Preparations 

Psychosis causes types of diagnosis. What is psychosis? Signs, symptoms, treatment

Definition of disease. Causes of the disease

Acute psychotic disorder(OPA) or acute psychosis is a painful mental condition in which there is difficulty in determining what is real and what is not. With this disorder, a person develops false beliefs that cannot be dissuaded (delusional ideas), he begins to perceive things that others do not see or hear (hallucinations).

Sometimes people with acute psychosis are distinguished by incoherent (torn or disorganized) speech and behavior that does not correspond to the external situation (in everyday life this is called inadequacy). They may also experience sleep problems, social withdrawal, lack of motivation, and difficulty performing daily activities.

This disorder was described in ancient times: Hippocrates mentions it already in the 4th century BC. e.

On average, about 3% of people experience psychosis at some point in their lives, and in a third of them it is developmental.

Acute psychosis has many different causes:

Separately, two reactive psychoses are distinguished:

If you experience similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of acute psychotic disorder

About acute psychosis four main symptoms testify: senestopathies, illusions, hallucinations and delusions.

Senestopathy- These are unusual, frilly, unpleasant somatic sensations that may be associated with diseases internal organs or exist in the imagination of a hypochondriac patient.

The most common senestopathies are:

Illusions - these are distorted, incorrect perceptions of a real-life object. They can also occur in mental healthy people, since the distorted perception of an object depends, for example, on illumination, emotional state person or condition auditory analyzer(hard of hearing people).

Psychosis can cause:

  • verbal illusions- the real speech of the surrounding people is perceived as hostile statements;
  • pareidolicillusions- occurs in deliriums (mental disorders with clouding of consciousness) of intoxication or traumatic origin. Thus, a patient with delirium tremens (delirium tremens) in spots on the wallpaper notices stirring and bizarre, changing faces, and in cracks in the ceiling he notices snakes ready to pounce on him. With twilight confusion associated with trauma or epilepsy, the patient perceives the doctor as a killer, and the phonendoscope in his hand is like a gun aimed at him.

hallucinations is the perception of an object that does not actually exist. Most often they are auditory or verbal. For example, the patient hears non-existent "voices" that can play different roles:

  • comment on his actions (commenting hallucinations);
  • attack or defend (dramatic hallucinations);
  • justify and praise (angelic hallucinations);
  • obsessively and unsystematically repeating something (stereotypical or obsessive hallucinations);
  • order to do something (imperative hallucinations) - can be dangerous for the patient and others.

Hallucinations associated with ODA should be distinguished from hallucinations caused by the disease, and from manifestations of eidetism - a phenomenal ability to visualize representations (memories) with extraordinary sensory brightness, which is found in artists and children, and in children bright and "live" images of visualized representations can play the role of heroes-friends and interlocutors.

crazy ideas- these are subjective judgments taken by the patient with OPD as true, which are objectively false, plausible, ridiculous and do not correspond to reality. It is impossible to dissuade the patient or psychologically correct such conclusions.

Crazy ideas are:

  • primary - associated with the defeat of thinking
  • secondary - occurring on the basis of illusions, hallucinations or mental automatisms (when a person ceases to be the master of his own thoughts);
  • systematized - supported by subjective evidence of the patient himself (everything that does not agree with the evidence is rejected);
  • unsystematized - devoid of evidence base and logic;
  • encapsulated - sketchy;
  • residual - residual, fading;
  • figurative - reflecting the prevailing mood;
  • interpretive - arbitrarily interpreting reality.

Delusional ideas can also occur in healthy people who are in close contact with "delusional" patients. This form of delusion is called induced. If a person with OPD has strong charisma and leadership qualities, then induced delusions can become a kind of "epidemic".

  • paranoid - ideas of a special relationship;
  • paranoid - ideas of persecution;
  • paraphrenic - ideas of greatness, wealth and reassessment of one's capabilities.

The pathogenesis of acute psychotic disorder

ODA is traditionally seen as a consequence disruption of the dopamine neurotransmitter system of the brain. This hypothesis states that psychosis is the result of overactivity of dopamine in the brain, especially in the mesolimbic system. Dopamine is a substance involved in the transmission of impulses between nerve cells.

The main source of evidence for this hypothesis is the pharmacological effects of antipsychotic drugs, which block dopamine D2 receptors, thereby reducing the intensity of psychotic symptoms. Conversely, drugs that increase the production of dopamine or block its "return" and destruction (for example, amphetamines and cocaine) can provoke psychosis.

Which affect the intensity of the interaction of nerve cells, has also been proposed as a possible mechanism for the onset of psychosis. This theory is supported by the fact that partial NMDA receptor antagonists, such as ketamine and dextromethorphan, contribute to the onset of a psychotic state in large overdoses. The symptoms of such intoxication are considered mirror symptoms of schizophrenia, with both positive (productive) and negative symptoms occurring.

Antagonism of NMDA receptors, in addition to provoking symptoms resembling psychosis, is also manifested by other neurophysiological aspects: a decrease in the amplitude of P50, P300 and other evoked potentials of nerve cells.

Long-term use or high doses of psychostimulants can change the normal functioning of the brain, making it look like the manic phase of bipolar disorder, a type of psychotic condition. NMDA receptor antagonists replicate some of the so-called "negative" symptoms, such as thought disorder (at low doses) and catatonia (at high doses). Psychostimulants, especially in those who are already prone to a psychotic style of thinking, can cause some "positive" symptoms such as delusional beliefs, especially persecutory (haunting) content.

Classification and stages of development of acute psychotic disorder

Acute psychosis is:

Primary psychoses must be treated immediately with antipsychotic drugs, while secondary ones require the elimination of the root cause: brain tumors, intoxication and other pathologies.

ODAs are classified according to psychiatric disorder to which they are assigned. If they are associated with schizophrenia spectrum disorders, then acute psychoses can take the following forms:


In the next revision of ICD-11, it is proposed to abandon the forms of schizophrenia. This is due to the difficulty in differentiating the forms among themselves, as well as the fact that in practice the transition of the disease from one form to another is often observed.

Complications of acute psychotic disorder

People with a history of OCD are more likely to abuse drugs and/or alcohol than others. Some use them to treat psychotic symptoms. And although psychoactive substances do relieve psychotic symptoms (albeit briefly and slightly), their abuse can only aggravate psychotic symptoms or cause other problems.

For example, studies show that people with schizophrenia are more likely to smoke. Nicotine helps them cope with anxiety and also reduces some side effects antipsychotic therapy. But at the same time, the risk of lung cancer and vascular accidents (strokes and heart attacks) increases significantly. Therefore, drugs and alcohol are not used as medicines: their use does not solve the problem, but only through an imaginary relief adds another problem.

If left untreated, psychotic symptoms can lead to social disturbances: problems in school and work, strained family relationships, and loss of close social contacts - friends and acquaintances. The longer the symptoms persist, the greater the risk of additional problems - frequent unreasonable calls to the ambulance medical care, admission to a psychiatric hospital, problems with the law. In general, all this is called "social drift" - the loss of social status, professional skills, competencies with a violation of contacts accumulated throughout life. The end result of this drift is homelessness and the need for constant social support. Therefore, among the homeless people, the percentage of people with psychotic disorders is very high.

People with acute psychosis also have a high risk of self-harm and suicide. Therefore, if the patient harms himself, you should immediately contact a doctor or the Helpline service. Loved ones should be on the lookout for signs of unexplained cuts, bruises, or cigarette burns, which are commonly found on the wrists, arms, thighs, and chest.

