paranoid syndrome. Paranoid syndrome: description, causes, symptoms and treatment. Who is prone to paranoid psychosis

Classification

Depending on the disorders prevailing in the clinical picture, they talk about:

Description

Paranoid syndrome indicates a significant depth of mental disorder, which captures all spheres of mental activity, changing the behavior of the patient. The syndrome is characterized by a predominance of figurative delusions, closely associated with auditory hallucinations, anxiety, and depressed mood. Delusions of persecution are most common in paranoid syndrome. The systematization of crazy ideas of any content varies within very wide limits. If the patient talks about what the persecution is (damage, poisoning), knows the date of its beginning, the purpose used for the purpose of persecution (damage, poisoning, etc.), the means, grounds and goals of the persecution, its consequences and the final result, then we are talking about systematized delirium. Delusion can arise like insight and does not require confirmation by facts. When to the patient everything around seems to be filled with hidden meaning (understandable only to him alone), then we are talking about delusions of special significance. If it seems to the patient that strangers on the street pay attention to him, “hint” at something, exchange meaningful glances with each other, then we are most likely talking about a delirium of the relationship. The combination of delusional ideas with hallucinations of any type forms a common hallucinatory-paranoid syndrome. Sensory disorders in paranoid syndrome may be limited to some true auditory verbal hallucinations, often reaching the intensity of hallucinosis. Typically, such a hallucinatory-delusional syndrome occurs primarily in somatically conditioned mental illness. The complication of verbal hallucinations in these cases occurs due to the addition of auditory pseudo-hallucinations and some other components of ideational mental automatism - "unwinding of memories", a sense of mastery, an influx of thoughts - mentism. Depending on the predominance of delusions or sensory disorders in the structure of the hallucinatory-delusional syndrome, delusional and hallucinatory variants are distinguished. In the delusional variant, delirium is usually systematized to a greater extent than in the hallucinatory one, mental automatisms predominate among sensory disorders, and patients, as a rule, are either inaccessible or completely inaccessible. In the hallucinatory variant, true verbal hallucinations predominate. Mental automatism often remains undeveloped, and in patients it is always possible to find out certain features of the state, complete inaccessibility is rather an exception here. In terms of prognosis, the delusional variant is usually worse than the hallucinatory one. Paranoid syndrome can be acute and chronic: in acute, affective disorders are more pronounced and less systematized delirium.

Clinic

Questioning patients with paranoid syndrome often presents great difficulties due to their inaccessibility. Such patients are suspicious, speak sparingly, as if weighing the words. This is suspected by typical statements for such patients (“why talk about it, everything is written there, you know and I know, you are a physiognomist, let's talk about something else”). Even if, as a result of questioning, the doctor does not receive specific information about the subjective state of the patient, he can almost always conclude by indirect signs that there is inaccessibility or low availability, that is, that the patient has delusional disorders.

Syndrome of mental automatism Kandinsky-Clerambault

Nosology

Treatment

Apply complex therapy, based on the disease that caused the syndrome. Although, for example, in France, there is a syndromological type of treatment.
1. Light form: chlorpromazine, propazine, levomepromazine 0.025-0.2; etaperazine 0.004-0.1; sonapax (meleril) 0.01-0.06; meleryl-retard 0.2;
2. Medium form: chlorpromazine, levomepromazine 0.05-0.3 intramuscularly 2-3 ml 2 times a day; chlorprothixene 0.05-0.4; haloperidol up to 0.03; triftazin (stelazin) up to 0.03 intramuscularly 1-2 ml 0.2% 2 times a day; trifluperidol 0.0005-0.002;
3. Aminazine (tizercin) intramuscularly 2-3 ml 2-3 per day or intravenously up to 0.1 haloperidol or trifluperidol 0.03 intramuscularly or intravenously drip 1-2 ml; leponex up to 0.3-0.5; moditen-depot 0.0125-0.025.

see also

Notes

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• Paranichev
• Paranoia and Anhedonia

See what "Paranoid Syndrome" is in other dictionaries:

PARANOID SYNDROME- indicates a significant depth of mental disorder, which captures all spheres of mental activity, changing the behavior of the patient. The syndrome is characterized by the predominance of figurative delusions, closely associated with auditory hallucinations ...

