Diseases of the nerves and mental disorders. Neuropsychiatric disorders. Causes of a neuropsychiatric disorder

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Mental illnesses, also called human mental disorders, occur in people of all ages, from infancy to old age. Contrary to popular belief, they do not always manifest outwardly - for example, aggressive behavior or other gross violations, referred to as "madness" or "abnormality."

The list and description of such diseases will not be able to provide exhaustive information, since each manifestation of any pathology is individual.

The peculiarity of such ailments is that some of them are episodic, that is, they appear from time to time, and are considered incurable. Also, many mental illnesses are still not fully investigated by doctors, and no one can accurately explain the factors that cause them.

People who have been diagnosed with any diseases receive certain restrictions and prohibitions - for example, they may not be given a driver's license or be denied employment. You can get rid of the problem not only on an outpatient basis - you need a strong desire of the patient himself.

Now there are different types of mental illnesses, depending on their characteristics, the average age of patients and other characteristics.

Mental illnesses that are inherited

Their occurrence is not always predictable. A child whose parents had such disorders does not necessarily have to be born sick - he may only have a predisposition that will forever remain so.

The list of hereditary mental illnesses is as follows:

• depression - a person is constantly in a depressed mood, feels despair, his self-esteem decreases, and he is not interested in people around him, loses the ability to rejoice and experience happiness;
• schizophrenia - deviations in behavior, thinking, movements, emotional and other areas;
• autism - observed in young children (up to 3 years old) and is expressed in delays and violations of social development, monotonous behavior and abnormal reactions to the world around them;
• epilepsy - characterized by seizures of a sudden nature.

The classification of such disorders also includes the most terrible and dangerous mental illnesses. These include those that can cause great harm to human health and life:

• neurosis - based on hallucinations, delusions and inappropriate behavior;
• psychosis - a temporary violation, occurs as a reaction to stress, when a person falls into a state of passion;
• Psychopathy is a state of imbalance associated with a sense of one's own inferiority, mainly formed in childhood. The exact reasons are still unknown.
• Addictions - from alcohol, drugs, cigarettes, computer and gambling. Their insidiousness is that patients are often unaware of the presence of a problem.

Endogenous diseases are those in the occurrence of which heredity plays an important role. It:

• schizophrenia;
• manic, depressive psychoses;
• epilepsy.

A separate place is occupied by mental illness in the elderly and senile age:

• hypochondria - the belief in the presence of severe physical abnormalities without confirmation of the existence of such from a doctor;
• mania - an increase in mood, interspersed with sudden aggressiveness, lack of criticism towards oneself;
• delirium - the sick person becomes suspicious, he is visited by strange thoughts, hallucinations, he can hear voices or sounds;
• dementia or dementia - impaired memory and other functions;
• Alzheimer's disease - forgetfulness and distraction, inactivity and other disorders.

There are also rare mental illnesses that many have never heard of.

Some of them got their name in honor of famous people or heroes of fairy tales:

• Alice in Wonderland syndrome - a violation of the perception of space;
• Capgras syndrome - a person is sure that one of his friends was replaced by a double;
• depersonalization - characterized by a lack of a sense of self, and loss of control over oneself;
• fear of the number 13;
• sensation of severed body parts.

Mental illness in children:

• delays in speech, development;
• hyperactivity;
• mental retardation.

Such a list of mental disorders is incomplete; in fact, there are a lot of rare and unknown types, or not yet identified by doctors.

The most common ailments in our time are autism, speech and movement disorders in children, depression, various forms of psychosis and schizophrenia.

Mental diseases are characterized by the creation of inconvenience for people around, especially relatives and those living in the same apartment with the sick person. They don't always go to the hospital.

Some neuropsychiatric disorders are incurable, and there may be a need for life-long detention of a person in a special institution.

Symptoms of mental illness

The symptoms of this type of problem are varied and individual in nature:

If you experience such symptoms of mental illness, you need to consult a doctor. Perhaps the condition is temporary, and it is really possible to eliminate it.

In women, signs of mental illness can be associated with moments in their lives (birth, pregnancy, menopause):

• a tendency to starvation, or vice versa, bouts of gluttony;
• depression, feeling of worthlessness;
• irritability;
• postpartum depression;
• sleep disturbances, decreased libido.

