From the standpoint of practical expediency, mental illnesses are divided by origin into exogenous and endogenous. Exogenous diseases are a consequence of the pathological influence on the activity of the brain of various external (relative to brain tissue) physical, chemical and psychogenic traumatic factors. These include harmful infectious-allergic, metabolic, intoxication, thermal, mechanical, cerebrotraumatic, radiation and other physical and chemical effects, as well as those caused by adverse social circumstances, in particular those that cause intrapersonal conflicts. Most researchers of psychogenic traumatic mental disorders belong to the third independent group called "psychogeny".
If the main causes of exogenous diseases are sufficiently known, then the etiology of endogenous mental illnesses (schizophrenia, manic-depressive or bipolar, psychosis, the so-called idiopathic or genuin, epilepsy, some psychoses of late age) cannot be considered resolved. Diseases develop under the influence of hereditary, constitutional, age and other characteristics of the body, which cause certain biochemical, immune and other changes, which leads to primary pathological disorders of mental activity. According to generally accepted ideas, any external factors can only affect the onset and further course of endogenous diseases, and not be their root cause.
However, some authors consider it inappropriate to single out groups of endogenous mental illnesses, because they associate the occurrence of these disorders with the consequences of exogenous influences that have become entrenched in the genetic matrix for future generations. That is, the listed diseases in a particular patient are due to certain exogenous (or environmental) effects on his close or distant relatives, which he inherited.
Thus, the doctrine of the etiology of mental illness is still far from perfect. At the same time, the least known, as in the rest of the pathology, is the causal relationship of many factors that affect mental activity.
The impact on a person of any potentially pathogenic factor does not at all mean the fatal inevitability of a mental illness. Whether the disease develops or not depends on a combination of factors: constitutional-typological (genetic and congenitally determined signs, features, morphological and functional constitution, individual characteristics of biochemical, immune, vegetative and other processes), somatogenic (acquired features of metabolic processes due to the state of organs and systems of the body and ecology), psychosocial (the peculiarity of interpersonal, in particular industrial, family and other relations of the patient in the micro- and macroenvironment).
Having analyzed the mutual influence of constitutional-typological, somatogenic and psychosocial moments in each specific case, one can come closer to understanding why, for example, during an influenza epidemic, the mental reaction of one patient is limited to an adequate individual within the limits of the psyche reserves, the second - to a short-term pathological reaction of the psyche, and in third, it takes the form of a stable neurosis-like or neurotic state or develops a clear mental disorder, etc. Therefore, methodologically, the emergence of a mental illness cannot be put in strict dependence on any, even powerful, factors. It is more correct to speak about the interaction of a certain factor with the individual mechanisms of biological, psychological and social adaptation of a person. So, mental illness is the result of an unsatisfactory integral adaptation of the individual to biopsychosocial influences. Moreover, each mental illness has its own underlying cause, without which it cannot develop. For example, post-traumatic encephalopathy will not occur without traumatic brain injury (TBI).
It is worth noting the high significance of all the above groups of factors that lead to mental disorders, and to emphasize the not absolutely pathogenic significance of each of them individually. For example, speaking about the significant role of heredity in the occurrence of diseases such as schizophrenia and manic-depressive psychosis, one must remember that even if any of them is present in one of the identical twins, the risk of developing it in the other is quite large, but not one hundred percent. Therefore, it is worth talking about heredity not of endogenous mental pathology, but of a tendency to it. This also applies to the influence of innate personality traits, morphological constitution, typical features of the autonomic nervous system, and others.
In the implementation of hereditary predisposition, an important role is played by the influence of additional harmful factors. Most researchers note that the onset of schizophrenia and its relapses in almost two-thirds of cases provoke mental or physical trauma, somatic diseases, intoxication, etc. Psychogeny (neurosis, reactive psychosis), alcoholic delirium and other disorders of consciousness most often occur against the background of somatic problems.
