Senile psychosis is a group of mental illnesses that develop in people over the age of 60. These disorders are accompanied by a decrease in mental and intellectual activity, loss of skills acquired by a person.
Some sources contain information that senile psychosis is senile dementia. This statement not entirely correct. One of the signs of senile psychosis may be dementia, but it will not be total. The main symptoms of this group of diseases are of the psychotic type. Moreover, intelligence can be completely preserved.
Senile psychosis has similar symptoms to Pick's disease, as well as presenile psychoses, which develop at an earlier age. This complicates diagnosis in the early stages of the disease.
- All information on the site is for informational purposes only and is NOT a guide to action!
- Can give you an ACCURATE DIAGNOSIS only DOCTOR!
- We kindly ask you NOT to self-medicate, but make an appointment with a specialist!
- Health to you and your loved ones!
Causes
Senile psychosis occurs due to the gradual, age-related death of a group of cells. To date, the reasons causing these processes have not been precisely determined. Experts put forward various versions.
For example, as with many other atrophic processes, the presumed cause is heredity. Indeed, in medical practice, cases of “familial dementia” are often encountered. Unfavorable external influence and somatic pathologies are provoking factors in the development of the disease.
One more probable cause the occurrence of senile psychosis are degenerative processes localized in the brain. There is a theory that the disease develops under the influence of various infectious diseases.
Among other causes of senile psychosis, experts identify the following:
- physical inactivity,
- unhealthy diet
- sleep disorders,
- deterioration of vision and hearing.
Symptoms
The disease may occur acutely or be preceded by a prodromal period, which is accompanied by increased fatigue, sleep disorder, loss of appetite, difficulties with self-care.
All senile psychoses are characterized by a smooth course. They gradually progress, leading to deep decay mental activity.
The main signs of senile psychosis are the following:
- fast fatiguability;
- clouding of consciousness;
- occasional hallucinations;
- rave;
- insomnia;
- loss of appetite;
- motor excitement.
This general symptoms, which occur in the vast majority of cases of development of this group of ailments. However, you should know that senile psychosis occurs in two forms - acute, chronic. Accordingly, their individual signs will be different.
Yes, for chronic disease The following main symptoms of the disease are characteristic:
- the occurrence of depressive and paranoid syndromes;
- prolonged bouts of delirium, hallucinations;
- development of productive diseases with preservation of intelligence and memory.
Forms of senile psychosis
There are two main forms of prussian psychosis - acute and chronic. The first is accompanied by clouding of consciousness, the second by the emergence of depressive and paranoid states.
In addition, doctors distinguish other forms of hydrocyanic psychosis:
| Simple | It manifests itself as a sharpening of the boundaries of individual character traits (for example, thriftiness is transformed into greed), a change personal characteristics, a tendency towards egocentrism, the development of indifference towards close people, as well as other similar negative changes. |
| Expanded | Accompanied by memory loss, disorientation in space and time, return to the past, drowsiness in daytime and increased activity at night. |
| Final | It can transform from an advanced one in a few weeks, it is characterized by the patient being in the grip of a complete marasmic state and leads to death due to concomitant disease. |
| Confabulatory | An alternative variant of the development of the developed form of the disease, it is distinguished by the predominance of delusional inventions in the patient, the manifestation of excessive good nature, and the use of emphatically correct speech. |
The disease is divided into the following forms:
| Acute | The acute form of the disease occurs suddenly. Sometimes it is preceded by a prodromal period, which is expressed by the patient’s weakness, impaired appetite and insomnia. The acute form of senile psychosis is manifested by the following symptoms:
As a rule, it is accompanied by the appearance of delusional ideas, for example, the patient unreasonably believes that he is in danger or is subject to any material damage. Hallucinations may occur. The acute form of senile psychosis causes an exacerbation of somatic diseases, if they became the cause of its development. Psychosis can last up to 2-3 weeks. In rare cases, this period lasts longer. The acute form of the disease can occur in two variants:
In the second case, patients feel weakness and apathy in between “outbreaks” of the disease. |
| Chronic | The chronic form of the disease can manifest itself with various signs. We can identify the conditions that most often accompany it:
The chronic form of senile psychosis is manifested by depressive or subdepressive states. Subdepressive states are expressed by the following symptoms:
The chronic course of the disease may be accompanied by paranoid delusions. For example, it seems to the patient that others are deliberately trying to harm him or his property. Delusional behavior occurs already in the early stages of the disease. Thus, patients, in the absence of objective reasons, begin to complain about neighbors or loved ones to the police, as well as other authorities, want to change their place of residence, etc. The chronic form of senile psychosis may be accompanied by hallucinations (verbal, verbal, visual, tactile). These conditions often bother the patient for a long time - 10-15 years. |
Diagnostics
Diagnosing the disease in the early stages of its development is quite difficult. The disease is masked behind symptoms that are characteristic of tumor, cardiovascular and other ailments that often occur in older people.
