Any person who is part of social security and healthcare systems. In addition, patients suffering from mental illness have the right to be treated with humanity and respect. human personality. Persons suffering from, or perceived to be, mentally ill are entitled to rights that protect them from any form of exploitation. They are also protected from various physical abuses that degrade human dignity. The right to mental health care does not permit discrimination against a patient based on mental illness.
It should be clarified that, in in this case is meant by "discrimination". This means that there should not be any distinction, preference, or exception that makes the enjoyment of rights difficult or impossible. At the same time, the use of special measures aimed at improving or protecting the rights of mentally ill people does not constitute discrimination. The right to mental health care involves a number of features. For example, a determination of a patient's incapacity requires a hearing by an impartial and independent judicial body that operates in accordance with domestic law.
The right to psychiatric care also lies in the fact that every patient with a mental illness has the opportunity to undergo treatment in an environment that provides for the patient minimal restrictions. Also, less restrictive invasive treatments should be used. They must be consistent with the need to truly protect the safety of others and maintain the health of the patient. A person with a mental illness should receive care according to an individualized plan. Wherein, this plan should be discussed with the patient or his representatives. The plan is subject to regular clarification and, if necessary, changes. The plan is implemented by qualified medical personnel.
The right to psychiatric care also includes such an item as the right to diagnosis. Diagnosis of the patient mental illness is set taking into account internationally recognized standards. It should be noted that the diagnosis of mental illness is never based on social or economic background. In particular, the diagnosis cannot be made taking into account the patient’s membership in a particular religious or racial group, or for other reasons not directly related to the person’s mental state. In particular, a conflict of work or family type is not considered the determining factor. Also, the reason cannot be considered to be the person’s inconsistency with social, cultural, or other values that are widespread.
If a patient has been hospitalized and treated for mental disorders in the past, this is also not a reason to claim that the person currently has a mental illness. The right to psychiatric care provides that authorities or individuals can declare that a person has a mental illness only for the purpose of ensuring the safety of the said patient to prevent negative consequences diseases. It should be noted that everyone has the opportunity not only to receive the required psychiatric care, but he can expect that, if possible, he will continue to be in society, work in his previous place, or in another one that corresponds to his state of health, but, nevertheless, not in isolation.
It is unacceptable to force a person to undergo a special medical examination in order to identify a mental illness, unless this is a procedure provided for by domestic legislation. The right to non-psychiatric care ensures each patient confidentiality of information relating to his mental health. As far as the course of the disease allows, the patient has the right to be treated and receive care at the place of residence, outside the hospital. If psychiatric care is provided to a patient in a specialized clinic, then the patient has the right at the first opportunity to switch to outpatient or home treatment. In addition, treatment must be culturally appropriate.
Admitted for treatment at psychiatric institution the patient must be informed of his rights. Moreover, this should be done in a form that is simple and understandable for the patient. The information should include not only an explanation of these rights, but also the procedure for their practical implementation. It often happens that at a certain stage the patient does not understand the information, even provided in the in simple form. In such cases, his personal representatives, or those persons who are ready to represent the interests of this patient, must be informed about the patient’s rights. If the patient has the required legal capacity, he independently appoints a person who will represent his interests.
For the first time, “Regulations on the conditions and procedure for providing psychiatric care, aimed at protecting the rights of the mentally ill” were adopted by the Decree of the Presidium of the Supreme Soviet of the USSR on January 5, 1988. Subsequently (1993), a special law “On psychiatric care and guarantees of the rights of citizens during its provision” was adopted, according to which qualified psychiatric care is free, taking into account all the achievements of science and practice. This law is based on regulations according to which the dignity of the patient must not be violated when providing psychiatric care. Also this law regulates the procedure for conducting a psychiatric examination. This law states that psychiatric examination and preventive examinations are carried out only at the request or with the consent of the person being examined, and examinations and examinations of a minor under 15 years of age - at the request or with the consent of his parents or legal representative.
When conducting a psychiatric examination, the doctor is obliged to introduce himself to the patient, as well as his legal representative, as a psychiatrist. The exception is those cases when the examination can be carried out without the consent of the subject or his legal representative: in the presence of a severe mental disorder with an immediate danger of the patient to himself and others, if the subject is under dispensary observation. Outpatient psychiatric care for persons with mental illnesses is provided depending on medical indications and is carried out in the form of consultative and therapeutic care and dispensary observation.
Persons with mental disorders regardless of their consent or the consent of their legal representative (in cases where they are declared legally incompetent). At the same time, the attending physician constantly monitors the state of their mental health through regular examinations and provision of the necessary medical and social assistance.