These problems are not always irremovable, in most cases, after consulting a psychologist and adequate treatment, it is possible to cope with them.

Causes of mental illness

They are different, in some cases it is impossible to determine them. Scientists still don't know exactly why autism or Alzheimer's occurs.

The following factors can influence the psychological state of a person and change it:

Usually, a combination of several causes leads to pathology.

Treatment of mental illness

Methods of therapy for neuropsychiatric pathologies provide for an integrated approach and have an individual focus. They consist of:

• drug regimen - taking antidepressants, psychotropic, stimulant drugs;
• Hardware treatment - some types of disorders can be eliminated by exposure to electric currents. For example, in autism, the brain micropolarization procedure is often used.
• psychotherapy - methods of suggestion or persuasion, hypnosis, conversations;
• physiotherapy - acupuncture, electrosleep.

Modern techniques have become widespread - communication with animals, treatment with creative work, and others.

Learn about mental disorders that present with somatic symptoms

Prevention of mental illness

It is possible to avoid mental health problems if:

Preventive measures include regular visits to the hospital for examinations. Disorders in the initial stages can be prevented if they are diagnosed and treated in time.

Mental disorders- in a broad sense, this is a disease of the soul, meaning a state of mental activity that is different from healthy. Their opposite is mental health. Individuals who have the ability to adapt to daily changing life conditions and resolve everyday problems are generally considered mentally healthy individuals. When this ability is limited, the subject does not master the current tasks of professional activity or the intimate-personal sphere, and is also unable to achieve the designated tasks, ideas, goals. In a situation of this kind, one can suspect the presence of a mental anomaly. Thus, neuropsychiatric disorders refers to a group of disorders that affect the nervous system and behavioral response of the individual. The described pathologies may appear as a result of deviations occurring in the brain of metabolic processes.

Causes of mental disorders

Due to the numerous factors that provoke them, neuropsychiatric diseases and disorders are incredibly diverse. Disorders of mental activity, whatever their etiology, are always predetermined by deviations in the functioning of the brain. All causes are divided into two subgroups: exogenous factors and endogenous. The former include external influences, for example, the use of toxic substances, viral diseases, injuries, and the latter include immanent causes, including chromosomal mutations, hereditary and gene ailments, mental development disorders.

Resistance to mental disorders depends on the specific physical characteristics and the general development of their psyche. Different subjects have different reactions to mental anguish and problems.

There are typical causes of deviations in mental functioning: neurosis, depressive states, exposure to chemical or toxic substances, head injuries, heredity.

Worry is considered the first step leading to exhaustion of the nervous system. People often tend to draw in their fantasy various negative developments of events that never materialize in reality, but provoke excessive unnecessary anxiety. Such anxiety gradually escalates and, as the critical situation grows, it can transform into a more serious disorder, which leads to a deviation in the mental perception of the individual and to dysfunctions in the functioning of various structures of internal organs.

Neurasthenia is a response to prolonged exposure to traumatic situations. It is accompanied by increased fatigue and exhaustion of the psyche against the background of hyperexcitability and constant over trifles. At the same time, excitability and grumpiness are protective means against the final failure of the nervous system. Individuals are more prone to neurasthenic states, characterized by an increased sense of responsibility, high anxiety, people who do not get enough sleep, and are also burdened with many problems.

As a result of a serious traumatic event, which the subject does not try to resist, hysterical neurosis occurs. The individual simply “runs away” into such a state, forcing himself to feel all the “charm” of experiences. This condition can last from two to three minutes to several years. At the same time, the longer the period of life it affects, the more pronounced the mental disorder of the personality will be. Only by changing the attitude of the individual to his own illness and attacks, it is possible to achieve a cure for this condition.

In addition, people with mental disorders are prone to a weakening of memory or its complete absence, paramnesia, and a violation of the thought process.

Delirium is also a frequent companion of mental disorders. It is primary (intellectual), sensual (figurative) and affective. Primary delirium initially appears as the only sign of impaired mental activity. Sensual delirium is manifested in the violation of not only rational cognition, but also sensual. Affective delirium always occurs along with emotional deviations and is characterized by imagery. Also, overvalued ideas are distinguished, which mainly appear as a result of real-life circumstances, but subsequently take on a meaning that does not correspond to their place in the mind.