The origin of some mental illnesses is directly related to age. For example, oligophrenia is caused by mental retardation, which is formed in early childhood or is a consequence of congenital underdevelopment of the brain. Pycnoleptic attacks in children stop at puberty. Presenile and senile psychoses occur in the elderly and senile age. In crisis age periods (puberty and menopause), such mental disorders as neurosis and psychopathy often debut or decompensate.
The gender of the patients is of some importance. Thus, affective mental disorders are more common in women than in men. In women, Pick's disease, Alzheimer's, involutional, hypertensive and climacteric psychoses predominate. Naturally, they have mental disorders due to hormonal and other changes during pregnancy or childbirth. And among people with atherosclerotic, intoxication, syphilitic psychoses, as well as patients with alcoholism and alcoholic psychoses, with neuropsychiatric disorders caused by TBI, men predominate.
A number of psychosocial and exogenous factors leading to mental disorders are directly related to the patient's professional activities. We are talking about such harmful production factors as mental and physical overstrain, emotional overstrain, intoxication, hypothermia and overheating, high vibration levels, radiation pollution, noise, hypoxia, physical inactivity, various types of deprivation, etc. Each of these adverse effects has quite typical psychopathological consequences. For example, psychosocial situations, accompanied by excessive mental stress, often lead to neurotic disorders, while a pronounced deficit in sensory and other types of stimulation mainly causes deviations in the psychotic register.
It is advisable to recall the seasonal changes in mental activity. In some psychopathological conditions, especially endogenous psychoses with a phase course, an exacerbation is observed in the autumn and spring periods. It is worth noting the adverse impact of intense changes in meteorological factors. Patients with vascular, cerebrotraumatic and other organic brain disorders are very sensitive to them.
Negatively affect the neuropsychic state of the situation, leading to the so-called desynchronosis, that is, a violation of biological rhythms, for example, daytime wakefulness and nighttime sleep, the distribution of mental and physical activity is inadequate to the type of character ("owl" and "lark"), artificially provoked violations menstrual cycle, etc.
The pathogenesis (or mechanism of development) of mental illness depends on the interaction in the prenatal and postnatal periods of hereditarily determined factors of the individual's body and adverse psychosocial, physical and chemical effects on his personality, brain and extra-cerebral somatic sphere. Biochemical, electrophysiological, immune, morphological, systemic and personal changes arising from such interaction and which can be investigated by modern methods are accompanied by characteristic pathophysiological disorders. In turn, such changes are subject to certain spatial and temporal patterns, which ultimately determine the stereotype of manifestations of painful neuropsychic symptoms, their dynamics and specificity.
Thus, the pathogenesis, and, consequently, the type of mental illness, determine the peculiar individual reactions to a variety of situations, both exogenous and endogenous, formed in the process of ontogenesis and phylogenesis. It is worth noting that the neuropsychic sphere of each individual person responds to various pathogenic influences with typical restrictions for this individual and a stereotyped set of reactions.
At the same time, the same harmful effect in different people, depending on the individual compensatory capabilities of the body and a number of other circumstances, can cause various psychopathological complexes. For example, alcohol abuse is accompanied by psychotic states that are markedly different from each other. Here it is worth recalling alcoholic delirium, acute and chronic alcoholic hallucinosis, acute and chronic alcoholic paranoid, Korsakov's polyneurotic psychosis, alcoholic pseudoparalysis, Gaye-Veriike encephalopathy. The same infectious disease can lead to febrile delirium, or amentia, epileptiform syndrome, symptomatic mania, and in the long term - to Korsakoff's amnesic syndrome, post-infectious encephalopathy, etc.
It is also worth giving examples of monoetiological monopathogenetic diseases. So, in the origin of phenylpyruvic oligophrenia, the leading role is played by genetically determined metabolic disorders. Or another example: thanks to a cytological study, a specific chromosomal disorder was revealed, on which the pathogenesis of Down's disease is based.
