THE THEMATIC PLAN OF LECTURE EMPLOYMENT PSYCHIATRY AND
ADDICTION, RATE FOR 5 TREATMENT AND MEDICAL-PEDAGOGICAL
FACULTY. LECTURE№ 2
The pathology of thought. The pathology of memory, attention and intelligence.
Syndromes. Mental retardation. Pathology emotional volitional and voluntary activity.
Syndromes of impaired consciousness. The main psychopathological syndromes.
Memory - one of their most important properties of the mind. Any form of mental activity based on memory.
Memory - a reflection of past experience, which consists in remembering, preserving, playing and getting to
know later what was once perceived, experienced or done. Sechenov considered memory, "the main force of
mental
life",
the
"cornerstone
of
mental
development."
Ability to save and later recovery of temporary connections - a necessary physiological basis of memory.
Memory is
associative.
Distinguish
association
by similarity,
contiguity
and
contrast.
Through the formation of associations in the process of obtaining information is memorization, which can be
involuntary in nature. Involuntary memorization promotes a strong sense of (joy, fear, disgust, etc.). This way of
remembering a certain positive value, it was built in memory of the initial period of learning.
The main role in our life and work belongs, however, any form of remembering. The most characteristic feature
of an arbitrary memory, but an act is obligatory presence of the motif, the crucial problem. For any memory used
by mechanical and meaningful ways. Rote in quality inferior to semantic: it is not so firmly, play store, obtained
by a mechanical method, is difficult. By rote people turn to when the material is unclear, or there is no desire to
assimilate. Priority should be given to the method of semantic information into the consciousness. When the
semantic remembering vividly expressed the need for analytical and synthetic material indiscriminately.
The physiological basis of involuntary memory - mainly the formation of temporary connections at first,
arbitrary
at
the
second
signal
system.
The next stage of memory - preserving what people remember is the lock can be short-term and long-term. Shortterm memory - retaining information from several seconds to 1-2 days, long - many months and years.
Mechanical short-term memory is of great significance for the selection of incoming information into the brain of
the ongoing life and work. Storing this information allows for a short time from the received information to
choose
what
should
be
preserved
in
memory
for
a
long
time.
Without this physiological mechanism of selecting long-term memory would always reloaded at the information
that
would
contribute
to
the
rapid
depletion
of
central
nervous
system.
When memorizing leaves the memory of all secondary. Significant is more durable, better maintained and more
time. The fact that the brain is almost always leave marks after the interaction with objects, images and events
around the world, evidenced by the fact that even with the incidental repetition of material already forgotten
easily
restored
in
memory
and
reinforcement
may
persist
throughout
life.
The process of conservation is closely linked with the mindset: the material is systematized, separate the primary
from the secondary, is the analysis and synthesis with conclusions and generalizations.
Playing as the third stage of memory is based on the activation process the traces left in the human brain in the
reflection of reality to them. Reproduced exactly what fits into the human needs of the particular situation. The
rest of mnemonic material remains for the time being "in the storerooms of" our memory. Reproduced what had
been well secured. The ability to play depends on the condition of the body, particularly the mind.
Like memorizing, reproduction distinguish voluntary and involuntary. Involuntary reproduction may contribute
to relatively unimportant fact, bar (lighting, a sound similar situations, etc.). In involuntary playing one of the
busiest accident associations like pulling a chain one way or another associated with her other relationships. Any
reproduction of human life has a fundamental importance. It is mandatory for this particular set of volitional
effort. The ease, speed and accuracy are closely related to several factors: Are the conceptual method of
memorizing, systematically whether the material was whether there were positive feelings, etc.
Memory
impairment.
In various diseases may be suffering from the individual components of memory storage, retention, reproduction.
The most common disorders - gipomneziya (weakening), amnesia (loss) and paramnesia (memory error). In
addition,
it
is
possible
gipermneziya
Increased
ability
to
memorize.
Not always be attributed to gipermneziyu painful memory impairment. Gipermneziya sometimes arbitrarily
created by a teacher or a psychologist for the purpose of optimizing memory in suggestopedicheskogo intensive
training.
Gipomneziya occurs in asthenic conditions arising from fatigue, resulting in serious illness. As the recovery of
memory is restored. In old age, in patients with severe cerebral arteriosclerosis, and degenerative disorders
deteriorate sharply storage and preservation of what is happening in this period. On the contrary, the events of
the
past
stored
in
memory.
