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Paranoid schizophrenia

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Paranoid schizophrenia is a common type of schizophrenia, which leads to disruption of thinking processes, alternation of affect and apathy, hyper-arousal and dispersal of attention, memory problems, etc. Without treatment, people with paranoid schizophrenia lose their ability to socialize. The disease usually begins after 20 years.

Clinical studies indicating the exact causes of the disease have not been conducted. Doctors believe that the main provocative factor of paranoid schizophrenia is brain dysfunction. In particular, the imbalance between the production of neurotransmitters brain tissue, as well as daily fluctuations of adrenaline, norepinephrine, serotonin. These substances provide a link between the functioning of individual mental reactions and optimal mood.

Additional factors that increase the risk of developing the disease:

  • family history of psychotic disorders
  • stress in early childhood
  • the effect of intrauterine viral infection,
  • malnutrition of the fetus,
  • older age of parents
  • physical or sexual abuse
  • use of psychotropic substances in adolescence.

The course of paranoid schizophrenia is:

  • continuous (chronic)
  • episodic (paroxysmal) with a growing defect,
  • episodic with a stable defect
  • episodic remitting.

The first signs of paranoid schizophrenia in most patients include dullness of feelings, fading emotional reactions and emotional inadequacy. These states manifest themselves in a pronounced discrepancy between the quality of emotions and the nature of the stimulus that causes them. There is groundless incontinence, distrust, suspicion, anger and aggression towards native people, a lot of ridiculous grimaces and gestures, excessive religiosity, megalomania - confidence in the possession of special powers. At the same time, relationships with people who do not require spiritual closeness, remain at the same level.

Also, the initial symptoms of paranoid schizophrenia manifest themselves in the form of a narrowing of the range of interests and hobbies inherent in the previous patient. Such people are not engaged in anything: they sit at home or wander aimlessly somewhere. Their lower instinctive feelings weaken: schizophrenics become less sensitive to hunger, stop taking care of their appearance, ignore hygiene standards. These manifestations persist for 10 years or more.

Sometimes emotional disturbances do not appear immediately, but some time after the onset of the disease. The patient is worried about delusions and hallucinations. The plot (main idea) of delirium is innovation, jealousy, persecution, invention, relationships. At the same time, the patient not only expresses delusional ideas, but also tries to bring them to life: to find out his enemies, expose imaginary rivals, to implement obsessive ideas with the help of various instances, etc. The development of polythematic delusions, which has several story lines connected between by myself.

In some cases, paraphrenic syndrome occurs in paranoid schizophrenia. The mood background rises, and impact ideas change from malicious to “benevolent.” The patient appears delusions of grandeur absurd and fantastic content. For example, he believes that he has a special mission.

With a hallucinatory variant of the disease, delusions are less systematized and not long lasting. Tactile and verbal (verbal) hallucinations are more pronounced. It seems to a schizophrenic that someone calls him, scolds him, comments on his behavior. As a result, he feels anxiety, depression and fear. Gradually, voices coming from outside are transformed inwards. The patient believes that they sound in his head (pseudo-hallucinations). This leads to the development of Kandinsky syndrome - Clerambo - a combination of pseudohallucinations, delusions of influence and mental automatisms. The latter imply a feeling of sounding own thoughts: the patient feels that his thoughts are heard by those around him. Some people suffer from olfactory hallucinations - they are haunted by smells of blood, corpse, gas, etc. These sensations are made up as they are formed as a result of a disruption in the transmission of brain mediators.

There are neurosis-like signs of paranoid schizophrenia, which are characteristic of the sluggish form of the disease. They are manifested by obsessions (obsessive thoughts), phobias (obsessive fears), compulsions (obsessive actions), hypochondriacal complaints, dysmorphism or depersonalization. The distinguishing feature of obsessions is a powerful force of coercion. The patient can spend hours meaningless rituals in the presence of others.

Phobias in schizophrenia lose their emotional component. The patient can calmly talk about their fears, even the most ridiculous (for example, the fear of individual letters). The hypochondriac complaints are pretty fantastic: the patient supposedly feels how the intestines in the stomach have lumped together or how the blood moves through the vessels. Depersonalization is manifested by complaints about a change in oneself and a painful insensibility.

Diagnostics

Diagnosis of the disease is carried out on the basis of the clinical picture. This requires a clear expression of the main symptoms of paranoid schizophrenia - speech disorders, hallucinations, delusions, emotional and volitional disorders. After analyzing this information, the psychiatrist determines the type of pathology.

An important diagnostic criterion is the absence of acute transient (short-term, transient) psychosis, disorganized speech, chronic and organic delusional disorders, disorganized or catatonic behavior, schizoaffective disorders. The latter include hypomania, gloomy-angry mood, erased depression. It should also exclude the fact of induced delusions, which is present during the upbringing of the child by mentally ill parents.

Treatment of paranoid schizophrenia is long and requires the participation of a team of medical specialists. It consists of several periods: active, stabilizing and supporting. At the stage of active therapy, the main task is to eliminate the productive manifestations of the disease. It lasts from 7 to 30 days. With hallucinatory symptoms, classic neuroleptics have proven themselves well. In the presence of psychomotor agitation, Aminazine, Azaleptin, Tizertsin are additionally prescribed. These drugs stop the acute symptoms of pathology, but they have many side effects. Also, they do not eliminate the characteristic personality changes that develop in paranoid schizophrenia.

In the fight against the disease, the appointment of atypical antipsychotics is more promising. They not only affect the productive symptoms of schizophrenia, but also inhibit the development of personality changes. Against the background of their use, side effects occur less frequently. In order for the drugs to perform their work with high quality, the patient must adhere to the schedule and dosage.

Then the treatment is continued with the deposited forms of neuroleptics - Klopiksol depot, Haloperidol decanoate, Fluuxol depot. These medications are available in ampoules and are injected 1 time in 2-4 weeks. As the drug substance is released gradually, a uniform concentration of the neuroleptic in the blood is maintained. Depot medications are prescribed to patients who refuse to take their own pills.

When resistance (immunity) of the body to antipsychotics, monolateral electroconvulsive therapy is necessary. This is a method of neurological and psychiatric treatment, in which an electric current is passed through the patient's brain. It causes an epileptiform convulsive seizure, which provides a therapeutic effect.

At the stage of stabilizing treatment, the dose of the drug used is reduced. The duration of this period ranges from several months to six months. Then follow-up therapy follows, the task of which is to prevent the exacerbation of schizophrenia and to consolidate the results obtained. After the elimination of acute symptoms and discharge from the hospital, medication is not stopped. Otherwise, it is fraught with the return of signs of schizophrenia and the development of relapse.

Outcome of the disease

With proper treatment, signs of illness such as pseudo-hallucinations or systematic delirium become less pronounced. They are replaced by a monologue symptom: the patient answers simple questions with infinitely long phrases. His speech is devoid of any content and meaning, although it remains grammatically correct. A characteristic schizophrenic defect also arises - irreversible changes in the personality and psyche of a person.

