The main signs of psychopathy are: Lack of deep feelings

When we encounter a person whose behavior does not correspond to generally accepted human rules, what do we call it? That's right, a psychopath. Who are psychopaths and how are they dangerous for society as a whole and each person individually? Is it possible to cure psychopathy and is it worth doing? Why do psychopaths act differently in a given situation? ordinary people? Attempts to answer these questions are presented in this article.

Definition of Psychopathy

Psychopathy is a character pathology that is persistent and not typical of healthy people. Psychopathy appears from birth or in the early years of life and refers to mental personality disorders. Psychopathy accompanies a person throughout his life and is characterized by overly expressed character traits on the one hand and underdevelopment of other traits. For example, a person is extremely irritable and excitable, but his behavioral control is weakened. Or, the individual has inflated aspirations and egocentrism, while there is no adequate assessment of their capabilities. Psychopathy is not a mental illness, but it is not a normal variant either. mental health personality, that is, this state refers to borderline states.

In society, similar character traits are often observed in healthy people, but they are balanced, and behavior is within the framework of social norms.

A distinctive feature of character psychopathy is the lack of dynamics throughout life, that is, the psychopath’s condition does not worsen, but does not improve over time.

According to statistics, psychopathy occurs in 1–2% of all people, and its incidence increases to 25% in criminal circles. Despite the fact that almost all criminals (maniacs, murderers) are essentially psychopaths, this does not mean that all psychopaths, without exception, are criminals.

Accentuation of character

Accentuations of character are often mistaken for psychopathy, although accentuations and psychopathy are completely different things.

If psychopathy refers to borderline mental states, then accentuation is just a variant of the norm, characterized by the fact that some of a person’s personality traits are too pronounced, while the general makeup of a person is within the normal range, which looks like disharmony. Accentuation of character is quite capable of provoking various mental pathology(psychosis, neurosis), despite the fact that this condition in itself is not a pathology.

For accentuation to occur, certain conditions are necessary, for example, defects in upbringing, a specific social environment or mental trauma.

Causes of psychopathy

To date, psychopathy has not been sufficiently studied, so it is impossible to identify the main factor that contributes to its appearance. In fact, this condition is multifactorial, but there is always a trigger factor that affects the character to a greater extent.

Certain characterological traits or their pathology are programmed genetically, just like the external features of a person (eye and hair color, shape of ears and nose, etc.). And although each of us changes somewhat throughout our lives, develops, and tries to coexist in one or another group of people, many of the qualities of our character are already laid down at the stage of intrauterine existence.

So, basically, the causes of psychopathy are congenital, that is, a person is born with a certain type of character or its anomaly. But various unfavorable situations also play a role in the occurrence of these conditions, in which abnormal behavior is reinforced, which aggravates maladjustment. For example, a child grew up in an orphanage, or later a person was imprisoned or captured.

Severe somatic diseases, for example, brain damage, can also provoke a pathological change in character. This is facilitated by:

• bad ecology;
• brain infections (encephalitis, meningitis);
• head injuries;
• brain tumors;
• spicy and chronic intoxication(poisoning with poisons, nicotine, alcohol, drugs);
• high ionizing radiation.

Due to the action of these factors, painful and almost irreversible changes occur in the brain and nervous system as a whole, which causes severe mental changes.

It is not excluded, as already indicated, the hereditary transmission of psychopathy (if parents have a pathological character, then it is possible that the same will happen in their children).

Predisposing factors in childhood

The following factors contribute to the development of psychopathy in children:

• “pulling” a child out of the family (long stay in a sanatorium, for example, for tuberculosis or placing him in a boarding school);
• overprotection, contributing to the development of painful conceit;
• insufficient attention to one’s own children or its complete absence;
• “moving” the adopted child to the side upon the appearance of one’s own or the “Cinderella” syndrome;
• the development of an inferiority complex in a child as a result of increased parental attention to another child;
• cruel parenting of a child/children;
• the “idol” phenomenon - when a child is sensitive to caring for other children in the family, because he considers himself “the best.”

Classification of psychopathy

There are several classifications of these conditions. The following types of psychopathy are distinguished:

• nuclear psychopathy, which is determined by the constitutional type of a person and is genetically determined;
• marginal psychopathies are determined by the environment where the child grows and develops as a person (they play a role social reasons: parents’ drunkenness, orphanage, etc.);
• organic psychopathy is caused by brain damage, for example, trauma and infection of the brain, including intrauterine and birth.

According to another classification, in which the predominance of excitation or inhibition processes in the cerebral cortex is decisive, the following types of psychopathy are distinguished:

1. Excitable psychopathy:
   • explosive;
   • epileptoid;
   • paranoid;
   • hysterical;
   • unstable;
   • hyperthymic.
2. Inhibited psychopathy
   • psychasthenic;
   • anancaste;
   • asthenic;
   • sensitive schizoid;
   • heboid or emotionally dull personality.

A separate column is mosaic psychopathy, which is characterized by signs of several types of these conditions, in another way – mixed psychopathy.

IN clinical practice Doctors use a classification of psychopathy according to the main clinical manifestations - forms, which include sexual psychopathy (sexual perversions and disorders).

Psychopathy is also divided according to severity:

• moderate or grade 1, characterized by pronounced compensation, and breakdowns occur only in certain situations;
• severe or 2nd degree, the slightest reason for a breakdown is enough, compensation is unstable, psychopaths are in constant conflict with others;
• severe or 3rd degree, even the slightest reason is not needed for a breakdown, psychopaths are completely maladjusted, unable to start a family, self-criticism is completely absent.

Clinical picture

This condition is characterized by a variety of symptoms, which are divided into groups depending on the form of psychopathy. Characteristics psychopathic individuals are:

Manipulating others

One of the leading symptoms of psychopathy is manipulation of loved ones. To achieve their goal, psychopaths use the entire range of possible influences (screams, Bad mood or health, blackmail and threats to commit suicide or disinherit).

Lack of empathy

Empathy is the ability of a person to empathize with a loved one, animal or plant. Psychopaths completely lack compassion and empathy; they are heartless, although they can understand the pain of others. From such individuals you are unlikely to get sympathy in any situation (death or illness of loved ones, street children or stray animals).

Deceit

Similar personalities are different pathological lies, telling “true” stories, and when they are caught in a lie, they categorically refuse everything told earlier.

Promiscuity in intimate relationships

Such people are also prone to sexual promiscuity. They easily cheat without feeling any remorse.

Lack of deep feelings

Psychopaths cannot experience deep feelings: deep fear, anxiety, attachment. Such people are completely incapable of loving anyone (human, animal).

Lack of remorse

A psychopath, even if his own guilt is obvious, will shift it onto another person. They do not repent, do not feel shame, never apologize and are not tormented by remorse.

Alcoholism/drug addiction

Such people often behave excessively or become drug addicts.

Men are psychopaths

Manifestations of psychopathy in men are observed much more often than in the opposite sex. Male psychopaths are incomparable pretenders and are distinguished by their hypocrisy. All feelings visible through the eyes of other people on the part of men who are psychopaths are just visible, since such people do not actually experience them, they simply “play” at them. In addition, men with psychopathy are excellent manipulators; relatives and colleagues suffer from communicating with them. Especially family and close women. Marriage to a psychopathic man is almost always a huge psychological trauma for a woman. Regarding the weaker sex similar men prone to physical and moral violence, they often cheat on women and humiliate them. Also, such men are characterized by immorality and coldness, which is why personal life male psychopaths are in emotional chaos.

Often, psychopathic men cannot succeed either in education or professionally, although this is not a mandatory rule. With strict control (by parents), psychopathic men adapt well in terms of careers. These are successful entrepreneurs, competent managers, and talented organizers.

Women are psychopaths

Psychopathy in women is much less common than in men, no matter what “advanced” individuals try to tell us. According to statistics for 1997, signs of psychopathy in women in prison were found in only 15% of prisoners, while the percentage of male prisoners who are psychopaths is much higher and amounts to 25 - 30. Women with psychopathy are characterized by less aggressiveness and cruelty compared to stronger sex. Based on the above statistics, they are much less likely to commit illegal acts in an affective state. However, female psychopaths are prone to kleptomania, alcoholism and dependence on psychotropic drugs, often wander and are characterized by sexual promiscuity. In family life, such women are scandalous, uncontrollable and “explosive.” The lives of female psychopaths are characterized by disharmony, they are easily “flamed” and either have difficulty or do not control their emotional outbursts at all, which can ultimately result in depression. Also, such women are distinguished by a tendency to melancholy and a love of “being sad and being sad.”

Women are psychopaths who are essentially egocentric; they live only indulging their own desires, being indifferent to social rules of behavior and to their relatives.

But there are also apathetic, withdrawn female psychopaths. In this case, representatives of the fair sex have significant complexes or a strong, even painful dependence. The behavior of such women - mothers - adversely affects their children, which leads to the formation of various borderline or pathological mental states in them.

Children are psychopaths

The initial manifestations of psychopathy in children appear at two to three years of age. But, as a rule, signs of psychopathy occur more often in adolescents. You can suspect a character pathology in a child if he lacks the ability to empathize and sympathize, the child does not repent for inappropriate behavior, but the leading sign is cruelty (in relation to other children or animals). IN adolescence there is a “failure to fit” into the standards of society, a desire to commit immoral acts, drink alcohol or take drugs, and break the law (theft, hooliganism). Such teenagers are often registered in the children's room of the police.

Distinctive signs of a child who is a psychopath:

• the child constantly fights, steals or damages other people’s property;
• violates parental restrictions;
• does not feel guilty for negative actions;
• indifferent to the feelings of people around him;
• does not study well and is indifferent to studies and grades;
• irresponsible, does not want to be responsible for anything;
• do not respond to threats of punishment;
• fearless, risky;
• egocentric.

Symptoms of various forms of psychopathy

Schizoid

People with this form of character disorder are withdrawn, their inner life predominates, they prefer loneliness, and instead of active communication they prefer to read, contemplate nature, and look at works of art. Such individuals lack spontaneity and impulsiveness. In addition, schizoids have either excessive sensitivity (hyperesthesia) or emotional coldness (anesthesia). Depending on the prevalence of one or another type of sensitivity, schizoids are divided into 2 types: sensitive (hyperesthetic) and expansive (cold, emotionally dull).

Sensitive schizoids include overly sensitive and mimosa-like individuals. They experience negative comments about them for a long time, any, even minor insults and rudeness. Such individuals are wary of the world around them, and their attachments are limited. They are modest, dreamy and easily exhausted, but they are not inclined to show violent emotions and are proud to the point of being painful. They are in-depth in their work, but only one-sidedly, conscientious and thorough. The action of traumatic factors for schizoids leads to their loss of mental balance, depression and lethargy.