People with OCD who self-harm can always wear covering clothing, even in hot weather. In view of the immediate danger, involuntary examination of such patients by psychiatrists is allowed, as well as involuntary treatment in psychiatric hospitals.

Diagnosis of acute psychotic disorder

Diagnosis of OPD is primarily carried out by observing the behavior of the patient and talking with him. In the process of such an examination, objective signs of the presence of psychotic experiences can be identified:

  • disorganized behavior and speech - sometimes the patient's speech is so disturbed that it is impossible to understand what he wants to say (this is called "verbal okroshka");
  • signs of hallucinations - the patient can constantly close his ears, talk when there is no one around, look past the interlocutor, etc .;
  • indirect indicators of the presence of delusional experiences - for example, a patient can wrap his head with metal objects, because he thinks that his brain is affected by rays.

In addition, a list of additional paraclinical examinations is carried out in order to exclude an external cause other than mental disorders:

  • brain tomography - to exclude tumors and vascular disorders;
  • testing for psychoactive substances and others.

When all external causes are excluded, go to differential diagnosis among the psychiatric causes of acute psychosis. Schizophrenia is the most common cause of OPD. For a long time, the diagnosis of schizophrenia was based on the symptoms of Kurt Schneider, who identified them by statistical analysis of case histories:

  • sounding thoughts;
  • third-person hallucinations;
  • hallucinations in the form of comments;
  • somatic hallucinations;
  • withdrawal or insertion of thoughts;
  • translation (openness) of thoughts;
  • delusional perception;
  • perception of sensations or actions as if they were caused by someone else's influence.

In modern classifications, there is a departure from these criteria, since they have shown their low specificity for schizophrenia.

Other psychiatric causes of ODA may include:

  • bipolar affective disorder - then affective (emotional) disorders will prevail in the clinic of psychosis;
  • - in this case, there will be many psycho-organic signs in the clinic of psychosis;
  • withdrawal syndrome after substance abuse.

Treatment of acute psychotic disorder

Treatment for ORD includes a combination of antipsychotic medications, psychological therapies, and social support(support for a person's social needs such as education, employment, or housing).

Antipsychotic medicines

Antipsychotic medications are not suitable for everyone, as their side effects can affect people in different ways. For example, antipsychotics must be carefully monitored and selected for people with cardiovascular disease, epilepsy, and other conditions that cause convulsions or seizures.

Side effects may include drowsiness, trembling, weight gain, agitation, muscle twitches and spasms, blurred vision, dizziness, constipation, loss of sex drive (libido), dry mouth, and others. They are all reversible and correctable.

Antipsychotics reduce feelings of anxiety within a few hours of using them. But to reduce directly psychotic symptoms, such as hallucinations or delusional thoughts, it may take several days or weeks.

Antipsychotics can be taken by mouth (by mouth) or by injection. There are several slow-release antipsychotics that require only one injection every two to six weeks (eg, maintenance prolongs).

After an episode of psychosis, most people who get better on medication need to continue taking it for at least a year. Approximately 50% of people need to take medication for more than long time to prevent recurrence of symptoms. If a person has severe psychotic episodes, they may need to be sent to a psychiatric hospital for treatment.

Psychological treatment

Psychological treatments include:

  • cognitive- behavioral therapy(CBT), based on individual conversation - very successful in helping people with psychosis;
  • family interventions - the participation of family members and close friends in therapy reduces the need for inpatient treatment.

Forecast. Prevention

Before developing OPD, people usually experience criteria for ultra-high risk of developing psychosis:

  1. episodic occurrence of one or more psychotic symptoms:
  2. hallucinations;
  3. delirium;
  4. formal disorders of thinking (disconnection of thinking, feeling of "an influx of thoughts" or their "blocking", etc.);
  5. the appearance of one attenuated (smoothed) psychotic symptom or more:
  6. ideas of attitude (thoughts that others treat him in a special way);
  7. strange beliefs or unusual "magical" thinking, including ideas of grandiosity;
  8. paranoid ideas;
  9. unusual perceptual experience (elementary deceptions of perception);
  10. oddities of thinking and speech;
  11. the presence of hereditary risk factors (history of psychosis, schizoid or schizotypal personality disorder in relatives).

It is very important to “catch” the development of OPD at the stage of the listed early manifestations, since only this makes it possible to stop the development of serious irreversible personality changes.

The period of symptom-precursors that occurs before the onset of acute psychotic manifestations is called the "window of opportunity" when it is possible to really change the course of the disease. All other attempts at therapeutic intervention after the manifestation of psychosis only alleviate the patient's condition, but do not allow to radically influence the course of the disease itself.

Primary prevention of psychosis includes:

  • knowledge of risk factors for ODA;
  • the use of methods to reduce the risk of these factors;
  • knowledge of the neurobiological pathways that mediate the impact of various risk factors in the development of OPD, and the presence of specific interventions that block these risk factors leading to the disease.

Secondary prevention of psychosis(after a psychotic episode):

  • identification of a group of people at high risk of relapse;
  • the availability of safe and effective specific treatments that reduce the likelihood of relapses;
  • the presence of specific effective methods treatments that can prevent or slow the progression of the disease.

Acute psychosis is a pronounced violation of mental activity, manifested in an inadequate perception of reality and oneself. With this disease, a person can completely lose control over their own behavior and actions.

In this state, are often observed,. The disease can develop against the background of a somatic illness, psychotrauma, or after strong emotional upheavals.

psychosis in acute form usually the phenomenon is not isolated, but constantly recurring. At what the probability of a recurrence is high. But unlike the chronic form, acute psychosis is a temporary mental disorder that can last for several days or weeks. The prognosis of therapy is favorable.

People suffering from this disease often withdraw into themselves and do not accept the help and advice of loved ones. Therefore, it is important to diagnose the problem as early as possible so that timely therapy, albeit forced, is prescribed. Indeed, over time, the adequacy of a person becomes lower and lower, against the background of which irreversible for mental state processes.

Causes and forms of acute psychosis

According to statistics, women are more likely to suffer from acute psychosis. This is probably due to hormonal imbalances.

Depending on the cause that provoked the development of the disease, the following types of acute psychosis are distinguished:

According to clinical manifestations, the following types of deviations are observed:

Often difficult to diagnose initial reason illness. The impetus may be a combination of several factors.

alcohol form

Acute develops in those people who abuse alcohol for several years. And it develops when a person abruptly renounces his bad habit. Alcoholic psychosis manifests itself as follows: there is a sharp change in mood, hallucinations and delusions appear, the patient is dangerous to others.

In this condition, immediate admission to the hospital and bed rest is required. Usually the patient does not understand what is happening and resists.

In the hospital, he will be constantly monitored, and an appropriate course of therapy will be prescribed.

mental breakdown after childbirth

This condition may appear in the first weeks after the birth of the baby. The main cause of mental disorders is illness during childbearing and pain shock during childbirth. How does it manifest itself? The woman becomes very emotional, tearful, sleep problems appear, there is no appetite.

Emotional behavior can be different. Some women are indifferent to their baby, while others begin to take care of all the children in the ward. Some young mothers may be in a state of euphoria, while others, on the contrary, become withdrawn and taciturn.

Acute psychosis should not be confused with postpartum depression. In the second case, delirium and hallucinations are absent. Women in labor with such mental disorders should be referred for treatment, otherwise there may be terrible consequences, up to suicide or the death of the baby.