PARANOID SYNDROME- a syndrome that occurs in the presence of disorders of affect and perception (illusions, hallucinations), without disorders of consciousness. According to the content, it can be delusions of persecution, damage, robbery ... Forensic pathopsychology (book terms)

Manic paranoid syndrome- (Greek mania para near, near, deviation from something; noeo perceive, think; eidos similar) a manic state, combined with manifestations of the Kandinsky Clerambault syndrome (pseudo-hallucinations, delusions of the mental and / or physical ... ... Encyclopedic Dictionary of Psychology and Pedagogy

Syndrome- - 1. a cluster or group of symptoms that usually occur together, at the same time and are considered as indicators of a particular disease or disorder. The term is more commonly used in this elementary sense; 2. in the domestic ... ... Encyclopedic Dictionary of Psychology and Pedagogy

Depressive-paranoid syndrome- Combination of depressive mood disorder with paranoid syndrome. The content of the delusion is holotimic in nature (delusions of self-deprecation, self-accusation, sinfulness, delusions of illness, nihilistic delusions), there may be illusions, verbal ... ... Encyclopedic Dictionary of Psychology and Pedagogy

Acute hallucinatory-paranoid syndrome- - an acute psychotic state characterized by anxiety, affective tension, fear, hallucinations and delirium of intersecting content. Often, pseudohallucinations, phenomena of openness and delusional ideas of the physical and ... Encyclopedic Dictionary of Psychology and Pedagogy

Chronic hallucinatory-paranoid syndrome- - a psychotic state with a predominance in the clinical picture of symptoms of mental automatism (delusions of influence, mental automatisms and phenomena of openness), delusional ideas of persecutory content, characteristic mainly of paranoid ... ... Encyclopedic Dictionary of Psychology and Pedagogy

paranoid syndrome- It is characterized by signs of personality change - the experience of unnatural voice, posture, senestopathies with predominant localization in the face and genitals, an inexplicable feeling of discomfort, alienation of one's own sensations and ... ... Encyclopedic Dictionary of Psychology and Pedagogy

hallucinatory-paranoid syndrome- (syndromum hallucinatorium paranoideum) a combination of delusions of persecution with auditory hallucinations or pseudo-hallucinations; seen in schizophrenia and some schizophrenia-like psychoses... Big Medical Dictionary

depressive-paranoid syndrome- (syndromum depressivoparanoideum) a combination of anxious depression with agitation or stupor, delusions of accusation, illusory hallucinosis and verbal hallucinations of content corresponding to delusions, double orientation, figurative delirium; ... ... Big Medical Dictionary

Introduction

The term "paranoid" can refer to symptoms, syndromes, or personality types. Paranoid symptoms are delusional beliefs most often (but not always) associated with stalking. Paranoid syndromes are those in which paranoid symptoms form part of a characteristic constellation of symptoms; an example is morbid jealousy or erotomania (described below). The paranoid (flax) personality type is characterized by such traits as excessive focus on oneself, increased, painful sensitivity to real or imagined humiliation and neglect by others, often combined with an exaggerated sense of self-importance, militancy and aggressiveness. The term "paranoid" is descriptive, not diagnostic. If we qualify this symptom or syndrome as paranoid, then this is not yet a diagnosis, but only a preliminary stage on the way to it. In this regard, we can draw an analogy with the situation when the presence of a stupor or is established.

Paranoid syndromes present significant difficulties in classification and diagnosis. The reason for this can be explained by dividing them into two groups. The first group includes cases where paranoid traits appear in connection with a primary mental illness, such as schizophrenia, an affective disorder, or an organic mental disorder. In the second group, in the presence of paranoid features, no other - primary - mental disorder, however, is detected; thus, the paranoid features appear to have arisen independently. In this book, in accordance with the DSM-IIIR and ICD-10 classifications, the term "" is applied to the second group. It is with the second group that significant difficulties and confusion are associated with classification and diagnosis. For example, there were many disputes about whether this condition is a special form or stage in the development of schizophrenia - or whether it should be recognized as a completely independent nosological unit. Since such problems often arise in clinical practice, an entire chapter is devoted to them.

This chapter begins by identifying the most common paranoid symptoms; the following is an overview of their causes. This is followed by a summary of the relevant personality disorder. This is followed by a discussion of primary mental disorders, such as organic mental states, affective disorders, and in which there are often paranoid manifestations. These diseases are discussed in detail in other chapters of the book, while here the focus is on their differentiation from, which are discussed below. At the same time, a special place is given to paraphrenia; these terms are discussed in a historical context. A number of characteristic paranoid symptoms and syndromes are then described, some of which are fairly common and some extremely rare. In conclusion, the main principles for assessing the condition and treating patients with paranoid manifestations are outlined. .

paranoid symptoms

As noted in the introduction, the most common paranoid delusion is perse. Curtain(). The term "paranoid" also applies to less common types of delusions - grandeur, jealousy; sometimes to delusions related to love, litigation or religion. It may seem counterintuitive that such different types of delusions should be grouped into one category. The reason, however, is that the central disturbance defined by the term "paranoid" is a painful distortion of ideas and attitudes regarding the interaction, the relationship of the individual with other people. If someone has a false or unfounded belief that he is being persecuted, or deceived, or praised, or that he is loved by a famous person, this in each case means that this person interprets the relationship between himself and other people. painfully distorted way. Many paranoid symptoms are discussed in Chap. 1, but the main ones will be briefly described here for the convenience of readers. The following definitions are taken from the Status Survey (PSE) glossary (see: Wing et al. 1974).

