Fur coat schizophrenia. What is the difference between fur coat schizophrenia

Coated schizophrenia is a form of the disease that is characterized by acute or subacute attacks with gaps of "enlightenment" between them. This kind mental disorder also called paroxysmal-progredient. The attacks that occur, called "fur coats", can harm a person's personality, provoking changes, but sometimes they pass without a trace. This name is of German origin, and translated into Russian, the word "fur coat" means "shift".

To date, the exact causes of schizophrenia are unknown. The impetus for its development can be various mental disorders, as well as a genetic predisposition.

Symptoms

Personality changes occur in any form of schizophrenia that progresses and worsens over time. But a feature of the fur-like form is that during attacks, the symptoms intensify or completely new manifestations appear. Due to the characteristics of organisms and the degree of mental defects, the clinical picture of schizophrenia can be completely different, but there are some common signs that indicate the presence of the disease:

• delusional and obsessive ideas;
• paranoid thoughts and excessive suspicion;
• self-perception disorder;
• hallucinations.

The prognosis of fur-like schizophrenia is disappointing, as it can turn into dementia for a person. But sometimes the disease takes on a sluggish form with mild symptoms that cause minor personality defects. As for the frequency of attacks, about a third of patients during the entire course of schizophrenia have only one exacerbation, while in other people the disease reminds of itself every 2-3 years. Properly selected treatment can reduce the number of attacks, eliminate negative manifestations and prevent further development of the disease.

Forms

There are 4 forms of fur-like schizophrenia, each of which has its own symptoms and features of development:

1. schizoaffective psychosis. Light form ailment, which is manifested by mood swings, periodic hysteria, hypochondria and senestopathic disorder. Periods of exacerbation rarely become manic and turn into a depressive form. In addition, schizoaffective psychosis rarely, unlike other forms of the disease, leads to visible personality changes.
2. paranoid schizophrenia. This form leads to strong changes in the patient's character: emotional reactions become mild, the range of interests is significantly narrowed, suspicion appears and paranoid ideas arise. The course of paranoid mental disorder can be paroxysmal or permanent. In rare cases, the disease leads to autism and the inability to live normally in society.
3. Periodic or circular form. In this case, the attacks are manic and depressive. They can appear without interruption or with a slight clarification of consciousness. As the disease progresses, the patient develops fantastic delusions, persecution mania, and catatonic disorders. Quite often there is stupid behavior and lethargy.
4. Malignant schizophrenia. This form of mental disorder manifests itself in adolescence, and the duration of attacks can exceed 1 year. Pronounced symptoms often alternate with short periods of "enlightenment". Throughout life, exacerbation attacks can occur 3-4 times. The main signs are: senestopathy and catatonia.

Treatment

Schizophrenia was previously thought to be chronic disease which cannot be cured. But through long-term research and study of pathology, it was possible to develop methods and medicines that allow eliminating symptoms and achieving long-term remission. Thus, patients suffering from fur-like schizophrenia were able to lead a normal life.

Treatment is based on the use of medications and psychotherapy. The placement of a patient in a hospital is a necessity only if his condition borders on critical. In most cases, antipsychotics are prescribed, which suppress the activity nervous system thus eliminating the symptoms of schizophrenia. The dosage of drugs for each patient is set individually.

Among the numerous forms of schizophrenia, the fur-like or paroxysmal-progredient form is today considered one of the most common. Fur coat schizophrenia combines two different types the course of a mental illness or a pathological process in the psyche, continuously current and passing through periods. Each of the new attacks of the disease brings new positive symptoms. And this is the main difference of this form from others, in which there is an aggravation of already existing disorders that manifest themselves earlier in the anamnesis.

Attack-like schizophrenia or fur-like - a disease in which subacute or acute attacks end with interictal "light" intervals. Each of the new attacks can pass without a trace, or leave behind changes in personality. Otherwise, these attacks of exacerbation are called "fur coats". FROM German language, the word "Schub" can be translated as - push or shift. Each new exacerbation of this form of schizophrenia leads to the fact that a "shift" occurs in the patient's psyche, showing a fairly visible, irreversible defect.

Clinical manifestations (stages) of paroxysmal-progressive fur-like schizophrenia

Negative personality changes typical for all types of schizophrenia appear in the initial period, and gradually, with each period, only continuously progress. This form of the disease is also characterized by such types of productive symptoms as:

• obsessive, delusional ideas;
• depersonalization - an upset self-perception, in which a person perceives all his actions as if from the outside and believes that he cannot control them;
• paranoid or overvalued ideas that ultimately lead to excessive suspicion and enemy-seeking, delusions of grandeur or persecutory delusions.

New - manifest and all the following symptoms, manifested during attacks, arise as qualitatively new manifestations, in relation to the general permanent symptoms of a mental disorder. Attacks of the disease of fur-like schizophrenia have the most diverse clinic. Among them, the most common are: depressive-hallucinatory, acute paranoid, catatonic-hebephrenic and acute paranoid, catatonic-depressive, depressive-obsessive. And this is only a part that is much wider in its manifestations.

Progredient schizophrenia is manifested by varying degrees of depth of emerging mental defects, which differ in their variations and degree of progression. In some situations, this fur-like form of schizophrenia can be close to the form of a malignant type, the result of which is schizophrenic dementia, and in others, the progressive tendencies are not very pronounced, and recurrent schizophrenia takes a sluggish form, leading to minor personality defects. In most cases, this form of schizophrenia is in an intermediate position, between these two variants of the course of the disease.