Expansive schizoids are distinguished by decisiveness, lack of doubts and hesitations, disregard for the views of other people, dryness and formality in relationships. Despite their demanding adherence to principles, such individuals are completely indifferent to the fate of those around them. Their character is called difficult or even bad, they are arrogant, cold and incapable of empathy, heartless and cruel. At the same time, this type of schizoid is easily vulnerable, but skillfully hides dissatisfaction and its own insecurity. They may experience angry outbursts and impulsive actions in response to life's difficulties.

Outwardly, schizoids lack emotionality, facial expressions and mental flexibility, which makes them look like robots. There is always an invisible barrier between schizoids and those around them, which prevents them from mixing “with the crowd.”

Asthenic

Psychopaths - asthenics are easily exhausted and irritable, timid, shy and extremely impressionable individuals, prone to introspection. The self-awareness of asthenics is dominated by dissatisfaction with oneself, a sense of one’s own inferiority, insolvency, lack of self-confidence, low self-esteem, dependence on the opinions of others, and fear of upcoming difficulties. They are afraid of responsibility, lack initiative, are passive, submissive and submissive, and endure all insults without complaining.

Some psychopaths - asthenics - are sluggish and indecisive individuals, very suspicious and apathetic, or are in a constantly depressed mood. They listen carefully to the slightest sensations in their body, which often leads to the development of “organ neuroses” (cardioneurosis). Asthenics cannot tolerate the sight of blood and sudden temperature changes, they react very painfully to rudeness/tactlessness, and are weather sensitive. When they are dissatisfied with something, they are either offendedly silent or grumbling.

As a type of asthenic psychopathy, the psychasthenic type is distinguished, which is characterized by indecision, anxiety and exaggerated suspiciousness. Psychasthenics are easy to offend; they are shy and timid, but at the same time very proud. They are characterized by constant “digging” into themselves, obsessive doubts and fears. Any, even minor, change in life (change of job or place of residence) increases their uncertainty and anxiety. On the other hand, these are dutiful and disciplined individuals, which sometimes leads to pedantry and importunity. Psychasthenics make excellent deputies, but as leaders they are not wealthy (they cannot make decisions on their own and take initiative).

Hysterical

These individuals are characterized by an exaggerated demonstration of their emotions and experiences, deep egocentrism, spiritual emptiness, and a love of external effects. All of the above speaks of their mental immaturity and infantilism. They strive to impress others and crave recognition. Such psychopaths are characterized by Munchausen syndrome (fiction, fantasy, pseudology), and their feelings are superficial and unstable. Hysterics often commit extravagant acts, dress brightly and even loudly, and are incapable of work that requires perseverance and tension. They also prefer to lead an idle life, full of entertainment and get only pleasure from it, they show off in society and admire themselves, they tend to “show off.” They consider themselves experts in philosophy and art, although their knowledge is shallow. They strive to be in the center of attention, which makes it impossible to achieve success in creative or scientific activities.

Paranoid

The signs of this form of psychopathy are similar to the schizoid type. Paranoid psychopaths overestimate their “I”, are suspicious and irritable, and are prone to forming overvalued ideas. The character of such individuals is dominated by lack of frankness and willfulness, irritability to the point of affective actions, and logic and reason are suppressed. However, paranoids are distinguished by accuracy and conscientiousness, intolerance to injustice. They are also characterized by a limited outlook and narrow interests, straightforwardness and rigidity of judgment. The random actions of others are always seen as hostility and some kind of secret meaning. In addition to extreme egocentrism, they are distinguished by inflated self-esteem and a heightened sense of self-esteem. But everything that is outside one’s own “Ego” is absolutely indifferent. Despite the constant opposition of the paranoid to those around him, he has a well-disguised internal dissatisfaction. Such individuals are distrustful to the point of suspicion, they believe that they are not given due respect, and they want to insult and infringe on their rights.

A separate type of paranoid psychopathy is distinguished as expansive paranoid personalities. These people are characterized by pathological jealousy, a tendency to conflict, litigiousness, truth-seeking and “reformism”. Such individuals are absolutely content with themselves, they are not embarrassed in cases of failure, and the fight “with enemies” only hardens them and charges them with energy. Such people are often observed among religious fanatics.

Unstable

Affective

Psychopaths of the affective circle are also divided into 2 types: cyclothymic and hypothymic. Cyclothymics easily communicate with almost any person, they are sincere, responsive, pleasant, simple and natural in their behavior. They do not hide their feelings, they are distinguished by their kindness, friendliness, sincerity and warmth. In ordinary life, these people are realists; fantasies and abstruse constructions are not typical for them; fantasies and daydreams are not typical for them; they accept life in its in the usual form. Cyclothymics are also distinguished by their entrepreneurial spirit, flexibility and hard work. But a positive mood easily changes in the opposite direction (constant mood swings).

Hypothymic or depressed psychopaths are always in a negative mood (gloominess, sadness, dissatisfaction with everything and lack of sociability). At work, hypothymic people are characterized as conscientious, careful and efficient individuals, but they always strive to see failures/complications in everything. They experience troubles very hard, they are able to empathize, but they hide their feelings from other people. They are characterized by a pessimistic attitude and low self-esteem. They are reserved in conversations and do not express opinions. They believe that by definition they cannot be right, so they are always guilty and insolvent.

Excitable

Such psychopaths are characterized by increased irritability, constant mental stress and explosive emotional reactivity, which sometimes leads to inappropriate angry attacks. They are demanding of others, extremely selfish and selfish, distrustful and suspicious. They often fall into dysphoria (angry melancholy). They are distinguished by stubbornness and quarrelsomeness, conflict and authority, rudeness in communication and aggressiveness when angry. They are prone to severe beatings and even murder.

Mosaic

Psychopaths with this form of the disorder are characterized by many signs of different types of psychopathy, as a result of which they experience pronounced difficulties in existing in society. In other words, mosaic psychopathy is a mixed psychopathy, when it is impossible to identify the leading symptoms of one form or another.

Treatment

To diagnose psychopathy, a study of brain functions is used - electroencephalography and special tests for psychopathy are carried out (they can be carried out independently).

Therapy for character disorder is necessary only when pathological traits are so intense that they constitute an existential problem not only for those close to the psychopath, but also for himself. Treatment of psychopathy includes the prescription of psychotropic drugs, explanatory and family psychotherapy, auto-training and hypnosis.

Drug treatment is selected on an individual basis, taking into account personality characteristics and psychopathological reactions (a form of psychopathy).

In case of constant emotional fluctuations, antidepressants (Prozac, amitriptyline) are prescribed, with anxiety states– tranquilizers (phenazepam). Hysterical psychopathy is treated with small doses of antipsychotics (aminazine), and anger and aggressiveness are suppressed with more “serious” ones. antipsychotic drugs(haloperidol, triftazine). For sleep disorders, antipsychotics with a pronounced sedative effect (chlorprotexen) are recommended, and for antisocial behavior, “behavior correctors” (neuleptil, sonapax) are used.

Psychopaths – asthenics – need to take stimulants (Sidnocarb) or natural (herbal) drugs that have a stimulating effect (Eleutherococcus, ginseng, zamanikha).

Also, for psychopathy of any form, it is necessary to take multivitamins, immunomodulators and antioxidants.

It is important to remember that when treating with psychotropic drugs, it is strictly forbidden to use alcohol and drugs, since such a combination can lead to the death of the patient.

For the entire period of decompensation, with the prescription of treatment, the patient is issued a certificate of incapacity for work.

Question answer

Question:
My son has been drinking for a very long time (more than 10 years) and consistently. Lately he has become completely uncontrollable, “explodes” at the slightest remark, refuses to do anything around the house, and has begun to raise his hand against me. Is he a psychopath or does he already have some kind of mental illness? What to do?

You answered your own question. According to the description, yes, your son is a psychopath and an alcoholic (it is impossible to make another diagnosis in absentia). Of course, he needs treatment, and most likely in a hospital. But an alcoholic is unlikely to voluntarily agree to hospitalization, as well as to outpatient treatment (after all, he will have to give up alcohol). In your case, you are left with an appeal to law enforcement agencies, a court and a decision on compulsory treatment. A person will never be the same again, since alcohol extremely quickly destroys the nervous system, but some time of compensation for the condition after therapy is guaranteed.

Question:
My husband has an official diagnosis of “excitable psychopathy,” he periodically undergoes courses of treatment, tries to restrain himself in life, and does not show aggressiveness. Is it dangerous to give birth to a child from such a person? Is psychopathy inherited?

If your husband is aware of his own diagnosis and is trying to fight it, then give birth and don’t hesitate. Psychopathy as such is not inherited, but it is possible that the child will have a dysfunction of the nervous system, which is not necessarily accompanied by a character anomaly.

Question:
I am a “chronic dreamer” - that’s what my loved ones and even work colleagues say. How to cure this, because constant daydreaming is one of the signs of psychopathy?

Absolutely not. No pills have yet been invented for daydreaming, and is it really necessary to get rid of it? If your dreams get in the way real life, which means you should reconsider them, set realistic goals and try to achieve them. Your daydreaming indicates a good imagination - channel your energy into a creative direction, try painting, photography, and other types of art. creative activity and you will achieve real success.

For the first time in Russian medical literature The concepts of “psychopathy” and “psychopaths” appeared in 1884. Then forensic psychiatrists I.M. Balinsky and O.M. Chechett conducted an examination of a certain Semenova, who was accused of murdering a girl, and came to the conclusion that she cannot be considered mentally ill in the generally accepted sense of the word, but it is also difficult to recognize her as mentally healthy. The case caused a great public outcry and newspapers began calling Semenova a “psychopath,” meaning her difficult character. Until now, in everyday life, “psychopaths” are people whose behavior brings a lot of concern to others, and sometimes contradicts the norms of public morality.

Today, psychopathy refers to stable congenital or acquired character traits that introduce disharmony into the human psyche and create significant difficulties in everyday life. As a rule, with psychopathy, some character traits are very strongly expressed, while others are underdeveloped. For example, irritability and excitability are excessively expressed, and the function of behavior control is reduced. Or this: a high level of aspirations, egocentrism and lack of an adequate assessment of one’s capabilities. Healthy people may have such traits, but in them they are balanced and behavior does not go beyond social norms. Psychopathy differs quite significantly from mental illness. Individuals with psychopathic tendencies do not worsen over time, but they also do not improve – i.e. there is no dynamics. Also, such people do not have intellectual impairments, there are no delusions or hallucinations. Psychopaths are characterized by a one-sided perception of the environment, i.e. they see only what matches their expectations, and other information is ignored or denied. Therefore, people with psychopathy often have inadequate self-esteem (both high and low) and cannot learn from their mistakes.

