How to recognize mental illness? endogenous disorder

Queen without retinue.

Among the mental illnesses classified as major psychiatry, schizophrenia attracts the most attention - a special mental illness, the manifestations of which are the most diverse: there may be delirium, and a lack of craving for communication, and a catastrophic decrease in volitional activity (up to abulia and apathy, that is, until the complete disappearance of desires and the ability to volitional effort and the inability to purposefully and productively use the available gaps, often very large). No matter how they called schizophrenia, no matter what metaphors they used. In particular, the thinking of a schizophrenic patient was compared to an orchestra without a conductor, a book with mixed pages, a car without gasoline...

Why is the interest of psychiatrists in schizophrenia so great? Indeed, in social terms, this disease is not so important: it occurs very rarely, only a few patients with schizophrenia are socially completely maladjusted ...

Interest in this disease is due to many reasons. Firstly, its origin is unknown, and what is not studied always attracts special attention. But this is not the main thing, because there are a lot of unexplored diseases in modern psychiatry. Secondly, schizophrenia is an ideal model (if there can be an ideal model of human disease at all) for studying the general patterns of the clinic and treating all other mental disorders. Thirdly, schizophrenia changes over the years: those patients who were described by Kraepelin or the creator of the term "schizophrenia", the outstanding Swiss psychiatrist Eugen Bleleer (1857-1939) - he proposed this word, meaning the splitting of the psyche, in 1911 - now or not at all or they are much less common than 50-60 years ago. Schizophrenia, like the many-faced Janus, like a cunning chameleon, takes on a new guise each time; retains its most important properties, but changes attire.

Schizophrenia has many clinical variants. expressiveness psychopathological disorders at the same time, it can be different and depends on age, the rate of development of the disease, the personality characteristics of a person with schizophrenia, and others. various reasons, most of which it is not always possible to isolate pathogenic factors from the complex that cannot be accounted for.

The causes of this disease are still unknown, but the most common assumption is that schizophrenia is caused by some biological factors, such as viruses, metabolic products, etc. However, to this day no one has discovered such a factor. Since there is big number forms of this disease, it is possible that each of them has its own cause, which affects, however, some common links in mental processes. Therefore, despite the fact that patients with schizophrenia differ sharply from each other, they all have those symptoms that were broadly listed above.

Like all diseases existing on earth, schizophrenia can proceed continuously (here the rate of increase painful manifestations can be the most diverse: from catastrophically fast to hardly noticeable even over decades of illness), paroxysmal (this is most often the case in life: the painful attack is over, the patient's condition has improved, although some consequences of the attack persist) and in the form of outlined painful periods, after the end of each of which the person, it would seem, fully recovers. The last two forms of schizophrenia are the most prognostically favorable. Between the resumption of the disease, a more or less stable remission is formed (i.e., a period of weakening of the disease or complete recovery from it). Sometimes remission lasts for decades, and the patient does not even live to see the next attack - he dies due to old age or from some other reason.

Who is born from people with schizophrenia? Absolutely accurate information is not available. Mostly healthy children are born. But if at the time of conception both parents were in a state of psychotic attack, then the probability that the child will have something similar is about 60%. If at the time of conception one of the child's parents was in such a state, then every third child will be mentally ill. At the end of the 1930s, the prominent German geneticist Franz Kalman (1897-1965) came to approximately such conclusions.

Our observations show that at least 50% of children of sick parents are completely healthy or show some personality traits, which, although they may attract attention, should in no way be considered as signs of a serious illness. Of course, such parents bring "genetic harm" to their children, but social harm is much more dangerous: due to poor upbringing (many schizophrenic patients treat children either too indifferently or too affectionately, instill in them many of those forms of behavior that parents like, and etc.), due to insufficient control over children, and the latter may also be due to the fact that parents are often hospitalized, etc. In each case, the doctor gives different advice to people suffering from mental illness regarding what awaits their unborn child and how to give him timely and correct needed help, if required.

Due to the fact that schizophrenia has many faces and the carriers of this disease are not similar to each other, many psychiatrists seek to more strictly define its boundaries, highlighting the nuclear (true) forms of this disease and distinguishing them from other forms that are very conventionally related to schizophrenia. Other psychiatrists, on the contrary, expand the boundaries of this disease, referring to schizophrenia all cases of neuropsychiatric pathology in which there are symptoms that even outwardly resemble schizophrenia. The narrowing or expansion of the boundaries of this disease is connected, of course, not with the evil or good intent of specific psychiatrists, but with the fact that this problem is very complex, little studied and controversial, like all problems that are at the intersection of biological and social in man.

Despite the fact that a lot of money is being spent in industrialized countries on studying the causes of schizophrenia, the dynamics of its clinical forms and the creation of new methods of treatment, the results so far have not matched the money spent, and by now researchers are almost as far from the final solution to this problem. as in the beginning of the 20th century, when the foundations of the doctrine of schizophrenia were laid.

A great contribution to the disclosure of the nature of schizophrenia was made by Soviet psychiatrists (N. M. Zharikov, M. S. Vrono and others), especially those involved in the biochemistry of psychoses, the study of their biological substrate (M. E. Vartanyan, S. F. Semenov , I. A. Polishchuk, V. F. Matveev and many others).

Most forms of schizophrenia are not caused by mental shocks, head injuries, alcoholism, or any other external influences. However, these effects can provoke this disease and increase its manifestations. Therefore, in general, the exclusion of domestic drunkenness, the reduction of conflicts, industrial injuries, and the adherence of people to psychohygienic principles play an important role in the prevention of this disease.

Schizophrenia schizophrenia is different, there are so many clinical forms of this disease, and social adaptation is violated in these forms in so many different ways that psychiatrists very often find themselves in a very difficult position when they have to solve expert and other specific social issues. The guiding star in solving such objectively complex problems is not only the clinical skill of a specialist, but also his moral principles understanding of the special responsibility that rests on him, the desire to combine the interests of society and the interests of the patient.

Dementia praecox - considered earlier. Is dementia precocious and mandatory? - doubt now. We deliberately put these words in the title so that it is clear to the reader that the views of scientists of the past on schizophrenia have undergone very big changes. Kraepelin was convinced that schizophrenia (he called it by a different term - "dementia praecox") necessarily begins in childhood and adolescence and almost inevitably leads to the collapse of the psyche. Studies of subsequent eras have shown that there are no grounds for such pessimism. Of course, some forms of this disease are unfavorable, but most types of schizophrenia do not lead to any dementia. The only thing Kraepelin was right about was that schizophrenia really almost always begins in childhood and adolescence. Such children draw attention to themselves by ridiculous behavior, countless oddities, incomprehensible, pretentious interests, paradoxical reactions to life phenomena, and a violation of contact with others. The vast majority of them are immediately hospitalized in psychiatric hospitals, and many stay in hospitals for a very long time. If the child is treated in a timely and correct manner, then the symptoms gradually subside, the patient recovers, although some oddities (sometimes in a very mild form) may still persist. The whole trouble lies not so much in the presence of schizophrenia, but in the fact that while the child is sick, his brain functions at half strength, the child does not acquire the necessary information, he knows little, although at times he knows a lot. Then the disease passes, and the signs of a lag in intellectual development are already coming to the fore. Therefore, some of these patients do not seem to be sick, having suffered an attack of schizophrenia, but mentally retarded, that is, oligophrenic. The eminent Soviet child psychiatrist Tatyana Pavlovna Simeon (1892-1960) called this phenomenon "an oligophrenic plus."

It depends on the art of the doctor how correctly he will assess the ratio of signs of mental destruction due to schizophrenia and lagging behind. mental development due to long-term mental illness. In some cases, children with schizophrenia do not study at all, others follow the program of a special school, and still others - the vast majority of them - attend a public school. In cases where signs of disorganization of mental activity are very noticeable and prevent the child from adapting well at school, he is transferred to individual education, that is, he does not go to school, and teachers come to his house. It depends on classmates and teachers how the patient will study at school: if he is in the center of unhealthy attention, if schoolchildren laugh at his eccentricities or - even worse - mock him, then a child who has had schizophrenia is unlikely to be able to attend school. He will withdraw into himself to an even greater extent, conflict with children, and this, as a rule, intensifies his symptoms. A careful, benevolent attitude towards such a student, a reasonable alternation of praises and demands, the desire to rely on healthy ingredients his psyche - all this greatly helps similar patients, as a result of which they are gradually drawn into the normal educational process and over time are not inferior in their studies to healthy peers.

And this is not surprising either among specialists or among the general public. This mysterious and frightening phrase has long become in our minds a symbol of the mental suffering of the patient himself, the sorrow and despair of his loved ones, and the unhealthy curiosity of the townsfolk.

In their understanding, mental illness is most often associated with this concept. At the same time, from the point of view of professionals, this does not fully correspond to the actual situation, since it is well known that the prevalence of endogenous diseases of the schizophrenic spectrum has remained approximately at the same level for a long time and up to the present in various regions of the world and on average reaches no more than 1%.

However, it is not without reason to believe that the true incidence of schizophrenia significantly exceeds this figure due to the more frequent, easily flowing, erased (subclinical) forms of this disease, which are not taken into account by official statistics, as a rule, are not in the field of view of psychiatrists.

Unfortunately, even today, general practitioners are far from always able to recognize the true nature of many symptoms that are closely related to mental distress. People who do not have medical education, especially not being able to suspect mild forms of endogenous diseases of the schizophrenic spectrum in the primary manifestations. At the same time, it is no secret to anyone that early start qualified treatment is the key to its success.

This is an axiom in medicine in general and in psychiatry in particular. The timely start of qualified treatment in childhood and adolescence is especially important, since, unlike adults, children themselves cannot recognize the presence of any illness and ask for help. Many mental disorders in adults are often the result of the fact that they were not treated in a timely manner in childhood.