It is possible to make an accurate conclusion about the presence of senile psychosis only after the disease manifests itself in the involution phase. Diagnosis is based on symptoms and additional methods studies such as computed tomography.
It is the use of the latter that makes it possible to accurately determine the presence of senile psychosis and differentiate it from diseases with similar symptoms (for example, late schizophrenia).
Treatment
There is no effective treatment to completely cure senile psychosis. These conditions require the use of maintenance therapy, which will reduce the severity of symptoms or eliminate them altogether.
Treatment can be outpatient or inpatient. The decision on hospitalization is made by the doctor, his consent to place the patient in medical institution relatives give.
Typically, in the early stages of the disease, the patient is not hospitalized. A change of environment can negatively affect his condition and cause a sharp progression of the disease.
Treatment is prescribed by a doctor taking into account the following factors:
- Form and severity of the disease.
- The presence of somatic diseases and their severity.
- General condition of the patient.
Medical practice shows that it is easier to cope with acute senile psychosis than with a chronic illness. Its treatment also involves the correction of somatic diseases that caused its development.
If senile psychosis manifests itself as depressive states, then the patient is prescribed psychotropic drugs. The dosage is calculated individually. Other manifestations of psychosis are eliminated with the help of triftazine, propazine, sonapax, haloperidol.
These drugs have quite serious side effects. Increasing the dosage on your own is unacceptable, as it can lead to the development of complications.
Self-medication for senile psychosis is prohibited, because it can cause a chronic form of the disease. Under the supervision of the attending doctor, the patient will be able to get rid of the symptoms of the disease, which complicates both his life and the lives of his loved ones.
Effective preventive measures against senile psychosis have not been developed. Experts call general recommendations, which allow older people to prolong a full and healthy life:
- maintaining a sufficient level of activity;
- maintaining social connections;
- searching for new hobbies that are accessible to older people.
In addition, it is necessary to promptly treat emerging somatic diseases, as they can cause the development of senile psychosis.
Psychological impact
Treatment of senile psychosis includes not only prescription medications, but also psychotherapy.
It provides impact in several directions at once:
- focusing the patient's attention on the illogicality of his behavior and probable complications which it can cause;
- treatment with positive memories, which leads to an improvement in the patient’s mood and helps reduce anxiety;
- forced orientation of the patient in time and space;
- using games for mental stimulation, solving puzzles;
- art therapy, listening to music, as well as other methods that have a stimulating effect on the patient.
Senile psychosis (or senile psychosis) is a group of mental illnesses of different etiologies that occur after 60 years. It manifests itself as clouding of consciousness and the emergence of various endoform disorders (resembling schizophrenia and manic-depressive psychosis). In various sources you can find information that senile psychosis is identical to senile dementia, that they are one and the same thing. But this is not entirely true. Yes, senile psychosis can be accompanied by dementia, but in this case it is not total. AND key features senile psychosis, still have the character of a psychotic disorder (sometimes the intellect remains intact).
The main cause of senile psychosis is considered to be the gradual, age-related death of brain cells. However, this phenomenon cannot be explained only by age, because not all older people develop this condition. Predisposition to this disease may be genetic character, cases of the development of senile psychosis are often repeated in the same family.
