Sensory disorders: species, symptoms, treatment. Sensory and Gnostic Disorders

10.04.2020

This group includes violations of the perception of their own body, spatial relations and form of surrounding reality. They are very close to illusions, but differ from the last presence of criticism.

The group of disruptions of sensory synthesis includes depersonalization, drama, violation of the body scheme, the symptom of already seen (experienced) or never seen, etc.

Depersonalization - This is the conviction of the patient in the fact that his physical and mental "I" somehow changed, but to explain exactly what has changed, it cannot. Allocate varieties of depersonalization.

Somatopsychic Depersonalization - the patient claims that his bodily shell has changed, his physical body (some stupid skin, the muscles became gladless, the legs lost their former energy, etc.). This species of depersonalization is more common in organic lesions of the brain, as well as in some somatic diseases.

Outopsychic Depersonalization - the patient feels the change in the mental "I": became a worm, indifferent, indifferent or, on the contrary, hypersensitive, "the soul is crying for a minor occasion." Often, he cannot even verbally explain his condition, it simply states that "the soul has become completely different." Outopsychic depersonalization is very characteristic of schizophrenia.

Alopsichetic Depersonalization is a consequence of autopsychic depersonalization, a change in the attitude towards the surrounding reality "Already modified soul". The patient feels like a different person, his worldview changed, the attitude to loved ones, he lost a sense of love, compassion, empathy, debt, the ability to complicate to before his beloved friends. Very often, allopsis depersonalization is combined with an autopsychic, forming a single symptom complex characteristic of the schizophrenic spectrum of diseases.

A special variant of depersonalization includes the so-called loss of body weight. The patients feel how the mass of their body is steadily approaching zero, the law of global gravity ceases to act, as a result of which they can be carried out into space (on the street) or they can be filled under the ceiling (in the building). Understanding the mind, the absurdity of such experiences, the patients nevertheless "for the peace of mind" are constantly carrying with them in his pockets or portfolios any gravity, not parting with them even in the toilet.

Derealization - This is a distorted perception of the surrounding world, the feeling of its alienation, unnaturalness, lifelessness, unreality. The surrounding seems like drawn, devoid of life paints, monotonous gray and one-dimensional. The size of the items are changed, they become small (microxy) or huge (Macro region), extremely brightly illuminated (gallery) up to the appearance of halo around, surrounding painted in yellow (xantopsy) or a crimson-red (erythroxia), the feeling of perspective (Porreropsy) changes , form and proportions of objects, they seem to be reflected in the mirror curve (metamorphopy), twisted around their axis (dismgalopsy), the items double (polycopy), while one object is perceived as a set of its photocopy. Sometimes there is a rapid movement of surrounding items around the patient (optical storm).

From hallucinations, the delayed disorders differ in that there is a real object here, and from illusions, the fact that, despite the distortion of form, color and size, the patient takes this object as this, and not any other. Derealization is often combined with depersonalization, forming a single densoalization syndrome.

With a well-known proposition to the special form of depersonalization, the symptoms can be attributed "Deja Vu)," already experienced "(Deja Vecu)," already tested "(Deja Eprouve)," Never seen "(Jamais VU). The symptom of "already visible", "already experienced" is that the patient, for the first time in an unfamiliar situation, an unfamiliar city, was absolutely sure that it was already experiencing this situation in the same place, although he understood: in reality, he was here for the first time and I have never seen this before. The symptom of "never seen" is expressed in that in a completely familiar setting, for example, in his apartment, the patient has the feeling that he was here for the first time and never seen this.

Symptoms of the "already seen" or "never seen" are short-lived, lasts a few seconds and are often found at healthy people Due to overwork, inappreciation, mental overvoltage.

Close to the symptom "never seen" symptom "Turn the object", It is relatively rare. It manifests itself in the fact that a familiar area seems to be turned over 180 or more degrees, while in the patient may come short-term disorientation in the surrounding reality.

Symptom "Violations of a sense of time" It is expressed in the feeling of acceleration or slowing down the flow of time. It is not a pure mermaidant, as it includes the elements of depersonalization.

Derealization disorders, as a rule, are noted in organic lesions of the brain with the localization of the pathological process in the region of the left interpaired furrow. In short-term versions, they are also celebrated in healthy people who have suffered in childhood "Minimum brain dysfunction" - Minimal Brain Damage. In some cases, the delayed disorders are paroxysmal and indicate an epileptic process of organic genesis. Derealization may also be observed with intoxicating psychotropic drugs and narcotic drugs.

Violation of body diagram (Alice Syndrome in Wonderland, Authethmorfopsy) is a distorted perception of the magnitude and proportions of its body or its individual parts. The patient feels how to lengthen its limbs, the neck grows, the head increases to the size of the room, the torso is shortened, it is extended. Sometimes there is a sense of expressed imbalance of body parts. For example, the head decreases to the size of a small apple, the torso reaches 100 m, and the legs stretch to the center of the Earth. Sensations of changing the body scheme can perform isolated or in a complex with other psychopathological manifestations, but they are always extremely painful for patients. Characteristic feature Disorders of the body scheme is their vision correction. Looking at her legs, the patient is convinced that they are ordinary sizes, and not multi-meter; Looking at himself in the mirror, it detects the normal parameters of his head, although it feels the feeling that the head in diameter reaches 10 m. The vision correction ensures the critical relationship of patients to the specified disorders. However, when monitoring vision control, the patient again begins to experience a painful feeling of the change in the parameters of his body.

Violation of the body scheme is often noted during the organic brain pathology.

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Marilov V. B.
M25 General psychopathology: studies. Manual for studies Higher. studies. establishments. - M.: Publishing Center "Academy", 2002. - 224c. ISBN 5-7695-0838-8 in uch

Pathology of sensations
Feeling is an elementary act cognitive process, The function of reflection of individual qualities and properties of the surrounding reality. Philo and ontogenetically feeling is one and

Illusions
Illusions are called erroneous, altered perception of actually existing items or phenomena, "perception of perception" (J. Easqueurol), "delusion of imagination" (F. Piel), "Mnoymosis

Hallucinations
Hallucinations are perception disorders when the patient sees, hears and feels what actually does not exist in this situation. This is the so-called perception without an object.

Thinking disorders
Thinking is the highest form of human mental activity, which includes the active processing of sensory sensations and perceptions, i.e. This is an indirect reflection of ties and about

Pathology of the associative process
The acceleration of thinking is expressed in the fact that more associations are conventionally formed per unit than normal, while their quality suffers. Quickly replacing friend

Pathology judgment
The pathology of judgments include obsessive states, utmost, instantaneous and delusional ideas. Obsessive states (obsessions) t

Supercent ideas
Superresent (dominant, hypercavalent) are considered extremely emotionally charged and plausible ideas that are not ridiculous, but having for some reason

Dead ideas
Brad is an incorrect, false conclusion, having a tremendous value for a patient who permeates its life, always developing on pathological grounds (on the background of psychic

Brada-like ideas
Breeding (similar to nonsense) Ideas are false conclusions, closely related to emotional disorders, they arise in the structure or at the peak of manic and depressive

Dead syndromes
The paralyaleous syndrome is a relatful systematized non-motility of a monothematical character. Another component of the Jav syndrome

Memory pathology
Memory is a special kind of mental activity related to the perception (reception), withholding (retention) and reproduction of information. Memory is integral

Pathology of intelligence
Intellect is a concept that combines a person's ability to rational knowledge, judgments, conclusions, analysis and synthesis, the separation of the main one from the secondary, Nako

Congenital dementia
Depending on the level of underdevelopment of intelligence distinguish three degrees of pronation, idiots (severe mental underdevelopment), imbecil

Dementia
If oligofrens on intelligence are "beggars from birth", then the suffering is "broken rich". Dementia is smallness that has developed in the result

Symptoms of emotional disorders
Pathological affect is a stormy emotional reaction of anger or rage, which arises in response to insignificant stimuli and accompanied by aggressive Dais

Maniacal syndrome
This syndrome is manifested by the so-called manic triad major symptoms: pathologically increased mood (euphoria), acceleration of the associative process and motor

Depressive syndrome
For depressive syndrome, a triad of interrelated symptoms is characterized by: pathologically reduced mood (distortimia), slowing the associative process and motor inhibitor

Apache syndrome
Apathy (indifference) as a symptom is often combined with Abulia (braveless), drawing into a single apatico-abulic syndrome, also called apathetic. This is the final state of the schizofra

Will and its violations
Will is a mental process that manifests itself as an ability to choose actions related to overcoming internal and external obstacles, i.e. This is an individual ability

Hymanobulia
Lowering volitional activity can manifest in various mental diseases, especially in schizophrenia and sturden states of different genesis. Katatonich

Parabulia
This perversion of volitional activity is particularly clearly manifested in a catatonic excitation. Parabulia is expressed in chaotic, stereotypical, meaningless movements performed in

Violation of impositions
This group of pathological conditions includes the perversion of instinctive impositions to food, violation of the instinct of self-preservation and interference disorder. Perverted

Impulsive attractions
An irresistible thrust for some kind of actions and actions without an inner struggle fully seizes the patient's consciousness and determines its behavior. Impulsive attractions perceived bo