Causes of psychoptia

The causes of psychopathy have not been thoroughly studied. Some scientists believe that the character traits that form psychopathy are genetically determined, just like eye color, for example. Others are inclined to think that a psychopath is shaped by an unfavorable environment. There is also an opinion that psychopathy is based on unrecognized organic brain damage.

Symptoms of psychopathy

The external manifestations of psychopathy are extremely diverse. Depending on the prevailing motives in behavior, the following types of psychopathy are distinguished:

1. Paranoid psychopathy Such people are prone to suspicion, they have a heightened sense of justice. They are vindictive and difficult to get along with in a team. They are too straightforward in communication. In a family, these are often jealous spouses. Often paranoid psychopaths are passionate about litigiousness - i.e. initiate litigation For any reason, hypochondria is common - the belief in the presence of some disease and obsession with one’s health.
2. Schizoid psychopathy. These are closed dreamers, eccentrics with non-standard judgments. In everyday life they are stupid, but they are passionate about abstract sciences - philosophy, mathematics. Schizoids are lonely, but they are not burdened by this. They are often indifferent to loved ones.
3. Unstable psychopathy. Such people are characterized by a lack of willpower. They also do not have any interests or their own point of view. They are subject to external influence and suggestible. Such people have no remorse; they easily make promises and forget about them. They do not feel a sense of affection even to close relatives. At school they often had behavior problems, and in adolescence they ran away from home (if the parents tried to somehow discipline the child). As adults, these people are prone to dependency and search for easy money, without thinking about morality. Therefore, among patients with unstable psychopathy there are many criminals, alcoholics, and drug addicts.
4. Excitable psychopathy. Outwardly, such people may be no different from those around them until their interests are affected. In this case, an inadequate outburst of anger, irritation, and aggression is possible. Sometimes patients regret their incontinence, but do not fully admit their guilt. In childhood, excitable psychopaths constantly had conflicts with peers, mature age they often change jobs and tend to blame others for all their troubles in life.
5. Hysterical psychopathy. People of this type are characterized by theatrical behavior, a desire to be the center of attention, and inflated self-esteem. They dress brightly, are sociable, impressionable, and suggestible. Interested in art. They attach great importance to relationships with the opposite sex and are constantly in a state of love, but deep feelings are uncharacteristic for them.
6. Psychasthenic psychopathy . These are anxious, suspicious and insecure people. They are punctual, hardworking, but do not achieve success in life due to fear of failure and inability to make decisions on their own. The social circle is small, they are strongly attached to loved ones. They don't like public attention. Sometimes, to relieve constant anxiety, they may abuse alcohol.
7. Asthenic psychopathy. Its main symptom is increased fatigue and decreased performance. Asthenics cannot concentrate on one thing for a long time. They are unsure of themselves, impressionable, and quickly get tired of society. Concerned about their health.
8.Affective psychopathy. These people are characterized by frequent mood swings, including without apparent reason. Sometimes they are active and cheerful, but after some time they become depressed and gloomy. Such changes may be associated with the seasons.

These are the main variants of psychopathy. In practice, they are often mixed, i.e. in the character of the patients are expressed different traits. Understanding such a variety of options is not easy for a doctor either; as for attempts to independently diagnose psychopathy, they are doomed to failure, because It is almost impossible for a person without specialization in the field of psychiatry to draw a line between manifestations of psychopathy and character traits healthy person. Without a psychiatrist’s verdict, it is impossible to confidently say whether a person has psychopathic traits or whether he has a mental illness, for example, schizophrenia or depression. Therefore, if there are any of the listed symptoms that negatively affect a person’s life in society, it is better to consult a specialist: a psychiatrist or psychologist.

Timely seeking qualified help will help improve social functioning and avoid many problems in the future (after all, if a serious mental illness is hidden under the guise of psychopathy, then quickly started treatment significantly improves the prognosis for the patient).

Examination for suspected psychopathy

When contacting a psychiatrist, most likely, to clarify the diagnosis, an electroencephalogram will be prescribed - a painless method for studying the functioning of the brain, and a consultation with a psychologist to identify the characteristics of thinking, the state of intelligence, and memory. The doctor may need to review the examination data of a neurologist or urine and blood tests. This is necessary to exclude some diseases in which symptoms similar to manifestations of psychopathy may be observed (for example, thyroid disease, consequences of stroke, traumatic brain injury, epilepsy).

Treatment of psychopathy

Treatment of psychopathy with medications is carried out if pathological character traits are so pronounced that they create a significant problem for everyday life the patient and his environment. For low mood, antidepressants (fluoxetine, Prozac, amitriptyline and others) are prescribed. For anxiety, tranquilizers (phenazepam, rudotel, mezapam and others) are used. If there is a tendency towards aggression or antisocial behavior, the doctor will prescribe antipsychotics (haloperidol in small doses, sonapax, etaprazine, triftazine). Also, antipsychotics with sedative properties (chlorprotexen) are used for sleep disorders, because Psychopaths easily develop dependence on sleeping pills. For severe mood swings, anticonvulsants (carbamazepine) are effective.

It must be remembered that when treating with psychotropic drugs, the use of alcohol and, especially, drugs is unacceptable, because this combination can lead to irreversible consequences, up to fatal outcome. Also, during the treatment period, it is better to refrain from driving; at least, it is necessary to clarify this issue with the attending physician. It is advisable for the patient’s relatives to monitor the dosage of the drug, because With psychopathy, there is often a tendency to abuse medications. Without a doctor's prescription, you can buy mild sedatives at the pharmacy, such as valerian, novopassit, motherwort tincture (if we are talking about psychopathy of the excitable type or there is anxiety), but you can hardly expect visible results from them.

Psychotherapy sometimes gives good results in correcting manifestations of psychopathy. Methods such as psychodrama are used - this is a type of group psychotherapy in which scenes from everyday life are played out. In Western countries, psychoanalysis is popular - a long-term individual psychotherapy program to identify subconscious complexes and negative attitudes.

It happens that people avoid contacting psychiatrists, even if there are indications for this. For fear of publicity or side effects psychotropic drugs, such patients resort to traditional medicine. But herbalists have no effective treatments for psychopathy. All they can recommend is herbal teas, consisting of valerian, lemon balm, mint, hops and other plants with soothing properties. Perhaps aromatherapy will be offered using essential oils of geranium, lavender, marjoram, or hot baths with some infusions (usually the same lemon balm or pine extracts). Such methods most likely will not cause direct harm to health, but often the passion for traditional medicine prevents the patient from receiving modern medical care, which leads to a worsening of the condition. In consultation with your doctor, you can use medicinal plant therapy along with the main treatment.

Psychopathy greatly complicates the patient’s life in society and often makes his loved ones unhappy. Psychopaths often find themselves in criminal situations, and they often make suicide attempts - sometimes due to the inability to control their impulses, and sometimes for the purpose of blackmail or attracting attention to themselves. Asthenics and psychasthenics with good intellectual data cannot achieve recognition due to their character traits, and awareness of this fact can lead them to depression. Depression, in turn, often entails alcohol or drug abuse - patients consider this method of relaxation to be the simplest and most effective, but in reality the problems only get worse. Timely and correct treatment saves patients and their families from these troubles. Also, visiting a specialist will help you not to miss the onset of more severe mental illnesses, which from the outside may seem like a manifestation of psychopathy.

Psychiatrist Bochkareva O.S.

O. V. Kebrikov (1968) divided psychopathy into: - nuclear (constitutional) - regional (acquired)

Constitutional, genetic, “nuclear” psychopathy – unfavorable heredity. They are revealed even under the most favorable conditions of upbringing. There are few of them - about 5-10% of all psychopaths. Regional psychopathy, pathocharacterological personality development (PCPD), “acquired” psychopathy are more plastic; in favorable situations, compensation is possible. They are softer.

Incorrect upbringing plays a major role in the formation of PHRL. Wagner-Jauregg: “parents burden their children not only with their heredity, but also with their upbringing.” Phenomenon: late depsychopathy. Occurs at 50-55 years old, when vascular changes smooth out psychopathic changes. We can only compensate for psychopaths. There can be no talk of recovery...

O. V. Kebrikov (1968) types of education: - hypoprotection or neglect - excitable

Overprotectiveness - inhibited (psychosthenic, anxious suspiciousness, he is not used to making decisions and being responsible for them). The desire to protect a child from a cruel world can lead to a psychosthenic psychopath. - “family idol”: hysterical personality. A late child, very welcome. He gets used to the fact that any of his needs is immediately satisfied. - “Cinderella”: more often than not, a boy is the stepfather in the family. When there is still common child. The stepfather begins to force this child to clean and do “dirty” work. We went to the zoo, but they didn’t take her... She feels like a kind of outcast. Psychopathy of an unstable circle.

Regional psychopathy includes: - organic psychopathy (some harmful effects affect a child under 3 years of age, but there is no intellectual delay, personality traits appear) - psychopathic-like disorders based on residual organic damage GM factor is effective after 3 years

V. A. Gilyarovsky - “psychopaths are more often made than born.”

53. Psychopathy of unstable type. Signs: disregard for the feelings of others, lack of empathy, irresponsibility and disregard for social norms, ease of aggressive outbursts, including cruelty; lack of guilt. The main feature is constant thirst easy entertainment and pleasures, an idle lifestyle with avoidance of all work. Loneliness is not tolerated well.

54. Excitable psychopathy.(explosive). the main manifestations are excessive excitability, impulsiveness, conflict, even anger and aggressiveness. At work they get into open conflicts, which is why they are promoted slowly or not at all. mood is changeable. explosive reactions are intense, but usually short.. stable friendships are difficult to establish. speech and movements are very fast. Neurological examination often reveals signs of early cerebral-organic failure.

55.Epileptoid psychopathy. In addition to explosiveness, states of dysphoria arise - a gloomy, angry mood, during which patients are looking for something to vent their accumulated evil on. Dysphoria lasts from several hours to several days. In the heat of the moment, during fights, they become wild and are capable of inflicting serious damage. They take pleasure in tormenting and mocking the weak. can get pleasure from causing pain to themselves with cuts and burns. Suicidal attempts, both demonstrative for the purpose of blackmail, and during diphoria with the actual intention of committing suicide. The tendency to explosive reactions and dysphoria in epileptoid psychopaths is often combined with general mental rigidity, specific manifestations of which are thoroughness of thinking and accuracy.

56.Psychasthenic psychopathy.(anankastic) is characterized by indecision, constant doubts, excessive forethought regarding the possible course of events dangerous for oneself; perfectionism (the desire to always achieve the highest results, to do everything in the best possible way regardless of the unimportance of the matter); the need to repeat what has been done. Obsessive thoughts, movements, rituals, fears appear almost constantly, sometimes intensifying, sometimes weakening. Pedantry, the desire to foresee everything in advance and plan it in the smallest detail, minute adherence to rules serve as overcompensation for constant fear for the future. This type of psychopathy usually appears from school years, but intensifies when they begin to live independently.