How frequent are seizures? Almost a third of those who are ill with this form of mental pathology can suffer only one exacerbation in all time, while in others the disease can remind of itself once every two or three years. But no matter how many times her attacks are repeated, they may not lead to pronounced personality changes with a schizophrenic defect characteristic of the disease.

The main forms of manifestation of the disease

According to its development and symptoms, paroxysmal-current schizophrenia is divided into the following variants or forms of the disease:

• schizoaffective disorder (schizoaffective psychosis, circular schizophrenia, periodic schizophrenia, recurrent schizophrenia);
• progredient schizophrenia, the attacks of which resemble the paranoid form of pathology;
• malignantschizophrenia With continuously growing personality defect.

schizoaffective psychosis- a form of the disease, the symptoms of which are manifested in cyclic mood swings, in which the cyclothymic component becomes more pronounced and psychotic symptoms are noted - mania, a depressive disorder. Between attacks of the disease, a condition may also appear - hypochondria, hysteria, senestopathic disorder. The schizophrenic defect is not very pronounced, in comparison with other types of this form of mental disorders. The intensity of symptoms with each attack is different and they are rarely manic in nature, turning into a depressive form.

Circular schizophrenia passes by single - depressive and manic attacks, or one type of flow follows the other continuously (double attacks). Clinical features diseases resemble attacks of manic-depressive psychosis, and the first attacks of this type of schizophrenia almost do not differ from it. With repeated attacks, ideas of persecution, fantastic delirium, catatonic disorders begin to develop. Gaiety can be replaced by stupid, foolish behavior, and the desire for work or some kind of occupation - disinhibition of drives.

Paroxysmal-progredient form or fur-like paranoid appearance disease and its clinic proceeds with significant changes in the nature of the patient. The circle of interests of a patient with paranoid schizophrenia becomes more and more narrow, and emotional reactions become weakly expressed, simplified. Also, he may show suspicion or express ideas of a paranoid nature.

The paranoid form of the disease proceeds continuously or paroxysmal. Between attacks, the patient has paranoid disorders, delirium persists, during periods of exacerbation, hallucinatory and delusional disorders can be observed, and at the time of enlightenment, the absence of psychotic symptoms. Attacks can last from one month to a year or more and are accompanied not only by delirium, but also by acute hallucinosis, paraphrenia, Kandinsky-Clerambault syndrome.

Despite a rather pronounced disorder in the patient's personality, he treats the attack uncritically, even when he has symptoms in the form of delusional ideas and fragmentary hallucinations during the period of remission. The paranoid form of schizophrenia can not only affect the character of a person, but also lead him to the inability to live in society, autism. Like schizoaffective psychosis, this type of schizophrenia is similar to a low-grade form of mental disorder.

Malignant fur-like form of the disease most often begins in early adolescence. That is why it is called malignant juvenile schizophrenia. Its periods of exacerbation are very long and can last from one year or longer. Vivid symptoms of the psychotic type alternate with short, "light" periods. During the life of such attacks can be from three to four. Each time, the period of remission is reduced and the progression of the disease can develop into a continuous-current stage. It is rather difficult to treat malignant juvenile schizophrenia, since the disease is characterized by diverse and variable psychotic manifestations. Symptoms of the disease include senestopania, catatonia. Mental defects that appeared at the time of the attack persist in the patient and in their intervals. Children's fur-like schizophrenia most often also takes the form of malignant, with a continuously growing personality defect.

Classic bout of fur-like form of schizophrenia

A description of the development of attacks of recurrent schizophrenia can be done according to the following scheme:

• The initial stage of the disease passes with emotional disturbances, when the patient has periods of excellent mood, enthusiasm, and he wants to do some kind of activity. They alternate with sudden changes in mood, indifference to everything, inactivity and pronounced autonomic disorders.
• At the next stage - the person begins to rave. It seems to him that a film or a performance is going on around him, everyone around him is hired actors and someone is also directing his actions. In every spoken word, he is looking for a hidden meaning that is close to him. To this we can add the confidence that his thoughts are controlled and put into his head.
• A progressive disorder is complicated by antagonistic delusions, when the patient believes that all the people around him are divided into two camps - evil and good, who are fighting. He develops delusional and paranoid symptoms
• The peak of exacerbation of the disease is marked by catatonic and oneiroid disorders. The person does not respond to the appeal and freezes in one position. In such a situation, he has a clouding of consciousness of the oneiroid type and he sees absolutely fantastic visions.
• In a regressive state, the symptoms of the disease are again expressed in emotional disorders.

Attacks of the disease do not always pass in this sequence. Their development may end at any of these stages, and subsequent ones will appear in very short episodes in comparison with the main symptomatology. Such an attack lasts from several days to a week (short period) or several months.

Features of the disease

According to studies, in most people suffering from fur-like schizophrenia, even during the period of remission, productive and chronic disorders continue to develop slowly. The depth of the developing mental defect and its degree of progression vary.

The features of the disease include mood swings that occur before the onset of the first attack and pass through the cyclotomic type. After a while, changes in mood become more and more noticeable, the patient falls into severe depression, he develops mania and manifests psychotic symptoms. In the intervals between attacks, the patient is characterized by hypochondriacal, senestopathic disorders, tantrums and obsession. This type of schizophrenia is characterized by slight changes in the human psyche, when compared with other types of pathologies.

Causes of the development of schizophrenia of the fur-like type

The pathological genesis of this type of disease is not fully understood. And the factors of its development include: a person's age and gender, his constitutional and genetic characteristics. severe forms schizophrenia is most often manifested in men, and women suffer from less pronounced forms of the progressive form. The malignant course of the disease is observed if it began in early adolescence.