Long enough talking with a large number of people suffering from endogenous diseases of the schizophrenic spectrum and with their immediate environment, I became convinced of how difficult it is for relatives not only to properly build relationships with such patients, but also to rationally organize their treatment and rest at home, to ensure optimal social functioning.

Here are excerpts from the book, where experienced specialist in the field of endogenous mental disorders that develop in adolescence - and wrote a book that aims to fill in the existing gaps, giving a wide readership an idea of ​​​​the essence of schizophrenic spectrum diseases, and thereby changing the position of society in relation to the patients suffering from them.

The main task of the author is to help you and your loved one to survive in case of illness, not to break down, to return to a full life. By following the advice of a practitioner, you can save your own mental health and get rid of constant anxiety for the fate of your loved one.

The main signs of a beginning or already developed endogenous disease of the schizophrenic spectrum are described in such detail in the book so that you, having discovered such disorders of your own psyche or the health of your loved ones as described in this monograph, have the opportunity to contact a psychiatrist in a timely manner, who will determine whether you really or Your relative is sick, or your fears are unfounded.

Chief Researcher of the Research Department

endogenous mental disorders and affective states

doctor medical sciences, professor M.Ya.Tsutsulkovskaya

Most people not only heard, but often used the concept of "schizophrenia" in everyday speech, however, not everyone knows what kind of disease is hidden behind this medical term. The veil of mystery that has accompanied this disease for hundreds of years has not yet been dispelled. Part of human culture is directly in contact with the phenomenon of schizophrenia, and in a broad medical interpretation - endogenous diseases of the schizophrenic spectrum.

It is no secret that among the diseases that fall under the diagnostic criteria of this group of diseases, there is a fairly high percentage of talented, outstanding people, sometimes achieving serious success in various creative fields, art or science (V. Van Gogh, F. Kafka, V. Nizhinsky, M. Vrubel, V. Garshin, D. Kharms, A. Arto, etc.). Despite the fact that a more or less harmonious concept of endogenous diseases of the schizophrenic spectrum was formulated at the turn of the 19th and 20th centuries, there are still many unclear issues in the picture of these diseases that require careful further study.

Endogenous diseases of the schizophrenic spectrum today are one of the main problems in psychiatry, due to both their high prevalence among the population and significant economic damage associated with social and labor maladjustment and disability of some of these patients.

PREVALENCE OF ENDOGENOUS DISEASES OF SCHIZOPHRENIC SPECTRUM.

According to the International Psychiatric Association, about 500 million people worldwide are affected by mental disorders. Of these, at least 60 million suffer from endogenous schizophrenia spectrum diseases. Their prevalence in different countries and regions is always approximately the same and reaches 1% with certain fluctuations in one direction or another. This means that out of every hundred people, one is either already sick or will get sick in the future.

Endogenous diseases of the schizophrenia spectrum usually begin at a young age, but can sometimes develop in childhood. The peak incidence occurs in adolescence and youth (the period from 15 to 25 years). Men and women are affected to the same extent, although in men the signs of the disease usually develop several years earlier.

In women, the course of the disease is usually milder, with the dominance of mood disorders, the disease is less reflected in their family life and professional activity. In men, developed and persistent delusional disorders are more often observed, cases of a combination of an endogenous disease with alcoholism, polytoxicomania, and antisocial behavior are not uncommon.

DISCOVERY OF ENDOGENOUS DISEASES OF SCHIZOPHRENIC SPECTRUM.

It would probably not be a big exaggeration to say that the majority of the population considers the diseases of the schizophrenic circle to be at least dangerous diseases than cancer or AIDS. In reality, the picture looks different: life confronts us with a very wide range of clinical variants of these many-sided diseases, ranging from the rarest severe forms, when the disease flows rapidly and leads to disability in a few years, to the relatively favorable, paroxysmal variants of the disease that prevail in the population and mild, outpatient cases, when the layman would not even suspect illness.

The clinical picture of this "new" disease was first described by the German psychiatrist Emil Kraepelin in 1889 and named by him "dementia praecox". The author observed cases of the disease only in psychiatric hospital and therefore he dealt primarily with the most seriously ill patients, which was expressed in the picture of the disease he described.

Later, in 1911, the Swiss researcher Eugen Bleuler, who worked for many years in an outpatient clinic, proved that one should speak of a “group of schizophrenic psychoses”, since milder, more favorable forms of the course of the disease that do not lead to dementia often occur here. Rejecting the name of the disease, originally proposed by E. Krepelin, he introduced his own term - schizophrenia. The studies of E. Bleuler were so comprehensive and revolutionary that the 4 subgroups of schizophrenia identified by him are still preserved in the international classification of diseases (ICD-10):

WHAT IS SCHIZOPHRENIC SPECTRUM DISEASE?

Currently, endogenous diseases of the schizophrenic spectrum are understood as mental illnesses characterized by disharmony and loss of unity of mental functions:

thinking, emotion, movement, prolonged continuous or paroxysmal course and the presence in the clinical picture of the so-called

varying degrees of severity

The name of the disease comes from the Greek words "schizo" - split, split and "phren" - soul, mind. With this disease, mental functions seem to be split - memory and previously acquired knowledge are preserved, and other mental activity is disturbed. By splitting is meant not a split personality, as is often not quite understood,

and disorganization of mental functions,

the lack of their harmony, which is often manifested in the illogicality of the actions of patients from the point of view of the surrounding people.

It is the splitting of mental functions that determines both the originality of the clinical picture of the disease and the features of behavioral disorders.

patients who often paradoxically combined with the preservation of intelligence.

The term "endogenous diseases of the schizophrenia spectrum" in its broadest sense means

and the loss of the patient's connection with the surrounding reality, and the discrepancy between the remaining capabilities of the individual and their implementation, and the ability to normal behavioral reactions along with pathological ones.

The complexity and versatility of the manifestations of schizophrenic spectrum diseases have led to the fact that psychiatrists from different countries still do not have a unified position regarding the diagnosis of these disorders. In some countries, schizophrenia proper includes only the most unfavorable forms diseases, in others - all disorders of the "schizophrenic spectrum", in still others - they generally deny these conditions as a disease.

In Russia, in recent years, the situation has changed towards a stricter attitude towards the diagnosis of these diseases, which is largely due to the introduction of the International Classification of Diseases (ICD-10), which has been used in our country since 1998. From the point of view of domestic psychiatrists, schizophrenia spectrum disorders are quite are reasonably considered a disease, but only from a clinical, medical point of view.

At the same time in social sense it would be incorrect to call a person suffering from such disorders sick, that is, inferior. Despite the fact that the manifestations of the disease can also be chronic, the forms of its course are extremely diverse: from one-attack, when the patient suffers only one attack in his life, to continuously flowing. Often a person who is currently in remission, that is, out of an attack (psychosis), can be quite capable and even more productive professionally than those around him who are healthy in the generally accepted sense of the word.

MAIN SYMPTOMS OF ENDOGENOUS DISEASES OF SCHIZOPHRENIC SPECTRUM.

positive and negative disorders.

Positive Syndromes

Positive disorders, due to their unusualness, are noticeable even to non-specialists, therefore, they are relatively easy to identify, include various disorders mental activity, which may be reversible. different syndromes reflect the severity mental disorders relatively light to severe.

There are the following positive syndromes:

• asthenic (states of increased fatigue, exhaustion, loss of ability to work for a long time),
• affective (depressive and manic, indicating a mood disorder),
• obsessive (conditions in which thoughts, feelings, memories, fear arise against the will of the patient and are obsessive),
• hypochondria (depressive, delusional, obsessive hypochondria),
• paranoid (delusions of persecution, jealousy, reformism, delirium of a different origin.),
• hallucinatory (verbal, visual, olfactory, tactile hallucinosis, etc.),
• hallucinatory (mental, ideational, senestopathic automatisms, etc.),
• paraphrenic (systematic, hallucinatory,
• confabulatory paraphrenia, etc.),
• catatonic (stupor, catatonic excitation), delirious, clouding of consciousness, convulsive, etc.

As can be seen from this far from complete list, the number of syndromes and their varieties is very large and reflects the different depths of mental pathology.

Negative Syndromes

Negative disorders (from Latin negativus - negative), so called because in patients, due to the weakening of the integrative activity of the central nervous system, a “falling out” of powerful layers of the psyche due to a painful process can occur, expressed in a change in character and personality traits.

At the same time, patients become lethargic, low-initiative, passive (“decreased energy tone”), their desires, urges, aspirations disappear, emotional deficit increases, isolation from others appears, avoidance of any social contacts. Responsiveness, sincerity, delicacy are replaced in these cases by irritability, rudeness, quarrelsomeness, aggressiveness. In addition, in more severe cases, the above-mentioned mental disorders appear in patients, which becomes unfocused, amorphous, empty.

Patients can lose their previous work skills so much that they have to register a disability group. One of essential elements psychopathology of diseases of the schizophrenic spectrum is the progressive impoverishment of emotional reactions, as well as their inadequacy and paradox.

At the same time, even at the beginning of the disease, higher emotions can change - emotional responsiveness, compassion, altruism.

As the emotional decline, patients are less and less interested in events in the family, at work, they break old friendships, lose their former feelings for loved ones. Some patients observe the coexistence of two opposite emotions (for example, love and hate, interest and disgust), as well as the duality of aspirations, actions, tendencies. Much less often, progressive emotional devastation can lead to a state of emotional dullness, apathy.