Psychotic behavior in children can manifest itself in different ways. The most important sign is, that is, the ability to hear and see what is not in reality.

There is also delirium, incomprehensible laughter for no reason and irritation. Psychosis in a child can develop against the background of short-term or long-term states of physical appearance. It's drug use fever, hormonal disruptions. It is important to cure the underlying disease, then the mental deviation will also pass.

If psychosis is suspected, the necessary diagnostic tests should be carried out. It is required to visit a neuropathologist, a specialist in developmental diseases, an ENT doctor, a speech therapist. If the child has experienced severe stress, long-term psychotherapeutic support will be required.

Risk factors

In different life cycles, there may be different types mental deviations. In adolescence, there is a high probability of development.

In old age, when age-related changes often occur in the vessels and are disturbed, it is formed.

manic depressive young ambitious individuals are more likely to be seen. During this life period, some global changes in fate can adversely affect mental health.

As for the gender factor, statistics show that the disease develops in men and women in the same way. But there are types of the disease, which men are more susceptible to. This and also at . But manic-depressive syndrome is three times more common in women, since hormonal surges often occur in the weaker sex.

If we consider the geographical factor, it is noted that mental illnesses affect residents of large cities more. Because in the metropolis there is a high level of stress and a frantic pace of life, so the psyche suffers.

The social factor manifests itself when a person could not realize himself. For example, a girl did not marry and could not give birth, or a man did not achieve his goals. In such cases, the burden of negativity puts pressure on the person, but contributes.

Symptoms of the disease

The disease manifests itself from different sides. It all depends on the characteristics of the organism and the causal factor that led to the failure in the psyche.

Warning symptoms that may indicate a possible acute psychosis:

  • changeable mood, depression and phobias develop;
  • change in character: appears

Modern approach to treatment

Treatment of acute psychosis should begin as early as possible. Only a qualified psychotherapist can identify the provocative cause and prescribe high-quality therapy. You can not leave the patient at home on self-treatment.

Modern specialists use the following methods of therapy:

For high-quality treatment, a complex of different measures is needed. Such a complex is individual for each person and only a good doctor can pick it up. Timely therapy will help increase the likelihood of a good prognosis.

It should be remembered that psychosis is a curable disease. The main thing is not to delay the therapy. Only self-discipline, regular use of drugs, psychotherapy and the help of others will help restore mental health and joy of life.

In acute psychosis, there is a clear violation of the human psyche, expressed in an inadequate perception of what is happening around. Often occurs against the background of a complete loss of control over oneself and one's actions.


Physiotherapeutic methods can be used, which include acupuncture, reflexology, exercise therapy, electrosleep. Additional methods are occupational therapy and spa treatment.

Thanks to an integrated approach, it is possible to remove psycho-emotional stress, increase the body's resistance to stress.

Emotional activity or a breakdown is a consequence of psychosis. The condition occurs as a result of heredity, injury or against the background of serious diseases. A patient with psychosis requires urgent treatment, since the prolongation of the disease leads to long-term therapy. The task of close people is to observe a person prone to illness and respond in a timely manner. What are the symptoms and types of psychosis?

Psychosis - what is it?

In a state of psychosis, real life is replaced by fictional stories. Obsessive ideas, fear for life, fears, or vice versa, an emotional upsurge. At the same time, a person retains the abilities acquired during life. He still has the ability to think, analyze, evaluate the situation. The only difference is the strong influence of the suggestions imposed by the psychosis.

Patients believe in secret intelligence agencies, aliens who hunt for humanity or assure others of incredible abilities. Psychosis extends to feelings. Patients choose an object of love, pester a person, persecute, impose feelings, and become jealous.

You can not argue with a patient with psychosis or discuss his condition. Such behavior worsens a person's health and delays treatment.


Do not treat the patient as a hopeless person. The disease manifests itself cyclically. After treatment, there is a long interval, accompanied by excellent health. But, then aggravation comes, hallucinations appear, crazy ideas arise. In rare cases, the disease is cured completely, occurs full recovery psyche.

Types of psychosis

Despite the variety of symptoms and behaviors of patients, physicians have identified two large groups. Under them, various types of psychoses were combined. There are the following categories:


  1. organic psychoses. Occur as a result of sexually transmitted (syphilis), infectious diseases (meningitis). Also, ailments that disrupt cerebral circulation (atherosclerosis) lead to an unstable state. In other words, organic psychoses develop as a result of physical pathologies.
  2. functional psychoses. The formation is influenced by human behavior in society, the psychological state. At the same time, the brain remains healthy, but obsessive ideas arise, in the form of persecution, belief in superpowers.

You should not consider psychosis as a consequence of other diseases or a random combination of circumstances. In many cases, the disease appears as a result of head injuries, alcohol or drug abuse, after childbirth, stressful situations. Consider the most common types of psychosis.

Symptoms of manic psychosis

Relatives of a person prone to mental disorders should carefully monitor him. There are a number of signs that indicate an exacerbation of the disease. At the same time, keep in mind that the patient will hide his condition, so a thorough analysis of human behavior will be required. Symptoms of manic psychosis:


  1. Positive attitude. Sometimes completely unfounded. No matter what happens in your personal life, a person’s mood does not deteriorate at work. Accompanied by manic psychosis rise in all areas. The patient is optimistic, emotional, cheerful, confident in his strengths and talents. The exacerbation is characterized by increased sociability, the acquisition of new friends.

    Be careful. A positive attitude is deceptive. It will be followed by outbursts of anger, fights and quarrels. Especially if you argue with the patient.

  2. Rapid speech and accelerated thinking. At manic syndrome activation of individual points of the brain starts. As a result, a person thinks, decides, acts and speaks faster. Pay attention if the patient's speech has become loud, expressive and confused. Creative manifestations were noticed: composing songs, writing poems, drawing pictures. Many patients during this period decide to leave work and travel or decide to take up a life's work. Women are characterized by such symptoms: a change in appearance, a new haircut, revealing clothes. A person takes on several things at the same time. But none of them finishes, because attention is scattered.
  3. Constant movement. Motor symptoms are added to a good mood, loud speech. It is difficult for a person to stand still. The patient constantly moves, shifts from foot to foot, actively gesticulates. Manic psychosis is characterized by sharp attacks, early awakening. The patient sleeps no more than 5 hours a day, while full of energy.

When identifying the described signs, do not convince the person that he is sick. Otherwise, you will stumble upon aggression. The best way out is to consult a psychologist.

Depressive psychosis: symptoms

The disease is characterized by slow development. Man gradually falls into sad state, biting himself for every act. The patient's thoughts boil down to the fact that he is a loser, a bad person, a poor spouse or wife, cannot cope with work, raising children. Nothing good is expected in the present, past and future, only pain and remorse.


Depressive psychosis is accompanied by the following symptoms:

It is not possible to get out of a depressive psychosis on your own. All attempts to shake a person, pull him out into the street, show how others live, lead to the opposite result. The patient becomes even more convinced that he is bad and good for nothing. Depressive psychosis requires medication. Often there is a mixture of symptoms and behavior of the patient. This condition is called manic-depressive psychosis.

Alcoholic psychosis

The abuse of alcohol leads to a painful condition. It should be understood that wine on holidays does not lead to alcoholic psychosis. This diagnosis is faced by people at stages 2-3 of alcoholism. Symptoms do not appear immediately and are aggravated as a result of external and physiological circumstances: serious injury, infectious diseases.