At the same time, various etiological factors can “trigger” the same pathogenetic mechanisms that form the same psychopathological syndrome. As noted above, a delirious state, for example, occurs in patients with alcoholism and in infectious diseases in a state of fever. It can also develop after TBI, intoxication due to poisoning with various substances, with somatic diseases (somatogenic psychosis). A convincing illustration of the existence of such psychopathological conditions arising for various reasons is epilepsy, which refers to polyetiological monopathogenetic diseases.
However, the stability of individual psychopathological response is relative. Qualitative and quantitative characteristics of painful symptoms depend on many circumstances, in particular on the age of the person. So, for children, due to the morphological immaturity of the central nervous system, and, consequently, the insufficiency of abstract-logical, thought processes, ideational, primarily delusional, deviations are atypical. For this reason, quite often they observe pathological psychomotor (convulsions, agitation, stupor), as well as emotional (cowardice, excessive lability, fear, aggression) phenomena. With the transition to pubertal, youthful and mature periods of development, delusional elements may first appear, and then delusional disorders, and finally, stable delusional states.
The study of the etiology of a mental disorder in each case is a prerequisite for the rational construction of the so-called etiological therapy, the purpose of which is the rehabilitation of the external and internal environment of the patient. Elucidation of the pathogenesis of the disease contributes to the choice of strategy, tactics and methods of pathogenetic treatment aimed at the destruction of internal pathological connections that determine individual symptoms and syndrome kinesis.
Knowledge of the etiological factors and pathogenetic mechanisms of mental illness, along with the analysis of clinical psychopathological and somato-neurological signs, is the basis for classifying the disorder, and, consequently, for predicting and solving the social problems of psychiatric care.
Chapter 1. General theoretical foundations of mental pathology
Currently, a large number of factors that can cause a mental disorder have been described and studied. It should be noted that a violation of any physiological process in the human body, due to internal (genetic defect, metabolic disorders, endocrinopathy) or external (infection, intoxication, trauma, hypoxia, and others) causes, can lead to the appearance of mental pathology. In addition, factors of emotional stress, violations of interpersonal relationships and socio-psychological climate play an important role in the occurrence of mental disorders.
When diagnosing mental disorders, the doctor always faces difficulty in determining the leading causes of the disease. The problem is that, firstly, the mechanisms of development of the most common mental illnesses (schizophrenia, manic-depressive psychosis, epilepsy, atrophic diseases of late age, and others) have not yet been determined. Secondly, the same patient can be exposed to several pathogenic factors at once. Thirdly, the influence of a damaging factor does not necessarily cause a mental disorder, since people differ significantly in mental stability. Thus, the same damaging effect can be regarded by the doctor in different ways, depending on the specific situation.
The factor that determines the entire course of the disease, equally significant in the onset of the disease, its exacerbations and remissions, the cessation of which leads to the cessation of the disease, should be defined as main cause. Influences that play an important role in starting the disease process, but after the onset of the disease cease to determine its further course, should be considered as starting, or trigger. Some features of the human body, natural phases of development can in no way be recognized as pathological and at the same time often create certain conditions for the development of the disease, contribute to the manifestation of latent genetic pathology; and in this sense they are considered as risk factors. Finally, some of the circumstances and factors are only random, not directly related to the essence of the disease process (they should not be included in the circle of etiological factors).
Answers to many questions regarding the etiology of mental disorders have not yet been received, but the following materials from some biological and psychological studies provide important information for understanding the essence of mental illness. Of particular importance are the results of epidemiological studies, which make it possible, on the basis of large statistical material, to analyze the degree of influence of a wide variety of biological, geographical, climatic, and sociocultural factors.
