Paranoid syndrome: description, causes, symptoms and treatment features

There are no healthy people, there are unexamined ones. Mental disorders are the scourge of our time. However, you should not blame such people: it is a disease, like diabetes, but who would look at a diabetic with contempt? The sad thing about such diseases is that diabetes cannot spoil relationships with others or even harm them. But paranoia can...

Pathogenesis of the disorder

Many scientists consider paranoia to be an independent form of mental disorder.
The pathology is characterized by gradually developing delusions that occur without visual or auditory hallucinations. But often its appearance is accompanied by false memories. Over time, delirium becomes persistent. The patient's mood is closely related to obsessions. In certain cases it can be suppressed, expansive or increased. In this case, the pathology is not accompanied by a pronounced change in mental abilities. There is a tendency to detail and thoroughness in thinking. The patient's behavior may remain unchanged for a long time.

Provoking factors

Scientists have not yet identified the exact causes of the disease. But experts have identified a number of factors that significantly increase the risk of developing pathology. These include:

• heredity;
• protein metabolism disorder;
• psychological trauma that the patient received in childhood;
• neurological and mental diseases;
• long-term depression;
• neuroses;
• prolonged isolation from society;
• difficult life situations;
• long-term use of medications, drugs or alcohol consumption.

The risk group includes patients suffering from Alzheimer's and Parkinson's diseases.

Many scientists believe that regular consumption of large quantities of strong coffee can provoke the development of paranoid syndrome. The drink negatively affects the quality of sleep, insomnia develops, against the background of which the body is constantly in a depressed state.

Paranoid syndrome and similar disorders

Paranoid syndrome is a mental disorder characterized by the presence of systematic delusions. This condition develops slowly and over time the patient develops a complex system of inferences.

Kraepelin

The disease was described in 1863 by Emil Kraepelin. However, a little later, in 1912, several forms of pathology were identified, such as paranoid delusions and paranoid schizophrenia. In Soviet and Russian psychiatry, it is also customary to separate these concepts, since they differ in development patterns and clinical signs.

Unlike paranoia, paranoid syndrome is characterized by the presence of several delusional ideas. The disease is one of the stages in the development of paranoid schizophrenia, and in rare cases it is observed with the development of various other mental disorders.

Paranoid schizophrenia is a pathology characterized by a predominance of paranoid syndrome. Symptoms increase gradually, but paranoia is not observed.

The disease was identified in 1912 as an independent mental disorder. Before this period, it was believed that paranoid schizophrenia was only a form of paranoia.

In contrast to paranoia, patients retain a sense of the reality of what is happening. There are no hallucinations or systematic delusions. The pathology is characterized by periods of remission and exacerbation.

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Delirium can be observed within a number of different syndromes (for example, within the delirium syndrome, manic and depressive syndromes of the psychotic level), however, in Soviet psychiatry, several syndromes were identified in which delirium arising against the background of clear consciousness takes a leading place. They were called delusional syndromes (in foreign psychiatry, the identification of delusional syndromes was not and is not given a significant place).

Paranoid syndrome (derived from the term “paranoia”, Greek - para - near, near; nous - thought, mind) - is represented by systematized interpretive delusion. Delusions within the paranoid syndrome are not accompanied by other productive psychopathological disorders (hallucinations, mood disorders, etc.).

• Delusional ideas are well systematized , the most common ideas are damage, jealousy, invention, litigiousness, and hypochondriacal.
• The development of paranoid delusions is usually long-term, gradual , often the formation of delusions is preceded by a stage of prolonged existence of overvalued ideas, the very content of delusions at first gives the impression of relative plausibility.
• Delusions in paranoid syndrome are closely associated with the patient’s personality traits in the form of a tendency to one-sided, tendentious thinking and the emergence of overvalued ideas on this basis, as well as sthenicity (from the Greek sthenos - strength, personality type, characterized by high vitality, significant mental activity, stability motives, high personal self-esteem).
• Patients with this type of delusion are very active , and most of the time they are engaged in the struggle for their imaginary rights and achievements.
• Paranoid syndrome has a chronic course and is difficult to treat.
• It can be observed in the context of chronic delusional psychoses (for example, involutional), schizophrenia, decompensation of paranoid psychopathy. Previously, such conditions were designated by the term “paranoia,” but currently the independent existence of such a disease is not recognized by all psychiatrists.