Total amnesia (loss of memory of events occurring in any interval of time) is observed in senile psychoses,
severe brain injury, poisoning by carbon monoxide, etc. There are retrograde amnesia when memory is lost to the
events leading up to disease, injury, etc., and antegrade when forgotten what happened after the disease.
By
the
disorders
are
playing
paramnesia
confabulation
and
psevdoreministsentsii.
In the memory spaces are replaced with confabulation of events and facts, which have no place in reality, and
this is in addition to the desire of patients to deceive, mislead. This kind of pathology of memory can occur in
patients with alcoholism during the development of Korsakoff's disease, and patients with senile psychosis with
lesions
of
the
frontal
lobes
of
the
brain.
Gipermneziya observed in patients in a state of manic excitement in manic-depressive psychosis and manic state
in
schizophrenia.
Attention.
A specific focus of mental activity, the consciousness of man to selective perception of objects and phenomena
called
attention.
The physiological basis of attention is the concentration of excitation in certain parts of the cerebral cortex, in
areas of optimal excitability, while the remaining parts of the cortex in a state of inhibition (Pavlov).
Taken to distinguish between voluntary and involuntary attention. About involuntary attention should say that
when the direction and focus of consciousness is not caused by an act of man. The appearance of this kind of
attention playing the role of human habits, compliance with the internal state of the stimulus person, the constant
expectation of something, etc. involuntary attention is based on the absolute orientation reaction, which manifests
itself
in
constant
readiness
to
respond
to
newly
emerging
stimulus.
Any attention is due to an act of a person and knowingly associated with the intended purpose. The physiological
basis of voluntary attention is the concentration of excitation in certain functional systems of the cerebral
hemispheres, corresponding to the most significant events for people of the world.
Among the most important features of the concentration of attention is allocated, or its concentration on a limited
number of objects. The number of these objects determines the amount of attention. Concentration and attention
spans depend on the personality characteristics and the nature of the activity to which attention is directed, and
his object. The disease can reduce the ability to focus on a variety of reasons: because of the weakness of brain
cells, decreased activity, asthenia. It is often observed in some somatic diseases.
Disorders
of
attention.
The weakening of attention is manifested in the lack of attention. The first type of carelessness is a distraction,
determined by the low intensity of attention. This type of inattention and astenizirovannyh age of patients.
The second type of negligence is determined by the high intensity and hard pereklyuchaemostyu
vnutrinapravlennogo attention. This type is observed in persons afflicted with any idea of focusing on their
experiences. In disease states it is typical for people with obsessions and overvalued. The peculiar ability to
switch attention disorder is observed in local lesions organic process of the frontal lobes of the brain. In these
patients, a repeated action which arose as a result of difficulties switching attention to a new action
(perseveration of attention). Observed the opposite case, when the ability to switch attention to pathologically
increased.
This
is
seen
in
manic
patients.
The third type of negligence is not only a very weak intensity of concentration of attention, but even weaker
pereklyuchaemostyu it. This kind of attention changes seen in old age, with cerebral arteriosclerosis under
conditions
of
oxygen
starvation.
Int. When people talk about mental abilities, they often mean by this intelligence. However, this is not
synonymous. Intelligence includes the newly acquired knowledge, experience and ability to further their
retention and use in mental activity. Intellectual qualities of man are determined by the terms of his interests, the
volume of knowledge. Thinking is an active function and improved intelligence under the laws of logic. Such
mental operations as analysis, synthesis, comparison, inference and opinion, are self-categories, but is based on
intellectual capacity, experience and knowledge. Thinking - it is intelligence in action.
The main forms of intelligence are violations of mental retardation and dementia.
Mental retardation - congenital hypoplasia of the intellect, is varying degrees of severity. Distinguished by the
severity
of
debility,
imbecility,
idiocy.
Retardation - mild mental retardation. Individuals suffering from retardation, speech is formed, retained some
ability to learn in special schools, often they have good mechanical memory and the ability to account and the
ability to generalize and abstract lowered. Such persons are passive and are only able to low-skilled manual
labor.
Imbecility - the average degree of underdevelopment of the intellect. I suffer from poor speech imbecility and
tongue-tied. They are practically learning disabilities, with great difficulty, they can learn how to write a few
words and to learn the numbers to ten. The movements of these individuals is very awkward and clumsy. They
can instill skills and self-hygiene, easy to adapt to work under constant supervision and control.
