiazepine use may be revealing. Disclosure: Dr. Seens has nothing to disclose. Dr. Hirsch has nothing to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".