Paranoid syndrome (from the Greek paranoia + -oid form, similarity) - represented by sensory delusions of persecution; sensory delirium can be supplemented by an interpretive component. Delusions in paranoid syndrome are in most cases combined with other productive psychopathological disorders. Variants of the syndrome depend on these additional disorders:

• Paranoid syndrome (in the narrow sense) - represented only by delusions of persecution, a few illusions or hallucinations.

• Hallucinatory-paranoid (hallucinatory-delusional) syndrome - a combination of hallucinations and delusions.

• Affective-delusional syndrome - a combination of altered mood (mania or depression) and delirium. As part of typical affective syndromes (manic and depressive), secondary delusions may be observed, corresponding (congruent) to affect (for example, ideas of self-blame in depression). Affective-delusional syndrome was talked about when an altered mood was combined with primary delusions (ideas of persecution) inappropriate to affect and hallucinations.

• Syndrome of mental automatisms (Kandinsky-Clerambault syndrome) - see the next section.

• Paraphrenic syndrome (from the Greek para - next to, about; phren - mind, mind) - is represented by megalomanic delusions of grandeur (which distinguishes it from the syndrome of mental automatisms), delusions of persecution and influence, pseudohallucinations and mental automatisms.

Paranoid syndrome can have a different course (acute or chronic).

Acute paranoid syndrome (usually with minimally expressed mental disorders other than delirium, i.e. paranoid in the narrow sense) can be caused by unfavorable external (exogenous) factors. These include:

• paranoid of the external environment (“railroad” paranoid, delirium in a foreign language environment, delirium of the hard of hearing);
• acute intoxication paranoid;
• acute alcoholic paranoid.

The development of psychosis in these cases is caused by overwork, prolonged exposure to anxious anticipation (this option was first described in the middle of the 20th century during long railway crossings, and therefore received the appropriate name; similar symptoms were also described in migrants and people with hearing loss when they , having found themselves in an unfamiliar situation, they are unable to understand what they are saying and how others treat them), intoxication with psychoactive substances (especially psychodysleptics) or alcohol withdrawal. Patients suddenly “realize” that those around them are plotting something against them, and begin to perceive all their words and actions in a threatening way, try to escape, and sometimes attack their pursuers. In these cases, patients often say that, for example, they “saw” disguised pursuers on the street and so on, but in this situation these are most often not hallucinations or illusions, but simply a delusional interpretation of the surrounding reality.

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History of diagnosis

Paranoid syndrome began to be studied in more detail after the disease was identified as an independent disease. In 1915, a number of scientists proved that pathology is accompanied by interpretive delusions and that often all the patient’s thoughts are systematized.

Later, already in 1934, in the works of V.M. Morozov, it was proven that patients develop persistent delusional thoughts over time. All conclusions have a special system and patients are confident that they are right.

Also in the works of A.B. Smulevich and M.G. Shchirina in 1972 found that in some cases the disease develops like an epiphany, acutely and suddenly.

Delusional syndromes: paranoid, paranoid (including Kandinsky-Clerambault syndrome), paraphrenic.

PARANOAL SYNDROME - is formed as a primary, interpretive delusion. With it, there are no other gross mental disorders, real or completely plausible facts and events are interpreted.