Idiocy - severe mental retardation level. Mind and it is virtually absent in patients, they can not master the skills
of
self-service.
Dementia - dementia. Divided by the total (globular, diffuse) and lacunar (patchy).
Pathology of emotional - volitional and voluntary activity. syndromes. Emotions are one of the
most important aspects of the mental processes that characterize human experience of reality. Man inherited
mechanism of emotions from animal ancestors, and therefore part of his emotions coincides with the emotions of
animal: anger, fear, pleasure, etc. On the basis of simple emotions with the development of the mind and the
higher
human
needs
shaped
complex
human
emotions.
Emotions
and
feelings
have
two
main
functions:
signaling
and
regulatory.
Alarm function - the emotions are caused by situations and signals that precede the direct impacts, which allows
the subject to pre-cooked to these effects. For example, a frown of your opponent may be a signal that the quarrel
is brewing that will cause you to feel resentment. And you can prepare in advance, to calm the situation with a
joke
and
an
unpleasant
feeling
of
resentment
does
not
arise.
Regulatory function - persistent feelings guide our conduct, support him, forced to overcome obstacles, or
conversely, blocking some activity. Regulatory mechanisms of emotions can take an excess of emotional
excitement or contribute to its growth. Sometimes the emotions of reaching extreme strain, transformed into a
"harmless" processes, such as the secretion of tears, the reduction of mimic facial muscles, ie, in mourning. 15
minutes
of
crying
is
enough
to
relieve
any
excess
emotional
stress.
Emotions can be divided into: 1) emotional reactions, and 2) emotional states, and 3) emotional relationships.
Emotional reactions are characterized by a clear communication of emerging experiences with external
circumstances, their cause. There are suddenly emerging, rapid and short-term emotional reactions - affects. In
the heat of passion tapering mind control: the subcortical centers are exempt from the regulatory influence of the
cortex and the man of passion poorly aware (or unaware) that he does. To affect people tend to unbalanced
excitation and inhibition, but was subject to more relaxed people, if they formed a critical situation.
In human life are important emotional states that are able to smooth over a period of time all the psychic activity
of
man.
Among
emotional
states
can
be
identified:
1. Moods, which differ in varying degrees of severity, varying duration of different awareness. The mood is
always a reason, although it is not always understood. A positive, upbeat mood can activate a person bad - to
suppress
its
activity.
2. Another common emotional state - stress. It is a term used to describe the human condition that arises in
response to extreme effects: in a situation of risk and danger, if necessary, immediately make a responsible
decision, with a sharp change in the situation to which we must adapt. Originating in physiology to describe nonspecific reactions of the body - the general adaptation syndrome in response to any adverse effects ..
3. Emotional relationships characterized by emotional selectivity, ie, link certain emotions with certain persons
or objects. These include: affection, love, passion - on the one hand, and hostility, enmity, hatred - on the other.
Respect and loyalty, trust and distrust, disdain and contempt - all kinds of emotional relationships, which we
usually call emotions. The dynamics of human emotions and feelings, their content is the property of the
individual is characterized as emotional. It is associated with the pivotal features of the individual, his moral
capacity, oriented motivational sphere, value orientations, etc. Emotionality, along with an activity is an
important
part
of
temperament.
In the emotional reactions people have always involved the cortex of the brain, in which there is a higher
representation, purely human, emotions. The cerebral cortex can largely suppress the hypothalamic activity by
controlling
the
way
a
manifestation
of
emotional
reactions.
In the psychiatric clinic in the description of pathology of emotions often resort to the term "affectivity". It
includes
the
concept
of
emotions,
feelings,
affects,
moods.
Pathological aberration - a condition that occurs inappropriately force stimulus, motive, followed by a dimming
of consciousness on the type of twilight state with subsequent amnesia. In this condition, patients may be
dangerous to themselves or others. Can occur in individuals with organic brain damage, the psychopaths.
Affective (emotional) syndromes - psychopathological states in the form of persistent mood changes, often
manifested
its
decrease
(depression)
or
increase
(mania).
