Affective psychosis: symptoms, course of the disease, treatment
The group of disorders that develop in patients with the onset of extreme shock and severe stress is included in the category of affective psychoses. These pathologies arise on the basis of the development of affect, for which the periodicity of the phases is characteristic. In this article we will find out what are the symptoms with the appearance of affective psychosis, the main regularities of the course will also be presented.
Feature of the development of
The peculiarity of the development of psychosis of affective type is:
- Suddenness of formation. This form appears, as a rule, without any previous symptomatology.
- Strictly two-phase course of the disorder. As these phases it is necessary to consider mania and depression.
Aggravating factors of the disease
Affective psychoses, as a rule, can be caused by the following factors:
- The presence of strong fluctuations of the hormonal level in the human body.
- Genetic predetermination.
- Concomitant somatic pathology.
- The use of antidepressants.
The main provoking factor
Affective psychoses in psychiatry are diagnosed quite often. The main provocative factor causing the onset of such a state is the finding of a person within the extreme for his psyche situation. This can be, for example, the situation of an obvious threat to life. In addition, figuratively speaking, the mind can perceive the ordinary situation as a threatening death for the body or simply speculate the circumstances to such a state. Through the mind, the appearance of pain can be mimed along with suffocation or other similar sensations.
Constriction of consciousness
Conditions in the context of affective psychosis are characterized by a narrowing of the level of consciousness. It is also accompanied by inadequate thinking for the environment. All this, as a rule, affects the behavior and speech. Deviations in such functions arise as a result of abrupt changes in the energy of the brain due to accumulation in the blood of under-oxidized products of vital activity under the influence of a stress factor. These products become toxic substances, so-called hallucinogens.
The first experience of being in an affective state is experienced by a person who is a fetus in the womb. The process occurs under the influence of brain hypoxia, which is determined by the behavior, as well as the energy of the pregnant woman.
The risk category includes both sexes. But mostly women fall into it with such an individual personality, in which the psychopathic and hysterical component prevails. In addition, this category includes people with the psyche, which was deformed as a result of the injuries suffered. Such changes in the structure of the nervous system can also be affected by neuroinfections.
Recurrent depression has a nosological position among affective psychoses.
Features of the
Distinction of this type of psychosis from bipolar disorder that occurs in two phases is that the latter type, as a result of its course, forms mixed states in which the symptoms of depression are replaced by signs of mania or vice versa. The development of psychotic states of affective genesis occurs as a result of a change in depressive and manic phases.
What are the differences?
The difference between them is diametrically opposite behavior. Also, they can be distinguished by changes in speech and movements, which are characterized either by an uncharacteristic animation or by the oppression of the patient's psyche. The classical sign of the first phase is the presence of dreary depression, but the disorder can have features of anxious, hypochondriac or hysterical nature.
The prevailing emotions of
The predominant emotion is, as a rule, the appearance of despondency along with depression, passivity and indifference in behavior. All this is determined by the circumstances of seemingly at first glance hopelessness from the traumatic human psyche situation. At the same time, absolutely all thoughts of the patient are concentrated on it. Symptoms of affective psychosis in each person are manifested in different ways.
Statements of the patient are filled with self-incriminations, as well as all kinds of ideas of their own uselessness and sinfulness. Either this condition can be expressed in the context of accusations against others, who become especially persistent because of concerns about the state of health of the opponent. Manifest and reactive forms of depression are accompanied by a pronounced negative vegetative. Physically, this usually manifests itself in the form of a rapid heart rate, blood pressure jumps, dyspnoea and sweating. Improving the mood while you can celebrate in the evening. True, the night sleep is extremely upset, it is intermittent and full of nightmares. Appetite, as practice shows, usually decreases.
Excessive dramatization of
In bipolar affective psychosis, excessive dramatization with complaints about fate and life circumstances can be accompanied by general motor inhibition, along with slowed-down speech and thinking processes. In this case, both speech and thinking do not differ in the richness or variety of their shades. The duration of the depression presented, in which complaints about mental pain often take the form of a physical sensation, form a time span of three to six months. The overall structure of the depressive phases themselves is up to eighty percent of their total volume.
It is also worth noting that among affective psychoses, the manic-depressive variant occurs quite often.
The manic phase of this form of psychosis is characterized by atypia of behavior and movements, which is explained by the patient's being in a state of inexplicable and incomprehensible euphoria in situations in which the matter concerns self-assessment of his activities.
