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Keywords: psychiatry, lecture, consciousness, frustration of consciousness, a delirium, an oneiroid, deenergizing of consciousness, a stupefaction, a tremens, an alcoholic abstinent set of symptoms
Lecture ¹5
FRUSTRATION OF CONSCIOUSNESS
Frustration of consciousness arise not only at mental patients. Can be, for example, at infections at children.
"Delirium tremens" - develops at each 20-th patient with an alcoholism. Infringements of consciousness can be at narcomaniacs and glue sniffers.
Classification of frustration of consciousness:
- the Set of symptoms of the switched off consciousness. Allocate the following stages:
- an obnubilation,
- a sopor,
- a coma - the consciousness is absent.
- Sets of symptoms of the changed consciousness - the consciousness is kept, but in new quality - patients behave unusually. Then do not remember or badly remember, happened with them at the moment of obscuring event. Experiences bright, externally not clear.
Criteria of the changed consciousness (on K.Jaspers):
à) detachment from the real world
á) infringement of orientation
â) an amnesia - specific to each variant.
Jaspers has described stages of development of a delirium.
there Are 4 basic such as a stupefaction:
- a delirious stupefaction - more often;
- an oneiric stupefaction;
- an amental stupefaction;
- a twilight stupefaction.
the Delirium- nonspecific reaction of mentality to the fact of an intoxication. In the majority there is a delirium - an alcoholic genesis. Atsetaldegidovaja the intoxication results in alcoholic psychosises.
The delirium is one of many alcoholic psychosises. Develops only on 2 or 3 stages of an alcoholism. It is a lot of signs.
"Delirium tremens" is preceded with an alcoholic abstinent set of symptoms. On the CART the alcoholic abstinent set of symptoms is a set of somatic, vegetative neurologic and psychopathologic sets of symptoms which arise at sudden deprivation of alcohol, and all these displays reduce the expressiveness and intensity at addition of new doses of alcohol. The abstinence is preceded with a drinking-bout, as a rule, a true drinking-bout (5-7 days) after which reception of alcoholic drinks suddenly stops that results in occurrence of a symptomatology.
Psychopathologic displays of an alcoholic abstinent set of symptoms:
à) infringements of dream;
á) irritability;
â) alarm, anxiety (probably subdepressive mood);
ã) rudimentnoe false perception (phonemes, photopsias).
Neurologic displays of an alcoholic abstinent set of symptoms:
à) static and dynamic ataksija (infringements koordinatornyh assays, instability in pose Romberga);
á) convulsive paroxysms are possible;
â) a tremor (isolated or generalized).
Somatic and vegetative displays of an alcoholic abstinent set of symptoms:
à) abdominal pains;
á) a nausea, a vomiting;
â) frustration of a chair;
ã) absence of appetite;
ä) kardialgii;
å) an arterial hypertension (occasionally a hypotension);
æ) a tachycardia;
ç) tahipnoe;
è) the fervescence (sometimes an appreciable hyperthermia), is especial in a combination to an infection;
ê) a hyperhidrosis;
ë) tongue is impose with a grey raid.
3 groups of signs gradually on the first place leave these psychopathologic, others depart on the second plan. For 2-3 day after deprivation of alcohol, is closer by the night the delirium develops.
Clinical displays of a delirium:
The patient lays in bed fixed, but the patient unshaven, dirty, "vegetative" tries to rise, tongue is impose with a brown raid, frustration of perception, frustration of thinking are observed. The behaviour of the patient is defined by potent hallucinative experiences. The patient in own person, a place, time is focused. Frustration of perception are shown by true hallucinations, all the images long with a negative shade (draw, mice, rats, cockroaches). Huge value for statement of the correct diagnosis is played with emotional reaction of the patient. The patient defends actively, protected from hallucinative images. To I shall wipe a delirium it is weakened - " ljutsidnoe a window " - decrease of an expressiveness of a symptomatology. Sometimes bezljutsidnoe current of a delirium - less favorable variant.
In treatment of patients by a delirium it is important to achieve dream which will be an output from a delirium. During 2-3 months after an output from a delirium - an asthenic condition.
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Keywords: psychiatry, lecture, consciousness, frustration of consciousness, a delirium, an oneiroid, deenergizing of consciousness, a stupefaction, a tremens, an alcoholic abstinent set of symptoms
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