Psychomotor disorders
This group of disorders include manifestations of stupuses (catatonic, depressive, psychogenic), catatonic excitation, gebifrenic syndrome (all of this is described above) and

Differences between epileptic and hysterical seizures
Signs Epileptic seizure Hysterical fit start a sudden psychower

Symptoms of violation of consciousness
Consciousness is the highest form of reflection of reality and the ability to purposefully influence it. Pathology of consciousness accompanies many mental and severe somatic

Stunning
Stunning, or "Pares Psychological Activities" (Walter Bewell), is characterized by an increase in the instance of excitability and the depletion of mental activity in the form of a slowdown in mental

Delia
This is one of the most common syndromes of disturbed consciousness. In its pronounced form, it is characterized by the influx of bright illusions and hallucinations, disorientation in time and m

Oneiroid syndrome
Ogeeroid perisage of consciousness (Oneroid, a dreamless, dreamless violation of consciousness) Reminds the dream to appease - this is a perisage of consciousness with the influx of involuntary upcoming fiction

Twilight permanent consciousness
This syndrome is characterized by a sudden start, the presence of a pronounced intense affect of a rayful malicious and rage, illusory-hallucinatory symptoms, secondary delusions of Press

Amenia
AMENTION (Amenament of consciousness) - a deep degree of violation of consciousness is characterized by incoherence to all types of mental activities. There is gross disorientation in

Self-conscious disorders
Self-consciousness is the allocation of yourself from the objective world, awareness of your personality, your body, their mental functions. Self-consciousness (private side of consciousness) includes

Speech disorders
Alalia - loss of ability to speak. Afazia - speech disorder, in which partially or completely loses the joint venture

Disorders of attention
Scattered - disorders of the ability to significantly concentrate attention, focusing with constant transitions from one phenomenon to another, no

Neurotic sleep disorders
With many mental illness, various disorders of the sleep formula are noted - the process of falling asleep, awakening, the duration of sleep, its depth, also occurs pervert

Asthenic syndrome
This condition is characterized irritable weakness, increased excitability, rapidly replacing the advancing after it, sharply pronounced fatigue,

Obsessive state syndrome
AT clinical picture This neurotic syndrome is dominated by various obsessions - a variety of phobias, alarming doubts, "mental gum", great thoughts, obsessive

Hypochondriac syndrome
Urgent concern for their health is manifested in a significant exaggeration of gravity or in the experience of the disease that is not really not. Patients constantly listening

Psychopathic conditions
In psychopathic states, a violation of mental activity is expressed in disharmony, impassableness, instability, weakness of various mental processes, disproportionate

Culture syndromes
Cultural psychiatry (croscultural psychiatry, ethnopsychiatry, comparative psychiatry) is studying the influence of certain culture features (belief, legends, pre

Syndrome Coro
First described in 1895 and still continues to attract the attention of psychiatrists as a typical version of the boundary culture mental pathology. Allocated at first only men

Munchhausen syndrome
Described in 1951 by the English researcher R.asher Pathological state, named after the notorious Baron Münhhausen, is still the subject of close

Psychosomatosis
Psychosomatic is considered to be disorders of the functions of organs and systems, in the origin and the flow of which the leading role belongs to the effects of psycho-bearing factors (stress,

The concept of psychosomatic cycles
To a certain extent, these problems can solve the hypothesis on the formation and subsequent self-development of psychosomatic cycles within the framework of psycho-physiological syndromes (diseases). D.

Functional dysfagia
Functional dysfagia occupies an important place among the discrepancies of a non-zero genesis. More often this pathology is celebrated in young people and middle-aged people of both sexes, but with some

Personal features of patients with dysfagia

Syndrome of psychogenic nausea and vomiting
In clinical practice, nausea and vomiting are quite common, these are symptoms of many somatic and mental illness. Often, their appearance indicates a weighing

Personal features of patients
Test Damage Patients Sick Healthy R Aizenka Extraversion

Psychogenic gastralgy syndrome
Gastralgy Along with neurogenic nausea and vomiting is the manifestation of the so-called irritable stomach syndrome. A man feels acute pain in the stomach resembling ulcerative,

Personal features of patients with gastralgias
Test Damage Patients Sick Healthy R Aizenka Extraversion

Syndrome of irritated colon
This is one of the most common types of psychosomatic pathology. To the share of this syndrome (CRP, synonyms: excitable intestine, unhappy intestine, mucous colitis, spastic

Personal features of patients with CRTK
Test Damage Patients Sick Healthy R Aizenka Extraversion

Ratio of age and symptoms at CRP
Couples signs age maximum expression symptom age-anxiety up to 30 years

Depression ratio with other symptoms at CRP
Pair of signs Depression increases depression up to 25 and after 50 years of depresis

The dependence of the suatization of affect from other SPR symptoms
Couples Signs Somatization Somatization Somatization up to 35-40 years Somatization -tre

The ratio of anxiety and other symptoms at CRP
Couples of signs of anxiety grow anxiety up to 30 years old anxiety depression

The group of disruptions of sensory synthesis includes depersonalization, drama, violation of the body scheme, the symptom of already seen (experienced) or never seen, etc.

Depersonalization is the persuasion of the patient in the fact that his physical and mental "I" have somehow changed, but it cannot be explained, which and how has changed, it cannot. Allocate varieties of depersonalization.

Somatopsychic depersonalization - the patient claims that his bodily shell has changed, his physical body (some kind of skin is stupid, the muscles became gladless, the legs lost their former energy, etc.). This species of depersonalization is more common in organic lesions of the brain, as well as in some somatic diseases.

Outopsychic depersonalization - the patient feels the change in mental "I": became a worm, indifferent, indifferent or, on the contrary, hypersensitive, "the soul is crying for a minor occasion." Often, he cannot even verbally explain his condition, it simply states that "the soul has become completely different." Outopsychic depersonalization is very characteristic of schizophrenia.

Allopsichetic depersonalization is a consequence of an autopsychic depersonalization, a change in the attitude towards the surrounding reality "already changed soul". The patient feels like a different person, his worldview changed, the attitude to loved ones, he lost a sense of love, compassion, empathy, debt, the ability to complicate to before his beloved friends. Very often, allopsis depersonalization is combined with an autopsychic, forming a single symptom complex characteristic of the schizophrenic spectrum of diseases.

A special variant of depersonalization includes the so-called body weight loss. The patients feel how the mass of their body is steadily approaching zero, the law of global gravity ceases to act, as a result of which they can be carried out into space (on the street) or they can be filled under the ceiling (in the building). Understanding the mind, the absurdity of such experiences, the patients nevertheless "for the peace of mind" are constantly carrying with them in his pockets or portfolios any gravity, not parting with them even in the toilet.

Derealization is a distorted perception of the surrounding world, the feeling of its alienation, unnaturalness, lifelessness, unreality. The surrounding seems like drawn, devoid of life paints, monotonous gray and one-dimensional. The size of the items are changed, they become small (microxy) or huge (Macro region), extremely brightly illuminated (gallery) up to the appearance of halo around, surrounding painted in yellow (xantopsy) or a crimson-red (erythroxia), the feeling of perspective (Porreropsy) changes , form and proportions of objects, they seem to be reflected in the mirror curve (metamorphopy), twisted around their axis (dismgalopsy), the items double (polycopy), while one object is perceived as a set of its photocopy. Sometimes there is a rapid movement of surrounding items around the patient (optical storm).

With a known share of conventionality, the symptoms "already seen" (Deja VEC), "already tested" (Deja Entendu), "already tested" (Deja Eprouve) can be attributed to the special form of delinealization-depersonalization. Never seen "(Jamais Vu). The symptom of "already visible", "already experienced" is that the patient, for the first time in an unfamiliar situation, an unfamiliar city, was absolutely sure that it was already experiencing this situation in the same place, although he understood: in reality, he was here for the first time and I have never seen this before. The symptom of "never seen" is expressed in that in a completely familiar setting, for example, in his apartment, the patient has the feeling that he was here for the first time and never seen this.

Symptoms of the type "already seen" or "never seen" are short-lived, lasts a few seconds and are often found in healthy people due to overwork, insecurity, mental overvoltage.

Close to the symptom "never seen" the symptom of the "rotation of the object", which is relatively rare. It manifests itself in the fact that a familiar area seems to be turned over 180 or more degrees, while in the patient may come short-term disorientation in the surrounding reality.

The symptom of "disorders of the sense of time" is expressed in the sense of acceleration or slowing down the flow of time. It is not a pure mermaidant, as it includes the elements of depersonalization.

Derealization disorders, as a rule, are noted in organic lesions of the brain with the localization of the pathological process in the region of the left interpaired furrow. In short-term versions, they are also noted in healthy people who have become minimal brain dysfunction in childhood - Minimal Brain Damage. In some cases, the delayed disorders are paroxysmal and indicate an epileptic process of organic genesis. Derealization may also be observed with intoxicating psychotropic drugs and drugs.