In the absence of adequate therapy, people who have suffered from paranoid schizophrenia for a long time become emotionally and phlegmatic. The scope of their interests is significantly narrowed, the motives for action are absent or poorly expressed. Over time, the symptoms of the disease worsen, and contact with the real world is completely lost. Often, such people are visited by thoughts of suicide and persistent suicidal activity directed both at the patient himself and at the people around them.

This article is posted solely for educational purposes and is not a scientific material or professional medical advice.

Content

Paranoid schizophrenia manifests itself mainly through a violation of the processes of thinking, which is expressed mainly in distorted perception or paranoid behavior and thinking [6].

The clinical picture is characterized by relatively stable, usually paranoid delusions [7]. Paranoid schizophrenia is more often manifested by delusions of persecution, grandeur, relationships, exposure, and sometimes other delusional ideas, such as delusions of jealousy, erotic or ipohodrichichesky nonsense [4]. Delusional attitudes arise either sharply, as insight, or gradually in the process of personality restructuring [2]. Auditory hallucinations are more common than tactile, olfactory and gustatory hallucinations [4]. Catatonic symptoms, volitional and speech disorders, as well as disorders of the emotional sphere are usually mild [7].

Paranoid schizophrenia may be accompanied by excessive religiosity [8].

There is a decrease in mental activity (decrease in energy potential).

Persistent suicidal activity may be detected in patients with paranoid schizophrenia with depressive-delusional symptoms [4].

Sometimes there are two types of paranoid schizophrenia hallucinatory (pseudo-hallucinatory) and delusional, depending on the prevalence in the picture of the disease of one or another [9]. L. M. Yelgazina (1958) and E. D. Sokolova (1967) also distinguished these variants of the course (that is, hallucinosis and the prevalence of delusional disorders). L. M. Yelgazina argued that even at the initial stage of the development of the disease, it is possible to determine the hallucinatory-delusional or delusional variant of the development of the disease.

Stages of development of the disease Edit

Paranoid schizophrenia usually goes through several stages, with the stereotype of developing the disease: initial, paranoiac (a stage of delirium that is not accompanied by hallucinations and mental automatism), paranoid (a stage of delirium with unsystematized delusional ideas of polithematic content and hallucinations, or Kandinsky syndrome - Clerambo syndrome) impact), paraphrenic (paraphrenic) with fantastic delirium, and the termination of the disease, the final state is a pronounced schizophrenic defect [9]. However, a consistent change of psychopathological syndromes in paranoid schizophrenia is not necessary and is not always observed [10]: 11. The literature describes the rapid cases of transition paranoid syndrome in paraphrenic syndrome, bypassing the paranoid and hallucinatory-paranoid stage, such cases indicate an unfavorable course of the disease [10]: 105.

The initial stage of the disease can manifest itself as psychopathic disorders (disorders similar to personality disorders), depersonalization, obsessions, senesthopathias or hypochondria [9]. In some patients, in the initial stage mistrust, narrowing of the range of interests, fading of emotional reactions and rigidity are observed [9]. In the hallucinatory variant of paranoid schizophrenia, psychopathic (pseudo-psychopathic) and neurosis-like (pseudo-neurotic) disorders can be observed at the initial stage [9]. The duration of the initial period can be from 10 years or more [9].

When the manifestation of the disease occurs, interpretive nonsense usually occurs with varying degrees of systematization of delusions [9]. Systematic interpretive delusions may be accompanied by hyperbulia, that is, increased volitional activity of patients: patients with delusions of invention or reforming turn to all sorts of instances to immediately implement their ideas, patients with delusions of persecution seek to find their enemies, patients with delusions of jealousy do everything possible to expose their imaginary rivals etc. [9] Sometimes psychosis, which is characterized by a high degree of systematization of monothematic delusions, is delayed by fairly For a long time, a special subtype of paranoid schizophrenia, paranoiac schizophrenia, is distinguished for these cases [9]. Paranoid schizophrenia in adapted for use in the Russian Federation carries the code F22.82 and belongs to the group of delusional disorders.

Then the paranoiac stage can be replaced by Kandinsky-Klerambo syndrome, which may be preceded by arising mental automatisms, anxious and fearful agitation, feeling of fear and impending danger [9]. This syndrome can be formed in different ways: sometimes there are delusional disorders with one or two types of mental automatism, and sometimes, in addition to delusions of influence and persecution, ideator or other types of mental automatisms develop with a gradual expansion of their circle and the formation of a complete mastery syndrome [9].

Then follows the stage of paraphrenia (paraphrenic syndrome). The emergence of signs of paraphrenia in the clinical picture of Kandinsky syndrome - Clerambo occurs gradually [9]. The impact ideas can change from malicious to “benevolent”, the background mood is raised. Subsequently, there is a delusion of greatness of fantastic and absurd content (a patient, for example, can believe that he has a special mission, that he influences the destinies of all people and even the Universe, etc.) [9]. In the rubric "paranoid schizophrenia" of the International Classification of Diseases 10-revision (F 20.0 20.0) is included paraphrenic schizophreniawhich does not have nosological independence, but is considered a kind of (stage) paranoid schizophrenia.

The last stage is a schizophrenic defect (defective state), or end state. It can cause schizophasia (a phenomenon where speech is grammatically structured correctly, but is devoid of any meaning or content) [9]. The behavior of patients with schizophasia is usually ordered, externally correct [9]. In the final states in paranoid schizophrenia, the diagnosis changes to residual schizophrenia (F 20.5 20.5).

Western researchers on the schizophrenia clinic Edit

Karl Kleist (1947) identified the following forms of paranoid schizophrenia: typical, atypical, extensive, and combined [10]: 14. In atypical and combined forms, a remitting course was most often observed [10]: 14.

Gohe Alfred [en] (1934) considered the hallmark of paranoid schizophrenia to be personality changes that precede delusional experiences [10]: 14. In his opinion, systematization of delirium is less characteristic of paranoid schizophrenia, its rather acute development is characteristic, and as the disease progresses, the development of delirium more and more incoherent and strange [10]: 14.

Karl Leonhard (1957) divided endogenous psychosis into many forms, with paranoid psychosis he attributed to systematized schizophrenia, the form of paraphrenia, which Emile Kraepelin distinguished - to paranoid schizophrenia [10]: 14.

G. Benedetti (1962) pointed out characteristic for paranoid schizophrenia syndrome - hallucinatory-paranoid syndrome [10]: 16. According to his research, the onset of the disease can be acute or slow, and the course can be linear or wavy [10]: 16. Benedetti attributed all known forms of paraphrenia to paranoid schizophrenia [10]: 16.

Oneroid states Edit

In paranoid schizophrenia, oneiric syndrome may also occur. TA Klimusheva (1965) described the features of oneiric states in paranoid schizophrenia with Kandinsky – Clerambo syndrome [10]: 9. In the patients she observed, the neuroid states were in the form of an “oriented” one -roid, were short in time, characterized by a feeling of “done”, and their development occurred against the background of passing hallucinatory-delusional confusion or catatonic symptoms [10]: 9.

