Category: Uncategorized Page 1 of 4

Asthenic Syndrome

The name of this syndrome comes from the Greek word astheneia — that is, “powerlessness, weakness”. Perhaps, this is the most common syndrome in psychiatry, and it does not matter-whether it is a psychosis, neuroses or other mental disorders. In fact, it is also one of the most simple syndromes in psychiatry (of course, from the point of view of understanding) and reflects mainly quantitative rather than qualitative changes in the psyche. Do not forget that we are talking about positive, or productive, symptoms. Differences from it asthenic syndrome, which is negative, or deficient, I will explain when it is his turn to describe.

What is asthenic syndrome in its essence, it is easy to understand if we consider the human psyche as an open thermodynamic system. Anticipating the mass immersion of readers in a trance or catatonic stupor from the abundance of terminology, I venture to resort to a simple example. There’s a leaky bucket. It’s mental. It is constantly pouring water. This is a replenishing stock of mental forces (to the limit conditionally, but the essence reflects). The flowing water is the sum of psychic forces that are expended: on study, work, relationships with others, love, hostility, worries about trifles and concern for the vital-in short, all our mental activity.

If the water supply is sufficient, and the flow rate is small, then an equilibrium is established, which can be considered the norm. If the supply of water is running out (the inflow is small or the flow increased) – there is a depletion of mental activity, which is manifested by asthenic syndrome. Accordingly, and approaches to treatment, at least, two: to plug a hole or to make a pressure more.

The reasons leading to mental exhaustion, quite a lot. These are psychoses and neuroses, which draw a lot of energy, and intense mental activity, and violent emotions, and even about the everyday small mischief of life and can not speak — they sometimes pull away forces in small things faster than a flock of piranhas. In addition, we should not forget the factors that can weaken the body as a whole or the brain in particular: injuries, infections, intoxication, long chronic diseases, starvation and lack of sleep.

In total, it is customary to consider two variants of asthenic syndrome: hyperesthetic and hyposthetic.

Hyperesthetic variant (from lat. hyper-and Greek. Genesis-a sense of, sense of, camping on E. literally “heightened sensitivity”). Remember the expression “kindness is the privilege of the strong”? It well illustrates the essence of this option. Exhaustion, weakness here are manifested in the fact that a person does not have the strength to restrain himself, to keep himself in hand.

A person flashes like a match, easily, with a half-turn, from what seems to most a trifle, not worth attention: not so said, not so looked, NOT so SILENT… However, the flash also quickly exhausts itself — the fuel is at the bottom. Emotions are also at odds, they are labile, like the gait of a drunken sailor, their change is easy and unpredictable. It is just as easy to bring tears to the eyes, it is necessary to flash a little bit of a sentimental episode on the screen, an exciting topic in memories or a sentimental scene in a book: weakness — nothing can be done. Most of the time such people go gloomy and dissatisfied with something, the rest of it is used to search for the causes of discontent and gloomy appearance. As a rule, find. Capricious: after all on the, to truly want and be able (Ah okay-okay, simply want),, too, need forces. Hence the variability of appetite, whims in the menu (I want this today, but I can not stand it anymore), other fads. As a rule, with libido and potency, too, there are problems: excited-exhausted-extinguished.

Such patients do not tolerate everything bright and sharp: colors, smells, taste sensations; from a sharp sound they shudder, jump on the spot or give a source of sound to the neck (here as lucky). They do not tolerate waiting and monotonous work-both require patience, and it is catastrophically small.

Attention is also affected, since the strength of the need and it. Distraction, distraction increases, it becomes more difficult to concentrate, to focus on anything. Because of this, the ability to both remember something and quickly remember something is reduced, while such patients often complain of “leaky memory”, although in this case, memory problems are just reversible-it is only necessary to replenish the reserve of forces properly. Violation of attention and memory entails difficulty in solving domestic and social issues. Increasingly, these decisions become stereotypical and shallow (do not forget-creativity and originality need strength), more and more time is required to make decisions themselves, I want to quickly dump everything from myself, and relax, and not to pull!

Like the masses, deprived of ideological leadership, a bright goal and a guaranteed better future, the autonomic nervous system is peddling [25]. There is a complete set of unforgettable sensations: headaches, and sweating, and pale cold hands, and surprises from the heart, which then freezes, then starts to gallop, and then pinches, as if already quite-quite a heart attack — – only an electrocardiogram like an athlete, and the ambulance wearily curses … Sleep, too, to hell-frequent awakenings, dreams of every day-household painful rubbish, and even completely overcomes insomnia. And if previously such a person was sensitive only to the direct hit of lightning or, alternatively, the demolition of a hurricane, now begins to feel so subtle nuances of the weather that they can quite successfully bet on it.

Here in the foreground is not flash and explosive, but complete powerlessness-both physical and mental, emptiness, exhaustion, lethargy, the feeling that all the arable land of the vast homeland plowed personally and that the forces are not just there: THEY will NEVER BE. Hence the General pessimism and zero, if not negative, performance. Sleep is of no use, no pleasure, only a heavy and broken head, like a hangover.