Violation of the body scheme (Alice Syndrome in Wonderland, Authethmorfopsy) is a distorted perception of the magnitude and proportions of its body or its individual parts. The patient feels how to lengthen its limbs, the neck grows, the head increases to the size of the room, the torso is shortened, it is extended. Sometimes there is a sense of expressed imbalance of body parts. For example, the head decreases to the size of a small apple, the torso reaches 100 m, and the legs stretch to the center of the Earth. Sensations of changing the body scheme can perform isolated or in a complex with other psychopathological manifestations, but they are always extremely painful for patients. A characteristic feature of violations of the body scheme is their vision correction. Looking at her legs, the patient is convinced that they are ordinary sizes, and not multi-meter; Looking at himself in the mirror, it detects the normal parameters of his head, although it feels the feeling that the head in diameter reaches 10 m. The vision correction ensures the critical relationship of patients to the specified disorders. However, when monitoring vision control, the patient again begins to experience a painful feeling of the change in the parameters of his body.

Violation of the body scheme is often noted during the organic brain pathology.

Marilov V. V.

M25 General psychopathology: studies. Manual for studies Higher. studies. establishments. - M.: Publishing Center "Academy", 2002. - 224c.

ISBN 5-7695-0838-8

AT tutorial The main symptoms and syndromes of the mental sphere of a person are covered in detail. Particular attention is paid to the clinical description of culture symptom complexes characteristic of various ethnographic groups, because in connection with modern migration processes, these syndromes are increasingly and more often found in domestic clinical and psychological practice.

It may be useful to practical psychologists and medical professionals.

UDC 616.89 (075.8)

ISBN 5-7695-0838-8 © Publishing Center "Academy", 2002

Preface

In clinical practice, symptoms and syndromes of many mental diseases are often found, often disguised under the pathology of the internal organs.

The task of specialists is to accommodate true mental symptoms from similar complications of a somatic disease, for example, a hypochondriatic nonsense - from conventional hypochondriacification for the disease of any internal organ. That is why physician students and psychologist students need a thorough study of general psychopathology (symptoms and mental symptoms), because the treatment of a somatic disease and its psychopathological layering (the so-called psychopathological grima) is fundamentally different.

The study of general psychopathology is also important because many mentally patients explain their bad state of health The presence of a somatic or "psychological" disease. This particularly concerns the border circle disorders (between somatic and mental, pathology and norm). It is about neurosis (including neurosis of organs), pathological development, psychopathy and psychosomatic disorders. In addition, unresolved personal problems can act as pseudocaboloval in the form of various options for passive psychological protection.

The ability to delimit personal problems from certain mental illness - the main task of adequate psychological, and therefore, and social rehabilitation patients.

Pathology of sensations

The feeling is an elementary act of the cognitive process, the function of reflection of individual qualities and properties of the surrounding reality. Philo and ontogenetically, the feeling is one of the earliest functions of the central nervous system.

During the sensation, the person is aware of the color, sound, smell, the consistency of the subject, but not the object as a whole. For example, he can only say about the handle that it is something dense, black, elongated. Almost any mental illness to one degree or another accompany sentestate - Diverse unpleasant, painful pathological sensations of tingling, squeezing, burning, twisting, boulders that are not associated with somatic diseases and arising in different parts of the body. They have an extremely unusual, often confused. With a thorough study modern methods It fails to identify a somatic disease that could cause these diverse and unusual sensations.

The patient K. believed that he had something in his chest, brains were compressed and squeezed "," inside the throat, it's warm, it's cold, in the abdomen of something burns, and on the right scatters ", hips constantly frightened, also experienced numbness in the testicles and the feeling of the pan of the penis on the right. At times he felt like his face "melting and flows down" or "dry eyes", the muscles of the hands rub about the bone, "stretching" the testicles and pain when they are touching them with the inside of the hips or clothes (so at home preferred to walk naked, even in The presence of female relatives).

Patient M. felt pain in the bones of the skull, experienced "splitting" temporal bone And penetrating the bones of air bubbles, these bubbles filled the entire porous part of the bone and caused a sense of "painful cutting of the bones of the whole skull."

To the pathology of sensations with a known share of conventionality agnosia (Unstable), which manifests itself in the inability of a person to learn and explain the meaning of certain sensory sensations. The agnosia can be visual, auditory, olfactory, tactile. This type of pathology is mainly occurring during organic lesions of the brain, but often agnosia is and functional (most often hysterical, when the patient after stress ceases to feel the smells, the taste of food, "not hears" the unpleasant information for it.

Loss of sensitivity of individual areas of the skin or individual analyzers are called anesthesia. It is often found, especially in the neurological clinic, is an important symptom of the defeat of one or another brain structure. Anesthesia in psychiatry is often hysterical, it is not associated with any particular neuroameal substrate, with it all forms of sensations, both superficial and deep, are turned off. In the time of the inquisition, anesthesia was considered one of the main signs of "the devil obsession", which meant that through the sensitivity of the skin, the unexpected skin entered the human body. Hypshetics - This is a decrease in sensitivity to external stimuli: the bright light is felt as weak, barely luminous stain, loud sounds - as barely audible. It is observed in severe asthenia and depressed. Hyperresthesia - Increased sensitivity to ordinary sounds (hyperactus), smells (hyperosmia), touch (hypertension), light (the usual candle shines as a bright sun), etc. It occurs with a hyperstandic version of neurasthenia, manic state and in some intricensic psychosis.

Paints in various parts of the body - algia - Meet in the form hyperalgiy (key sign of Münhhausen syndrome) or hypoalgiy, At times, it is difficult to distinguish between the sensencenetics. Algia is characteristic of depression, hysterical states and are associated with many mental illness, especially in elderly and old age.

Patient C. believed that he had everything hurts: in the heart acute pain, in the stomach - novaya, in the lungs - "overtaking", in the head - "grace". When listed by the affected diseases, only nose called the organs. With an objective examination, it turned out that no somatic diseases, except for the crowd, did not reveal in the patient.

Synesthesia Or reflex illusions - a rare feature of sensations, when the irritation of one analyzer causes a response of several analyzers at the same time. Hence the feeling of the delicious smell of any note, the sonor of yellow sunflowers V Van Gogh, the musicality of the touch of the collar of the shirt to the neck. Synesthesia are often found in mentally healthy gifted artists, poets and musicians. Received in pathology when taking some narcotic drugs.

Pathology of perception

Perception is a holistic reflection of our "I" of the subject or phenomenon.

Illusions

The illusions are called the erroneous, altered perception of actually existing items or phenomena, "perception of perception" (J. Easkirol), "delusion of imagination" (F. P. P. P. P. Serbsky). Illusions can be both mentally ill and completely healthy people.

Descriptions of illusions are shown in the "Forest Tsar" and in the "demons" A. S. Pushkin. In the first case, the painful imagination of the boy, instead of a tree, the image of a terrible, bearded forest king is presented, in the second, there are circular figures of demons, and their voices are heard in the wind of the wind in the wind noise.

In healthy, physical, physiological illusions may occur, as well as illusion of inattention.

Physical illusions Based on the laws of physics. For example, the perception of the refractiveness of the subject on the border of various transparent environments (a spoon in a glass of water seems refracted, on this occasion it also said Descartes: "My eye refracts it, and my mind straightens"). A similar illusion is a mirage.

Physiological illusions related to the features of the functioning of analyzers. If a person looks at a moving train for a long time, he has a feeling that the composition stands on the spot, and he seems to be rushing in the opposite direction. With a sudden stop of the rotating swing, people sitting in it in it lasts a sense of circular rotation of the surrounding. For the same reason, the small room placed by light wallpaper seems more in volume. Or a complete person dressed in a black dress seems more slim than in reality.

Illusions of inattention Noted in cases where, with an excessive interest of the fabuli literary work, a mentally healthy person does not notice obvious grammatical errors and typos in the text.

Illusions associated with the pathology of the mental sphere are usually divided into affective (affectogenic), verbal and paternolical.

Affective illusions There are an affect or unusual emotional state (strong fear, excessive desire, tense expectation, etc.), in a situation of insufficient illumination of the surrounding space. For example, hanging on the chair tie in the twilight can be perceived as ready for a coba jump. Affective illusions are sometimes noted in healthy people, for this distorted perception is associated with an unusual emotional state. Almost anyone can experience affective illusions, if he one will visit the cemetery at midnight.

A single religious patient was afraid to go past the balcony of his apartment at night, as in the home utensils stored on the balcony, constantly saw the "tempter".

Verbal or hearing, illusions They also appear against the background of any affect and are expressed in the erroneous perception of the meaning of the conversations of the surrounding people when neutral speech is perceived by the patients as a threat to his life, cursing, insults, accusations.

Patient N., suffering from alcoholism, often in the background of the included TV heard (and saw), as they invite him to divide the company "On Troy", completely unfamiliar to him "hairy people with tails", freely passing through the wall of the house.

Paternolic (NOT) illusions Associated with the activities of imagination while fixing a view on subjects having a fuzzy configuration. In this disorder, perception is bizarre-fiction. For example, in a kaleidoscope of forever moving clouds, a person can see divine paintings, in the wallpaper drawing - millions of small animals, in the carpet patterns - their own life path. Paridolic illusions always arise with a reduced tone of consciousness against the background of various intoxication and are an important diagnostic sign. In particular, this version of illusions can be one of the first symptoms of the starting alcohol delicacy.

The patient N. saw in the patterns of sheltered wallpaper all the same, but significantly reduced in the sizes of "hairy people with tails", which hospitably smashed a gate to hell in front of him, holding "for a meeting" in each hand on the bottle of vodka.