There are acute and chronic forms of senile psychosis. Acute forms are manifested by clouding of consciousness, and chronic forms are manifested by the occurrence of paranoid, depressive, hallucinatory and paraphrenic states. Regardless of age, medical treatment such conditions are mandatory.
Their occurrence is associated with the presence of somatic diseases, which is why they are called somatogenic. The cause may be a lack of vitamins, heart failure, illness genitourinary system, diseases of the upper respiratory tract, lack of sleep, physical inactivity, decreased hearing and vision.
Such somatic diseases in older people are not always diagnosed in a timely manner, and treatment is often delayed. On this basis, an acute form of senile psychosis arises as a consequence. All this once again emphasizes how important the role is timely treatment any somatic diseases in older people - their mental health may depend on this.
Typically, the acute form of senile psychosis occurs suddenly. But, in some cases, the onset of acute psychosis is preceded by a so-called prodromal period (1-3 days).
During this period, the patient experiences weakness and problems in self-care, spatial orientation becomes difficult, appetite and sleep are disturbed. Then, in fact, the attack of acute psychosis itself occurs.
It is expressed in motor restlessness, fussiness, and confusion of thinking. Various crazy ideas and thoughts (the patient usually believes that they want to harm him, take away his property, etc.). Hallucinations and illusions may appear, but they are few and have a stable appearance. As a rule, when acute senile psychosis develops, the symptoms of somatic disorders that led to its development also worsen. Psychosis lasts from several days to 2-3 weeks. The disease itself can occur continuously, or it can occur in the form of periodic exacerbations. During the period between exacerbations, the patient feels weakness and apathy. Treatment of the acute form of senile psychosis is preferably carried out in a hospital.
Chronic forms of senile psychosis
There are several chronic forms, and they are determined by the key signs (symptoms) that accompany the course of the disease.
Depressive states
Depressive states (more common in women). In mild cases, there is lethargy, apathy, a feeling of the meaninglessness of the present and the futility of the future. At severe course- there is pronounced anxiety, deep depression, delirium of self-blame, agitation up to Cotard's syndrome. The duration of the disease is usually 12-17 years, and nevertheless, the patient’s memory disorders are usually not profound.
Paranoid states
They are characterized by chronic delusions, which are usually directed at the immediate environment (relatives, neighbors). The patient constantly says that he is offended and oppressed in his own home, and they want to get rid of him. It seems to him that his personal belongings are being stolen or damaged. In severe cases, delusional ideas arise that they are trying to destroy him - kill him, poison him, etc. The patient can lock himself in his room and restrict access to other persons. However, with this form of the disease, the person is able to take care of himself, and in general socialization is preserved. The disease develops and lasts for many years.
Hallucinosis
Hallucinatory states (or hallucinosis). There are several varieties - verbal, tactile and visual hallucinosis.
Usually expressed by a combination of hallucinations of various kinds with paranoid ideas and thoughts. This disease appears at the age of about 60 years and lasts for many years, sometimes up to 10-15 years. The clinical picture quickly becomes similar to the signs of schizophrenia (for example, the patient suspects that they want to kill or rob him, and this is accompanied by various visual hallucinations, the patient “hears voices,” etc.). Memory impairments develop slowly, are not noticeable in the first stages of the disease, and clearly manifest themselves after many years of the disease.
Senile paraphrenia (confabulosis)
Typical signs of the disease are multiple confabulations related to the past (the patient attributes to himself acquaintances and connections with famous and influential people, there is an overestimation of oneself, up to delusions of grandeur). Such confabulations take on the appearance of “clichés”, that is, they practically do not change either in form or content. Such disorders occur at the age of 70 years or more; memory impairments are not pronounced at the initial stage and develop gradually.
Of course, the gradual age-related breakdown of the psyche is partly natural process. However, the symptoms of such illnesses can be painful both for the patient himself and for his loved ones. At extremely severe conditions the patient may cause unintentional harm to himself or others. Therefore, treatment of such conditions is certainly necessary. While a person is alive, you need to do everything possible to last years his life was filled with joy and peace.
Treatment methods for senile psychosis
The decision on the need for hospitalization is made by the doctor, with the consent of the patient’s relatives. Treatment is carried out taking into account general condition patient: the form and severity of the disease, as well as the presence and severity of somatic diseases are taken into account.