Alcoholic psychosis is divided into acute and chronic form. It is characterized by such symptoms:

  • hallucinations;
  • crazy ideas;
  • depression
  • memory impairment;
  • the patient is poorly oriented in time and space.

The initial stage of alcoholic psychosis is curable. Chronic appearance is accompanied by long-term therapy. At the same time, all body functions are not restored: problems with memory and perception remain.

Signs of postpartum psychosis

The disease occurs rarely and differs from depression in dangerous symptoms. In addition to the oppressed state, a woman has a desire to harm herself and the baby. Symptoms appear within 1–1.5 months. after the birth of a child. Postpartum psychosis is recognized by the following features:


  • sudden mood swings;
  • delusional states;
  • unreasonable concern;
  • constant feeling of anxiety.

A woman imposes incredible hypotheses on others: the child has been replaced, the baby is terminally ill. The mother of the child closes in on herself, does not let anyone near the baby. The condition worsens with hallucinations, which lead to sad consequences. Therefore, it is important to respond in a timely manner and take the woman in labor to the doctor.

Psychosis is treatable. Acute phases require medical intervention. After the decline of dangerous symptoms, therapy flows into communication with a psychologist. A clear medication, walking, following the hospital regimen will give a positive result.

Psychoses are mental disorders that are characterized by productive symptoms.

Pathologies of this group are manifested by conditions for which true and false hallucinations, delusions, and illusions are inherent. Also in people suffering from psychosis, disorders such as depersonalization and derealization are observed.

Psychoses are expressed by a clear violation of mental activity, as evidenced by a disorder in the perception of reality and disorganization of behavior. Patients are characterized by an inadequate reaction, which grossly contradicts the actual situation.

Classification

If we talk about what types of psychosis are, then we can distinguish two main categories of mental illness:

  1. organic origin.
  2. Functional origin (endogenous).

Organic psychoses arise due to damage to the medulla during the development of diseases such as meningitis, syphilis and similar infectious pathologies. The cause of these types of psychoses can be atherosclerosis, leading to blockage of blood vessels and impaired cerebral circulation. Risk factors include stroke, which has more severe consequences than atherosclerosis.

Functional psychoses progress in the absence of the above diseases, that is, in conditions where the brain is physiologically healthy and complete. This category of mental disorders includes schizophrenia, manic-depressive psychosis, affective disorders and their psychotic forms, as well as conditions where personality changes occur due to paranoid phenomena.

Classifying mental diseases according to their etiology and pathogenetic mechanisms of development, they distinguish not only organic and endogenous types of psychoses, but also:

  • intoxication;
  • reactive;
  • senile;
  • traumatic;
  • affective.

According to the characteristics of the clinical picture and the predominant signs, mental disorders are divided into the following types:

  • paranoid;
  • depressive;
  • hypochondria;
  • manic.

Patients can be diagnosed with both independent and combined forms of neurosis - manic-depressive, depressive-hypochondriac, depressive-paranoid, etc.

Consider the main, common types of psychosis, their characteristic features and features.

Intoxication

This group includes alcoholic and withdrawal mental disorders that arose against the background of poisoning the body with various toxic substances. In most cases, the cause of the development of the disease is alcohol abuse, in connection with this, as a rule, specialists consider alcoholic psychosis, manifested in such forms as:

  • hallucinosis.
  • Delirium.
  • Paranoid.

Alcoholic hallucinosis is often the result of the use of surrogate alcohol, which causes intoxication of the body. Patients are disturbed by visual disturbances and auditory hallucinations of a judgmental nature, which occur mainly in the evening and at night. There may be periods of physical activity, provoked by a desire to hide from others and get rid of intrusive voices.

Alcoholic delirium, more commonly known as delirium tremens. This form of intoxication psychosis is the most common. signs mental disorders appear when you stop drinking alcohol after a long binge. Patients have various hallucinations, mostly of a frightening nature, very realistic and frightening. At the same time, consciousness is clouded, motor activity increases and the mania of persecution worries.

Alcoholic paranoid manifests itself suddenly, mainly during prolonged use of alcohol. The main symptom is delusions of persecution, when it seems to patients that they want to encroach on their lives and cause harm. The condition may worsen and be accompanied by auditory, visual hallucinations. People with such an ailment are afraid of everything and everyone, often turn to law enforcement agencies with a request for help and protection.

If alcohol is consumed constantly and in large volumes, then acute intoxication psychosis passes into the chronic stage, its clinical picture becomes more pronounced and pronounced. Chronic forms of alcoholic psychosis:

  • Brad of jealousy.
  • hallucinosis.
  • Pseudoparalysis.
  • Korsakov psychosis.

Alcoholic delirium of jealousy develops at the stage of personality degradation. Patients, often representatives of the stronger sex, lose contact with loved ones, especially with their other half and children. There is a firm conviction about the betrayal of the spouse, there are even false confirmations of this. Over time, interest in children also disappears. Men delve into the past, trying to find facts of betrayal, further heating up the situation.

Chronic alcoholic hallucinosis has symptoms characteristic of schizophrenia. This form of the disease progresses against the background of recurring attacks of hallucinosis and delirium. Personal degradation is not observed. With the withdrawal of alcohol, the symptoms lose their severity and may completely recede.

Pseudoparalysis develops mainly in men and is manifested by a decrease in muscle strength, impaired motor reflexes, involuntary vibrations of the limbs (tremor). Disorders also occur in the work of the central nervous system. Representatives of the stronger sex, who abuse alcohol, are in euphoria, feel themselves omnipotent (delusions of grandeur).

Korsakov's psychosis is expressed by impaired memory and signs of delirium that occur against the background of a lesion nerve fibers due to the intake of large doses of alcohol.

jet

Such mental disorders are the result of psychological trauma. Depending on the period after which the signs of the disease appeared, acute and subacute are distinguished. The main symptoms are bouts of hysteria, erratic excitement, increased emotional sensitivity, fear, a desire to hide and hide. At the same time, pathology can drive patients into a stupor and make it impossible to think normally.

Senile

Mental disorders due to age-related changes in the body are observed in men and women aged 65 years and older. The main reason is the course of atherosclerosis, which affects the vascular system of the brain. This disease is characterized by pronounced manifestations of the nature of patients or, conversely, a complete decrease in skills, the disappearance of interests. Over time, memory impairment occurs, and mild signs of delirium may appear. Pathology progresses slowly and often has irreversible consequences.

traumatic

Such types of psychosis develop as a result of severe trauma. Most often, the predisposing factor is the stay of the victims in a coma. This disease is characterized by an acute short-term course, vivid hallucinatory phenomena, increased motor activity and severe fear.

affective

Mental disorders of this type are represented by manic-depressive syndromes. Signs of psychosis occur periodically, attacks are characterized by increased mobility. The desire for action is abruptly replaced by apathy and passivity. In rare cases, personality changes occur.

All described types of psychoses adversely affect the state of the nervous system and the body as a whole, therefore, they need mandatory adequate treatment!

