Brad is a mental disorder with inherentA state of painful reasoning, ideas, conclusions that do not correspond to reality and are not subject to correction, but in which the patient is unshakable and fully convinced. In 1913, this triad was formulated by KT Jaspers, he noted that these signs are superficial and do not reflect the very essence of delusional disorder, but only presuppose the presence of it. This disorder can only appear on a pathological basis. Brad touches deeply all spheres of the psyche of the person, especially affecting the affective and emotional-volitional spheres.
The traditional definition of this disorder forRussian school of psychiatry is the following. Delirium is a collection of ideas, painful arguments and conclusions that have taken possession of the patient's consciousness, falsely reflecting reality and not subject to correction from outside.
Within the framework of medicine delusional disorderIs considered in general psychopathology and in psychiatry. Brad along with hallucinations is part of a group of psychoactive symptoms. Delusional state, being a disorder of thinking, affects one of the spheres of the psyche, while the brain of man acts as a lesion.
The researcher of schizophrenia E. Bleuler noted that for a delusional state it is characteristic: - self-centeredness, with a bright affective coloration, which is formed on the basis of internal need, and internal needs can only be affective.
The concept of "delirium" in the spoken language has an excellent value from the psychiatric, which leads to its incorrect use from a scientific point of view.
For example, in everyday life delusional behavior is called the unconscious state of a person, accompanied by a meaningless, incoherent speech, often occurring in patients with infectious diseases.
From the clinical point of view, this phenomenon is necessaryCall amenity, because this is a qualitative disorder of consciousness, not thinking. Similarly, erroneously in everyday life delirium is called other mental disorders, for example,
In a figurative sense of the delusional stateInclude any incoherent and meaningless ideas, which is also not right, because they may not respond to a delusional triad and act as delusions of a mentally healthy
Examples of delirium. The delirium of the paralytic is filledContent about bags of gold, untold riches, thousands of wives. The content of crazy ideas is often specific, imaginative and sensual. For example, a patient can be recharged from the power grid, imagining himself an electric locomotive or able for weeks not to drink fresh water, because he considers it dangerous for himself. Patients with paraphrenia claim that they live for a million years, and are convinced of their immortality or that they were senators of Rome, took part in the life of ancient Egypt, other patients claim that they are aliens from Venus or Mars. At the same time, such people operate with imaginative vivid ideas and are in a state of increased mood.
Symptoms of delirium
Brad touches deeply all spheres of the psyche of the person, especially affecting the affective and emotional-volitional spheres. Thinking changes in full submission to a delusional story.
For delusional disorder is characteristicParalogism (false conclusion). Symptoms are characterized by redundancy and conviction by delusions, and in relation to objective reality, there is a discrepancy. At the same time, the human consciousness remains clear,
Delirium should be distinguished fromErrors of mentally healthy individuals, because it is a manifestation of the disease. When differentiating this disorder, it is important to consider several aspects.
1. For the appearance of delirium, a pathological basis is necessary, as the errors of the person are not caused by a mental disorder.
2. Delusions refer to objective circumstances, and a delusional disorder refers to the patient himself.
3. For delusions, correction is possible, and for the patient in delirium this is impossible, and his delirious conviction contradicts the previous worldview before the onset of this disorder. In real practice, sometimes differentiation is very difficult.
Sharp nonsense. If consciousness is completely subordinate to the delusionalAnd this affects the behavior, then this is an acute nonsense. Occasionally the patient can analyze adequately the surrounding reality, control his behavior, if this does not apply to the topic of delirium. In such cases, a delusional disorder is called encapsulated.
Primary delirium. The primary delusional disorder is calledPrimordial, interpretative or verbal. Primary with it is the defeat of thinking. The logic, rational consciousness is affected. At the same time, the patient's perception is not disturbed and he is able to work for a long time.
Secondary (figurative and sensual) delirium Is due to impaired perception. This condition is characterized by the predominance of hallucinations and illusions. Delusional ideas are inconsistent, fragmentary.
Violation of thinking appears again, comesDelusional interpretation of hallucinations, there is a lack of inferences that occur in the form of insights - emotionally rich and bright insights.
Elimination of the secondary delusional state is achieved mainly by treating the symptom complex and the underlying disease.
Distinguish figurative and sensual secondaryDelusional disorder. At a figurative there are sketchy, disjointed representations by type of memoirs and imaginations, that is - delirium of representation. With the sensual delirium of the plot, visual, sudden, saturated, concrete, emotionally bright, polymorphic. This state is called delusional perception.
The delirium of the imagination is significantly different fromSensual and interpretive delusional state. With this variant of delusional disorder, ideas are based not on perceptual distress and not on logical error, but arise on the basis of intuition and fantasy.
There are also delirium grandeur, delirium of invention, love delirium. These disorders are not systematized, polymorphic and very variable.
In domestic psychiatry, it is currently accepted to distinguish three main delusional syndromes.
Paranoid syndrome - unsystematic, often observed in combination with hallucinations and other disorders.