1.1. Etiology and pathogenesis of mental disorders
In practical psychiatry, the causal factors of mental illness are conventionally divided into internal and external. This division is really arbitrary, since many internal somatic diseases act as a kind of external agent in relation to the human brain, and in this case, the clinical manifestations of the disease sometimes differ little from disorders caused by such external causes as trauma, infection, and intoxication. At the same time, many external conditions, even with a significant force of influence, do not cause mental disorders, if there was no internal predisposition of the organism for this. Among external influences, psychogenic factors, such as emotional stress, occupy a special position, since they do not directly lead to a violation of the structure of the brain tissue or a gross disorder of the basic physiological processes. Therefore, diseases caused by psychotrauma are usually distinguished into an independent group. In studies devoted to the study of the etiology and pathogenesis of mental illness, the greatest attention is paid to genetic, biochemical, immunological, neurophysiological and structural-morphological, as well as socio-psychological mechanisms.
The essence of psychosis has not been fully elucidated to date. In the 20th century, in connection with the successes of genetics, molecular genetics, neuroimmunology, neurochemistry, physiology, i.e., the entire complex of neurosciences, many mechanisms for the development of such conditions as depression, anxiety, fear, arousal, became more understandable; it became possible to accurately diagnose DNA in a number of diseases (Down's disease, other differentiated oligophrenia). Such a "breakthrough" in science became especially noticeable in the last decade of the 20th century, which was designated by WHO as the "decade of the brain." By the beginning of the 21st century, the human genome was deciphered and scientists got their hands on "genetic anatomy". This allows us to look to the future of psychiatry with optimism, as it receives the status of an "exact science". In this regard, it is advisable to present in the textbook the most important of the fundamental scientific data of biology that are directly related to psychiatry.
A psychiatrist working in a clinic, when studying case histories, constantly notes in patients the presence of various factors influencing the psyche that are involved in the development of the pathological process. P. Yu. Moebius (1893) was the first to propose that all causes of psychosis be divided into external (exogenous) and internal (endogenous). In accordance with this dichotomy, mental illnesses themselves are divided into exogenous and endogenous.
Among endogenous causes of disease Of particular importance are genetic factors, developmental disorders at an early age, somatic diseases that impede and impair brain function due to ischemia, autointoxication, endocrinopathy.
Exogenous factors are mainly divided into two groups. The first includes organic brain-damaging effects - such as trauma, intoxication, infection, and radiation damage. The second group includes the impact of emotional stress due to intra-personal or interpersonal conflicts, various adverse environmental, negative social influences on the individual. A special role is played by the characteristics of the personality itself, primarily those that determine individual reactions.
In practical psychiatry, it is well known that exogenous and endogenous factors often act together, while in some cases the endogenous radical prevails, and in others the exogenous radical. For example, the toxic effects of alcohol can manifest themselves in different ways. In some cases, this exogenous factor can become a trigger for the endogenous process (), in other cases it causes a typical exogenous psychosis, which can have various clinical shades, sometimes creating schizoform pictures. This circumstance must be taken into account when diagnosing the underlying disease. The main causative factor of mental illness should be considered the one that determines the debut pictures and is noted throughout the disease process, emphasizing the features of its dynamics, the picture of remission and the initial state. In a number of cases, there is evidence of an external triggering factor for the disease, which later loses its role and is not of decisive importance in the formation of the psychopathological structure of the underlying disease. These factors are considered as provoking. Difference causal mechanisms of psychosis it is clearly seen in the examples of the development of "axial" ("axial", according to A. Gohe) syndromes - such as exogenous-organic, underlying exogenous-organic diseases; endogenous symptom complex underlying endogenous process diseases (
The concept of mental illness
Section II. General psychopathology
The development of psychiatry in recent years is associated with the growth of a number of biological sciences - anatomy, physiology of the central nervous system, pathological anatomy, physiology, biochemistry, etc.
An important stage in the evolution of psychiatric knowledge dates back to the middle of the 19th century, when it was established that mental illnesses are diseases of the brain. Later, the position that mental disorders are caused by a disease of the central nervous system changed somewhat, since it was established that the general state of the body is important for the psyche.
Mental illness- the result of complex and diverse violations of the activity of various systems of the human body, with a primary lesion of the brain, the main features of which are disorders of mental functions, accompanied by a violation of criticism and social adaptation.