Depression and mania - the most common mental disorders. In terms of frequency in the clinic they take a big
place and psychiatry I are very frequent in the borderline mental diseases. Affective syndromes are constantly
encountered in the opening of mental illness, may be paramount throughout the disease, complication - to coexist
with other psychopathological disorders. In the reverse development of the disease depression and mania often
disappear
last.
Euphoria - improving the mood with a touch of contentment and satisfaction. This is not characteristic of the
acceleration rate of thinking or the desire for increased activity. The patient sees everything around him in the
"pink", self-righteous. Short-term euphoria resulted from consumption of alcohol and drugs. A state of euphoria
seen in patients with progressive paralysis, syphilis of the brain, CDS, organic brain disease, tumors.
Ecstasy - the highest level of enthusiasm, often observed in epileptic psychosis. Considered a characteristic
symptom
of
emotional
expansive
forms
of
PP.
Mania - a combination of: 1. elevated mood; 2. accelerating the rate of mental activity; 3. excessive motor
activity.
Negative
emotions:
1.
dysthymia
low
mood;
2. depressive symptoms - the essence of depression is the predominance of negative emotions (sadness, grief,
depression, anxiety), which determine the basic emotional background mood patients. Depressive syndrome is a
triad of symptoms:
- Depressed mood; - Reduction of psychic (mental activity);
- Inhibition of movement. Depressive symptoms vary depending on the severity of depression - from mild to
severe depression gipotimii with suicide attempts. In depressive states clearly supports a close relationship and
unity of psychic and somatic factors. In depressive states observed in insomnia, headaches, intestinal disorders
(constipation), abdominal cramps in the internal organs, disorders of peripheral circulation (cold extremities
cyanotic), increased heart rate, blood pressure swings upward, dry skin, weight loss, women with depression are
terminated
monthly.
With the deepening depression, mood depressed, patients complain of sadness, that "soul squeezed, aching,
burning, tearing to pieces." Marked motor and speech retardation. Against this background, there may be
delusions. In some cases, this depressive delusions of self-abasement and self-blame, and in other cases - or
hypochondriacal delusions of persecution, poisoning, or other depression encountered, especially in patients with
mature-aged and elderly, for which there is not merely the absence of ideomotor inhibition, but also a long-term
stimulation Speech . In these cases, depressive affect is complicated by anxiety. Such depressions are called
agitated
or
anxious
and
agitated.
Depending on the prevalence of certain disorders produce different types of depression: 1. adynamic; 2.
neurotic;3. anankasticheskaya; 4. tearful; 5. Hidden 6. senestopaticheskaya; 7. soft (matte); 8. nihilistic delusion
with depression; 9. depressive-paranoid. Syndrome Kotara - paraphrenic melancholy, melancholic delirium of
imagination, megalo-melancholic delirium - a combination of anxiety and agitated depression with
hypochondriacal
depressive
delusions.
Other emotional disorders: 1. apathy; 2. emotional inadequacy; 3. ambivalence; 4. emotional slabodushie; 5.
emotional dullness. Apathy - a state of emotional indifference, stupidity. Patients are indifferent to everything, to
a close. Apathy is combined with a complete inactivity of the patient, indifference to physical appearance.
Apathy - a characteristic symptom of schizophrenia, but can occur as a temporary condition in acute head
trauma,
with
brain
tumors,
brain
atrophic
process
(Pick's
disease,
Alzheimer's).
Emotional inadequacy - an outpouring of not conforming to the actual situation in which the patient. The most
characteristic of schizophrenia. Ambivalence - a state in which it is possible the simultaneous expression of
opposite feelings. Emotional slabodushie - a symptom of emotional weakness, exhaustion, patients are moved
easily, cry. This symptom is observed in vascular, organic, infectious brain lesions.
- Anxiety - a feeling of great excitement, anxiety, often without an external cause, unexplained anxiety for his
welfare,
the
welfare
of
their
loved
ones;
- Fear - display a sense of tension and expectation-threatening events. Sometimes the fear is associated with a
particular
situation
that
threatens
the
well-being.
Pathology
of
the
will
and
desires.
The attraction is phylogenetically older function than will. They are based on instinctive activity. Individual
ability to consciously purposeful mental activity is called the will. Volitional qualities peculiar to man. In the
implementation of volitional function is dominated consciousness, thought and intelligence, who participated in
the
preparation
and
execution
of
volitional
passions.