In cases inpatient treatment patient with mental disorders must consent to this treatment in writing, with the exception of patients who are on compulsory treatment by court decision, as well as patients hospitalized involuntarily by law enforcement agencies. Without the consent of the patient, i.e. involuntarily, persons with mental disorders that make them dangerous to themselves and others, as well as patients in conditions where they are unable to satisfy basic life needs (for example, catatonic stupor, severe dementia) and can cause significant harm to their health due to deterioration mental state if they are left without psychiatric help.
A patient admitted to a hospital as a result of involuntary hospitalization must be examined within 48 hours by a commission of doctors, which determines the validity of hospitalization. In cases where hospitalization is considered justified, the commission’s conclusion is submitted to the court to decide the issue of the patient’s further stay in the hospital at the location of the hospital.
The patient's involuntary stay in a psychiatric hospital lasts as long as the reasons for the involuntary hospitalization remain (aggressive actions due to delusions and hallucinations, active suicidal tendencies).
To extend involuntary hospitalization, a re-examination by the commission is carried out once a month for the first six months, and then once every 6 months.
Human rights activists have been defending the rights of people with mental illness for a long time and persistently. And in Lately laws have appeared that give such people much more freedom and opportunities.
It would seem that one can only rejoice at this. But free will for the mentally ill turns into a huge danger. For others, for loved ones, but first of all - for themselves. Because a mentally ill person, left to his own devices, becomes easy prey for unscrupulous people, and most often for criminals. Especially in our country. The circle closes: in an effort to protect the rights of the patient, on the contrary, he is deprived of the protection he needs so much.
This is that rare case when the sweet word “freedom” has a very bitter aftertaste. I will say more - when it is generally inappropriate.
Since the late 90s, changes have been made to the Law on Psychiatric Care and Guarantees of Citizens' Rights in its Provision almost every year. They touch on many things. For example, in most cases, psychiatric care in our country is provided only when a person voluntarily turns to specialists. A doctor cannot even simply give an injection to a patient with PND without the patient’s consent. And before starting treatment, the doctor is obliged to tell the patient “about the goals, methods and duration of the recommended treatment, as well as pain, possible risk, side effects and expected results”... However, nowhere is it said who should determine whether the patient is able to correctly understand the doctor...
And getting doctors to hospitalize those whose condition has become dangerous for themselves or those around them is generally a disastrous endeavor.
That is, the mentally ill were given the right to decide for themselves whether to be treated, whether to take medications... But people with a disordered psyche who refused necessary medications, not only destroy themselves, but are sometimes deadly to others. They can commit any crimes, including the most terrible ones. And only after big trouble the patient can be hospitalized without his consent.
According to many psychiatrists, the struggle for the rights of the mentally ill led, in essence, to the collapse of the system of dynamic monitoring of them - as a result, all more people those with a disturbed psyche were at risk. In 2011, the Constitutional Court of the Russian Federation went even further, adopting a resolution allowing persons suffering from mental disorders to participate in court hearings to declare them incompetent on an equal basis with other participants in the process.
According to the law, bypassing guardians, doctors and guardianship authorities, incompetent citizens can apply to the courts to restore their legal capacity, which they do. Guardians, accordingly, are exempt from protecting sick people.
And that's what's scary. Having become capable, patients with persistent mental disorders receive the right to refuse to visit the ICP, to declare their deregistration and refusal of treatment. Everything is according to the law.
For many, restoring their rights becomes a road to nowhere.
“People with an unhealthy psyche do not consider themselves sick. Having given up the pills, they begin to look for enemies and grab knives - there are enough such cases. Relatives, neighbors, and random passers-by can become enemies,” says the doctor about the results of the ongoing reorganization medical sciences, psychiatrist-criminalist Mikhail Vinogradov. “Without drug support, they will do whatever they want.”
Inga Sergeevna Kulikova (name and surname have been changed), a 74-year-old Muscovite who has long suffered from a severe form of schizophrenia, no longer takes medications. It turned out to be beneficial for someone that she became “healthy” - and now the expert’s conclusion is ready for the court, confirming her adequacy, and soon a decision will be made to recognize Kulikova as legally competent.
Of course: Inga Sergeevna lives alone in a three-room apartment in Moscow.
And if the patient’s adequacy is judged not by expert opinions, but by her behavior and actions, then it becomes clear that Kulikova is a very tasty morsel for apartment swindlers.
* * *
“God forbid I go crazy, no, it’s better to have a staff and a bag” - Pushkin wrote this. But almost more than the mentally ill themselves, their relatives suffer. Responsibility for inadequate, but still loved and close people is a heavy burden that not everyone can bear.