Along with the emotional decline in patients, there may also be disturbances in volitional activity, which are more often manifested only in severe cases of the course of the disease. We can talk about abulia - partial or complete lack of motivation for activity, loss of desires, complete indifference and inactivity, cessation of communication with others. Sick all day, silently and indifferently, lie in bed or sit in one position, do not wash, stop serving themselves. In especially severe cases, abulia can be combined with apathy and immobility.

Another volitional disorder that can develop in schizophrenic spectrum diseases is autism (a disorder characterized by the separation of the patient's personality from the surrounding reality with the emergence of a special inner world that dominates his mental activity). On the early stages an autistic disease can also be a person who formally contacts others, but does not allow anyone into his inner world including those closest to him. In the future, the patient closes in himself, in personal experiences. Judgments, positions, views, ethical assessments of patients become extremely subjective. Often, a peculiar idea of ​​​​the surrounding life acquires in them the character special outlook, sometimes there is autistic fantasizing.

A characteristic feature of schizophrenia is also a decrease in mental activity. It becomes more difficult for patients to study and work. Any activity, especially mental, requires more and more tension from them; extremely difficult to concentrate. All this leads to difficulties in perception. new information, the use of the stock of knowledge, which in turn causes a decrease in working capacity, and sometimes complete professional insolvency with the formally preserved functions of the intellect.

Negative disorders can exist for quite a long time without paying much attention to themselves. Symptoms such as indifference, apathy, inability to express feelings, lack of interest in life, loss of initiative and self-confidence, impoverishment vocabulary and some others, may be perceived by others as traits of character or as side effects of antipsychotic therapy, rather than the result of a disease state.

In addition, positive symptoms may mask negative disorders. But, despite this, it is precisely the negative symptoms in most affects the patient's future, his ability to exist in society. Negative disorders are also significantly more resistant to drug therapy than positive ones. Only with the advent of new psychotropic drugs at the end of the 20th century - atypical antipsychotics (rispolepta, zyprexa, seroquel, zeldox) did doctors have the opportunity to influence negative disorders. For many years, studying the endogenous diseases of the schizophrenia spectrum, psychiatrists have concentrated their attention mainly on positive symptoms and the search for ways to stop them.

Only in recent years has an understanding emerged that specific changes are of fundamental importance in the manifestations of schizophrenic spectrum diseases and their prognosis.

Causes, symptoms, treatment of endogenous and exogenous psychoses in children and adults

Endogenous disorders of the human psyche are a fairly common phenomenon today. For a number of factors, both adults and children can be exposed to this disease. Therefore, the issue of this disease is relevant and requires our close attention.

About mass mental disorder from history

In world history there are sad examples of people falling ill with the strongest psychopathic ailments. Because of this "ailment" in the first centuries of our era, died great amount people, entire civilizations disappeared. In those days, the reason for this was the loss of people's trust in the authorities, the change of ideologies, religious views and beliefs. People, not wanting to live, committed suicide, women had abortions, abandoned their children, generally stopped creating families. In science, this deliberate popular extinction, associated with the hatred of one's own life, was called "endogenous psychosis of the 2nd-3rd centuries." It was a mass psychogenic pathology in people who had lost the meaning of life.

A similar situation developed in Byzantium before the collapse. The Byzantine people, after the conclusion of the union, felt the betrayal of their faith, their worldview on the part of the authorities. People in Byzantium at this time succumbed to mass pessimism. The men became chronic alcoholics. A terrible depopulation began. In Byzantium at the end of the 14th century, only 25 out of 150 well-known intellectuals and intellectuals created their own families.

All this led in Byzantium to a serious destruction of the normal mental state of people, which brought the great empire very close to its "decline".

Psychoses. Their types

Psychosis is a clear disorder of the mental state and mental activity of a person, which is accompanied by the appearance of hallucinations, changes in consciousness, inappropriate behavior, disorganization of the personality.

There are many types of psychotic illnesses. Their classification according to such a feature as origin is based on two types: endogenous and exogenous species.

Endogenous disorders of consciousness are caused by factors of internal influence: somatic or mental illness, age-related pathologies. Such deviations in the psyche develop gradually. The cause of exogenous deviations from the normal consciousness of a person are external factors: mental trauma resulting from negative influence on a person of stressful situations, the transfer of infectious diseases, serious intoxication. Exogenous psychosis today very often becomes a consequence of chronic alcoholism.

Exogenous psychoses are considered the main source of the acute form of a psychopathic illness, which forms suddenly and very rapidly.

In addition to acute exogenous mental disorders, there are acute endogenous psychoses and acute organic (disorders of brain activity, consisting in damage to brain cells due to injuries or tumors) psychotic abnormalities. Their distinguishing feature lies in the sudden and very rapid development. They are temporary, not chronic. Also, a person with impaired consciousness in an acute form may experience relapses. Acute endogenous psychoses and other acute forms respond well to treatment, it is only important to diagnose psychosis in time and start treating it immediately. Timely therapy, first of all, is necessary due to the fact that with a deviation over time, the adequacy of a person and his ability to control the situation are increasingly reduced, this can lead to the appearance of processes that are already irreversible for the psyche.

endogenous psychosis. Causes, symptoms

Endogenous psychosis is a pathology of human consciousness, in which the patient experiences irritability, nervousness, delusions and hallucinations, memory problems caused by internal processes occurring in the human body.

These forms include:

It is difficult to determine the causes of this disorder in each individual person. They may be:

• somatic (bodily) diseases: cardiovascular, nervous, respiratory, endocrine systems, etc.;
• genetic predisposition;
• another mental disorder (for example, Alzheimer's disease - the death of brain neurons, oligophrenia);
• age changes.

In this case, the patient can observe the following symptoms:

• irritability;
• excessive sensitivity;
• loss of appetite and sleep disturbances;
• decreased efficiency, ability to concentrate;
• feeling of anxiety and fear;
• rave;
• disruptions in thinking, hallucinations;
• deep depression;
• inability to control their behavior.

Mental pathology caused by internal factors in children and adolescents

The close attention of parents and mandatory treatment from specialists require mental disorders in children and adolescents.

Psychosis in children may be accompanied by the appearance of illusions, strange behavior unreasonable aggressiveness. A child with a disorder caused by internal factors often composes some incomprehensible words. He may have a delusional state, hallucinations may appear.

The sources of deviations here are very different. The main ones are taking medications for a long time, failure hormonal balance suffered high temperature.

Quite often in our time there are psychotic disorders in adolescents. However, it can be difficult for parents and even doctors to determine any deviations in a person at this age due to complex adolescent behavior. Therefore, if a pathology is suspected, it is necessary to contact a narrow-profile specialist.

Modern statistics say that approximately 15% of adolescents need the help of a psychiatrist, 2% of young people are diagnosed with a psychotic disorder.

Symptoms of endogenous psychosis in adolescents differ little from the signs of the course of the disease in adults. But it is necessary to take into account the not fully formed teenage psyche, changes in the hormonal system. Pathological processes against the background of processes occurring with a person in adolescence can lead to the most sad consequences, up to the commission of suicide by a teenager.

Diagnosis and treatment of endogenous psychosis

The symptoms of different types of psychotic disorders are quite similar. In this regard, only a specialist (psychiatrist) after a thorough examination can determine the type of pathology in a patient caused precisely by factors of internal influence. Already at the first suspicious signs of a deviation in a person, first of all, his relatives and relatives, it is necessary to urgently consult a doctor and consult with him. The patient himself may not understand his condition. Self-treatment of endogenous psychosis is dangerous not only for health, but also for the life of the patient.

With the manifestation of an acute pathological form in a person, it is necessary for him to call an ambulance.

When confirming the diagnosis, the doctor prescribes a list of medicines to the patient. Typically, the following apply medications:

• sedatives (soothing);
• antidepressants (fighting depression and feelings of depression);
• tranquilizers (removing nervous tension, fatigue, relieving anxiety and fear), etc.

Apart from drug therapy psychotherapy is also important. For each patient, individual techniques are used to cure him. For the successful recovery of the patient, it is important for the doctor to choose the right methods of therapy.

The duration of treatment for endogenous or exogenous psychosis may vary. It directly depends on at what stage of the course of the pathology the patient asked for help, how severely the disease is started. With timely medical attention, the cure can last for about two months. AT running case the recovery process can stretch for a long, indefinite period.

Diagnosis and treatment of endogenous psychosis in the younger generation is not the same as in adults. When the first symptoms occur, the baby is examined by a number of specialists: a psychiatrist, an otolaryngologist, a neuropathologist, a speech therapist, and a psychologist. Diagnosis consists in a complete examination of the health of the little man, his mental, physical, speech development, doctors check his hearing, the level of development of thinking. For an even more detailed examination, the baby can be placed in a hospital. It happens that the roots of deviations in the psyche come from some other serious illness. In this regard, it is important not only to determine the child's psychogenic disorder, but also to identify the causes of the development of this disease.

Ways to cure small patients are different. Some children can recover after a few sessions with specialists, others need a fairly long observation. Most often, a child is prescribed psychotherapy, but sometimes only this method of dealing with endogenous psychosis is not enough. Then drugs are used. However, potent agents are used extremely rarely.

A special attitude and constant supervision of a psychotherapist is required by representatives of a younger age, in whom endogenous psychosis has developed against the background of severe stressful situations.

In today's world, children mental illness(including endogenous and exogenous psychoses) are successfully treated. Relapses later in life are minimized if young children and adolescents have received timely help specialists, of course, provided that there are no strong psychological shocks.

Huge responsibility falls on the shoulders of relatives and friends of sick kids. Parents must comply with the medication regimen, proper nutrition, spend a lot of time with your child in the fresh air. It is very important that relatives do not treat the “flower of life” as an unbalanced person. The key to a speedy recovery of children is the unquestioning faith of parents in victory over the disease.