Very often, specialists have to look for differences (differentiate) this type of disease, which is similar to reactive states, neuroses, symptomatic psychoses and psychopathy. To simplify the diagnosis, those changes in the personality that take place in the form of a gradual, stepwise increase help. The patient manifests disturbances in thinking, delusions of abstract or metaphysical content, mental automatism and symptoms of the catatonic-hebephrenic type.

Methods for the treatment of fur-like schizophrenia

Despite the fact that schizophrenia is a complex and completely unexplored disease, the time has passed when it was considered incurable. This pathology is chronic, but modern methods in psychology and medical preparations make it possible to reduce the general symptoms of the disease, increase the time of remission, reducing the development of positive symptoms and frequent mental moments that lead to mental defects. With the help of innovative treatment methods, patients can lead ordinary life, without restrictions and find their place in society. The success of treatment largely depends on an accurate diagnosis according to ICD-10 criteria.

The basis of drug treatment is the use of neuroleptic drugs. They help relieve the manifestations of psychosis, which is characteristic of this disease, reduce negative symptoms - the loss of the patient's personal qualities and do not allow to develop positive symptoms- delirium, hallucinations and obsessions. The intake of drugs should be systematic, and after these manifestations become weak, the patient is prescribed maintenance therapy or reduces the number of drugs already prescribed.

Attention! Any treatment of this type of disease and the appointment of drugs is carried out only by the attending physician, since their independent and uncontrolled reception can lead to general ill health and drug-induced parkinsonism.

Depending on the clinical picture and stages of the disease, as well as the psychotic state of a person, he is hospitalized or prescribed an inpatient treatment method. With a slow development of the process, drug treatment combined with psychotherapy and occupational therapy is used.

Among other forms, a fur coat occupies a significant place, it also has the name paroxysmal-progredient. This form is characterized by the occurrence of acute or subacute seizures, clearly separated by interictal intervals. Some exacerbations may pass without a trace, after others certain personality changes remain. With a variety of seizures called fur coats (translated from German as “shift”), it is noted that after such seizures, irreversible changes occur in the patient’s psyche, leaving mental defects of varying severity. Fur coat schizophrenia has three variants. This is a paroxysmal-progressive type, close to paranoid schizophrenia, as well as malignant and schizoaffective types.

In malignant fur-like schizophrenia, the onset of the first attack falls on adolescence. This form is characterized by the presence of prolonged attacks, sometimes they last a year or even more. While interictal intervals tend to decrease. Often, over time, the disease becomes completely continuous. In fur-like malignant schizophrenia, psychotic symptoms are quite variable and very diverse. Both catatonic disorders and senestopathies can be manifested. With the onset of remissions, a defect in the psyche is revealed, which is always pronounced.

With paranoid fur-like schizophrenia, clinical manifestations do not occur immediately, they may be preceded by various personality changes. A person’s circle of interests narrows, emotional reactions become flatter, besides, suspicion is constantly growing, personal ideas arise, and so on. With this form of fur-like schizophrenia, the course of the disease develops in two variants. It can be a continuous flow, when the interictal period is marked by the onset of delirium, paranoid disorders, they are the background for the development of acute psychotic attacks. If separate attacks occur, then their manifestation is expressed by the presence of hallucinatory and. There are no psychotic symptoms in the interictal period.

Attacks of paranoid fur-like schizophrenia can have a different duration, from several weeks to several years. Their number starts from three or more. Features of the clinical picture of the attack are due to the form of the disease. In this case, it can be delusional, as well as delusional-hallucinatory. Often there is interpretive delirium, paraphrenia, acute, Kandinsky-Clerambault syndrome. During the interictal interval, residual psychotic symptoms are preserved, and the patient develops delusional ideas, fragmentary. Personality Disorders are expressed in different ways, sometimes they are insignificant, but it happens that pronounced autism occurs.

Studies have shown that in a certain proportion of patients diagnosed with fur-like schizophrenia, chronic and productive disorders continue to slowly progress in the intervals between attacks. At the same time, the depth of the emerging mental defect and the degree of progression vary significantly. There are many cases when fur-like schizophrenia approaches a malignant course, that is, the disease comes to an end state, expressed in schizophrenic dementia. There are also examples when progredient tendencies are weakly expressed, and the disease is close to sluggish schizophrenia. In this case, the patient has a shallow personality defect. But in most cases, fur-like schizophrenia is in an intermediate position between these extremes.

If we talk about the features of schizoaffective fur-like schizophrenia, then before the onset of the first attack, mood swings are observed that occur according to the type. After a certain time, mood changes become more noticeable, the patient develops depression, sometimes mania, psychotic symptoms are observed. During the interictal period, this form of schizophrenia is characterized by obsessions, senestopathic, hypochondriacal, hysterical disorders. Also, schizoaffective schizophrenia is characterized by less personality changes when compared with other forms. Sometimes a mental defect is more noticeable if psychotic symptoms are predominant during an attack.

The pathogenesis of fur-like schizophrenia has not yet been sufficiently studied. A significant factor is the constitutional and genetic characteristics, age of patients, gender. As a rule, men suffer from more severe forms of the disease, while women have less progressive forms. If fur-like schizophrenia began in adolescence, then it has a more malignant course. Often there is a need to differentiate fur-like schizophrenia from various

Schizophrenia is the queen of mental illness, a severe mental illness with really crazy manifestations.

Synonyms: literally split mind (schizo, before it was schizo from "schism"- splitting); premature/precocious dementia, "dementia præcox"; Escekha, Bleuler's disease; "schizophrenia", "SCH".