Sometimes illusions are divided into senses: visual, auditory, olfactory, taste and tactile. It should be emphasized that the presence of only affective, verbal and pareidolic illusions in an isolated form is not a symptom of a mental illness, but only indicates affective tensions or overworking a person. Only in combination with other mental disorders, they become symptoms of certain mental disorders.

Hallucinations

Hallucinations are perception disorders when the patient sees, hears and feels what actually does not exist in this situation. This is the so-called perception without an object. According to the figurative expression of Lasega, illusions refer to hallucinations, as a slander's slander (i.e., the basis of crosses is always a real fact, disturbed or perverted, while there is even a hint of the truth in the slander).

Highlighted hallucinations by sense organs: visual, hearing, olfactory, taste, general feeling (visceral and muscular).

Hallucinations are simple and complex. Simple hallucinations are usually localized within a single analyzer (for example, only auditory or only olfactory, etc.). Complex (combined, complex) hallucinations are a combination of two and simpler hallucinations.

For example, the patient sees a huge boost lying on his chest (visual deceptions of perception), which "threatening hinders" (auditory), feels his cold body and huge severity (tactile hallucinations).

In addition, hallucinations are true, more characteristic of exogenous mental diseases in which the patient sees the absent moment in the present moment or hears non-existent sounds, and false (pseudogalucification), which are noted in case of endogenous disorders, in particular schizophrenia. Essentially pseudogalucification includes not only perception disorders, but also the pathology of the associative process, i.e. thinking.

Patient M., the teacher of one of the Moscow universities, the "inner eyes" constantly saw two groups of physicists, American and Soviet people in his head. These groups stole each other "Atomic Secrets", the nuclear bombs were tested in the head, from which her eyes rolled out. " The patient all the time mentally talked to them in Russian, then in English.

For the separation of true hallucinations from false, having tremendous importance for the nosological estimation of the disease, differential diagnostic criteria are distinguished:

1. Projection criterion. With true hallucinations, there is a projection of the hallucinatory image in the outside, i.e., the patient hears the voice of the ears, sees his eyes, feels the smell of his nose, etc. In pseudogalucinations, the projection of the image inside the patient's body is noted, that is, he hears the voice not ears, but his head and voice is located inside the head or another part of the body. In the same way, he sees visual images inside his head, chest or other part of the body. At the same time, the patient says that inside the body is like a small TV. Pseudogalucinations are quite widely represented in fiction. So, for example, the prince Hamlet saw the ghost of his father "led his mind."

2. Criterion of making. Characterized for pseudogalucinations. The patient is confident that the demonstration of pictures in the head, mounted in the head of the TV and the tape recorder, recording his secret thoughts, is specially adjusted by powerful organizations or individuals. With true hallucinations, there is never feelings of making, ardent.

3. Criterion for objective reality and sensual brightness. True hallucinations are always closely related to the real environment and are interpreted by patients as existing in reality. The patient sees a small King Kong, sitting on a real chair, in a real room, surrounded by real students commenting on a real television program and drinking vodka from a real glass. Pseudogalucinations are deprived of objective reality and sensual liveliness. Thus, hearing pseudogalucinations are quiet, unpleasant, as if distant. This is not the voice, not that whisper, and not feminine, and not male, and not children, and not an adult. Sometimes patients doubt whether this voice is either the sound of their own thoughts. Spectative pseudogalucinations are often bright, never associated with a real environment, more often they are translucent, icon-like, flat and devoid of form and volume.

4. Criterion for relevance of behavior. True hallucinations are always accompanied by relevant behavior, because patients are convinced of the reality of hallucinatory images and behave adequately to their content. With frightening images, they test panic fear, with the voices of a threatening character that comes from a neighboring apartment, seek help in the police and are preparing for defense or hide from acquaintances, and sometimes they just boil their ears. For pseudogalucinations, the relevance of behavior is not characteristic. Patients with voices of unpleasant content inside the head continue indifferently lying in bed. Extremely rarely, "adequate" pseudogalucinations of actions are extremely possible. So, for example, the patient, for a long time heard voices coming from the thumb left, tried to cut off the latter.

5. Criterion of social confidence. True hallucinations are always accompanied by a sense of social confidence. So, a sick, experiencing commenting hallucinations of unpleasant content, is convinced that all residents of the house are heard about his behavior. In pseudogalucinations, patients are confident that such phenomena are purely personal character and are experiencing exclusively by them.

6. Focusing criteria for mental or physical "I". True hallucinations are directed to the physical "I" of the patient, while pseudogalucinations are always addressed to the mental "I". In other words, in the first case the body suffers, and in the second - the soul.

7. Criterion for the time of day. The intensity of true hallucinations is enhanced in the evening and night time. Such patterns in pseudogalucinations are usually not noted.

In psychiatric practice, hearing (verbal) hallucinations are most often found.

Hearing hallucinations may be elementary in the form of noise, individual sounds (acoazma), as well as in the form of words, speeches, conversations (phonemes). In addition, auditory hallucinations are divided into the so-called octiki (The patient is constantly hearing how he is dying by name), imperative, commenting, threatening, contrasting (contrast), speech, etc.

Patient S., who suffers from suspicious schizophrenia, so described his hearing hallucinations: "On the night of March 4 to March 5, I slept very badly from fear, since all night heard various voices. The most unpleasant voice belonged to the devil. He said that he came for me, for at my birth he put a spell on me - a curse. Upon fulfilling me, I should go to another world - hell. And this day came - March 5th. The terrible voice of the devil was growling that it was time for me to gather that now he will turn inside all my insides - this is a pass to hell. And in hell, he flicks the blue eyes, the poverty back through, sill with me all the nails. He added what they do with all the newly arrived in hell. Another voice, soft and gentle, appeared so that I could sorce all my sins and save the world from the filthy devils. This voice said that if at the moment I can overcome this unclean power, My life will change and I will become in five years by the World Healer. "

Imperative (Orders, imperative) verbal hallucinations are expressed in the fact that the patient hears orders, to resist which he can almost. These hallucinations bear a significant threat to the surrounding and patient, since "order" usually kill, hit, destroy, blow up, throw away the child from the balcony, cut off my leg, etc.

Patient X. On the day of the death of Mother heard "order from heaven," prohibiting her to bury, because "she, like Jesus Christ, will rise in three days." To prevent the damage, the patient wrapped the corpse of the mother film and placed in the refrigerator, where she lacked not three days, and three years.

The patient under the action of imperative voices jumped out from the sixth floor and, having taken into a snowdrift, miraculously remained alive. In the future, that she remained alive, her mother regarded as a fact of mental health ("If she had been sick, it would be crashing, and since she was able to plan a snowdrift, which means it is mentally healthy"). This once again confirms the wisdom of the folk proverb - "Apple from the apple tree does not fall far."

Commented Verbal hallucinations are also very unpleasant for the patient and are expressed in that the voices constantly seem to discuss all the actions of the patient, his thoughts and desires. Sometimes they are so painful that the only way to get rid of them the patient finds suicide.

Threatening Verbal hallucinations are expressed in the fact that the patients constantly hear the verbal threats to their address: they are going to bore, quarter, castrate, make drinking slowly acting poison, etc.

The patient K., the abusive alcohol, he heard the voice of the attending physician, threatening "disassembled him to spare parts, late at night, in particular" pick up the heart to transfers to the president. " Frightened, he ran to the police station, but on the way I heard from the voice of other people who threatened to burn him alive, if only he dares to complain.

Contrasting (antagonistic) verbal hallucinations are the nature of the group dialogue - one group of votes angry condemns the patient, it requires a sophisticated torture and bring death, and the other - timidly, hesitantly protects him, asks deferred execution, assures that the patient will correct, will stop drinking, will be better . It is characteristic that the voices do not directly turn directly to the patient, but they will be discussed. Sometimes, however, they give him directly opposite orders, for example, fall asleep and simultaneously sing and do dance pas. This version of hearing deceptions of perception is an imperative type of antagonistic hallucinations. The contrasting disorders also include clinical cases when the patients with one ear hears threatening, hostile voices, and others are friendly, approving his actions.

The same patient K., who was one in the apartment, late in the evening heard a group of votes, of which the majority very actively and persistently demanded his quarters or drowning in a bath with vodka as a unworthy man who collapsed the family who had lost all things because of alcohol , including child clothes. Another group of votes is how his lawyers - quite timidly and with great doubts offered to give the patient the last chance to correct, encoded, return the family. K. I heard "This Collection" all night, tried to justify, but no one had listened to him, the voices were busy discussion about his "accident or already predained death."

RECHEDGY The hallucinations of the seglass are characterized by the patient's confidence in the fact that someone speaks by his speech apparatus, affecting the muscles of the mouth and language. Sometimes the speech machine utters unworchable votes. Many researchers relate to hallucinations of segal to the species of pseudogalcycinator disorders.

Patient G. During a conversation with a doctor, suddenly unexpectedly began to speak in Tatar, the doctor's surprised question replied that it was not he said, his mouth was ruled by the village of the village, who does not understand and speak Russian.

Spectative hallucinations According to its representation in psychopathology, they ran second after auditory. They range from elementary (Photos) in the form of smoke, fog, sparks panoramic When the patient sees dynamic battle scenes with many people. Highlight zoopsy or zoological visual deceptions in the form of various aggressive wild animals attackers on the patient (more often they are marked with alcohol delirium).