57. Schizoid psychopathy. Traits: inability to experience pleasure (anhedonia), emotional coldness, inability to express warm and hostile feelings towards others; weak reaction to praise and blame; little interest in sexual intercourse with others; tendency to fantasize to oneself and to introspect; lack of close, trusting contacts with others. Closedness and unsociability. They often live by their unusual interests and hobbies, in which they can achieve success. Hobbies and fantasies fill the inner world. They are prone to nonconformism - they do not like to act like everyone else.

58. Paranoid psychopathy. Excessive sensitivity to the dissatisfaction of one's claims; rancor, which does not allow one to forgive insults, insults and damage. suspiciousness and desire to distort the neutral or friendly actions of others; tendency to pathological jealousy; excessive self-confidence. Conviction of their superiority over others, they always claim an exceptional position, to ensure that everything is done as they see fit. They begin to sophisticatedly and even cruelly pursue their imaginary enemies and real opponents, believing that they are pursuing them.

59. Psychopathy of the affective circle. Psychopathy of the affective circle. E. Kretschmer contrasted cycloid psychopathy with schizoid, noting the naturalness of affects and all mental life, the “roundness” of the cycloid’s character in contrast to the schematism of schizoids. E. Bleuler (1922) designated the peculiarity of cycloids with the term “syntony”. These people find it easy to communicate with everyone, they are mentally responsive, pleasant, simple and natural in their behavior, and freely express their feelings; They are characterized by kindness, friendliness, good nature, warmth and sincerity. In everyday life, cycloids are realists; they are not prone to fantasies and abstruse constructions, accepting life as it is. Psychopathic personalities of the affective circle are enterprising, flexible, and hardworking. Their main features are emotional lability and mood instability. Joy, a “sunny mood” is easily replaced by sadness, sentimentality is their usual property. Psychogenic and autochthonous phase disorders can occur quite often in them. Such affective instability begins to be detected in such individuals even at school age. G.E. Sukhareva notes that in children, affective lability has periodicity, but the phases are short in time (two to three days), sadness can be replaced by motor restlessness. Throughout life, periodic changes from one state to another are possible, but they are also short-lived. When considering the dynamics of affective psychopathy, the question arises about the relationship of such cases with cyclothymia as an endogenous disease. A number of follow-up studies testify in favor of the independence of psychopathy of the affective type (K. Leongard, 1968, etc.). Depending on the predominant affect, this group is divided into hypothymics and hyperthymics. Hypotimics are born pessimists, they do not understand how people can have fun and enjoy anything, even any kind of luck does not give them hope. They say about themselves: “I don’t know how to rejoice, it’s always hard for me.” Therefore, they notice only the dark and unsightly sides of life, most of the time they are in a gloomy mood, but they can mask it, hide despondency with ostentatious fun. They react to any misfortune more heavily than others, and in case of failure they blame themselves.

60. Mosaic psychopathy. Psychopathy does not always appear in a “pure” form; more often it is the so-called “mosaic psychopathy”, when a person carries radicals of various forms of psychopathy.

62. Schizophrenia – a mental illness characterized by disharmony and loss of unity of mental functions (thinking, motor skills, emotions), a long continuous or paroxysmal course and varying severity of productive (positive) and negative disorders, leading to personality changes in the form of autism, decreased energy potential and emotional impoverishment ( Tiganov A.S., 1999) Disharmony and loss of unity - this is schisis (splitting) - based characteristic of schizophrenia. Dementia praecox (dementia praecox)

E. Kraepelin, 1896 – 1899 He divided all mental illnesses according to the principle of course and prognosis.

E. Kraepelin combined those observed before him into a single nosological unit:

1) “dementia praecox” (M. Morel, 1852) 2) hebephrenia (E. Hecker, 1871) 3) catotonia (K. Kahlbaum, 1874)

4) chronic delusional psychoses (V. Magnan, 1891) Diagnostic criteria: dementia prehos is a disease that begins at an early age, has a continuous course and ends with an unfavorable outcome in dementia. Then debate began about whether dementia occurs. In schizophrenia, the intellect does not suffer, emotions and will suffer. The concept of personality defect was formed.

Primary signs of schizophrenia (4 “A) according to E. Bleuler (1911) The term "schizophrenia" belongs to Bleier. This term comes from the word "schisis". For a long time, the sound was not “schizophrenia”, “schizophrenia”. Splitting of the psyche. He classified as secondary: delusions, hallucinations, senestopathies, etc.

Primary signs (4 “A”) 1.Autism – loss of social contacts by the patient

2. Violation Associations (or pathology of thinking) – reasoning, fragmentation, slippage, paralogy, symbolism3. Depletion Affects – impoverishment of emotionality up to apathy.

4. Ambivalence – schizis – dissociation, splitting between various mental manifestations. So, the basis of schizophrenia are negative disorders. These disorders can only occur in patients with schizophrenia. If negative disorders appear, we can say that the patient has schizophrenia.

Schizophrenia, clinical forms: - simple - paranoid - catatonic - hebephrenic + juvenile malignant schizophrenia (lucid catatonia, hebephrenic, simple)

Types of schizophrenia:- continuously flowing - paroxysmal-progressive (fur-like)

Recurrent (acute attacks, in remission – a fairly benign condition)

The forecast depends on the type of flow: how quickly the defective state will occur (or not at all...)

Characteristic attacks ( acute condition) and remission (interictal state).

Schizotypal disorder (sluggish schizophrenia) It can be added to the clinical forms of schizophrenia. - neurosis-like (for example, senestepato-hypochondriacal syndrome)

Psychopathic-like (heboid syndrome), a personality disorder or psychopathy that occurs as part of schizophrenia

40% of schizophrenia is low-grade schizophrenia 4. 1. Continuous flow type . There are no remissions. Progression: from malignant juvenile schizophrenia to sluggish neurosis-like schizophrenia. Paranoid schizophrenia occupies an intermediate position. A defective state quickly forms. 4. 2. Episodic with increasing defect (paroxysmal-progressive type of course) . Remissions of varying quality are characteristic. Acute attack (fur coat): hallucinatory-paranoid, affective-delusional, oneiric-catatonic symptoms. IN interictal period there is a stepwise increase in the personality defect. The final stage of the disease is continuous. 4. 3. Recurrent (periodic) type of flow (ICD-10 F 25 - schizoaffective psychosis). Remissions are of fairly high quality (up to intermission).

The most acute psychopathological syndromes are characteristic: oneiric-catatonic and affective. The personality defect is weakly expressed. Examples of diagnoses: - sluggish neurosis-like schizophrenia; continuous type of flow; senestepato-hypochondriacal syndrome; - schizophrenia; hebephrenic form; continuous type of flow; defective state; - schizophrenia; paranoid form; episodic type of course; hallucinatory-paranoid syndrome.

63. Simple form of schizophrenia (F 20.6). There are no productive disorders, or very few of them. Onset in adolescence or young adulthood (13-17 years). Continuous, non-remission course. Clinical manifestations – negative symptoms. “Simplex syndrome” (autization, emotional impoverishment, EPR, schizis, “metaphysical intoxication”, negativism towards relatives (mother). Moreover, when he is visiting, he speaks well about his mother. He communicates with her bad. Polymorphic, rudimentary productive symptoms. Voices, dereleasing, depersonalization. Senestopathies, hypochondriacal disorders. But they are blurry and dim.

64. Paranoid form of schizophrenia (F 20.0)“Chronic delusional psychoses” by V. Magnan (1891) . The most common form of schizophrenia (about 30-40%) . Favorable prognosis (in terms of defect formation) . Age of onset of disease – 25 – 30 years . Syndromotaxis of paranoid schizophrenia: neurosis-like syndrome – paranoid syndrome – paranoid (hallucinatory-paranoid) syndrome – paraphrenic syndrome – personality defect (apato-abulic syndrome).

65. Hybephrenic form of schizophrenia (F 20.1).“Hebephrenia” (E. Hecker, 1871). DSM-IV - disorganized form. The most malignant form of schizophrenia. The age of onset of the disease is 13-15 years. Non-remission course (2-4 years - defect). Pfropfschizophrenia - the onset of schizophrenia in early childhood leads to an intellectual defect similar to manifestations of mental retardation. It is necessary to differentiate. Hebephrenia is a combination of motor and speech excitation with foolishness, labile affect, negativism, behavioral regression. Against this background, personality changes are growing catastrophically.

66. Catatonic form of schizophrenia (F 20.2)“Catatonia” by K. Kahlbaum, 1874 . Currently rarely diagnosed (4-8% of all Sch) . Clinical picture: movement disorders: catatonic stupor-catatonic agitation. Catatonia + hebephrenia . Catatonia + oneiroid (the most favorable form) . Lucid catatonia (most malignant). Against the background of clear consciousness. We often deliberately aggravate the patient’s condition to make it easier to treat. Chronic, protracted, with minor manifestations are less treatable.

67. TIR– endogenous disease, which occurs in the form of attacks or phases with affective disorders, light intervals between attacks. MDP, unlike dementia praecox, according to Kraepelin, is characterized by an onset at a later age, a phasic course and a favorable outcome. Currently, the concept of MDP is used to designate a group mental disorders characterized by: 1) the frequency of occurrence of autochthonous endogenous affective disorders in the form of manic or depressive phases 2) their complete reversibility and the development of intermissions with restoration of PF . Classification of depression in ICD-10 Mood disorders (F 30 – 39) F 30 Manic episode F 31 Bipolar affective disorder (i.e. MDP). The average age of onset is 30 years. Men and women equally. F 32 Depressive episode F 33 Recurrent affective disorder (depression only). The average age of onset is 40 years. For one man there are three women F 34 Chronic affective disorders F 34.0 - cyclothymia F 34.1 - dysthymia The average duration of the depressive phase is 4-9 months. The average duration of the manic phase is 5-6 months. 1. Prevalence of depression. Less than 1% - treatment in a psychiatric hospital 3% - outpatient treatment with a psychiatrist 10% - visiting an internist for somatic complaints (masked depression) 30% - representative surveys of the population (regarding depression) 2. Etiology2.1. Degree of relationship (genetic): BAR, Monopolar

68. Cyclothymia- This is an analogue of MDP, but at a softer level. And therefore, to characterize the phases, their own names were created: subdepression and hypomania. Patients with subdepression will go to a somatologist (they have bad feeling), a patient with hypomania will not go anywhere. All the first businessmen were hypomanic... There is one bad nuance: a third of patients with cyclothymia will become patients with MDP. Their hypomania will become mania, and their subdepression will become depression. Cyclothymia is a mental affective disorder in which the patient experiences mood swings between vague (close to dysthymic) depression and hyperthymia (sometimes even episodes of hypomania occur). Pathological changes in mood occur in the form of separate or double episodes (phases), separated by mental health states (intermissions), or alternating continuously. The word "cyclothymia" was previously used to describe bipolar disorder, and in the traditional classification it is considered as a mild, unexpressed variant, belonging to the general class of cyclophrenia. In addition, cyclothymia also includes personality disorders of a cycloid nature. In German psychiatry, for deontological reasons, cyclothymia refers to any disease of a manic-depressive nature, regardless of the specific form and severity of the disorder. Symptoms of cyclothymia are similar to those of bipolar disorder, but are less severe. The patient experiences phases of depression (depression), which are replaced by periods of elevated mood (hyperthymia or hypomania). Episodes of mania or clinical depression exclude the diagnosis of cyclothymia. Symptoms of mild depression are: Decreased interest in communicating with people, Difficulty making decisions, Impaired concentration, Memory problems, Apathy, Hopelessness; helplessness, irritability, lack of motivation, guilt, low self-confidence (low self-esteem), ideas of self-destruction, decreased or, conversely, increased appetite, decreased libido, fatigue, sleep disorders: insomnia or drowsiness.