Endogenous psychoses are not uncommon today. However, you should not despair if you, a loved one or your offspring have been diagnosed with this. Psychotic disorders are successfully treated! It is only necessary to consult a doctor in time, follow the treatment and believe in recovery. Then the person will be able to live a full life again.

Classification of mental disorders: endogenous, somatogenic, psychogenic types

After reading the article, you will learn what the main types of mental disorders are. What is the difference between them? And what groups of diseases unite? In addition, you will get an answer to the question of what 6% of the world's inhabitants suffer from.

The reality of the modern world

What is a disorder? Psychologists say that to one degree or another it depends on a person's ability to adapt to the realities of life. Overcome problems and difficulties, achieve your goals. Deal with challenges in your personal life, family, and work.

In the modern world, mental disorder is a common phenomenon. According to the World Health Organization (WHO), every 5 inhabitants of the planet are diagnosed with such a problem.

Moreover, by 2017 an updated version of the international classification will be adopted, in which a separate place is occupied by the dependence of modern man on social networks, selfie and video games. From that moment, doctors will be able to officially diagnose and begin treatment.

In the course of studying the number of visitors in the Internet space, scientists from Hong Kong came to the conclusion that 6% of the world's inhabitants suffer from Internet addiction.

Endogenous mental disorders

By itself, the word "endogenous" means development as a result of internal causes. Therefore, endogenous disorders occur spontaneously, without the influence of an external stimulus. What is different from other types.

They progress under the influence of internal general biological changes in the functioning of the brain. The third distinguishing feature is heredity. In most cases, a hereditary predisposition is clearly traced.

Combines 4 main diseases:

1. Schizophrenia
2. Cyclothymia (unstable mood)
3. Affective insanity
4. Functional Disorders late age(melancholy, presenile paranoid)

For example, schizophrenia affects the emotions and thought process. For such people, reality is perceived in a distorted form. They think, express and act differently than everyone else. And this is their reality.

Moreover, in everyday life there is an opinion that a split personality is schizophrenia. No, there is nothing in common between the two concepts. Schizophrenia is, first of all, a distortion of perception of the surrounding world.

Did you know that the famous American mathematician, Nobel laureate John Nash had paranoid schizophrenia. The story of his life formed the basis of the popular film A Beautiful Mind.

• epilepsy
• Atrophic brain disease (Alzheimer's disease, senile dementia)
• Pick's disease and other disorders

Somatogenic mental disorders

In general, the group is represented by disorders that are caused by:

• Medicinal, industrial and other intoxication
• extracerebral infection
• alcoholism
• Substance abuse and drug addiction
• Somatic diseases
• brain tumor
• Neuroinfection or traumatic brain injury

Psychogenic mental disorders

The causative agents of this type are micro- and macrosocial factors, an unfavorable psychological situation, stress and negative emotions (anger, fear, hatred, disgust).

How do psychogenic disorders differ from the previous two? First of all, the absence of clear organic disorders of the brain.

Combines the following five deviations:

1. neuroses
2. Psychoses
3. Psychosomatic disorders
4. Abnormal reactions of the body to a particular phenomenon
5. Psychogenic development of personality after trauma

For example, neuroses are characterized by obsessive, sometimes hysterical manifestations. Temporary decrease in mental activity, increased anxiety. Sensitivity to stress, irritability and inadequate self-esteem. Patients often experience phobias panic fears and obsessions, as well as the inconsistency of life principles and values.

The concept of neurosis has been known to medicine since 1776. It was then that the term was introduced into everyday life by the Scottish physician William Cullen.

Pathologies of mental development

This class is associated with deviations and pathologies of the formation of mental individuality. Anomalies are observed in different areas - intelligence, behavior, skills and even abilities.

• Psychopathy (unbalanced, unstable behavior and human psyche)
• Oligophrenia (mental retardation)
• Other delays and violations

Let's summarize

Whatever category your disease belongs to (perhaps relatives and friends are ill), it is important to understand one thing - it is difficult to cope without the support of not only doctors, but also friends. Lend a helping hand. Do not refuse if it is offered to you. Everything is surmountable, the main thing is to believe in it!

Etiology of mental disorders. "Endogenous" and "exogenous"

The entire scientific period of the study of mental pathology, the relationship between psychogeny and schizophrenia remains key issue, which merges, on the one hand, into the century-old discussion about "endogeneity and exogeneity", on the other hand, into the no less old and complex issue of the etiology of schizophrenia. It is known that in psychiatry the etiology of most diseases remains unknown. Moreover, in general somatic medicine, questions of the etiology and pathogenesis of most diseases are clear only at first glance. In fact, everything turns out to be no less complex and contradictory. (I.V. Davydovsky "The problem of causality in medicine (etiology)")

Traditionally, psychogenic disorders are classified as exogenous pathology, while schizophrenia is endogenous. The question of such a division is debatable, but the answer to it is of decisive importance and far-reaching consequences. It is appropriate to illustrate the importance of this problem with a quote from A. Kronfeld: “..is it possible to make a division into exogenous and endogenous diseases on the basis of a symptomatic picture? This is the cardinal question of clinical psychiatry. The fate of Kraepelin's entire systematics depends on the answer to it.

In the work of J. Fernel "General Medicine" (1554), in the chapter "Diseases of the Brain", the author already contrasts disorders, later called exogenous and endogenous. (PelicierL Histori de psychiatri. - Paris, 1971. - P. 45) F Plater (XVII century), the compiler of the first classification of mental illness, singled out the external and internal causes of psychoses. Those originating from the former are of the nature of mental shock - "commotio animi", they lead to fear, jealousy, etc. Sondras (1851) classified disorders with a pathogenesis not studied at that time as a group of neuroses. This group, respectively, included future endogenous psychoses. V. Magnan (1887) extended the teachings of B. Morel (1857) about degenerative psychoses to a wide range of people. According to this concept, mental disorders are the result of degeneration, which manifests itself as both physical and mental symptoms. Magnan believed that the tendency to mental illness can be both hereditary and acquired. This predisposition is a consequence of either the usual "fragility of the psyche", or is based on degeneration. In German psychiatry, "degenerative psychoses" were dealt with by Griesinger, Schule, Krafft-Ebing, Schroder, Kleist, O. Binswanger, Kolle.

Möbius (1893) first subdivided all etiological factors into two large groups - exogenous and endogenous. The features of these two groups, according to the author, was the presence of obvious external harm in the case of exogenous, and innate determinism in the case of endogenous. K. Kleist opposed such a division, instead he proposed to distinguish between "allogeneic" and "somatogenic" etiological factors. In 1894, Sommer coined the term "psychogenic illness". In 1905, Dubois proposed to replace the concept of "neuroses" with "psychoneurosis". The German scientist K. Bonhoeffer created the doctrine of exogenous type reactions, which was based on the limited response to a variety of external hazards. Thus, according to Bongeffer, any exogenous factor can cause any of the following reactions, that is, exogenous mental disorders are nonspecific, and their clinic depends not only on the type of harmfulness, but on its intensity and duration. Symptomatic psychoses (K. Bonhoeffer, 1908):

1. Delirium associated with febrile and infectious diseases.
2. The epileptiform type, which can be detected in violent motor arousal, in arousal with fear, with a lost or preserved orientation, or in a dreamy twilight state of consciousness.
3. Hallucinosis, close to delirium, and sometimes developing from them, with rapidly increasing symptoms.
4. States of stupor of varying intensity. It is often associated with aphatic, apractical and perseverative elements.
5. Amentia in the narrow sense, i.e., states in which ambiguity of thinking comes to the fore, a disorder of combinatorial abilities with hallucinatory elements, with elements of a jump of ideas, elements of hypermetamorphosis, fleeting delusional states, psychomotor symptoms- the nature of the lability of affect.

In contrast to Bongeffer, Specht made the assertion that a certain pathogenic factor affects the psyche in all psychopathological conditions, and is the cause of any disease, both "exogenous" and "endogenous". The only difference is that in "endogenous" conditions, the effect of this factor is weakly expressed, not very intense, as a result of which a "mild form" develops - similar to endogenous diseases. It should be noted that the discussion between Bongeffer and Specht remains relevant to this day. The following assessment of this problem is given by O. Bumke:

“However, the confusion between analyzes of reality and analyzes conditioned by point of view has always given rise to great misunderstandings. If an external cause evokes an abnormal psychic reaction only when the brain, by virtue of predisposition, i.e., endogenously, is abnormal, then it is precisely then, as is often the case, that real endogenous non-exogenous causes or conditions come into play in the aggregate. If the struggle of opinions associated with the names of Bongefer-Specht revolved around whether it is really possible to distinguish exogenous from endogenous disorders by a certain set of symptoms, then the outcome of this dispute does not change anything in the issue of recognizing certain points of view”

H. Wieck (1956) designated as "transitional syndromes" psychopathological conditions observed after an acute exogenous Bongeffer reaction. These states occupy an intermediate place between the above states and the psychoorganic syndrome. H. H. Wieck singled out the following registers of transitional syndromes: 1) characterizing the syndromes of change in impulses; 2) affective syndromes (asthenic, anxio-depressive); 3) schizophrenia-like syndrome (hallucinatory-paranoid syndrome); 4) amnestic Korsakov's syndrome.

Manfred Bleuler, son Eugena Bleuler, was a supporter of not a nosological, but a syndromological approach, so he singled out “an organic psychosyndrome that developed as a result of diffuse brain damage”; "endocrine psychosyndrome" caused by diseases of the endocrine system; "acute exogenous reactions" such as the Bongeffer reaction that occur with general somatic diseases; "psycho-reactive and psychogenic disorders" caused by mental experiences; "personality options" (psychopathy and oligophrenia), as well as "endogenous psychoses".