For depressive conditions, psychotropic drugs such as azafen, pyrazidol, amitriptyline, and melipramine are prescribed. Sometimes a combination of two drugs is used at a certain dosage. Other forms of senile psychosis are treated with the following drugs: triftazine, propazine, haloperidol, sonapax. Treatment of any form of senile psychosis also involves the appointment of correctors (for example, cyclodol).
Senile psychosis belongs to the category of mental illnesses that develop in older people. The gradual atrophy of brain cells is accompanied by a breakdown of mental activity, which leads to dementia. The main reasons for the formation of this pathology are genetic predisposition And somatic diseases. Treatment of this type of psychosis is made difficult by the absence of early symptomatic manifestations.
Causes of the disease
Presenile and senile psychoses in most cases develop in women. This pathology is formed due to atrophy of cells in the cerebral cortex. The risk of the disease increases if there are cases of senile psychosis in the patient's family. The main reasons that provoke the appearance of the disease in old age are:
- age-related death of cellular structures;
- deterioration of brain function;
- heredity;
- infectious diseases;
- somatic diseases;
- pathologies of hearing and visual analyzers;
- psychotrauma;
- use of anesthesia;
- weakening of muscle tone;
- insomnia;
- poor nutrition.
Not all older people show clinical signs of mental illness. In this regard, scientists identify heredity as the leading factor. IN in this case progression of the disease is noted, despite timely treatment and provision of necessary living conditions.
Classification of senile senile psychosis
Senile mental disorder has acute and chronic forms. The most common is the acute form of psychosis, characterized by a sharp development pathological process. In this case, the duration of the disease does not exceed 30 days and ends in remission.
The chronic form of the disorder does not have specific symptoms, which makes diagnosing the pathology difficult. The disease of this form can last about 20 years, during which the person retains mental activity.
Acute forms of senile psychosis
The occurrence of this form of hydrocyanic disorder in old people occurs under the influence of somatic diseases that have progressed in the body over a long period. The formation of pathology is also influenced by the use of anesthesia, surgical interventions and complications during rehabilitation.
Acute stage preceded by a prodromal period of 24-72 hours. At this time, the patient experiences loss of appetite, insomnia, weakness, and slight difficulties in spatial orientation. Offensive acute phase accompanied by delusions, hallucinations, confusion of thinking, and motor disinhibition. The patient's delusional ideas and thoughts are characterized by increased scrupulosity and aggression towards others.
Chronic forms of senile psychosis
Psychosis in older people in the chronic stage manifests itself in the form of a paranoid, hallucinogenic mixed syndrome. The first syndrome is characterized by constant delusions aimed at the immediate environment. IN this state the patient can take care of himself and communicate with other people.
Hallucinogenic syndrome is a mental disorder of verbal, visual or tactile perception. With the verbal type, a person is characterized by intimidation, the use of profanity, loss of control over one’s own behavior, and chaotic movements. Visual hallucinations at the initial stage they have dim images, which over time turn into realistic pictures. Some patients talk to characters in their hallucinations.
The tactile type of psychosis is associated with a feeling of itching and burning of the skin, insects crawling over the body. This condition forces a person to constantly wash their hands, consult a dermatologist, and try to get rid of the discomfort in every possible way.
At mixed form psychosis, the patient experiences a combination of hallucinations and paranoia. The condition is similar to manifestations of schizophrenia - the patient sees images, performs all kinds of movements, hears voices. Mnemonic functions are preserved at the initial stage of the disease.
Depending on the duration of the disease and the degree of progression of the symptomatic picture, chronic psychoses are divided into the following types:
- Simple, manifested by character accentuations.
- Expanded, characterized by memory loss, disruption of sleep and wakefulness, disorientation in a familiar environment.
- Final, accompanied emotional oppression and complete insanity caused by the gradual age-related death of the cerebral cortex.
- Confabulatory, associated with the development of delirium, excessive love of others, the desire to talk a lot, pathological friendliness.