70. senile dementia.(senile dementia). Usually develops between the ages of 65-85 years. The onset of the disease is always slow and unnoticeable. Personality changes are characterized by severity, exaggeration, and faster progression. Patients become characterologically similar to each other. They are characterized by caricatured egocentrism, callousness, stinginess, and collecting old unnecessary things. at the same time the elementary biological needs. a kind of hypersexuality appears in the form of increased interest in young people of the opposite sex. There are signs of mnestic-intellectual deficiency, which is growing steadily. First of all, mechanical memory is affected, then fixation amnesia is revealed, leading first to disorientation in time, and then to the surrounding environment. Gaps in memory are often accompanied by false memories (confabulations). Thinking disorders begin with difficulties in abstracting and generalizing, establishing cause-and-effect relationships. senseless talkativeness. At night, episodes of confused consciousness often occur with false orientation and preparation for the journey. Some patients live to the point of senile insanity. The course of senile dementia is continuous or progressive in waves.

71.Alzheimer's disease. It begins with memory loss. There is a hereditary predisposition. Also – untreated hypertension, sedentary lifestyle. The GM cortex dies. This leads to progressive memory loss, first affecting memory for recent events. Dementia develops and the patient needs outside help. From the first signs of forgetfulness to the death of the patient, 5-10 years pass. The rate of progression is slow. It is possible to pause the course of the disease. The diagnosis is made by a neurologist or psychiatrist. Therapy methods slow down the development of the disease. Signs of asthma: 1. Repeating the same question2. Repeating the same story over and over, word for word3. Loss of everyday skills, such as cooking or cleaning the apartment4. Inability to manage financial affairs, such as paying bills5. Inability to navigate to a familiar place or place common household objects in their usual places6. Neglect of personal hygiene, statements like “I’m already clean”7. Entrusting someone with making a decision life situations, With which formerly man managed on my own . Early dementia - Decreased memory, impairment of other cognitive abilities. The man cannot find his way. It starts at the age of 60 and earlier. Part of the symptom in AD belongs to the syndromological series of depression. It all starts with depressive complaints: bad mood, lethargy, difficulty concentrating. The woman no longer understands how to fill out receipts. Doctors often attribute this to depression, and when memory and intellectual disorders are already in full bloom, it is too late to treat. Moderate dementia - The areas of the brain that control speech and intelligence are damaged. Symptoms: progressive memory loss and general confusion. Difficulty performing multi-step tasks (getting dressed), problems recognizing loved ones, etc. Severe dementia - They cannot communicate and are completely dependent on outside help. The patient spends most of the time in bed. Severe dementia includes the inability to recognize oneself and family, weight loss, seizures, skin infections, moaning, crying, inability to control pelvic functions. Atrophy - parietotemporal lobes in Alzheimer's disease. In Pick's disease - frontal lobes. Dementia: - lacunar - total. In Alzheimer's disease, first lacunar, then total. With Pick's disease - immediately total. Therefore, their behavior differs very much. Vascular: flow in waves (worse - better), atrophic flow immediately with an increase. Loss of memory and intelligence - with atrophic, with vascular - symptoms can be reversible until a crisis occurs (such as a stroke). One of the first symptoms characteristic of Alzheimer's disease is finger agnosia (they stop recognizing and naming fingers). Aphato-apracto-agnostic syndrome (aphasia, dysarthria, apraxia and gnosis). This is typical for AD. Appearance: Apathetic appearance. Spontaneous, imitative, speaks in a monotonous voice.

72. Pick's disease. It begins gradually at the age of 40-6 years. At the initial stage, emotional-volitional disorders, rather than disorders of the intellectual and mnestic sphere, predominate. Particularly characteristic is aspontaneity: indifference, passivity, lack of internal motivation for activity. The predominance of increasing intellectual insufficiency (weakening of the abilities to generalize and abstract, construct adequate judgments and conclusions) over memory disorders. Severe memory impairment occurs late, amnestic disorientation is absent. In peak disease, speech disorder takes the leading place among the manifestations of total dementia. It begins with difficulty understanding someone else's speech, impoverishment of one's own speech, and over time turns into speech helplessness. Speech is saturated with perseverations and echolalia. Some patients develop marasmus. They die as a result of secondary infections after -6 years from the onset of the debilitating cerebral atrophic process.

73. Mental disorders in traumatic brain injuries. Mental disorders in traumatic brain injuries are usually correlated with the corresponding stages of development of the traumatic disease:

mental disorders of the initial period, manifested mainly by disorders of consciousness (stunning, stupor, coma) and subsequent asthenia; acute traumatic psychoses that occur immediately after brain injury in the initial and acute periods; subacute or prolonged traumatic psychoses, which are a continuation of acute psychoses or first appear several months after the injury; mental disorders remote period traumatic brain injury (long-term or residual consequences), appearing for the first time several years later or arising from earlier mental disorders. Symptoms and course: Mental disorders that occur during or immediately after an injury are usually manifested by varying degrees of loss of consciousness (stunning, stupor, coma), which corresponds to the severity of the traumatic brain injury. Loss of consciousness is usually observed with concussion and contusion of the brain. When consciousness returns, the patient experiences a loss of memory of a certain period of time - the period following the injury, and often even preceding the injury. The duration of this period varies - from several minutes to several months. Memories of events are not immediately or completely restored, and in some cases - only as a result of treatment. After each injury with impaired consciousness, post-traumatic asthenia is noted with a predominance of either irritability or exhaustion. In the first option, patients become easily excitable, sensitive to various stimuli, with complaints of light sleep with nightmares. The second option is characterized by a decrease in desires, activity, performance, and lethargy. There are often complaints about headache, nausea, vomiting, dizziness, unsteadiness of gait, as well as fluctuations in blood pressure, palpitations, sweating, salivation, focal neurological disorders.

74. Mental disorders in brain tumors. On initial stages neurasthenic or hypochondriacal symptoms are most often observed. Characterized by increased irritability, severe fatigue, headaches, and dysmnestic disorders. As the condition worsens, stupor may develop, hallucinatory and delusional phenomena occur, affects of fear and melancholy are detected, and drowsiness appears. At the same time, focal symptoms may occur in accordance with the presence of a certain affected area: paralysis, epileptiform seizures, hyperkinesis. Typically, mental disorders in cases of brain tumors are divided into persistent, tending to increase, and transient, transient. Persistent mental disorders: These include productive and negative manifestations, which remain unchanged for a long time, and then tend to increase. Sleep disorders are expressed in disturbances in the sleep-wake rhythm, drowsiness developing during the day and the appearance of nightmares, which tend to be stereotypical repetition. Memory impairments are manifested by the development of signs of Korsakov's syndrome with varying degrees of severity of all its structural components. Such phenomena are more often found in cases of development of a tumor of the third ventricle, posterior sections right hemisphere. Manifestations of fixation amnesia, paramnesia, and amnestic disorientation are clearly expressed. Against the background of the development of Korsakoff's syndrome, many patients experience euphoria and anosognosia. With tumors of the left hemisphere, long-term anxious depression develops with loss of emotional responsiveness. Euphoria is an almost obligate symptom in neoplasms in the area of ​​the bottom of the third ventricle, while manifestations of anosognosia are recorded in patients.

Melancholy depression in brain tumors is combined with motor retardation and an inadequate attitude towards one’s illness. Often such melancholy depression is accompanied by the development of olfactory hallucinations, depersonalization, derealization, and a violation of the “body diagram.” Such depression can be replaced by euphoria when the tumor spreads to the frontal region of the right hemisphere.

Hallucinations (olfactory, tactile, gustatory, auditory) are found in tumors of the temporal lobes of the brain. They are often combined with vegetovisceral manifestations, such as palpitations, rumbling in the stomach, flushing or pallor of the face, hyperhidrosis. Olfactory hallucinations are quite varied, patients talk about the smell of burning, rotten eggs, unbearable stench, etc. Patients localize odors in different ways, they feel them either directly near the nose or coming from the mouth; some say that the body itself smells. Attacks of olfactory hallucinations are sometimes the first symptom of a tumor of the temporal region or the bottom of the third ventricle. Taste hallucinations usually occur later than olfactory hallucinations, they are manifested by a feeling of an unpleasant taste in the mouth, which patients cannot immediately identify. Auditory hallucinations occur with tumors of the right hemisphere, they are quite common acoasms, excerpts of some melodies, most often sad, chirping birds, etc. Auditory hallucinations of a verbal nature are noted with left hemisphere tumors; patients hear someone repeating their first and last name; “voices,” as a rule, are monotonous, heard from the outside, sometimes from somewhere far away; “auditory dialogues” and imperative hallucinations are not noted.

Affective disorders. With tumors of the right hemisphere localization, attacks of melancholy, fear, and horror may develop. This is accompanied by a change in facial expressions, facial hyperemia, and dilated pupils. Affective manifestations can often be accompanied by the paroxysmal development of depersonalization, derealization, and olfactory hallucinations. With tumors of the frontal localization, transient speech disorders such as motor aphasia (the inability to pronounce individual words against the background of normal speech) can develop. Similarly, in a number of cases of temporal localization of the tumor, the phenomena “ verbal deafness,” or sensory aphasia, which resembles the symptoms of Alzheimer’s disease, when patients do not understand speech addressed to them and at the same time speak with emphasis, pronouncing individual syllables or short words. A feature of the symptoms is the transient nature of sensory aphasia. Almost always with brain tumors, transient disorders of consciousness appear in the form of transient stupor or mild numbing, in some cases short-term pareidolia are noted. With an increase in intracranial pressure, the developing stupor can deepen and turn into a soporous or even comatose state. When stunned, the patient's attention can only be attracted by a very strong stimulus, the patients become lethargic, indifferent to everything that is happening, their mental life becomes impoverished, extremely slow. A delirious state in such patients may develop after stunning, or it may be replaced by twilight stupefaction. Such fluctuation of symptoms complicates diagnosis, requiring the exclusion of dynamic cerebrovascular accident.