Asthenic syndrome can be combined with a number of other syndromes (manic does not count), in this case they are called, based on the combination: asthenic-subdepressive, asthenic-depressive, asthenic-hypochondriac, asthenic-phobic and other terrible words.

Syndromes. Entry

If the picture of the disease had to be divided into levels of complexity, I would prefer three main gradations: symptoms-syndromes-the actual disease in its entirety. Moreover, the disease should include not only a set of symptoms and syndromes characteristic of each particular nosology, but also reflect the dynamics of these symptoms and syndromes: what was, what will be, than the heart will calm down — and you can no longer go to the fortune-teller.

So, syndromes are the next (after symptoms) step to understanding what happened to the patient. Syndrome (from Greek. syndrome, a cluster, confluence) is not just a set of symptoms. There is no arbitrary combination of them, simply because the card is so laid. Pathogenesis with the layout is not joking, then cry “stick to the soap!” no way. All symptoms are combined in strict accordance with what kind of disease, and what stage we are now seeing. And if the diagnosis was made correctly — and at all it is possible to make cautious predictions.

Of course, the syndrome is not a disease, and to complete the clinical picture often need a lot: from properly collected history (born-baptized-married-what’s amiss) to analyses and abusive-rave reviews specialists. However, the correct recognition of the syndrome can help determine the tactics of further management of the patient (delirium, oneiroid and catatonic syndrome — in the hospital, asthenic-can be treated on an outpatient basis), with prescriptions of drugs (Yes, already at this stage). What can I say — the international classification of diseases 10th revision, aka ICD-10, is mainly based on syndromic approach to classification. And again, knowing the syndromes, we can easily identify a simulant that demonstrates some symptoms, but can not show the whole picture of the disease (there are, of course, the master in this case, but such units).

There is one more subtlety of medical practice: each syndrome it is necessary though time in life to see in the presence of a teacher who will tell you: “Watch and remember, it’s paraphrenic syndrome, and this syndrome Kandinsky — clerambault, it’s the asthenic syndrome of the neurotic, and the depletion of mental activity of a schizophrenic, I feel the difference in each pair and look for patients, is something that words cannot Express or describe it so that you can avoid misunderstandings and double interpretation“. That’s why there is no correspondence study at the doctor. Only personally, internally, through the stage of joyful recognition — “that’s it, I was taught this!” – to the shining peaks of intuition and infallible medical guess (this is almost the same as the military savvy — allows one fleeting glance at the grenade flew into the trench to determine that in fact it mimicked the Northern fur-bearing beast).

All psychopathological syndromes can be divided into positive and negative.

Positive psychopathological syndromes (they are “plus-symptoms”) are new, previously absent in the psyche syndromes, which normally should not be. In other words, it was not — there was add on (however, the pros and positivism come to an end).

Recognizing a certain conventionality of disposition, by the degree of increasing complexity, severity and totality of manifestations, as well as by the degree of disturbance of mental activity and as reversibility decreases, positive syndromes could be arranged in the following order:

  • Asthenic syndromes (positive);
  • Affective symptoms;
  • Neurotic syndromes;
  • Hebeny syndrome;
  • Syndromes of overvalued ideas;
  • Hallucinatory-delusional syndromes;
  • Lucene catatonic syndromes;
  • Syndromes of impaired consciousness;
  • Convulsive disorders;
  • Psychoorganic syndrome (aka organic psychosyndrome — Faberge, self-portrait, fragment, different camera angles).

Negative psychopathological syndromes (they are deficit syndromes, they are “minus symptoms”) are characterized by the fact that from mental activity (such as it should be normal) with the inherent set of qualities and properties of a normal person something of these falls, is lost. Accordingly, damage is caused to mental activity and a personality defect is formed.

According to the degree of increase of negative syndromes can be arranged as follows:

  • Asthenic syndrome (as negative);
  • Change of the subjective “I” (or subjectively perceived change “I”),
  • Objective personality changes;
  • The disharmony of the individual;
  • Reduction of energy potential (REP);
  • A decrease in the level of the individual;
  • The regression of the individual;
  • Amnestic disorder;
  • Total dementia;
  • Mental insanity.

Now we can proceed to a more or less thoughtful consideration of each group of syndromes.

Pathology of the Motor Sphere

Submitted to oppression, and strengthening the perversion of physical activity.

Inhibition of motor activity

Hypomimiawhen facial movements are scarce and inexpressive, the amim — they are entirely absent, the face more like a mask.

Hypokinesia (movement inhibition, stupor) — slowing of voluntary movements, and a reduction in their volume and amplitude. Complete immobility is akinesia.

Found depressed hypokinesia where there is a slowdown and an overall reduction in the number of voluntary movements, accompanied by poor-poor depressed facial expressions (the man frozen in grief and had made great efforts already to just move, not to mention other things); manic hypokinesia (usually short, replaced by maniacal excitement): a man so overcome overwhelm his senses that froze in ecstasy, and only the richest facial expression conveys how he is now well. There is also a hallucinatory hypokinesia, especially if hallucinations peremptory or threatening (or both) — the patient stiffens, listening and dreading (“the COMMAND was SIT!!!”); and crazy hypokinesia, usually accompanying delusions of exposure, facial expressions of anxiety and fear (“Ah, THEY began again for me!”).