Criteria for delusion: 1. The patient’s primary conviction that he is right. 2. Paralogical justification of one’s point of view or all facts are interpreted one-sidedly. 3. Particular thoroughness of the patient in talking about delusional experiences. 4. gradual complication of the delusional system, inclusion of new persons in it. 5. Characterological shift - the appearance of new qualities in the patient’s mental appearance, for example, suspiciousness. With this delusion there are no hallucinations; in terms of content, it is most often delirium of jealousy, physical handicap, love, litigious, etc.

HALLUCINATORY - PARANOID SYNDROME includes delusional episodes and hallucinations. One of the varieties is the Kandinsky-Clerambault sm, consisting of 1. pseudohallucinations, 2. Delusional ideas of influence, 3. Phenomena of mental automatism (a feeling of alienation, the doneness of one’s own experiences, actions, movements, sensations. - ideational, sensory, kinesthetic)

PARAPHRENIC SYNDROME - fantastic delusions of grandeur combined with delusions of persecution. This is the highest degree of development of delusional disorders. It forms at distant stages of chronic delusional psychoses or during their rapid development.

One of its varieties is Cotard's syndrome - deep depression combined with hypochondriacal delusions or delusions of evil power.

Characteristics of delusional syndromes, diagnostic significance.

Paranoid syndrome

characterized by systematized delusions of relation, jealousy, and invention. The judgments and conclusions of patients outwardly appear to be quite logical, but they proceed from incorrect premises and lead to incorrect conclusions. This delusion is closely related to the life situation, the personality of the patient, either altered by mental illness, or pathological from birth. Hallucinations are usually absent. The behavior of patients with paranoid delusions is characterized by litigiousness, querulant tendencies, and sometimes aggressiveness. Most often this syndrome is observed in alcoholic, presenile psychoses, as well as in schizophrenia and psychopathy.

Paranoid syndrome.

Characterized by secondary delirium. The group of paranoid syndromes includes hallucinatory-delusional, depressive-delusional, catatonic-delusional and some other syndromes. Paranoid syndromes occur in both exogenous and endogenous psychoses.

In schizophrenia, one of the most typical variants of hallucinatory-paranoid syndrome is often observed - Kandinsky-Clerambault syndrome

, which consists of the following symptoms: pseudohallucinations, mental automatisms, delusional ideas of influence. Automatisms are the phenomenon of loss of the sense of belonging to oneself in thoughts, emotional experiences, and actions. For this reason, the mental actions of patients are subjectively perceived as automatic. G. Clerambault (1920) described three types of automatisms:

1) Ideatorial

(associative) automatism manifests itself in a feeling of outside interference in the course of thoughts, their insertion or removal, breaks (sperrungs) or influxes (mentism), the feeling that the patient’s thoughts are becoming known to others (a symptom of openness), “echo of thoughts”, violent inner speech, verbal pseudohallucinations, perceived as a sensation of thoughts being transmitted over a distance.

2) Touch

(senestopathic, sensory) automatism. It is characterized by the perception of various unpleasant sensations in the body (senesthopathy), a feeling of burning, twisting, pain, sexual arousal as caused, specially caused. Gustatory and olfactory pseudohallucinations can be considered as variants of this automatism.

3) Motor

(kinaesthetic, motor) automatism is manifested by a feeling of compulsion of certain actions, actions of the patient, which are performed against his will or caused by external influences. At the same time, patients often experience a painful feeling of physical lack of freedom, calling themselves “robots, phantoms, puppets, automata,” etc. (feeling of mastery).

The explanation of such internal experiences using hypnosis, cosmic rays or various technical means is called delusion of influence

and sometimes has a rather ridiculous (autistic) character. Affective disorders are most often represented by feelings of anxiety, tension, and in acute cases, fear of death.

Paraphrenic syndrome

. It is characterized by a combination of fantastic, absurd ideas of greatness with expansive affect, phenomena of mental automatism, delusions of influence and pseudo-hallucinations. Sometimes delusional statements of patients are based on fantastic, fictitious memories (confabulatory delusions). In paranoid schizophrenia, paraphrenic syndrome is the final stage of the course of psychosis.