The etiology of most mental illnesses remains largely unknown. It is not clear the correlation in the origin of most mental illnesses of heredity, internally determined characteristics of the organism and environmental hazards, in other words, endogenous and exogenous factors. The pathogenesis of psychosis has also been studied only in general terms. The main patterns of gross organic pathology of the brain, the impact of infections and intoxications, and the influence of psychogenic factors have been studied. Significant data have been accumulated on the role of heredity and constitution in the occurrence of mental illness.
There is no single reason that caused mental illness and cannot exist. Οʜᴎ are congenital and acquired, resulting from traumatic brain injuries or as a result of past infections, are found at a very early or advanced age. Some of the reasons have already been clarified by science, others are not yet exactly known. Let's consider the main ones.
Intrauterine injuries, infectious and other diseases of the mother during pregnancy, and as a result, the "deformity" of the newborn. As a result, the nervous system and, first of all, the brain are formed incorrectly. Some children experience developmental delays and sometimes disproportionate brain growth.
Hereditary factors due to incorrect divergence of chromosomes. In particular, nondisjunction of the 21st chromosome causes Down's disease. Modern genetics believes that the information that determines the structure of an organism is contained in chromosomes - formations that are present in every living cell. Human cells have 23 pairs of chromosomes. Anomalies in the system of the 21st pair are the cause of Down's disease. At the same time, in the vast majority of cases, we are talking about a hereditary predisposition to mental illness.
Brain damage due to traumatic brain injury, cerebrovascular accident, progressive sclerosis of cerebral vessels and other diseases. Concussions, injuries, bruises, concussions suffered at any age can lead to mental disorders. Οʜᴎ appear either immediately, immediately after the injury (psychomotor agitation, memory loss, etc.), or after some time (in the form of various deviations, including convulsive seizures).
Infectious diseases- typhus and typhoid fever, scarlet fever, diphtheria, measles, influenza and, especially, encephalitis and meningitis, syphilis, affecting primarily the brain and its membranes.
The action of toxic, poisonous substances. This is primarily alcohol and other drugs, the abuse of which can lead to mental disorders. The latter can occur in case of poisoning with industrial poisons (teraethyl lead), with improper use of drugs (large doses of quinacrine, etc.).
Social upheavals and traumatic experiences. Psychic traumatization should be acute, more often associated with an immediate threat to the life and health of the sick person or his relatives, as well as chronic, relating to the most significant and difficult aspects for this person (honor, dignity, social prestige, etc.). These so-called reactive psychoses are characterized by a clear causal relationship, the "sound" of an exciting topic in all the patient's experiences, and a relative short duration.
Numerous studies have shown that the mental state of a person is also influenced by the type of personality, individual character traits, intelligence level, profession, environment, state of health, and even the rhythm of natural functions.
In most cases, psychiatry divides diseases into "endogenous", that is, those arising from internal causes (schizophrenia, manic-depressive psychosis), and "exogenous", provoked by environmental influences. The reasons for the latter are more obvious. The pathogenesis of most mental illnesses should be presented only at the level of hypotheses.
The concept, etiology and pathogenesis of mental illness - the concept and types. Classification and features of the category "The concept, etiology and pathogenesis of mental illness" 2017, 2018.
The concept, etiology and pathogenesis of mental illness
The development of psychiatry in recent years is associated with the growth of a number of biological sciences - anatomy, physiology of the central nervous system, pathological anatomy, physiology, biochemistry, etc.
An important stage in the evolution of psychiatric knowledge dates back to the middle of the 19th century, when it was established that mental illness is a disease of the brain. Later, the position that mental disorders are caused by a disease of the central nervous system changed somewhat, since it was established that the general state of the body is important for the psyche.
Mental illness- the result of complex and diverse violations of the activity of various systems of the human body, with a primary lesion of the brain, the main features of which are disorders of mental functions, accompanied by a violation of criticism and social adaptation.
