Maniac-depressive psychosis

General characteristic of a disease

Maniac-depressive psychosis is a difficult mental disease which is shown by two states, polar on the psychopathic characteristics: manias and depressions. Usually at the patient periodic approach of only one of affective states is observed, and in an interval between them the patient stays in a condition of an intermissiya or interphase. The periods of an exacerbation of maniac-depressive psychosis more often are called phases or psychotic episodes. At sharp change of one of polar states by another the disease gets the most severe mixed form with symptoms of maniac-depressive psychosis of both phases.

Maniac-depressive psychosis is also called bipolar affective disorder. Its softened form of smaller expressiveness carries the name "cyclotomy". Symptoms of maniac-depressive psychosis 3-4 times more often are diagnosed for women. Prevalence of a disease makes about 0,5-0,8% (on average 7 patients with maniac-depressive psychosis on 1000 people).

Reasons of maniac-depressive psychosis

The disease has an autosomal and dominant mode of inheritance and is transmitted to a thicket from mother to the child. There is also a theory that dominance of one of two possible affective conditions of maniac-depressive psychosis, whether it be the mania or a depression, is caused by various genes. Differential genetic diagnosis of the reasons of maniac-depressive psychosis is not available to medicine today yet.

At the physical level failures in work of the highest emotional centers located in subcrustal area are the reason of maniac-depressive psychosis. It is considered that disturbances of processes of excitement and braking in a cerebral cortex lead to development of a clinical picture of a disease. The role of the most various environmental factors – the relations with people around, a stress, etc. – can be considered only as a concurrent cause of maniac-depressive psychosis, but not the major provocative factor.

Symptoms of maniac-depressive psychosis

Polar affective conditions of a disease are characterized by a different feature set. Carry to symptoms of maniac-depressive psychosis of maniacal type unreasonably the increased mood of the patient, his increased motor and speech performance. Patients with symptoms of maniac-depressive psychosis of this type speak much, joke, laugh, undertake a set of cases, but because of impossibility to concentrate, any their attempt of activity is unproductive.

The exacerbation of maniac-depressive psychosis of the first type can proceed of several weeks before half a year, and all this time of the patient will be subject to sudden jumps of the ideas and hobbies: to new acquaintances, accidental sexual bonds, extravagant acts, alcohol abuse, wastefulness, etc. One more important symptom of maniac-depressive psychosis of this form – total absence at the person of critical thinking. He is not able to estimate really the opportunities, is inclined to extol the achievements, does not consider himself the patient and therefore does not agree to undergo procedures or to take medicine.

The depressive form of a disease is shown by other feature set. The patient with symptoms of maniac-depressive psychosis of the second type is apathetic, indifferent to everything. On faces of such patients constant mournful expression, their speech silent, without emotions, the movements are slowed down. Patients with symptoms of maniac-depressive psychosis of this form quite often fall into a depressive stupor - the state which is characterized by mental anesthesia, full loss of all feelings and requirements up to primary: to eat, drink, go to a toilet, to wash.

Carry to symptoms of maniac-depressive psychosis of the second type also thoughts of suicide. The world seems to the patient uninteresting, life aimless therefore he tries to finish it and shows at the same time an ingenuity maximum, deceiving people around. At the physical level symptoms of maniac-depressive psychosis are shown by heavy feelings behind a breast and trouble breathing.

Diagnosis of maniac-depressive psychosis

Differential diagnosis of maniac-depressive psychosis is usually carried out with all other types of mental disorders: various forms of neurosises, schizophrenia, psychoses, psychopathies, depression, etc. For an exception of probability of organic lesions of a brain as a result of injuries, infections or intoxications the patient with suspicion of maniac-depressive psychosis goes to a X-ray analysis, an electroencephalography, brain MRT.

Wrong diagnosis can lead to purpose of the wrong treatment and to burdening of a form of a disease as to its investigation. Many patients, unfortunately, do not receive the corresponding treatment as it is quite easy to confuse some symptoms of maniac-depressive psychosis with seasonal fluctuations of mood at the person.

Treatment of maniac-depressive psychosis

Treatment of maniac-depressive psychosis with maniacal states assumes reception of antipsychotic means on the basis of Chlorpromazinum or levomepromazinum. These drugs stop excitement and have the expressed sedation. Additional components of treatment of maniac-depressive psychosis of maniacal type are salts of lithium and a haloperidol. Reception of these drugs happens under strict control of the doctor because of probability of development of a serious complication of therapy – an antipsychotic syndrome. It is shown in disturbances of movements, a tremor of extremities and the general constraint of muscles.

In treatment of maniac-depressive psychosis with the prevailing depressions antidepressants actively are applied. For achievement of the most bystry therapeutic effect the intensive rate of drugs with the accelerated increase in doses of medicine therefore you should not postpone treatment of a depression is usually appointed. The break of a depressive attack in treatment of maniac-depressive psychosis is reached by sudden interruption of a course of therapy on high doses and purpose of diuretics. For treatment of maniac-depressive psychosis of a long form sessions of electroconvulsive therapy in a complex with unloading diets, medical starvation, and sometimes and a sleep deprivation up to several days are used.

For prevention of psychotic episodes mood stabilizers – so-called stabilizers of mood are appointed. Long system reception of these drugs allows to reduce significantly expressiveness of symptoms of maniac-depressive psychosis and as much as possible to postpone approach of the next phase of a disease.