All forms of senile psychosis develop gradually. Progression of the disease leads to severe disorders mental state an elderly person.
Symptoms of senile psychosis
Psychosis in the elderly is accompanied by symptomatic picture, common to all forms of pathology:
- slow course of the disease;
- distorted perception of current events;
- fading of memory functions;
- a sharp increase in character traits;
- anxiety;
- sleep disturbance.
With psychosis, a change in personality occurs - exaggeration of character traits, narrowing of horizons, loss of interests, deterioration of critical thinking. A person becomes selfish, picky, stingy, and angry.
In the intellectual sphere, the patient loses creative and abstracting functions, mnemonic abilities, and the ability to navigate in time and space. Such people lose their memory, feel like children, and do not recognize their reflection. Emotional disturbances characterized by detachment, depression, gloominess, depressive disorders, gradually giving way to carelessness and euphoria.
Treatment of senile psychosis
Therapy for senile psychoses is based on integrated approach using psychocorrection methods and drug treatment. Psychotherapeutic correction has the following goals:
- reduction of worry and anxiety;
- improvement of memory, intellectual and speech functions;
- return of the patient to society.
Pharmacotherapy of senile disorder is based on the use of antidepressants, antipsychotics, sedatives. Parallel correction of concomitant somatic diseases is also carried out.
This disease cannot be completely eliminated, but it can be reduced symptomatic manifestations and reduce the rate of disease progression. In addition to medical treatment, the patient needs comfortable conditions, regular walks, visits public places, attention and care of relatives.
Prognosis and prevention
At early detection and well-chosen treatment, it is possible to control the course of senile psychosis. At acute form The prognosis for the disease is favorable. Chronic forms violations cannot be eliminated completely. In such cases, it is possible to achieve stable remission and reduce the severity of clinical symptoms.
There are no specific measures to prevent the disease. Experts recommend what to do to minimize the likelihood of developing senile mental disorders: perform regular physical exercise, develop intellectual abilities, adhere to proper nutrition, consult a doctor promptly.
– a group of psychotic conditions that occur in people over 60 years of age and are not accompanied by rapid development profound dementia. They vary in etiology and symptoms and can be acute or chronic. They manifest themselves as confusion, disturbances reminiscent of the clinical picture of schizophrenia or bipolar affective disorder. Paranoid, hallucinatory and hallucinatory-delusional states are possible. Diagnosed by a psychiatrist based on anamnesis, interviews with the patient and his relatives. Treatment includes antipsychotics, tranquilizers, nootropics, and therapy for concomitant somatic pathologies.
General information
Senile (senile) psychoses are mental disorders that first arise in old age and are largely functional character. They were first described and classified in late XIX century by the German psychiatrist K. Fürstner, his colleagues J. Segla and A. Ritti. Then interest in the study of this group of disorders decreased; many researchers considered senile psychoses as psychotic variants of senile dementia. In the 40s of the twentieth century, the German psychiatrist W. Mayer-Gross and other specialists began to successfully treat such conditions. This, as well as the increase in average life expectancy and, accordingly, the number of patients, led to a revival of psychiatrists' interest in senile psychoses. The exact prevalence is unknown; according to various sources, the share of nosology in general structure mental illnesses of late age range from 12 to 25%. The age of onset of symptoms and gender distribution depend on the form of the disorder.
Causes of senile psychoses
Etiology and pathogenesis have not been established. It is assumed that the cause of the development of the disorder is an age-related weakening of mental activity against the background of certain personal characteristics, the influence of exogenous and endogenous unfavorable factors. Circumstances that increase the likelihood of senile psychosis include:
- Female. Proportion of men and women suffering various forms diseases varies significantly, however, in general there is a predominance of female patients, especially among patients with depressive disorders.
- Hereditary predisposition. According to experts, senile psychoses are more often diagnosed in patients whose families have had cases of similar psychotic conditions or senile dementia.
- Somatic diseases. Exacerbations therapeutic pathology provoke acute psychoses, existing diseases aggravate and modify the picture of chronic psychotic conditions.