Classification according to ICD-10

In the international classification of diseases intended for use in Russia, delusional disorders have code F 22.01. It also includes paranoid development.

Also, other delusional personality disorders, including the querulant form, belong to the section coded F28.8 and F28.88. In the official ICD-10, paranoia is not classified as a separate section and corresponds to delusional disorder, code F22.0.

With a mild course of the pathology, they speak of paranoid disorder, the code of which, in accordance with ICD-10, is F60.0. In this case, the term “paranoid” means something similar to paranoia.

In addition, there is another form of personality disorder similar to paranoia. Paranoid schizophrenia. In the ICD, adapted for use in Russia, it belongs to the heading F22.03 - paranoid schizophrenia.

Varieties and symptoms

Several types of disease progression have been described in the scientific literature. The first is episodic, in which a period of exacerbation of symptoms alternates with a state of remission. There is complete or incomplete remission. In the first case, the patient experiences an episode of complete relief of symptoms. In the second case, the manifestations of the disease do not go away completely. The second type of flow is continuous. In this case, the disease progresses progressively, there are no periods of remission. All types of illness involve an altered state of thinking and perception. The integral structure of consciousness is disrupted and disintegrates.

Researchers consider productive symptoms to be the central feature of the paranoid form. The main role is given to illusions and delusional thinking. The behavior of patients is often withdrawn; aggression and rudeness are possible. Characterized by frequent mood swings. Joy and depression alternate at intervals of several minutes.

The pathology code in ICD 10 is F20.0. Basic symptoms of the paranoid form of schizophrenia:

• delusions of influence or persecution, special purpose, jealousy or relationship, etc.;
• auditory, visual, tactile hallucinatory phenomena of a threatening form;
• visual hallucinations are less common;
• depersonalization;
• attacks of senestopathy;
• affective disorders;
• violation of the emotional-volitional sphere of the personality: lack of volitional efforts, unemotionality, detachment;
• disturbances in the thought process.

There are different variants of paranoid schizophrenia, different clinical pictures and symptoms. Paranoid schizophrenia tends to occur in several stages. The first is the initial period of initial symptoms of the disease. The second is the paranoid stage, which most often does not include hallucinations and mental automatisms.

The third stage is the paranoid stage, which includes delusions of an unsystematized nature, hallucinations, and Kandinsky-Clerambault syndrome. The fourth is the paraphrenic stage, accompanied by delusions of a fantastic nature. The fifth stage is the increase in schizophrenic defects. The described sequence is not typical for all patients. Sometimes the paranoid stage goes directly into the paraphrenic stage.

At the first initial stage, psychopathic-like disorders are noticeable. The symptoms can easily be confused with a personality disorder. A person suffers from depersonalization, obsessions, and hypochondria. Senestopathies occur - uncomfortable sensations without objective pathological causes, located outside or inside the body. A person acquires new character traits that were previously absent.

More often there is distrust of others, loss of interest in previously interesting activities. Emotionality dulls. The first stage lasts from 5 to 20 years. After it, paranoid syndrome is formed.

Researcher K. Conrad also points to the existence of successive stages of paranoid schizophrenia:

• trema stage - a person loses the relationship between the perception of the internal and external world, characterized by a feeling of loss of freedom, depersonalization (an unrecognizable world);
• apophenia stage - the relationship is lost so much that objectively existing objects and events are indistinguishable by the patient from fictitious ones, delusions and paranoid manifestations arise;
• stage of the apocalypse - mental activity is destroyed, it becomes fragmented, problems with self-awareness arise;
• stage of residual defects.

Paranoid syndrome

Paranoid syndrome is considered a mild form of delusion. The first symptoms are systematized delusions of an interpretative nature. Often - delirium of persecution, greatness, invention. Patients are often characterized by delusional beliefs about their spouse’s betrayal, severe hypochondria, and a belief in a non-existent illness. Patients demonstrate the following delusions:

• reformism - a person is convinced that he is able to change the structure of a certain country or the whole world;
• erotic - the belief in the presence of a certain stalker/sexual maniac;
• conviction of high origin, the presence of non-existent ancestors - kings, princes, etc.;
• Querulism - excessive struggle for one's own rights, constant filing of complaints to various authorities.