In modern psychiatry, the tendencies of denying nosological units, on the one hand, and refusing to use the concepts of "endogeny" and "exogeny", on the other hand, have intensified. This approach is fraught with consequences that are destructive for psychiatry as a scientific discipline, which are warned by such scientists as A.B. Smulevich and N.A. Ilyina: “However, since we are talking not only about the alternative “schizophrenia – a disease or syndrome”, but also about leveling/denying the autochthonous (endogenous) nature of suffering, in relation to clinical practice, this approach is fraught with serious consequences.

With this approach, the facts established by fundamental clinical studies (including those belonging to A.V. Snezhnevsky and his school) conducted throughout the 20th century, which are valid for any diagnostic system, are leveled.

In accordance with the data of these studies, there is a group of mental disorders defined as autochthonous or endogenous, formed on the basis of a constitutional genetic predisposition, the manifestation of which at the current level of knowledge cannot be satisfactorily justified by the influence of exogenous, situational, psychogenic or somatogenic factors alone. The existence of this group meets the criteria of clinical practice and should be reflected in new taxonomy of mental disorders.”

An interesting picture of "internal" and "external" in relation to the subject is given by J. Lacan, correlating it with a topologically impossible figure - a "Klein bottle", which cannot be realized in three-dimensional space without a defect, or a "Mobius strip" which has no internal and outside.

Thus, the term "endogenous" most often means such concepts as "internal", "with unknown etiology", "autochthonous", "genetic". Another group under consideration here is the psychogenies, a term first used by Kurt Sommer in 1894 in relation to hysterical reactions. as already noted, refers to exogenies, although some authors allocate a special place for this category, and some even bring them closer to endogenies. So, V.N. Myasishchev, the author of the psychology of relationships and the conceptual basis of pathogenetic, or psychogenetic, psychotherapy (1955) reminds us that the experience is derived from the personality of the experiencer, and the pathogenicity of the situation is due to the impossibility of its rational resolution or the rejection of unrealizable desires. According to Myasishchev, with psychogenies, due to the characteristics of the individual's character - "situational insufficiency", the relationship of the individual with the external environment is violated. According to Kerer (1920), a "psychogenic reaction" is the result of an interaction between a predisposition and a specific trauma leading to a mental disorder. The constitutional predisposition is seen as endogenous factor. According to the author, psychogenic illness is ultimately determined by the conditions in which the personality was formed, and, in fact, also includes genetic mechanisms. K. Jaspers classifies psychogenic reactions into three aspects: 1) by precipitating factors (including imprisonment, earthquakes and catastrophes, nostalgic reactions, isolation, linguistic barriers, deafness); 2) according to the mental structure of reactive states (impulsive, with clouding of consciousness, hysterical, hallucinatory-paranoid); 3) by type mental constitution, which determines the reactivity, and in this classification the apparent contradictions shown above are solved. Thus, K. Jaspers in his classification of reactive states takes into account both classical "exogenous" and "endogenous" moments.

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Psychoses are severe disorders psyches, which are characterized by behavioral changes and abnormal manifestations. In this state, a person is far from an adequate assessment of the surrounding reality, his consciousness is distorted, and excitability is often replaced by apathy.

There are many types of this disorder, one of which is endogenous psychosis.

Characteristics and causes of the disorder

Endogenous psychosis is a type of mental disorder that is accompanied by increased, and.

The following types of mental disorders are classified as endogenous psychoses:

It is impossible to determine the exact causes of this condition, however, there are a number of factors that can provoke endogenous mental disorders.

Most often this occurs against the background of negative manifestations in the body: diseases of a somatic and neuroendocrine nature, hereditary pathologies of the psyche and age-related changes. Often, psychoses make themselves felt in diseases associated with. Also, this condition often accompanies.

And also we must not forget about the presence of the patient's predisposition to such conditions and the instability of the psyche of certain individuals.

Features of symptoms

Clinical manifestations of psychosis with an endogenous nature can be very diverse, but there are a number of the most common symptoms that allow you to recognize the violation in a timely manner:

The listed symptoms can accompany various types of mental disorders, for this reason it is not easy to distinguish endogenous psychosis from another type of disorder due to similar symptoms.

Characteristic behavioral signs

Most often, psychoses are characterized by an undulating course of the disorder, when, after the exacerbation stage, complete or partial remission occurs. Most attacks occur spontaneously, but can be triggered by any psychogenic factors, such as physical and emotional overwork and .

In this state, the patient is dangerous and can harm himself or others. When characterized by persistent, irresistible mania, intrusive thoughts about suicide and irritability. Then there is a sharp change in mood and depression occurs. This is the main feature of the state.

Also, the patient may experience inexplicable fear and, while the person does not adequately assess his condition and does not realize that he is unwell.

In most cases, such patients refuse treatment and hospitalization, considering themselves perfectly healthy. Sometimes relatives and close people are not easy to convince such a patient of the need for medical care and it is almost impossible to cope with outbreaks of aggression on his part. However, it is impossible to leave a person in this state, he needs qualified treatment.

Attacks of endogenous psychosis are acute and chronic. In the first case, the violation develops rapidly and unexpectedly, and after a few days you can observe clinical picture psychosis. Such attacks are relatively short, lasting from 10–12 days to 2–3 months.

At chronic form The patient stays in this state for 3 to 6 months. If this phase lasts more than 6 months, the attack is considered protracted.

Diagnosis and treatment

Due to the fact that the symptoms of various psychoses are largely similar, it is the endogenous type of disorder that can only be diagnosed by a psychiatrist after a thorough examination of the patient's condition.

At the first manifestations of mental abnormalities, an urgent consultation with a specialist is necessary. You should not try to take independent measures or convince the patient in this condition, this will not give an effect, you need to call an ambulance.

After the diagnosis is made, medication is prescribed. As a rule, in these cases, the following types of drugs are used:

In addition to taking medications, the patient also needs psychotherapeutic methods of treatment. Success directly depends on the correctness of the chosen methods of therapy, as well as on how timely assistance was provided. Therefore, you should not delay a visit to the doctor when symptoms of the disorder appear.

The duration of treatment is approximately 2 months, but only if the assistance was provided on time. In a situation where the disease is running, it is difficult to make a prognosis, the recovery process can drag on for an indefinite time.

Possible consequences

If the diagnosis is made on time and competent treatment is prescribed, the chances of a favorable outcome are very high. Symptoms of the disease disappear, often without leaving any serious consequences, after a while a person will be able to adapt to the surrounding reality and lead a full life.

But there are cases when, even with competent treatment and timely treatment for help, a person's personality undergoes changes.

In such a situation, peculiar “fallouts” of certain personal characteristics are characteristic, for example, a person loses leadership qualities or initiative, and the attitude towards loved ones becomes almost indifferent. This can lead to various violations in the social adaptation of a person.

Endogenous psychosis can occur once in a lifetime, and after the treatment, it will never happen again. But the possibility of repeated attacks cannot be ruled out, they can become permanent and turn into a serious continuous illness.

The main differences between exogenous and endogenous psychosis

Exogenous psychoses refer to mental disorders against the background of pathological processes in the nervous system. If endogenous psychosis is provoked by various disorders, then exogenous processes provoke diseases of the central nervous system:

Like endogenous psychosis, an exogenous disorder can be of a one-time nature or, conversely, periodically manifest itself, and subsequently transform into a continuous illness.

The human psyche is an issue little studied by modern medicine, and therefore it is rather difficult to predict the consequences of mental disorders. But subject to the following rules, you can increase the effectiveness of treatment, thereby increasing the chances of success:

• do not try to treat the patient yourself;
• at the first manifestations of mental illness, seek medical help;
• timely treat diseases and conditions that can cause such mental disorders.

The effectiveness of treatment largely depends on how quickly and competently the necessary measures were taken, so you should not ignore alarming symptoms and postpone a visit to a specialist.

• Affective diseases:

- affective psychoses (including manic-depressive psychosis)

- cyclothymia

- dysthymia

• Schizoaffective psychoses
• Functional psychoses of late age (including involutional depression (E. Krepelin, 1908)).

These are diseases that have an internal cause.

The main signs of endogenous diseases

1. Spontaneous nature of the onset of the disease. When we try to find out from relatives how the disease began, we fail to identify the cause. This is the mysticism of endogenous psychoses. Suddenly, for no reason, in May, a woman develops depression (nothing happened!) Or a man develops in the fall.

1. Autochthonous course of the disease. Not affected by changes external factors. No environmental influences can affect the course of the disease. Depressed patient - no matter what joyful event happens, she will not come out of depression.

1. chronic course diseases(exogenous diseases - most often acute), manifested by exacerbations in the form of phases (MDP) or seizures (schizophrenia).

And exogenous diseases are most often acute conditions that develop quickly, do not last long and end after treatment.

Schizophrenia

Schizophrenia - a mental illness characterized by disharmony and loss of unity of mental functions (thinking, motor skills, emotions), a long continuous or paroxysmal course and different severity of productive (positive) and negative disorders, leading to personality changes in the form of autism, a decrease in energy potential and emotional impoverishment ( Tiganov A. S., 1999)

Disharmony and loss of unity - this is schism (splitting) is the underlying characteristic of schizophrenia.

Dementia praecox ( early dementia )

E . Kraepelin, 1896 - 1899

He divided all mental illnesses according to the principle of course and prognosis.

E. Kraepelin united the following observed before him into a single nosological unit:

1) "dementia praecox" (M. Morel, 1852)

2) hebephrenia (E. Gekker, 1871)

3) catotonia (K. Kalbaum, 1874)

4) chronic delusional psychoses (V. Manyan, 1891)

Criteria for diagnosis: dementia prejos is a disease that begins at an early age, is characterized by a continuous course and ends with an unfavorable outcome in dementia.