Sick Ya. I saw a lot of stencil small crocodiles, which with a revealed mouth climbed to him under the blanket and gradually bought his sexual organ and scrotum.

Demonological Hallucinations - the patient sees the images of mystical and mythological creatures (devils, angels, mermaids, waswolves, vampires, etc.).

Sick C. was convinced that his mother-in-law is a relative of Viya, he periodically saw it turns into a vampire and sucks his blood. Sometimes she sat down "bloody peirs" with the Dracula himself, while the patient was always left for the dessert, because his blood is "this and drinking, and a snack at the same time."

Outoscopic (deuteroscopic), or double hallucinations - the patient observes one or more twins, which completely copy its behavior and manners. Multication of negative outoscopic hallucinations, when the patient does not see its reflection in the mirror. Outoscopy is described in alcoholism, with organic lesions of the temporal and dark brain departments, with hypoxia phenomena after the heart surgery, as well as against the background of a pronounced psycho-level situation. Outoscopic hallucinations, apparently, experienced Heine and Goethe.

Microscopic (Liliput) hallucinations - deceptions of perception are reduced dimensions (a plurality of gnomes dressed in extremely bright clothes, as in a puppet theater). These hallucinations are more common in infectious psychosis, alcoholism and inxication by chloroform and ether.

The patient M. saw many small, but extremely embittered and aggressively tuned rats, which chased him across the apartment.

Macroscopic Deaths of perception - giants, giastico-like animals, huge fantastic birds appear in front of the patient.

Patient C. Suddenly saw himself surrounded by huge flying, crawling and floating, but equally frightening lizards who hunted her. The patient with horror realized that she was "transferred to the" Park of the Jurassic "."

Polyectic Hallucinations are a set of identical hallucinatory images, as if created under the carcake, are marked with some forms of alcoholic psychosis, for example, with white hot.

Patient N. in white hot saw in his room late in the evening many completely identical nude girls with absolutely identical bottles of vodka and completely identical salted cucumbers (snack).

Adeomorphic Hallucinations are visual deceptions, devoid of clarity of forms, volumetric and brightness of paints, disembodied contours of people flying in a concrete closed space. Many researchers include audioomorphic hallucinations to the special form of pseudogalucinations; Characteristic for schizophrenic process.

Extracpine Hallucinations - the patient sees the corner of the eyes behind him out of the edge of the common vision of some phenomena or people. When he turns his head, these visions instantly disappear. Hallucinations are found in schizophrenia.

Sick S. saw the corner of his eyes, as a man standing behind him brings his hand with a hammer to hit his head. To avoid dying, the patient was constantly turned around, but never saw the attacker.

Gemian Pinsic Hallucinations - the fallout of one half of the view, are found in organic lesion of the central nervous system.

Hallucinations type Charles Bonne. - Always true deceptions of perception, noted when defeating any analyzer. So, when glauer or retinal detachment, the visual version of these hallucinations is noted, during otitis - the auditory.

Patient F. With complete loss of hearing constantly hears the voices of employees on work accused of simulation, unfair attitude to work, "if not to say more."

Negative those. Cosnounced visual hallucinations. The patient is in a state of hypnosis inspire that after exiting the hypnotic state, for example, it will not see on the table, dated books and notebooks, absolutely nothing. Indeed, after leaving the hypnosis, a person sees a completely clean and empty table for a few seconds. These hallucinations are usually short-lived. They are not pathology, but rather indicate the degree of human hypnotation.

In the diagnosis of mental illness, there are great importance to the subject of visual hallucinations (as, however, and auditory). Thus, the religious topics of hallucinations are characteristic of epilepsy, images of the dead relatives and loved ones - for reactive states, the vision of alcohol scenes - for white hot.

Obony hallucinations Present an imaginary perception of extremely unpleasant, sometimes the disgusting odors of the decaying corpse, the tension, the burned human body, feces, stench, an unusual poison with a stileanese smell. Often, olfactory hallucinations cannot be distinguished from olfactory illusions. Sometimes one and the same patient exist synchronously both disorders. Such patients are often stable refuse to eat food.

Patient C. During a long time he refused breakfast, as it was that the morning portion of food had the smell of a sick woman who was written earlier, which "in the basement was tested onto the cutlets to the entire department."

Obony hallucinations may occur with different mental illness, but first of all, they are characteristic of organic lesion of the brain with temporal localization (the so-called unzinate seizures during temporal epilepsy).

Taste hallucinations often combined with olfactory and expressed in the feeling of availability oral cavity rot, "Death", pus, feces, etc. These disorders with the same frequency are found both in exogenous and endogenous mental illness. The combination of olfactory and taste hallucinations and illusions, such as schizophrenia, indicates the malignancy of the course of the last and bad forecast.

Patient X. For a long time he refused food, since the food that fell into her mouth was always "with the taste of stumbling of the body of human meat."

Tactile hallucinations There are a sense of touch to the body of something hot or cold (thermal hallucinations), the appearance on the body of some kind of fluid (hygrical), setting the body from the back (gadetic), crawling on the skin of insects and small animals (outer zoopathy), presence under Skin "As if insects and small animals" (inner zoopathy).

Some researchers relate to tactile hallucinations also a symptom of a foreign body in the mouth in the form of threads, hair, thin wire, described in tetraethylswin delicates. This symptom is essentially a manifestation of the so-called roto-felling hallucinations.

Tactile hallucinations are very characteristic of cocaine psychosis, delicious permanent of consciousness of various etiology, schizophrenia. With the latter, tactile hallucinations are often localized in the field of genital organs, which is an unfavorable prognostic sign.

Patient W., who suffered from alcoholism, suddenly night awake strong pain In the back and to his horror, I realized that his drinking companions were trying him to the network with an electric iron, demanding recognition about where he hid the nerves on the eve of the bottle of vodka.

Visceral hallucinations They are expressed in sensation in the cavities of the body of some small animals or items (green frogs live in the stomach, they are breeding headsticks in the urinary bubble).

The patient of C., who lived in the countryside, was convinced that, together with Swampy Water, she swallowed the eggs of the frog, Ikrinka turned into a tasty, and then in an adult frog. For about a year, the patient went to the only doctor in the village asking to remove the frog in operational way. In the end, an inexperienced physician who tired of her visits was informated: the patient was given anesthesia, they made a cut of the skin in the middle line of the abdomen. While the patient was under anesthesia, the real frog was put in the bank and presented it to the patient who came to themselves. The patient was happy for several days, but in a week it came to the same doctor with a statement that the frog who lived in it had previously managed to sweep the caviar to the operation, and now the patient is all "fascinated" with tadpoles.

Functional hallucinations There are against the background of a real stimulus and exist until this stimulus acts. For example, on the background of the violin melody, the patient is heard at the same time and the violin, and the "voice". As soon as the music is mounted, auditory hallucination ceases. In other words, the patient perceives parallel and the real stimulus (violin), and a voice of an imperative character (which distinguishes functional hallucinations from illusions, since there is no transformation of music in voice). Select visual, olfactory-flavor, verbal, tactile and other options for functional hallucinations.

Patient J. With the noise of falling water in the bathroom or with an open crane in the kitchen, heard the selected mat of the neighbor from the apartment floor above, directed to the patient. This "conversation" instantly stopped when the water is turned off. The patient, a very nearby man, decided that the neighborhood was learned to transmit his thoughts through the water.

Close to functional reflex hallucinations, which are expressed in the fact that when exposed to one analyzer, they arise from others, but exist only during irritation of the first analyzer.

For example, when looking at a certain picture, the patient is experiencing a touch of something cold and wet to heals (reflex hygromic and thermal hallucinations). But as soon as he takes a look from this picture, these sensations instantly disappear.

Kinesthetic (psychomotor) hallucinations It is manifested in the fact that the patients have a sense of movement of some parts of the body, in addition to their will, although in fact there are no movements. It is found in schizophrenia within the framework of mental automatism syndrome.

The patient N. felt like on his first in the life of a date of his hips, besides the will, became frivolous to rotate.

Hynogogical and hypnopomplic hallucinations Appear in a patient before falling asleep: on the background of closed eyes, various visions arise, the paintings of the action with the inclusion of other analyzers (hearing, olfactory, etc.). As soon as the eyes open, the visions instantly disappear. The same pictures may appear at the time of awake, also against the background of closed eyes. These are the so-called sample or hypnopomplic hallucinations.

Patient M. Against the background of closed eyes in a wakeful state, I saw a fixed portrait of the deceased son and the deceased uncle, who turned his fingers from the temple, hinting sick to her mental unhealthy.

Hypnogogical and hypopause hallucinations are often the first sign of beginning intoxication psychosis, in particular alcohol delicacy.

Ecstatic hallucinations It is noted in a state of ecstasy, differ in brightness, imagery, effect on the emotional sphere of the patient. Often have religious, mystical content. May be visual, auditory, complex. It is held for a long time, marked with epileptic and hysterical psychosis.

Hallucins - psychopathological syndrome, which is characterized by severe abundant hallucinations against the background of clear consciousness. With sharp hallucinoses of a critical attitude to the disease, there are no patients. In the chronic flow of hallucinosis, criticism may appear to hallucinatory experiences. If the periods of hallucinosis alternate with light gaps (when there are no hallucinations are completely absent), they say about mental diplopia.

