A constant stay in a near-delirium state is natural for patients diagnosed with paranoid syndrome. Moreover, people with such a disorder are divided into two types: those who can systematize their delirium, and those who are unable to do this. In the first case, the patient clearly understands and can tell others when he noticed that he was being watched; can name the date of the onset of a persistent feeling of anxiety, how it manifests itself, and, moreover, even names a specific person from whom he feels danger.
Most patients, unfortunately, cannot systematize delirium. They understand their condition in general terms and create conditions for preserving life: they often change their place of residence, observe increased security measures in various situations, and lock all doors.
The most well-known disorder of a person’s mental state is schizophrenia - a paranoid syndrome in which thinking is partially or completely impaired, and emotional reactions do not correspond to natural ones.
Causes of the disease
Doctors find it difficult to name the exact cause or their complex, which can provoke a violation of a person’s psycho-emotional state. The etiology can be completely different and is formed under the influence of genetics, stressful situations, congenital or acquired neurological pathologies, or due to changes in brain chemistry.
Some clinical cases of the development of paranoid syndrome still have a clearly established cause. To a greater extent, they occur under the influence of psychotropic and narcotic substances and alcohol on the body.
Where does the disorder begin?
Until now, medicine has found it difficult to name the exact cause or complex of provoking factors. The phenomenon can have a very different etiology. The syndrome is formed on the basis of genetic predisposition, congenital or acquired diseases of the nervous system, which are characterized by changes in the biochemical processes of the brain.
In cases of the use of narcotic or psychotropic drugs, or alcohol abuse, the cause of the paranoid syndrome is clearly defined. A short-term phenomenon of paranoia can be observed in people under the influence of prolonged severe stress.
Those at risk of developing this deviation are primarily patients with chronic mental illness (most often schizophrenics), sometimes patients with organic lesions of the brain and central nervous system (encephalitis, cerebrovascular disease, and others).
Medical statistics indicate that paranoid syndrome is most often observed in men.
And the first symptoms of deviations can appear at a young age (from 20 years).
In some cases, there is a rapid increase in characteristic symptoms.
Classification and symptoms of the disorder
Doctors agree that paranoid and paranoid syndromes have similar symptoms:
- patients are more likely to be in a state of secondary delusion, which manifests itself in the appearance of various images, rather than in a state of primary delirium, when they do not understand what is happening to them;
- in each clinical case, a predominance of auditory hallucinations over visual phenomena was noted;
- the state of delirium is systematized, which allows the patient to tell the reason and name the date of origin of anxious feelings;
- in most cases, each patient clearly understands that someone is spying on him or stalking him;
- Patients associate the views, gestures and speech of strangers with hints and a desire to harm them;
- sensory impairment.
Paranoid syndrome can develop in one of two directions: delusional or hallucinatory. The first case is more severe, because the patient does not make contact with the attending physician and loved ones; accordingly, making an accurate diagnosis is impossible and is postponed indefinitely. Treatment of delusional paranoid syndrome takes longer and requires strength and perseverance.
Hallucinatory paranoid syndrome is considered a mild form of the disorder, which is due to the patient’s sociability. In this case, the prognosis for recovery looks more optimistic. The patient's condition can be acute or chronic.
Anxiety-depressive syndrome
As in previous cases, the features of this type of depression can be understood from the name itself. This is characterized by a combination of anxiety and panic fears. These manifestations are characteristic mainly of adolescents, so it is not surprising that anxiety-depressive syndrome is most often diagnosed in people in puberty. The reasons are the inferiority complex, vulnerability and excessive emotionality characteristic of this stage of personality development.
Manifestations of this type of depression include painful various fears that develop into phobias. Often teenagers with this syndrome are very afraid of punishment, both for actions done and for actions not committed. They are afraid of punishment for their lack of intelligence, talent, skills, etc.
A person can no longer objectively evaluate the world, his personality with all its characteristics and roles, and the situations happening to him. He sees everything in the darkest tones and perceives it with a great deal of hostility. The formation of persecution mania is quite likely. Patients in such cases think that someone (most people or everyone) conspired to frame, deceive, hurt, etc.
With persecution mania, a person may begin to think that there are enemy agents around, monitoring the patient’s actions. A person becomes suspicious (even towards the closest people), and is characterized by excessive suspiciousness. The patient’s energy is spent on confronting the world and those elements that he himself invented. He begins to go into hiding and take other actions to "protect himself from the agents." To recover from anxiety-depressive syndrome (and persecutory mania), you need to consult an experienced psychotherapist or psychiatrist. He may also prescribe sedatives if he sees a need for them for a particular patient.