Psychosis is a mental anomaly that can be explained as "loss of contact with reality." People who suffer from psychosis are called psychotics. Psychotics may experience some personality changes and thought disorders. Depending on the severity of the psychosis, there may be erratic behavior, difficulty communicating and functioning in daily life. The diagnosis of psychosis (as a sign of a psychiatric disorder) is made by excluding all other possible diagnoses. Thus, a newly occurring episode of illness will not be considered a symptom of a psychiatric disorder until other known possible reasons psychosis. Prior to diagnosis of a psychiatric illness, medical and biological laboratory testing should be performed to rule out possible central nervous system disease, disease or damage to other organs, substance use, toxins, and prescription drugs as the cause of psychosis. In medical training institutions, psychosis is often compared to fever, since both diseases have many causes that are not obvious at first glance. The term "psychosis" has many meanings, from the relatively standard deviation of the norm to the complex unconscious manifestations of schizophrenia and bipolar I disorder. When properly diagnosed as psychiatric disorders (excluding other causes using biological and laboratory methods), psychosis includes symptoms such as hallucinations, delusions, sometimes violence, and a lack of understanding of the motives of one's behavior. Psychosis also denotes a significant deviation from normal behavior (negative signs), and most often various types of hallucinations or delusions, especially in the relationship between the individual and others, such as ideas of grandeur and pronoia/paranoia. Excessive dopaminergic signaling is believed to be associated with the positive symptoms of psychosis (especially in schizophrenia). However, this hypothesis has not been conclusively confirmed. It is believed that disturbances in the dopaminergic system are the cause of abnormalities in the perception or evaluation of the significance of environmental stimuli. There are many antipsychotic drugs that act on the dopamine system; however, a meta-analysis of placebo-controlled studies of these drugs showed no significant difference between the effects of the drugs and placebo, or, at best, an average effect size. Thus, it can be concluded that the pathophysiology of psychosis is much more complex than previously thought.

Signs and symptoms

In psychosis, one or more of the following symptoms are observed: hallucinations, delusions, catatonia, thought disorders. There are also violations associated with socialization.

hallucinations

Hallucinations are the sensory perception of something in the absence of an external stimulus. Hallucinations are different from illusions (perceptual disturbances), which are misperceptions of external stimuli. Hallucinations can appear on any sense organ and take almost any form, including simple sensations (light, color, taste, smell) and complex sensations such as seeing and interacting with fully formed animals and people, perceiving voice, and complex tactile sensations. Auditory hallucinations, especially the perception of voices, are the most common type of hallucination and a common symptom of psychosis. Voices can talk about or to a person, and the speakers can represent different people with different characters. Especially painful can be auditory hallucinations of a derogatory, commanding nature, or hallucinations that absorb all the attention of a person. However, the experience of perceiving voices is not always negative. One study showed that the majority of people who hear voices do not need psychiatric care. To support people experiencing auditory hallucinations, whether or not they have mental disorder, the Voice Hearing Movement was founded.

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Catatonia

Catatonia is an extremely strong excitement, in which the perception of reality is greatly disturbed. There are two main manifestations of catatonic behavior. The classic illustration of catatonia is being awake in the absence of movement and interaction with the outside world. This type of catatonia is represented by the so-called. waxy flexibility (a state where a person, when moving his limbs by another person, maintains a pose, even if it is uncomfortable and strange). Another type of catatonia is associated with more pronounced external manifestations of strong excitement. It includes excessive and meaningless movements, as well as a strong preoccupation with something that interferes with the normal perception of reality. An example is the behavior associated with quickly walking in circles and completely immersed in one's own thoughts, not noticing anything around (not focusing on things that are acceptable to the situation), which was not typical for a person before the onset of symptoms. With both types of catatonia, a person does not react at all to the external, surrounding world. It is important to distinguish between catatonic arousal and bipolar mania (although some patients may experience both).

Thinking disorders

Thought disorders are associated with impaired conscious thinking and their classification is largely based on the impact that these disorders have on speech and writing. Patients with thinking disorders show a weakening of associations, a weakening of the connection and organization of the semantic content of speech and writing. In severe forms, speech becomes incoherent.

The reasons

Many causes of schizophrenia are also causes of psychosis.

Psychiatric disorders

In terms of diagnosis, organic disorders were considered disorders caused by a physical disease in the brain, and functional disorders were disorders associated with the functioning of the brain in the absence of physical diseases (predominantly psychological or psychiatric diseases). The materialistic view of the Mind-Body dichotomy says that mental illness caused by physical processes; according to this theory, the difference between brain and consciousness, and thus between organic and functional diseases, is made up. Minor physical abnormalities have been found in diseases originally thought to be functional, such as schizophrenia. The DSM-IV-TR does not distinguish between functional and organic disorders, and lists traditional psychotic disorders, psychosis associated with general condition health and psychosis caused by substance abuse. The primary psychiatric causes of psychosis are:

    Schizophrenia and schizophreniform disorder

    Mood disorders (mood disorders), including depression, major depression, or mania in bipolar disorder (manic depression). People experiencing a psychotic episode in the context of depression may have persecutory or self-flagellation delusions, and people experiencing a psychotic episode in the context of mania may develop megalomania.

    Schizoaffective disorder, including both symptoms of schizophrenia and mood disorders

    Brief psychotic disorder, or brief/transient psychotic disorder

    Delusional disorder (persistent delusional disorder)

    Chronic hallucinatory psychosis

Psychotic symptoms may also be seen in:

    schizotypal disorder

    Certain personality disorders during stress (including paranoid personality disorder, schizoid personality disorder, and borderline disorder personality)

  • methamphetamine

    Methamphetamine causes psychosis in 26-46% of regular users. Some users develop long-term psychosis that persists for more than six months. Individuals with short-term methamphetamine psychosis may experience a relapse of methamphetamine psychosis years after use as a result of a stressful event, such as prolonged insomnia or an alcohol binge. With long-term methamphetamine abuse and a history of methamphetamine psychosis, there is an increased risk of recurrence of methamphetamine psychosis within a week of resuming methamphetamine use.

    Medications

    Use or cancellation a large number drugs can provoke the development of psychotic symptoms. Substances that can induce psychosis in experimental settings and/or in large numbers of people include amphetamine and other sympathomimetics, dopamine agonists, ketamine, corticosteroids (often along with mood changes), and some anticonvulsants such as vigabatrin. Stimulants that can cause psychosis include lisdexamfetamine.

    Other

    A 2014 study found no risk of developing psychosis as a result of childhood abuse.