Dopamine Shiz

Previously, the theory of schizophrenia associated with an increase in the concentration of dopamine in the brain developed quite intensively. It appeared when it became known that the main effect of antipsychotics is the blocking of dopamine receptors, which means that dopamine is increased in schizophrenics. They began to dig further, and suggested a connection between such facts: dopamine is part of the reward system (gives a feeling of pleasure), in the brain of a patient with schizophrenia elevated level dopamine and the fact that we can voluntarily increase it with just thoughts - like pleasant memories or anxious anticipation of something good.

And it is precisely to increase the level of dopamine that almost all drugs are aimed. It turns out that schizophrenics are dopamine self-addicts? Psychic car addiction without unnecessary intermediaries in the form of substances?

However, new (atypical) antipsychotics have much less effect on dopamine receptors, and schizophrenic delirium is still stopped, alas. It was here that the theory suffered some collapse.

The disease includes emotional disorders, thought disorders and the resulting inappropriate behavior.
Each type of shiza is beautiful in its own way, but any without treatment leads the patient to the state of a cactus in a pot, which is not at all funny. Patients not only lose the desire / need for any interactions, but generally lie motionless, occupied only with experiences in their heads, which by this moment are a terrible vinaigrette, from which anyone would go crazy.
At this stage, schizophrenia loses all charm and turns the patient into a punishment for himself and others as well. And most people consider shiza to be a stereotypical “split personality”, which is fundamentally wrong, since the psyche itself bifurcates here, the personality remains alone.

There are also light versions that are not schizophrenia: schizoid personality disorder and schizoid character accentuation, which are almost 5 times more in the population than 2% of true schizophrenics among the population.

deficit ary symptomatology - the gradual disappearance of the mental abilities that are normal for most people, first emotional, and later related to the rest of the mind. The loss of emotions and callousness is followed by a decrease in social activity, negligence and hygienic neglect, and then the disappearance of enthusiasm / initiative / purposefulness in general.

Productive symptoms - you acquire new, very unusual psychological abilities: delusions and hallucinations.
Delusional ideas are false beliefs (that is, not inherent in the corresponding socio-cultural stratum) that the patient defends with titanic firmness, regardless of any rational arguments and facts. Criticism to this is also completely absent.
Hallucinations are an image in the mind of the patient, which cannot be distinguished from the real; most often these are voices, even more often - voices in the head (these are pseudo hallucinations) discussing the patient's actions. For an outside observer, glitches can manifest as listening to the patient in apparent silence, sudden whispering, plugging the ears, laughter for no reason.

Schizophrenics do not have “friends” whom they see, hear, hold hands and occasionally hug. There are voices, but they are either secret agents or aliens or something generally indefinite, because with pseudo hallucinations. A person will not be able to describe what the one who owns the voice looks like, because it's all in the head: the schizophrenic does not see or hear them, the voices appear in the head as if these are thoughts that someone from the outside put in the head.

A true hallucination occurs outside the head, a person hears it with his ears, sees with his eyes, can describe and show where it is or where the sound comes from, because he considers the stimulus to be really present in the external environment. Like an alcoholic squirrel: against the background of delirium, patterns on the wallpaper or carpet come to life, snakes, insects or devils begin to crawl, and a person sees them, looks in their direction with horror and points with a finger.
Classical for schizophrenia, the Kandinsky-Clerambault syndrome involves pseudohallucinations: a visual image or voice is as if part of thoughts, and is not felt by the eyes or ears, there is no system “I saw it with my eyes or heard it with my ears”, it is impossible to understand the nature of its origin. From here, the legs grow that the hallucinatory voices in the head are the cosmic mind, aliens, invisible rays, and so on, which allegedly can communicate with the human brain directly and contactlessly “put” thoughts into it. Outside the acute phase, a pseudohallucination can become a “friend”, but a person will talk to her in the head, and not as with a person next to her.

And this is one of the diagnostic keys: if a person himself does not explicitly talk about voices, it is necessary to find out the reasons for his actions. Willful decision or someone told him what to do? Although voices can order a person not to talk about them, for example, under the threat of something or pressing on some secret, they say, he is the chosen one: a person is not completely in control of himself, he can follow the orders of voices.

Diagnostics

Uncle psychiatrist will consider you as belonging to the order of the mournful head, if there is:

However, the diagnosis of schizophrenia remains one of the most difficult tasks in psychiatry to this day.

Since there are no established exact factors that predispose to the development of the disease, then, in principle, shizu can provoke itself and quite normal person if you try hard.
To do this, you need to go more into the astral plane and other esotericism, seek the truth and meaning of life, engage deeply in religion / philosophy, spiritual self-development, etc. - all those harmless things that, with excessive zeal, lead not to the opening of the third eye, but to overloading the brain with too abstract information. If suddenly a small pathological loophole was found in the head that would not allow to dump all this garbage from the RAM, then at some point a person runs the risk of getting to know a new voice in his head or suddenly begins to notice that he is quite the “Chosen One”.

Types of the course of schizophrenia

Types of schizophrenia

According to different classifications, from 4 to 22 types of schizophrenia are distinguished, but recently there has been a clear trend towards combining them into a classification of the minimum size. According to DSM, five types are obtained:

• Paranoid - the most popular option, includes paranoid, paraphrenic or paranoid delusions in the form of delusions of persecution, invention, as well as hallucinations; often there are no negative symptoms, thinking is not affected up to a certain point, but there is a classic Kandinsky-Clerambault syndrome.
• Catatonic - shows itself alternating with opposite psychomotor problems: sticking (catalepsy) or wild excitement. Sticking with dumbness, stupor and abnormal postures, it can be oneiroid and lucid, one worse than the other. Oneiroid is a state of a long stay "in two worlds": in the usual and in its parallel with terrible content like scenes of hell, war and other terrible and unknown things; and lucid - without cartoons, just emptiness in the head and flows more unfavorably. Without treatment, patients can freeze for months in one position, watching their jokes.