Viktor Kulikov is one of those who survived. In recent years, he has been patiently and tenderly caring for his mother. Inga Sergeevna was declared incompetent in 2011, Victor became her guardian.
“Mom’s problems with her head began 25 years ago,” he says. “She started saying that they were following her, beating her in the subway, putting razors in her shoes, and following her. She burned the materials of her recently defended dissertation. She developed an insurmountable fear of infection - she called the SES, believing that the water was contaminated, and took a dosimeter with her everywhere. I didn’t allow my husband, my father, Georgiy Petrovich, to keep his things in the bathroom, since they were also “infected.” By the way, she simply hated her father, called him an informer, separated herself from him in the room with a curtain, and threw stones at his car. She wrote complaints and statements to the prosecutor's office, the Minister of Defense, the UN, even Prince Charles - against her husband, against me, against her brother. She demanded from all of them that my father be evicted from the apartment. She insisted that her family wanted to sell her to Arab countries, suspended by the legs from a chandelier, etc.
In August 1991, Inga left for the village where the Kulikovs have a house. Neighbors called from there and said that she was walking around naked with a backpack on her back, climbing onto the roof and not allowing herself to be filmed. The husband and son called a medical team and took Inga to a psychiatric hospital, where she was diagnosed with “paroxysmal-progressive schizophrenia, affective-delusional attack.”
She was discharged under the guarantee of her husband and registered with PND No. 17.
“Our life has turned into a kind of swing,” recalls Inga’s ex-husband Georgy Petrovich Kulikov. - For some time, the wife took medication and behaved quietly. Then the aggression and delirium returned. Her hatred for me grew, she demanded a divorce, I considered myself responsible for my wife, but in the end she kicked me out of the house and filed for divorce. I left with only the essentials. The son was already living separately at that time. Inga was left alone in the three-ruble ruble, believing that everything around her belonged to her, and only to her.
Later, the court recognized the ex-husband’s right to half the apartment and house in the village. But he only had housing on paper - Inga changed the locks and shouted through the door that she wouldn’t let anyone in. Georgy Petrovich had to leave the apartment he had earned at one time and rent a room.
“I, of course, could insist on an exchange,” recalls Georgy Petrovich. - But I imagined what would happen to Inga... To move her, real violence would have to be used. I couldn’t agree to this: after all, despite her terrible character and behavior, she is the mother of my child...
After Inga felt like a complete mistress, things began for the housemates. hard times. They tell how a crazy woman poured urine from the windows onto passers-by, at night she pulled the wire in front of the entrance, and in the morning she watched people stumble and fall. Inga covered the staircases with powder and broken glass as punishment for the cleaning lady who “cleaned up poorly.” And she wrote, wrote, wrote complaints to various authorities - about her ex-husband, about neighbors at the entrance, about the management of the housing cooperative, about her son, who allegedly keeps weapons and drugs at home, called riot police to his address, etc. 
Behind Last year Inga Sergeevna became addicted to alcohol.
“I have been living in an apartment since 2004. Until 2010, Kulikova did not let us live,” says Nastya, Inga Sergeevna’s neighbor. “At least once a week she called the local police officer and stated that I was a Mujahideen, Ukrainian or Belarusian. In short, the enemy. A squad arrived with machine guns, and I was pregnant at that time. Inga Sergeevna said that my husband and I “buried a child” under the windows, that I had a T-shirt with radioactive signs, that we sprinkled various mixtures with radiation on it. She accused us of climbing into her window every odd day at the beginning of the month, and climbing out a few days later. These days we steal her bed linen and medicine. She asked my husband to pull out snakes, etc., from under her bed.
Only at the end of 2010 was Inna able to be hospitalized - after her neighbors contacted the police with a collective letter. After long-term treatment and observations in the hospital. Gannushkin and in the 10th psychiatric hospital in 2011 she was declared incompetent, since the mental illness had no longer acquired a paroxysmal, but a continuous nature.
At the end of 2011, the woman returned home. The son, who took on the duties of a guardian, constantly came, looked after her, made sure that her mother visited doctors and took medications, fully supported her, and took her for walks and to the village. It seemed that everyone had somehow adapted to the difficult life with a mentally ill patient...
* * *
About a year ago, a new wave began in Inga Sergeevna’s condition: the 74-year-old woman developed an uncontrollable sexual attraction to young men. Products from sex shops and related literature began to appear in the apartment. Without hesitation, the mother began to turn to her son with requests to find her a “cowboy” for an intimate relationship...
Then she moved from talk to action. Neighboring young men from the category of those who are called asocial personalities often visited her home.
