THE THEMATIC PLAN OF LECTURE EMPLOYMENT PSYCHIATRY AND ADDICTION, RATE FOR 5 TREATMENT AND MEDICAL-PEDAGOGICAL FACULTY. LECTUREâ„– 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.