• Hebephrenic / hebephrenic - at first simply as foolishness and impulsiveness, and then the rapid erasure of thinking itself to a complete pe. Schizophasia included. Also called disorganized type of schizophrenia.
• Undifferentiated - when more than one of the listed types is clearly manifested in a patient, it is the most severe, it starts very early, but it is also rare.
• After successful treatment, which left an indelible mark on the patient's soul in the form of residual delirium or negative symptoms (although these are manifestations of the disease they inherited there), and without repeated psychoses after a long time, a diagnosis is made. residual schizophrenia

MKB adds a couple more:

• Simple - everything is simple: it starts early, the course is malignant, there are no remissions, it is poorly treated with drugs. It is difficult to diagnose, because it has a little from all other types of schis, but negative symptoms predominate.
• Post-schizophrenic depression.

Ideally, no syndrome manifests itself clearly, each schizophrenic has a little of each of this species, but more often with a predominance of one of them. Previously, neurosis-like, febrile (hypertoxic), pfropfschizophrenia (against the background of oligophrenia) were separately distinguished; if the doctor himself has no doubts about the diagnosis of "schizophrenia", however, until it is possible to isolate the leading symptom in a particular patient, then the diagnosis "F20.9 - schizophrenia is questionable, unspecified" can be made.

Unfortunately (perhaps), individual symptoms do not mean anything at all, and people with any personality accentuations may have them. But when something begins to qualitatively grow/improve, a person dramatically changes his lifestyle or begins to alert others, then welcome to a psychiatrist.
However, at this stage, you will no longer believe in all this text, so infa for the neighbors of all sorts of weirdos.

A crowd of ordinary people, due to limitations in knowledge, will never in their life recognize a patient on early stage schizophrenia, attributing everything to eccentricity and foolishness. Even if a person himself assumes that something is wrong with his head, then in 99% of cases, others will offer him not to toil with garbage and not to invent diseases for himself.

And what will happen next? After some time, with an increase in all symptoms, without treatment, a person will fall into a deep emotional-volitional defect - into that early dementia: the patient simply lies for days on end, not wanting anything, his brain is completely loaded with delirium and hallucinations, there is not even a need for food.

Are you a patient?

Are you comfortable alone and want to hide from everyone? Few friends and enraged relatives? Do people around you think that you care too much? And the voices from the darkness or from the head do not disturb? Yeah, there is, but do not bother? It won't go away on its own, mate. You can take the test from the ISP from Tyumen, but this is too approximate.

“Is there a chance to make an excursion to the mental hospital?” Dear, everyone has it. But some have more. Schizophrenia at the social stage can show itself as:

• Frequent looking into your soul and self-digging there, reflection. Without other symptoms, alas, it does not mean anything, otherwise half the world can be written down as predisposed.
• Increased faith in astral things, religion, the search for the right worldview (not counting single women of Balzac age, this is the norm for them).
• Strange hobbies and hobbies, up to picking up a collection of shit.
• Reduced emotions - such as watching animals suffer became less unpleasant, or "no one and nothing matters."
• Obsessive ideas, rituals like cleansing the chakras and uncontrollable spitting over the shoulder (more typical for obsessive-compulsive disorder, but still).
• Schizis in the style of "The Demon of Contradiction" by Allan Poe.
• Overvalued ideas, delusions of reformism with drawing schemes and plans for changing the structure of the world, carried away to the point of lack of appetite, etc., in the style of Pinky and Brain's plans for the reality of incarnation.
• Too lazy to breathe, lie down and move - abulia, like depression and apathy at once.
• Improving the skill to come up with neologisms, especially if they are completely incomprehensible to anyone, for example, the Jabberwock or the logical chain “firewood → grass → lawn”, which has become “pricked a dragon for winter”, etc.
• Empty chatter in a philosophical style about some simple and ordinary things, i.e. philosophizing without a reason, “reasoning”.
• Dreams and fantasies do not just seem more vivid and pleasant than the surrounding reality, but give rise to a strong desire to go there and not return.
• Count slowly to 5. Stop at three. Out? (If it doesn't work: Again. Still doesn't work? Then there is predisposition. )
• The notorious swing in the head is to spin the swing in the imagination with the “sun” and stop after 10 revolutions. Then back. They can fly by from time to time, “out of stubbornness”, “to spite you”, always making more than 10 revolutions, 20 revolutions, become a single bright rotating circle ... Welcome.
• Thoughts are thought against desire, they float on their own, you can’t switch from them. They can even sound so loud that those around them are about to hear them. Or they suddenly shut up sharply and there is complete silence in their head, like a rolling ball.
• Suddenly, somehow I didn’t want to feel something, but it doesn’t work, or something is done by itself, to the point that my legs walk by themselves.
• Everything that happens around is related to you, although the surrounding people for some reason do not understand this (idiots!); everywhere there is a deep meaning for the accomplishment of great ideas according to an ancient plan.
• Search for conspiracies in every pebble on the road: "psychotronic weapons are to blame for everything, Jews and Anglo-Saxons want me dead, meat-eaters are destroying the planet, HIV does not exist."
• The feeling of "going into the astral plane", as if the reality around suddenly became a little fake, like in a dream. It should be distinguished from derealization, which is common for VVDshnikov and other tender, vulnerable personalities who have no other manifestations.
• Unwillingness to admit that any of the above can be a real problem, complete intransigence, steel and concrete: if the logic does not correspond to delirium, to hell with such logic.
• A person who is authentically ill with schizophrenia looks at you as if he were his own. Yes, yes, it is in some way true that "a fool sees a fool from afar."