For alcoholic Hallucinosis is noted an abundance of auditory hallucinations, sometimes accompanied by secondary delusional ideas of persecution. It comes in chronic alcoholism, can manifest itself in acute and chronic form.

Hallucins pedicellate It occurs with the local lesion of the brain trunk in the third ventricular region and the brain legs due to hemorrhage, tumors, as well as inflammatory process specified areas. It is manifested in the form of moving non-ferrous, microscopic visual hallucinations that constantly change the shape, magnitude and position in space. They, as a rule, appear in the evening and do not cause patients with fear or anxiety. Criticism is preserved to hallucinations.

Hallucins Platua - The combination of verbal (significantly less often visual and olfactory) hallucinations with nonsense prosecution or impact with unchanged consciousness and partial criticism. This shape of halucinosis is described in the syphilis of the brain.

Hallucins atherosclerotic It is more common in women. At the same time, hallucinations are first isolated, as atherosclerosis is deemed, gain is marked characteristic signs: Weakening of memory, intellectual decrease, indifference to the surrounding. The attitude towards hallucinations is lost in the first stages of the disease. The content of hallucinations is more often neutral, concerns simple everyday affairs. With the course of atherosclerosis of hallucinations can take a fantastic character. It is noted, as follows from the name, under cerebral atherosclerosis and in some forms of senile dementia.

Hallucins olfactory - The abundance of olfactory, more often unpleasant hallucinations. It is often combined with nonsense of poisoning, material damage. It is observed in organic cerebral pathology and in the psychosis of late age.

Disorders of sensory synthesis

The group of disruptions of sensory synthesis includes depersonalization, drama, violation of the body scheme, the symptom of already seen (experienced) or never seen, etc.

Symptoms of the type "already seen" or "never seen" are short-lived, lasts a few seconds and are often found in healthy people due to overwork, insecurity, mental overvoltage.

Violation of body diagram (Alice Syndrome in Wonderland, Authethmorfopsy) is a distorted perception of the magnitude and proportions of its body or its individual parts. The patient feels how to lengthen its limbs, the neck grows, the head increases to the size of the room, the torso is shortened, it is extended. Sometimes there is a sense of expressed imbalance of body parts. For example, the head decreases to the size of a small apple, the torso reaches 100 m, and the legs stretch to the center of the Earth. Sensations of changing the body scheme can perform isolated or in a complex with other psychopathological manifestations, but they are always extremely painful for patients. A characteristic feature of violations of the body scheme is their vision correction. Looking at her legs, the patient is convinced that they are ordinary sizes, and not multi-meter; Looking at himself in the mirror, it detects the normal parameters of his head, although it feels the feeling that the head in diameter reaches 10 m. The vision correction ensures the critical relationship of patients to the specified disorders. However, when monitoring vision control, the patient again begins to experience a painful feeling of the change in the parameters of his body.

Violation of the body scheme is often noted during the organic brain pathology.

Thinking disorders

Thinking is the highest form of human mental activity, which includes the active processing of sensory sensations and perceptions, i.e. This is an indirect reflection of connections and relations between objects and phenomena of the objective world. At the heart of the thinking process, there are operations such as analysis, synthesis, comparison, abstraction, generalization, classification of signs. As a result of these operations, concepts and conclusions are formed.

The concept is a reflection in human consciousness of common patterns and qualities of objects and phenomena. The concept includes the knowledge of the real inner essence of a phenomenon or subject.

Depending on the degree of abstraction and generalization, the concepts are concrete or abstract. Therefore, it is allocated specifically-shaped and abstract thinking. Vite-figurative, sensual or concrete thinking is associated with verbal images of specific items directly known with the help of sense organs. With abstract thinking, we generalize, i.e. Calculate the set of essential features that are characteristic of this phenomenon by discarding all sorts of irrelevant, private signs. Thus, abstract concepts arise, for example, "animals", "trees", "underwater world". They differ from specific concepts, such as "Rhino", "Birch", "Shark".

The conclusion occurs as a result of comparing several judgments, their comparisons and, thus, finishes the process of thinking as a final output.

The physiological basis of thinking is, as you know, the second signaling system (I.P. Pavlov) reflecting on more high level Not only the past and present, but also the coming through the formation of temporary relations - associations. Thinking materializes into speech. That is why, by analyzing human speech products, one can judge the presence or absence of his thinking pathology.

Thinking disorders are divided into the pathology of the associative process and the pathology of judgment.