“I didn’t know what to do,” says son Victor. “Mom began to see me as an enemy who stood in her way to happiness. At first, she studied dating advertisements, hoping for a long-term relationship with a wealthy man. Then she began to become more and more fixated on intimacy itself. Neighbors reported that drunk men often come out of her apartment and spend the night there. Then, in an indecent state, they lie on the floor in the common vestibule. The guests extorted money from the pensioner and demanded that she buy vodka and beer. And it’s scary to remember her partners in the village where her mother spends the summer. Completely degraded homeless people with whom she drank alcohol and “consoled” almost every day.
Nastya, a neighbor next door, says: “For the past year now, men of about forty, drunk, dirty, smelly, looking like homeless people or drug addicts, have been constantly visiting her at night. They talk loudly and make noise, so I hear them coming. Early in the morning, around seven o'clock, they leave the apartment. Then they sit in our yard all day, smoke, drink, and wait until evening to go to Kulikova. They discuss her among themselves, they say that she is a crazy old woman, she is ready to do anything for the sake of intimacy. She buys them alcohol, food, and demands that they do this with her all night. They boast that they will soon move into her apartment. Inga Sergeevna has changed a lot this year, she has dropped. She was well-groomed, but now she is becoming like her drinking buddies...
By the way, none of the drugs prescribed by PND No. 17, where Kulikova is observed, can be combined with alcohol. Inga Sergeevna knows this and prefers alcohol - it helps to improve her personal life...
Victor repeatedly informed the attending physician T.V. Peregudin about what was happening to his mother. and guardianship authorities: “...due to the patient’s refusal to take medications prescribed by doctor PND No. 17, her mental state has deteriorated significantly... Kulikova I.S. needs supervision by a psychiatrist at a dispensary, as well as psychiatric care in outpatient setting, she was recommended to continue taking drug therapy, but the patient does not take any of the prescribed medications.”
* * *
But it turned out that this is not the worst thing.
Thunder struck in the spring of 2015, when Victor learned that his mother, who was in the already described “excellent” condition, filed an application with the Tushinsky District Court to recognize her as legally competent.
Who helped Inga Sergeevna collect all the documents? Who taught her how to write a statement correctly? Who put her in touch with lawyer Lomteva, who took on this case?
Further more. At dispensary No. 17, the district doctor Peregudina, who knew Inga Sergeevna well, quit. And the new doctor E.A. Kochurina, who observed her for only three weeks, concluded that the patient with continuous flow chronic mental disorder is observed in “persistent remission.”
“All through May 2015, I ran to the PND, trying to get an appointment with the new district police officer to tell me what was really happening,” says Victor, “but Dr. Kochurina categorically refused to meet with me.
Further - even more. The examination ordered by the court was carried out at the Center. Serbian. Victor says that on the day of the examination, they prevented him from going with his mother in every possible way; they demanded that he give her his passport, although all the other subjects of the examination went through with their guardians and relatives without hindrance.
For such an important examination, the center needed only a few hours. No surveillance. No analysis of documents about the extremely painful and ridiculous behavior of a very elderly patient. There just happened a miraculous transformation of a woman suffering from a chronic and protracted mental disorder with persistent painful manifestations, into absolutely normal person. Experts recognized Kulikova as unexpectedly cured. With full criticism and understanding of what she is doing.
And further important point. Someone clearly prepared Kulikova to communicate with the commission of experts. In her notes made in the spring of 2015, Victor found a multi-page “cheat sheet” on how to behave during the examination at the Serbsky Center. And the woman tried very hard to follow the recommendations.
From the conclusion:
“The expert characterizes herself as calm, non-conflict, indicates that she prefers difficult questions decides “through good reasoning”, “always thinks about her actions”, emphasizes that she “likes to live positively”... Indicates that she currently leads an active lifestyle, takes care of herself completely, strives to improve herself, reads books, goes to literary evenings."
And - no reaction to any document that would prevent Kulikova from being restored to legal capacity. On Inga Sergeevna’s painful sexual behavior, her connections with degenerate alcoholics and the emerging craving for alcohol. on her own statements that she was allowed to rent out Georgy Petrovich’s room to a young resident of Tula at the PND, and also cousin The husband (?!) also gave his consent. In response to Kulikova’s claim that her ex-husband registered her with the PND in order not to repay a debt in the amount of 9,000 rubles, which were allegedly given to him in the late 80s. Her plans to fight in court with the head of Sberbank German Gref, because the “electronic queue” introduced by Sberbank is her invention, which Gref “stole” from her. The intention, having become legally capable, is to start suing almost all relatives and relatives of relatives, because they are all rich and greedy... 
At the same time, from the board of the housing cooperative of the house where the “non-conflict” and “emotionally restrained” Kulikova lives, complaints are received from her guardian Viktor:
“... your ward Kulikova I.S. pours out the products of his own vital activity on the landing of the first floor and in the elevator... places unknown substances near mailboxes, motivating his actions by the need to fight rats and dogs.”