The etiology of most mental illnesses remains largely unknown. It is not clear the correlation in the origin of most mental illnesses of heredity, internally determined characteristics of the organism and environmental hazards, in other words, endogenous and exogenous factors. The pathogenesis of psychosis has also been studied only in general terms. The main patterns of gross organic pathology of the brain, the impact of infections and intoxications, and the influence of psychogenic factors have been studied. Significant data have been accumulated on the role of heredity and constitution in the occurrence of mental illness.
There is no single reason that caused mental illness and cannot exist. They are congenital and acquired, obtained as a result of traumatic brain injuries or as a result of past infections, are found at a very early or advanced age. Some of the reasons have already been clarified by science, others are not yet exactly known. Let's consider the main ones.
Intrauterine injuries, infectious and other diseases of the mother during pregnancy, and as a result, "deformities" of the newborn. As a result, the nervous system and, first of all, the brain are formed incorrectly. Some children experience developmental delays and sometimes disproportionate brain growth.
Hereditary factors due to incorrect divergence of chromosomes. In particular, nondisjunction of the 21st chromosome causes Down's disease. Modern genetics believes that the information that determines the structure of an organism is contained in chromosomes - formations that are present in every living cell. Human cells have 23 pairs of chromosomes. Anomalies in the system of the 21st pair are the cause of Down's disease. However, in the vast majority of cases, we are talking about a hereditary predisposition to mental illness.
Brain damage due to traumatic brain injury, cerebrovascular accident, progressive sclerosis of cerebral vessels and other diseases. Concussions, injuries, bruises, concussions suffered at any age can lead to mental disorders. They appear either immediately, immediately after the injury (psychomotor agitation, memory loss, etc.), or after some time (in the form of various abnormalities, including convulsive seizures).
Infectious diseases - typhus and typhoid fever, scarlet fever, diphtheria, measles, influenza and, especially, encephalitis and meningitis, syphilis, affecting primarily the brain and its membranes.
The action of toxic, poisonous substances . This is primarily alcohol and other drugs, the abuse of which can lead to mental disorders. The latter can occur in case of poisoning with industrial poisons (teraethyl lead), with improper use of drugs (large doses of quinacrine, etc.).
Social upheavals and traumatic experiences . Mental trauma can be acute, often associated with an immediate threat to the life and health of the sick person or his loved ones, as well as chronic, relating to the most significant and difficult aspects for a given person (honor, dignity, social prestige, etc.). These so-called reactive psychoses are characterized by a clear causal relationship, the "sound" of an exciting theme in all the patient's experiences, and a relative short duration.
Numerous studies have shown that the mental state of a person is also influenced by the type of personality, individual character traits, level of intelligence, profession, environment, state of health, and even the rhythm of natural functions.
In most cases, psychiatry divides diseases into "endogenous", that is, those that have arisen from internal causes (schizophrenia, manic-depressive psychosis), and "exogenous", provoked by environmental influences. The reasons for the latter are more obvious. The pathogenesis of most mental illnesses can only be presented at the level of hypotheses.
Incidence, classification, course, prognosis and outcome of mental illness
Today, there are more mentally ill patients in many countries in Europe and North America than there are patients with cancer, tuberculosis, and cardiovascular disease combined.
In addition, for every patient in a neuropsychiatric hospital (according to UNESCO data), there are two people with one or another mental disability outside the walls of medical institutions. These people cannot be hospitalized - they are "not sick enough", but they cannot live a healthy mental life either.
In the US, mental illness is one of the major national problems. According to the Federal Health Service, one in sixteen people in America spend some time in a psychiatric hospital, and according to the National Association for Mental Illness, one in ten people in the United States “suffers from some form of mental or nervous illness (ranging from mild to severe), requiring a referral to a psychiatrist.