Pathology
will
have
the
mentally
ill
is
reduced
to
three
basic
options:
1.
decrease
in
volitional
activity
gipobuliya,
Abul;
2.
increasing
volitional
activity
giperbuliya;
3.
perversion
of
the
will
parabuliya.
Lowering
the
volitional
activity
occurs
in
various
diseases,
especially
schizophrenia.
As noted, the desire arise and are formed on the basis of instincts. However, the attraction - a broader concept
that includes not only certain forms of conduct, but also means the experience of certain biological needs. Thus,
the attraction - a condition or seek to avoid inciting the vital situations in which it would be able to resolve the
instinctive
movement.
Violations of the drives in psychiatric practice are common, their manifestations are diverse. Most often have to
deal with violations of food craving. The suppression of this desire, accompanied by persistent lack of appetite,
refusal of food intake, which can lead to extreme exhaustion patient is called anorexia. Persistent refusal of food
may be associated with delusions of poisoning or the belief that food is made from non-edible products. Refusal
to eat is often observed in states of depression, various forms of stupor, hysteria. It should be borne in mind that
in some cases, anorexia is a protective physiological mechanism by which the body adapts to disease and
overcome it. Is based on this method of fasting, the currently used in psychiatric practice.
Strengthening the desire for food (bulimia), the absence of saturation (acorea) and mnogoedenie (polyphagia) are
found
in
progressive
paralysis,
idiocy,
senile
psychoses
and
neuroses
sometimes.
Perversion of desire for food is often observed in pregnant women (need to eat chalk, salt, etc.), sometimes
comes
with
schizophrenia
to
eating
feces
(coprophagy).
Fear takes the form of pathological desire for self-preservation. This is a profound experience of the vital,
absolutely meaningless, usually no reasoned and extreme intensity. Manifestation of his varied in a stupor,
torpor,
restlessness
or
stormy.
Suicidal impulse (suitsidomaniya) is usually associated with mental illness, sometimes very short (a paroxysm of
grief, pathological affect). Mentally ill often displaying great ingenuity and perseverance in carrying out their
suicidal intent in a very vigilant monitoring. Weakening desire for self-preservation is also expressed in a number
of mentally ill indifference to a dangerous situation. Close to the impulse to take his own life is attracted to selfmutilation, are often impulsively and in the most radical form. Patients emasculate or castrate themselves, and to
rescue his eyeballs, and language. Often this is associated with delusional and hallucinatory experiences, as well
as
states
stupefaction.
It should also be noted frequent, especially in the clinic of epilepsy, paroxysmal episodes of dysphoria with
aggressive
behavior
in
the
form
of
an
inadequate
response
fury.
Thus, isolated disturbances of drives: 1. weakening of the food instinct; 2. strengthening food instinct; 3.
lowering of the sexual instinct; 4. perversion of instincts; 5. impulsive desire: pyromania, kleptomania,
dromomaniya;
posiomania.
Pathology
of
motor
areas.
In Psychopathology and gipobuliya abulia occupy an important place, because find expression in the stuporous
state. The most widespread is catatonic stupor, that manifests itself in immobility or slowing the rate of
movement (substupor), catalepsy or waxy flexibility (maintenance patients attached to it postures), mutism
(silence), the air bag syndrome. Distortion of volitional activity seen in negativism, which can be both active and
passive. Perhaps the proboscis syndrome, fetal position. Sometimes catatonic stupor may be interrupted by bouts
of catatonic excitement: stereotyped, meaningless movements or impulsive motor acts (gain volitional activity the desire for movement, action, impulsive behavior). However, catatonic excitement can not be considered an
increase volitional activity, as the motor acts of catatonic excitement are not the appropriate activity. They should
be
seen
as
a
consequence
parabulii.
Catatonic excitement - the stereotypical pretentious and meaningless movements, hallucinatory-delusional
experiences. It is thought disorders: symbolism, paralogika, delays, broken character. There have echolalia,
verbegeratsiya. Maybe dumb (silent) motor agitation, impulsive actions, sudden anger, rage, fury, which are
"psevdoaffektivnye reaction" - the result counterinhibition unconditioned reflex activity. Maybe hebephrenia
excitement: foolishly, grimacing, manernichanie, clowning, senseless laughter, silent mere affectation. The
development of catatonic excitement there is a sequence: the pathetic, catatonia-hebephrenia, impulsive, silent.