    Pathophysiology

    The first image of the brain of a person suffering from psychosis was obtained back in 1935 using the pneumoencephalography technique (a painful and now unused procedure in which cerebrospinal fluid is pumped out of the space around the brain, and air is pumped in its place, which allows you to get a clearer image of the structure of the brain on an x-ray). The main function of the brain is to collect information from the senses (about pain, hunger, etc.) and from outside world , interpretation of this information into a coherent picture of the world, and the implementation of an adequate response. Information from the sense organs enters the primary sensory areas of the brain. Here it is processed and sent to secondary areas in which this information is already interpreted. Spontaneous activity in the primary sensory areas can cause hallucinations that the secondary areas perceive as information coming from the outside world. For example, a brain scan of a person who claims to hear voices can show the presence of activation of the primary sound complex or areas of the brain involved in the perception and understanding of speech. The paracortex collects interpreted information from the secondary cortex and creates a coherent picture of the world from it. A study of structural changes in the brain in people with psychosis showed a significant decrease in gray matter in the temporal lobe, inferior frontal gyrus and anterior cingulate cortex bilaterally in people before and after the development of psychosis. These and similar studies have led to a debate about whether psychosis causes excitotoxic brain damage and whether potentially harmful brain changes are related to the duration of the psychotic episode. Recent research has shown that it is not, however research is still being done. Studies using sensory deprivation techniques have shown that the functioning of the brain depends on signals from the outside world. In the absence of a balance between spontaneous brain activity and information from the senses, there may be a loss of contact with reality and psychosis. A similar phenomenon in the elderly, when the deterioration of vision, hearing and memory makes a person unnaturally suspicious of the surrounding space, is called paranoia. On the other hand, loss of contact with reality can also be observed if the spontaneous activity of the cerebral cortex increases, upsetting the balance with information from the senses. The 5-HT2A receptor plays an important role in this process because psychedelics that activate this receptor can cause hallucinations. The main symptom of psychosis, however, is not hallucinations, but an inability to distinguish external from internal stimuli. Close relatives of psychotics can also hear voices, but they can be aware of the unreality of these hallucinations, ignore them, preventing them from interfering with their lives; thus, such people will not be diagnosed with psychosis. Traditionally, psychosis has been associated with the neurotransmitter dopamine. In particular, the dopamine hypothesis of psychosis suggests that psychosis causes an excessive increase in the activity of dopamine function in the brain, especially in the mesolimbic pathway. This theory is supported by the following facts. Firstly, drugs that block the dopamine D2 receptor (antipsychotics) reduce psychotic symptoms, and secondly, drugs that increase dopamine activity (amphetamines and cocaine), on the contrary, increase psychosis in some people. Recently, however, there is increasing evidence that psychosis may be influenced by a possible disruption of the excitatory neurotransmitter glutamate, in particular with respect to NMDA receptor activity. Supporting this theory is the fact that dissociative NMDA receptor antagonists such as ketamine, phencyclidine, and dextromethorphan (at large overdoses) induce psychosis much faster than dopaminergic stimulants, even at "normal" recreational dosages. The symptoms of dissociative intoxication also have more in common with those of schizophrenia, including negative psychotic symptoms, than do amphetamine psychosis. Dissociative-induced psychosis is more pronounced and predictable than amphetamine-induced psychosis, which usually occurs only with overdose, prolonged use, or insomnia, which itself can precipitate psychosis. New antipsychotic drugs that act on glutamate and its receptors are currently being tested. The link between dopamine and psychosis is thought to be complex. While the dopamine D2 receptor inhibits the activity of adenylate cyclase, the D1 receptor, on the contrary, increases it. When taking drugs that block D2 receptors, the blocked dopamine moves to D1 receptors. Increased activity of adenylate cyclase does not immediately affect the expression of genes in the nerve cell, thus, it takes a week or two for the effects of antipsychotics to manifest. Moreover, newer and equally effective antipsychotics block slightly less dopamine in the brain than older generation drugs while also blocking 5-HT2A receptors, so perhaps the "dopamine hypothesis" is oversimplified. Soyka and colleagues found that in alcoholic psychosis there is a normal functioning of the dopaminergic system. Zoldan and colleagues reported that ondansetron, a 5-HT3 receptor antagonist, has moderate efficacy in the treatment of levodopa-induced psychosis in parkinsonians. Psychiatrist David Healey has criticized pharmaceutical companies promoting biological theories of mental illness that justify the benefits of pharmaceutical treatments while ignoring social and developmental factors that have a strong influence on the etiology of psychosis. Some theories suggest that many of the symptoms of psychosis are a problem in perceiving internally formed thoughts and experiences. For example, hallucinations associated with the perception of voices can occur as a result of speech formed inside the human mind, which is mistakenly perceived as speech coming from an external source. It is hypothesized that bipolar disorder may show increased activity in the left hemisphere of the brain, while schizophrenia may show increased activity in the right hemisphere. Increased activation of the right hemisphere of the brain is also observed in people who believe in the paranormal and in people who have a certain mystical experience. A similar pattern of brain activation is also shown by creative people. Some researchers argue that this is by no means proof that paranormal, mystical, or creative experiences are in themselves symptoms of a mental disorder, since it is still unclear why some experiences of this kind are perceived as positive, and others as negative.

    Neurobiology

    In otherwise healthy individuals, exogenous ligands may induce psychotic symptoms. NMDA receptor antagonists such as ketamine can cause psychosis similar to schizophrenia. Long-term use of stimulants or high doses can alter the normal functioning of the brain, leading to a condition similar to the manic phase of bipolar disorder. NMDA antagonists at subanesthetic doses (doses insufficient to produce an anesthetic effect) cause some so-called "negative" symptoms of thought disorder and catatonia at high doses. Psychostimulants, especially in susceptible individuals, can cause "positive" symptoms such as delusions, particularly persecution delusions.

    Diagnosis

    The diagnosis of "psychosis" is made only by excluding all other possible diagnoses. A new psychotic episode cannot be considered a symptom of a psychiatric disorder until all other possible causes of psychosis have been ruled out. Many physicians skip this step, leading to errors and misdiagnosis. The initial assessment includes obtaining a complete medical history and a physical examination by a physician. Biological testing of the patient should be performed to rule out psychosis associated with substance abuse, drugs, toxins, complications from surgery, or other medical conditions. Delirium should be ruled out, which may present with visual hallucinations, rapid onset, and fluctuations in consciousness, suggesting other underlying causes of psychosis, including a medical condition. Exception possible diseases associated with psychosis is done using blood tests to measure:

      Thyroid-stimulating hormone levels to exclude the possibility of hypo- or hyperthyroidism,

      The level of basic electrolytes and calcium in serum to exclude metabolic disorders,

      Complete blood count including erythrocyte sedimentation rate to rule out systemic infection or chronic disease

      Serology to rule out syphilis or HIV infection.

    Other studies:

      Electroencephalogram to rule out epilepsy

      MRI or CT scan of the head to rule out brain lesions.

    Because psychosis can be caused or exacerbated by certain medicines, the possibility of substance-induced psychosis should be ruled out, especially if this is the first case of psychosis. This type of psychosis can be ruled out with:

      Urinalysis

      Complete toxicological screening of blood serum.

    Because some dietary supplements can also cause psychosis or mania but cannot be detected by laboratory testing, the physician should ask family members, partners, or friends if the patient has taken any dietary supplements. Common mistakes in diagnosing psychosis:

      Delirium not ruled out

      Anomalies in the state of health have not been established,

      Not received medical history and family history of the patient,

      non-selective screening,

      Missed the possibility of toxic psychosis because screening for substance and drug use was not performed

      Family members or others were not interviewed about the use of dietary supplements by the patient,

      Early diagnosis,

      The physician was not aware of the initial diagnosis of the primary psychiatric disorder.

    Only after excluding other causes of psychosis, the doctor can put a psychiatric differential diagnosis using the patient's family history, additional information received from the patient and his family members or friends. Types of psychosis in psychiatric illnesses can be established using formal rating scales. The Brief Psychiatric Rating Scale (BPRS) lists 18 symptoms such as hostility, suspicion, hallucinations, and ideas of grandeur. The scale is filled on the basis of a patient interview and observation of the patient's behavior over the previous 2-3 days. The patient's family members can also answer questions about the patient's behavior. Both positive and negative symptoms of psychosis will be assessed during the initial study and follow-up period using a 30-item scale.