При начале заболевания протекание онейроидных состояний происходило в рамках зрительных псевдогаллюцинаций, они были кратковременными, неразвёрнутыми и аффективно (эмоционально) насыщенными [10] :10 . Онейроидные состояния в стадии выраженного процесса имеют сложную структуру с истинными галлюцинациями, бредом особого значения или бредом инсценировки, а также ложными узнаваниями.

Онейроидные и близкие к ним переживания при параноидной шизофрении также описаны такими авторами, как В. Н. Фаворина (1959), М. П. Подобед (1969), Г. Н. Шумский (1974), С. М. Lifshits (1965) [10]: 10.

Wilhelm Meyer-Gross described the patient with paranoid schizophrenia with onyroid disorder with the End of the World experience [10]: 13. In this case, the psychosis was constantly reduced, and the depressive-paranoid syndrome, which consisted of delusional perception in the form of delusions of sinfulness (characteristic of depressive states) and delusions of persecution, came to the fore [10]: 13. With this clinical example, Mayer-Gross emphasized the difficulty of dividing paranoid schizophrenia into clinical forms, justifying this by the existence of transitional forms and the many-sidedness of its psychopathological manifestations [10]: 13.

Affective Disorders Edit

In paranoid schizophrenia, there are also affective disorders (mood disorders): hypomania, mania, erased depressions, a sullen-spiteful mood and affective vibrations [10]: 9. An elevated mood usually precedes the onset of the paraphrenic stage of paranoid schizophrenia [10]: 9.

MV Sivanova and E.N. Efremova (1973) described the peculiarities of manic syndrome in 30 patients with paranoid schizophrenia [10]: 10. In 16 patients, manic syndrome was accompanied by paraphrenic syndrome, in 8 patients it was noted at the beginning of psychosis, in the remaining 6 patients appeared during therapy with antipsychotic drugs (it was short-lived) [10]: 10.

The manic-delusional state in the paroxysmal course of schizophrenia in the Russian adapted version of the ICD-10 is included in the headings F30.24 "Manic-delusional state with incongruent affect delusion" and F31.24 "Manic-delusional state, bipolar type, with incongruent affect nonsense" [eleven] . If the manic symptoms are clearly expressed and long-term, a diagnosis of schizoaffective disorder is more appropriate [11].

Some researchers distinguish between two types of paranoid schizophrenia: monomorphic (paranoid) and hallucinatory (“hallucinatory equivalent”) [10]: 73. The development of a simple hallucinatory variant or hallucinatory-paranoid type of paranoid schizophrenia in some cases can be predicted from the characteristics of the initial and initial stages of the development of mental disorder [10]: 73.

ICD-9 Edit

According to the International Statistical Classification of Diseases, Injuries and Causes of Death of the 9th revision (ICD-9), adapted for use in the USSR, paranoid schizophrenia had a number of clinical options: 295.31 295.31 - paranoid form (unfavorable option), 295.32 295.32 - paranoid form (typical variant), 295.33 295.33 - paranoid form (paroxysmal-progressive flow), 295.39 295.39 - paranoid form with an unspecified type of flow [12]. Separately allocated 295.53 295.53 - sluggish paranoid (paranoid) schizophrenia, which was a subtype of sluggish schizophrenia [12].

ICD-10 Edit

Below are the official general criteria for paranoid, hebephrenic, catatonic, and undifferentiated schizophrenia (F20.0 — F20.3) [13]. According to ICD-10, at least one of the following symptoms should be observed for a diagnosis:

  • (a) “Echo” of thoughts (the sound of one’s own thoughts), insertion or withdrawal of thoughts, openness of thoughts to others.
  • (b) Delusion of mastery, influence, or passivity, distinctly related to the body or limbs, thoughts, actions or sensations, delusional perception.
  • (c) Hallucinatory "voices", commenting on or discussing the behavior of the patient, other types of "voices" coming from different parts of the body.
  • (d) Sustained delusional ideas that are culturally inadequate, ridiculous, impossible and / or ambitious in content.

Or, at least two of the following "minor" symptoms should be observed:

  • (e) Persistent hallucinations of any kind, if they occur daily for at least one month and are accompanied by delusions (which may be unstable and half-formed) without distinct affective content.
  • (f) Neologisms, sperrungs (interruptions in thinking), leading to disruptions or inconsistencies in speech.
  • (g) Catatonic behavior, such as agitation, hardening, or waxy flexibility, negativism, mutism, and stupor.
  • (h) “Negative symptoms” (but not caused by depression or pharmacotherapy), as a rule, leading to social exclusion and a decline in social indicators, symptoms that can be expressed:
    • apathy
    • speech impoverishment or smoothness
    • inadequate emotional reactions
  • (i) Reliable and consistent changes in the overall quality of behavior, manifested by a loss of interests, aimlessness, absorption with one's own experiences, social exclusion.
Diagnostic instructions

At the same time, these symptoms should be noted for at least a month. Conditions that meet these criteria, but lasting less than a month, are classified as acute schizophrenia-like psychotic disorder (F 23.2 23.2 with an additional fourth sign indicating the nature of the disorder), and if they continue for more than a month, the diagnosis changes (recoded) to the appropriate form of schizophrenia [ 13] .

With the development of symptoms of schizophrenia, along with pronounced symptoms of other disorders (affective: manic or depressive episodes, epileptic, other brain diseases, alcohol or drug intoxication or withdrawal syndrome), schizophrenia is not diagnosed, and the appropriate diagnostic categories and codes are used. The diagnosis of schizophrenia is made if the case meets the criteria for a manic episode F 30 30. - or a depressive episode (F 32 32. -), but the above general criteria are identified before development of mood disorders [13].

Symptom (i) in the above list refers only to the diagnosis of “simple type of schizophrenia” (F 20.6 20.6), and the duration of symptom symptoms should be observed by a psychiatrist for at least one year [13].

According to ICD-10, a diagnosis of paranoid schizophrenia is made when the following criteria are met:

  • A. Must identify (F20.0 — F20.3) general criteria for schizophrenia.
  • B. There must be marked delusions and hallucinations (such as delusions of persecution, meaning and relationships, high kinship, special mission, bodily change or jealousy, threatening or imperative “voice”, olfactory or gustatory hallucinations, sexual or other bodily sensations).
  • B. Emotional smoothness or inadequacy, catatonic symptoms or broken speech should not dominate the clinical picture, although they may be present in a light degree of severity.

  • A. The general criteria for Schizophrenia (F20.0 — F20.3 above) must be met.
  • B. Delusions or hallucinations must be prominent (such as delusions of persecution, reference, exalted birth, special mission, bodily love, or threatened or commanding voices, or
  • C. Flattening or incongruity of catatonic symptoms, or incoherent disease.

Differential Diagnosis Edit

It is important to exclude acute transient psychotic disorders, schizoaffective disorder, chronic delusional disorder, and organic delusional disorder. In acute transient psychotic disorders, negative and positive symptoms of schizophrenia may be present, but they usually disappear within 2 weeks. It is important to exclude the fact of induced delusions, which may be present, for example, when raising children in a family of patients with mental illness.