The data of the clinical material on mental alienation syndrome in various diseases show that in the overwhelming majority of cases, thin complex psychopathological phenomena is usually accompanied to a greater or lesser extent to more elementary psychoseensory violations. Some authors deny all the belonging of these disorders to depersonalization, while others simply identify these disorders with the phenomenon of alienation (Erenwald and others). We have already indicated that the origins of the development of teachings about changes in psycho sensory functions Remove in the concept of Wernik and Jackson about agnosions and violations of spatial impact images. Anatomical-clinical direction in neurology and psychiatry studied these disorders with coarse morphological destructive lesions of the brain with clinical pathological and anatomical and experimental research methods. The study of these phenomena was particularly contributed to the phenomena of phantom limbs in amputated. These phenomena showed the presence of an unusually persistent structural cortical formation of the body scheme. Somathognostic disorders were especially studied in hemipelage. Patients usually do not know about their paralysis, because they lose the knowledge and feeling of one half of the body. Some forms of anosognosia show their close relationship with agnosia and apraxia. Further studies have shown that only optical and kinesthetic sensations are part of the body scheme, it turns out that there are certain relationships between the sensotoric that carries out the position of the body in space and the visual sphere. Hoff believes that all impulses from the vestibular apparatus are suppressed and sublimated in the highest cortical center of the visual sphere, which is the case of incorporating complex mechanisms for the integration of perception. In case of violations in this area, vestibular irritations as the products of disintegration of higher visual functions distort the visual perception, causing metamorphycia, macro and microxy and other spatial experience disorders. Parker and Scheler observed changes in the body scheme when the elevator moves (at a speed of 150--300 meters per minute), which confirms the connection of the labyrinth functions with the body structure structure. At the first moment of lifting in the elevator, legs are felt harder. Upon descent, schiz hands and the body become easier and lengthened slightly. When stopped legs are harder; Feels like the body continues to descend, so that two phantom legs are felt under their feet. Petzl and his students mechanism of psychoseensory disintegration of the surrounding perception are at the place of the transition of the parietal share in the occipital. They suggest here the presence of functions that suck the excitation "regulating the processes of excitation and braking. This area is a phylogenetically young education specific to human brain and having a tendency to further phylogenetic development. Meeleovich in his book on the disorders of the body scheme exposes fair criticism the theory of Petzl. In his opinion, this theory should be considered locally anatomical, it turns out insolvent when solving such a basic issue of the theory of the "body scheme", as a question about how the feeling of its own body turns into the consciousness of its own body. Staying within the physiological and energy positions, Petzl to explain this transformation is forced to resort to various metaphysical buildings. Schariaan leads one operation about the cyst of the right interparietal area and the reckoning share produced by N. N. Burdenko. During the operation, the patient seemed to all surrounding unnatural L in strange, all items were suddenly distinguished, decreased in sizes, the Schariaan was evenly sampled, indicated that this case convincingly shows the relationship between the stem, the trunk and the visual sphere and reveals the role of proprioceptivity in the sense of Sherington in the genesis of the syndrome The irreality of perception external world . A number of authors talk about the famous role of Talalamic foci, as well as about a certain role of cerebellum and the vestibular system. Members believe that the body scheme requires a constant inflow of sensations from the periphery; Any kind of sensitive and tonic disorders, wherever they arise, can be reflected in the body scheme. The author suggests that "the body scheme has its own central substrate with numerous tails stretching to the periphery." Hauptman, Kleist, Redlich and Bonwichini The emergence of the anosognosia is attributed to the damage to the corn body, the stock in its work on the grinding of half of the body, based on the glands of the brastic, distinguishes "two forms of cleavage of half of the body": one, - at which the disorder is confessed; This form, in his opinion, is localized in Talamus and the Supramginal region; And another form - which is not confessed, is localized in the corner body. Gurevich M. O. put forward an anatomy-physiological concept of interparity syndrome. According to his point of view, the pathophysiological data indicate that the synthesis of sensory functions is carried out in the interparity area, which the person has nodal items of higher sensory mechanisms. This brain zone is rich in anatomy-physiological bonds with engines of a crust, a visual hill, a corn body, etc. Localization of the disorder may also be in other parts of the brain, but the interparietal bark is the head of the extensive underlying system. Gurevich puts forward two types of this syndrome: a) Parieto-occipital, - in the pathological picture of which optical phenomena with phenomena of an extensive violation of the "body scheme" and depersonalization, b) Parieto-postcentral, - with the predominance of general feeling disorders and with more elementary somatotonic partial Violations of the "body scheme". Subsequently, after a thorough study of cytoarchitectonics, Gurevich's interparity bark abandoned the term interparietal syndrome. He came to the conclusion that psychoseensory functions include mechanisms of cortical, subcortical and peripherals these functions can be impaired with the defeat of various links of this system, i.e. in different areas of the brain, however, it is impossible to draw conclusions regarding the localization of functions. Galvan R. Ya. And employees who continue the clinical traditions of the Bekhterev school V. M., studied psychoseensory disorders from various sides. She described a number of syndromes and symptoms of these disorders: syndrome with a sense of weightlessness and ease; denial and alienation of speech; feelings of the change in the whole body and violation of the sense of satisfaction at the end of physiological needs; violation of the feeling of completion of perception; The symptom of the absence of constancy of objects of the outside world. When deposlery, Gallan watched the lack of a sense of satisfaction when swallowing food, defecation, sleep, violation of a sense of time, lack of a sense of space. The author draws attention to certain forms of disturbing of consciousness with these paintings of the disease, namely - onairoid, special twilight - and delicious states. Relaxing the question of the localization of psychoseensory disorders, Galvan puts forward the concept of the extractual localization of the primary pathological focus with a representative in the cerebral cortex. Meerovich R. I. In his book, devoted to the disorders of the body scheme in mental illness, gives a detailed clinical analysis Tatt scheme disorders and reproduction of this syndrome in the experiment. Experiments who have made their task clarify the localization of the "body scheme" disorder in the central devices, showed the predominant value of the sensory bark, the dark-occipital lobe and the visual boogue. The author believes that the "body scheme" is included in the overall structure of consciousness: this is confirmed by the fact that this violation is possible only under the disorders of consciousness. These disorders occur with the lesions of the sensory cortex, in the broad sense of the word. Violations of consciousness, accompanying the disorder of the body scheme, are the result of a functional decrease in the bark in general. Erensald, Klein, partly and glue, pathological changes in the body of the body are considered as a manifestation of partial depositization, i.e. between these states they see only a quantitative difference. Gug various forms Violations of the body scheme considers relative depositizer phenomena, and therefore it calls them by deposlery-like disorders. And indeed, clinical facts show that under the states of mental alienation, it is usually possible to observe a number of inclusions in the form of elementary forms of violation of the body scheme, disintegration of the optical structure of the metamorphopsy type, etc. However, the intensity and nature of the manifestation of these disorders of sensory synthesis are not the same in various diseases . Especially brightly they perform on the basis of organic brain destruction - with tumors, injuries, arteriosclerotic injuries, acute infections and toxic processes. We observed in one patient N. with a tumor of the right temporal share in the foreground. The picture of the disease is the phenomenon of a violation of the body and metamorphopsy scheme: the patient says that he lost his stomach that he has two heads, and one lies nearby, on the bed, loses his legs surrounding perceives in a distorted form; Walls, beds, tables are twisted, seem broken, the persons of others look amazing; The faces of all people, especially the lower part, is beveled to the right. In another pain with a tumor of the corn body and anterior frontal share, there was a feeling of increasing the nose in length and thickness, the face allegedly covered with tubercles, the floor seemed uneven. However, in these cases, the phenomena of the alienation was not observed. Similar phenomena was observed in a patient with an injury of the dark skull area. With acute infections, psychoseensory disorders are especially often noted by V children. In patient V. On the soil of malaria, against the background of a violation of clarity of consciousness of psychoseensory disorders: all the surrounding saw in the yellow light, the faces of familiar people somehow changed, seemed elongated, loudly pale; He speaks aligned, some others. In another patient, Sh. (13 years old) on the soil of the protracted influenza, the phenomena of the metamorphopsy appeared: the items increased, they decreased, it seemed that the head was doubled, the nose and ears increase, extend. Among adults after acute infections, psychoseensory violations predominantly appeared, which were accompanied by the states of alienation of the individual and the external environment. In the patient K. After the flu, there have been a feeling of gradually pulling the head in the body, the omission of the internals; The body seems to be divided into separate parts: head, torso and legs; People seemed flat and non-residents like dolls. Along with this, he complained about the state of unreality and alien to the surrounding world and his body; The phenomena of the mentistivity: "We swim in these thoughts and do not join them, exactly in the enchanted circle." In the patient S., also after the influenza, there were body scheme disorders. The following character appeared: it seemed to her that the head was twisted on the part in the field of the backbone, the bones of the forehead were narrowed, the body was asymmetrically one shoulder above each other; The torso seemed to turn 180 °, the back is ahead, and the chest is rear. Along with this, more complex violations of the consciousness of their personality are: it seems to her that her "I" splits and the second "I" is in front of it and looks at her; It seemed that her "I" disappears. With the rapid processes of schizophrenic nature, significant elementary psychosensory disorders were noted: the patient P. In the perception of surrounding items, it seemed that they change their spatial relationships: the floor was twisted, zigzag, the walls and ceiling of the chamber were removed, then approach. The body is perceived too small and narrow and seemed to be divided longly in half, the patient feels automatically. There are also subtle violations of their "I": the patient seems to be that his "I" consists of two "I". In another patient, a sharp schizophrenic process also noted similar states. Patient V. experienced the experience of the transformation and the horse: it seemed to her that the legs turn into hooves, the wool grows on the hips, because of the mouth goes "Konsky Spirit", sometimes it seemed that the body became male, did not feel his chest glands; At times, it seems to disappear, the body becomes thin like a candle\u003e h However, the patient had changes in feelings, self: doubted that it exists or not. One patient K. was so brightly lengthening of one leg that she tried to shorten this leg. Among schizophrenia patients were more often observed, when elementary psychoseensory disorders were not in the foreground, but only accompanied the experiences of alienation, mental automatism. So, in the patient P. The state of mental automatism with a hallucinatory-delusive picture of the disease was accompanied by the experiences of the emptiness of his body: it seemed that she had no insides; Easy, almost weightless; walks like an empty shell. In a patient D., the first period of the disease was observed metamorphopsy - items changed in the form and magnitude, their spatial relations changed. Along with this sick it seemed that the body takes the shape of his father's body; One part of the person seems to be reminded of Mayakovsky, the other part is Yesenin, and in the middle - he himself. It seemed that his "I" changed that it had passed into the "I" of his father. In patient V. In the first period of the disease, peculiar violations of the body of the body were noted: during the lesson it seemed that the neck was drawn up like a snake, a few meters, and the head begins to smoke in the neighboring parties; I felt that it would be scattered into separate pieces. At times, he as if forgot his body somewhere and then returned to him back. Subsequently, the patient develops a resistant picture of mental automatic automatism with hallucinatory-delirious phenomena. Psychosensory phenomena were observed in cyclophrenia; So, the sick L. periods felt the simultaneous increase in the head and the decrease in the body, hands and naked; It became easy, as if unable to compare himself with a stratostat. Finally, in one case of epilepsy, significantly pronounced, paroxysmally emerging psychosensory disorders: the patient seemed that his body was large and easy; walking on the ground, he does not feel it; At times, on the contrary, it seems to him that a huge severity presses him, under the influence of which the body is compressed, the insides are broken, legs grow into the ground. The light becomes unclear, as if the twilight comes along with this sometimes it suddenly comes to the perishes of clarity of consciousness with the phenomena of changes in self. All cases of cases showed quite demonstratively prove the fact of the coexistence of complex phenomena of mental alienation and more elementary psychoseensory disorders. It is curious to recall that these two rows of related pathological changes in the structure of substantive consciousness over the course of several decades were studied from two sides by various methods of research: clinical and psychological and anatomy-physiological. For this past period, these directions came close to each other in this problem. Psychiatrist Gaug is trying to combine the achievements of one and other direction. In his monograph, he says that it is necessary to assume that the person is also carrying three schemes: one scheme from the outside world, the other - from his bodilyality, and the third - from the actual intraxichetic phenomena. Accordingly, it appears to alienation or one of them, or two or complete alienation of both somato- and alcohol and an autopsychiatric nature. The author undertakes the classic structure of the division of mental disorders on the Wernik. Further, Gay indicates that depersonalizational phenomena may occur through the disorder of central mental functions, which leads to a change in vital energy, voltage and vital efficiency. These vital factors, according to the author, are of great importance for higher mental activities. Taking the basis of the triple division of the Sterza: on my throat, the brain trunk and brain bark, the author believes that the phenomena of alienation may arise as a result of disorders of each of these three areas. A number of researchers especially attaches the value of the violation of the brain barrel, which contains the central functions of the motivation, activity, clarity of consciousness and efficiency. These cerebral functions have a close relationship with vase gestative hormonal regulation. These functions of the brain barrel can be broken or psychogeneously or somatogeneously. The clay School, following the next rewarded position, is trying to localize the central function "I" of the personality in the brain barrel area, at least the kernel of this "I", weighing a rather modest role of cortical functions of the brain. Such "consistent" local oils, imbued with the spirit of mechanism, such as Cleighte and Clerambo, are constantly looking in the brain "Society", "Souls" in the brain and at the same time fall into explicit "cerebral mythology", fetishizing genuine biological science about a person. A significant part of scientists of this type is trying to find the main, central functions of the person in the depths of the brain in the subcortex region, in the intermediate brain. This passion for the intermediate brain has arisen since the most important functions of subcortical areas of the brain were established. Just as at the end of the last century, most researchers clearly ignored the subcortex zones, attributing the core of the brain a comprehensive role, and at present a number of authors moved to another extreme, raising an intermediate brain to the fetishist pedestal. The successes of neuromorphology continued to stimulate the narrow localization search for the highest integrative mental functions in the brain. So, in its work, "Brain Pathology" K. Kleist amounted to the carp of the human brain, on which there were the centers of various mental functions, up to the localization of "volitional motives" and "moral actions". Claysta, Ponfield, Cupperse, and others. With persistence, try to bring the morphological base for psychoanalytic concepts about the leading role of animals of instincts and deposits in human behavior. They are looking for and allegedly found in the subcortical formations of the zone, governing the consciousness and behavior of the person. In the famous book "Epilepsy and Brain Localization" V. Ponfield and T. Eruroson write: "Anatomical analysis of the main field of representation is very difficult due to the numerous number of short neurons, which there seems to have. However, clinical data indicate that the level of final integration in the nervous system lies above the middle brain and within the interstitial brain. it ancient brainexisting even in lower animal species; Some of them can still have consciousness. " As can be seen, the authors consider consciousness as an exclusively biological function inherent in not only human, but also lower, animal species. And the highest center regulating the activity of consciousness, they consider the "region below the bark and above the middle brain", "within the intermediate brain". The metaphysical principle of laying is unchanged, "abstract functions in separate isolated portions of the brain is completely helpless in explaining the causes of the internal wealth of the social content of human consciousness. Therefore, representatives of psychomorphologism are not content with the interpretation of mental processes as the result of the work of cerebral cells; They are forced to stretch their hand and Freudsmu and to Husserlyland and to pragmatism. The problem of localizing mental functions and mechanisms for their integration is closely related to the gnoseology and psychological concepts of individual personality consciousness, and therefore, quite naturally, the presence of such a variety of views. The main definition of each researcher in this problem is that he, fond of any fashionable philosophical epistemological concept, is trying on this pate soil to build his mind on depersonalization, sometimes ignoring and unwittingly distorting clinical facts in favor of this speculative concept. The classic example in this regard can serve as followers of the Neokantian sense of the phenomenological direction: and among them the palm of the championship holds psychoanalysts. Consider the problem of sensory synthesis and its pathology in the light of the teachings on the brain mechanisms of mental abilities and functions that have historically established in humans. It is known that psychological education, which arose during historical development, are reproduced by a person not as a result of the laws of biological heredity, but during ontogenetically individual lifetime acquisitions. The concept of mental function in psychology arose similarly to a biological understanding of the function of a particular organ in the body. Naturally, the need for searching for certain organs, which would be carriers of the respective mental functions. We have already spoken of methodologically vicious psychomorphological attempts to direct direct localization of one or another mental function in separate parts of the brain. As clinical material accumulates and laboratory studies Gradually arose the correct idea that psychoseensory functions are a product of association and joint activities of a number of receptor and effector brain zones. I. P. Pavlov, developing similar thoughts I. M. Sechenov, considers not enough to adhere to the previous ideas about the anatomical centers to understand the behavior of the animal. Here, in his opinion, it is necessary to "join the physiological point of view, to the physiological, allowing functional association by means of a special deability of compounds of various departments of the central nervous system, for committing a certain reflex act." A. K. Leontyev, developing this concept, notes that the specific feature of these synthetic system formations is that "once established, they further function as a whole, without showing its component; Therefore, the corresponding name mental processes Always have the character of simple and immediate acts. " These features, according to Leontiev, make it possible to consider these foliating functional systemic education as peculiar bodies, specific sections of which and act as manifest mental abilities or functions. Here, in this important issue, Leontyev resonantly relies on a very valuable statement by A. A. Ukhtomsky on the "physiological bodies of the nervous system" in his classical work on Dominant, Ukhtomsky wrote: "Usually with the concept of" authority ", our thought binds something morphologically excellent, permanent, with Some more constant static signs. It seems to me that this is absolutely optional, and in particular the spirit of the new science it would be characteristic of not seeing anything compulsory. " It is very significant that these reflex system education, which acquired the nature of durable, sustainable and simple acts, once occurred, are further regulated as a whole. Next Leontiev, relying on its own, as well as scientific findings of works by P. K. Anokhina, N. I. Grazhekova L L. L. Luria, writes that the violation of the processes arising after the defeat of a certain area of \u200b\u200bthe brain should be understood "not as a function of function , but as a decay, disintegration of the corresponding functional system, one of which is destroyed "in the question of the disorders of the sensory synthesis of psychoseensory functions M. O. Gurevich adhered to a similar point of view. According to his view, the structures of higher functions are determined by the fact that they are developing not so much by the emergence of new morphological formations, as by synthetic use of old functions; At the same time, new qualities arise that cannot be derived from the properties of the components included in the composition new function. Therefore, with the pathology of higher gnostic functions, complex disintegration arises and a qualitative decline to the lowest level, which lead to the appearance of decay phenomena. The study of these phenomena of decay makes it possible to learn complex nature higher Functions. Therefore, the localization of the function should be carried out in the searches of individual centers and the study of individual systems, internally interconnected. In the chapter on mental automation, we specify more detail that nature specified forms Sensory decay of images for time space, prospects, shapes, values \u200b\u200band movements makes it possible to assume the presence of an automated mechanism that displays the external phenomena and human body in the form of a similarity of systemic cinematic images. This complex process is carried out by integrating and senesythetic use of simple receptor functions Pathological dehautomatization of complex images identifies role brain Systems: optical, kinesthetic, proprioceptive and vestibular in the construction of substantive images in this form, in which it objectively exists.