It should be understood that even all at once from this ≠ diagnosis, there are normal diagnostic criteria, which are of little interest to an ordinary person, and if necessary, they can always be googled. The above points are only a means to make the person understand how a patient with schizophrenia can think.

After a successful diagnosis, do not forget to visit a good neurologist, since it often happens that some of the miracles described can be provoked by some kind of organic pathology in the brain, which the psychiatrist will not see in life, and the neurologist can easily clarify by some barely noticeable sign. And not all psychiatrists know how to correct the effect of their pills.

With positive symptoms, of course, it is more difficult, but long-term reluctance to do everything or a decrease in the emotional background without depression - that is, something that Haloperidol alone cannot fight, may well be a neurological problem that you can get rid of.

Prevention

And for people with a rich imagination and hypochondria who just want to get sick with something, I recommend that you familiarize yourself with the brochure: Understanding Schizophrenia for Patients and Their Relatives.

Coated schizophrenia wikipedia

Coated schizophrenia wikipedia

Attack-like progredient (fur-like) schizophrenia

Coat-shaped schizophrenia is the most common of all forms of schizophrenia. The essence of the paroxysmal-progressive type of schizophrenia dynamics is the combination of two variants of the course - continuous and periodic.

In the initial period, negative personality changes typical of schizophrenia appear and gradually progress, and in some cases productive symptoms in the form of obsessions, depersonalization, overvalued or paranoid ideas. Then there are manifest and subsequent attacks in the form of transient, qualitatively new disorders in relation to the permanent symptomatology.

Attacks of fur-like schizophrenia are distinguished by a special clinical diversity. There are acute paranoid, acute paranoid, catatonic-gebephrenic, catatonic-depressive, depressive-hallucinatory, depressive-obsessive and other attacks. Each attack is accompanied by a personality shift, a deepening of negative personality changes and an increase in permanent productive disorders.

In some patients with fur-like schizophrenia, negative personality changes and chronic productive disorders progress slowly even in the intervals between attacks.

The degree of progression of fur-like schizophrenia, the depth of the emerging mental defect vary significantly. In some cases, fur-like schizophrenia is close to a malignant form and eventually ends in a final state (schizophrenic dementia), in others, due to the low severity of progressive tendencies, it is close to sluggish schizophrenia and leads to a shallow personality defect. Most cases of fur-like schizophrenia are intermediate between these extremes.

Special forms of schizophrenia. The essence of paranoid schizophrenia lies in the emergence and long-term existence of systematized delirium. In some patients, delirium develops acutely - like insight, in others gradually - on the basis of previous overvalued ideas. Clinical manifestations paranoid schizophrenia have significant similarities with the paranoid stage of paranoid schizophrenia described above.

The difference is that in paranoid schizophrenia, the picture of the disease throughout its entire length is limited to systematized delirium. The transition of the paranoid syndrome to the paranoid does not occur.

Paranoid schizophrenia is manifested by delusions of persecution, physical deficiency, hypochondriacal, inventive, reformist, religious, litigious delusions. In many patients, delirium is monothematic.

In the most severe cases, at the height of the attack, the oneiric stupefaction of consciousness is replaced by amental-like with deep disorientation, incoherent speech and monotonous motor excitation, limited to the bed. Perhaps the appearance of choreiform hyperkinesis.

Usually a remission occurs after a few weeks. In rare cases, death is possible. Sometimes the patient suffers several bouts of febrile schizophrenia.

Treatment and rehabilitation. In the treatment of patients with schizophrenia, almost all methods of biological therapy and most methods of psychotherapy are used.

biological therapy. The leading place in the biological treatment of schizophrenia belongs to psychopharmacotherapy. The main classes of psychotropic drugs used are antipsychotics and antidepressants. Drugs of other classes are used less frequently.

In malignant schizophrenia, high doses of the most powerful neuroleptics with a general antipsychotic effect are prescribed to stop the progression of the disease and mitigate its manifestations. However, therapy is usually not effective enough.

In paranoid schizophrenia, neuroleptics-antipsychotics (haloperidol, triftazin, rispolept, azaleptin, fluanxol) are used. After improvement of the condition, partial reduction of hallucinatory-delusional disorders, long-term (usually many years) maintenance therapy is carried out, often with the same drugs, but in smaller doses. Often, injectable deposited forms of neuroleptics are used (haloperidol decanoate, moditen-depot, fluanxol-depot). In the first 2 years after the development of hallucinatory-paranoid disorders, it is possible to conduct insulin-comatose therapy (with the consent of the patient or his relatives). Paranoid syndrome and chronic verbal hallucinosis are especially resistant to therapy.

Prolonged use of neuroleptics often leads to intolerance to patients with drugs, mainly in the form of neurological side effects and complications (neurolepsy, tardive dyskinesia). In these cases, antipsychotics should be used that do not cause or almost do not cause side neurological effects (leponex, rispolept, ziprexa).

In recurrent and paroxysmal-progredient schizophrenia, the choice of drugs is determined by the syndromic structure of seizures. Patients with depressive attacks are shown the most active antidepressants (amitriptyline, melipramine, anafranil), which are usually combined with low doses of antipsychotics that do not have a depressogenic effect (triftazine, etaperazine, rispolept).