Then the debate began whether dementia occurs. In schizophrenia, the intellect does not suffer, emotions and will suffer. The concept of a personality defect was formed.

Primary signs of schizophrenia (4 "A") according to E. Bleuler (1911)

The term "schizophrenia" belongs to Blayer. This term comes from the word "schism". For a long time, it was not "schizophrenia", "schizophrenia" that sounded. Splitting of the psyche.

He attributed to the secondary ones: delirium, hallucinations, senestopathies, etc.

Primary signs (4 "A")

1. Autism – loss of social contacts by the patient
2. Violation Associations (or pathology of thinking) - reasoning, fragmentation, slippage, paralogy, symbolism
3. Impoverishment affects - impoverishment of emotionality up to apathy.
4. Ambivalence - schism - dissociation, splitting between various mental manifestations.

So, the basis of schizophrenia are negative disorders. These disorders can only occur in patients with schizophrenia. If negative disorders appear, we can say that the patient has schizophrenia.

Symptoms of the first rank according to K. Schneider

If Kraepelin proceeded from the course of the mental process, Blair considered negative disorders, then Schneider considered positive ones.

It looks like the Kandinsky-Clerambault syndrome (impacts, pseudo-hallucinations, mental automatisms).

What Kraepelin wrote about would be characteristic of only one small form of schizophrenia. This is history. Four "A" according to Blair - the basis of diagnosis, negative disorders.

Most common symptoms of acute schizophrenia

(according to M. Gelder et al., 1999)

The main clinical manifestations of schizophrenia

1. Autism - separation of the patient's personality from the surrounding reality with the emergence of a special inner world that dominates the mental activity of the patient.

Hobbies of patients become not only very subjective, but also incomprehensible to others. Disorder "metaphysical intoxication" (15-16 years old) or "philosophical intoxication". The teenager is engaged in philosophy, religion, psychiatry, psychology. Unproductiveness is characteristic: what philosophical currents do you know? But he cannot say this, although he studies literature.

Interpersonal relationships, friendships, love, family ties will be destroyed. A patient with autism is better off alone. At the same time, separation from the surrounding world does not mean that his inner world is empty. E. Kretschmer has a comparison of an autistic patient with ancient Roman villas, shuttered from others, and inside there are balls and feasts. Patients with autism are not allowed into their world. He fantasizes, he has his own thoughts and ideas.

1. emotional changes :

From emotional flattening to complete affective dullness (“affective dementia” - E. Krepelin);

The extreme expression of emotional decline is apathy.

The disappearance of a sense of shame (“nakedness”).

Here the range is very large. From emotional cooling to affective dullness. There is a peculiar symptom: negativism towards the closest people. Often to mothers. Mothers come and say: the child treats everyone the same, but to me - the worst. There is no such reaction to father, grandmother, grandfather.

Disappearance of feelings of modesty: since the patient is emotionally emasculated, modesty is also lost. For example, it is often detected in clinical trials. Sick in the presence a large number people begins to talk about their sexual preferences, calmly, with an amimic face.

When it comes to apathy, we must remember that not all patients develop apathy, abulia. Not everyone has apathico-abulic syndrome, a very small number.

Comparison: with an allegedly extinct volcano (so they say about patients with schizophrenia). But he has a lot of power under his belt. And in many cases, well-conducted treatment (iglanil - a neuroleptic with a stimulating effect) - and patients with apato-abulic syndrome began to rise.

During the 2nd World War, when psychiatric hospitals were evacuated, patients with schizophrenia suddenly committed heroic deeds, rescued nurses, for example.

1. Thinking disorders in schizophrenia

1. Blockage of thinking, often with a subjective sense of loss of control over thoughts (sperrung)
2. Neologisms- new, own language
3. Blurred thinking– lack of clear conceptual boundaries
4. reasoning- the chain of reasoning eludes the patient
5. slipping- sudden change of topic of conversation
6. Verbigerations- mechanical repetition of words and phrases (especially common in chronic forms)
7. Own logic
8. Difficulties in generalizing and understanding similarities and differences
9. Difficulties in separating the major from the minor and discarding the non-essential
10. Combining phenomena, concepts and objects according to insignificant features

It happens: clinical method(psychiatrist) does not reveal disorders, he asks the psychologist: look carefully if there are thought disorders. The psychologist begins to lay out the cards and highlight the thinking disorders. Psychologists who will work in clinical psychology are of great help to psychiatrists in the early diagnosis of mental disorders.

1. Decrease in mental activity (“reduction of energy potential” according to K. Konrad (or “broken wing syndrome”))

Lost "steel" and "rubber" in the individual. There are problems with learning, with work, it becomes difficult to read books, watch TV, learn new knowledge. The condition improves after physical work. He does it with pleasure and does not get tired. “Steel” is purposefulness, striving for achievements. "Rubber" is flexibility, the ability to adapt to the environment (Gannushkin).

P. Janet - mental strength - determines the ability of an individual to implement any mental functions; psychic tension is the ability of an individual to use his psychic power.

A balance is needed between psychic power and mental stress.

The extreme expression of a decrease in mental activity is abulia.

Apato-abulic syndrome.

It often happens: there is psychic strength, but there is no tension. In everyday life, we call this laziness. There are opportunities, but you don't want to use them. A schizophrenic patient cannot use his psychic power. "Broken wing syndrome" - you have to force, give the command. Otherwise, nothing will be done, a push from the outside is needed.

1. Disharmony of the mental make-up of the personality - schism - splitting

The coherence between the main mental processes is violated: perceptions, feelings, thoughts and actions (the unity of the personality is lost).

1. 1.Schisis in thinking:

- diversity of thinking (both essential and non-essential confessions are used at the same time. Honesty is a category of reasonable relations that are reflected in mathematics, physics and psychiatry - the definition of a patient)

- fragmentation of thinking (the patient tells the psychiatrist that he has somatic disease, and why it is treated at the psychiatrist? Because there was a queue to the therapist ...)

- schizophasia

How to distinguish schisis from Kandinsky-Clerambault syndrome? We understand schism as a negative disorder. Some psychiatrists consider Kandinsky-Clerambault to be a manifestation of schism. But this is a productive disorder.

1. 2. Schism in the emotional sphere:

According to E. Kretschmer, the psychesthetic proportion is “wood and glass” (emotional dullness + fragility, sensitivity of mental organization). Don't cry at funerals loved one, but at the sight of an abandoned kitten, he begins to sob over him.

- ambivalence

- paramimia (what worries you? - longing (and at the same time he has a smile on his face)

- parathymia (the funeral of a loved one, everyone is crying, but he rejoices)

1. 3. Volitional split

- ambitency (duality of desires, illustration - Buridan's donkey, which died of hunger between two haystacks)

- the concept of negativism (E. Blair) - all ideas, emotions, tendencies of a patient with schizophrenia always correspond and coexist in their opposites.

1. 4. Psychomotor splitting

- catotonic stigmas: the patient stereotypically wrinkles his forehead, makes movements with his hands

- mannerisms and pretentiousness: the movements of patients become peculiar and incomprehensible to others

E. Kraepelin "an orchestra without a conductor": dissociation, inconsistency of the patient's mental activity resembles an orchestra that is trying to play without a conductor. Each instrument plays its part correctly, but the overall sound is not obtained. Cacophony. "Book with mixed pages"

1. Appearance and demeanor

They begin to dress differently, look different (example: Zh. Aguzarova, who has turned into a “space girl”). Sometimes you pay attention to the announcers: he talks about sad events, and he has a mask on his face. He speaks in a monotone, amimic, "wooden voice." The gait becomes angular, “bouncing bird”, smoothness and naturalness are lost.

1. "drift" phenomena

Due to changes in mental processes, patients compare themselves with a boat or an ice floe, which is carried in an unknown direction. Such is the life of the sick. Among the homeless - about 50% of mental patients. They lose apartments, begin to become alcoholic ... A person began to drift through life, nothing depends on him ...

Positive and Negative Disorders in Schizophrenia

1. schizophrenia

The prevalence of schizophrenia in the world is 0.8 - 1.1%.

The ratio of men and women is 1: 1

The average age of onset of the disease: men - 18-25 years, women - 25-30 years.

75% of patients with schizophrenia require inpatient treatment.

They occupy 1/2 of all psychiatric beds.

Schizophrenia is the most expensive of all mental illnesses (in Russia - 2% of GDP or 5 billion rubles, in Germany - ten times more)

1. Etiology of schizophrenia

1. 1. Genetic concept.

hereditary origin.

The general population is 1%.

Nephews, nieces - 4%.

Stepbrothers, sisters - 6%.

Brothers, sisters - 9%.

One of the parents - 14%. It was found that if the mother is sick, then the probability of getting schizophrenia is 5 times higher than if the father is sick.

Children with two sick parents - 46%. If a child of a parent with schizophrenia is adopted, they still get sick (may get sick).

Dizygotic twins - 17%.

Monozygotic twins - 48%.

The hereditary factor in endogenous diseases is very important.

1. 2. Neurochemical (neurotransmitter) concept.

Appeared after psychotropic drugs were introduced into the practice of psychiatrists.

1. 2. 1. Hypothesis of hyperactivity of dopamine systems. Dopamine receptors (D2) in the mesolimbic system of the brain. Amphetamine, cocaine, mescaline - they enhance dopanine transmission, manifestations similar to schizophrenia. Patients have 6 times more dopamine receptors than healthy people.

1. 2. 2. Serotonin hypothesis

Serotonin 5-HT2A receptors. LSD, psilocybin.

1. 2. 3. Norepinephrine hypothesis.

Blockers of these neurotransmitters lead to the elimination of schizophrenic symptoms. Substances that accelerate the action of these neurotransmitters lead to psychosis.