Signs of a mental disorder

Knowing the signs and characteristics of mental disorders, it is easier to prevent their development or to identify deviations at an early stage than to treat an advanced form.

Signs of a mental disorder include:

- the appearance of hallucinations (auditory or visual), expressed in conversations with oneself, in response to interrogative statements of a non-existent person;

- unreasonable laughter;

- difficulty concentrating when performing a task or a thematic discussion;

- changes in the behavioral response of the individual in relation to relatives, often there is a sharp hostility;

- in speech there may be phrases with delusional content (for example, “I myself am to blame for everything”), in addition, it becomes slow or fast, uneven, intermittent, confused and very difficult to perceive.

People with mental disorders often seek to protect themselves, in connection with which they lock all the doors in the house, curtain the windows, carefully check every piece of food, or completely refuse meals.

You can also highlight the signs of mental deviation observed in the female:

- overeating leading to obesity or refusal to eat;

- alcohol abuse;

- violation of sexual functions;

- depression of the state;

- fast fatiguability.

In the male part of the population, signs and characteristics of mental disorders can also be distinguished. Statistics show that the stronger sex is much more likely to suffer from mental disorders than women. In addition, male patients are characterized by more aggressive behavior. So, common signs include:

- inaccurate appearance;

- there is sloppiness in appearance;

- can avoid hygiene procedures for a long time (do not wash or shave);

- quick mood swings;

- mental retardation;

- emotional and behavioral deviations in the childhood age period;

- personality disorders.

More often, mental illnesses and disorders occur in the childhood and adolescence age period. Approximately 16 percent of children and adolescents have mental disabilities. The main difficulties children face can be divided into three categories:

- mental development disorder - children, in comparison with their peers, lag behind in the formation of various skills, and therefore experience difficulties of an emotional and behavioral nature;

- emotional defects associated with severely damaged feelings and affects;

- expansive pathologies of behavior, which are expressed in the deviation of the baby's behavioral reactions from social norms or manifestations of hyperactivity.

Neuropsychiatric disorders

The modern high-speed life rhythm makes people adapt to various environmental conditions, sacrifice sleep, time, and energy in order to do everything. A person cannot do everything. The price of constant haste is health. The functioning of the systems and the coordinated work of all organs is directly dependent on the normal activity of the nervous system. The impact of external environmental conditions of a negative orientation can cause mental disorders.
Neurasthenia is a neurosis that arises against the background of psychological trauma or overwork of the body, for example, due to lack of sleep, lack of rest, prolonged hard work. The neurasthenic state develops in stages. At the first stage, aggressiveness and increased excitability, sleep disturbance, inability to concentrate on activities are observed. At the second stage, irritability is noted, which is accompanied by fatigue and indifference, decreased appetite, discomfort in the epigastric region. Headaches, slowing or increased heart rate, and a tearful state may also be observed. The subject at this stage often takes "to heart" any situation. At the third stage, the neurasthenic state passes into an inert form: the patient is dominated by apathy, depression and lethargy.

Obsessive states are one of the forms of neurosis. They are accompanied by anxiety, fears and phobias, a sense of danger. For example, an individual may be overly worried about the hypothetical loss of some thing or be afraid of contracting one or another ailment.

Obsessive-compulsive disorder is accompanied by repeated repetition of the same thoughts that are not significant for the individual, a series of mandatory manipulations before any business, the appearance of absurd desires of an obsessive nature. At the heart of the symptoms is a feeling of fear to act contrary to the inner voice, even if its requirements are absurd.

Conscientious, fearful individuals who are unsure of their own decisions and subordinate to the opinion of the environment are usually subject to such a violation. Obsessive fears are divided into groups, for example, there is a fear of darkness, heights, etc. They are seen in healthy individuals. The reason for their origin is associated with a traumatic situation and the simultaneous impact of a specific factor.

It is possible to prevent the appearance of the described mental disorder by increasing confidence in one's own significance, developing independence from others and independence.

