- Symptoms of the Paranoid syndrome
- Reasons of the Paranoid syndrome
- Treatment of the Paranoid syndrome
Paranoid syndrome (hallucinatory paranoid, hallucinatory-dilision syndrome) — a combination of an interpretive or interpretive and figurative persecution complex (poisoning, causing physical or moral harm, destruction, material damage, shadowing), with touch frustration in the form of mental avtomatizm and (or) verbal hallucinations.
Symptoms of the Paranoid syndrome:
Systematization of the crazy ideas любог contents fluctuates in very wide borders. If the patient speaks about what prosecution consists in (damage, poisoning, etc.), knows date of its beginning, the purpose, испол zuyemy for the purpose of prosecution (damage, poisoning, etc.) means, the bases and the purposes of prosecution, its effect and net result, it is about the systematized nonsense. In one cases patients rather in detail speak about all this, and then does not make special work to judge extent of systematization of nonsense. However much more often the paranoid syndrome is accompanied by this or that degree of unavailability. In these cases about systematization of nonsense it is possible to judge only by indirect signs. So, if persecutors are called by "them", without concretizing who exactly, and the symptom of pursued - the persecutor (if it exists) is shown by migration or passive defense (additional locks on doors, the care shown by the patient when cooking, etc.) — the nonsense is rather systematized in general. If speak about persecutors and call the specific organization and furthermore names of certain persons (crazy personification) if there is a symptom of an active presleduyemogopresledovatel, most often in the form of complaints in public organizations — the speech, as a rule, goes about rather systematized nonsense. Touch frustration at a paranoid syndrome can be limited to one true auditory verbal hallucinations reaching often intensity of hallucinosis. Usually such hallucinatory-dilision syndrome arises first of all at somatic the caused mental diseases. Complication of verbal hallucinations in these cases happens due to accession of acoustical pseudohallucinations and some other components of ideatorny mental automatism — "unwinding of memoirs", feeling of mastering, flow of thoughts — a mentism.
At schizophrenia in structure of a touch component of a paranoid syndrome mental automatism (see below) dominates while true verbal hallucinations pale into insignificance, exist only at the beginning of development of a syndrome or are absent oats. Mental automatism can be limited to development only of an ideatorny component, first of all "echo thoughts", "the made thoughts", acoustical pseudohallucinations. In more hard cases touch and motor avtomatizm join. As a rule, at complication mental automatism is followed by emergence of nonsense of mental and physical impact. Patients speak about impact from outside on their thoughts, physical departures, about action of hypnosis, special devices, beams, atomic energy, etc.
Depending on dominance in structure of a hallucinatory-dilision syndrome of nonsense or touch frustration allocate crazy and hallucinatory its options. At crazy option the nonsense is usually systematized more than at hallucinatory, red of touch frustration prevail mental avtomatizm and patients, as a rule, either are inaccessible, or are unavailable absolutely. At hallucinatory option true verbal hallucinations prevail. Mental automatism remains often not developed, and it is always possible to find out from patients these or those features of a state, full unavailability it there is rather an exception. In the predictive relation crazy the option is usually worse hallucinatory.
The paranoid syndrome, especially in crazy option, quite often represents chronic состо ny In this case to its emergence often the developing systematized interpretive nonsense (a paranoiac syndrome) to which a cher з considerable periods, quite often years later, join touch frustration precedes gradually. Transition of a paranoiac state in paranoid usually is followed by an exacerbation of a disease: there is a confusion, motive excitement with alarm and fear (alarming and timid excitement), various manifestations of figurative nonsense.
Such frustration continue days or weeks, and then the hallucinatory-dilision state is established.
Modification of a chronic paranoid syndrome happens or due to emergence of paraphrenic frustration, or due to development of the so-called WTO ichny, or consecutive, catatonias.
At an acute paranoid syndrome the figurative nonsense prevails over an inta pretativny. Systematization of the crazy ideas either is absent, or exists only in the most habit view. Confusion and the expressed affective frustration, advantage but in the form of a depression, intense alarm or fear is always observed.
The behavior changes. Quite often there is a motive excitement, impulsive actions. Mental avtomatizm are usually limited to an ideatorny component; true verbal hallucinations can reach intensity of hallucinosis. At the return unless AI of an acute paranoid syndrome it is quite often long the clear depressive or subdepressive background of mood, sometimes in combination with residual nonsense remains.
Inquiry of patients with a paranoid syndrome as well as patients with other crazy syndromes (paranoiac, paraphrenic) (see below), often presents great difficulties because of their unavailability. Such patients are suspicious, tell avariciously, as if vzvesh ая words vaguely. To suspect unavailability existence позволяв statements, typical for such patients ("why to speak about it, there everything is written, you know and I know, you the physiognomist, let's talk about something another", etc.). At full unavailability of the patient does not speak not only about the painful frustration which are available for it, but also about events of the ordinary life. At incomplete availability of the patient quite often reports about himself the detailed data concerning household questions, but immediately becomes silent, and in some cases becomes intense and suspicious at questions — direct or indirect, concerning his mental state. Such dissociation that the patient reported about himself in general and as he reacted to a question of the mental state, always allows to assume small availability constant or very frequent sign of delirium.
In many cases for receiving from the "crazy" patient of his necessary data follows "get to talking" on the subjects which do not have a direct bearing on crazy experiences. The rare patient during such conversation accidentally will not let fall any phrase having a tnosheniye to nonsense. Such phrase often has, apparently, the most ordinary contents ("in any case to speak, I live well, here only with neighbors it was not absolutely lucky..."). If the doctor, having heard the similar phrase, manages to ask the specifying questions of household maintenance, it is very probable that he will receive the data which are the clinical facts. But even if as a result of inquiry the doctor does not receive specific data on a subjective condition of the patient, he on indirect signs can almost always draw a conclusion on existence of unavailability or small availability, i.e. on existence at the patient of crazy frustration.
Reasons of the Paranoid syndrome:
The paranoid syndrome most often meets at endogenous and procedural diseases. The paranoid syndrome shows many mental diseases: alcoholism (alcoholic paranoid), presenile psychoses (involutional paranoid), exogenous (intoksikatsionny, traumatic paranoid) and psychogenic disturbances (reactive paranoid), epilepsy (epileptic paranoid), etc.
Treatment of the Paranoid syndrome:
Apply complex therapy, on the basis of a disease which caused a syndrome. Though, for example, in France, there is a syndromologic type of treatment.
1. Easy form: aminazine, propazine, levomepromazinum 0,025-0,2; этаперазин 0,004-0,1; сонапакс (melleril) 0,01-0,06; meleril-retard 0,2;
2. Average form: aminazine, levomepromazinum 0,05-0,3 intramusculary 2-3 ml 2 times a day; chlorprothixene 0,05-0,4; a haloperidol to 0,03; Triphtazinum (Stelazinum) to 0,03 intramusculary 1-2 ml of 0,2% 2 times a day; Trifluperidolum 0,0005-0,002;
3. Aminazine (Tisercinum) intramusculary 2-3 ml 2-3 in day or intravenously to 0,1 haloperidol or Trifluperidolum 0,03 intramusculary or intravenously kapelno 1-2 ml; leponexum to 0,3-0,5; motidel-depot 0,0125-0,025.