Delusional ideas are systematized - they have a logical system, subjective evidence, and arguments. Paranoid syndrome is not accompanied by perception disorders, hallucinations, or mental automatism. A clear sign of the development of pathology is problems with recognizing and perceiving humor. Some authors (G.I. Zaltsman, R.G. Ilesheva, N.T. Izmailova) indicate a high risk of developing depressive symptoms with paranoid syndrome in patients with schizophrenia.

Kandinsky-Clerambault syndrome

Kandinsky-Clerambault syndrome is named after the Russian psychiatrist V. H. Kandinsky and the French doctor G. G. De Clerambault. The disorder occurs at the third stage of development of schizophrenia. Initially, patients experience one or more types of automatisms.

With ideational automatisms, a person is convinced that other people’s thoughts are being “put” into his head. Patients describe feeling as if their thought processes could be “heard” or “read” by strangers. Sometimes the phenomenon of “theft” of the thought process occurs. Characteristic are interruptions of thoughts and the phenomenon of mentism. “Madeness” is also characteristic of the patient’s dreams and memory.

Ideatorial automatism is sometimes called associative. It affects the course of the thought process and other types of mental activity. Patients have a feeling of “sounding” of their thoughts, a feeling of memories unwinding. The second phenomenon involves the belief that extraneous forces are forcing one to remember some event in a person’s life.

Sensory or senestopathic automatisms are accompanied by fanciful, unusual bodily sensations. The patient becomes convinced that his sensations are “made” or “caused” by someone outside. This also applies to sensations of cold, warmth, excitement, etc.

Motor or kinesthetic automatisms are the belief that any activity is caused by influences from the external or unreal world. Patients claim that they move, walk or jump in ways that are inconsistent with their own will. A special place is given to speech motor pseudohallucinations. Patients indicate that the movements of their mouth or tongue are not of their own free will.

People with the described syndrome feel influence from the outside world, carried out by witchcraft, alien forces, hypnosis, radiation, etc. Mental automatisms are characterized by a certain order. At the initial stage, ideational symptoms are observed, then senestopathic, and finally kinesthetic. However, the described sequence of stages does not always occur.

The structure of Kandinsky-Clerambault syndrome contains the phenomenon of pseudohallucinations. They are visual, auditory, olfactory, gustatory, tactile, visceral, kinesthetic. Patients distinguish hallucinatory phenomena from existing objects. However, there is a feeling of “done”. Visual and auditory pseudohallucinations include:

• visions of familiar or unfamiliar faces;
• panoramas, landscapes;
• noise (usually similar to the noise of a radio);
• fragments of words or phrases.

The faces or phrases represented in the hallucinations belong to men, women, and children. In visions, both familiar and unfamiliar pictures and voices appear.

Paraphrenic syndrome

Symptoms of paraphrenia often develop at the previous stage of Kandinsky-Clerambault syndrome. Researchers emphasize that before the onset of paraphrenia, people often experience severe anxiety and fearfulness. This stage does not overtake a person suddenly. At the beginning of paraphrenia, the nature of pseudohallucinations and mental automatisms changes. If previously they were harmful and threatening, then at this stage they are characterized by goodwill. In the first stage of paraphrenia, a person is in high spirits. He begins to claim that he has paranormal, supernatural skills and abilities. The patient has the feeling that he is able to “read” the thoughts of other people and change their mood.

Unusual processes occur in memory. A person experiences the feeling that he has just remembered a long-forgotten event. This event either did not exist at all in reality, or its details were greatly distorted and supplemented. Some forces or people from the outside world allegedly “force” the event to be remembered. The described phenomenon is called memory hallucinations.