75. Mental disorders in infectious diseases. These disorders include psychopathological changes in encephalitis, which occur both with primary damage to the brain infection (epidemic, tick-borne, mosquito and other encephalitis), and as a result of complications with common infections(typhoid infections, influenza, etc.). During the acute stage, pathological drowsiness (lethargy) appears against the background of a febrile state. Hence the name – “lethargic encephalitis”. Patients sleep day and night and can hardly be awakened to eat. In addition, delirious disorders and oneiroid may occur. Delirium is manifested by visual and auditory hallucinations, often in the form of photopsia and acoasmas; sometimes verbal illusions arise, which may be accompanied by fragmentary delusional ideas of persecution. At severe course diseases with pronounced neurological symptoms, when ptosis, paresis of the oculomotor and abducens nerves, diplopia, impaired coordination of movements, convulsions, myoclonic twitches, etc. develop, and there are persistent and occupational deliriums.

During the development of the acute stage, many patients (about a third) die, some completely recover as a result of treatment. But most often the acute period of the disease turns into a chronic stage, which is called parkinsonian. At chronic stage Along with mental changes in the form of an apatoabulic state, postencephalic parkinsonism develops. It is the leading sign of the disease. In addition, depressive disorders with suicidal tendencies are possible, occasionally - euphoria, importunity, petty pedantry, occasionally - hallucinatory-paranoid inclusions, sometimes with elements of Kandinsky-Clerambault syndrome. Oculogyric attacks often occur: violent abduction of the eyeballs upward, less often - to the sides for several seconds, minutes or even hours. Oculogyric crises are accompanied by oneiric disorder of consciousness with fantastic experiences: patients see another planet, space, underground, etc.

76.Intoxication psychoses. Intoxication psychoses arise as a result of acute or chronic poisoning with industrial or food poisons, chemicals used in everyday life, drugs, and medicines. Intoxication psychoses can be acute and protracted. Acute psychoses usually occur during acute poisoning and are most often manifested by disturbances of consciousness, the structure and depth of which depend on the nature of the person. toxic agent, constitution and acquired characteristics of the body. Stunning, stupor, coma are the most common forms of disturbance of consciousness in case of poisoning. Stunning and stupor can be accompanied by chaotic motor excitation. Often intoxication psychoses are manifested by delirious stupefaction and hallucinatory disorders (in case of poisoning with atropine, arsenic hydrogen, gasoline, lysergic acid derivatives, tetraethyl lead). In severe cases, the disorder of consciousness takes on the form of amentia. Psychoorganic disorders may be limited to asthenoneurotic phenomena; in more severe cases, intellectual-mnestic decline and psychopathic personality changes are observed. Finally, psychoorganic disorders can reach the level of dementia with severe memory disorders (Korsakov's syndrome), complacent, high spirits and foolish behavior (pseudoparalytic syndrome). These disorders may be accompanied by epileptic seizures and combined with neurological and somatic disorders characteristic of poisoning with a specific toxic substance. Acute intoxication psychoses occur either immediately after poison enters the body (carbon monoxide; gasoline), or after a latent period that lasts from several hours to several days (tetraethyl lead, antifreeze). The outcome of abortive forms of acute psychosis is usually favorable. After acute psychosis has passed, psychoorganic disorders of varying severity and structure may remain. At chronic poisoning mental disorders grow slowly and manifest themselves mainly as psychoorganic syndrome. After cessation of contact with a toxic substance, both a regressive course of mental disorders and their further increase are possible.

Psychopathy (Greek psyche - soul and pathos - suffering) – a borderline disorder of personality development, characterized by disharmony in the emotional and volitional spheres. This is an incorrect, painful development of character, an anomaly of character, from which both the person himself and society suffer (“deformity of character”). Psychopathy is not a mental illness, but it is not a normal option, nor is it health.

Psychopathy is characterized by 3 main signs, established by the Russian psychiatrist P.B. Gannushkin:

1. The totality of pathological character traits that manifest themselves always and everywhere, under any conditions.

Stability of pathological character traits - they first appear in childhood or adolescence, less often in adults, and persist throughout a person’s life; periodically they increase (decompensation) or weaken (compensation), but do not completely disappear.

Violation social adaptation precisely because of pathological character traits, and not because of unfavorable external influences.

Psychopathy is formed when a combination of congenital or acquired in early childhood (in the first 2-3 years) inferiority of the nervous system with adverse environmental influences (but based on the biological inferiority of the child’s nervous system).

There are many reasons for the occurrence of psychopathy, the main ones are the following:

hereditary factors - psychopathic parents most often give birth to children with similar pathology(these are so-called constitutional, genetic psychopathy - the most unfavorable option, they cannot be corrected even with proper upbringing);

alcoholism and drug addiction in parents;

various factors that negatively affect the fetus in the intrauterine period of development (alcohol, nicotine, drug intoxication of the mother, taking medications, poisoning with anything, mental trauma and infectious diseases, especially viral ones, nutritional deficiencies, severe toxicosis of pregnancy, threat of miscarriage, placental abruption and etc.);

birth injuries, asphyxia during childbirth, prolonged difficult labor, application of forceps, etc.;

traumatic brain injuries, brain infections (meningitis, encephalitis), severe poisoning in the first 3 years of a child’s life;

long-term debilitating illnesses in the first 3 years of life;

disadvantages of upbringing (atmosphere of scandals, drunkenness, single-parent family, permissiveness, etc.)

Psychopathy should be distinguished from character accentuation.

Accentuation of character(Latin accentus - emphasis and Greek charakter - trait, feature) - these are mildly expressed deviations of character, sharpening of certain personality traits. This is not a disease, but one of the normal variants.

The concept of accentuated personalities was developed by K. Leonhard.

With accentuation of character (as opposed to psychopathy):

social adaptation is not impaired (or the impairment of adaptation is minor and temporary);

features of accentuation do not appear everywhere and not always;

a person is aware of his shortcomings and tries to avoid situations that affect him, and with psychopathy there is an uncritical attitude towards himself and his own behavior.

Both psychopathy and character accentuations with similar manifestations are called the same.

Manifestations of psychopathy are diverse. Despite the rarity of pure types and the predominance of mixed forms, it is customary to distinguish the following classic types of psychopathy:

Explosive (excitable) psychopathy . From the early childhood The child exhibits loudness, slight excitability, motor restlessness, light sleep with frequent awakenings, and twitching. Then the following main pathological features appear:

1. irritability and short temper, lack of restraint,

   bouts of uncontrollable rage,

   mood disorders (sadness, anger, fear),

   aggressiveness, vindictiveness, despoticism,

   tendency to quarrels and fights (aggressive reaction like a short circuit “stimulus-reaction”),

   the desire to assert oneself at the expense of the weak,

   self-centeredness, cruelty, etc.

Behavior at school is uncontrollable; such a child cannot be taught discipline. Does not show interest in classes, studies poorly, does not feel the distance between himself and the adult. Most people have been drinking alcohol since adolescence, and their pathological character traits become even more pronounced (this is the group with the highest risk of developing alcoholism). They can be energetic and active. Among them there are gamblers (as a rule, this takes on a painful nature). Conflicts with others run through their entire lives and cause disruption in social adaptation: they are intolerant at school, in the family, in the army, at work.

With excitable psychopathy, those around him suffer more than the psychopath himself (although in fights he also suffers).

Hysterical psychopathy . The first personality deviations appear in children at 2-3 years of age or in preschool age. Children are capricious, touchy, active, inclined to talk, imitate adults, imitate them; easily remember poems, jokes, anecdotes overheard from adults; They are impressionable and emotional, often the idols of the family. They have high self-esteem.

Hysterical psychopathy is characterized by:

the desire to appear larger than it actually is;

desire to be the center of attention;

an unquenchable thirst for recognition;

selfishness (living at the expense of others), selfishness, indifference to others;

posturing, actions designed for external effect;

tendency to lie, fantasize;

the importance of assessing others;

ability to gain trust and rapport

Such children and adults usually have a good memory, uninhibited thinking, and quickly master a new profession, but they are not characterized by perseverance and hard work. They only like what comes easy. They prefer professions where they can be visible. They have big problems with honesty and integrity (they should never be trusted to manage money). Like all weak individuals, they are cowards, they will betray and sell everyone, because... They love themselves more than anything in the world. Prone to alcohol abuse.

Unstable psychopathy , in which there is blatant irresponsibility and lack of permanent attachments; people with such a character easily get married, easily leave, often change their place of work, place of residence (“rolling stones”), these are people who live for one minute.

4. Asthenic psychopathy .Its main features are:

timidity, shyness, timidity;

lack of self-confidence;

lethargy, decreased activity;

vulnerability, mimosis;

increased fatigue, by the end of the lesson their attention is scattered, unable to perceive new material.

An asthenic person at home must rest for a long time before doing homework. Usually such children do not have friends, they cannot call and ask for lessons, or they are embarrassed to do so. Parents should constantly help them with homework. They are very worried before any important event - an exam, a performance, etc. A slight complication of a life situation causes them to have neurotic reactions such as neurasthenia. They cannot carry out assignments or hold positions associated with great responsibility and the need to manage other people. Moreover, failures in such cases are very painful.

5.Psychasthenic psychopathy . S.A. Sukhanov called psychasthenics anxious and suspicious individuals. Their main features:

indecision, suspiciousness;

tendency to doubt, difficulties in making decisions;

tendency to introspection, mental chewing gum;

a feeling of inferiority, but at the same time pronounced pride and increased appreciation;

touchiness;

communication difficulties

Since childhood, such people are fearful, impressionable and anxious, and are characterized by low physical activity. At school age, anxiety intensifies, they painfully endure reprimands, repeatedly check the correctness of solutions to problems, and take the longest to complete tests in class (they double-check!). at the same time, most of them are of a thinking type and have good intelligence. They have an inquisitive mind, a desire to meticulously get to the bottom of things, they are excellent performers, they ask a lot of questions (but only to their people), but the call to the board is painful. The “weakest” point is the need to make a quick decision or complete work in a short time .

Psychasthenic psychopathy is the option when the person himself suffers the most, and not society (they spend their whole life in a heroic struggle with themselves).