Relationship Ideas occur in overly shy people. The subject is unable to shake off the feeling that he is being noticed on public transport, in restaurants, or in other public places, and others notice many things that he would prefer to hide. A person is aware that these sensations are born in himself and that in reality he is no more conspicuous than other people. But he cannot but experience all the same sensations, completely disproportionate to any possible circumstances.

delusions of relationship represents a further development of the simple ideas of relation; the falsity of ideas is not recognized. The subject may feel like the whole neighborhood is gossip about him, far beyond the realm of possibility, or he may find mention of himself on TV shows or in the pages of newspapers. He hears as if they are talking on the radio about something related to the issue that he has just been thinking about, or it seems to him that they are following him, watching his movements, and what he says is being recorded on a tape recorder.

. The subject believes that some person or organization or some power or power is trying to harm him in some way - to ruin his reputation, inflict bodily harm, drive him insane or even drive him to the grave.

This symptom takes a variety of forms, from the subject's simple belief that people are following him, to complex and bizarre plots in which all kinds of fantastic constructions can be used.

paranoid syndrome is also characterized by a systematized delusion of interpretation, but, unlike the paranoid syndrome, it is accompanied by hallucinations (mainly verbal), even more often - pseudohallucinations and phenomena of mental automatism (see below). With paranoid syndrome, with rare exceptions, various variants of delusions of persecution are observed. The syndrome is characterized by considerable persistence and occurs, as a rule, without confusion.

The structure of the syndrome combines delusions of persecution and influence (physical and mental), pseudohallucinations, a sense of mastery and openness, delusional depersonalization (alienation of the mental and physical acts performed by the patient from his own "I"; this alienation is regarded by the patient as something artificially caused: the patient believes that he is under hostile outside influence). The patient is convinced that he has become a victim of a criminal organization, whose members monitor his every deed, pursue him in every possible way, seeking his death or discredit. "Pursuers" act on him through special devices that emit electromagnetic waves or atomic energy, or use hypnotic influence. With the help of this influence, as the patient feels and is convinced, "enemies" control his thoughts, feelings, desires, actions, mood, somatic functions. These phenomena are called mental automatism (Kandinsky-Clerambault syndrome).

The following types of mental automatism are distinguished. 1. Associative (ideational) automatism. It is characterized by the loss of freedom of thought, thinking beyond will, withdrawal of thoughts, the appearance of "made" thoughts, "made" dreams, memories, visual images, mental conversations (visual and auditory pseudohallucinations), "made" emotions (see Hallucinatory Syndromes). The same type of automatism includes a feeling of openness (others, including "persecutors", recognize all the thoughts of the patient). Forcibly, against the will, the emerging thoughts and images belong to the so-called mentism (associative and figurative). Senestopathic automatism. It is characterized by painful, extremely unpleasant painful sensations (senestopathies) with the nature of being made, of extraneous influence. The same type of automatism includes the feeling of extraneous influence on the functions of internal organs. It seems to patients that they are specially caused pain, burning, cold, heat, squeezing various parts of the body, speeding up or slowing down the heart rate, artificially inducing or delaying urination, etc., cause (“impose”) odors, change taste sensations. 3. Kinesthetic (motor) automatism. It is characterized by the appearance of "made" motor acts (movements). Complex forms of automatism, including associative and kinesthetic automatism, include speech-motor hallucinations (“pursuers” speak the language of the patient).

The behavior of patients with the development of paranoid syndrome is determined by delirium. They write numerous statements, demanding that they be protected from persecution and influence, often take measures to protect themselves from rays, hypnosis, for example, they destroy electrical wiring in an apartment, switches, sew special clothes with metal plates, arrange special screens, cages, etc. Fighting against "persecutors", they can commit socially dangerous actions.

Paranoid syndrome occurs, as a rule, with chronically current mental illness, primarily with schizophrenia, less often with organic diseases of the central nervous system (brain, encephalitis, etc.).

Paranoid psychosis is a severe mental disorder accompanied by delusions. The current is characterized by ideas of persecution, aggression. Hallucinations do not occur in paranoid psychosis.