At the next stage of paraphrenia, delusions of a fantastic, absurd nature are formed. A person claims that he has become or has always been a special or popular person. There is a belief that there are special missions, the ability to influence the fate of another person or group of people. The patient says that in the country (or on the planet) there is a battle between his supporters and opponents. Fantastic delirium is always similar to the described logic of thinking of a person with schizophrenia.

Other signs of paraphrenia:

• false recognitions—unfamiliar faces are perceived as important people involved in the patient’s life;
• ideas of greatness;
• feeling of euphoria, pleasure;
• confabulation - the memory is filled with false memories.

With paraphrenia, a gross disruption of metabolic processes in the brain occurs, and excessive activity of structures in the subcortical region is observed.

Paraphrenic syndrome is formed not only in various types of schizophrenia. It is present in persons with organic mental pathologies, with atypical bipolar affective disorder, with schizoaffective disorder. There are two types of syndrome. In acute cases, symptoms develop quickly, over a short period of time, and are amenable to therapy. In a chronic course, the symptoms are poorly controlled and sometimes last for several decades.

Paranoid schizophrenia ends with the fifth stage - schizophrenic defects. After therapy, symptoms of schizophasia are often present. Speech abilities suffer - the patient constructs phrases correctly, but the meaning of their content is partially or completely absent. The behavior of patients suffering from schizophasia appears orderly and correct. After the paranoid form of pathology, the diagnosis is often changed to F20.5 (residual schizophrenia).

Delusional and hallucinatory variants

Some researchers (L. M. Elgazina, E. D. Sokolova) note that there are two types of course of the paranoid form of schizophrenia. The first is a hallucinatory or pseudohallucinatory course. The second is crazy. Types are distinguished based on which symptoms predominate. At the initial stages of pathology development, a mixed, hallucinatory-delusional course occurs.

The hallucinatory type has the following features:

• the presence of pseudohallucinations or hallucinations in the disease picture;
• relatively small number of delusional ideas;
• mental automatisms are either absent or not clearly expressed.

During the course of delusions, pseudohallucinations and hallucinations are almost not observed. With this option, patients more often exhibit delusional thinking, ideas of persecution and influence. They also have a more pronounced syndrome of mental automatisms.

Delusional and hallucinatory variants occur in acute or chronic form. Acute course - symptoms are more pronounced, delusional ideas are not systematized, all types of mental automatisms are present. In the acute form, the patient experiences fear, anxiety, and confusion.

Chronic course - affects are less vivid, there are no feelings of confusion, delirium is systematized. In the chronic form, mental automatisms develop in accordance with the stages described above. The delusional form of the course becomes more complicated after several years of illness. Pathological beliefs develop into conspiracy theories. Fictional and real-life forces, organizations, and political parties are involved in delusional thinking.

With a hallucinatory course, auditory and verbal hallucinations are more often observed. They are often associated with the course of the thought process. The danger lies in the fact that a person in a state of delirium or pseudohallucinations is capable of harming himself and other people.

Characteristics of a typical patient

Patients suffering from paranoid syndrome are distrustful and suspicious of other people. This manifests itself in systematized delirium. A person always believes that others have bad intentions and are plotting against them. They can talk about their suspicions with a trusted person. But if this person allows himself to doubt that the patient is right, he immediately falls into the circle of conspirators.

In another case, a person imagines a conspiracy in which a group of people participates. The patient tells about this to everyone he meets and can trust. In this way he wants to protect himself and warn others about evil intentions.

A person with paranoid syndrome believes that they are trying to deceive him or take advantage of him for their own purposes. However, there is no evidence. Such relationships permeate not only personal relationships, but also professional ones, regardless of the environment.

Paranoid syndrome: symptoms

• Unfounded suspicions that others are taking advantage of them, harming them or deceiving them.