Classification
The modern classification of senile psychotic conditions has existed since 1958, developed by a special WHO commission as part of the classification of mental disorders of late age, and compiled according to the syndromic principle. Includes diseases with a predominantly functional component (as opposed to senile dementia, in which the organic component predominates), including:
- Affective psychoses. Manic and depressive disorders, which first appeared in old age.
- Paraphrenia. Psychotic conditions, the defining symptoms of which are hallucinations, hallucinatory-delusional and delusional disorders.
- States of Confusion. Disorders in which confusion plays a dominant role.
- Psychoses in somatic diseases. They occur during exacerbation or decompensation of an existing therapeutic pathology.
There is also a Russian clinical classification, according to which there is one form of acute senile disorder (somatogenic or symptomatic psychosis) and five forms of chronic psychotic state: senile depression, hallucinosis, hallucinatory-paranoid and paranoid psychoses, senile paraphrenia. Experts note that along with pathological conditions, characteristic only for old age, this group disorders includes forms similar to presenile psychoses (involutional depression and involutional paranoid). Some Russian psychiatrists consider these forms as late-onset variants of presenile disorders.
Symptoms of senile psychoses
Acute forms of senile psychoses. They are the most common. They usually occur against the background of decompensation or exacerbation of a somatic disease, therefore they are called somatogenic or symptomatic. Most often, the provoking factor is heart failure, acute or chronic pathologies respiratory tract, diseases genitourinary organs and hypovitaminosis. They are characterized by disturbances in orientation, fragmented symptoms, and frequent changes in forms of confusion. Possible motor agitation, anxiety, confusion, delusions, and mild hallucinations. Disorders last from several days to several weeks, can be single or multiple, intensity mental disorders directly correlates with the severity of somatic pathology. The outcome is a persistent or transient psychoorganic syndrome, asthenia, adynamia.
Chronic senile depression. Develops predominantly in women. Occurs in the form of apathy, adynamia, or “quiet” depressive states with heavy affective disorders(up to suicide unexpected for relatives against the backdrop of outwardly blurred pronounced changes mood). Possible hypochondriacal disorders, agitated states with self-blame, anxiety, and in severe cases - with the development of Cotard's delirium. The duration of the disease can be 10 years or more. In recent years there has been a softening clinical picture, severe depression with delirium and agitation are less common. The pathology has a slight effect on the level of intelligence and cognitive functions, and appears gradually over time. pronounced violations memory.
Chronic paranoid psychoses. They manifest themselves as delusions of a small scale - interpretative delusions about harmful intentions and actions on the part of relatives and neighbors. Patients believe that other people are trying to hasten their death, try to force them out of the apartment, secretly add poison or something inedible to their food, steal and rearrange things. Accompanied by attempts to “protect oneself” (changing locks, complaints to official authorities). Little influence on social adaptation, the possibility of self-service remains. They last for years with a gradual reduction of symptoms.
Chronic hallucinosis. Occurs over the age of 70-80 years. They manifest themselves as visual, auditory (Bonnet hallucinosis) or tactile hallucinations. For visual and auditory hallucinosis, it is typical to maintain a critical attitude in combination with reactions to hallucinations as to real phenomena at the height of the attack. Average age the onset of symptoms of verbal hallucinosis - 70 years, visual - 80 years. Subsequently, patients develop dysmnestic disorders.
Hallucinatory-paranoid psychoses. They are characterized by the emergence of delusions of harm, which are later joined by hallucinations, which gradually acquire fantastic content and are subsequently replaced by confabulations. The first symptoms appear at the age of about 60 years, the clinical picture is initially similar to paranoid senile psychosis. At the age of 70-80 years, the symptoms are supplemented by polyvocal verbal hallucinosis, which resembles Bonnet hallucinosis, sometimes supplemented by echo thoughts, a feeling of mental openness, and mental voices. A schizophrenia-like picture of the disease develops. The outcome is paraphrenic-confabulatory disorders or ecmnestic confabulations. The duration of the course can be tens of years; over time, slowly progressive memory impairments are revealed.