The disorder can develop both independently and be the result of schizophrenia or alcohol abuse. It is more severe than paranoia, but milder than paraphrenia.

Kinds

Types of paranoid psychoses are differentiated depending on the delusional states accompanying the disorder:

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The reasons

Paranoid psychosis has an organic origin. It occurs with pre-existing somatic disorders. As causative factors can be: brain injury, progressive syphilis of the brain, atherosclerosis of blood vessels.

The occurrence of this type of psychosis is influenced by external and internal factors.

It can be:

• causes associated with metabolic processes in the body;
• diseases caused by external influences or internal pathological processes;
• factors of a neuroendocrine nature (damage to the nervous system and endocrine glands);
• hereditary predisposition;
• the circumstances under which personality development took place.

Symptoms

In paranoid psychosis of any type, a typical clinical picture can be observed:

In combination with schizophrenia, it is manifested by mental automatisms and pseudohallucinosis.

Sooner or later paranoid psychosis leads to self-isolation.

Diagnostics

The diagnosis is made after examining the patient and talking with him. This should reveal an imbalance of personal positions and disharmony in behavior that affect several areas of the patient's life.

A specialist can fix inadequate protective reactions in a patient.

The final confirmation is the complete denial by the patient of his condition and the need for treatment even after discussing the negative consequences.

Treatment

A feature of the disease is that it becomes a chronic condition, and without treatment, a person will behave the same way all his life.

The decision to hospitalize a patient with paranoid psychosis is considered individually. With aggressive behavior, suicidal tendencies, a threat to the life and health of others, the likelihood of damage, etc. – hospitalization is mandatory. Hospitalization is recommended in cases where additional examinations are required.

Some patients can be convinced of the need for treatment. If this is not possible, then involuntary hospitalization can be used after agreement with relatives.

Drug treatment is not always prescribed, but only in cases where the symptoms are excessively pronounced or in the presence of concomitant diseases.

With exacerbations of delusional states occurring against the background of motor excitation, tranquilizers are prescribed. Antipsychotics are used for maintenance therapy. The doctor may postpone treatment if there is a possibility that the patient himself may agree with the need for it.

The complex of therapeutic measures necessarily includes psychotherapy. It is she who is the basis of treatment. At the same time, at the initial stage, the main task of the doctor is to create a friendly atmosphere and a trusting atmosphere.

First of all, it is necessary to convince the patient of the advisability of taking the drugs. Initially, it is not necessary to focus the patient's attention on the treatment of a delusional state. Since paranoid psychosis is manifested by mood swings, anxiety, it is better to treat these manifestations in the first stage.

When a patient is sick, it is better for relatives not to communicate with the doctor and not discuss the course of the disease, since these actions will be regarded as collusion. However, relatives can contribute to a speedy recovery by controlling the intake of drugs, creating a normal atmosphere in the patient's environment.

Paranoid psychosis is not always treatable. The task of therapy is not only to rid the patient of delusional ideas, but also to return the person to a normal life, having achieved adaptation in society.

Physiotherapy can also be prescribed - massage, balneotherapy, which help restore the nervous system.

Complications

Psycho-emotional overstrain, accompanied by constant suspicion, can cause various social and personal consequences:

• relinquishing a sense of responsibility; the patient blames others for the disorder that has arisen, not wanting to take any actions aimed at recovery;
• inability to endure stressful situations; usually manifested by a state of affect and severe depression;
• develop addictions (alcohol, drugs);
• categorical refusal of treatment.

Who is prone to paranoid psychosis

• Most often, this diagnosis manifests itself at a young age, mainly men suffer from this disorder.
• The condition greatly affects the socialization of a person, negatively affecting the quality of his life.
• These people are scandalous, cannot stand criticism and rejection, and are arrogant.
• The patient performs actions that seem inadequate to a healthy person, his reactions are unpredictable.

paranoid syndrome can develop both reactively and chronically, but most often it is dominated by a little systematized (sensual delirium).

Do not confuse the paranoid syndrome with the paranoid one - with a possible similarity in the content of delusional ideas, these states differ both in their "scope" and speed of development, and in the features of the course and further prognosis. In paranoia, delusions most often develop gradually, starting with small ideas and growing into a solid, systematized delusional system that the patient can reasonably explain. With sensual delirium, which usually develops as part of a paranoid syndrome, the systematization is rather low. This is due to the fact that delirium is either of a fantastic nature, or, due to the rapid increase in painful symptoms, it is still a little conscious patient, in whose picture of the world it suddenly appears.