The patient is in a state of unjustified complacency, experiencing a pleasurable sensation of his mobility. At the same time, he also talks a lot and eagerly, accompanying the speech with rich gestures. The patient is contact, but against the background of all this, his attention is extremely superficial, and the actions are not considered and justified.
All the behavior of the patient as a whole gives the impression of some random movement and unconscious arousal. In addition, the general behavior of the patient seems unproductive. There is a kind of movement just to make it happen. Actions do not bring any fun or joy. The patient is incited by an explosion of irritation along with anger at any insignificant criticism from the side or by listening to adequate questions.
Thought activity, as well as speech against the background of the disorder, also have a low concentration of attention, which is accompanied by superficial unconsciousness along with blanching. Emotions in a patient with bipolar affective psychosis are shallow and monotonous, they are interrupted by outbursts of absolutely unmotivated anger. Appetite and sleep disorders can complement the overall picture of the phase. Its duration is sometimes up to one year. The exception is mania, which grows for five days and lasts about six months.
It's interesting to note that up to twenty percent of patients with this psychopathology suffer from a classic funk that lasts up to four months with the advent of delusional disorders directly at the peak of affect.
Diagnosis of affective psychosis
As part of the diagnosis, the following factors are of great importance:
- Clinic with a characteristic two-phase component.
- The presence of a connection with fluctuations in the hormonal activity of the human body.
- Presence of the genetic determinant and the transition of the disease from generation to generation.
In order to confirm the diagnosis, specialists also use instrumental research methods:
- Computer tomography of the brain.
- Collection of analyzes of biological materials of the body. Thus, it is necessary to study the clinical and biochemical analysis of blood.
For the purpose of diagnosis, it is advisable to invite an oncologist, as well as an oculist, pediatrician and other specialists.
Methods and methods of treatment of affective psychoses
Treatment directly depends on the phase in which the disease is at a particular time. When exacerbation is particularly actively used medicamental directions. In the period of remission, specialists resort, as a rule, to psychotherapeutic methods of influencing patients. Directly to the methods of conducting psychotherapy include the following techniques:
- Hypnotic therapy.
- Group or individual ergotherapy.
- Art therapy.
- Conducting psychoanalysis.
- Relaxation therapy.
The medicamentous effect is carried out on the basis of the pathology phase. In the depressive phase, specialists use the following drugs:
- Drugs that prevent the inhibition of the nervous system.
- Drugs that contribute to overall mood enhancement, improving the tone of the body as a whole.
- Medicines, whose effects are aimed at preventing muscle stiffness and motor deceleration.
The drugs from the first category include antipsychotics, which improve the clarity of thinking. These include "Risperidon", "Eglonil" and others. The use of benzodiazepines, which include "phenazepam", makes it possible to reduce the overall level of depression and anxiety, reducing the manifestations of fear and stiffness of the muscles. Such tablets artificially lower the thresholds of excitability of subcortical structures. The use of normotimics( lithium salts) promotes the rise of mood. In turn, the category of antidepressants, which includes "Sertralin" and similar drugs, mitigates the phenomenon of anguish and despair. The group of holinoblokatorov, among which can be called "Akineton" and its analogues, significantly reduce muscle stiffness and contribute to greater freedom in movements.
Directly in the manic phase, the following drugs are desirable:
- Drugs that have neuroleptic effects. Among them, it is worth mentioning such drugs as "Fluanaxol" and "Solian".
- Drugs related to the benzodiazepine series. In this case we are talking about Zopiclone and Oksazepam. These drugs have a sedative effect on the patient's body, helping to restore sleep and reducing anxiety.
- Preparations related to the normotimic spectrum. These include "Contemnol" and "Actinerval", they allow you to monitor the level of emotional state.
- Holinoblokatory, which includes "Cyclodol" and its similar facilities. Such drugs reduce the level of side effects from neuroleptics, preventing excessive excitability from the neurons of the brain.
Symptoms and treatment of affective psychosis are often interrelated.
The states of psychosis that are capable of leading to vital angst, provided that they are properly and timely treated, can be completely reversible. Thus, with timely treatment it is possible to achieve positive changes in the psyche, as well as completely restore all its functions.
Measures to prevent manic-affective psychoses are primarily the preservation of the nervous system. In this case, it must be protected from psychological trauma and neuroinfections. It is also very important to observe the norms of the duration of work and rest, maintaining an adequate and healthy psychological climate in any team. In addition, it is required to take measures aimed at maintaining the body in a state of full working capacity and a tonus required for life. Also for a healthy psycho-emotional state a person needs regular reception of positive emotions.