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Psycology » Psychiatry and psychotherapy » Late-onset psychosis » Atrophic brain disease

Table of ContentsContents: Psychosis later age: - presenile (involution) psychoses atrophic brain diseases: - Senile dementia of Alzheimer's type - Alzheimer's Disease - Pick's disease - Parkinson's disease and Huntington's chorea borderline disorders in later life

In most cases, atrophic diseases begin in elderly and senile age. The most typical atrophic process leading to dementia, senile dementia is developing as 70 years or later. Because in the future similar to endogenous dementia clinic described Alzheimer A. (1906), now had the idea of ​​dementia of the Alzheimer type (DAT). Isolated senile dementia of the Alzheimer type (DAT I) and presenile dementia of the Alzheimer type (DAT II), starting at 55-65 years, or Alzheimer's disease. In addition, atrophic dementias include Pick's disease, Huntington's chorea, and several others.

Senile dementia of the Alzheimer type

Senile dementia of the Alzheimer type (senile dementia) - it occurs predominantly in old age endogenous organic (atrophic) disease of the brain with the progressive disintegration of the psyche in general and the development of total (globarnoy) dementia.

Prevalence of senile dementia by different researchers estimated ambiguously. According to Scandinavian gerontopsychiatry (X. Sjögren, 1956), of mental illness later in life, leading to dementia, senile dementia cases ranged from 12-15% to 34.4%. In the United States suffers from senile dementia of 5% of the population older than 65 years.

According to SI Gavrilova, among the older population (60 years or more) of one of the districts of Moscow prevalence of dementia, Alzheimer's type of varying severity is 4.4%. Women with two times more than men.

Clinic. The disease begins to develop on the background of aging changes the whole body between the ages of 70 and 80 years. Its first manifestations are changing warehouse with particular personality traits peculiar to the patient earlier. As a diagnostic specific phenomenon is of great importance increasing leveling of the individual properties of the patient's symptoms and a special "senile restructuring" of the whole person - that Scheid described as "senile psihopatizatsii", "senile change in the nature" (1933). They appear increasingly coming to the fore rigidity and roughness personality, narrowing of interests, general narrowing horizons. Increases simplification, stereotyped views of the surrounding, which manifests itself in an equally stereotypical template statements. Reduced emotional responsiveness, the former lost responsiveness. At the same time, patients become gullible, suggestible, easily influenced by someone else, even to their own detriment. Appear distrust, self-centeredness, suspicion, suspicion. Found distraction, inattention towards his duties, becomes noticeable forgetfulness. Since many of these people do not work, such phenomena for some time do not pay much attention to themselves. However, with clear progression soon her symptoms become noticeable. Along with increasing weakness and memory considerations increasingly act strange behavior. Patients long stay up, walk around the house, visiting the locks on doors and windows, listening to obscure sounds, sometimes look around, fearing thieves and robbers. Often the entire night passes suspenseful, walking through the rooms, and they are sleepy during the day, can fall asleep sitting on a chair, sometimes even while eating or talking with others. Detected early emotional staling may appear disinhibition, promiscuity, often with accentuation inadequate eroticism, such attempts of sexual violence. Lost initial interests, flexibility and plasticity of the psyche, which is extremely conservative. Expression of a general reduction of the individual becomes the growing prevalence of dementia with loss primarily new experience while maintaining the old stock memory (memories of the past remain for a long time accurate enough). There is obviously a manifestation of the law of the progressive reduction Ribot memory.

Dementia syndrome, referring to the main manifestation of the disease in such cases takes on the character of total dementia and accompanied by a complete collapse of the mental activity. Central to the development of dementia occupy memory disorders. At the beginning of the disease to some extent, still retain the ability to direct memory but

consolidation of the new material is given heavier becomes incomplete and inaccurate. In the future, because it is impossible "formation of new connections» (AB Snezhnevsky, 1948) mental disorders are becoming more pronounced and lead to fixation amnesia. This reveals a picture of amnestic disorientation, especially in history (in time), and then later in the surrounding and only self. Patients poorly oriented in space, can not determine the direction, distance, location of objects, lose all sense of time. From the outset of the disease, an infringement of reproductive memory, selective reproduction needed at the time of the material, such as names, dates, names. One of the early symptoms is finger agnosia (AB Snezhnevsky, 1949). While patients may point fingers, call them they can not. Gradually, layer by layer, there is a complete devastation reserves memory (F. Ribot, 1881) in a sequence opposite to that in which materials are purchased in memory for life. At the final stage of the disease patients can not give any information about yourself. Confabulation are usually scarce, but often there are characteristic false recognition. In others, patients recognize individuals they knew in childhood or young age. For example, consider their children and siblings and siblings take for parents. "The shift in the past" applies to an idea of ​​self: patients say that they are still young, in school, are not married (not married), living in her parents' house, etc.

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