    Prevention of psychosis

    Evidence for the effectiveness of early intervention to prevent psychosis has been inconclusive. Although early intervention in people with a psychotic episode may improve short-term outcomes, after five years, the benefit of such intervention is no longer seen. However, there is evidence that cognitive behavioral therapy can reduce the risk of developing psychosis in people at risk, and in 2014 the UK National Institute for Health and Care Excellence recommended the use of preventive cognitive behavioral therapy in people at increased risk of psychosis.

    Treatment

    Treatment for psychosis depends on the specific diagnosis (schizophrenia, bipolar disorder, or substance poisoning). Psychiatric treatment The first line of treatment for many psychotic illnesses is antipsychotic medication, which can reduce the positive symptoms of psychosis in 7-14 days. Which specific antipsychotic to use depends on the benefits, risks, and cost of the drug. It is debatable whether typical or atypical antipsychotics are better, but there is evidence that most effective drugs are amisulpride, olanzapine, risperidone and clozapine. When used at low to moderate doses, typical antipsychotics perform similarly to atypical antipsychotics in terms of the percentage of patients who stop treatment and the risk of recurrence of symptoms. 40–50% of patients have a good response to treatment, 30–40% have a partial response, and 20% are treatment resistant (no satisfactory response after six weeks of two or three different antipsychotics). Clozapine is an effective treatment for patients who do not respond well to other drugs (treatment-resistant or refractory schizophrenia), but this drug has a potentially serious side effect in the form of agnarulocytosis (leukopenia), that is, a decrease in the number of white blood cells, which occurs in less than 4% of people. Most people develop side effects when taking antipsychotics. Typical antipsychotics show more extrapyramidal side effects, and atypical antipsychotics are associated with weight gain, diabetes, and risk metabolic syndrome; this is most pronounced with olanzapine, while risperidone and quentiapine also cause weight gain. Risperidone has a similar side effect profile to haloperidol.

    Early Intervention

    Previously, intervention in psychosis can be carried out only after the conclusion of the doctor that the diagnosis and treatment of the patient for early stages disease may improve clinical outcome in the long term. With this approach, during the critical period (when therapy is most effective), intensive multidisciplinary therapy is used to prevent long-term clinical manifestations diseases associated with chronic psychosis.

    Story

    The word "psychosis" entered the psychiatric literature in 1841 thanks to Carl Friedrich Kanstatt, who wrote the Handbuch der Medizinischen Klinik. He used the word to refer to mental neurosis. At that time, the word "neurosis" denoted any disease of the nervous system, and Kanstatt referred to the psychological manifestations of a disease of the brain. Another author of the term is Ernst von Feuchtersleben, who described psychosis in 1845 as an alternative name for insanity and mania. The name comes from the Medieval Latin term psychosis, "soul or life, living, reviving", and from the Greek word ψυχή (psyche), "soul", with the addition of the suffix -ωσις (-osis), in this case denoting "anomaly". The word was also used to refer to an illness associated with mental illness, as opposed to neurosis, which was considered a disease of the nervous system. Thus, psychosis has become the modern equivalent of the obsolete word "madness". In 1891, Julius Koch used the word in the sense of "psychopathic deviations", which Schneider later borrowed in the sense of "anomalies of the personality." The division of the basic term "psychosis" into manic-depressive disorder (now called bipolar) and dementia praecox (schizophrenia) was carried out by Emil Kraepelin, who tried to combine the various mental disorders known by the 19th century, grouping the diseases based on the classification of the main symptoms. Kraepelin used the term "manic depressive insanity" to describe the full spectrum of mood disorders, in a broader sense than it is used today. According to Kraepelin's classification, the term "manic-depressive insanity" included unipolar clinical depression, bipolar disorder, and other mood disorders such as cyclothymia. These disorders are characterized by difficulty in controlling mood and psychotic episodes associated with mood changes, with patients often having periods of normal functioning between psychotic episodes even without medication. Schizophrenia is characterized by psychotic episodes not associated with mood swings, with the majority of non-medicated patients showing signs of mood swings between psychotic episodes.

    Treatment

    In ancient times, madness was considered machinations evil spirits. Archaeologists have unearthed skulls with clearly marked sawn parts, some of which date back to 5000 BC. It is assumed that at that time a common treatment for insanity was craniotomy. Written evidence of supernatural causes and cures for insanity is found in the New Testament. In the fifth chapter of the Gospel of Mark: 8-13, a man is described who, speaking modern language psychotic symptoms were observed. Jesus Christ cured him of the “demon sickness” by calling demons from his soul and throwing them into a herd of pigs. Exorcism is still used in some religious circles as a treatment for psychosis. A study of laboratory patients in psychiatric clinics showed that 30 percent of religious patients believe that their illness is caused by the machinations of the devil. Many of the patients have undergone exorcist insanity treatments, which, despite being perceived by patients as a positive experience, do not have any effect on the symptoms of the disease. The results, however, showed a significant worsening of psychotic symptoms in the absence of medical treatment with forced forms of exorcism. Hippocrates wrote about natural, not supernatural, causes of disease. In his work on medicine, he provided a comprehensive explanation of health and disease, including insanity and other mental disorders. Hippocrates wrote: “People should know that in the brain, and only in the brain, our pleasures, joys, laughter, jokes, as well as our sorrows, pain, regrets and tears are created. With the help of the brain, we think, see, hear and distinguish beautiful from ugly, good from bad, pleasant from unpleasant ... The brain is responsible for madness or delirium, inspires us with horror or fear ... it is the cause of insomnia, unfortunate mistakes, senseless excitement, absent-mindedness and actions that are contrary to the usual. Hippocrates was a supporter of the humoral theory, believing that disease is the result of an imbalance in body fluids such as blood, mucus, black bile and yellow bile. According to this theory, each fluid or "humor" has a confluence on temperament and behavior. Symptoms of psychosis, for example, were thought to be associated with excess black and yellow bile. So for surgical treatment psychosis or mania, bloodletting was recommended. Benjamin Rush, physician, educator and "founder of American psychiatry" who lived in the 18th century, also recommended bloodletting to his patients as a first line treatment for psychosis. Although not a supporter of the humoral theory, Rush, however, believed that active cleansing and bloodletting are effective means to correct disorders in the circulatory systems of the body, which, in his opinion, was the main cause of "madness". Although Rush's treatments are considered outdated and wild today, his contributions to psychiatry, namely the biological interpretation of psychiatric phenomena such as psychosis, are considered invaluable. In honor of his achievements, Rush's image is on the official seal of the American Psychiatric Association. At the beginning of the 20th century, treatments for long-term severe psychosis were mainly associated with suppression of the nervous system. Such methods included insulin shock therapy, cardiazole shock therapy, and electroshock therapy. Despite the significant risk, shock therapy was considered a highly effective treatment for psychosis, including schizophrenia. The use of such risky therapies has led to more invasive treatments such as psychosurgery. In 1888, the Swiss psychiatrist Gottlieb Burckhardt performed the world's first authorized medical psychosurgical operation to remove the cerebral cortex. Although some patients showed improvement in symptoms, one patient died and some developed aphasia and/or epilepsy. Burckhardt published his clinical findings in a scientific paper. The work was criticized by the scientific community, and the scientist's academic and surgical ambitions were ignored. In the late 1930s, Egas Moniz devised a procedure called leucotomy (prefrontal lobotomy), which removed the fibers that connect frontal lobes with the rest of the brain. Moniz was inspired by a 1935 experiment demonstrated by neuroscientists John Fulton and Carlyle, in which two chimpanzees underwent a leucotomy and then compared their behavior before and after the operation. Prior to leucotomy, subjects exhibited typical chimpanzee behaviors, including throwing feces and fighting. After the procedure, both animals became calmer and less cruel to their relatives. During the interview, Morish asked the scientists if a similar procedure could be done on humans, a question that stunned Fulton. Moniz went further and began to test this procedure on people suffering from various psychotic disorders, for which he received Nobel Prize 1949. In the late 1930s and early 1970s, leucotomy was a widespread practice and was often performed in non-sterile settings such as small outpatient clinics or in patients' homes. Until the discovery of antipsychotics in the 1950s, psychosurgery remained a common practice. The first clinical trial of antipsychotics (also known as neuroleptics) for the treatment of psychosis was carried out in 1952. Chlorpromazine (brand name Thorazine) was clinically tested and was the first antipsychotic approved for the treatment of short-term and chronic psychosis. Despite the fact that the mechanism of action of the drug was not studied until 1963, chlorpromazine marked the emergence of a class of dopamine antagonists, or first-generation antipsychotics. Despite its high clinical efficacy in the treatment of psychosis or diseases with psychotic symptoms, the drug had a huge number of side effects, some of which, such as parkinsonian symptoms such as tardive dyskinesia, were especially serious. With the advent of atypical antipsychotics (second-generation antipsychotics), the advent of dopamine antagonists has been associated with comparable efficacy, but with a different (also serious) side effect profile, including a lower risk of developing parkinsonian symptoms, but an increased risk of developing cardiovascular disease. Atypical antipsychotics remain the first-line treatment for a variety of psychiatric and neurological diseases including schizophrenia, major depressive disorder, bipolar disorder, anxiety disorders, dementia, and some activity spectrum disorders. We know that dopamine is the main neurotransmitter involved in psychotic symptoms. Thus, blocking dopamine receptors (namely dopamine D2 receptors) and reducing dopaminergic activity is an effective but very crude way to treat psychosis. New data from pharmacological studies show that the decrease in dopaminergic activity is not associated with the complete eradication of symptoms of psychosis such as hallucinations and delusions, but with the mitigation of the reward mechanisms involved in the development of delusional ideas; thus connecting or finding meaningful connections between unrelated stimuli or ideas. The author of this study, Shitij Kapoor, also speaks of the importance of future research: “The model presented is based on incomplete knowledge about dopamine, schizophrenia and antipsychotics – thus, drawing on all the knowledge and resources we have is required to get a complete picture.”