Hysterical neurosis or is found in increased emotionality and the desire of the individual to draw attention to himself. Often such a desire is expressed by rather eccentric behavior (deliberately loud laughter, affectation in behavior, tearful tantrums). With hysteria, there may be a decrease in appetite, fever, weight changes, nausea. Since hysteria is considered one of the most complex forms of nervous pathologies, it is treated with the help of psychotherapeutic agents. It occurs as a result of a serious injury. At the same time, the individual does not resist traumatic factors, but “runs away” from them, forcing him to feel painful experiences again.

The result of this is the development of pathological perception. The patient likes being in a hysterical state. Therefore, such patients are quite difficult to get out of this state. The range of manifestations is characterized by scale: from stamping feet to rolling in convulsions on the floor. By his behavior, the patient tries to benefit and manipulates the environment.

The female sex is more prone to hysterical neuroses. Temporary isolation of people suffering from mental disorders is useful in preventing the onset of hysterical attacks. After all, as a rule, for individuals with hysteria, the presence of the public is important.

There are also severe mental disorders that occur chronically and can lead to disability. These include: clinical depression, schizophrenia, bipolar affective disorder, identities, epilepsy.

With clinical depression, patients feel depressed, unable to enjoy, work and conduct their usual social activities. Persons with mental disorders caused by clinical depression are characterized by bad mood, lethargy, loss of habitual interests, lack of energy. Patients are not able to "pick up" themselves. They have insecurity, low self-esteem, increased guilt, pessimistic ideas about the future, appetite and sleep disorders, and weight loss. In addition, somatic manifestations can also be noted: dysfunction of the gastrointestinal tract, pain in the heart, head and muscles.

The exact causes of schizophrenia are not known for certain. This disease is characterized by deviations in mental activity, logic of judgments and perception. Patients are characterized by detachment of thoughts: it seems to the individual that his worldviews were created by someone else and a stranger. In addition, withdrawal into oneself and into personal experiences, isolation from the social environment is characteristic. Often people with mental disorders provoked by schizophrenia experience ambivalent feelings. Some forms of the disease are accompanied by catatonic psychosis. The patient may remain immobile for hours, or express motor activity. With schizophrenia, emotional dryness can also be noted, even in relation to the closest.

Bipolar affective disorder is called an endogenous ailment, expressed in phase changes of depression and mania. Patients have either a rise in mood and a general improvement in their condition, or a decline, immersion in spleen and apathy.

A dissociative identity disorder is a mental pathology in which the patient has a "separation" of the personality into one or more components that act as separate subjects.

Epilepsy is characterized by the occurrence of seizures, which are provoked by the synchronous activity of neurons in a certain area of ​​the brain. The causes of the disease can be hereditary or other factors: viral disease, traumatic brain injury, etc.

Treatment of mental disorders

The picture of the treatment of deviations in mental functioning is formed based on the anamnesis, knowledge of the patient's condition, and the etiology of a particular disease.

Sedatives are used to treat neurotic conditions due to their calming effect.

Tranquilizers are mainly prescribed for neurasthenia. Drugs in this group can reduce anxiety and relieve emotional tension. Most of them also reduce muscle tone. Tranquilizers are predominantly hypnotic rather than causing perceptual changes. Side effects are expressed, as a rule, in a feeling of constant fatigue, increased drowsiness, and disorders in remembering information. Negative manifestations also include nausea, low blood pressure and decreased libido. Chlordiazepoxide, Hydroxyzine, Buspirone are more commonly used.

Antipsychotics are the most popular in the treatment of mental pathologies. Their action is to reduce the excitation of the psyche, reduce psychomotor activity, reduce aggressiveness and suppress emotional tension.

The main side effects of neuroleptics include a negative effect on skeletal muscles and the appearance of deviations in dopamine metabolism. The most commonly used antipsychotics include: Propazine, Pimozide, Flupentixol.

Antidepressants are used in a state of complete depression of thoughts and feelings, a decrease in mood. Preparations of this series increase the pain threshold, thereby reducing pain in migraines provoked by mental disorders, improve mood, relieve apathy, lethargy and emotional tension, normalize sleep and appetite, increase mental activity. The negative effects of these drugs include dizziness, tremor of the limbs, confusion. The most commonly used as antidepressants Pyritinol, Befol.