Delusion in schizophrenia differs from delirium in delusional disorder in its absurdity and pretentiousness, polythematism and fragmentation [4].

Flow Options and Remission Designation Edit

The course of paranoid schizophrenia may be chronic (continuous) or episodic (paroxysmal) with partial or complete remission.

The types of the disease are encoded by the addition of the fifth character [15]:

  • continuous F20.00,
  • episodic with increasing defect F20.01,
  • episodic with stable defect F20.02,
  • episodic remitting (recurrent) F20.03,
  • incomplete remission F20.04,
  • complete remission F20.05,
  • other F20.08,
  • current unclear, observation period is insufficient F20.09.

In the version of the ICD-10 adapted for use in the Russian Federation, the “other current” is indicated by code F20.07, and by code F20.09 - the observation period is less than a year.

A.V. Snezhnevsky noted that the concept of "continuous flow" is relative. In essence, all forms of schizophrenia, including continuous ones with the course of the disease, “flow with periods of exacerbations and temporary lull (remission)” [16].

The presence or absence of remission in the adapted version is indicated by the sixth sign of the code, and if there is remission, and an indication of its nature [17]. Remission type designation using paranoid schizophrenia as an example:

  • F20.0x4 incomplete remission,
  • F20.0x5 complete remission
  • F20.0x6 lack of remission,
  • F20.0x8 another type of remission
  • F20.0x9 remission
  • BDU.

DSM Edit

The American Diagnostic and Statistical Manual of Mental Disorders, 2nd Edition (DSM-II), included a “paranoid type of schizophrenia” (code in manual 295.3). Three subtypes were distinguished, depending on the prevailing symptoms: hostile (hostile), grandiose (majestic) and hallucinatory (hallucinatory) [18].

Diagnostic criteria for paranoid-type schizophrenia (295.3x) in DSM-III-R (3rd revised edition) [19]:

  • A. The predominance of one or more systematized delusional systems or frequent auditory hallucinations associated with one topic.
  • B. Absence of the following manifestations: incoherence of speech, pronounced relief (inadequacy) of associations, flattened or significantly disturbed affect, catatonic behavior, sharply disorganized behavior.

  • A. Preoccupation of a single theme.
  • B. None of the following, marked loosening of associations, flat or grossly inappropriate affect, catatonic behavior, grossly disorganized behavior.

Diagnostic criteria for paranoid-type schizophrenia (295.30) in DSM-IV-TR (4th revised edition) [20]:

  • A. The predominance of one or more delusional systems or frequent auditory hallucinations.
  • B. Absence of the following manifestations: disorganized speech, catatonic or disorganized behavior, flattened or inadequate affect.

  • A. Preoccupation with one or more delusions or frequent auditory hallucinations.
  • B. None of the following is a disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect.

In the next DSM-5 edition, there are no types of schizophrenia [21] [22].

Acute manifest psychosis in this disorder is treated with antipsychotics and detoxification therapy [23]: 158. The growth of negative disorders can be prevented by small doses of risperidone (up to 2 mg) and other antipsychotics, as well as insulin-comatose therapy [23]: 158. Risperidone and flupentixol have been shown to be effective in treating patients with paranoid schizophrenia, including improving their cognitive abilities [24].

Antipsychotics prolongations (haloperidol depot, liorodin depot) and lithium carbonate are used for maintenance therapy in the presence of affective disorders in the structure of psychosis [23]: 158.

For antipsychotic drugs, monolateral electroconvulsive therapy is used [23]: 158.

Famous people who suffered from paranoid schizophrenia:

  • John Forbes Nash - American mathematician, Nobel Prize winner in economics in 1994 "For the analysis of equilibrium in the theory of non-cooperative games" [25] [26].
  • Daniel Paul Schreber is a German judge, known for describing his condition in the book Memoirs of a Neuropathological Patient [27].
  • Theodore Kaczynski - also known as Unabomber - Doctor of Mathematical Sciences, a social critic, known for his mailing bomb campaign [28].
  • Mark David Chapman is the killer of John Lennon, a member of The Beatles. Mark was diagnosed by Dr. Daniel Schwartz [29].
  • Nikolai Dzhumagaliev - Soviet serial killer - cannibal, "Iron Fang".
  • Richard Chase is an American serial killer, the Vampire from Sacramento. Suffered hypochondriac delirium.
  • Lionel Aldridge (Eng.) - American professional footballer [26] [30].
  • James Chassie (Eng.) - American writer and singer [31].
  • Kevin Archer (Eng.) - English guitarist and songwriter [32].
  • Parvin Babi - Indian actress [26].
  • Tom Harrell is an American jazz musician (trumpeter) and composer [26].
  • Betty Page - American fashion model [33].
  • Veronica Lake is an American actress who has been awarded a star on the Hollywood Walk of Fame [34].

Controversial or erroneous examination results:

  • Peter Sutcliffe is a British serial killer. He was recognized as “no longer mentally ill” and sent from a psychiatric hospital to a prison [35] [36].
  • Anders Behring Breivik is a Norwegian terrorist, the diagnosis of paranoid schizophrenia was made by two teams of psychiatrists appointed by the court [37] [38], but after widespread criticism of the first reports, the case was revised and it was declared sane [39] [37]. The second psychiatric examination of his condition was regarded as a manifestation of narcissistic personality disorder in combination with pathological fantasy (pathological falsehood), which does not exempt from criminal liability [37].

Causes of paranoid schizophrenia

The main cause of the paranoid type, like all other types of schizophrenia, is considered to be a physiological disorder in the dopamine metabolism system in certain parts of the brain, as well as a genetic predisposition to this disease.

Schizophrenia of the paranoid type may be chronic or episodic in nature with preservation of the primary bright symptoms (delusions, hallucinations). At the initial stage of the disease, the patient is also characterized by isolation, experiencing attacks of anxiety, suspicion, and various obsessive states. At the clinical stage of development of schizophrenia, the patient manifests pseudohallucinations, delusions of persecution, sensations of physical impact, which require qualified treatment. Alcohol, drugs and other psychotropic drugs are contraindicated in patients with paranoid schizophrenia. To identify other contraindications and prescribe the most effective therapy can experts of the health center "Neopsi".

The disease is distinguished by the bright presence of the following symptoms:

  • Hallucinations
  • Anxiety, persecution mania,
  • Crazy ideas
  • Excessive religiousness
  • Persistent suicidal activity

Delusions and hallucinations are the two main symptoms that manifest themselves in varying degrees at different stages of the disease (about the stages in more detail below).

Brad is a false notion of a person about the world around, which is taken from his distorted perception. The most frequent manifestation is the sensation of persecution (it is monitored, the phone is tapped). Often patients behave aggressively, and not limply and passively. Among the visual hallucinations are the following types:

  • simple - elementary images (circles, spots, points, lines),
  • subject - visions of objects, real and fictional,
  • micro and macroscopic - increase or decrease of objects,
  • autoscopic - the patient sees himself or his twin,
  • zooscopic- visions of birds and animals
  • extracampy - The patient sees someone or something behind him.