6.Paranoid psychopathy .Its distinctive features are

suspicion, suspiciousness;

a high degree of readiness to form highly valuable ideas (most often ideas of jealousy, litigiousness, and invention);

selfishness, self-confidence, lack of doubt;

belief in one's infallibility;

intransigence, activity in defending one’s idea

heightened self-esteem.

Schizoid psychopathy has the following features:

unsociability, isolation, isolation, secrecy;

phlegmatic, but also capable of outbursts of emotions;

emotional coldness, dryness;

lack of empathy;

greater proximity to nature and books than to peers (such people are always aloof, often lonely);

in friendship - constancy, importunity, jealousy;

one-sidedness and inflexibility of judgment (a person can be boring, corrosive)

Cycloid psychopathy, the main symptom of which is a constant change in mood (either high or low) with cycles from several hours to several months.

Pathological drives , which include kleptomania, pyromania, sexual psychopathy (in which sexual satisfaction is achieved only in a perverted way), including:

homosexuality (attraction to people of the same sex);

sadism (satisfaction of sexual feelings while causing pain to a partner);

masochism (satisfaction of sexual feelings when pain is caused by a partner);

pedophilia (sexual attraction to children);

sodomy, bestiality (sexual attraction to animals);

exhibitionism (satisfaction of sexual feelings by exposing the genitals in front of people of the opposite sex) and others.

Various psychopathic personalities quite often come into conflict with others. By creating conflict situations themselves, they make it even worse for themselves, because... during a conflict, an additional psychogenic effect occurs and a psychopathic reaction may develop with an exacerbation of abnormal character traits (the teacher must take this into account). A psychopathic reaction occurs suddenly, in response to insignificant (for a normal person) events (for example, someone accidentally touched someone while passing by), as a rule, it is inadequate, most often expressed in the form of protest, indignation, anger, malice, rage and even aggression.

3. Neuroses and neurotic conditions in children and adolescents

Neuroses are the most common group of neuropsychiatric diseases in children. The manifestations of their neuroses are very diverse.

The cause of neuroses is interpersonal conflicts (neurotic conflict). Neurosis is a form of mental adaptation (with the manifestation of signs of maladaptation). It is always conditioned constitutionally, associated with the characteristics of the psyche, and not with the nature of the traumatic situation. The form of neurosis in a person does not change throughout his life. The neurotic form of response is established in childhood as a manifestation of overcompensation of some quality when significant relationships with the microenvironment are disrupted and has a childish connotation. There are no organic changes in the brain during non-existence.

An important feature of neurosis is that a person is aware of his illness and strives to overcome it. The ability to adapt to the environment is retained.

There are three main forms of neurosis:

Neurasthenia (asthenic neurosis) - the most common form of neurosis. In the development of neurosis in children and adolescents, the main role belongs to stress or chronic psychological trauma , most often associated with conflicts in the family (quarrels between parents, alcoholism, their divorce, a conflict situation due to the lack of work of spouses, a sense of social injustice - the inaccessibility of much that other peers have) or protracted school conflicts. Has the meaning and the wrong approach to education (excessive demands, unnecessary restrictions), as well as poor health child due to frequent illnesses, contributes to the development of overloading the child with various activities , primarily intellectual (increased teaching load in specialized schools, additional classes in clubs, etc.). However, the factor itself of intellectual (as well as physical) overload in childhood and adolescence, although it can cause overwork and asthenia of the nervous system, in the absence of a traumatic situation, it usually does not lead to the development of asthenic neurosis.

Asthenic neurosis in its expanded form occurs only in school-age children and adolescents (initial and atypical asthenic reactions are observed in children of early, preschool and primary school age).

The main manifestation of neurasthenia is the condition irritable weakness, characterized by On the one side, increased lack of restraint, a tendency to affective discharges of dissatisfaction, irritability and even anger, often aggression (excessive reaction to a minor issue), and with another- mental exhaustion, tearfulness, intolerance to any mental stress, rapid fatigue. Passive defense reactions are excessively expressed. At the same time, volitional activity is reduced, a feeling of futility arises against the background of over-responsibility, a depressed mood, there is dissatisfaction with oneself and everyone around, depression - severe melancholy, accompanied by a feeling of despair and anxiety, there may be attempts at suicide (suicide).

With neurasthenia, autonomic disorders are always present: palpitations, a feeling of heart sinking or interruptions, pain in the heart area, a tendency to vascular fainting (with a rapid change in body position), a decrease or increase in blood pressure, shortness of breath, increased vomiting reflex, decreased appetite, shallow sleep, cold hands and feet, sweating (hyperhidrosis), which contributes to the child’s colds, which in turn aggravate the course of asthenic neurosis.

Hysteria (Greek hystera - uterus) - in frequency it ranks second after neurasthenia. Occurs in infantile, hysterical individuals with poor mental adaptation (often with a pyknotic somatic constitution), often in a traumatic situation associated with a contradiction between what is desired and what is actually achievable (low academic performance, inattention from peers, etc.), with damaged pride, with dissatisfaction with their position in the team. Its forms are varied and are often disguised as various diseases (“the big liar”, “ big monkey" - this is how this type of neurosis is figuratively called). Its forms reflect two well-known animal (and children's) types of reactions in the face of danger - “imaginary death” (freezing) and “motor storm” (frightening, avoidance, attack) - seizures (by type epilepsy). A hysterical attack usually occurs in the presence of spectators and is aimed at attracting their attention. Partial fixation can manifest itself as functional paralysis and paresis, disorders of pain sensitivity, coordination of movements, speech disorders (stuttering, soundlessness up to complete muteness), attacks of suffocation reminiscent of asthmatic ones, etc. “Flight into illness” plays the role of a kind of pathological defense of the individual from difficult situations. situations, justify the child’s poor performance or eliminate the need to go to school.

Obsessive-compulsive neurosis. It occurs more often in asthenics, people of a melancholic nature. It is believed that definite obsessive-compulsive neurosis cannot arise before the age of 10. This is due to the achievement of a certain degree of maturity of self-awareness of the child’s personality and the formation of an anxious and suspicious background of the psyche, on the basis of which obsessive phenomena arise. In younger children, it is advisable to talk not about neurosis, but about neurotic reactions in the form of obsessive states.

There are two types of neurosis:

- obsessive anxiety neurosis(phobias). Their content depends on the age of the child. In younger children, obsessive fears of infection and contamination, sharp objects, and closed spaces predominate. In older children and adolescents, fears associated with the consciousness of their physical “I” dominate. For example, obsessive fears of illness and death, fear of blushing (ereitophobia), obsessive fear speech in people who stutter (logophobia). A special type of phobic neurosis in adolescents is no expectation, which is characterized by anxious anticipation and fear of failure when performing any habitual action (for example, fear of giving oral answers in front of the class, despite being well prepared), as well as violation of it when trying to perform it.

- neurosis of obsessive actions. However, there are often obsessive states mixed character. In this case, the mood tends to decrease, and autonomic disorders occur.

Children often have systemic neuroses :

- neurotic stuttering - disturbance of the rhythm, tempo and fluency of speech associated with muscle spasms involved in the speech act. It occurs more often in boys than in girls.

- Mutism ( lat.mutus - silence) is a disorder predominantly of school age (rare in adults), because The child’s developing speech is the youngest function of the psyche, and therefore is more often broken under the influence of a wide variety of harmful factors.

Children with mutism need to be treated with care - not to punish, not to ridicule, not to insult, not to put them on the board until they speak.

- neurotic tics– a variety of automated and unusual elementary movements (blinking, licking lips, twitching the head, shoulders, various movements of the limbs, torso), as well as coughing, “grunting”, “grunting” sounds (the so-called respiratory tics), which arise as a result of fixation of one or another protective action. Most often observed between the ages of 7 and 12 years. Tics can become obsessive in nature, in which case they are a manifestation of obsessive-compulsive neurosis ;

- anorexia nervosa – refusal to eat;

- neurotic sleep disorder – disturbance of falling asleep, depth of sleep with night awakenings, night terrors, as well as sleepwalking (somnambulism) and sleep talking.

- neurotic enuresis – unconscious urinary incontinence, mainly during night sleep ;

- neurotic encopresis – involuntary release of bowel movements that occurs in the absence of disorders or diseases lower section intestines. As a rule, the child does not feel the urge to defecate, at first does not notice the presence of bowel movements, and only after some time does he feel an unpleasant odor. Most often occurs at the age of 7–9 years, more often in boys.

Treatment methods for neuroses are based on a combination of pharmacological therapy with various types of psychotherapy.

Buyanov M.I. Conversations about child psychiatry. – M.: Education, 1992

Buyanov M.I. Fundamentals of psychotherapy for children and adolescents. - M.: Education, 1998

Doroshkevich M.P. Neuroses and neurotic conditions in children and adolescents: Textbook for students of pedagogical specialties of higher educational institutions / -Mn.: Belarus, 2004

Enikeeva D.D. Borderline states in children and adolescents: foundations of psychiatric knowledge. A manual for students. Higher Ped. Educational institutions.-M.: 1998

Fundamentals of psychological knowledge - Textbook. Author-compiler G.V. Shchekin - Kyiv, 1999

list the most common signs of disorders of cognitive activity, emotional and volitional activity.

name border mental states in children.

explain the need for knowledge about such conditions for the teacher.

characterize different types of psychopathy

Having analyzed the causes of psychopathy, give recommendations for their prevention.

give the concept of neurosis.

talk about the types of neuroses and their prevention.

Questions submitted for independent study:

1. Factors for the risk of mental illness in the era of scientific and technological revolution: urbanization, physical inactivity, information revantation, etc..

Weiner E.N. Valeology: a textbook for universities. – M.: Flinta: Nauka, 2002. – pp. 68-74; 197-201.

Additional block of information.

The living conditions of modern man differ significantly from those in which he became a biosocial being. On early stages During the existence of Homo sapiens, he led a lifestyle close to natural. In particular, he was characterized by a high level of physical activity, which in itself corresponded to the neuropsychic stress necessary in the struggle for existence. People lived in small communities, living in an ecologically clean natural environment, which could be replaced (but not changed) by the entire community if it became unsuitable for life.

The development of civilization went in the direction of property stratification and professional specialization of people, necessary for mastering new tools, increasing the length of training and gradually lengthening the period of specialization of part of the population. From the perspective of the life of one generation, all these changes occurred rather slowly, against the backdrop of relatively slow changes in the environment, low population density and the preservation high level motor activity. All this did not represent any special requirements for the human psyche that went beyond the requirements established in evolution.

The situation began to change with the beginnings of the development of capitalism and progressive urbanization, and most radically in the second half of the 20th century, when human lifestyle began to change rapidly.