Senile paraphrenia. Usually occurs after age 70. The leading place in the clinical picture is occupied by confabulations of fantastic content related to the past, sometimes combined with everyday confabulations. Patients talk about incredible, fascinating events that allegedly happened to them, about friendships with celebrities, about victories in love, etc. Confabulations are persistent in nature, changes both in the basis of the plot and in details are uncharacteristic. Typically euphorically elevated mood, possible development of delusions of grandeur. The duration of the course is 3-4 years; subsequently, a gradual reduction of symptoms is observed with the development of dysmnestic disorders.
Diagnostics
A senile psychotic state is diagnosed taking into account the patient’s age and the clinical picture of the disease. Characteristic features are:
- Stability, limited manifestations. Symptoms change little over time, usually limited to disorders of one circle, often to one syndrome (with the exception of the hallucinatory-paranoid form, in which standard changes in clinical symptoms are observed).
- Severity of disorders. Psychopathological manifestations in senile psychoses, they are usually expressed clearly enough to accurately identify the psychotic state and determine its type.
- Duration of productive disturbances. Delusions and hallucinations in senile psychoses persist stably for a long period of time (several years), and then gradually decrease.
- Preservation of intelligence. Gross violations there are no cognitive functions; a gradual increase in dysmnestic disorders with long-term preservation of emotionally charged memories is characteristic.
Differential diagnosis of senile psychoses is carried out with depression with late manifestation of bipolar disorder, late schizophrenia, paranoid disorders that occur in initial stages senile dementia. Chronic verbal hallucinosis is differentiated from rare hallucinatory disorders in vascular pathology brain, paraphrenia - with presbyophrenia. If a somatic pathology is suspected, appropriate diagnostic studies are performed, for example, CT and MRI of the brain.
Treatment of senile psychoses
The basis of treatment is drug therapy. Patients are prescribed antipsychotics, antidepressants, sedatives. When selecting a drug and determining the dosage, take into account age change reactions to the effects of medications and an increase in the likelihood of side effects. The treatment program must be supplemented with nootropics. At the same time, they treat somatic diseases, correct the general condition of the patient, and provide careful care.
Prognosis and prevention
The prognosis for timely treatment of acute senile psychosis is favorable; with a late start of treatment and severe symptoms, the outcome is the formation of a psychoorganic syndrome. Chronic forms of senile disorders of the psychotic level are considered as prognostically unfavorable in terms of recovery. Remission during treatment is sometimes observed in Bonnet hallucinosis and senile depression; in other disorders, a decrease in the intensity of the manifestations of the disease is possible. There is no specific prevention. Non-specific preventive measures include maintaining mental hygiene, avoiding stress, timely treatment of somatic diseases and early contact with a psychiatrist when signs of mental disorders appear.
Old age is a difficult period in a person’s life, when not only his physiological functions, but also major changes psyche.
A person’s social circle narrows, health deteriorates, and cognitive abilities weaken.
It is during this period that people are most susceptible to developing mental illness, a large group of which are senile psychoses.
What is fairy tale therapy for older people? Find out about this from ours.
Personality characteristics of older people
According to WHO classification, old age begins in people after 60 years of age, this age period is divided into: advanced age (60-70, senile (70-90) and long-lived age (after 90 years).
Major mental problems elderly:
- Narrowing your social circle. The man does not go to work, the children live independently and rarely visit him, many of his friends have already died.
- Shortage. In an elderly person, attention, perception. According to one theory, this occurs due to a decrease in the capabilities of external perception, according to another, due to a lack of use of the intellect. That is, functions die out as unnecessary.
Main question— how the person himself relates to this period and the changes taking place. Here his personal experiences, health and social status play a role.
If a person is in demand in society, then it is much easier to survive all the problems. Also, a healthy, cheerful person will not feel old.
The psychological problems of an elderly person are a reflection public relations in old age. It may be positive and negative.
At positive At first glance, it appears to be guardianship over the elderly, respect for their life experience and wisdom. Negative is expressed in a disdainful attitude towards the elderly, the perception of their experience as unnecessary and superfluous.
Psychologists identify the following types of people's attitudes towards their old age:
- Regression, or a return to childhood behavior patterns. Old people demand increased attention, show touchiness and capriciousness.