• Concerns and unjustified doubts about the loyalty and reliability of friends, spouses, or partners.
• They are reluctant to trust others because of an unreasonable fear that the information will be used maliciously against them.
• They perceive comments or criticism addressed to them as humiliation or a threat and immediately react with vicious attacks or counterattacks.
• They stubbornly do not forgive insults.
• They have delusional ideas, without justification, regarding the fidelity of a spouse or sexual partner.
• Patients are confident that people nearby are whispering or laughing, mocking them (verbal illusions).

Clinical picture

Signs of paranoia can manifest themselves in varying degrees of severity, so the main symptoms of paranoid syndrome include:

• decreased mental activity;
• inability to adequately perceive criticism;
• suspicion;
• hostility;
• hallucinations, most often auditory;
• megalomania;
• touchiness;
• jealousy is constant and unfounded;
• tendency to pass off fantasies as reality.

In addition, there is constant anxiety and fear. Patients suffer from depression and prolonged psychosis. Often they begin to file complaints to various authorities against people whom they consider their enemies and involved in the conspiracy.

Development of pathology

Paranoid syndrome develops in two stages. The first is characterized by the secrecy of delusional ideas in the patient’s behavior and actions. But the character begins to gradually change, suspicion appears. The patient adjusts his life to his fantasies, taking them for reality.

The second stage is characterized by an improvement in delusional deviations. The patient suffers from auditory hallucinations. The paranoid constantly imagines surveillance, alien voices that call him and impose their truths.

Often such people turn to investigative authorities for help due to wiretapping. The patient begins to be overcome by fear, panic, and anxiety. He feels like he is surrounded by a secret conspiracy. He talks about his plans with caution.

Only a doctor can stop the development of mental disorders, psychosis, depression and constant horror.

Character of the current

In medicine, there are several types of paranoia, which differ in signs and causes, these include:

1. Alcoholic . Occurs due to prolonged use of alcoholic beverages. One of the signs is pathological jealousy. The mania of persecution also manifests itself.
2. Involutionary . Characterized by delusions of persecution, grandeur, and jealousy. Occurs at the age of 45-60 years.
3. Megalomaniac . Systematized delusions of grandeur. Often the patient feels like a pioneer or reformer.
4. Delirium of jealousy . The patient always thinks that his spouse is unfaithful to him.
5. Religious . Delusional ideas of religious content.
6. Persecute . Systematized ideas of persecution.
7. Erotic . It develops more often in women 40-50 years old. Characterized by a predominance of erotic delirium.
8. Senile . Occurs in old age.
9. Spicy . Manifested by sudden, figurative delusions of grandeur, relationships, or persecution.
10. expansive paranoia is also distinguished Images of delirium also appear suddenly. Most often they are of a religious nature.

Diagnostic criteria

The diagnosis is made based on complaints from the patient and his relatives. Often patients do not admit that they need help. The doctor also asks a number of questions and examines the patient's medical history to determine the cause of the disease.

Special psychological tests can also be carried out to identify the degree of impairment and the nature of the course of the disease. There are no special instrumental diagnostic methods.

Treatment

Complex therapy is used based on the disease that caused the syndrome. Although, for example, in France, there is a syndromic type of treatment.

1. Mild form: aminazine, propazine, levomepromazine 0.025-0.2; etaperazine 0.004-0.1; sonapax (meleril) 0.01-0.06; Meleril-retard 0.2;
2. Moderate form: aminazine, levomepromazine 0.05-0.3 intramuscularly 2-3 ml 2 times a day; chlorprothixene 0.05-0.4; haloperidol up to 0.03; triftazine (stelazine) up to 0.03 intramuscularly 1-2 ml 0.2% 2 times a day; trifluperidol 0.0005-0.002; risperidone 0.002-0.01;
3. Aminazine (tizercin) intramuscularly 2-3 ml 2-3 per day or intravenously up to 0.1 haloperidol or trifluperidol 0.03 intramuscularly or intravenously drip 1-2 ml; Leponex up to 0.3-0.5; moditene-depot 0.0125—0.025.

