Causes, signs and treatment of vascular psychosis
What is vascular psychosis?
The definition of vascular psychoses includes psychoses, which are based on vascular diseases of the brain (atherosclerosis, hypertension, hypotension, thrombosis, and others). These psychoses have an acute and subacute form, occurring with the presence of a transitional syndrome and dim consciousness, as well as chronic manifestations of psychoses of an affective or hallucinatory-paranoid type.
Mental disorders, in the formation of which pathologies of the vascular system are involved, cause a variety of symptoms, which is explained by various diseases.
It is impossible to say exactly how widespread these psychoses have become.
The reflection of clinical diversity and the possible difference in mental disorders, taking into account their origin, is presented in the following classification of mental disorders, which are based on vascular disorders: syndromes in an initial, neurosis-like, pseudo-neurosthenic form; various types of vascular dementia; exogenous, delusional, affective, hallucinatory and other types of syndromes.
The special isolation of the syndrome in its initial form with vascular genesis is justified by the frequency of its occurrence, as well as by the fact that in most cases the presence of vascular pathology this particular syndrome may be the only manifestation of the clinical picture of the disease for its entire period. Under such circumstances, the progress of the disease is not observed, but rather stabilizes at this stage of manifestation.
Content:
- Signs and symptoms of vascular psychosis
- Differential diagnosis
- Treatment of vascular psychosis
Signs and symptoms of vascular psychosis
Vascular psychoses in their initial manifestations are recorded as a syndrome in a pseudo-neurasthenic form. This means a non-psychotic type of symptoms with certain inclusions of pathologies of an organic nature. Against this background, symptoms of a psychopathological type are closely intertwined with mild stigmas of a neurological type. The patient complains of the presence of noise or ringing in the ears, the onset of which occurs suddenly and disappears just as quickly. The headache in the occipital region resembles a constriction and occurs in the morning.
The characteristic symptom is a feeling of numbness in the cheeks, chin, nose and twitching of the facial muscles. Psychosis takes place against the background of disturbed sleep patterns, the duration of which decreases to 3 hours without the possibility of falling asleep again and is superficial. The patient becomes sensitive to any stimulus and may experience episodic dizziness, imbalance while walking. He has an instability of the emotional plan, forgetfulness, excessive tearfulness, instability of attention, rapid fatigability.
The patient is aware of his pain and his negative changes. They are expressed in slow motility of reactions and speech, a tendency to judicious edification, difficulty in remembering new events and information, a violation in the exact dating of what is happening. The instability of the emotional sphere and incontinence of affect (moodiness, tearfulness, anxious concerns about health, relatives) are constantly present. Hypochondria may develop.
Reactive states and disorders of the neurotic type have the ability to develop when transient somatic disorders occur. At the same time, depressive reactions, symptoms of hypochondria, fear of imminent death, helplessness and dependence are constantly present. Such symptomatology of the initial stage in vascular pathologies makes it possible for the manifestation of personal changes with manifestations of a psychopathic type, a certain rigidity in the sphere of the psyche. Subordination of psychopathization to the factor of age is observed.
Differential diagnosis
The initial period of the process of vascular pathology has signs that resemble neurasthenic and neuropathic diseases. When diagnosing, the doctor relies on the somatics of arteriosclerotic sigma or the symptoms of hypertension (detects changes in the fundus, determines the diffuse microsymptomatics of the neurological type).
The greatest difficulty is the delimitation of senile dementia from vascular dementia. In this variant, a flickering of symptomatic signs of vascular processes with periods of recovery alternating with sharp changes in the functions of the psyche is considered to be a distinctive feature, and senile dementia is constantly progressing without visible intervals of stabilization. Also, vascular disorders have an acute manifestation at the onset of the disease with the presence of a nocturnal increase in the undulation of consciousness.
Treatment of vascular psychosis
The basis of therapeutic measures in the treatment of vascular psychosis is to eliminate the underlying disease of a somatic nature. The doctor prescribes psychotropic medications depending on the predominance of certain mental disorders. At the beginning of treatment, sedative tranquilizers are used (atarax, rudotel and others).
In small doses, it is possible to prescribe antipsychotics (rispolept, propazin, haloperidol). Anxiety-depressive disorders require atypical antidepressants to prevent confusion with amitriptyline.
During treatment, they strive to maintain the patient's vital activity in a normal mode.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