Mutism (remember the mute button on the TV remote?)- this is when a person can not speak spontaneously or answer a question, despite the fact that he understands speech, as well as in PRINCIPLE able to speak.

Enhancing locomotion

It is represented by obsessive, compulsive and impulsive actions, as well as various variants of hyperkinesia and convulsions.

Obsessive actions are implemented obsessive desire, often having the character of ritual action (say Hello, washed my hands, stepped across the threshold three times touched the jamb).

Compulsive actions are implemented compulsive desire (the same campaign for a beer in a stall on the second stage of alcoholism or dose to the patient puchero issued with heroin addiction). There is no longer a struggle of motives, but the goal is still present.

Impulsive action is action sudden, without a motive, without a target, without much colouring emotions: only that all was quiet, and suddenly the man seemed to explode from the inside like got invisible push and here it already where-that rushed, something ruined, aggressiveness and a tendency to fracture under impulsive action occurs very, very often.

Violent actions are movements and actions that arise by themselves, without any motives, involuntarily, but are perceived by the patient as alien to him, interfering and superfluous, while the consciousness remains clear (ridiculous movements of hands, feet, head, violent cry, crying, laughing, etc.).

The hyperkinesis is, increased physical activity, up to initiation with a loss of focus and expediency motions.

Distinguish euphoric (manic) the hyperkinesis, when revival movements happening against the backdrop of mania (“Oh, del bunch, Oh, I ran”), euphoria; anxiety-depressive hyperkinesis (agitation) that occurs at the height of anxiety and depressive affect and manifested unfocused restlessness (“Oh, now that would be something, Oh, what to do, what to do?”) into the excitation (melancholic raptus); the hallucinatory hyperkinesis when hallucinations frighten the patient or cause him rage, he either flees or tries to attack their alleged source; crazy hyperkinesis (usually with delusions of persecution, or when the patient hides from his pursuers, or he’s on the prowl); a catatonic hyperkinesis — in this case, the action is chaotic, repetitive (the patient may spend hours rocking from side to side or go from corner to corner, or sit-up), with the negativity (try to get him to stop doing it or where to take).

The perversion of locomotor activity (paragenesia).

Negativism — unmotivated opposition, active (when it is possible ogresti) and passive (when the patient will passively let you to do anything against him).

Passive podchinyalas — pathological inclination to execute any instructions without thinking said “follow me” — will go tail all day.

Waxy flexibility (it is catalepsy, from GK. katalēpsis — grasp, hold) — long-term retention of patients attached to or arising postures when the body as though made of wax, including the symptom of “air pillow” (patient, if you remove the pillow from under the head will keep the head on weight, not touching the bed), the fetal position.

Speech stereotypes is a monotonous repetition of certain words (mantras do not count); they are also called stand-up momentum or symptom gramophone records.

Motor stereotypies involuntary, frequent repetition of bizarre postures and movements, devoid of any meaning.

Echopraxia (from Greek. echo-echo and praxia-action) – meaningless copying of the actions of others.

Agonimia (echo + the Greek. mimia — imitation) — mindless copying facial expressions of others.

Echolalia (echo + Greek. lalia — speech) — mindless copying of the speech of others.

Pathology Indicative of Instinct

Strengthening research instinct is manifested by extreme diversity and variability of interests and aspirations: “dramatic circle, the circle of the photo, and I also sing hunting”; also includes dromomania — pathological attraction to a permanent change of habitat, vagrancy (Gypsies and occupational travellers are not in the bill. Well, almost doesn’t count); the oniomania (from the Greek. onios-for sale, mania-madness) – an uncontrollable desire to make purchases, to acquire things without material and personal interest, without looking at the consequences-just to BUY.

Decrease of research instinct-when it is uninteresting not only to do something and learn, it is when you yourself, in General, already uninteresting.

Perversion of research attraction includes kleptomania — pathological attraction to theft, often unnecessary, useless and repetitive things (for example, the twenty-eighth portrait of the President of the country); arson — the attraction to arson or contemplation of the flame.

Therefore, having felt an urgent need for something, do not rejoice prematurely, but ask yourself sternly: “do I need it?»

Pathology of Sexual Desire

Hyposexualitysexual desire or reduced, or absent. In men, this is some form of impotence (when it’s not so much in the problems of the Executive bodies, as in the crisis, what is called “legislative power”), in women — frigidity.

Hypersexuality – increased sexual desire with appropriate behavior in both men (satyriasis) and women (nymphomania).

Sexual perversion

Autoeroticism is Masturbation, Masturbation and narcissism. This should make an important note: a perversion that should be considered when there are episodes caused by the fact that the partner is unavailable or absent, and when, in addition to yourself, no one would EVER need.