All these facts are from documents and protocols court hearings for some reason they did not become the subject of expert research, and there is not a word about them in the conclusion.
* * *
Despite the right of the legal representative to familiarize himself with all the materials of the case, including documents on the state of health of his mother and ward, Judge Moiseeva persistently does not allow the guardian to familiarize himself with the medical records and does not attach to the case those documents that would be very important for the experts to read.
Viktor Kulikov has repeatedly applied to Judge Moiseeva to provide him with copies to review and make copies of medical card from PND No. 17, where his mother is observed and where it should be reflected how changes occurred in the consciousness of the once seriously ill patient.
The applications were denied.
Everything suggests that there are interested parties in this matter. The scheme is well known: a mentally ill grandmother is given back her legal capacity and passport, and married to one of her favorite “cowboys.” Then the “young wife” will be persuaded to transfer her share of the apartment to the so-called. husband, after which it will be removed forever, the housing will be occupied, and the co-owner of the apartment, Georgy Petrovich, will have no choice but to transfer his share to the scammers for symbolic money. All this is a classic of the genre, as a result of which the housing ends up with the author of the entire scam.
“For almost a year now, Mikhail, born in 1974, has been regularly visiting his mother during the day and at night,” says Victor. - This is confirmed, among other things, by recordings from the CCTV camera at the entrance. This comrade does not work, drinks alcohol, moves in a criminal environment, and is registered with the PND. He drinks and eats at his mother’s expense, enters into intimate relationships with her, and regularly receives money from her. She also has another boyfriend - Maxim, born in 1967. He knows that his mother is mentally ill, but neither he nor his friends care. Alcohol as a condition for sex is what he needs. He not only comes himself, but also brings his drinking companions to her for drinking and sexual intercourse.
Victor wrote a statement about this to the local police department.
And on October 2 of this year, when the son came to visit his mother, at the door of her apartment he found a strong man behind him. He explained his presence in the entrance by the fact that he, being a student at VGIK, was filming the windows of Inna Sergeevna’s apartment, where there were still old frames. Victor was unable to find out why he had to go into the entrance to do this. But we managed to find a note: “Call this phone, you won’t regret it”...
Where does negligence and indifference end in this story? government agencies, and where crime begins is difficult to understand. But it seems like both are happening. We really hope that specialists both in the field of psychiatry and the law enforcement system will understand all its details.
In the interests of Inga Sergeevna. In the interests of her family and neighbors. It is in the interests of all Moscow residents, each of whom may be unexpectedly affected by the fact that a mentally ill person is left to his own devices.
In this case, everyone’s interests coincide. They do not coincide only with the interests of criminals.
Reference
According to research, most criminals have various types of mental disorders. According to the results of forensic psychiatric examinations, almost 70% of convicts were found to have neuropsychiatric disorders. Among murderers, more than 71% have various mental illnesses.
Reference
According to the chief psychiatrist of the Ministry of Health of the Russian Federation, Zurab Kekelidze, in Russia the number of people suffering from mental disorders (who are registered) exceeds four million. At the same time the doctor Science Center mental health at the Research Institute of Psychiatry of the Ministry of Health of the Russian Federation Olga Shchelokova says that in our country there are about 21 million 680 thousand people with mental illnesses, which is 14% of the Russian population.
For the first time, “Regulations on the conditions and procedure for providing psychiatric care aimed at protecting the rights of the mentally ill” were adopted by the Decree of the Presidium of the Supreme Soviet of the USSR on January 5, 1988. Subsequently (1993), a special law “On psychiatric care and guarantees of the rights of citizens” was adopted when providing it,” according to which qualified psychiatric care is provided free of charge, taking into account all the achievements of science and practice. This law is based on regulations according to which the dignity of the patient must not be violated when providing psychiatric care. This law also regulates the procedure for conducting psychiatric examinations. This law states that psychiatric examinations and preventive examinations are carried out only at the request or with the consent of the person being examined, and examinations and examinations of a minor under 15 years of age - at the request or with the consent of his parents or legal representative.
When conducting a psychiatric examination, the doctor is obliged to introduce himself to the patient, as well as his legal representative, as a psychiatrist. The exception is those cases when the examination can be carried out without the consent of the subject or his legal representative: in the presence of a severe mental disorder with an immediate danger of the patient to himself and others, if the subject is under dispensary observation. Outpatient psychiatric care for persons with mental illnesses is provided depending on medical indications and is carried out in the form of consultative and therapeutic care and dispensary observation.
