Mental disorders are a group of especially dangerous endogenous diseases. The best treatment outcomes are available to a patient who has been accurately and promptly diagnosed and has begun adequate treatment. The current classification distinguishes several schizophrenia syndromes, each of which requires an individual approach to correcting the situation.
Relevance of the issue
In recent years, the incidence of schizophrenia has increased significantly. The disease is dangerous, it harms not only a person, but also people close to him. Schizophrenia can destroy the patient’s life, start irreversible processes, exclude a person from social life without a way back. You can prevent such consequences if you make a diagnosis in time, determine which schizophrenia syndrome is occurring, and also select the appropriate treatment.
With schizophrenia, saving a person is possible. This is not about temporary relief and slowdown, but long-term remission. True, this is achievable only if you take a responsible approach to the issue, turn to a qualified doctor and carefully follow the treatment program developed by him.
Disease history
For the first time, schizophrenia syndromes were discussed more than two millennia ago. From the records that have reached our times, it is known that already then patients were observed whose behavior deviated from the norm, occasionally accompanied by external symptoms. Since patients behaved inappropriately, they were called insane - such an unofficial name for the disease has survived to the present day. Official medicine first described it in the nineteenth century. The doctor Kraepelin noted that more often inappropriate behavior is observed in adolescents and youth. Since then, they began to diagnose "youthful dementia." And in the next century, doctor Bleiler was able to fully describe the disease, reflect the clinical picture, identify the syndromes of schizophrenia and highlight its symptoms.
It was in the twentieth century that the term “schizophrenia” became widespread. It is formed from two Latin words: splitting and mind. Thus, the name reflects the essence of the disease, that is, the splitting of the human mind.
About classification
Various negative syndromes are known for schizophrenia, and their manifestations may overlap, which creates certain difficulties in making a diagnosis. For some, the disease flows sluggishly and it is very difficult to notice it, only the person himself knows about the inherent oddities, often considering them the result of the influence of stress factors or depressed mood.
Currently, it is customary to divide all cases into negative, productive. The second option expresses itself by hallucinations and delirium, and in case of a negative, the patient is apathetic, does not respond to stimuli, shows indifference, often slurredly expresses thoughts.
Negative schizophrenia
This form of the disease manifests itself as a split state in which hatred and love arise for some object for no apparent reason. There is a tendency to see in everything symbols, parology, torn consciousness, apathy, isolation. The patient avoids contacts in society, limits the inner world, loses activity, is not capable of volitional actions.
Productive manifestations are secondary factors. These are hallucinations, delirium, effect, catatonia.
Possible syndromes
Currently, quite a few different syndromes are known. A number of them are observed even in healthy people. One of the severe cases is a nervous-like syndrome. Its distinguishing features are hysteria, obsession, spontaneous attacks, which are not preceded by some obvious external factor.
Schizoeffective syndrome is a form of the disease in which the patient is characterized by depression and delusional states, mania and hallucinations. Febrile - a serious disorder in which there is a fever, phantasmagoric visions appear to the patient. The patient is characterized by committing inexplicable, strange, unnatural movements, throwing, increased heart rate, the manifestation of hematomas.
A possible form of schizophrenia is paranoid syndrome. She expresses herself with hallucinations and delusions, but the patient can think coherently. Productive signs gradually expand, it is possible the development of the disease to the state of Kandinsky-Clerambo syndrome. Gradually, violations in the emotional sphere are observed, a person loses his will.
About types and forms
Catatonic syndrome with schizophrenia is another fairly common condition. With it, dysfunctions of the motor apparatus are observed. The patient is characterized by a stupor, which at times becomes specific excitement. Mutism is characteristic of patients. Schizophrenia can be suspected by observing a person from the side: at times he freezes in an unnatural pose, maintaining it for a long time. Often patients avoid hygienic procedures, refuse food. Perhaps a delusional state, hallucinations.
Sometimes schizophrenia is characterized by a "hebephrenic" syndrome. For him, negative symptoms are more characteristic, and the most pronounced are associated with the ability to think, as well as the emotional sphere. You can identify the patient by silly behavior, mannerisms and a tendency to chatter, frequent mood swings.