Algolagnia (from Greek. algos — pain and lagneia intercourse, lust) — the need to inflict physical pain or moral suffering to achieve sexual pleasure (including orgasm), yourself (masochism) or sexual partner (sadism).

To vicarious forms of sexual perversion previously attributed homosexuality (in men, sodomy, women lesbianism, tribadism), but now, due to certain nuances, as reasoned in the thesis, and politically hard-won, considered it a sign of broadmindedness and their own sexual preferences. There were visionism, voyeurism (spying on naked faces of the opposite sex, stock up on binoculars, as well as drills and micro-cameras), exhibitionism (exposure of the genitals in the presence of persons of the opposite sex — “and look what I HAVE!”), transvestism, fetishism (idol not only created, but also raped), frotterism (that’s really who the crush in public transport just a joy).

Orientation of sexual attraction to inappropriate objects emit:

  • Pedophilia – sexual attraction to minors;
  • Gerontophilia – sexual attraction to the elderly;
  • Bestiality – sexual attraction to animals;
  • Necrophilia – sexual attraction to corpses;
  • Pygmalionism — sexual attraction to photographs, statues, paintings (ideal place of work-art Museum, such a person can not pay a salary).

Pathology of Self-Preservation Instinct

Strengthening the instinct of self-preservation can manifest itself in two opposite forms of behavior:

Passive defensewhen a person runs from danger, hiding, digging trenches and dugouts, bypasses it for the quarter or pretends to be a hose, a corpse (reaction supposed death).

Active-defensewhen the best method of protection is declared an attack, and is now “in the woods, the worst is we.”

The weakening of the instinct of self — preservation — when life becomes uninteresting, indifferent, and even a burden, and even if the mood is not to hell-everything, hide ropes and sharp objects, remove vinegar and medicines.

The perversion of the instinct of self — preservation is when a comrade does not kill himself, but bites hard, suddenly finding something extraordinarily attractive in self-torture, self-mutilation, swallowing all sorts of uneaten items, like family silver. Sometimes, however, the latter has a strictly defined purpose: for example, when a prisoner swallows a piece of razor tied to a thread, in order to cause stomach bleeding and end up in the infirmary, it is no longer a perversion of the instinct of self — preservation, but a simulation and a convict’s ingenuity.

Pathology of Drives

Disorders of drives (needs, instincts) can be manifested in the form of their pathological strengthening, weakening or perversion.

With the increased craving may be in the nature:

a) Intrusive — at the same time encourage the activities occur beyond the will of a patient when he realizes what attracted him in General that are alien, does not correspond to any moral values or interests, even criticism persists to this alien phenomenon, saying, not mine, not mine! A striking example is when alcohol dependence is just beginning to form, and a person feels that he would like to drink, but still realizes that this does not come from within, and he clearly does not agree with it.

b) Compulsive-impulses to activity in this case already dominate, they have destroyed at the root of the struggle of motives: why, when here it is, the desired, and it is vital to me (in other words, has a vital character), give it here! That is, if a drink is not just possible-it is NECESSARY. Ergo bibamus!

C) Impulsive — when wide horizons of consciousness was curled up in a mesh of sight, and the person who received the internal pendel (aka pulse) is taken up, without thinking: wait, wait… It just eliminates the annoying economic-geographical blunder: the money should be in the store, and alcohol — in the body.

The pathology of food craving:

Bulimia (Greek. bulimía from bús — bull and limós — hunger) — a strong irresistible craving for food, the constant feeling of hunger.

Anorexia (from Greek. an-without and orexis-urge to food) – lowering, the lack of appetite or aversion to food.

Parorexia, the perversion of food craving, manifested by eating of inedible substances (earth, lime), — paralexia pregnant peak, Kala (CE). One lady, being pregnant, and did prefer kerosene. It’s hard to say what she thought the husband, from time to time passing her in the hospital a bottle of the coveted fuel, but until the illegal supply of hydrocarbons is not stopped, the lady had to go through several miscarriages.

Crazy Idea

Can be particularly point to the next basic signs of delirium.