Persons with mental disorders are placed under dispensary observation, regardless of their consent or the consent of their legal representative (in cases where they are declared legally incompetent). At the same time, the attending physician constantly monitors the state of their mental health through regular examinations and provision of the necessary medical and social assistance.
In cases of inpatient treatment of a patient with mental disorders, written consent to this treatment is required, with the exception of patients undergoing compulsory treatment by court decision, as well as patients involuntarily hospitalized by law enforcement agencies. Without the consent of the patient, i.e. involuntarily, persons with mental disorders that make them dangerous to themselves and others, as well as patients in conditions where they are unable to satisfy basic life needs (for example, catatonic stupor, severe dementia) and can cause significant harm to their health due to deterioration of their mental state if left without psychiatric help.
A patient admitted to a hospital as a result of involuntary hospitalization must be examined within 48 hours by a commission of doctors, which determines the validity of hospitalization. In cases where hospitalization is considered justified, the commission’s conclusion is submitted to the court to decide the issue of the patient’s further stay in the hospital at the location of the hospital.
The patient's involuntary stay in a psychiatric hospital lasts as long as the reasons for the involuntary hospitalization remain (aggressive actions due to delusions and hallucinations, active suicidal tendencies).
To extend involuntary hospitalization, a re-examination by the commission is carried out once a month for the first six months, and then once every 6 months.
An important achievement in respecting the rights of mentally ill citizens is to release them from responsibility for socially committed acts committed by them during illness dangerous actions(crimes).
End of work -
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Subject and tasks of psychiatry. History of development
Psychiatry is a medical discipline that studies the diagnosis and treatment, etiology, pathogenesis and prevalence of mental illnesses, as well as the organization of mental health care.
Inpatient psychiatric care
To provide inpatient care there are psychiatric hospitals and psychiatric departments, which may be specialized to treat patients with borderline non-
Out-of-hospital care for mentally ill people
Psychoneurological dispensaries operating on a territorial basis were established in 1923. Currently, psychiatric care outside the hospital is developing in three
Basic psychopathological syndromes. The concept of nosology
Translated from Greek, “syndrome” means “accumulation”, “confluence”. At present medical term"syndrome" means a set of symptoms united by a single pathogenesis,
General provisions
Throughout the world, there are officially two types of classifications of mental disorders: national classifications and the International one, developed within the framework of the World Health Organization.
Symptoms of Perceptual Disorders
Hyperesthesia – increased sensitivity to stimuli of normal strength. Often occurs with exogenous organic lesions of the central nervous system (intoxication, trauma, infection
Perceptual disorder syndromes
Hallucinosis – psychopathological syndrome, the leading disorder of which is hallucinations. Hallucinations, as a rule, occur in one analyzer, less often in several
Disorders of the form of associative process
Accelerated pace (tachyphrenia) – thinking is superficial, thoughts flow quickly, easily replacing each other. Characterized by increased distractibility, patients
Mixed forms of delirium
Delirium of staging. Patients are convinced that those around them are putting on some kind of performance especially for them. Combined with delirium of intermetamorphosis, for which
Delusional syndromes
Paranoid syndrome– the presence of monothematic primary systematized delirium. One theme is typical, usually delusions of persecution, jealousy, invention
Pathology of memory
Memory is a cognitive (gnostic) function that allows the accumulation of perceived information. Manifests itself in the form of abilities (functions) to write by holding
Generalized forms of amnesia
Fixation amnesia - the memory function (fixation) is impaired; patients do not retain in their memory the events that just happened to them. With this form amne
Pathology of intelligence
Intelligence is the totality of a person’s cognitive abilities, the desire to acquire new knowledge. Intelligence helps to adapt to a situation, understand the meaning of
Psychopathological speech disorders
Tachyphasia is accelerated speech, which can manifest itself in verbosity or interspersed with proverbs and puns. It is noted with accelerated thinking, depending on the severity
Types of Emotional Disorders
Hyperthymia (mania) manifests itself in the form of inappropriate elevated background mood, which is accompanied by an increased desire for activity, overestimation of one’s capabilities
Depressive states
Depression is a condition accompanied by an affect of melancholy (hypotymia), inhibition of thinking and decreased motor activity(depressive triad). Classified by origin
Somatized (masked, larved) depression
The leading one is the somato-vegetative component. Complaints about Bad mood usually absent, patients tend to turn to somatic doctors. The effect of melancholy was not expressed
Disorders of will
Will is a person’s purposeful activity, the ability to set goals. Great importance in the formation of volitional acts has the motivational sphere of people
Desire disorders
Attraction is a need that arises as an unconscious desire for something. Disorders of impulses are manifested by their weakening, intensification and perversion. Disorders
Desire disorders
Self-torture is the desire to beat oneself and cause bodily suffering. Usually observed in melancholic raptus, abstinence, and delusional states.