Normotimics regulate inadequate expression of emotions. They are used to prevent disorders that include several syndromes that manifest themselves in stages, for example, with bipolar affective disorder. In addition, the described drugs have an anticonvulsant effect. Side effects are manifested in trembling of the limbs, weight gain, disruption of the digestive tract, unquenchable thirst, which subsequently entails polyuria. It is also possible the appearance of various rashes on the skin surface. The most commonly used salts of lithium, Carbamazepine, Valpromide.

Nootropics are the most harmless among drugs that help cure mental pathologies. They have a positive effect on cognitive processes, enhance memory, increase the resistance of the nervous system to the effects of various stressful situations. Sometimes side effects are expressed in the form of insomnia, headaches and digestive disorders. The most commonly used Aminalon, Pantogam, Mexidol.

In addition, hypnotechniques, suggestion are widely used, less commonly used. In addition, the support of relatives is important. Therefore, if a loved one suffers from a mental disorder, then you need to understand that he needs understanding, not condemnation.

It is especially important to study these signs in diseases accompanied by pronounced changes in the brain itself, that is, in so-called organic diseases (progressive paralysis, syphilis of the brain, arteriosclerosis, encephalitis, etc.). In these cases, the very presence of neurological symptoms already indicates the organic nature of the disease and allows, to a certain extent, to judge its prevalence, course and location of lesions in the brain substance, in particular, the disruption of the activity of individual "centers" brain.

The most important neurological symptoms are the symptoms cranial nerve lesions, changes in the reflex sphere, disorders of sensitivity, motor functions and speech.

Among the lesions of the cranial nerves, the so-called eye symptoms.

In a healthy person, the pupils of the eyes have a uniform size and a regular round shape. They automatically constrict under the influence of light (pupillary response to light) and when fixing the gaze on close or distant objects (pupillary response to convergence and accommodation).

In organic diseases of the brain, there is abnormal pupillary constriction, their unevenness and irregular shape. Reactions to light and accommodation are disturbed. A constant symptom of progressive paralysis is the absence of pupillary reaction to light, while the reaction to accommodation and convergence is preserved (Argil-Robertson symptom).

In some cases, as a result of damage to the optic nerve, it may develop decreased visual acuity up to total blindness.

The study of the "fundus" is important, which can be considered due to the transparency of individual parts (environments) of the eyeball. Fundus changes indicate an increase in intracranial pressure, allow you to establish damage to the optic nerve with an increase in intracranial pressure or nerve atrophy.

As a result of damage to the cranial nerves, the following can develop: strabismus, causing "double vision", restrictions on the movement of the eyeballs or their rhythmic twitches, which are called nystagmus.

Next, it should be noted facial symmetry disorder, most often due to the smoothness of the nasolabial fold, different widths of the palpebral fissures and deviation of the tongue from the midline when protruding, which is also observed due to damage to the cranial nerves.

In nervous and mental diseases, the study of the so-called tendon reflexes caused by tapping on the tendons of certain muscles (knee reflexes, from the Achilles tendon, from the muscles of the forearm) and skin reflexes (abdominal, plantar).

In diseases of the central nervous system, reflexes can change both in the direction of their decrease or loss (for example, lack of knee jerks with dryness of the spinal cord), and in the direction of their increase, an expression of which is increase in range of motion of the lower leg when eliciting knee-jerk reflexes.

It should be borne in mind that a symmetrical decrease or increase in reflexes on both sides of the body (right and left) is not always a painful sign.

In contrast, uneven reflexes indicate damage to the nervous system. In the same way, a particularly sharp increase in the reflex, reaching frequent rhythmic repeated movements in response to a single irritation, is a painful sign and is called clonus or clonic twitches.

In addition, with painful changes in the central nervous system, new reflexes, not caused in healthy people, which therefore are called pathological reflexes and indicate an organic lesion of the spinal cord or brain.

The most important of the pathological reflexes is Babinski reflex, representing a pathological perversion of the plantar reflex, observed in the norm. It lies in the fact that when the sole is irritated, the thumb is unbent. Similar painful changes are also indicated Bekhterev and Rossolimo reflexes. Bekhterev's reflex is caused by tapping on the back of the foot, Rosso-limo reflex - with a light blow on the plantar side of the toes; in both cases plantar flexion of the fingers is observed.