  1. Delirium is a consequence of the disease, its product. It is not a mistake, not a self — deception, not a delusion of a healthy person-it is the product of a sick person, the same as, say, fever for an infectious patient or convulsions for an epileptic.
  2. Despite the possible validity of certain postulates and fragments, nonsense — always erroneous, not corresponding to reality, a distorted reflection of reality. Claiming that the neighbors are not good to him and saw him in the coffin, the patient may not be so wrong — in terms of guessing the vector of the relationship. But all of that complex structure which he has built on this premise, which has become his ideology, subjugated, changed his identity and has provided many years of holivar (from the English. holy war-Holy war), has nothing to do with reality.
  3. Delusional ideas are unshakable, reinforced concrete, they are absolutely not amenable to correction or persuasion. Attempts to dissuade, to convince the patient of the incorrectness of his crazy builds, to give conclusive arguments, including assault and battery, useless. The patient will only further establish himself in his own right, and using your own arguments and arguments as additional evidence in his favor. “What do you mean she’s loyal to me? Why are you telling me this? Well, well, well, something’s not right! Who do we work for?” I understand! You also have access to the body!”By the way, it will not be possible to dissuade such a patient by hypnotic suggestion either.
  4. Delusions inherent in the erroneous grounds (“paralogic”, “logic curve”). We touched upon these violations, considering violations of the associative process of thinking.
  5. In most cases (with the exception of certain categories of secondary delirium) delirium occurs when the patient’s clear, unclouded consciousness. And this sometimes leads to confusion: as, he quite sensibly says, the dates are not confused… Yes, but only until, while you have not touched the plot of his delusions.
  6. Delusional ideas and personality are inextricably linked. Under the influence of delusional ideas, the patient’s personality changes — his self-consciousness, value system, attitude to the environment and to himself. Well, judge for yourself: what might be the attitude of the Emperor of the Galaxy to itself and to its surroundings? A little different than what is expected from the seemingly ordinary unemployed.
  7. Delusions are not due to intellectual decline. On the contrary, delusions, especially complex and systematic, tend to indicate that the intellect is all right. And on the contrary — the less intelligent, the less common nonsense. But if she is, then it is easier and not so relevant for the patient. In addition, if dementia increases in a person who had delusional production, the delirium itself becomes simpler, takes up less space in the patient’s experiences, until its complete disappearance. And understandably so — there is nothing to produce.

Delirium is classified by stages of development:

A) delusional mood and delusional belief in changing the, of the inevitability of impending catastrophe, danger: “Oh, that, Oh, my heart feels”;

B) delusional perception delusional interpretation of the values of certain phenomena of reality in view of the looming concern: “These views for a reason, and a handful of citizens is clearly with a purpose, and a car drove up, and with special rooms, not otherwise encrypted»;

C) delusional interpretation — delusional explanation of the perceived phenomena: “It is something they bad started: staring accusingly, whispering with a view to developing an action plan, and the details of the plan are encoded in the rooms and the car drove up”;

G) crystallization of delirium — a certain vitality and the content of delusions, their completeness and logical sequence: “I understand. This community is black transplant! I’m about to be kidnapped and disassembled for parts that will be shipped to America and exchanged for cocaine!»;

D) a stage of attenuation of delirium with the emergence of a critical attitude: “Fuhhh carried by… Well, time in the hospital. And yet, what was it? It couldn’t have been like this, all of a sudden. Or could it?”; e) residual (residual) brad: “And transplant all the same bastards!»

The mechanism of occurrence of isolated nonsense:

1) the primary caused directly by thought disorder in the form of insight, feelings, views, perceptions, beliefs, delusional intuition, delusional interpretation of the recollections and observations of reality (Yes, even about the same black transplant);

2) secondary, sensitive, caused by the hallucinatory, illusionary, affective and other’s experiences: hear from the outlet of the “voices” that threaten to kill, believes that the neighbors banded together in a criminal syndicate;

3) holodilny (option of secondary nonsense), resulting in emotional disorders. So, with a depressive syndrome, the patient can declare that it’s all for a reason, it’s all for his sins (and the list on five sheets can provide), and that in General he is a worm and a mastday. And in the manic — almost Batman, only more serious mission;

4) katatelny, he’s sensitive delirium of attitude arising from the exciting and important for that specific individual emotional experiences from value-added sensitive and psychopathic people (delirium relations, persecution, arising from a paranoid psychopath, delusions of jealousy psychopath epileptic);

5) Arising on the basis of sensations from the internal organs: burning in the chest is deadly neighbours is irradiated with light; became mysteriously gurgle in my stomach — it special agents poisoned the water, and only in my apartment;

6) induced-induced, induced by another person, most often mentally ill. How does it work? Here’s a recipe for the average man in the street: run around the Mall with bulging eyes and ask everyone where they sell salt, matches and cereals. We ship all this in bulk quantities in a shopping cart. To complete the picture, connect a couple of like-minded people. I think the result will not be slow to wait;

7) delirium of the deaf, when a person thinks out what he does not hear. The content is often nonsense attitudes or delusions of persecution.

Since gelatinoso have been listed by the resale nonsense.

The content of delusions can be divided into:

  1. Persecutory (from lat. persecutio — chase) nonsense, he is delusions of persecution, which may also include: delusions of influence (rays, radio, hypnotism, telepathy, witchcraft); attitude (usually negative, but there are exceptions), poisoning, jealousy, antagonistic, or Manichaean delirium (when the person believes that it is in the center of confrontation between the forces of good and evil, light and darkness, or when he believes that he fighting two or more competing groups, even States or worlds); nonsense double (when a patient believes that he has a twin that lives beyond his life and committing acts that the patient a disgrace or embarrassing); the delusion of metamorphosis (when the patient believes that under the impact of external influences is he in some turns — into an animal, a tree, piece of furniture); the delirium of obsession (when the patient believes that he possesses someone who controls them).