The most common auditory hallucinations. A person hears “voices”, commenting on what is happening, giving advice, condemning or ordering to perform some actions. One of the difficulties of this disease is the presence of a hidden form that can occur for years, aggravating the situation of the patient, and only an experienced psychiatrist is able to reveal this phase. However, patients rarely go to a specialist on it. Psychotherapists of the NEOPSI Center detect symptoms in paranoid schizophrenics in the early stages and can start timely treatment.

Stages of paranoid schizophrenia

The disease takes place in several stages, each of which has its own symptoms. To grasp the boundaries of the stages, to correctly select the desired is difficult without special education. Our socialists will conduct a qualitative diagnosis and prescribe individual therapy and drug treatment. Let's try to tell a little about each stage of the disease (the patient's condition gradually worsens):

  • initial,
  • paranoiac,
  • paranoid,
  • paraffer,
  • severe schizophrenic defect.

The initial stage lasts from 10 years or more, characterized by disorders similar to personality disorder, depersonalization, various obsessions, hypochondria, senesthopathies (uncomfortable sensation in the body of unclear localization). At this stage, you may receive distrust, narrowing the range of interests, rigidity. When hallucinogenic variant at this stage manifest neurosis-like and psychopathic disorders.

Further, an interpretative nonsense appears, which the patient systematizes, and, using his increased volitional activity, tries to bring to life. For example, in the presence of reform ideas, they are required to be executed in various instances, in the presence of delusions of persecution, they try to calculate their pursuers, in the presence of delusions of jealousy to find an opponent, etc. If these symptoms are delayed, the disease moves into the next phase - paranoiac (refers to delusional disorders).

This stage in turn is replaced by Kandinsky-Klerambo syndrome, expressed by several (usually two) types of automatism, and their circle is gradually growing. It seems to patients that their thoughts are audible to those around them, that someone is guiding their thoughts, pseudo-hallucinations appear (sounding in the head of someone else's voice). Эта стадия переходит в парафрению, которая может отличаться бредом величия – наличие ответственной миссии, влияние на судьбы людей и вселенной и т.д. Все это перетекает в последнюю стадию – дефектное состояние: один из признаков, казалось бы, грамматически правильно построенная речь, но лишенная смысла и содержания (пациент отвечает на вопрос длинно и связно, но не по сути вопроса, структурируя предложения из первых попавшихся слов).

Шизофрения параноидного типа может носить хронический или эпизодический характер с сохранением первичных ярких симптомов (бред, галлюцинации). На начальном этапе заболевания пациент также отличается замкнутостью, испытывает приступы тревоги, подозрительности, различные навязчивые состояния. При клинической стадии развития шизофрении у больного проявляются псевдогаллюцинации, бред преследования, ощущения физического воздействия, требующие квалифицированного лечения. Больным с параноидной шизофренией противопоказан алкоголь, наркотики и другие психотропные средства. Выявить другие противопоказания и назначить наиболее действенную терапию могут специалисты центра здоровья "Неопси"

Шизофрения – сложное и опасное заболевание, которое может привести к негативным последствиям (физическим, экономическим, юридическим) как для больного, так и для его близких. Заболевание требует постоянного контроля со стороны медиков и близких, пациента необходимо убеждать продолжать терапию и отслеживать, принимает ли он препараты. Наиболее эффективными являются следующее лечение параноидальной шизофрении:

  • медикаментозное - neuroleptic drugs, detoxification therapy, insulin comatose therapy, lithium carbonate,
  • psychotherapeutic - confidential contact with the doctor, achieving the maximum level of trust, sympathy,
  • Ect - electroconvulsive therapy (with resistance to neuroleptic drugs).

When the result is achieved, the stage of stabilizing therapy begins, at which doses of the drug are gradually reduced. Stabilizing therapy is prescribed for several years, depending on the specific situation.

Maintenance therapy is usually carried out after stabilizing, its main task is to prevent the recurrence of the disease. It is important to follow all recommendations of the attending physician and not to stop taking prescribed medications.

Instead of pills, you can go to the deposited form of neuroleptics, which are administered 1 time in several weeks or months.

This type of treatment can be used in non-disciplined patients prone to forgetfulness. At the NEOPSI Center, patients achieve a high degree of remission and can continue to live and work with minimal medication support. The rehabilitation course allows patients to learn how to live with their illness and realize their potential. The patient can take part in the course together with his relatives and relatives.

What is paranoid schizophrenia?

The paranoid form of schizophrenia is a disease that occurs on the background of the disruption of the brain. The exact causes of the appearance of neurosis have not been identified, but it is assumed that infectious diseases, genetics, developmental abnormalities, stress, upbringing errors, etc., are capable of provoking the progression of the deviation. This form is observed in most schizophrenic patients.

Paranoid schizophrenia is characterized by the absence of the classic symptoms of the disease. Patients in the initial stages are not observed speech disorders, volitional deviations, affective disorders and catatonia. Patients remain focused and have no memory problems. This allows you to lead a normal life during remission. The main symptom of the disease is obsessive paranoid thoughts, which cause anxiety, psychosis and suicidal tendencies.

Types of paranoid schizophrenia

There are 3 main types of the disease:

  • periodic,
  • continuous,
  • paroxysmal progredient.

Additionally, depressive paranoid schizophrenia is isolated, in which the symptoms of the underlying disease are combined with a depressive syndrome. There is also a malignant form. It is characterized by a rapid course and rapid emergence of pronounced mental abnormalities. Treatment in such cases is difficult. Possible development of irreversible deviations.

Periodic flow type is the easiest. In some cases, people have only 1-2 attacks in a lifetime. Severe forms are detected more often. The paroxysmal flow is characterized by alternating periods of remission and exacerbations. The longer a person is in a normal state, the more pronounced deviations can be in the future.

Signs of paranoid schizophrenia

The main symptom of the disease is obsessive paranoid ideas. Most often, patients think they are being pursued. Patients fear surveillance in public places, transport, at home, etc. Patients believe that the pursuers have a complex system. Some argue that attackers transmit signals to each other through the media, the Internet, news, etc.

With the progression of delirium becomes more complex and confused. There are thoughts about conspiracy theories. Patients may be wary of existing or invented structures, celebrities, public figures and fictional phenomena. Patients think that they are trying to cause evil or damage. As a result of the incorrect work of the brain centers, patients are not able to distinguish reality from fiction. In such a condition, the patient may cause harm to himself and others due to confusion, depression and a state of affect.

Sometimes, in patients with paranoid schizophrenia, a delusion of special purpose, unusual origin and grandeur is revealed. Patients claim that they want to kidnap, kill or use for any fictional reasons. With the progression of the disease in the last stages, speech disorders (incoherent monologues) and emotional deviations occur. Patients feel joy and anger for no reason, sudden mood swings and nervous overexcitement are possible.

There are 2 main forms of the course of the disease, depending on the predominant symptom: hallucinatory or delusional. In the second case, the patient tries to discover conspiracy theories and does not trust others. The hallucinatory form is accompanied by the appearance of visual and auditory abnormalities. The patient may feel that someone is talking to him, condemning or commenting on his actions. In the future, with the progression of voices arise in the head, which hail and can give orders. Sometimes it becomes a reason for committing crimes.