And finally, hebephrenic (hebephrenia) syndrome, which is often associated with catatonic excitement.
Characterized by mannerism, foolishly, empty fun be infected. Patients grimace, pull a face, go artsy step, copy
the gestures and movements of others. It is inconsistent, sometimes without meaning to rhyme words.
THE MAIN PSYCHOPATHOLOGICAL SYNDROMES.
Syndromes of mental disorders. In the study of individual psychopathology is noteworthy that they occur in the
clinic disease is not isolated, but in certain typical combinations. Symptom - a separate sign of mental illness, and
symptoms - symptom, combined single mechanism for the development, pathogenesis. Syndromes express
varying degrees of mental disorder and is characterized by a separate stage of the disease, have their own
characteristics. As in any section of clinical medicine, psychiatry can be simple or complex, large and small,
specific and nonspecific, typical and atypical, functional and organic, positive and negative, neurotic and
psychotic. For the general practitioner should be able to identify the leading psychopathological syndrome for
competent performances Allative, prior, syndromic diagnosis, based on the structure of the mental status of the
patient.
Syndromes
can
be
positive
or
negative,
neurotic
and
psychotic.
The positive include abnormal formation of productive ("plus" syndrome), introduced into the state of the
organism
painful
process.
Negative syndromes ("minus"-syndrome, deficient disorder) - maloobratimye, trudnokurabelnye, without
absolute specificity nosological violation of a temporary or persistent depletion of mental activity.
Negative disturbances depend on the severity and progression of positive symptoms at the same time modifying
and
simplifying
the
structure
of
the
positive
syndrome.
In
the
group
of
syndromes
neurotic
level
include:
1. asthenic (neurasthenic) syndrome - a condition of irritable weakness, irritability and exhaustion;
2. obsessive-compulsive syndrome - a combination of obsessive thoughts, doubts, fears, fears, desires, actions
against
the
rigidity
of
mental
activity,
thoroughness
of
thinking,
depressed
mood;
3. hypochondriac or senestopaticheski-hypochondriasis - overvalued related to the condition of his health,
combined
with
the
haunting
fears
of
possible
severe
illness;
4. hysterical state - expressed in the rapid ostentatious external display of emotional response to the situation
(hysterics, psychomotor agitation, etc.) along with the possible different functional, vegetative, motor-sensory
impairments: paresis, paralysis, astasia-abasia, blepharospasm, mutism, stuttering, hiccupping, aphonia,
blindness, deafness, hysterical "lump in the throat", anorexia, flatulence, vaginismus, impotence, etc.;
5. psychopathic syndrome - a violation of mental activity, an individual's behavior in connection with
disharmony, disproportion reaction force of impact and irritation, which results in maladjustment of the
individual
in
society.
Neurotic disorder level, ie absence of mental symptoms and the most peculiar anosognosia different types of
neuroses - neurasthenia psychasthenic, hypochondriacal, hysterical. However, there may be and in many other
diseases
..
1. Asthenic syndrome - a condition of fatigue, irritability, unstable moods, combined with vegetative symptoms
and
sleep
disturbances.
Fatigue at fatigue leads to reduced productivity at work, intolerant of previous loads. Attention is concentrated
ill, reducing the number of submissions, hampered their verbal expression, a feeling of forgetfulness, poor
intelligence. No short rest, no willpower does not increase productivity. A sense of their own inadequacy and
emotional stress. Varies the mood, more to the downside, the pessimistic assessment. This is accompanied by
autonomic disorders: fluctuation of blood pressure, heart rate lability, tachycardia, chills or hot flashes,
discomfort
in
the
internal
organs,
dyspepsia.
Fatigue - the most common and the most common mental disorder. It can be found for any mental and physical
illness, it is often combined with other neurotic syndromes. Asthenia must be differentiated from depression,
sometimes
referred
to
as
asthenic-depressive
syndrome.
2. Obsessive-compulsive syndrome - obsessive syndrome - a psychopathological state dominated by the
phenomena obsessions. Obsessive Syndrome is often accompanied by subdepressivnye mood, fatigue,
vegetative-vascular disorders. Compulsion may be limited to some one species (monofobiya, the phenomenon of
mental
chewing
gum,
etc.)
or
a
combination
of
various
forms
of
obsessions.