But these concepts explain the emergence of productive symptoms. But the basis of schizophrenia is negative symptoms. They cannot explain the essence of negative disorders. It is not explained why there are 6 times more receptors for these neurotransmitters in the GM of schizophrenic patients.

And there are cases of schizophrenia resistant to antipsychotics. This concept does not explain everything.

1. 3. Theory of impaired brain development (dysontogenetic)

prenatal period (before birth)

- perinatal period (after birth)

An important role is played by the hazards that the child receives through the mother's body (alcohol, drugs, premature babies, birth trauma- all this leads to dysontogenesis). Synaptic transmission (neurotransmitters) is disrupted. Perhaps, as an explanation for why dopamine receptors prevail, it is connected with the prenatal and perinatal period in a child's life.

1. 4. Theory of neuromorphological changes

- affected limbic parts of the brain

- in 5-50% of patients, CT reveals an expansion of the lateral and third ventricles (correlates with the severity of negative symptoms)

- in 10-35% of patients on CT there are signs of atrophy of the brain cortex

1. 5. Psychodynamic / psychosocial concepts

1. 5. 1. Communicative deviations("SD"). There are no clear criteria in the family that allow the child to navigate the situation and correctly predict the consequences of his behavior (unpredictable change of rewards and censures, emotional closeness and distancing of the child)

1. 5. 2. "Pseudodependence".

"Rubber fence" - the desire of the family to demonstrate to others family harmony in the complete absence of the latter. And so that others do not know about it, they move the child away from the social environment. And the child moves away from interpersonal communication.

1. 5. 3. "Split Marriage"- an open conflict between parents, a struggle for power over a child, attempts to involve him in this struggle on his side. Two adults did not share something, and they involve the child in the conflict, they begin to drag him in different directions. The child is predisposed to...

1. 5. 4. Negative affective style("AS"). The emotional climate in the family is critical in relation to the patient, the induction of feelings of guilt, perseverance in relation to the patient (overprotection).

Characteristics of the negative affective style: if in a conversation with a child for 10 minutes: 6 comments (criticizes him, criticism with guilt).

In recent years, a hypothesis has emerged:

1. 6. Vulnerability-diathesis-stress theories

Schizophrenia requires:

1) specific vulnerability (diathesis) of the patient (hereditary burden, somatic constitution (morphophenotype - E. Kretschmer schizoids, MRI signs (neurobiology), dopaminergic dysfunctions, etc.),

2) the action of the stressor environment(alcoholism, trauma, social stress, psychosocial and psychodynamic factors,

3) personal protective factors, (coping (coping with the situation), psychological protection),

4) environmental protective factors (solving family problems, supporting psychosocial intervention).

The etiology of schizophrenia is still unknown. None of the theories explains all 100% of the incidence of schizophrenia.

1. Clinical forms of schizophrenia

ICD-10 (F20 - 29) "Schizophrenia, schizotypal and delusional disorders",

F 20 - schizophrenia

F 21 - schizotypal disorder (in the Russian Federation - sluggish neurosis-like schizophrenia), this is no longer schizophrenia!

F 22 - chronic delusional disorders

F 23 - acute and transient delusional disorders

F 24 - induced delusional disorder

F 25 - schizoaffective disorder (in the Russian Federation - recurrent schizophrenia)

F 28 - other non-organic psychotic disorders

F 29 - unspecified delusional psychosis

Dynamics of the schizophrenic process

1. prodromal period(5-10-15 years old). In a scrupulous analysis of the lives of patients, it was found that over 5-10-15 years of development of an acute attack of schizophrenia, 21% of patients had "first lightning bolts" (K. Konrad (1958)). These are depressive episodes lasting weeks, episodes of depersonalization, conditions with visual hallucinations, the child was afraid and did not sleep - the condition lasted 10-14 days. But no one has diagnosed it not only as schizophrenia, but also as a psychotic disorder.

1. Manifestation period(acute phase 4-8 weeks). This is the most acute phase of schizophrenia. After it has passed, schizophrenia takes on the character:

1. Periodic exacerbations, separated by remissions.

1. Post-psychotic depression(every 4th patient)

1. Defective condition(5-7 years of the course of the disease, it all depends on the malignancy of the course of the process. Every 4th now develops such a condition. At the beginning of the century - in 80% of patients. Antipsychotics helped.

Classification of schizophrenia (ICD-10 F -20)

F 20.0 paranoid type

F 20.1 hebephrenic type

F 20.2 catatonic type

F 20.3 undifferentiated schizophrenia

F 20.4 post-schizophrenic depression

F 20.5 residual schizophrenia

F 20.6 simple form of schizophrenia

F 20.8 other forms of schizophrenia

F 20.9 schizophrenia, unspecified

1. 1. Paranoid form of schizophrenia ( F 20.0)

"Chronic delusional psychoses" V. Magnan (1891)

The most common form of schizophrenia (about 30-40%)

Favorable prognosis (in terms of defect formation)

Age of onset of the disease - 25 - 30 years

Syndromotaxis of paranoid schizophrenia: neurosis-like syndrome - paranoid syndrome - paranoid (hallucinatory-paranoid) syndrome - paraphrenic syndrome - personality defect (apato-abulic syndrome).

1. 2. Hebephrenic form of schizophrenia ( F 20.1)

"Hebephrenia" (E. Gekker, 1871).

DSM-IV is a disorganized form.

The most malignant form of schizophrenia. The age of onset of the disease is 13-15 years. Non-remission course (2-4 years - defect).

Pfropfschizophrenia - the onset of schizophrenia in early childhood leads to an intellectual defect similar to the manifestations of oligophrenia. You need to differentiate.

Hebephrenia is a combination of motor and speech excitation with foolishness, labile affect, negativism, regression of behavior. Against this background, personality changes catastrophically increase.

1. 3. Catatonic form of schizophrenia ( F 20.2)

"Catatonia" by K. Kalbaum, 1874

Currently rarely diagnosed (4-8% of all Sch)

Clinical picture: movement disorders: catatonic stupor-catatonic excitation.

Catatonia + hebephrenia

Catatonia + oneiroid (the most favorable form)

Lucid catatonia (the most malignant). Against the backdrop of clear consciousness.

Often we deliberately exacerbate the patient's condition to make it easier to treat. Chronic, protracted, with small manifestations is treated worse.

1. 4. Undifferentiated schizophrenia ( F 20.3)

When it is difficult to isolate a particular disorder.

1. 5. A simple form of schizophrenia ( F 20.6)

No productive disorders, or very few.

Onset in adolescence or youth (13-17 years). Continuous, non-remission course. Clinical manifestations are negative symptoms.

“Simplex syndrome” (autization, emotional impoverishment, REP, schism, “metaphysical intoxication”, negativism towards relatives (mother). Moreover, when he is visiting, he speaks well of his mother. He communicates badly with her.

Polymorphic, rudimentary productive symptoms. Voices, derealization, depersonalization. Senestopathy, hypochondriacal disorders. But they are blurry and dim.

Juvenile malignant schizophrenia

Dementia praecox (E. Krepelin, 1896), "sudden fettering of all abilities." Everything that Kraepelin described (except dementia (it is not present in schizophrenia).

- simple shape

- hebephrenic form

- "lucid" catatonia

It makes up 5-6% of all schizophrenia.

Boys get sick 5 times more often than girls.

Adolescence and youth.

Continuous and pronounced defective course.

Rapid formation (2-4 years) of a defective state.

Resistance to therapy (since negative disorders predominate).

Sluggish neurosis-like schizophrenia (“schizotypal disorder” according to ICD-10)

"Latent schizophrenia" (E. Bleyer, 1911), "mild schizophrenia" (A. Kronfeld, 1928); "preschizophrenia" (N. Hey, 1957)

Prevalence - from 20 to 35% of all patients with Sch

Clinical picture: productive disorders - senestopatho-hypochondriacal, obsessive-phobic, hysterical, depersonalization-derelease syndromes + negative disorders ("Verschroben").

1. Types of the course of schizophrenia

• Continuous
• Episodic with increasing defect
• Episodic with stable defect
• Episodic remitting:

- incomplete remission

- complete remission

- another

- observation period less than a year

In domestic psychiatry:

1. continuously flowing
2. Paroxysmal-progredient (fur-like)
3. Recurrent (periodic)

One third of people with schizophrenia have only one attack. And then - a long-term remission, but negative symptoms are growing in it.

In 70% of patients - up to 3 attacks. The risk of relapse is twice as high in women as in men. In 50% of patients, an episodic (fur-like) course is noted. In 50% of patients - a continuous type of flow.

1. 1. Continuous flow type . There are no remissions. Progression: from malignant juvenile schizophrenia to sluggish neurosis-like schizophrenia. An intermediate position is occupied by paranoid schizophrenia. A defective state is quickly formed.

1. 2. Episodic with an increase in the defect (paroxysmal-progressive type of flow) . Remissions of various quality are characteristic. Acute attack (fur coat): hallucinatory-paranoid, affective-delusional, oneiroid-catatonic symptoms. In the interictal period, there is a stepwise increase in the personality defect. The final stage of the course of the disease is a continuous course.

1. 3. Recurrent (periodic) type of flow (ICD-10 F 25 - schizoaffective psychosis). Remissions of sufficiently high quality (up to intermission).

The most acute psychopathological syndromes are characteristic: oneiroid-catatonic and affective. The personality defect is mild.

Examples of diagnoses:

- schizophrenia sluggish neurosis-like; continuous type of flow; senestepato-hypochondriac syndrome;

- schizophrenia; hebephrenic form; continuous type of flow; defective condition;

- schizophrenia; paranoid form; episodic type of flow; hallucinatory-paranoid syndrome.