Clinical manifestations in men and women are almost the same. Manifestations depend on individual characteristics and worldview.

Symptoms and signs of paranoid schizophrenia in women

Positive and negative symptoms in women are often associated with complexes about appearance, family and children. Ideas are reflected in the content of hallucinations and delusions. Women often over-care for children and claim that someone wants to harm them. Sometimes they are vague persons, but in most cases patients point to relatives, neighbors, former spouses, etc. However, some men may also have similar symptoms.

Women more often develop depressive abnormalities. They complain of anxiety attacks. Patients become closed, they may not be in contact with the outside world.

Symptoms and signs of paranoid schizophrenia in men

Men are more likely to come up with ideas of harassment, surveillance and espionage. Sometimes delusions and hallucinations are associated with colleagues and work. If a paranoid schizophrenic has a partner, he will suspect the spouse of infidelity. In the later stages, the man may attempt to defend himself from imaginary enemies. This is reflected in the creation of barricades, the installation of additional locks, installation of video surveillance, etc.

In men, the disease often leads to psychopathy. In some cases, affective states are observed, the occurrence of which defies logical explanation.

Prognosis and treatment of paranoid schizophrenia

After making a diagnosis of paranoid schizophrenia, the psychiatrist prescribes a course of treatment aimed at stopping the attack, stabilizing the patient and preventing exacerbations. Additionally, social and labor adaptation is carried out so that the patient can lead a normal life.

Stopping the attack begins with the onset of aggression, the ideas of persecution and violation of the perception of the surrounding world. The patient is placed in the hospital. Individually prescribe medications that relieve symptoms. The most commonly used antipsychotics with a sedative effect. The drug is selected depending on the clinical picture and the presence of contraindications. After the disappearance of pronounced manifestations go to stabilize the state.

After removal of the acute symptoms of the patient is discharged to the day hospital or regional dispensary. The specialist selects drugs that are able to eliminate residual effects. Most often, the course of therapy includes nootropics, antidepressants and antipsychotics.

It is important to regularly visit the doctor, because at this stage even minor factors can cause a new exacerbation. The cause of a seizure may be hypothermia, mild stress, or physical stress.

After the withdrawal of symptoms and the return of an adequate perception of reality, adaptation is carried out. The patient is taught independent living and trying to make him a full-fledged participant in relationships in society and family. If possible, the patient is involved in the work process.

Prevention consists in the normalization of the psycho-emotional background and medication. Dosage can be reduced after the survey. Maintenance therapy helps prevent new seizures. For timely action, the patient must regularly visit the doctor, since only a specialist can detect uncharacteristic signs.

The prognosis depends on the individual characteristics of the patient. The chances of preserving personality, clarity of thinking and habitual lifestyle are increased under the following conditions:

  • female patient
  • there are no cases of schizophrenia in the family,
  • the disease began acutely, but progresses slowly,
  • the patient turned to the doctor in time
  • others support the patient and help him adapt.

With a good set of circumstances, the patient learns to independently recognize the signals of the body, resists them and visits the doctor in time. Maintenance therapy slows the progression of the disease. Get rid of schizophrenia completely sick will not succeed, but with the right approach will be able to achieve sustained remission.

With the hidden development of schizophrenia and lack of assistance, slow destruction of the personality is possible.

The most dangerous continuous course of the disease. The patient ceases to perceive reality adequately. This leads to chronic disorders and the further development of other mental disorders.

Causes and factors

If the symptoms of paranoid schizophrenia are reliably known, the researchers still argue about its causes. True, many agree on the enormous role that brain dysfunction plays in this pathology. But what factor contributes to this, has not yet been disclosed.

Genetics and environmental triggers are considered as a specific risk factor. However, no theory has enough hard evidence to prove.

Genetic predisposition often serves as a kind of “switch”, which is activated by some event, emotional experience, or some other factor.

Here are some factors that increase the likelihood of such a diagnosis as paranoid schizophrenia:

  • the presence of psychotic disorders in someone from relatives,
  • viral exposure in the womb,
  • lack of nutrients for the fetus,
  • getting stress in childhood
  • the result of violence
  • later conceiving a child
  • use of psychotropic substances (especially adolescents).

And here are the symptoms of a paranoid form of schizophrenic disorder:

  • persecution mania,
  • a sense of accomplishment of a particular mission
  • manifestation of aggressive behavior,
  • suicidal tendencies
  • appearance in the head of hallucinatory voices (including imperative),
  • possibility of tactile or visual hallucinations.

Criteria for diagnosing a disease should be consistent with this schizophrenic subtype. Only the presence of obvious hallucinations and pronounced delirium allows the doctor to diagnose the disorder described, moreover, that:

  • catatonic symptoms practically do not appear,
  • emotions and speech are almost not disturbed.

Among the delusional states, all sorts of persecutory beliefs are most characteristic.

But the development of drug-induced, as well as epileptic psychosis, as a rule, is excluded.

Interestingly, there is a definite relationship between the nature of delusions, as one of the symptoms of paranoid schizophrenia, and the level of human culture, and even its origin.

Features of treatment

What is it - paranoid schizophrenia, and how is it treated? In essence, this is a lifelong commitment, and not a temporary treatment course. Although the forecast is not the most joyful, it should be considered from the very beginning.

In general, the doctor prescribes therapy based on:

  • type of disorder,
  • intensity of symptoms
  • individual patient characteristics
  • case histories
  • age features
  • other significant factors.

Not only qualified psychotherapists and other medical specialists take an active part in the treatment process, but also the patient’s relatives as well as social workers.

Therapeutic strategy is usually built on:

  • taking neuroleptics (traditional and atypical),
  • psychotherapeutic procedures
  • electroconvulsive treatment,
  • social learning skills.

Often it takes treatment of paranoid schizophrenia in a hospital setting.

Non-medicinal, as well as psychotherapeutic intervention is aimed, first of all, at stopping symptoms. Prescription antipsychotics.

The diagnosis of the disease described can only be made by a qualified doctor. Accordingly, the prescription of drugs is carried out by a medical specialist - the same applies to the schedule of drug use and the correct dosage.

If the doctor’s prescriptions are not followed, the treatment process will not be as effective as we would like, and recovery will not be possible. Quite a lot of people stop taking medicines after the first few months, as a result of which the psychosis returns and continues to exhaust the patient with symptoms.

What happens if you start a disease? Signs will worsen regularly, and contact with the outside world will be lost. Suicidal thoughts are intensifying, which can lead to the danger of real suicide.

Often, the patient himself does not notice the oddity of behavior, and even hallucinations and delusional states are taken for real things. But the people around him (especially those close to him) will surely notice the changes and they will most likely have certain suspicions of mental abnormalities - accordingly, they should convince the person to see a doctor.