Sensitivity disorders can manifest itself in an increase in it, when ordinary stimuli are perceived extremely sharply or painfully, or, conversely, in a decrease in it, sometimes reaching a complete loss of sensation. There are also a variety of unpleasant, unusual sensations that occur without visible irritation, which are called paresthesias. So, sometimes patients feel a tingling or excruciating burning sensation under the skin.

Movement disorders in nervous and mental diseases, they arise as a result of a violation of certain parts of the nervous system and are expressed in the complete loss of limb movements ( paralysis) or a more or less significant limitation of the possibility of movement ( paresis).

Disorders of motor functions are also manifested in excessive, involuntary movements that cannot be overcome or delayed by the patient and which are called hyperkinesis. These include trembling, twitching, convulsions. Among these motor disorders, convulsive movements are of the greatest importance, which can occur periodically and cover most of the muscles of the body, acquiring the character of a convulsive seizure.

There are tonic and clonic convulsions, which are the main elements of an epileptic seizure. Tonic convulsions are expressed in prolonged contraction and tension of the muscles, as a result of which one or another part of the body is fixed in a certain position, independent of the will of the patient. Clonic convulsions are expressed in alternating tension and relaxation of the muscles, resulting in twitching of the limbs or torso.

Along with excessive movements (hyperkinesis), in diseases of the brain, there is also a general insufficiency of motor functions, characteristic, like most hyperkinesias, for damage to the subcortical brain. At the same time, the general slowness of movements, their awkwardness, accompanied by greater than normal muscle tension, is striking. On the whole appearance of the patient, as it were, lies the imprint of general stiffness, which is facilitated by the immobility of the facial muscles - the so-called mask-like face. Such disorders are observed in encephalitis, brain injuries and some other organic diseases.

Movement disorders are often accompanied by impaired gait, sometimes the ability to coordinate movements or maintain balance is also impaired, which primarily affects gait. The disorder of coordination and balance is expressed, in particular, in instability and staggering when standing with eyes closed ( Romberg's symptom).

Violation of motor functions may affect the loss of the ability to produce various complex, albeit well-known, memorized movements. The patient cannot light a match, start a watch, etc. This is not due to paralysis, but as a result of damage to certain centers of the cerebral cortex, the work of which is necessary to coordinate individual simple movements into complex motor acts, which are, in particular, writing and the vast majority of motor skills associated with labor processes.

To complex function disorders associated with the defeat of certain centers of the brain include disorders of recognition of objects, which is observed with the preservation of directly perceiving apparatuses. In this case, the patient sees the object, but cannot recognize it by its appearance.

Speech disorders can also be associated with the defeat of certain centers located in the temporal, frontal and parietal regions of the cortex (for right-handers - on the left, for left-handers - on the right). These speech disorders are called aphasia manifesting itself in various forms.

Loss of only arbitrary speech is possible, when the patient understands the speech addressed to him, but cannot find words for an answer or say something on his own impulse. Such a patient either does not say anything at all or has one or two words in reserve, with which he answers each question addressed to him. In another form of aphasia, patients do not understand the speech addressed to them, the meaning of the words spoken, because they cannot comprehend what they hear. They perceive words as meaningless sounds. Therefore, to some extent, the speech of the patient himself is also disturbed, since he does not understand the words that he himself utters. Finally, aphasia can manifest itself in the fact that patients forget and cannot remember words, most often the names of objects, which they try to replace with a description. This becomes especially noticeable if such a patient is asked to name the objects shown to him. Instead of calling it “pencil” or “glass”, he says: “this is what they write with”, “and this is for drinking, well, it’s so round, empty.” Sometimes it is enough to pronounce the first syllable of a word for the patient to remember it and pronounce it correctly. Aphasias are observed in organic diseases of the brain, causing focal changes in the cerebral cortex (trauma, arteriosclerosis, syphilis of the brain).

Organic changes also lead to a violation of the pronunciation of words, to the inability to pronounce the syllables of words in a certain sequence, as a result of which speech becomes, as it were, blurry, to stumbling on individual syllables (dysarthria), which is especially characteristic of progressive paralysis.

In some cases, patients temporarily completely lose the ability to speak as a result of painful mental disorders. Such a state is called mutism(muteness - lat.) And it is observed most often in schizophrenia and hysterical reactions.