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medicalmeds.eu Psychiatry Involutional psychosis

Involutional psychosis



Description:


Involutional (presenile, presenile) psychoses. Mental diseases of late age share the nainvolyutsionny functional (reversible) psychoses which are not leading to development of weak-mindedness and the senile pathopsyhosis arising against the background of destructive process in a brain and which are followed by development of gross violations of intelligence.

Carry an involutional depression (melancholy), involutional paranoid to involutional psychoses.


Symptoms of Involutional psychosis:


Involutional melancholy - the lingering alarming or alarming and crazy depression which for the first time arose at involutional age. It is noted more often at women at the age of 50-65 years.

Symptoms and current. The clinical picture of a disease consists of the suppressed mood,  with alarm, fear, confusion. Patients stay in a condition of motive concern, the fussiness turning with times into alarming and sad excitement. They rush about, cannot find any peace, lament, repeat the same words. In such state suicide attempts are possible. The state can become complicated due to accession of acoustical illusions: in a conversation of people around condemnation, reproaches, charge are heard. The crazy ideas of self-accusation, condemnation, ruin, an impoverishment or hypochiondrial contents join. The hypochiondrial ideas consist in conviction of patients available of a heavy somatopathy (cancer, a heart disease, digestive tract) that is not confirmed at an objective research. In some cases painful fears take the extreme forms of denial of functioning of separate bodies and the whole systems - "a wound is stopped", "the stomach decays", "intestines decayed", "there is no chair and urine is not emitted". The feeling of a hopelessness and alarming expectation can be also shown in extremely grandiose form - "everything perishes, there is a general accident... in total from my sinfulness... the only exit – in fair punishment".

Involutional paranoid - the psychosis for the first time arising at the age of involution (involution) and which is characterized by nonsense of small scope or the ordinary relations.

Symptoms and current. The disease is characterized by gradual development of resistant nonsense against the background of clear consciousness and externally concerning the arranged behavior. People from the immediate environment (family members, neighbors, acquaintances) who are suspected of intentional causing various troubles are involved in the crazy concept: wreckings, oppressions, poisonings, causing damage. The crazy concept usually does not extend out of limits of the narrow household relations therefore is called nonsense of "small scope" or "the ordinary relations". Patients are convinced that neighbors spoil their things, get secretly into the apartment, trying keys and master keys, pour salt, toxic agents in food, admit under a door gas, etc. To neighbors suspects who consist with them in a plot go. Everything becomes with a specific goal "to drive" the patient out of the apartment, to cause material damage or harm to health. At the same time patients can on - crazy interpret and the corporal feelings which are available for them. For example, cough, heartbeat are regarded as result of poisoning with gas, and gastric frustration, a diarrhea - as poisoning with poisons, podsypanny in food. Patients differ in big activity and persistence on upholding of the crazy beliefs and fight against imaginary enemies. They arrange shadowing, hang numerous locks, "seals" on a door, write complaints to various instances. The suppressed mood, unlike melancholy, does not happen.


Reasons of Involutional psychosis:


Emergence and development of involutional psychoses are promoted a peculiar warehouse of the personality with lines of rigidity, uneasiness, suspiciousness, by various psychoinjuring situations, the previous somatopathies. Involutional psychoses at women develop, as a rule, after a menopause (klimakteriya), i.e. after the period of hormonal reorganization in an organism. In other words, "climax" is not the reason of involutional psychoses.


Treatment of Involutional psychosis:


Treatment of involutional melancholy. Apply antidepressants with the calming action in combination with small doses of neuroleptics (сонапакс, Frenolonum, этаперазин) for the purpose of removal of fear, alarm, crazy расстройтсв. Drugs are appointed carefully, in the absence of contraindications, taking into account  possible, age reaction to drugs. In case of inefficient treatment by medicines sometimes apply electroconvulsive therapy. Treatment is usually carried out in the conditions of a psychiatric hospital since constant observation of a physical and mental condition of the patient is necessary especially as the probability of attempts to suicide is not excluded.

Treatment of involutional paranoid. It is carried out in a hospital. Neuroleptics (Triphtazinum, a haloperidol) in combination with tranquilizers (Seduxenum, Phenazepamum) are applied. Treatment by hormonal drugs inefficiently and is even contraindicated (the same concerns also involutional melancholy). The change of the residence recommended sometimes by doctors gives only temporary relief. Patients for some time calm down, but then crazy statements renew (or the old subject comes to life, or find new "enemies").




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