In patients with paranoid depressive states, the same combination of drugs is used, but the doses of neuroleptics should be significant or high. If the above antidepressants are ineffective, Zoloft, Paxil or other thymoanaleptics from the group of selective serotonin reuptake inhibitors can be prescribed. Manic episodes are most often treated with haloperidol in combination with hydroxybutyrate or lithium carbonate. The same drugs are used in patients with manic-delusional states. In case of oneiroid catatonia, antipsychotics with an inhibitory effect are prescribed. In case of ineffectiveness of neuroleptics, electroconvulsive therapy is indicated.

In patients with psychomotor agitation, injectable antipsychotics with inhibitory properties (clopixol-acufaz, chlorpromazine, tizercin, haloperidol, topral) are used in the structure of various attacks.

Treatment of febrile schizophrenia, if possible, is carried out in intensive care units. Apply active detoxification, including hemosorption, hemodez, as well as symptomatic therapy and sometimes chlorpromazine. In cases of special severity of the condition (according to vital indications), ECT is performed.

In interictal intervals, outpatient therapy is carried out to stabilize remission and prevent new attacks. Often the same drugs are used as during attacks, but in smaller doses. With a high specific gravity affective disorders in the structure of seizures, normotimic drugs (lithium carbonate, finlepsin, sodium valproate) are prescribed for a long time.

Drug treatment of indolent schizophrenia is carried out with a combination of small or medium doses of antipsychotics, antipsychotics or neuroleptics with more mild action(sonapaks, neuleptil) and antidepressants.

In many cases, tranquilizers are also prescribed. In sluggish schizophrenia with a predominance of phobias and obsessions, tranquilizers are prescribed - sedatives (alprazolam, phenazepam, lorazepam, Relanium), high doses of antidepressants and moderate doses of antipsychotics.

Psychotherapy. Psychotherapy plays an important role in the treatment of patients with schizophrenia.

In the presence of severe psychotic symptoms (paranoid schizophrenia, psychotic attacks of recurrent and fur-like schizophrenia), patients need the participation, encouragement, and support of a doctor. Demonstration of a skeptical attitude towards delusional judgments, attempts to refute them are unproductive, they only lead to a violation of contact between the doctor and the patient. Explanations are justified which statements and forms of behavior of the patient are assessed by others as painful. Family psychotherapy is useful (psychotherapeutic work with the patient's relatives, aimed at forming the right attitude towards his painful statements and behavior, at eliminating intra-family conflicts that often arise as a result of the painfully changed behavior of a family member).

At a non-psychotic level of disorders (remission of paroxysmal schizophrenia, sluggish schizophrenia), systematic psychotherapy, mainly rational (cognitive) and behavioral, is indicated.

Methods of stimulating, distracting psychotherapy are used. Special techniques are used to eliminate certain disorders, for example, functional training for transport phobias.

Methods such as hypnosuggestive psychotherapy, autogenic training, psychoanalytic psychotherapy are used in patients with schizophrenia to a limited extent due to the risk of worsening the condition of patients and low efficiency.

Social rehabilitation is indicated for almost all patients with schizophrenia (with the exception of patients with intact working capacity and sufficient social adaptation).

Even with chronic psychotic symptoms, a deep personality defect with complete disability, the systematic use of social rehabilitation measures in combination with pharmaco- and psychotherapy allows a number of patients to partially restore basic self-service skills, involve patients in simple labor activities.

In such cases, the process of social rehabilitation is multi-stage. It often begins during the period of hospitalization with the involvement of patients in simple household tasks.

Further, patients systematically perform simple work in the department, and then in the medical and labor workshops at the hospital. After discharge from the hospital, they continue to work in medical and labor workshops, moving on to more and more complex operations.

With a successful rehabilitation process, it is possible to return to work that does not require high qualifications in special enterprises for the mentally ill or even in general production conditions. For this, patients have to be taught new labor skills that are accessible according to their mental state.

With sluggish schizophrenia, recurrent schizophrenia with rare attacks, properly organized social rehabilitation in combination with treatment often allows you to maintain or restore pre-painful professional, family and social status.

hyperthermia.in.ua

47. Coat-shaped form of schizophrenia, special forms of schizophrenia

47. Fur-like form of schizophrenia, special forms schizophrenia

Attack-like progredient (fur-like) schizophrenia.

Fur coat schizophrenia is the most common among all forms of schizophrenia. The essence of the paroxysmal-progressive type of schizophrenia dynamics is the combination of two variants of the course - continuous and periodic.

Attacks of fur-like schizophrenia are distinguished by a special clinical diversity. There are acute paranoid, acute paranoid, catatonic-gebephrenic, catatonic-depressive, depressive-hallucinatory, depressive-obsessive and other attacks.

Special forms of schizophrenia. The essence of paranoid schizophrenia lies in the emergence and long-term existence of systematized delirium. In some patients, delirium develops acutely - like insight, in others gradually - on the basis of previous overvalued ideas. The clinical manifestations of paranoid schizophrenia bear considerable resemblance to the paranoid stage of paranoid schizophrenia described above.

Paranoid schizophrenia is manifested by delusions of persecution, physical deficiency, hypochondriacal, inventive, reformist, religious, litigious delusions.

Pathological ideas progress extremely slowly. Decades later, the delusion may undergo a partial reverse development, remaining in the form of residual or encapsulated (largely irrelevant) delusional ideas. Typical for schizophrenia negative personality changes can not always be identified.

