Synthesis synthesis. Sensory disorders: species, symptoms, treatment

Date: 04.03.2020

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, he cannot. Allocate varieties of depersonalization.

Somatopsychicdepersonalization - 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 andetc.) This species of depersonalization is more common in organic lesions of the brain, as well as in some somatic diseases.

Outopsychicdepersonalization - 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.

Outopsychicdepersonalization 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- It 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 dimensions of the items are changing, they become small (microxy) or huge (MacroSia), extremely brightly illuminated (GA-Leropia) up to the appearance of the halo around, surrounding painted in yellow (xantopsy) or crimson-red (eritth-ropsy) changes the feeling Prospects (Parrefia), shape and proportion of objects, they seem to be reflected in the mirror curve (metamorphopy), twisted around their axis (dismegalopsy), the objects are doubled (polyopy), 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 "Already seen", "already experienced", "already heard", "Already tested", "Never seen."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" short-term lasts for a few seconds and are often found in healthy people due to overwork, insecurity, 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".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 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.

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 (catatonic, depressive, psychogenic), catatonic arousal, gebifrenic syndrome (all of this is described above) and various types of seizures. 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, heart, bladder, 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"

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).

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 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" 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 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. 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.

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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
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 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
The decrease in volitional activity can manifest themselves in various mental illness, especially in schizophrenia and spooring states of various 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 of 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 by irritable weakness, increased excitability, quickly replacing the fascinability advancing, sharply pronounced fatigue,

Obsessive state syndrome
In the clinical picture of this neurotic syndrome, various obsessions predominate - a variety of phobias, alarming doubts, "mental chewing", hung 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

This disorder of complex synthetic functions of perception and representation (KF is the result of the collaboration of several senses).

May occur in extreme situations (in space, under water) or in mental illness. May be parole (patients feel a sense of horror) or persistent.

1. Somatootopagnosia (violation of the body scheme) - the perception of its body is violated, its shape, individual parts (they may be absent or multiplied). But this is felt only with a bodily feeling (and in the mirror he sees himself normal). There are partial (part of the body) or total.

2. Violation of the optical-spatial properties of objects (Metamorphopyia) - violation of the perception of the number of objects, their forms, etc.:

but). The illusion of "peak"- The item is in the room, and the patient seems to be behind the wall.

b). Dommegalopsy(Microes or MacroSia) is the distortion of the size of the items.

at). Polyopy.and Diplopia- multiplication (or doubling) numbers

d). Domorphopsy- distortion of the form of objects.

e). Optical allesthesia- The subject seems shifted to the side.

e). Porcecia- The subject seems closer or further.

g). Symptoms of turns- horizontally or vertically (more often than 90 or 180 degrees).

h). Dyslexia- Violation of reading (it seems that letters are inverted).

and). Negative hallucinations- Used in hypnosis.

to). Optical immobility- Everything around as if frozen.

l). Symptom of optical storm- Around all objects move.

m). Symptom of the "death of the world"- Everything around collapsing.

n). Changing natural color items.

about). Split perception- The branches are perceived separately, and the trunk is separate.

p). The disintegration of the holistic image (usually in dementia) - for example, the phone calls, and the patient does not know where the sound comes from.

3. Depersonalization - The experience of alien to the surrounding world. Read more - see below.

Depersonalization happens:

but). Hyperpatic - the whole world appears to be bright, alive.

b). Hypopathic - the whole world is dull, lifeless.

4. The experience of "already seen" and "first seen". Pathology of thinking

Thinking- This is a form of cognitive activity, the standard of knowledge (logical). This is a generalized, indirect reflection of reality in its natural and most significant relationships and relationships.

Thanks to the thinking, the cognitive abilities of a person are expanding, he knows the essence of objects.

In a healthy person, thinking relies on the feeling, perception and presentation, it is also closely related to practice (it becomes illogical without it). Thinking is closely related to speech, so when they appreciate speech, pay attention to :

2). Her understanding

3). Expressive speech

four). Immediateness of speech.

Thinking disorders

I. Violations of the form of thinking:

one). Distortion of processes of generalization :

but). Symbolism- Replacement 1 concept to another, which becomes the symbol of the first). Symbolic thoughts are often accompanied by relevant drawings and speech.

b). Neologisms- New words that patients came up with. Maybe even your language - cryptolalia.

2). Violation of the dynamics of mental activity (inconsistency of judgments or inertness of thinking):

but). Excitation of thinking- Patients are quick and loudly talking, they fuse with sharpness and figurative expressions, compound the industrious poems, but at the same time jumping from 1 themes to another (as a child), distracted by random stimuli.

At the same time prevail external Associations(and not semantic, as normal):

Associations on the consonance (constipation-ax),

Associations in contrast (stroke constipation),

Associations on adjacentness (called nearby objects).

These patients are characterized by extraordinary frankness.

b). Jade jumping(manic incoherence of thinking) - thoughts swirl in the head (the language behind them does not sleep - therefore the speech is incoherent),

at). Inhibition of thinking- patients say slowly, quietly, with difficulty picking words ( oligophasia). Extreme degree - m utism(silence).

d). Viscosity of thinking(pathological consistency, labyrinth thinking) - patients get stuck on minor details, is characterized by unproductive multi-mindability.

e). Persian thinking- "Turning on the spot."

Marilov V. V.

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

ISBN 5-7695-0838-8

In the study manual, the main symptoms and syndromes of human mental sphere 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 poor state of feeling 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 is the main task of adequate psychological, and therefore the social rehabilitation of 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 cannot 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).

The patient M. felt pain in the bones of the skull, experienced "splitting" of the temporal bone and penetrating the bubbles 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 entire 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.

Sick C. believed that he had everything hurts: in the heart of acute pain, in the stomach - novaya, in the lungs - "swelling", 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 criteria. 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 experience panic fear, with votes of a threatening nature that comes from the 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 Frequently combined with olfactory and expressed in the feeling of the presence in the oral cavity, "desolet", 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.

Sick U., who suffered from alcoholism, suddenly at night he woke up from severe back pain and understood his horror that his drinking companions were trying him on the network by electric iron, demanding recognition about where he hid heaven 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 barrel in the third ventricular area and the brain legs due to hemorrhage, tumors, as well as with the inflammatory process of these 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 the atherosclerosis deposits, there is a strengthening of the characteristic features: the attenuation of memory, the 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.

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 drugs.

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 at a higher level, not only the past and the 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.