2) Depressive delusion (delusions low self-esteem) involves the delusion of self-accusation, self-abasement, nihilistic (I’m terminally ill, I have syphilis, AIDS, leprosy, all my organs rotted-withered-scattered in the dust, my misery is eternal and infinite), hypochondriac (I have cancer-sarcoma-another incurable disease, but no one sees and I am here right now will die), dysmorphogenesis (I’m ugly, I stink worse than three-day corpse in the heat, exhalation can be killed on the spot, and emitted gases has long been prohibited by the International Convention on weapons of mass destruction).

3) The group of delirium with higher self-esteem (megalomaniacal nonsense) — delusions of grandeur (from the representative of the President and ending with the Emperor of all galaxies), high birth (really the king, just lost one), invention (Yes, the cure for cancer and the regular teleport also put it on my bill), claim (the theory of relativity, remember? Einstein, bitch, I stole), reformism (well as reorganize rabkrin, not for me to explain), altruistic, or Messianic nonsense — you sit here, the fifth Procurator, at the reception, and lead to person…

4) Mixed forms of delirium include the delirium patronage (we love you prepare for a new crusade, so do not be afraid and never hesitate), brad benevolent influence (here’s five points of charisma, mana, twenty, thirty health and the usual things — agility, resistance to magic), brad staging (the whole world — specifically for this sick theater, all the people in it are actors, and stuff like put that the author would say a few kind), verwandte (litigation), nonsense charges (the patient believe that others look askance at him and despise for what he did not commit at all).

The structure of delirium is divided into systematic and unsystematic.

Systematic nonsense is quite structured externally, it has its own special logic, a system of evidence and arguments in its favor.

Unsystematic nonsense is just a painful statement, devoid of a system of evidence and complex logical constructions: it is so because I know it is so. This is usually secondary to delirium, resulting from patients experiencing hallucinations, senestopatii, either due to depression or mania.

Strictly speaking, the varieties and names of delirium are much more than already given, which is not surprising — because the object on which thinking is directed is the whole world, in all its diversity. But the overall impression is received.

Pathology of Judgments

It’s Intrusive, overvalued and delusions, if we consider them according to the degree of aggravation. How to distinguish them?

Obsessions arise involuntarily, against the will, and disorganize the logical course of thinking. Important: they are perceived by the patient as painful, and they remain critical, they do NOT determine the direction of the activities of this person, that is, do not subordinate it to themselves, although they disorganize mental activity as a whole.

  • Obsessive thoughts arise in the mind of a person involuntarily and even against his will. While consciousness remains nepomucenum, clear.
  • Obsessive thoughts are not in a visible connection with the content of thinking, they are in the nature of something alien, extraneous to the thinking of the patient.
  • Obsessive thoughts can not be eliminated by the will of the patient. The patient is unable to get rid of them.
  • Obsessive thoughts arise in close connection with the emotional sphere, accompanied by depressive emotions, a sense of anxiety.
  • Remaining alien to thinking in General, they do not affect the intellectual level of the patient, do not lead to violations of the logical course of thinking, but their presence affects the productivity of thinking, mental disability of the patient.
  • The morbid nature of obsessive thoughts is recognized by patients, there is a critical attitude towards them.

Supervaluable idea. The concept of overvalued ideas was put forward by K. Wernicke (1892). They affectively rich take a large (disproportionate) in the mind of the patient, disrupt his mental activities and dominate in large measure his behavior. Occupying an intermediate position between obsessive and delusional ideas, they, unlike the latter, are always based on their real (not fantastic, not fictional) background, although criticism of them is already formal or not at all.

Delusional ideas are painful, absurd, unshakable judgments and conclusions that do not correspond to objective reality, disorganize mental activity and subordinate the behavior of the patient, not amenable to criticism and correction.

Figuratively speaking, the husband, suffering from obsessions of jealousy, tormented by the question — and does not change his wife, but because he can not find real evidence of that, suffers to himself. Husband with overvalued ideas of jealousy, convinced that his wife is wrong, can cause some very real, albeit indirect, of facts and a considerable part of free time devoted to the Amateur detective, aware that, even having found them, to kill no one. A husband with delusional ideas of jealousy doubts nothing. He KNOWS she has the mayor’s lover. Or downstairs neighbor. Or specially called her a witch, the Incubus. The evidence, therefore you don’t even have to look, but if someone still doubts — here: the color of the clothes in which she went to work, the spirits, who certainly likes not only her cigarette butt with her lipstick, thrown on the lower balcony, as well as traces of astral presence. And essential, volatile, ejaculate. And in case of paraphrenic delirium of the spouse and at all the organizer, the ideological inspirer and the only volunteer of an all-galactic brothel.

Now more

Obsessive phenomena can be divided into ideatory, phobic and motor. Ideational, or obsessions, is abstract obsessive thoughts, obsessive doubts (turned off or not turned off the stove-water-light) and memories, haunting score (and there are nine steps, and for me at the bus stop consisted of five people, and the next eight) and thought, often blasphemous or sacrilegious (and dead-it is better all settled, it is not hot; and there is the girl in black — well, so I would…), obsessive sophistication (at least the goal is to guess whether the mood of watching something dead or alive Schrodinger’s cat).