Febrile schizophrenia (fatal catatonia, hypertoxic schizophrenia) is called acute attacks of oneiroid catatonia in the framework of recurrent and paroxysmal-progressive schizophrenia, accompanied by hyperthermia and other somatic disorders. Along with catatonia in the form of stupor or excitation, there are rises in body temperature up to 38–40 ° C lasting up to 2 weeks. The temperature curve does not correspond to typical temperature fluctuations during somatic and infectious diseases. Dry mucous membranes, hyperemia of the skin, bruising, sometimes bullous rashes, ulceration of the skin are noted.

Coat-like schizophrenia is a form of schizophrenia in which acute and subacute attacks alternate with periods of remission. This form is called paroxysmal-progredient. During relapses, a person can be dangerous to himself and society.

What is fur coat schizophrenia?

This disease can negatively affect a person's personality, causing changes in his character, but in some cases it may not lead to any changes. Such attacks of the disease are called fur coats. "Shub" in German means "shift". This is one of the most common forms of the disease.

This disease can proceed in different ways depending on its form. In the circular form of schizophrenia, the attacks are manic-depressive in nature and can occur continuously or with short periods of calm.

There are signs by which this disease can be detected:

• fantastic nonsense;
• obsessive ideas;
• impaired thinking;
• paranoid thoughts;
• suspicion;
• defects in the perception of the surrounding world and one's own personality;
• hallucinations.

It may seem to a person that other people read his thoughts, that they exchange glances and whisper, etc. He may show distrust and aggression. Also, there can be obvious contradictions in his behavior and conversation.

Classification of forms of fur-like schizophrenia

There are 4 forms of fur coat schizophrenia. Each individual form has its own manifestations and features of the flow:

1. schizoaffective psychosis. The mildest type, accompanied by frequent mood changes, periods of hypochondria and hysteria. Relapses in rare cases are manic-depressive in nature. This type of fur coat schizophrenia infrequently leads to pronounced personality changes.
2. paranoid schizophrenia. This type of pathology causes dramatic changes in the behavior and character of the patient: his reactions to external stimuli become weak, interest in life and the world around him disappears, mistrust and persecution mania arise. This form of the disease can manifest itself in the form of attacks or be permanent. In some cases, a continuous pathological course can lead to the development of autism, which limits the ability of a person to interact with other people.
3. Periodic form (circular). Seizures are pronounced. With the progression of the disease, the patient may experience catatonic and delusional disorders, a feeling of persecution, etc. The processes of inhibition begin to dominate over excitation. The patient's behavior appears irrational and meaningless.
4. malignant form. The malignant nature of the course of the disease occurs during puberty. Seizures can last more than a year. Severe clinical symptoms may be followed by short periods of remission. Throughout the life span, relapses occur up to 4 times. The main manifestations of the disease are catatonia and senestopathy.

Symptoms and course of the disease

Each stage has its own symptoms depending on the phase of the disease.

Signs of the initial phase (remission):

1. Inconstancy of emotional reactions. The mood can change dramatically from cheerful and active to depressive and depressed. Such changes occur cyclically, that is, they alternate.
2. Hypochondria: a person begins to diagnose himself with various severe (fatal) diseases.
3. Irritability, hysteria, discontent.
4. Senestopathic disorders (impaired sensations). The patient begins to feel unpleasant and painful sensations of unknown origin (burning, cramps, colic, etc.).

The development of the disease is accompanied by more severe changes in the behavior and mood of the patient: there are separate attacks of irritability and aggression, followed by a depressive state.




The exacerbation of the disease manifests itself in the following forms:

• the occurrence of obsessive states, manias (greatness, persecution, threat and danger);
• violation of self-perception - the patient ceases to perceive himself as a whole person, can observe, as if from the outside, his behavior and thoughts, loses control over himself;
• catatonic symptoms - psychomotor disorders, which include stupor and obsessive motor activity;
• hallucinations and delusions of various nature and scale.

The clinical picture of the disease may be broader, and exacerbations may have varying degrees gravity. As the disease progresses, new pathological changes the personality of the mentally ill.

In women, in most cases, schizophrenia is characterized by a milder course, which strangers cannot always notice. After a period of exacerbation, women recover more easily and establish activity in various areas of life.

Treatment and prognosis

Predicting the outcome of the disease is quite difficult, because it depends on the form and stage of schizophrenia, as well as on the characteristics of its course. In some cases, this disease can lead to dementia. In the presence of a sluggish form with ill-defined symptoms, personality defects may be minor.

Schizophrenia is classified as a disease chronic course which is not treatable. In the course of the studies, it was found that its manifestations can be effectively dealt with with the help of medicines and various methods.

Thus, a long period of remission and elimination of symptoms can be achieved. Thanks to this, patients with fur coat schizophrenia can lead a normal life.

Treatment is based on medications and psychotherapy sessions. It is not always necessary to hospitalize the patient. If his condition is not critical and he does not pose a threat to society, then you can limit yourself to home treatment, which includes taking antipsychotic drugs. They suppress the activity of the central nervous system, preventing the manifestation of signs of the disease. The dosage is prescribed by the attending physician on an individual basis.

Fur coat (circular) schizophrenia involves lifelong medication. During periods of remission, lighter drugs are prescribed. It must also be taken into account that the constant use of medications can lead to negative consequences:

• Parkinson's disease;
• tremor of the limbs;
• muscle spasms.

It is advisable to conduct psychotherapy sessions in the presence of relatives of the patient, so that they have the opportunity to learn how to support him during exacerbations.