Psychosis is in which the patient does not have a normal perception of reality, and he cannot react to it in a certain way.

Often this ailment accompanies senile dementia and alcoholic delirium (madness), but it is possible to act as an independent pathology.

The reasons

The function of the nerve cell is impaired due to the fact that mitochondria do not produce ATP. The neuron does not receive proper nutrition, and it does not form and does not transmit a nerve impulse. Because of this, the activity of the entire central nervous system cannot function normally, which leads to the development of psychosis.

The manifestations of the disease depend on the damage to the structure of the central nervous system.

Provoking factors :

  1. genetic burden
  2. Head injury.
  3. Severe intoxication with alcoholic beverages, drugs and medicines.
  4. Diseases of the nervous system.
  5. Infectious diseases: influenza, mumps, malaria.
  6. Neoplasms of the brain.
  7. Severe attacks of bronchial asthma.
  8. Systemic diseases.
  9. Avitaminosis B1 and B3.
  10. Hormonal disorders.
  11. Strong neuro-emotional overstrain.
  12. Electrolyte disturbance caused by vomiting, diarrhea and a strict diet.

Classification

2 main groups of the disease:

Endogenous psychosis caused by internal factors (disorder of the functioning of the nervous and endocrine systems).

  • Exogenous caused by external factors (infections, intoxication, nervous strain, mental trauma).

Depending on appearance:

  • Spicy: develops instantly.
  • Reactive: formed due to prolonged exposure to mental trauma.

Besides, by etiology and pathogenesis distinguish the following forms of the disease:

  • Alcoholic;
  • amphetamine psychosis;
  • Hypomanic psychosis;
  • Hysterical;
  • Korsakovsky;
  • Senile;
  • involutionary;
  • Paranoid;
  • schizoaffective;
  • Postpartum.

Signs of psychosis


With the development of the disease, a change in behavioral and emotional reactions is characteristic, thinking is disturbed.

The patient is unable to perceive reality correctly, may resist hospitalization and medical measures.

Psychosis in women: symptoms and signs

For them, the most characteristic features are:

  • Sleep is disturbed;
  • Mood changes frequently
  • Appetite worsens;
  • There is a feeling of threat and anxiety;
  • Motor activity is sharply reduced;
  • Mindfulness is lost;
  • The woman becomes distrustful, tries to isolate herself from everyone;
  • Interest in religion, magic may suddenly wake up.

Alcoholic psychosis: symptoms and treatment

This form is characterized by the following features:

This state is also called "white fever" . Appears after 2-7 days, as a person finishes drinking alcohol. It can last for several hours or days. It is characterized by a sharp change in mood, insomnia and psychomotor agitation.

First, a person feels anxiety, appears shiver head and hands. After some time, the consciousness is clouded, terrifying hallucinations: the appearance of devils, monsters, a sense of touch, terrible voices. There is a complete violation of the topographic and temporal orientation. Available somatic disorders and in the form of muscle hypotension, increased sweating, increased body temperature, tachycardia.

As a rule, the delirium ends after a long sleep.

2. Alcoholic hallucinosis

Most common in people over 40 years of age with a total alcoholism experience of about 10 years . It can develop with withdrawal symptoms or on the last day of a prolonged binge.

Exists 2 forms of hallucinosis:

Acute: lasts several hours or weeks. The patient feels anxiety, sleep disorder. The appearance of auditory, sometimes visual hallucinations is characteristic.

After a few days, the visions lose their brightness and eventually disappear, and the patient loses tension and delusional ideas. The main feature of this form is that the patient does not lose topographic, temporal and personal orientation.

lingering: it is typical for her that a person is unable to distinguish hallucinations from reality, and they correspond to the everyday situation. Symptoms are dominated by hallucinations, delusions, or movement disorders.

3 . Alcoholic paranoid

Characteristic for individuals with alcoholism about 12-13 years old . Due to insomnia, a person is constantly tormented by anxiety, it is possible to develop an acute delusion of persecution.

Such patients are convinced that they can be poisoned or slaughtered.

Paranoid happens sharp and protracted. At first form, it appears for several days, less often weeks, and with second- long and lasts for months.

A person often looks healthy, but he becomes too suspicious, does not trust anyone, there is always fear and anxiety. The patient tries to limit the circle of communication.

Over time, such people are more and more convinced that they are right, and nonsense becomes extremely implausible . They are dangerous for loved ones, however, if a person stops drinking, crazy ideas disappear.

Treatment

  1. Medical therapy

  • (Aminazine,

    1. Physiotherapy

    The following methods are used:

    • Electrosleep;
    • Sanatorium-resort therapy;
    • Acupuncture;
    • Occupational therapy.

    They help relieve stress, increase efficiency and improve metabolism.

    1. Electroconvulsive therapy

      The basis is the induction of convulsive seizures due to the action of an electric current that affects the subcortical structures of the brain and the metabolism of the nervous system.

    The success of therapy largely depends on the time of the start of therapeutic measures: the earlier treatment began, the higher the likelihood of curing a mental disorder and preventing negative consequences for the individual.

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