Paranoid syndrome is an interpretive, systematized delusion. More often monothematic. In this syndrome, there is no intellectual-mnestic weakening.
Paraphrenic syndrome is fantastic, systematized in combination with psychic automatisms and hallucinations.
The syndrome of mental automatism and hallucinatory syndrome are close to delusional syndromes.
Some researchers distinguish delusional "paranoid" syndrome. It is based on an overvalued idea that arises in paranoid psychopaths.
The plot of delirium. Under the fable of delirium understand its content. Fabula, as in cases of interpretive delusions, does not act as a sign of the disease and directly depends on the socio-psychological, political and cultural factors within which the patient is staying. There are a lot of such plot lines. Often there are ideas common to the thinking and interests of all mankind, as well as characteristic for this time, beliefs, culture, education and other factors.
Allocate on this principle three groups of delusional states, united by a common plot. They include:
- Delirium of damage - the belief that the patient spoils the property or is stolen by some people;
- Delirium poisoning - the patient is convinced that one of the people wants to poison him;
- Delirium of relations - it seems to the person that the whole environment has a direct relation to it and the behavior of other personalities (acts, conversations) are conditioned by their special attitude towards it;
- Delusions of meaning - a variant of the previous delusions of delirium, (these two kinds of delusional state are difficult to distinguish);
- Delirium of influence - the person is haunted by the ideaExternal influence on his feelings, thoughts with a precise assumption about the nature of this effect (radio, hypnosis, "cosmic radiation"); - erotic delusions - the patient is sure that he is being pursued by a partner;
- Delirium of litigiousness - the ill struggles to restore "justice": courts, complaints, letters to the leadership;
- Delusions of jealousy - the patient is convinced of the betrayal of the sexual partner;
- Delusion of staging - the conviction of the patient thatAround everything is specially tuned and scenes of some performance are played out, and also an experiment is conducted, and everything constantly changes the meaning; (For example, this is not a hospital, but the prosecutor's office, the doctor is an investigator, medical staff and patients are disguised as security personnel for disguising the patient);
- Delirium of obsession - a pathological conviction of a person that an evil spirit or some kind of hostile creature came into him;
- Presenilny delirium - is the development of a picture of depressive delirium with ideas of condemnation, guilt, death.
- Delirium of wealth, in which the patient is pathologically convinced that he possesses untold treasures or wealth;
- Delirium of invention, when the patient is subject to the idea of committing an ingenious discovery or invention, as well as unrealistic different projects;
- The delirium of reformism - the patient creates social, ridiculous reforms for the good of mankind;
- Delirium of origin - the patient believes that his real parents are high-ranking people, or relates his origins to an ancient noble family, a different nation, etc .;
- Delirium of eternal life - the patient is convinced that he will live forever;
- Erotic delirium - the patient's conviction about the love of some person in him;
- Love delusional conviction, which is noted in sick women by the fact that they are loved by famous people, or everyone falls in love, meeting with them at least once;
- Antagonistic delirium - a pathological belief of the patient that he is a passive witness and contemplative of the struggle of opposing world forces;
- Religious delirious conviction - when the sick person considers himself a prophet, claiming that he can perform miracles.
- Delirium of self-deprecation, self-blame, sinfulness;
- Hypochondriac delusional disorder - a patient's conviction that he has a serious illness;
- Nihilistic delirium is a false feeling that the sick or the surrounding world does not exist, and the end of the world comes.
Separately, the induced (induced)Delusions are delusional experiences, which are borrowed from the patient in close contact with him. It looks like "infection" with a delusional disorder. The person to whom the disorder is induced (transmitted) does not necessarily obey or depends on the partner. Usually people are infected (induced) by a delusional disorder from the patient's environment, who communicate very closely with him and are related by family-related relationships.
Stages of delirium
The stages of delusional state include the following stages.
1. Delusional mood - the certainty that changes have taken place around and trouble is coming from somewhere.
2. Delusional perception arises in connection with the growth of anxiety and there is a delusional explanation of individual phenomena.
3. Delusional interpretation is a delusional explanation of all perceived phenomena.
4. Crystallization of delirium - the formation of complete, harmonious, delusional ideas.
5. Delirium of delirium - appearance of criticism to delusional ideas.
6. Residual nonsense - residual delusional phenomena.
Treatment of delirium
Treatment of delusional disorder is possible by methods,Which affect the brain, that is, psychopharmacotherapy (antipsychotics), as well as biological methods (atropine, insulin coma, electro- and drug shock).
The main method of treatment of diseases thatAccompanied by a delusional disorder, is treated with psychotropic drugs. The choice of neuroleptics depends on the structure of delusional disorder. In the case of a primary interpretive system with a pronounced systematization, preparations with a selective character of action (haloperidol, triftazin) will be effective. In an affective and sensual delusional state, neuroleptics of a wide spectrum of action (Frenolone, Aminazine, Melleril) are effective.
Treatment of diseases accompanied by delusionalDisorder, in many cases occurs in a hospital setting followed by supporting outpatient therapy. Out-patient treatment is prescribed in those cases when the disease is noted without aggressive tendencies and is reduced.