Some patients are diagnosed with simple schizophrenia. This is a form of the disease in which there are no positive symptoms at all or it appears very rarely. Negative signs are active, isolation and emptiness come to the fore. A person cannot name the purpose of his existence, his activity is close to zero, his condition is usually apathetic, his speech is scarce, and his thinking is poor.
Continuing consideration
An undifferentiated form of the disease is possible. It is characterized by manifestations characteristic of the catatonic, hebephrenic types, while at the same time, the symptoms are schizophrenia with paranoid syndrome.
The residual form of the disease is a condition in which the patient has productive symptoms, but these rarely occur and do not violate adequate life and social activity.
Schizophrenia and depressive syndrome are possible, leading to post-schizophrenic depression. This term describes the patient's condition, appearing after a certain long period of remission.
Mania and Schizophrenia
Of particular interest to doctors is schizophrenia with manic syndrome. Patients with this form are characterized by excessive excitability, which unpredictably changes into deep depression. Delusional conditions or hallucinations are possible, but those are rated as moderate. The activity is too high, this applies to movements and speech.
It is customary to say that schizophrenia with manic syndrome is the opposite of a relatively simple form. Currently practiced medical approach involves the allocation of the disease "manic-depressive syndrome" as an independent, requiring specific consideration and treatment.
About types: what else is there?
In some cases, schizophrenia is characterized by paroxysmal-progressive syndrome. This is a form of the disease in which psychosis periodically manifests with acute attacks, is followed by remission, and each new episode is more and more difficult and harder, and its consequences lead to a change in personality.
Continuous schizophrenia is possible . This is a syndrome that is characterized by constant progress. Mostly the symptoms are negative, there is no temporary remission in principle. Gradually, positive symptoms completely disappear, only negative ones can be detected. This distorts the personality, making it defective.
Hidden, sluggish schizophrenia is possible. With it, neurotic disorders without productive symptoms are observed. The disease lasts for years and decades, while personality degradation does not occur, the patient's condition does not worsen.
What is most common?
Kandinsky-Clerambo syndrome for schizophrenia, as doctors have established, is currently the most common manifestation of the disease. As a rule, it is observed with hallucinatory-paranoid syndrome. In the predominant percentage of cases, the prognosis is negative. A condition is possible with secondary psychosis due to alcohol poisoning, hypoxia, trauma, an infectious disease and pathology of the vascular system. In addition to the above name, in the literature appears under the term "mental automatism syndrome".
This form of the disease received its name in honor of Kandinsky, the second cousin of the artist with the same surname. Sensing the signs of the disease on himself, Kandinsky decided to study this issue in more detail, which allowed him to compose the work "On Pseudo-Hallucinations." Kandinsky is currently considered the founder of forensic psychiatry in our country.
The second part of the name of the disease, Clarembo, is taken on behalf of a person suffering from this form of the disease in France. He also described his symptoms, and he did this independently of the Russian psychiatrist.
Case Nuances
Studying schizophrenia, manic syndrome, delusions of grandeur, topics of hallucinations of patients, it should be noted that each form of the disease has its own characteristics of the patient’s thinking. In particular, in the Kandinsky-Clerambo form, there are three typical productive symptoms: pseudo-hallucinations, mental automatism and mania of influence from the outside.
Pseudo-hallucinations is a term used to denote visions within the subjective world (music playing in the head, voices in the head). The idea of ​​influence is the feeling that someone is acting on a person from outside, forcibly putting thoughts into his head, speaking through his mouth or using his legs to move. Such influence can be from some third party or, say, from space, from otherworldly forces. Mental automatism is expressed in the feeling of perfect unnatural, alienated. In medicine, this is called violent thinking. Patients describe their condition as if someone from outside forces them to think.
Hallucinatory paranoid form
Hallucinatory-paranoid syndrome in schizophrenia is a condition in which the patient is concerned about delusions of persecution, a sensation of extraneous influence, pseudo-hallucinations and mental automatism. The content of delirium can vary significantly from case to case. Some are convinced of the influence of witchcraft on them, others are of atomic energy.
