- Symptoms of Maniac-depressive psychosis
- Reasons of Maniac-depressive psychosis
- Treatment of Maniac-depressive psychosis
The Maniac-depressive Psychosis (MDP) (circular psychosis, tsiklofreniya) - the disease which is shown periodic maniacal and depressions (phases) which are usually divided by intermissiya; does not lead to formation of mental defect.
Symptoms of Maniac-depressive psychosis:
Expressiveness of affective frustration varies from easy disturbances (cyclotymia) which usually treat in out-patient conditions, to the heavy depressions and manias demanding urgent hospitalization. For MDP typically full involution of painful disturbances, return to a state which was to a disease. More rare, after a numerous recurrence, during remission, residual psychopathological manifestations mainly in the form of the erased hypomaniacal and subdepressive frustration are also noted. Number of phases throughout a disease very variously. Duration of phases - of 1 week up to 1-2 years and more, average duration - 6-12 months. Light intervals in certain cases can be absent (so-called continual disease), but usually they are measured for months, years and even decades. The bipolar current - change of depressive and maniacal phases - is observed in 1/3 cases. Most often the disease proceeds in the form of periodic depressions.
The diagnosis of MDP is based on autokhtonny emergence and the subsequent recuring of affective phases, on. to a picture of a mania, typical for endogenous affective frustration, and a depression and existence among relatives of persons with cyclotymic manifestations or sick MDP. Phases MDP need to be differentiated from it is endogenous, psikhogenno, konstitutsionalno (phases at psychopaths) and somatogenno the caused affective states. Otgranicheniye of MDP from periodic schizophrenia is based on absence at the time of an attack of hallucinations, the crazy ideas of the relation, prosecution and formal disorders of thinking. In cases, difficult for a differentiation, MDP manages to make the diagnosis only at long observation if in development of a disease changes of the personality do not accrue.
Reasons of Maniac-depressive psychosis:
The large role is played by hereditary predisposition and constitutional factors. Most often, persons of a cycloid and psychasthenic warehouse get sick. Also dysfunction of podbugorny area and pathology of endocrine system have a certain value. Women are ill more often than men. The first attacks can arise both in the pubertal period, and in old age. In most cases the disease begins in the 3-5th decade of life.
Treatment of Maniac-depressive psychosis:
Treatment of depressions is carried out by antidepressive means (amitriptyline, Melipraminum, Pyrazidolum, инказан on 50-300 mg/days). In hard cases administration of drugs is shown parenteral (in oil, in/in drop). At depressions, resistant to psychotropic drugs, carry out zlektrosudorozhny therapy. At hypomaniacal states tranquilizers [diazepam (Seduxenum), oxazepam (Tazepamum), chlordiazepoxide (Elenium) on 5-40 mg/days, Phenazepamum on 1-3 mg], neuroleptics in small doses, lithium salts are effective (lithium carbonate on 900-1200 mg/days). Maniacal states are stopped by neuroleptics (aminazine on 100-400 mg/days, a haloperidol on 6-20 mg/days, Triphtazinum on 20-50 mg, leponexum on 50-200 mg, сонапакс, chlorprothixene on 100-300 mg/days). At the phenomena of maniacal excitement administration of drugs in oil (aminazine, a haloperidol, Triphtazinum) is shown.
Forecast in most cases favorable. At depressive phases it is complicated in connection with danger of suicide attempts. The main warning facility of the subsequent affective phases is preventive therapy (within several years) salts of lithium and finlepsipy. Salts of lithium give under control of content of lithium in blood (optimum contents makes it providing preventive effect 0,4-0,8 mmol/l).