This group includes violations of their own body perception,
Spatial relationships and form of surrounding reality.
They are very close to illusions, but differ from the last presence of criticism.
The group of disorders of sensory synthesis includes: -defirelization, -duclealization, - body violations,
The symptom of already seen (experienced) or never seen, etc. Depersonalization- This is the conviction of the patient in
that his physical and mental "I" somehow changed,
But explain exactly what has changed, it cannot. Derealization- this is a distorted perception of the surrounding world,
The feeling of his alienation, unnaturalness, lifelessness, unreality.
Authethmorefopsy.The surrounding seems like drawn, devoid of life paints, monotonous gray and one-dimensional. Violation of the body scheme (Alice Syndrome in Wonderland) is a distorted perception of the magnitude and proportions of its body or its individual parts. The patient feels how to lengthen its limbs, the neck grows, the head increases to the size of the room, the torso is shortened, it is extended. Sometimes there is a sense of expressed imbalance of body parts. For example, the head decreases to the size of a small apple, the torso reaches 100 m, and the legs stretch to the center of the Earth. Sensations of changing the body scheme can perform isolated or in a complex with other psychopathological manifestations, but they are always extremely painful for patients. A characteristic feature of violations of the body scheme is their vision correction. Looking at her legs, the patient is convinced that they are ordinary sizes, and not multi-meter; Looking at himself in the mirror, it detects the normal parameters of his head, although it feels the feeling that the head in diameter reaches 10 m. The vision correction ensures the critical relationship of patients to the specified disorders. However, when monitoring vision control, the patient again begins to experience a painful feeling of the change in the parameters of his body.

Question 29: Psychomotor disorders(motor disorders) This group of disorders include manifestations of stupuses (catatonical, depressive, psychogenic), catatonic excitation, gebifrenic syndrome (all of this is described above) and of various types Saves. The seizure is a short-term, suddenly occurring painful state in the form of loss of consciousness and typical seizures. Most often in psychiatric practice there is a big convulsive fit (Grand Mat). In the dynamics of a large convulsive seizure, the following steps can be distinguished: precursor, aura, tonic seizure phase, clonic convulsions, a post-adopted state, passing into a pathological sleep. The forerunners compete in a few hours or days before the seizure and are expressed in general physical and mental discomfort, headaches, extreme irritability, weakness, dizziness, reduced mood with discontent and grinding, sometimes dysphoria. These disorders are not yet a seizure, but rather, the Forerunner of His. Aura (Breakfast) is an overture seizure, his actual beginning, consciousness remains clear and the patient clearly remembers the state of the aura. Aura usually lasts a split second or one or two seconds, but the patient seems to be that during this time the centuries swept. According to the clinical content of an aura, which, by the way, notes not at each seizure, it happens different, but each patient, as a rule, one and the same. Its character indicates the localization of the pathological focus. The sensory aura is expressed in various paresthesides, disorders of sensory synthesis, changes in the perception of body scheme, depersonalization, elongated hallucinations, the vision of fire, smoke, fire. The motor aura is manifested in sharp movements of the body, turning the head, the striving somewhere to escape or in a sharp change of the facial expressions. The mental aura is more often expressed in the appearance of fear, horror, feelings of the time stop or changing the speed of his flow, the patient can see the scenes of massacre, the abundance of blood, the dismemberment of the corpses. The extremely rarely patient, on the contrary, is experiencing an incredible feeling of bliss, ecstasy, its full harmony with the universe (also described by Prince Myshkin). Visceral Aura is manifested by unpleasant and painful sensations in the field of specific internal organs (stomach, hearts, bladder and etc.). Vegetative aura is expressed in the appearance of vegetative disorders (sharp sweating, the feeling of shortness of breath, a feeling of heartbeat). Considering the short-term aura, not all patients are able to perceive and, most importantly, to realize its content, often they say: "Something happened, and what - I did not understand, and I don't remember anything further"

Sensory disorders: species, symptoms, treatment. Sensory and Gnostic Disorders

General psychopathology

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