Obsessional syndrome usually determines the clinical picture of obsessive-compulsive neurosis, psychopathy is
at psychasthenic circle, with the depressed state of neurotic level. Obsessional syndrome occurs in schizophrenia
and
clinical
maloprogredientnoy
within
psychoorganic
disorders.
3. Hypochondriacal state - characterized by unrealistic or exaggerated interpretation of physical signs and
sensations, that is overvalued related to the condition of his health, concern about the possibility of contracting
severe physical illness. The degree of belief in the presence of physical illness can vary from overvalued to
delusional conviction. Other major structural component of the syndrome are senestopatii.
The
following
types
of
hypochondriacal
symptoms:
"Hypochondria health" - personality traits of persons "living interests of the body";
"Senestoipohondriya"
with
a
predominance
of
senestopaty;
"Ideoipohondriya" - dominated the intellectual processing of hypochondriacal complaints;
"Hysterical hypochondria" - a pathological fixation, "conventionally profitable" disease care, dramatized Easter
hypochondriacal
complaints;
obsessive
hypochondria
an
alarming
hypochondria,
obsessive
fears
of
contracting;
hypochondriac depression - overvalued or delusional hypochondriacal ideas on the background of depressive
affect;
hypochondriacal personality - personality traits with a tendency toward rigidity, masochistic tendencies,
egocentrism;
paranoiac hypochondria - a strong belief in an incurable disease with a system of evidence - this is the level of
psychotic
disorders,
and
all
subsequent
forms
of
hypochondriacal
symptoms:
delusional hypochondria - abundant senestopatii senestopatichesky or automaticity with delusions of influence,
corruption,
witchcraft,
possession;
paraphrenic hypochondriac - in the structure of the syndrome Kotara or hypochondriacal delusions
parafrenicheskih
experiences;
hypochondriacal psychosis monosimpatichesky - Ekboma syndrome - dermatozoyny delirium, tactile
hallucinations,
paratsitofobiya.
4. Hysterical state - isteronevrotichesky syndrome, which outlined the sequence of symptoms of autonomic,
affective sensorimotor to ideatornoy. Characteristic of hysterical seizures, hyperkinesis, tremor, sensory
disturbances, disruption of the senses, speech, pronounced mood swings. Hysterical manifestations of
psychogenic caused, are functional and reflect the reversible nature of the specific mechanisms of hysterical
personality responses: the desire to attract attention, the state of "conditional pleasantness, desirability," a
symptom of mechanisms "flight into illness" to help you find a "solution" of a difficult situation.
Affective disorders are characterized by lability of emotions, a tendency to violent emotional reactions.
Intellectual activity takes on the features of emotional logic, demonstrative behavior. When the trauma of
continuing
a
transition
to
a
hysterical
neurotic
development.
5. Psychopathic syndrome - psihopatizatsii personality - a process by which the form psychopathic condition that
can occur at any age due to severe or prolonged stress, severe mental, physical illness and cranial trauma.
Disharmony of personality traits in these cases is secondary psychopathy without intrinsic dynamics
(compensation, decompensation, development, etc.) and depends in its manifestations of the underlying disease.
The
group
of
psychotic
syndromes
level
include:
I.
Affective
(emotional)
syndromes:
1. depressive syndrome - a triad in the structure of symptoms and required an additional: depressed mood
(gipotimiya), slow thinking, motor retardation, sometimes in combination with delusions of self-blame, selfdeprecation;
2. mania - is characterized by a joyful mood (hyperthymia), accelerated thinking, physical activity, with a thirst
for
action
and
sometimes
with
delusions
of
grandeur;
3. dysphoric syndrome - characterized by a melancholy mood, angry with a tendency toward aggression.
II.
Hallucinatory-delusional
syndrome:
1. hallucinosis - is characterized by massive true or false, hallucinations, delusional interpretation of the low, not
accompanied
by
disturbances
of
consciousness
(verbal,
visual,
tactile);
2. paranoiac syndrome - limited to primary, systematic, monothematic delusions combined with thoroughness of
thinking;
3. paranoid syndrome - is made up of multidisciplinary delirium, sometimes in combination with hallucinations;
4. hallucinatory-paranoid syndrome (syndrome Kandinsky Clerambault) is a set of delusions or mental or
physical
coercion,
delusions
of
various
other
subjects,
pseudohallucinations,
and
III.