Motor (volitional) disorders are divided into the following categories:

Obsessive drives — the desire to make unnecessary, antisocial, sometimes dangerous actions, which is accompanied by internal discomfort, if not implemented. Most often they are not implemented, especially those that are dangerous:

Homicidalmaniac — obsessive attraction to murder, often of a close person; suicidaire — obsessive desire for suicide; coprolalia — the desire to flip off as it should. By the way, the obsessive desire to step out of the window or from the balcony belongs to the same group, it is almost never realized.

Obsessive actions — implemented obsessive drives, often ritual (made — obsession has passed). Among them, automania — obsessive hand washing when mysophobia, bacillophobia. There are other self-obsessive actions: autoreplace — pulling out own hair (not to be confused with makeup and autoreplace sacral-ischial region, since the objectives are totally different); onychophagia — nibble nails, burrs, obsessive ticks.

Overvalued ideas — allocate the content dismorphophobia (“my nose is a honker, not the chest, and the two blemishes, the legs are as hereditary cavalry, and authorship over the form of the ears are fighting elves Cheburashka”); hypochondria (“Oh, somewhere, something popped, gurgled, tumbled and capricornus — not otherwise kirdyk on approach”); inventions (“not bosonic engine for flying saucers, something more earthy, like a special feature head rivets, but the patent office zadolbali»); reformism (amendments to the law on pensions, the proposals of various parties about the change of the Charter, leadership and the main line); litigation (querulant, prosecutors in their work calculated volumes and tones); erotic (starting from the desire to bring happiness to a marriage Miss My Hometown and ending with a pathological belief in their own irresistibility and sexual omnipotence); sexual inadequacy (“I do not like human beings and, in General, such as me, is that a good wholesale”).

It is necessary to distinguish super-valuable ideas from dominant, dominant — which occur in mentally healthy people and represent devotion to any scientific, cultural or religious ideal, the idea for the sake of the celebration of which a person is ready to neglect everything else (remember the ardent fighters in the name of anything).

If you are paranoid — it does not mean,

that THEY’re not after you.

Every fighter against punitive psychiatry sincerely wish at least once in his life to be woven into the delusional system of one of our patients. An unforgettable experience is guaranteed, level up (raising the level) in the worldview and impatient “when will these wonderful people come in white coats?”as a free bonus.

Pathology of the Associative Process

Depending on what part of the associative process of thinking has suffered, we can conditiaonally divide these violations as follows.

On rates:

Accelerating the pace of thinking, when a person processes information, makes a decision and generates ideas much faster than others. Characteristic of manic States, where this acceleration can be expressed up to the “jump of ideas”. Slowing down the pace of thinking. Reflection and decision-making is delayed, sometimes so much that the attempt to talk turns into mutual torture for its participants, and if the second interlocutor is also still in a manic state (see the previous paragraph), not far from self-harm.

Mentalism is an involuntary influx of thoughts, when these thoughts invade in addition to the will of a person in his measured thought process, thoroughly interfere with his activities, often completely disorganizing it. How would you like, say, if the influx of thoughts about the fate of the Fatherland caught you watching a porn film?

Stop (blockage, sperrung) thinking — involuntary breakage, stopping the flow, the absence of thought. Thought-thought — and all. Deadlock. Cliff. No thoughts. And no dialogue to continue, no thing to do there is no way. Frozen, waiting for everything to move again.

By mobility, liveliness of the process:

Detail — secondary nonessential details are constantly involved in the thinking process. It is as if you are in a casual conversation about the weather made happy by the classification of clouds and the average annual norms of temperature and precipitation.

Thoroughness — a pronounced detailing with a systematic stuck on the details and side associations. The wind rose, the discussion of the spoiled ecology and the coordinates of the most trustworthy forecast Bureau would surely have been added to the previous details.

Viscosity — a pronounced thoroughness in which thinking becomes unproductive, to track the original thought is not possible, as well as the direction in which the conversation was originally – in General, by the fourth hour of the discussion, you are likely to be painfully decide who to beat the face: Greenpeace, meteorologists or interlocutor.

On the grammatical structure of speech:

Speech stereotypes — stamped turns or use of a question to build an answer; this is when the speech uses cliched, formulaic turns (“so, what I said…”, “well, as they say, let’s go back to our rams”, “as one of my friends said — however, you do not know…”), as well as the use of the question to build an answer: “How is my name? And my name is too well known for me to tell you!”Verbigeration is a meaningless repetition of the same words, phrases, endings of words or individual sounds. Incoherent — “verbal hash”, a set of individual words or phrases, devoid of logical and grammatical structure (not to be confused with the poem “Mom, dad, spoon, cat”).

By focus:

Flowery — in this case, to Express even a simple thought, the patient resorts to a mass of comparisons, excerpts from various sources, metaphors and sayings, formulas and scientific terms. All you have to do is say, “go fuck yourself.” Now imagine how such a person would sound an explanation of love.