Gender identity disorders
Transsexualism - a sense of self and attribution of oneself to opposite sex, is usually accompanied by the desire to change one’s appearance (in clothing, in manners, infusion
Sexual preference disorders
Homosexuality (excluded from ICD-10) – attraction to people of the same sex. It can be combined with attraction to the opposite sex (bisexuality). Patients do not strive for
Other disorders of sexual preference
Telephone bestiality - sexual arousal is achieved by making anonymous phone calls and saying obscenities. Frotteurism
Disorders of consciousness
Consciousness is the totality of a person’s knowledge and ideas about the world around him and about himself. This is the ability to navigate the environment and one’s own personality. Violation
Changes in consciousness (qualitative disorders of consciousness)
Delirium is a pronounced disorder of object orientation while maintaining personal orientation. Productive pathopsychological symptoms are expressed in the form of hallucinations (sp.
Attention disorders
Attention - mental function, ensuring the selection of certain objects in the mind (focusing on something) while simultaneously distracting from other stimuli. Attention
Neurotic syndromes
A feature of the neurotic circle syndromes is the shallow level of disorders. A critical attitude towards mental disorders remains, and awareness of the disease is present. IN
Masked (somatized, larved) depression
Somato-vegetative disorders that mask the affect of melancholy come to the fore. Characteristic of neuroses, psychopathy, reactive states. Depression with dysphoric otto
Manic syndrome with anger (angry mania)
In the clinic manic syndrome Dysphoric affect predominates. There is always manic hyperbulia with an active “struggle for justice” and an overestimation of social significance
Derealization-depersonalization syndrome
Characterized by the presence of changes in the surrounding world and (or) one’s own personality while maintaining criticism towards painful sensations and subjectively painful experiences of this state. Bol
Epileptic and epileptiform syndromes
Epileptic and epileptiform syndromes primarily differ in etiology. Epileptic syndrome is observed in the clinic of endogenous epilepsy. E
Convulsive paroxysms
Paroxysms (fits) are suddenly developing, short-term (up to several seconds, less often up to several days) conditions movement disorders, autonomic disorders and different
Nonconvulsive paroxysms
Absence seizures (absence - “absence”) are a short-term loss of consciousness, sometimes accompanied by a drop in muscle tone (but patients do not fall, but freeze in the position
Negative (deficiency) syndromes
Negative syndromes are persistent or reversible personality changes in the form of a decrease, defect or loss of any function. Productive and negative symptoms(syndromes) always su
Premorbid personality types
For diagnosis, prognosis and selection of methods of psychotherapy and rehabilitation, it is important to assess the premorbid personality type, which implies its main features, character type before
Personality disorders
Personality disorders (psychopathy) – pathological characters, may be constitutional, hereditary, or developed as a result of prolonged, especially
Affective mood disorders
Mood – predominant for a certain period and influencing the whole mental activity emotional condition. All mood disorders are characterized by two
Paroxysmal-progressive (fur-like) schizophrenia
Fur-like schizophrenia is the most common among all forms of schizophrenia. The essence of the paroxysmal-progressive type of dynamics of schizophrenia is the combination of two variants of the course
(1) Persons suffering from mental disorders have all the rights and freedoms of citizens provided for by the Constitution Russian Federation, the Constitutions of the republics within the Russian Federation, the legislation of the Russian Federation and the republics within the Russian Federation. Restriction of the rights and freedoms of citizens associated with mental disorder is permissible only in cases provided for by the laws of the Russian Federation.
(2) All persons suffering from mental disorders, when provided with psychiatric care, have the right to:
respectful and humane treatment, excluding humiliation of human dignity;
receiving information about their rights, as well as, in a form accessible to them and taking into account their mental state, information about the nature of the mental disorders they have and the treatment methods used;
mental health care in the least restrictive setting, preferably in the community;
all types of treatment (including sanatorium and resort) according to medical indications;
provision of psychiatric care in conditions corresponding to sanitary conditions hygienic requirements;
preliminary consent and refusal at any stage from use as a test object medical supplies and methods scientific research or educational process, from photography, video or filming;
inviting, at their request, any specialist involved in the provision of mental health care, with the consent of the latter, to work in medical commission on issues regulated by this Law;
assistance of a lawyer, legal representative or other person in the manner established by law.
(3) Restriction of the rights and freedoms of persons suffering from mental disorders solely on the basis of a psychiatric diagnosis, the facts of being under dispensary observation in a psychiatric hospital or in a psychoneurological institution for social security or special education is not allowed. Officials guilty of such violations bear responsibility in accordance with the legislation of the Russian Federation and the republics within the Russian Federation.