Hallucinatory-paranoid syndrome
This syndrome is a complex mental disorder of a person, in which he feels the constant presence of strangers who are spying on him and want to cause physical harm, even murder. It is accompanied by frequent occurrence of hallucinations and pseudohallucinations.
In most clinical cases, the syndrome is preceded by severe affective disorders in the form of aggression and neurosis. Patients are in a constant feeling of fear, and their delirium is so diverse that against its background the development of automaticity of the psyche occurs.
The progression of the disease has three stable stages, following one after another:
- A lot of thoughts swarm in the patient’s head, which every now and then pop up on top of those that have just disappeared, but at the same time it seems to him that every person who sees the patient clearly reads thoughts and knows what he is thinking about. In some cases, it seems to the patient that the thoughts in his head, not his, but those of strangers, are imposed by someone through the power of hypnosis or other influence.
- At the next stage, the patient feels an increase in the heart rate, the pulse becomes incredibly fast, cramps and withdrawal begin in the body, and the temperature rises.
- The culmination of the condition is the patient's awareness that he is in the mental power of another being and no longer belongs to himself. The patient is sure that someone is controlling him by penetrating his subconscious.
Hallucinatory-paranoid syndrome is characterized by the frequent appearance of pictures or images, blurry or clear spots, while the patient cannot clearly describe what he sees, but only convinces others of the influence of an outside force on his thoughts.
Paranoid personality disorder
The first signs of paranoid psychopathy are detected already in childhood. Characterized by stereotypical thinking, excessive suspicion and straightforwardness, and a persistent overestimation of one’s abilities and capabilities. Children with this disorder show disdain for the interests and feelings of other people, often conflict with peers, and are touchy, vindictive, and vindictive. With age, the listed character traits intensify. The full clinical picture of paranoid personality disorder usually develops at the beginning of the third decade of life.
The distinctive features of paranoid psychopathy in adults are pronounced mental rigidity, persistent black-and-white thinking, a constant, pronounced tendency to view the neutral or friendly actions of other people as potentially hostile, posing a threat to the psychological, physical or emotional state of the patient. A patient with paranoid personality disorder assumes that others want to exploit him in one way or another, trying to take advantage of his property, behavior and work results in their own interests. He is prone to jealousy, constantly doubts the loyalty of his partner and the reliability of his friends.
Neutral words or events seem to be filled with hidden meaning to a patient with paranoid personality disorder. For example, a patient may believe that the children of neighbors upstairs stomp loudly because their parents deliberately provoke children to such behavior in order to ruin his mood and create unbearable living conditions. Another characteristic feature of paranoid personality disorder is excessive sensitivity to arrogance, harm, or insults from others.
Patients are unable to forgive such actions, even if the damage was caused unintentionally and the other party sincerely repents of their action. Fictitious or real damage (even minimal) often becomes the cause of protracted conflicts and long-term hostility. Disrespectful attitudes (or behavior that people with paranoid personality disorder perceive as disrespectful attitudes) provoke violent outbursts of anger, immediate counterattacks, or contemplation of plans for revenge. Due to increased suspicion, patients are reluctant to share their feelings or intentions with others, as they fear that any information could be used against them.
Patients with paranoid personality disorder are prone to prejudice. They attribute negative intentions to others, suspect them of all mortal sins, and actively seek confirmation of their own fantasies in the behavior of other people. Thanks to a biased approach to the selection of information and the ability not to notice what does not fit into their understanding of the world, patients with paranoid personality disorder manage to build an outwardly logical, consistent picture of what is happening, which has nothing to do with reality, but convinces patients (and with a superficial consideration - and those around you) in your own rationality and objectivity.
In paranoid personality disorder, there is a scarcity and limited emotional repertoire. Emotions are strong, but monotonous; anger, irritation, indignation, dissatisfaction and disappointment predominate. Empathy, responsiveness, sense of humor and the ability to establish warm, trusting relationships are weak or absent. Patients with paranoid personality disorder disdain any manifestation of weakness and admire strength and power. The formation of highly valuable ideas is observed, including the ideas of jealousy, litigiousness and invention. There is a tendency towards fanaticism.
There are two types of paranoid personality disorder: expansive and sensitive. Patients with expansive paranoid psychopathy are assertive, active, aggressive with leadership abilities. They easily enter into conflicts, are prone to open pressure, openly accuse others of unseemly behavior, but do not admit their own shortcomings. Patients with sensitive paranoid personality disorder are withdrawn, touchy, suspicious, self-critical, ambitious, often suffering from a sense of inferiority. They are less likely to enter into open conflicts and tend to take the position of a victim. The reason for the violation of self-esteem and disagreements with other people is the excessive demands that patients place on both themselves and others.