Urbanization(Latin urbanus – urban) – socio-demographic process, which consists in the growth of the urban population, the number and size of cities, which is associated with the concentration and intensification of technogenic functions, the spread of a changed urban lifestyle

Urban population growth is sharp increased the density of person-to-person contacts.. Increased speeds of human movement lead to an increasing number of interpersonal contacts, and to a significant extent - with strangers. From a mental point of view, these contacts often turn out to be unpleasant for a person (the danger of developing distress). On the contrary, family relationships have a beneficial effect, if, of course, the relationships between family members are good. However, unfortunately, favorable family relationships occupy only 20-30 minutes a day in the family, according to statistics. There is often a disruption of traditional family ties.

An undoubted influence on the psyche of modern man is exerted by some factors that have noticeably changed external environment. So, The noise level has increased significantly within the city limits, where it significantly exceeds the permissible norms (busy highway). Poor sound insulation, TV, radio, etc. turned on in your own apartment or in your neighbors. make the influence of noise almost constant. They, unlike natural ones (wind noise, etc.), have Negative influence on the entire body and on the psyche in particular: breathing rate and blood pressure change, sleep and the nature of dreams are disturbed, insomnia and other unfavorable symptoms develop. Such factors have a particularly strong impact on a growing child’s body, and the level of fear in children increases more clearly.

A special place in radioactive contamination plays a role in disruption of a person’s mental state(the nervous system is very sensitive to its effects), electromagnetic pollution in the form of radiation from a tangle of wires and electrical appliances (makes a person more aggressive). On the emotional sphere of a person Some forms of rock music also have an extremely unfavorable effect, which are characterized by a monotonous rhythm, emphatically emotionally intense coloring of the soloists’ voices, increased volume above normal levels and a special spectrum of sound.

It should be taken into account that the person himself is a source of weak electromagnetic and other physical fields. Perhaps a large crowd of people (and this is typical for a city) generates electromagnetic waves of various characteristics, which at an unconscious level can have a negative effect on the brain.

Indirect influence on the state of the brain and mental health also has chemical pollution of the atmosphere(an increase in carbon monoxide in the inhaled air worsens gas exchange in brain tissue and reduces its functional characteristics, etc.).

Destruction of the natural human environment(which itself is a particle of nature), replacing it with an artificial environment made of stone and concrete, containing isolated spaces, etc., deforms the human psyche, especially the emotional component, disrupts perception, and reduces health potential.

The scientific and technological revolution led to a decrease in the share of physical labor, that is, to decreased level of physical activity(development of physical inactivity). This circumstance disrupted the natural biological mechanisms in which it was the latter that was the final link in life activity, therefore the nature of life processes in the body changed and ultimately the stock of human adaptive capabilities and its functional reserves decreased.

According to Academician Berg, over the last century, energy expenditure on muscle activity in humans has decreased from 94% to 1%. And this indicates that the body’s reserves have decreased by 94 times. Physical inactivity is especially unfavorable in children during the period of maturation of the body, when energy deficiency limits not only physical development, but also psychological (including intellectual). There may be a need for doping, first psychological, then medicinal, and quite possibly narcotic.

Physical inactivity turns off the final link of the stress response – movement. This leads to tension in the central nervous system, which, given the already high information and social overload of modern man, naturally leads to the transition of stress into distress, reduces physical and mental performance, disrupts normal brain function.

Modern life is associated with exceptionally large flow of varied information, which a person receives, processes and assimilates. According to some data, every 10-12 years the volume of newly acquired information in the world corresponds to that which was accumulated over the entire previous history of mankind. This means that modern children need to learn at least 4 times more information than their parents did at the same age, and 16 times more than their grandparents. But the modern human brain has remained almost the same as it was 100 and 10,000 years ago. This creates the preconditions for information overload. In addition, reducing the time for processing new information increases neuropsychic stress, which often causes negative reactions and conditions leading to disruptions of normal mental activity. At the same time, the brain tries to protect itself from excess and unfavorable information, which makes a person emotionally less sensitive, emotionally “dumb,” less responsive to the problems of loved ones, insensitive to cruelty, and then to kindness, aggressive. In some cases, this is already observed in young children.

The considered risk factors, characteristic of most cities, are associated with the so-called diseases of civilization - diseases widespread among economically developed countries: hypertension, ischemic disease heart disease, gastric ulcer, diabetes, metabolic diseases, bronchial asthma, neuroses, mental disorders, etc.

List the main health risk factors associated with the scientific and technological revolution.

Explain the negative impact of urbanization on human mental health.

Describe the connection between physical inactivity and human mental health

Describe the effect of excess information on the human psyche.

Give the concept of diseases of civilization.

– a personality disorder accompanied by short temper, quarrelsomeness, conflict and increased aggressiveness. Behavioral disorders are persistent, not controlled by volitional effort, and make it difficult to adapt to a team and create harmonious close relationships. Intelligence preserved. The change in character is stable, cannot be deeply corrected and does not progress throughout life, but can be aggravated under the influence of traumatic circumstances. At the compensation stage, measures for social, personal and labor adaptation are carried out. In the stage of decompensation, psychotherapy and drug therapy are used.

Reasons for the development of excitable psychopathy

The reason for the development excitable psychopathy are congenital or acquired at an early age features of the nervous system in combination with unfavorable external influences. If the main trigger factor the constitutional characteristics of the patient become, psychopathy is called nuclear. If the psychopathic traits of a patient are formed under the influence of unfavorable psychogenic influences, they speak of pathocharacteristic personality development or regional psychopathy.

Nuclear psychopathy is based on biological factors: unfavorable heredity, complicated pregnancy, difficult childbirth and developmental disorders in the first years of a child’s life. Regional psychopathy can be provoked by neglect, constant conflicts between parents, defects in upbringing, severe and long-term illnesses, congenital and acquired physical defects.

Excitable psychopathy can be provoked by constant humiliation, gross suppression of personality, ignoring the feelings and interests of the child or, on the contrary, admiration, adoration, an uncritical attitude towards his actions, the desire to indulge all his whims and whims. In this case, both the duration of the impact and the characteristics of the child’s character matter. Excitable psychopathy often develops in extroverted individuals with a stormy temperament and weak willpower, or in stubborn, persistent children.

With timely changes in social conditions and the creation of a psychologically favorable environment, the process of formation of a psychopathic personality stops, existing disorders stabilize or become less pronounced. Edge psychopathy is characterized by greater plasticity. With them, less pronounced behavioral disorders and better social adaptation are observed. The prognosis for marginal psychopathy is more favorable compared to nuclear ones.

Symptoms of excitable psychopathy

The main symptom of excitable psychopathy is repeated outbursts of uncontrollable anger that are inappropriate to the circumstances. Any minor event can provoke another attack of rage: an incorrectly prepared (from the patient’s point of view) and served breakfast at the wrong time, a poor assessment of a child, a small conflict in a queue or in transport, a disagreement between management and the patient’s position on some issue. professional issue etc. Usually it is possible to establish a connection between the behavior of others and an outburst of anger, but in some cases attacks can occur spontaneously, without any external reasons.

The degree of compensation can vary significantly. Some patients are well adapted, maintain families and work in one place for a long time. Others constantly destroy relationships, cannot get along with anyone, often change jobs or do not work at all. The cause of decompensation is usually acute conflicts and prolonged stress: divorce, breakup of personal relationships, dismissal or threat of job loss, physical illness, financial difficulties, etc.

Character changes in excitable psychopathy are noticeable from the first years of a child’s life. In childhood, patients are characterized by lack of restraint, sharp and rapid changes in emotions, unbridledness, inability to find compromises, a desire to take a leadership position and a tendency to aggressive behavior. They cannot control their emotional reactions through volition or conscious analysis of the situation. The only way to resolve the problem that has arisen for them is conflict, often rude, using threats and physical force.

Despite the ineffectiveness of aggression, frequent escalation of conflicts and deterioration of relationships with others, patients cannot find other, more productive options for solving problems. Both in childhood and as adults, they easily make enemies, which does not have the best effect on their personal relationships and social status. When decompensated in childhood, they often take part in fights and commit hooligan acts, and as adults they find themselves in the dock in connection with violent crimes.

In close contacts, such traits of explosive psychopaths as increased demands on family and friends, pickiness, suspicion, distrust, authority, quarrelsomeness, selfishness, and inability to take into account the interests and feelings of other people become especially noticeable. In a state of passion, the consciousness of patients narrows, they become capable of extremely cruel actions, including murder. Sometimes there is a tendency to develop addictions and persistently deviant behavior: alcoholism, drug addiction, gambling addiction, sexual perversion, vagrancy, etc.

Diagnosis of excitable psychopathy

The most important diagnostic criteria are aggressiveness, conflict and a tendency to sudden outbursts of anger, persistently persisting over many years, against the backdrop of preserved intelligence and the ability to critically evaluate one’s own actions. Psychopathic characteristics are stable and do not progress throughout life. Personality disorders are characterized by totality, global disharmony, and interfere with the patient’s family, social and work adaptation.

Often a differential diagnosis is required with neurotic-level disorders caused by chronic conflict (especially in the presence of severe psychological trauma in childhood). In both cases, persistent personal changes are observed, making professional fulfillment and building personal relationships difficult. The determining criterion in such cases is the severity and totality of personal transformation. Personality disorders in neurotic disorders are never so pronounced and global, sometimes reaching a psychotic level.

Treatment of excitable psychopathy

Despite the widespread prevalence of psychopathy, only a small proportion of patients seek professional help from psychiatrists, being in a state of compensation. Much more often, patients see a doctor at the stage of decompensation, when complications arise: substance abuse, drug addiction, alcoholism, acute psychotic episodes, depressive disorders, etc. After acute symptoms have been eliminated, most patients stop visiting a psychiatrist, and the doctor simply does not have any time correct psychopathic disorders.

Even with regular visits to a psychiatrist, treating excitable psychopathy is a daunting task. In essence, the psychiatrist needs to rebuild the core of the patient’s personality: his value system, life attitudes, attitude towards himself and others. In most cases, solving such a problem is absolutely unrealistic, so in practice, therapy for psychopathy consists of targeted impact on the most problematic areas. Elimination or mitigation of gross violations helps to improve the patient’s family and social adaptation, which, in turn, increases the chances of achieving sustainable compensation.

Most experts assign the main role to psychotherapy, considering it the most effective way to form an optimal style of relationships between the patient and others. Both individual therapy and group sessions are used. Foreign experts believe that best result is achieved through the use of long-term in-depth psychotherapy (psychoanalysis), but data for objective assessment this opinion is not yet enough.

In acute traumatic situations, they work with the patient’s current condition, help the patient at least partially reconsider internal standards and life attitudes, and provide psychological support. Psychological correction is carried out against the background drug treatment. To reduce excitability, drugs from the group of neuroleptics are prescribed, and antidepressants are used to normalize mood in depression and subdepression. To eliminate persistent malignant dysphoria, valproic acid and carbamazepine are used.