Pathopsychological syndromes of manic-depressive psychosis - Clinical psychology

Pathophysiological syndromes of manic-depressive psychosis

Manic-depressive psychosis (MDP) is a manic-depressive disorder that occurs in the form of seizures or phases with affective disorders, light intervals between attacks, i.e. complete restoration of mental health, lack of personality changes, regardless of the number of seizures.

A pronounced form of manic-depressive psychosis is called cyclophrenia. A lightweight, soft form is called a cyclotomy.

Diagnostics of MDP is determined by the characteristics of phases - their affective sign, degree of expression, type of alternation, the presence of mixed states and atypical phases, the duration of the intermission. The psychological diagnosis of MDP is primarily reduced to characterizing the changes in cognitive activity and emotional disorders during the phase. In connection with this psychologist, it is important to know the clinical features of the phases.

The disease can occur in the form of bipolar attacks (actually manic-depressive psychosis) and mopolarctic (unipolar depressive psychosis and monopolar manic psychosis).

The term cyclothymia K. Kallbaum first applied for mild, weakened variants of the disease. In 1883 E. Kraepelin called this disease "circular mental illness". In 1899, he introduced the concept of "manic-depressive psychosis", which included all forms of periodic psychosis.

Manic-depressive psychosis is characterized by alternation of affective psychotic episodes or phases and light intervals.

For the evaluation of psychotic seizures, the term phase is usually used. Phase - a limited in time psychopathological state of varying severity. After the passage of the phase, mental health is completely restored. The duration of the phases is different-from several days to several years. The average duration is between three and six months.

The most complete and clear typology of MTP phases, based on the allocation of clinical criteria, was developed by TF Papadopoulos.

Mental disorders in manic-depressive psychosis are observed in the form of affective disorders, changes in the mental and motor spheres. In manic and depressive states, these disorders are of opposite nature. For depressive and manic conditions, vegetative and somatic disorders are indicative of sympathetic-tonic orientation the autonomic nervous system.

Depressive state - an affective state characterized by a negative emotional background, slowing down of mental processes, motor inhibition.

Depressive states (phases) are characterized by a triad of mental disorders: low mood, slowing down of mental processes, motor retardation.

Cyclothymic depression (subdepression) is characterized by the prevalence of the phenomena "subjective discomfort of a changed sense of self. This is the easiest degree of hypothyroidism. Patients retain the old mode of life, decreasing in volume and productivity. Here a special role is played by personal reactions to the disease, which sometimes leads to suicidal tendencies with externally very shallow depression.

With weight gain hypothyroidism there is a syndrome of simple circular depression, in which depressive ideas do not go beyond the overvalued symptom formation. These ideas are available for correction or, at least, the patient will be able to raise doubts about their correctness. Suicidal thoughts are often present. With simple and cyclotimic depression, daily mood swings are very often observed - in the morning the mood is worse, and by the evening it improves.

The more severe variant of circular depression is melancholic paraphrenia, which is observed mainly at a later age and is characterized by the fantasticness of depressive delusional ideas (self-blame, sinfulness, self-abasement). Sometimes there is a nihilistic nonsense and delirium tremendous.

The next degree of depression is delirium depression. Here depressive ideas are delusional, in their light, patients are re-evaluated their biography. Characteristic is the expectation of imminent punishment for their fictitious or retrospectively reinforced offenses.

Manic condition is an affective condition characterized by symptoms that are opposite to depression: heightened mood, acceleration of mental processes and the emergence of various associations, psychomotor agitation.

About the increased mood-euphoria VA Gilyarovsky wrote: "All the phenomena that are part of the picture of the manic state, basically have an arousal in the sphere of feelings with an increase in mood, reaching a degree of complete bliss-euphoria" (1935).

Typology of manic states by TF Papadopoulos (1983) includes:

- cyclothymic hypomania, taking place subclinically and characterized by an increase in mental and physical tone, a good mood, increased desire for activity; a simple mania in which all the signs of hypertension and related features of cognitive activity, self-esteem, modus operandi become clinically distinct; - a psychotic mania, flowing with a marked emotional and idator excitation, a jump in ideas. The variant of the unfolded psychotic mania going with the formation of ideas of greatness, which, despite all the fantasy and absurdity, still remain overvalued and do not achieve real delusions when painful statements are stable, unshakable (VA Gilyarovsky, 1938). Circular phases are characterized by a symptomatology reflecting changes in the emotional sphere, thinking and psychomotorics.

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