Depressive-paranoid syndrome
The main cause of this form of the syndrome is the experience of a complex traumatic factor. The patient feels depressed and is in a state of depression. If these feelings are not overcome at the initial stage, sleep disturbance subsequently develops, up to complete absence, and the general condition is characterized by lethargy.
Patients with depressive-paranoid syndrome experience four stages of disease progression:
- lack of joy in life, decreased self-esteem, impaired sleep and appetite, sexual desire;
- the emergence of suicidal thoughts due to a lack of meaning in life;
- the desire to commit suicide becomes persistent, the patient can no longer be convinced otherwise;
- the last stage is delirium in all its manifestations, the patient is sure that all the troubles in the world are his fault.
This form of paranoid syndrome develops over a fairly long period of time, about three months. Patients become skinny, their blood pressure is compromised, and their heart function suffers.
Description of manic-paranoid syndrome
Manic-paranoid syndrome is characterized by elevated mood for no good reason, patients are quite active and mentally excited, they think very quickly and immediately reproduce everything they think. This condition is episodic and is caused by emotional outbursts of the subconscious. In some cases, it occurs under the influence of drugs and alcohol.
Patients are dangerous to others because they are prone to pursuing the opposite sex for sexual purposes, with possible physical harm.
Quite often, the syndrome develops against the background of severe stress. Patients are confident that those around them are plotting criminal acts against them. This results in a constant state of aggression and mistrust; they become withdrawn.
Clinic
Often patients with the syndrome do not make contact with a doctor, so it is simply impossible to talk with them and find out their complaints.
Patients are suspicious of friends, family and close people, they speak sparingly and for a long time, thinking about every word. They react sharply to simple remarks and statements addressed to them by others, are overly touchy, jealous and confident in betrayal, conspiracy, and infidelity. These are indirect signs of the syndrome, on the basis of which doctors usually make a diagnosis. As the pathology develops, auditory hallucinations, persecution mania, and disturbances in the functioning of sensory systems are added.
Hallucinatory-paranoid syndrome
This syndrome is a severe mental disorder manifested by the following symptoms:
- The feeling of the constant presence of strangers watching the patient and wanting to hurt him or even kill him,
- The occurrence of hallucinations and pseudohallucinations,
- Aggression and neurosis,
- Constant feeling of fear
- Various nonsense.
Patients are confident that those around them know their thoughts. This confidence often reaches the point of absurdity: patients feel that the thoughts in their heads belong to strangers. Patients' pulse quickens, convulsions occur, and body temperature rises. They realize that they are under the control of other people and are no longer their own. “Someone” controls their consciousness. Under the influence of an outside force, pictures, images and spots appear in their thoughts, which they clearly see.
As this form of pathology develops, patients develop mental automatisms. First, associative automatism is formed - rapidly arising thoughts in the head that “everyone knows about.” Then sensory automatisms appear - these are unpleasant sensations of pulsation, twisting, heat. Motor automatisms are the compulsion to submit to other people’s thoughts.
Video: film about hallucinatory-paranoid syndrome
Depressive-paranoid syndrome
Symptoms of this form of pathology are:
- Depression,
- Depression,
- Sleep disturbance, insomnia,
- lethargy,
- Unbearable sadness
- Lack of joy in life
- Decreased self-esteem, appetite and libido,
- Thoughts about suicide
- Lack of meaning in life
- Rave,
- Exhaustion of the patient
- Blood pressure disorder
- Cardiac dysfunction.
There are four stages in the development of this form of pathology:
- Cyclothymic - general depression with decreased self-esteem, loss of joy in life, pessimism, decreased libido.
- Hypotymic – melancholy, despondency, sadness, lack of desire to live.
- Melancholic - the transition of moral pain into physical pain, suicide attempts.
- Delusional – delirium of self-blame and sinfulness. Patients blame themselves for all tragedies and cataclysms. These thoughts lead them to suicide.
The disease lasts 2-3 months and is difficult to treat.
Manic-paranoid syndrome
The syndrome manifests itself:
- Unreasonable increase in mood,
- Hyperactivity and hypermobility of patients,
- Mental agitation,
- Fast thinking and reproduction of thoughts,
- Pursuit of the opposite sex
- Causing physical injury to others,
- Constant aggression and distrust of loved ones,
- Increased sexuality and appetite,
- Reassessment of your personal qualities.
Manic-paranoid syndrome occurs under the influence of alcohol or drugs . It is caused by emotional outbursts or extreme stress. Such patients are dangerous to others.
