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Psycology » Psychiatry and psychotherapy » Neurosis » Obsessional neurosis (obsessive-phobic neurosis)

  1. Neurosis: neurasthenia
  2. Hysterical neurosis
  3. Obsessional neurosis (obsessive-phobic neurosis)
  4. Diagnosis and treatment of neurosis
This neurosis involves a series of neurotic conditions under which patients have obsessive fears, thoughts, actions, memories that they themselves are perceived as alien and unpleasant, painful and at the same time, patients themselves can not free themselves from their obsessions.

At the origin of the disease plays an important role constitutionally-personal predisposition. Predominate among patients who suffer from reflection (introspection), and anxious-hypochondriac.

Most often, the leading symptoms of neurosis are fears (phobias). Dominated by fear of contracting severe physical or infectious diseases (kardiofobiya, cancerophobia, sifilofobiya, spidofobii etc.). In many patients, the feeling of fear is stay in confined spaces, transport (claustrophobia), and they are afraid to go out or be in a public place (agoraphobia), in some cases, fear arises when patients only imagine this difficult situation for them. Neurotics, in the presence of phobic disorders, trying in any way to get rid of those situations in which they appear fears. Many of them are constantly turning to different doctors to verify the absence of heart disease (when cardiophobia), cancer (cancerophobia). Careful attention to the work of their internal organs promotes formation hypochondriacal disorder.

Sometimes neuroses develop in connection with the violation of any normal activity, while patients are in a state of waiting for failure of its implementation. A typical example is the emergence of psychogenic weakening adequate erection in men, which further leads to fixing the attention on the possible disruption in the need for rapprochement with the woman and the formation of "neurosis expectation" (Kraepelin, 1910).

In more rare cases, especially neurosis characterized by the predominance of obsessions. In patients against their will arise, such as intrusive memories, from which they can not escape, some patients pointless recount steps on the stairs, the number of cars passing of a single color, many times to ask themselves different questions and try to answer them (why word "chair" four letters, and the word "lamp" five letters, why the chair - this chair, not the table, although both words have four letters, etc.). This forms the phenomenon of "ruminations." Patients understand the pointlessness of these reflections, but can not get rid of them. The hardest time of their obsessive thoughts about the need to commit kakih-nibud shameful actions, such as obscene swearing in public, to kill her child (contrasting thought, "blasphemous" thoughts). Although patients never realize these trends, experience them hard.

Besides these disorders may occur compulsive actions (compulsions) such as compulsive hand washing to achieve their ideal of purity (up to 100 times or more per day), returning home to check if the door is closed, whether the gas is turned off, iron. In some cases of compulsive actions (rituals) to eliminate obsessions. For example, the patient should jump 6 times and only after that he can leave the house as calm and know that anything is wrong with him today does not happen, etc.

In the dynamics of compulsion neurosis (NM Asatiani) are three stages. In the first stage obsessive fear arises only in a situation where the patient is afraid of something, the second - at the thought be in this situation, the third - opportunistic stimulus word is somehow associated with a phobia (for example, when such cardiophobia words may be "heart", "vessels" and "infarction", when cancerophobia - "tumor", "cancer", etc.).

Some patients have "panic attacks" - recurrent attacks of sudden fear, mostly fear of death, or loss of consciousness, accompanied by palpitations, shortness of breath, pain. These may be long enough time, the patients subsequently fear their recurrence, not go out alone on the street or move with the accompanying. Most of these vegetative paroxysmal attacks with palpitations and shortness of breath are closely associated with chronic stress and arise against overwork. In domestic psychiatry similar conditions as described sympathadrenalic crises or designated as diencephalic syndrome.

For obsessional neurosis often delayed for a long time, there is a formation of a neurotic personality development.


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