Mental automatisms in schizophrenia with hallucinatory-paranoid syndrome are not necessarily observed all at the same time. Perhaps the development of new ones as the state worsens. Initially, associative automatisms usually arise as a result of a supposed external influence on a person’s thought process and other activities. Thoughts flow quickly, anxiety is felt, and mentism is diagnosed. It seems to the patient that those around him know his thoughts, and everything that he thinks about in his head sounds loud and clear. Perhaps a mental echo when others suddenly repeat what a person thought. This leads to the appearance of new symptoms, the feeling of taken away, made thoughts, unwound memories.
The next step in the progress of the state is sensory automatism. It is characterized by unpleasant sensations, due to some extraneous force, supposedly affecting the person. The sensations made vary quite a lot. They can express themselves with heat and cold, soreness, pulsations, twisting.
Mental and Eating Disorders
One of the possible forms of schizophrenia is apathetic-abulic syndrome. This term is used to denote mental illness, in which a person loses emotionality, becomes indifferent to others. Gradually, depression is supplemented by sloppiness and lack of attention, other negative manifestations. Often this form is diagnosed in adolescents. Lack of adequate treatment can cause a person to lose his personality, complete loss of motivation, goals, which makes development and social adaptation impossible.
Currently, doctors share weak-willedness associated with educational errors, emotional inactivity due to problems in the functioning of the brain. There are several types of abulia, divided by severity.
About categories and classes
A mild form of abulia - deviations from the norm on a small scale. These are usually short-lived, soon after the acute phase, the person returns to normal. At the same time, he practically does not receive damage.
A serious form of the disease is a refusal to act in principle. Attention becomes distracted, depression is quite severe, which impedes the execution of everyday tasks. The patient refuses to eat, brush his teeth and wash, clean.
To assess the condition of the patient, it is important to describe the duration of the acute period and its features. For a short-term stage, insignificant neuroses and depression are characteristic. Periodic repetitions indicate developed schizophrenia or may be a marker of drug dependence. Constant apathy becomes the cause of schizotypal disorder.
The nuances of the disease
The peculiarity of abulia is that a person is isolated from society, ignores generally accepted standards of behavior. Life turns into a monotonous set of identical actions, and the disease progresses. The prerequisites for the formation of pathology are different. Doctors believe that most cases are due to injury to the skull, brain. Mental abnormalities are possible due to a tumor, cerebral hemorrhage. In some cases, the disease is provoked by hormonal disruptions or poisoning by toxic compounds. A genetic factor can play a role.
In a mild form, abulia is not uncommon in people who can hardly cope with the influence of stressful situations. This is a borderline condition in which nervousness is mild, but can gradually turn into a stable disorder.
Diagnosis of abulia is possible after a detailed examination of the patient's condition. From the outside it is noticeable that a person is difficult to make decisions, even related to everyday trifles, characterized by confused wording of thoughts, prolonged reflection and lack of activity. Such a person tries to isolate himself, does not differ in motivation, is surrounded by disorder in everyday life, and the absence of regular hygienic procedures affects his appearance.
Concluding the review
In conclusion, it is worthwhile to briefly consider as an organic disorder schizophrenia with delusional syndrome. This is usually accompanied by partial convulsive deviations. Higher incidence of this form among women. In most cases, it is due to organic disorders. With a higher degree of probability, the cause is in the hemisphere of the brain on the right, in the parietal, temporal lobes.
Delusions in the patient are fixed without impaired consciousness, but in some cases there are cognitive deficits. Possible rudimentary delirium or ideas that form a complex system. They differ significantly in content, but the most common topic is the persecution. Possible connection with personal problems, which only exacerbates the disease. Often the patient has incoherent speech, and movements vary from too active to complete apathy. The mood fluctuates, his jumps are unpredictable.
The course of the disease largely depends on the factors that caused it. To make a diagnosis, it is necessary to evaluate the clinical picture, to clarify the absence of impaired memory, consciousness.