Complex of therapeutic measures

Treatment can be carried out either inpatient or outpatient, depending on the patient’s condition. Therapy involves taking antipsychotics, sedatives and antidepressants. Medicines are prescribed only by a doctor after examination and all psychological tests.

There are also ongoing conversations with the patient in order to change his thinking. To treat the disease, the main directions are used: family psychotherapy, cognitive behavioral psychotherapy, individual and group work. Thanks to this approach, patients can manage their emotions. Support and understanding from loved ones is also important.

It is difficult to completely get rid of paranoia, since the patient’s suspicions also extend to the attending physician, and the prescribed psychotherapy is perceived as an attempt to keep his thoughts and actions under control.

If left untreated, long-term depression occurs. Patients constantly feel fear and anxiety. This condition leads to suicidal thoughts. Often patients become aggressive and dangerous to others.

Paranoid syndrome is a chronic disease that is characterized by mental disorder and the occurrence of delusional ideas. The causes of the pathology have not been established to date. There are a number of factors that increase the risk of developing paranoia. Treatment consists of constant monitoring of the patient and changing his consciousness.

general description

Paranoid syndrome indicates a significant depth of mental disorder, which covers all areas of mental activity, changing the patient’s behavior. The syndrome is characterized by a predominance of figurative delusions, closely associated with auditory hallucinations, anxiety and depressed mood.

The most common delusion of persecution occurs in paranoid syndrome. The systematization of delusional ideas of any content varies within very wide boundaries. If the patient talks about what the persecution is (damage, poisoning), knows the date of its beginning, the purpose used for the purpose of persecution (damage, poisoning, etc.), the means, grounds and goals of the persecution, its consequences and the final result, then we are talking about systematized nonsense. Delirium can arise like insight and does not require confirmation by facts.

When everything around the patient seems to be filled with hidden meaning (understandable only to him alone), then we are talking about delusions of special significance. If it seems to the patient that strangers on the street are paying attention to him, “hinting” at something, and looking at each other meaningfully, then we are most likely talking about delusions of attitude.

The combination of delusional ideas with hallucinations of any type forms the common hallucinatory-paranoid syndrome. Sensory disorders in paranoid syndrome may be limited to true auditory verbal hallucinations, often reaching the intensity of hallucinosis. Typically, such a hallucinatory-delusional syndrome occurs primarily in somatically caused mental disorders. The complication of verbal hallucinations in these cases occurs due to the addition of auditory pseudohallucinations and some other components of ideational mental automatism - “unwinding of memories”, a feeling of mastery, an influx of thoughts - mentism.

Paranoid syndrome can be acute and chronic: in acute cases, affective disorders are more pronounced and systematic delusions are less pronounced.

Delusional and hallucinatory variant of the syndrome

Depending on the predominance of delusions or sensory disorders in the structure of the hallucinatory-delusional syndrome, delusional and hallucinatory variants are distinguished.

In the delusional version, the delirium is usually systematized to a greater extent than in the hallucinatory version; among sensory disorders, mental automatisms predominate and patients, as a rule, are either inaccessible or completely inaccessible.

In the hallucinatory variant, true verbal hallucinations predominate. Mental automatism often remains undeveloped, and in patients it is always possible to find out certain features of the condition; complete inaccessibility is rather an exception here.

In prognostic terms, the delusional variant is usually worse than the hallucinatory variant.

Clinic

Questioning patients with paranoid syndrome often presents great difficulties due to their inaccessibility. Such patients are suspicious and speak sparingly, as if weighing their words. This can be suspected by statements typical of such patients ( “why talk about it, everything is written there, you know and I know, you’re a physiognomist, let’s talk about something else.”

). Even if, as a result of questioning, the doctor does not receive specific information about the patient’s subjective state, he can almost always conclude from indirect evidence that there is inaccessibility or low accessibility, that is, that the patient has delusional disorders.