Disease in ICD-10

Paranoid schizophrenia - what is it? The International Classification of Diseases contains this disorder under the code F20.0. Along with hallucinations and delusional disorders, the possible presence of affective disorders (anxiety and phobias), catatonic symptoms and speech disorders is assumed.

The following options for the course of the disease are also offered:

  • continuous flow - code F20.00,
  • current episodic, with an increasing defect - code F20.01,
  • episodic current with a stable defect - code F20.02,
  • current progressive, having paroxysmal character - code F20.03.

In the case of incomplete remission, the code is given F20.04, and with full - F20.05.

That is, the clinical picture of the described disease can be varied. This directly indicates the complexity of the origin of such schizophrenic disorders and explains the difficulties associated with the diagnosis.

How does the disease begin?

The onset of an illness can be both slow and sudden. If schizophrenia begins abruptly, the patient's behavior changes rapidly:

  • the thought process becomes inconsistent,
  • aggressive agitation appears,
  • develop delusional states, characterized by inconsistency,
  • possible development of phobias, that is, unreasonable fear,
  • behavior is becoming more strange (inadequate).

When the onset of the illness is slow, the behaviors also change, but not immediately. Periodically, the patient makes single inadequate actions, makes strange statements, builds strange grimaces. Gradually, he loses interest in what he previously thought was interesting. Often you can hear complaints about the feeling of inner emptiness.

Slowly, however, the pseudo-neurotic symptoms are also steadily increasing:

  • working capacity decreases,
  • a person becomes lethargic and apathetic,
  • obsessive desires appear.

Sometimes you have to deal with depersonalization, when a person’s perception of a personal “I” is distorted. The intellectual perception of the world that surrounds a person is disturbed.

Of obsessions should be noted hypochondria, delusions of exposure and harassment. Sometimes it’s enough for a person to watch some episode about secret agents, after which his paranoid schizophrenia takes control of the consciousness: makes the patient believe that some agents are chasing him, they are still pursuing him.

Personality becomes withdrawn and scarce on emotional reactions. At first, hallucinations are verbal - a person begins to hear voices inside himself. This becomes the starting point for the development of secondary delusional disorder.

The next stage in the development of paranoia in schizophrenia is the development of Kandinsky-Clerambo syndrome. The conclusion of the diagnostician confirms pseudo-hallucinations, as well as mental automatism (when a person does not perceive his own thoughts and movements as his own).

But it is delusional states that are considered as the main symptom at this stage of the disease.

Prevention

What can be said about the prevention of paranoid schizophrenia? Of course, it is always said that preventive measures are a more reasonable approach than curative procedures: it is better to prevent than to cure.

But in this case it should be noted a certain невозможность как-то предотвратить развитие шизофренического расстройства. Даже если генетическая теория права, «рычагом», который запустит болезнь, может стать какое угодно жизненное событие.

The only thing that should be remembered is the need to begin a therapeutic course, without delaying as soon as possible. This will help to control the course of the disease, helping to improve long-term prospects.

Definition of the disease

Paranoid schizophrenia is an endogenous or inherited mental illness characterized by polymorphism (variety of manifestations).

Mandatory signs:

  • thought disorder in the form of delirium,
  • perception disorder in the form of hallucinations,
  • an emotional defect that develops in late stages.

Disorganization of behavior is not typical, the patient until the last days retains self-care skills and tidiness.

The patient is held for a long time in society, family and even at work, because the delusional system is formed for a long time, and concerns only one thing: jealousy, persecution, greatness or hypochondria. Professional knowledge and skills remain intact, as well as other aspects of life.

The causes of the disease

Research on the causes of paranoid schizophrenia is conducted continuously, expanding the boundaries of understanding the essence of the disease.

The following theories are relevant:

  • hereditary or genetic - leading, based on statistical data. Having a sick first-line relative increases the incidence of disease by 10%,
  • neurochemical - patients necessarily have impaired metabolism of dopamine, kinureric acid, serotonin, some proteins and other substances,
  • long-term alcohol abuse and drug addiction, especially dangerous in this sense are smoking blends or spice, which cause schizoid-like psychosis after the first use,
  • childhood abuse, abandonment, it does not matter, it happened in a native or adoptive family,
  • maternal diseases during pregnancy, especially intrauterine infections,
  • oxygen starvation of the fetus or nutritional deficiency, when the newborn does not receive enough nutrients.

The difference in the course of the disease in men and women

The difference concerns not so much the syndromes as the ability to adapt to them, to build one’s state into the demands of society.

do not marry

In general, the disease in men is more open, clear and obvious than in women. Men by virtue of straightforwardness after the formation of the delusional system begin an active struggle for "justice", turn to various government institutions and public organizations, defending their point of view.

They are prone to disruption of public order, alcoholism and methods of physical influence, in connection with which they come to the attention of law enforcement agencies, and from there to treatment.

In women, the plot of delirium revolves around family problems, almost without affecting social ones. Relatives endure various oddities for a very long time, trying to manage with their own means, which is not possible, of course.

You can learn more about how this form of schizophrenia occurs in women in this material on the website.

Signs and symptoms of schizophrenia in men

Paranoid schizophrenia, the symptoms and signs of which in men appear most clearly, is characterized by the predominant delusional idea:

  1. Harassment (persecutory) - the patient discovers signs of harassment from neighbors, relatives, colleagues, aliens or inanimate objects. “Proof” are the views, words, deeds, intentions, gifts, and anything else. The system by which “evidence” is collected cannot be predicted. The patient can refer to the “secret signs” the color of clothes, the number of the trolleybus route, the sunrise and sunset, precipitation, the architectural design of buildings, and so on.
  2. Greatness is the unshakable conviction that the patient is incredibly important to the world. The motives are different: a descendant of the royal family, a scientist, a computer genius, a financier and the like. So, one of the patients who grew up in an orphanage and never had premium clothing considered himself an outstanding designer of men's clothing. Persuasion did not interfere with the fact that he spent all his days in a hospital gown, refusing to change clothes. During a short stay at home, the patient wore an unimaginable outfit consisting of multi-colored rags stitched on top of each other.
  3. Jealousy or Othello syndrome - occurs without a cause, is triggered by alcoholization. There is no real reason to find it, but it does not interfere with the formation of the structure. Imaginary rival can be not only real people, but also fictional characters. The formation of delusions of jealousy more inclined to men. In women, delusions of jealousy are delayed and manifest in old age. A husband who really didn’t always remain faithful in his young years, after co-aging, is perceived as an incredibly attractive object, which many women go to “meet”. Explicit contradictions - the age-related extinction of the male function, diseases and the like - are not taken into account. If a man in a fit of jealousy can cripple or kill, then women are more likely to suffer silently or "load" girlfriends and relatives.
  4. Hypochondria - the detection of incurable and rare diseases, while the results of medical examinations are ignored. It is peculiar to both sexes, but in men it may be more global.

The behavior of men with schizophrenia

Fully determined by the subject of delirium. After crystallization of the delusional system, the man begins to consistently embody what he believes.

The widespread availability of the Internet has somewhat transformed and updated the theme of delusional systems. Thus, some patients began to consider themselves surviving representatives of ancient civilizations, secret orders or identify themselves with the characters of the games.