Despite the enormous complexity of statistical research associated with the unequal use of counting methods in different countries, the peculiarity of understanding individual forms of diseases, the various possibilities for identifying mental patients, etc., the available figures gave reason to assume that in the whole world there are at least 50 million mentally ill, which represents approximately 17 people for every thousand of the population.
According to the GNTSSISP them. V.P. Serbsky, in the Russian Federation in recent years, the prevalence of neuropsychiatric disorders among the population is about 25%.
Mentally ill persons commit more than 100 socially dangerous acts per year, of which about 30% are grave offenses.
Most domestic classifications of mental illnesses invariably provide three main types of mental illness :
- 1) endogenous mental illness, in the occurrence of which exogenous factors are involved;
- 2) exogenous mental illness, in the occurrence of which endogenous factors are involved;
- 3) conditions caused by pathology of development.
Clinical pictures of mental illness are not permanent. They change over time, and the degree of change and the pace of this change may vary. Changes in the clinical picture of the disease, the patient's condition are of great forensic psychiatric importance, since it is important for experts to know what the morbid manifestations of the psyche were during the commission of the offense, during the investigation or examination. Experts should also take into account the further course of the disease, its prognosis, which is important when deciding on the appointment and cancellation of medical measures, when examining convicts.
There are mental illnesses that develop rapidly, last a short time and end in complete recovery (some alcoholic psychoses, acute psychoses in common infectious diseases, acute reactive states).
Other diseases are characterized by a long course, and many of them are characterized by a gradual increase in mental disorders ("chronic mental illness").
The disease can proceed continuously with a gradual increase in mental disorders and lead to an irreversible mental defect, to dementia acquired as a result of the disease. In another case, the course of the disease may be intermittent, with periods of improvement and repeated acute attacks of the disease, after which mental disorders become more and more severe. However, this does not mean that dementia and severe mental disability necessarily develop in all cases. Progressive mental illnesses may not lead to dementia, but cause only peculiar and, moreover, unsharply expressed changes in the personality and character of a person, when the patient's orderly behavior and his ability to work are maintained. With these diseases, long periods of improvement and recovery can occur, especially against the background of treatment.
The concept of symptoms and syndromes of mental illness
As stated earlier, psychiatry is divided into two main branches -- general psychopathology and private psychiatry.
Private psychiatry studies individual mental illnesses, their clinical manifestations, causes, mechanisms of development, diagnosis and treatment.
General psychopathology- This is a branch of psychiatry, the purpose of which is to study the general patterns and nature of mental disorders. General psychopathology studies individual symptoms and symptom complexes, or syndromes, that can be observed in various mental illnesses.
The study of the mental state, i.e., the assessment of the psychopathological picture, is a complex process - from the assessment of obvious signs to the knowledge of the essence of the disorder, which cannot be perceived directly, but is determined as a result of observing and generalizing the signs and building a logical conclusion on this basis. The selection of a separate feature - a symptom - is also a multi-stage process in which its association with other features similar in their internal structure takes an important place. In this regard, it is necessary to consider the relationship between the concepts of "symptom" and "syndrome".
Basic unit of general psychopathology- syndrome - a natural combination of individual symptoms, which is a kind of integration of the previous course of the disease and contains signs that make it possible to judge the further dynamics of the condition and the disease as a whole. An individual symptom, despite its significance, cannot be considered a psychopathological unit, since it acquires significance only in the aggregate and in interconnection with other symptoms - in a symptom complex, or in a syndrome. Symptoms of the disease are individual signs of the disease (fever, pain, nausea, vomiting). In different diseases, the same symptoms occur, which, combined, form homogeneous groups - symptom complexes, or syndromes.
The set of symptoms and syndromes observed in dynamics add up to the clinical picture of the disease, which, taking into account the etiology (causes), course, outcome and pathological anatomy, forms separate, so-called nosological units of diseases. Mental disorders of a sick person can affect the processes of perception, thinking, will, memory, consciousness, drives, emotions. These disorders occur in patients in various combinations and only in combination.
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