Alcoholic paranoid deserves special attention. Indeed, it is currently considered a serious disorder that develops in the majority of patients who are admitted to the clinic with psychosis due to alcoholism. It ranks third in patients with alcoholism after delirium tremens and hallucinosis. The disease requires immediate hospitalization and long-term rehabilitation therapy. Most often, alcoholic paranoid is diagnosed in alcoholics who have suffered a head injury, have severe heredity, or suffer from epileptoid psychopathy. The pathology manifests itself through sudden mood swings, sensual delirium and inappropriate behavior.
Diagnostic methods
If paranoid syndrome is suspected, it is necessary to take the person to a clinic, where they should undergo a thorough general medical examination. This is a method of differential diagnosis and allows us to clearly exclude mental disorders associated with stress.
When the examination is completed, but the cause remains unclear, the psychologist will schedule a personal consultation, during which a number of special tests will be performed.
Relatives should be prepared for the fact that after the first communication with the patient, the doctor will not be able to make a final diagnosis. This is due to reduced communication skills of patients. Long-term observation of the patient and constant monitoring of symptomatic manifestations are required.
For the entire diagnostic period, the patient will be placed in a special medical facility.
Treatment of patients diagnosed with paranoid syndrome
Depending on what symptoms the paranoid syndrome shows, in each clinical case the treatment regimen is selected individually. In modern medicine, most mental disorders can be successfully treated.
The attending physician will prescribe the necessary antipsychotics, which, when taken in combination, will help bring the patient into a stable mental state. The duration of therapy, depending on the severity of the syndrome, is from a week to one month.
In exceptional cases, if the form of the disease is mild, the patient can undergo therapy on an outpatient basis.
Drug therapy
The leading specialist in solving problems of mental personality disorder is a psychotherapist. In certain cases, if the disease is caused by the influence of drugs or alcohol, a specialist must work in tandem with a narcologist. Depending on the degree of complexity of the syndrome, medications will be selected individually.
For the treatment of mild forms, the following remedies are indicated:
- "Propazine."
- "Etaperazine."
- "Levomepromazine."
- "Aminazine."
- "Sonapax".
Moderate syndrome is treated with the following drugs:
- "Aminazine."
- "Chlorprothixene."
- "Haloperidol."
- "Levomepromazine."
- "Triftazine"
- Trifluperidol.
In difficult situations, doctors prescribe:
- "Tizercin."
- "Haloperidol."
- "Moditen Depot".
- "Leponex".
The attending physician determines which medications to take, their dosage and regimen.
Prognosis for recovery
It is possible to achieve a stage of stable remission in a patient diagnosed with paranoid syndrome, provided that the request for medical help was made in the first days of detection of mental disorders. In this case, therapy will be aimed at preventing the development of the exacerbation stage of the syndrome.
It is impossible to achieve an absolute cure for paranoid syndrome. The patient’s relatives should remember this, but with an adequate attitude to the situation, the disease can be prevented from worsening.
Development of the disorder and the nature of the patient’s actions
The development of the syndrome may continue for several years. The person is closed, all his attention is directed to himself. The patient sees others as a threat and an unfriendly attitude towards himself. As a rule, others evaluate such an individual as a self-centered person with high self-esteem, closed and distant from reality.
The delusional state develops gradually with small ideas. Delirium can be systematized. In this case, the patient can prove what his fears are based on. When a delusional idea is not systematically manifested, the patient is lost and cannot explain the reason for suspicion, but also sees everyone as an enemy and persecutor. Delirium of persecution occurs without clouding of consciousness.
The patient’s firm belief that enemies are watching him and using certain actions to control a person’s thoughts, desires and actions is called Kandinsky-Clerambault syndrome or mental automatism.
Mental automatism is divided into three groups according to the nature of the apparent impact:
- Associative (ideational) . The patient is convinced that his ability to think freely has been taken away. He believes that his pursuers know what he is thinking about.
- Senestopathic . This type is characterized by painful painful sensations. The patient is convinced that the pursuers cause pain by influencing internal organs. Through influence, enemies, for example, force you to restrain your heart rate or urination.
- Kinesthetic (motor) . Characterized by the manifestation of motor acts. Sometimes associative automatism is added to motor automatism. This form is the most complex of all manifestations of automatisms; speech motor hallucinations are noted in it.
Article on the topic: Ankylosing spondylitis in women - symptoms and stages
Patients try in every possible way to “protect themselves” from their enemies. They write numerous statements asking to be protected from persecution and sew protective clothing. Their actions become dangerous to others. For example, they can destroy electrical wiring in an apartment so that enemies cannot use their devices.