- Apathy. Old people stop communicating with others, become isolated, withdraw into themselves, and show passivity.
- The desire to join public life , despite age and illness.
Thus, an elderly person will behave in old age in accordance with his life lived, attitudes, acquired values.
Senile mental illness
As you age, your likelihood of developing mental illness increases. Psychiatrists say that 15% of old people acquire various mental illness. The following types of diseases are characteristic of old age::
Psychoses
In medicine, psychosis is understood as a severe mental disorder in which behavioral and mental reactions do not correspond to the real state of affairs.
Senile (senile) psychoses first appear after age 65.
They make up approximately 20% of all cases of mental illness.
Doctors call natural aging of the body the main cause of senile psychosis.
Provoking factors are:
- To belong to female . Among the sick, women make up the majority.
- Heredity. Most often, psychosis is diagnosed in people whose relatives suffered from mental disorders.
- . Some diseases provoke and aggravate the course of mental illness.
WHO developed in 1958 classification of psychoses, based on the syndromic principle. The following types are distinguished:
- . This includes mania and.
- Paraphrenia. The main manifestations are delusions and hallucinations.
- State of confusion. The disorder is based on confusion.
- Somatogenic psychoses. They develop against the background of somatic diseases and occur in an acute form.
Symptoms
The clinical picture depends on the type of disease, as well as on the severity of the stage.
Symptoms of the development of acute psychosis:
- violation of orientation in space;
- motor excitation;
- anxiety;
- hallucinatory states;
- the emergence of delusional ideas.
Acute psychosis lasts from several days to a month. It directly depends on the severity of the somatic disease.
Postoperative psychosis refers to acute mental disorders that occur within a week after surgery. The signs are:
- delusions, hallucinations;
- violation of orientation in space and time;
- confusion;
- motor excitement.
This state can last continuously or be combined with periods of enlightenment.
- lethargy, apathy;
- a feeling of meaninglessness of existence;
- anxiety;
- suicidal feelings.
It lasts quite a long time, while the patient retains all cognitive functions.
- delirium directed towards loved ones;
- constant expectation of trickery from others. It seems to the patient that they want to poison him, kill him, rob him, etc.;
- restriction of communication due to fear of being offended.
However, the patient retains self-care and socialization skills.
Hallucinosis. In this state, the patient experiences various hallucinations: verbal, visual, tactile. He hears voices, sees non-existent characters, feels touches.
The patient may communicate with these characters or try to get rid of them, for example, by building barricades, washing and cleaning his home.
Paraphrenia. Fantastic confabulations come first. The patient talks about his connections with famous personalities, ascribes to himself non-existent merits. Delusions of grandeur and high spirits are also characteristic.
Diagnostics
What to do? A consultation is required to make a diagnosis. psychiatrist and neurologist.
The psychiatrist conducts special diagnostic tests and prescribes tests. The basis for diagnosis are:
- Stability occurrence of symptoms. They occur with a certain frequency and do not differ in variety.
Psychoses are not characterized by severe mental disorders; they increase gradually as the disease progresses.
Treatment
Treatment of senile psychoses combines medicinal and psychotherapeutic methods. The choice depends on the severity of the condition, the type of disorder, and the presence of somatic diseases. Patients are prescribed the following groups of drugs:
The doctor selects a combination of drugs according to the type of psychosis.
It is also necessary to treat in parallel somatic disease, if it appeared cause of the disorder.
Psychotherapy
Psychotherapeutic sessions are an excellent remedy for the correction of psychosis in the elderly. In combination with drug therapy they give positive results.
Doctors mainly use group classes. Old people, studying in groups, acquire a new circle of friends with common interests. A person can begin to talk openly about his problems and fears, thereby getting rid of them.
Most effective methods psychotherapy:
Senile psychoses- this is a problem not only for the patient himself, but also for his relatives. With timely and correct treatment, the prognosis for senile psychosis is favorable. Even with severe symptoms stable remission can be achieved. Chronic psychoses, especially those associated with depression, are less responsive to treatment.
The patient's relatives need to be patient, show care and attention. Mental disorder is a consequence of the aging of the body, so no person is immune from it.
Loading...