Complex
motor-volitional
disorders:
1. catatonic excitement - is characterized by stereotyped, impulsivity, inexpedient, pretentiousness movements in
combination with inkogerentsiey thought echo-symptoms (echolalia, echomotism) and negativism;
2. catatonic stupor - combines in its structure symptoms of partial or complete immobility, negativism, catalepsy,
mutism, refusal to eat, raunch feces and urine, due to muscular hypertonicity may elaborate special postures
(embryonic, guard dogs), symptoms of "proboscis", "Air pillow, "" hood ", etc.;
IV.
Syndromes
of
impaired
consciousness:
1.
Syndromes
Shutdown
of
consciousness
(not
related
to
psychotic
syndromes):
- Stunning - characterized by increasing the sensitivity and perception, inhibition of all kinds of mental
processes, but with the ability to mobilize mental activity with external stimulation;
- Sopor - more profound disturbance of consciousness with complete loss of comprehension of the situation and
orientation,
followed
by
amnesia;
- Coma - even more profound disturbance of consciousness with loss of all types of orientation, the conditioned
and unconditioned reflex reactions to any external stimulation and dysfunction of internal organs.
2.
Syndromes
of
confusion:
- Delirium - a syndrome characterized by the structure of an illusory perception of,, visual, real, frightening
hallucinations stsenopodobnye, there may be verbal and tactile hallucinatory experiences, combined with
figurative sense delusions (often of persecution), psychomotor agitation, intense emotion of fear, dissociation of
thinking, disorientation in place time and partial amnesia of the real events of the output from the state (and
possible
mussitiruyuschy
professional
delirium);
- Oneiric - is characterized by the influx of fantastic grezopodobnyh representations pseudohallucinations twilight of consciousness disorder - paroxysmally comes with a deep disorientation in time, place, self, bright,
colorful, true hallucinations, delusions sensual, intense emotion of anger and sadness and a tendency to
aggressive actions , followed by complete delayed amnesia (option in an orderly and disorderly conduct);
V.
Syndromes
of
impaired
memory
and
intelligence:
1. Korsakoff amnestic syndrome - has in its structure fixation amnesia retro-and anterograde amnesia,
confabulation
and
psevdoreministsentsii,
disorientation
in
time
and
place;
2. psychoorganic syndrome - characterized by a triad of Walter Byuelya: memory loss, weakening of the
intellect, passion incontinence; 3. dementia (dementia) - persistent, maloobratimoe depletion of mental activity,
its
simplification
and
decline,
and
total
release
lacunary
dementia;
In the group of negative disorders distinguished: 1. personality changes; 2. asthenic syndrome;
3. apatiko-abulichesky syndrome (falling energy potential, reducing the individual, the individual regression); 4.
amnestic
syndrome
Korsakov;
5.
total
dementia;
Negative mental disorders, as well as positive, reflect: 1. existing at that time the level of disturbances of mental
activity that gives an indication of the severity of mental illness; 2. nosology of disease; 3. trend of development,
therefore,
established
prognosis
as
a
result
of
dynamic
monitoring
and
research.
CLASSIFICATION OF MENTAL ILLNESS. Single, universally accepted classification of mental illness does
not exist. Devised by the World Health Organization International Classification of Diseases (currently 10
revision) is modified and adapted to the existing national classification. Classification of mental illnesses. I.
Endogenous mental illness: 1. schizophrenia. 2. manic-depressive psychosis. 3. functional psychoses of old age
(involutional psychosis). II. Endogenous organic disease: 1. epilepsy. 2. atrophic processes in the brain: - Senile
dementia; - Alzheimer's disease; - Pick's disease - Parkinson's disease; - Gentingyuna chorea. 3. organic
hereditary disease. III. Exogenous-organic diseases: 1. disease of the brain; 2. mental disorders in traumatic brain
injury; 3. mental disorders in brain tumors; 4. mental disorders in infectious and organic diseases of the brain: Encephalitis; - Syphilis of the brain, paralysis; - Brain abscesses. - Acute psychosis - hallucinosis. IV. Exogenous
mental disorders: 1. Symptomatic psychoses: - In somatic non-communicable diseases; - With somatic
infections; - With intoxication. 2. Substance Abuse: - Alcoholism - non-alcoholic substance abuse - drug
addiction. 3. Psychogenic illness: - Neurosis - reactive psychoses. 4. The pathology of mental development: Psychopathology - mental retardation.