Contents
What is vascular psychosis?
The definition of vascular psychoses includes psychoses, which are based on vascular diseases of the brain (atherosclerosis, hypertension, hypotension, thrombosis, and others). These psychoses have an acute and subacute form, occurring with the presence of a transitional syndrome and clouded consciousness, as well as chronic manifestations of psychoses of an affective or hallucinatory-paranoid type.
Mental disorders, in the formation of which pathologies of the vascular system are involved, cause a variety of symptoms, which is explained by different diseases.
It is impossible to say exactly how these psychoses have spread.
The reflection of clinical diversity and the possible difference in mental disorders, taking into account their origin, is presented in the following classification of mental disorders, which are based on vascular disorders: syndromes in the initial, neurosis-like, pseudo-neurosthenic form; various types of vascular dementia; exogenous, delusional, affective, hallucinatory and other types of syndromes.
The special isolation of the syndrome in its initial form with vascular genesis is justified by the frequency of its occurrence, as well as by the fact that in most cases the presence of vascular pathology, this particular syndrome, may be the only manifestation of the clinical picture of the disease for its entire period. Under such circumstances, the progress of the disease is not observed, but rather stabilizes precisely at this stage of manifestation.
Signs and symptoms of vascular psychosis
Vascular psychoses in their initial manifestations are recorded as a syndrome in a pseudo-neurasthenic form. By this is meant a non-psychotic type of symptoms with certain inclusions of pathologies of an organic nature. Against this background, the symptoms of a psychopathological type are closely intertwined with mild stigmas of a neurological type. The patient complains of the presence of noise or ringing in the ears, the onset of which occurs suddenly and disappears just as quickly. The headache in the occipital region is like a constriction and comes on in the morning.
A characteristic symptom is a feeling of numbness in the cheeks, chin, nose and twitching of the facial muscles. Psychosis takes place against the background of a disturbed sleep pattern, the duration of which decreases to 3 hours without the possibility of falling asleep again and is superficial. The patient acquires sensitivity to any stimulus and may experience episodic dizziness, balance failures while walking. He has an instability of the emotional plan, forgetfulness, excessive tearfulness, instability of attention, and rapid fatigue.
The patient is aware of his pain and his negative changes. They are expressed in slow motor skills of reactions and speech, a tendency to reasonable edification, difficulty in remembering new events and information, and a violation in the exact dating of what is happening. There is constant instability of the emotional sphere and incontinence of affect (capriciousness, tearfulness, anxious fears about health, relatives). Perhaps the development of hypochondria.
Reactive states and neurotic-like disorders have the ability to develop when transient somatic disorders occur. At the same time, reactions of a depressive type, symptoms of hypochondria, fear of imminent death, helplessness and dependence are constantly present. Such symptoms of the initial stage in vascular pathologies make it possible for the manifestation of personality changes with manifestations of a psychopathic type, a certain rigidity in the psyche. There is a subordination of psychopathization to the age factor.
Differential diagnostics
The initial period of the process of vascular pathology has signs that resemble neurasthenic and neuropathic diseases. When diagnosing, the doctor relies on the somatics of arteriosclerotic sigmas or the symptoms of hypertension (reveals changes in the fundus, determines scattered microsymptoms of the neurological type).
The greatest difficulty is the delimitation of senile dementia from vascular dementia. In this variant, the flickering of symptomatic signs of vascular processes with periods of recovery, alternating with sharp changes in mental functions, is considered to be a distinctive feature, and senile dementia is constantly progressing without visible periods of stabilization. Also, vascular disorders have an acute manifestation at the onset of the disease with the presence of a nocturnal increase in undulation of consciousness.
Treatment of vascular psychosis
The basis of therapeutic measures in the treatment of vascular psychosis is to eliminate the underlying disease of a somatic nature. The doctor prescribes psychotropic medications depending on the prevalence of certain mental disorders. At the beginning of treatment, sedative tranquilizers are used (atarax, rudotel, and others).
In small doses, it is possible to prescribe antipsychotics (rispolept, propazin, haloperidol). Anxiety-depressive disorders require the use of atypical antidepressants to avoid confusion with amitriptyline.
During treatment, they strive to keep the patient’s vital activity in a normal mode as much as possible.