Prognosis for schizophrenia

Mental illness is a whole group of mental disorders that affect the state of the human nervous system. Today, such pathologies are much more common than is commonly believed. Symptoms of mental illness are always very variable and varied, but they are all associated with a violation of higher nervous activity. Mental disorders affect the behavior and thinking of a person, his perception of the surrounding reality, memory and other important mental functions.

Clinical manifestations of mental diseases in most cases form whole symptom complexes and syndromes. Thus, in a sick person, very complex combinations of disorders can be observed, which only an experienced psychiatrist can assess for an accurate diagnosis.

Classification of mental illness

Mental illnesses are very diverse in nature and clinical manifestations. For a number of pathologies, the same symptoms may be characteristic, which often makes it difficult to diagnose the disease in a timely manner. Mental disorders can be short-term and long-term, caused by external and internal factors. Depending on the cause of the occurrence, mental disorders are classified into exogenous and exogenous. However, there are diseases that do not fall into one or the other group.

Group of exocogenic and somatogenic mental illnesses

This group is quite extensive. It does not include a wide variety of mental disorders, the occurrence of which is caused by adverse impact external factors. At the same time, endogenous factors may also play a certain role in the development of the disease.

Exogenous and somatogenic diseases of the human psyche include:

• drug addiction and alcoholism;
• mental disorders caused by somatic pathologies;
• mental disorders associated with infectious lesions located outside the brain;
• mental disorders arising from intoxication of the body;
• mental disorders caused by brain injuries;
• mental disorders caused by an infectious lesion of the brain;
• mental disorders caused by oncological diseases of the brain.

Group of endogenous mental illnesses

The occurrence of pathologies belonging to the endogenous group is caused by various internal, primarily genetic factors. The disease develops when a person has a certain predisposition and the participation of external influences. The group of endogenous mental illnesses includes diseases such as schizophrenia, cyclothymia, manic-depressive psychosis, as well as various functional psychoses characteristic of older people.

Separately, in this group, one can single out the so-called endogenous-organic mental illnesses that arise as a result of organic damage to the brain under the influence of internal factors. These pathologies include Parkinson's disease, Alzheimer's disease, epilepsy, senile dementia, Huntington's chorea, atrophic brain damage, and mental disorders caused by vascular pathologies.

Psychogenic disorders and personality pathologies

Psychogenic disorders develop as a result of influence on human psyche stress that can occur against the background of not only unpleasant, but also joyful events. This group includes various psychoses characterized by a reactive course, neuroses and other psychosomatic disorders.

In addition to the above groups in psychiatry, it is customary to single out personality pathologies - this is a group of mental diseases caused by abnormal personality development. These are various psychopathy, oligophrenia (mental underdevelopment) and other defects in mental development.

Classification of mental illness according to ICD 10

In the international classification of psychosis, mental illness is divided into several sections:

• organic, including symptomatic, mental disorders (F0);
• mental and behavioral disorders arising from the use of psychotropic substances (F1);
• delusional and schizotypal disorders, schizophrenia (F2);
• affective disorders associated with mood (F3);
• neurotic disorders caused by stress (F4);
• behavioral syndromes based on physiological defects (F5);
• mental disorders in adults (F6);
• mental retardation (F7);
• defects psychological development(F8);
• behavioral disorders and psycho-emotional background in children and adolescents (F9);
• mental disorders of unknown origin (F99).

Main symptoms and syndromes

The symptomatology of mental illness is so diverse that it is rather difficult to somehow structure the clinical manifestations characteristic of them. Since mental illness negatively affects everything or practically everything nerve functions human body, all aspects of his life suffer. Patients have disorders of thinking, attention, memory, mood, depressive and delusional states occur.

The intensity of the manifestation of symptoms always depends on the severity of the course and the stage of a particular disease. In some people, the pathology can proceed almost imperceptibly to others, while others simply lose the ability to interact normally in society.

affective syndrome

An affective syndrome is usually called a complex of clinical manifestations associated with mood disorders. There are two large groups of affective syndromes. The first group includes states characterized by a pathologically elevated (manic) mood, the second group includes states with a depressive, that is, depressed mood. Depending on the stage and severity of the course of the disease, mood swings can be both mild and very bright.

Depression can be called one of the most common mental disorders. Similar states characterized by extremely depressed mood, volitional and motor retardation, suppression of natural instincts, such as appetite and the need for sleep, self-deprecating and suicidal thoughts. In particularly excitable people, depression can be accompanied by outbursts of rage. The opposite sign of a mental disorder can be called euphoria, in which a person becomes careless and contented, while his associative processes are not accelerated.

The manic manifestation of the affective syndrome is accompanied by accelerated thinking, fast, often incoherent speech, unmotivated elevated mood, and increased motor activity. In some cases, manifestations of megalomania are possible, as well as an increase in instincts: appetite, sexual needs, etc.

obsession

Obsessive states are another common symptom that accompanies mental disorders. In psychiatry, such disorders are referred to as obsessive-compulsive disorder, in which the patient periodically and involuntarily has unwanted, but very obsessive ideas and thoughts.

To this disorder also include various unfounded fears and phobias, constantly repeating meaningless rituals with which the patient tries to alleviate anxiety. There are a number of features that distinguish patients suffering from obsessive states. First, their consciousness remains clear, while obsessions are reproduced against their will. Secondly, the occurrence of obsessive states is closely intertwined with negative emotions person. Thirdly, intellectual abilities are preserved, so the patient is aware of the irrationality of his behavior.

Consciousness disorders

Consciousness is usually called the state in which a person is able to navigate in the world around him, as well as in his own personality. Mental disorders very often cause disturbances in consciousness, in which the patient ceases to perceive the surrounding reality adequately. There are several forms of such disorders:

Perceptual disturbances

Perceptual disturbances are usually the easiest to recognize in mental disorders. Simple disorders include senestopathy - a sudden unpleasant bodily sensation in the absence of an objective pathological process. Seneostapathia is characteristic of many mental illnesses, as well as hypochondriacal delusions and depressive syndrome. In addition, with such violations, the sensitivity of a sick person may be pathologically reduced or increased.

Depersonalization is considered more complex violations, when a person ceases to live his own life, but seems to be watching it from the side. Another manifestation of pathology can be derealization - misunderstanding and rejection of the surrounding reality.

Thinking disorders

Thinking disorders are symptoms of mental illness that are quite difficult to understand for an ordinary person. They can manifest themselves in different ways, for some, thinking becomes inhibited with pronounced difficulties when switching from one object of attention to another, for someone, on the contrary, it is accelerated. A characteristic sign of a violation of thinking in mental pathologies is reasoning - the repetition of banal axioms, as well as amorphous thinking - difficulties in orderly presentation of one's own thoughts.

One of the most complex forms of impaired thinking in mental illness is delusional ideas - judgments and conclusions that are completely far from reality. Delusional states can be different. The patient may experience delusions of grandeur, persecution, depressive delusions, characterized by self-abasement. There can be quite a few options for the course of delirium. In severe mental illness, delusional states can persist for months.

Violations of will

Symptoms of a violation of will in patients with mental disorders are a fairly common phenomenon. For example, in schizophrenia, both suppression and strengthening of the will can be observed. If in the first case the patient is prone to weak-willed behavior, then in the second he will forcibly force himself to take any action.

A more complex clinical case is a condition in which the patient has some painful aspirations. This may be one of the forms of sexual preoccupation, kleptomania, etc.

Memory and attention disorders

Pathological increase or decrease in memory accompanies mental illness quite often. So, in the first case, a person is able to remember very large amounts of information that are not characteristic of healthy people. In the second - there is a confusion of memories, the absence of their fragments. A person may not remember something from his past or prescribe to himself the memories of other people. Sometimes whole fragments of life fall out of memory, in this case we will talk about amnesia.

Attention disorders are very closely related to memory disorders. Mental illnesses are very often characterized by absent-mindedness, a decrease in the concentration of the patient. It becomes difficult for a person to maintain a conversation or focus on something, remember simple information, as his attention is constantly scattered.

Other clinical manifestations

In addition to the above symptoms, mental illness can be characterized by the following manifestations:

• Hypochondria. Constant fear of getting sick, increased concern about one's own well-being, assumptions about the presence of any serious or even deadly disease. The development of hypochondriacal syndrome has depressive states, increased anxiety and suspiciousness;
• Asthenic syndrome - syndrome chronic fatigue. It is characterized by the loss of the ability to conduct normal mental and physical activity due to constant fatigue and a feeling of lethargy, which does not go away even after a night's sleep. Asthenic syndrome in a patient is manifested by increased irritability, bad mood, and headaches. Perhaps the development of photosensitivity or fear of loud sounds;
• Illusions (visual, acoustic, verbal, etc.). Distorted Perception real-life phenomena and objects;
• hallucinations. Images that arise in the mind of a sick person in the absence of any stimuli. Most often, this symptom is observed in schizophrenia, alcohol or drug intoxication, some neurological diseases;
• catatonic syndromes. Movement disorders, which can manifest itself both in excessive excitement and in stupor. Such disorders often accompany schizophrenia, psychoses, and various organic pathologies.

You can suspect a mental illness in a loved one by characteristic changes in his behavior: he stopped coping with the simplest household tasks and everyday problems, began to express strange or unrealistic ideas, and shows anxiety. Changes in the usual daily routine and nutrition should also alert. Outbursts of anger and aggression, long-term depression, suicidal thoughts, alcohol abuse or drug use will be signals of the need to seek help.

Of course, some of the above symptoms can be observed from time to time in healthy people under the influence of stressful situations, overwork, exhaustion of the body due to past illness etc. We will talk about a mental illness when pathological manifestations become very pronounced and negatively affect the quality of life of a person and his environment. In this case, the help of a specialist is needed and the sooner the better.