Paranoid syndrome can develop both within the framework of schizophrenia, psychotic disorders with organic brain lesions, and within the framework of bipolar affective disorder (formerly manic-depressive psychosis). But still more often with the first and last.

Forms of the paranoid syndrome

Depending on what specific symptomatology appears most clearly in the clinical picture, within the framework of the paranoid syndrome, the following are distinguished:

• affective-delusional syndrome, where there is a sensual delirium and a change in affect, it can be in two versions: manic-delusional and depressive-delusional (depressive-paranoid syndrome), depending on the leading affect. It is worth noting that the content of delusional ideas will correspond here to the "pole" of affect: in depression, the patient can express ideas of self-accusation, condemnation, persecution; and with mania - ideas of greatness, noble birth, invention, etc.
• hallucinatory-delusional (hallucinatory paranoid syndrome), where hallucinations come to the fore, that this does not exclude the presence of affective-delusional disorders, but they are not in the foreground here.
• hallucinatory-delusional syndrome with the presence of mental automatisms- In this case, we can talk about Kandinsky-Clerambault syndrome,
• actually paranoid syndrome without other expressed and prominent other disorders. Only poorly systematized, sensual delirium prevails here.

Treatment of the paranoid syndrome

The treatment of paranoid syndrome requires urgent intervention by specialists, because, as practice shows, neither delusions nor hallucinations, especially against the background of endogenous (caused by internal causes) diseases, do not go away on their own, their symptoms tend only to increase, and Treatment is most effective when started as early as possible. Indeed, it happens that in some cases people live in a delusional state for years. But relatives need to understand that the prognosis of the disease, and the history of a person’s life in the future, depends on the quality of the assistance provided, its timeliness.

Treatment of a paranoid syndrome, like any disorder characterized by hallucinations and delusions, usually requires hospitalization: after all, it is necessary to qualitatively stop the existing symptoms, and before that - to conduct a comprehensive diagnosis and determine the cause of the development of the condition. All this can be effectively implemented only in a hospital setting. The presence of hallucinations or delusions in the clinical picture is always an indication for the use of pharmacological therapy. No matter how some laymen treat it negatively, it is thanks to pharmacology that psychiatrists have been successfully coping with acute psychotic states for decades, thereby returning patients to normal activity and the opportunity to live fully.

Again, it must be understood that sensual (non-systematized) delusions accompanied by hallucinations can be a source of danger both for the patient himself and for the people around him. So, with delusions of persecution (and this is one of the most common types of delusions), a person can begin to save himself or defend himself, which will cause irreparable damage to his own health. Just as dangerous is the delusion of self-abasement, which often develops in depressive-paranoid syndrome.

Often the situation develops in such a way that the patient himself does not regard his own condition as painful, and, naturally, opposes not only the possibility of inpatient treatment, but also a simple visit to the doctor. Nevertheless, relatives need to understand that there is no other way to help a person, except for treating him in a hospital.

Some psychiatrists cite sad cases as an example, when a paranoid state with sensory delusions and hallucinations first manifests itself, for example, in childhood. But relatives, due to stereotypes, not wanting to “put a label on the child”, go not to doctors, but to healers, resort to the use of religious rituals, which only trigger the disease, making it chronic. It is also often possible to see examples that relatives, not understanding the seriousness of the disease of a person close to them, do their best to oppose the hospitalization of adults.

However, if there is someone to take care of the patient, but he himself does not want to receive the necessary treatment in an acute condition, then the law specifically for these cases provides for the possibility of involuntary hospitalization. (Section No. 29 of the Psychiatric Care Law). The law provides for involuntary hospitalization when a patient's condition threatens his own safety or the safety of others. Also, this kind of assistance can be provided if the patient cannot ask for it himself due to illness, or if the failure to provide assistance to him will lead to a further deterioration in the condition.

Every citizen of our country has the right to receive this kind of assistance free of charge. However, many are afraid of publicity, and the very prospect of getting into a medical facility. If the issue of private provision of psychiatric care, as well as complete anonymity, is fundamental for you, then you should contact a private psychiatric clinic, where even a treatment option is possible when you are offered to remain completely anonymous.

Modern medicine has long been able to treat this kind of disorder, diagnose the underlying cause of the disease and offer various treatments.

Thus, only a qualified psychiatrist is able to determine both the underlying disease and prescribe a quality treatment for the paranoid syndrome.

Important: the symptoms of paranoid syndrome can increase rapidly. No matter how strange the behavior of a loved one who has changed in an instant may seem to you, do not try to look for metaphysical, religious or near-scientific explanations. Every disorder has a real, explainable, and, most of the time, treatable cause.

Contact the professionals. They will definitely help.