Slippage — this disorder can be represented as follows. The patient talks, for example, about cats. Thinks quite coherently and sensibly. Suddenly, clinging to the fact that some of them are gray, recalls the Maxim “in the dark all cats sulfur” and then gives a lengthy discussion on the relationship of cats, darkness, demonic beginning in the cat’s soul… and then as if nothing had happened returns to the discussion of what they are, in fact, cute and fluffy creatures. Why the slippage? Because such a course of thought looks like a patient, walking along the path of reasoning, slipped, leaning on a minor Association, and for a while rode on it, and then returned to the previous, well-trodden path.

Logic-chopping — long-winded philosophizing, the transfusion of a sieve, lengthy torrent minor subject — without a goal, without any direction. Who met with a flood (chatter off topic) in the comments replicas that way for twenty or thirty, I understand.

Formalism of thinking — when all the attention and all the power of the intellect is not thrown to the comprehension of the essence of the issue, but to a clear execution of the Protocol and the letter of the Charter.

Diversity — in this case, the patient can consider the subject or phenomenon from several points of view, based on several evaluation criteria, constantly changing the levels of generalization, but is not able to come to a decision what in this particular situation should be preferred. So, asking him to exclude from the pictures with the image of the castle, castle and hut one thing, you will not get an answer from him. He says that in one way or another all the pictures are interconnected, nothing extra on them, and in General, specifically, whether such an unsolvable puzzle planted?.. Amorphous — fuzzy, contradictory use of concepts. In this case, it is built syntactically and grammatically correct, but it is not possible to understand WHAT it says. There is no main idea, no conclusions — only a set of phrases that seem logical to the patient himself. If you ask him “how is life”, the answer may well be: “Well, how to say? That is to say must. Because you know the difference between that and that. You can’t just go one way. Justice will prevail though, but it’s when we second such a leader will find objective conditions are not impossible to satiate. When the top can’t, the bottom doesn’t want to. And when it’s full, it’s too late to talk. That’s it.”

Paralogical thinking is a violation of the logic of thinking, the so-called “logic curve”, when either the prerequisites or the evidence suffer, or the process of establishing a connection between cause and effect (this distinction is conditional). Example? The patient basically does not drink juices. Why? “Juice is health. Health is sport. Sport is a lot of money. A lot of money — a lot of women. A lot of women is AIDS. AIDS is death. Am I so fucking happy?”Symbolic thinking — thinking based on pseudo-concepts, symbols, the meaning of which is clear and accessible only to the patient. So, he can talk about the special meaning of what colors are dressed today his employees, and that it can mean. Or to say that for him all the numbers have, in addition to the main, more and additional, secret meaning, thanks to which each new date is an encrypted message with a guide to action.

Pathological polysemantism — when a patient discovers a new meaning in words, based on how many vowels or consonants they have, for example, whether they rhyme with a particular word — say, with such as “death”, “love”, “treason»…

Autistic thinking — is thinking, little in contact with the surrounding reality of the patient, clear and accessible only to him, reflecting his world, in which outsiders are not allowed. Thinking fantastic and bizarre, but not devoid of its own pretentious logic, “feast behind closed curtains” E. Bleiler. Here is an example given by Blejleru [18]: “the Patient B. S. in the work of Jung’s early dementia is Switzerland, she is also Ivikov the crane; she is the owner of all of the world and a seven-story factory of Bank bills; it is also double the Polytechnic University and the assistant of Socrates. All this seems, at first glance, complete nonsense, and indeed is nonsense from the point of view of logic. But if we look more closely, we will find clear connections: thoughts are essentially subject to affective needs, i.e. desires, and sometimes fears; the patient is a Willow crane because she wants to be free from guilt and depravity; she is Switzerland because she must be free.”

Archaic thinking — in this case, for the Foundation of the building are the judgments “the times of Ochakov and the conquest of the Crimea”, attitudes and stereotypes, for example, the same dissenters-old believers. Or the Neanderthals — there could be as lucky…

Perseveration (from lat. perseveratio — perseverance, perseverance; from persevere — persevere, continue) — most clearly this disorder is characterized by an anecdote: “Doctor, I do everything four times, four times, four times, I am very tired, very tired, very tired, but the wife is happy, the wife is happy, the wife is happy…” This is a steady repetition or continuation of once started activities, phrases, and this repetition continues even when the context appropriate for him is exhausted. For example: “what’s your name? — Lesha. — How old are you? — Lesha. Are you retarded or something? — Lesha. — Where do you go? — Lesha. — Who are your parents? I’m not retarded.…»

Fragmentation — the lack of logical connection between individual conclusions, judgments, concepts with the formal preservation of the grammatical structure of speech. If the rupture of thinking acquires an extreme degree of severity — begins to suffer and speech. Example: “I believe it is necessary to use extreme geographical, constitutional and obscene terms, that every kind and species, sex, and religion you have understood who could not stop performing our great, horrible, but extremely pleasant mission membership in the Federation Council”.

If the above were described violations of the associative process of thinking concerning how a person thinks, now we will talk about WHAT he thinks.

Page 1 of 4

Powered by WordPress & Theme by Anders Norén