Rights of patients in psychiatric hospitals
(1) The patient must be explained the reasons and purposes of his placement in a psychiatric hospital, his rights and the rules established in the hospital in the language he speaks, which is recorded in the medical documentation.
(2) All patients undergoing treatment or examination in a psychiatric hospital have the right to:
contact directly the chief physician or head of the department regarding treatment, examination, discharge from a psychiatric hospital and compliance with the rights granted by this Law;
submit uncensored complaints and statements to the bodies of representative and executive power, prosecutor's office, court and lawyer;
meet with a lawyer and a clergyman alone;
perform religious rituals, observe religious canons, including fasting, and, in agreement with the administration, have religious paraphernalia and literature;
subscribe to newspapers and magazines;
receive education according to the program secondary school or a special school for children with disabilities intellectual development if the patient is under 18 years of age;
receive, on an equal basis with other citizens, remuneration for work in accordance with its quantity and quality, if the patient participates in productive work.
(3) Patients also have the following rights, which may be limited on the recommendation of the attending physician by the head of the department or chief physician in the interests of health or safety
patients and in the interests of the health or safety of others:
conduct correspondence without censorship;
receive and send parcels, parcels and Money transfers;
use the telephone;
receive visitors;
have and purchase basic necessities, use their own clothing.
(4) Paid services(individual subscriptions to newspapers and magazines, communication services, etc.) are carried out at the expense of the patient to whom they are provided.
Administration and medical staff psychiatric hospitals are obliged to create conditions for the exercise of the rights of patients and their legal representatives provided for by this Law, including:
1. provide patients in a psychiatric hospital with the necessary medical care;
2. provide the opportunity to familiarize yourself with the text of this Law, the internal regulations of a given psychiatric hospital, addresses and telephone numbers of state and public bodies, institutions, organizations and officials who can be contacted in case of violation of the rights of patients;
3. provide conditions for correspondence, sending complaints and applications from patients to representative and executive authorities, the prosecutor’s office, the court, and also to a lawyer;
4. within 24 hours from the moment the patient is admitted to a psychiatric hospital on an involuntary basis, take measures to notify his relatives, legal representative or other person at his direction;
5. inform the patient’s relatives or legal representative, as well as another person at his direction, about changes in his health status and emergency incidents with him;
6. ensure the safety of hospitalized patients, control the contents of parcels and deliveries;
7. perform the functions of a legal representative in relation to patients recognized as legally incompetent, but who do not have such a representative;
8. establish and explain to religious patients the rules that must, in the interests of other patients in a psychiatric hospital, be observed during the performance of religious rites, and the procedure for inviting a clergyman, to promote the exercise of the right to freedom of conscience of believers and atheists;
9. fulfill other duties established by this Law.
The problem of the rights of mentally ill people in our country remains in the center of attention of the domestic and foreign public. Many abuses in this area have been exposed and condemned, but it is too early to talk about complete prosperity.
In general, ensuring the rights of citizens when providing mental health care is extremely difficult. Firstly, people generally have a negative attitude towards mental patients. The word "psycho" is offensive in Russian. Many people simply do not realize how many people suffer from mental disorders there are around. Most of these patients adapt well to harsh reality. And most of all they are afraid that they will not find out about their illness at work. Secondly, mentally ill people have traditionally had their rights limited, and this has been the basis for the abuse of psychiatry for centuries. The diagnosis of mental illness, both 300 years ago and more recently in our country, was a reason for placing unwanted people in a hospital. It doesn't matter whether they criticized the party or the farm director. Even the World Psychiatric Association wanted to exclude Soviet psychiatrists from among its members, since the use of medicine for political purposes is unacceptable. To avoid this, the Soviet Society of Psychiatrists itself left the association.
Currently, the question of the possibility of using PSYCHOSURGICAL treatment methods for mentally ill patients remains highly controversial. They mean a destructive effect on the brain or its pathways. Destruction can be carried out by mechanical methods, injections of chemicals, electric current, laser, ultrasound, cryotherapy methods. Proponents of such treatment methods note that the disease process is either interrupted or the person becomes much more manageable. However, they themselves note a significant percentage of failures, i.e. high risk percentage.
Opponents of these methods believe that the patient is not able to give informed consent to such an operation and therefore it will be illegal. The right of the family to give such consent is questionable.
In Russian legislation, such operations and other manipulations that cause irreversible phenomena when a patient is involuntarily admitted to a hospital are prohibited.
It seems that such treatment methods should not be used at the current level of medical development, because It is not human health that is restored, but an artificially altered human personality that is created.
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