From practice: the patient began to consider himself "the official representative of the secret order of the Roman Empire" after he had mastered the computer. At home he talked about this for 5 years, but continued to work and performed all the duties of a man in the family. A virtual acquaintance jokingly sent him an electronic certificate of belonging to the secret order. After that, the patient “understood” that it was time to act. On behalf of the order, he appealed to various organizations, demanding to protect the planet from invasion and cover it with a dome, and also to take measures to law enforcement agencies that did not react to his statements. Entered in handcuffs after a riot at the police station, where he fiercely fought "for the right thing."

Not everyone has the disease is so violent. For many years a person can live in a family and remain able to work - until the phenomenon of a defect is completely “eaten up” by a person, turning a person into a passive and indifferent creature.

In the later stages of the disease, negative symptoms or defect come to the fore. Fortunately, in paranoid schizophrenics, this happens late, almost in old age, when life is already lived, children are born and raised. Patients by that time either manage to earn an old-age pension or receive social allowance for disability. Some live in families, especially if the wife is alive. Women treat sick husbands often very mercifully, understanding their illness and creating conditions for a relatively comfortable existence. The exception is sick delusions of jealousy, which represent an immediate danger to their wives.

Diagnostic features

The difficulty is that the main manifestation, namely the crazy idea, is difficult or almost impossible to discuss with the patient. This is his “sore point”, which is carefully guarded from prying eyes and certainly not discussed with outsiders.

To judge the presence of delirium at first has only indirectly, analyzing the behavior, actions and methods of response. The collection of the medical history of the family will help in ascertaining the truth - information about the sick and strange relatives, suicides, alcoholics.

Requires a clinical assessment of the level of health, which is performed according to the results of somatic examination, data of instrumental and laboratory examinations. Brain harm - head injuries, alcoholism, poisoning, and heavy surgery with prolonged anesthesia have a direct impact on the course of the disease.

Crucial is the psychiatric assessment of the state: signs of hallucinations in the form of obvious signs of imaginary interlocutors, "voices" and images, as well as behavior that is caused by the delusional system.

Treatment of schizophrenia in men

It is selected individually depending on the clinical picture. In some cases involuntary hospitalization and hospital stay is required by court order. Neuroleptics of different groups, antidepressants, anticonvulsants, nootropic drugs are used.

As the patient calms down, they are attracted to various feasible forms of work, reading, walking, simple physical exertion.

The posttherapeutic period is a conditional concept, since remission is almost always supported by medication. Priority is given to prolonged forms of neuroleptics — Moditen Depot, haloperidol decanoate, and the like. Injections should be taken once every 3-4 weeks, the condition on these medicines remains stable, and the patient is relieved of the need for daily medication.

Prognosis of the disease

In general, more favorable than in other forms, because deficiency disorders come late. With continued treatment, the patient, after arresting the exacerbation, may well live in the family, doing feasible work.

Article author: Psychiatrist, psychotherapist Neboga Larisa Vladimirovna

What is this disease?

Paranoid schizophrenia - This is a mental disorder with characteristic distortions of the perception and thinking system.

The dominant feature of this disease is the predominance of gibberishand hallucinationsin the overall clinical picture.

Most often, the disease begins to manifest itself in people in adolescence or adulthood (from 30-35 years).

The nature of the disease is not fully understood, scientists adhere to both a biochemical theory (the occurrence of a disorder due to disorders of the central nervous system) and psychological (development of pathology on the background of mental trauma, neurosis, stress). A single look at the origin of the disease yet.

The course of the disease is very diverse and is accompanied by a number of specific syndromes and symptoms, the main of which is nonsense.

It happens:

  • paraphrased (complex and constant, accompanied by hallucinations), when patients are confident of their exceptional historical importance or extraordinary talents and abilities,
  • paranoid (fragmentary and unsystematic), proceeding as a fear of persecution or negative influences from surrounding people.

There are special features and behavior of patients - they aggressive, agitated, scared, suspicious and practically turned off from real life. But along with this, communication with them is possible, and many patients do well with their professional and family responsibilities.

Treatment of the disease is long, mostly in vivo, and the prognosis for recovery is unpredictable.

ICD-10 Code

Psychiatrists refer to schizophrenia as a mental disorder with marked distortions in the perception, memory, and behavior of patients.

While maintaining a certain clarity of thinking, patients behave inadequate , their the range of interests is constantly narrowing .

It seems to paranoid schizophrenics that they hear the thoughts of the higher mind or other people, can transmit their thoughts to others at a distance, that someone controls them from the outside or fills their minds with evil, irritability and pessimism.

The disease is characterized by unpredictability in the development, course, treatment and manifests a variety of symptoms.

However, in the international classification of diseases, all types of paranoid schizophrenia are combined under one code — F20.0. At the same time, doctors identify the main features of the disorder: delirium and the prevalence of auditory hallucinations, a distortion in the perception of reality.

Causes of illness

The mechanism of the formation of the disorder is not fully understood, it is believed that the basis of paranoid schizophrenia are functional disorders in the brain .

The factors that provoke this mental disorder include:

  • heredity,
  • intoxication of the body in case of viral, bacterial infections and chemical or radiation poisoning,
  • hormonal dysfunctions and endocrine diseases,
  • mental trauma, stress, shocks,
  • abuse of psychotropic drugs, drugs, alcohol.

Studies show that the weaker sex falls ill with paranoid schizophrenia less often strong.

However, they experience this disorder. more difficult . Apparently, the emotionality of women plays a significant role in the development of the disease, so they have more pronounced deviations in behavior and social life. With the progression of schizophrenia, the identity of the woman eventually collapses.

By changes in behavior and emotional response, it is easier to notice schizophrenia in women than in men. They become extremely tense, anxious, unbalanced, actively talk about their fixed ideas and made-up past merits, feel free to express a negative attitude and “splash out” the accumulated negative.

By virtue of restraint, the development of the disease in the stronger sex can be ignored for a long time, writing off changes in behavior to fatigue or natural male secrecy, although the disease can begin to progress from teenage years.

In representatives of the stronger sex, the plot of the disease can be very different from the female, among them are more often "historical figures", "political reformers", "generals" and "emperors", "geniuses" and "great inventors".

Men are more deeply immersed in the disease and their personality erodes over time. However, they retain their professional fitness and their social status for a longer time.

Therapy of the disease is carried out with the help of special medications that have a beneficial effect on brain function and relieve the acute symptoms of schizophrenia (antipsychotics, sedatives, hypnotics, antidepressants).

The basis of disease therapy are neuroleptics (Haloperidol, Solian, Rispolept and analogues), these funds at their course admission can slow personal deformation in patients.

Thus, the treatment of paranoid schizophrenia is carried out in two stages, in order to stabilize the patient's condition, and then maintain it at the proper level.

Due to the fact that therapy is carried out on an ongoing basis, psychiatrists practice changing preformed forms of neuroleptics on injectable and vice versa.

Additional methods of treatment are psychotherapeutic techniques, hypnosis, relaxation classes.

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