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Treatment of mania

Antipsychotics such as chlorpromazine (chlorpromazine) and haloperidol, usually allow you to quickly take control of the symptoms of acute mania, although sometimes this requires large doses (see Chap. 17). Lithium carbonate is also effective, however, in this case the therapeutic response often manifested only in the second week of treatment and hence, it is more retarded than the response to antipsychotic drugs. Controlled studies in which lithium carbonate was compared with chlorpromazine (see, e.g., Prien et al. 1972) th and haloperidol (see, for example, Garfinkel et al. 1980) showed that both of these drugs exceed

Causes of mood disorders: physique and personality

Kretschmer put forward the idea that people with endomorph physique (stocky, thick, rounded body shape) are particularly prone to affective disorders (Kretschmer 1936). But later in the studies using objective measurement methods failed to identify a stable connection of this kind (von Zerssen 1976). Kraepelin suggested that people with cyclothymic personality type (ie, with constantly repeated for a long time, mood swings) more likely to develop manic-depressive disorder (Kraepelin 1921). It was subsequently reported that such a connection, apparently, is more pronounced in bipolar disorder

Treatment of manic patients

First of all decide on the need for hospitalization. In virtually all cases, except for the lungs, it is desirable to place the patient in the hospital to protect him from the consequences of their own behavior. Patients in whom the disorder is not too heavy, it is generally agreed to go to hospital, to convince them of the wisdom of this step is usually easy. A more serious condition may need to involuntary hospitalization. When emergency treatment is usually prescribed neuroleptics. In most cases, haloperidol selected as the most suitable drug for this purpose; chlorpromazine is an alternative if

Treatment of depressive disorders

This section focuses on the effectiveness of various forms of treatment. Details regarding drug therapy and ECT are given in Sec. 17, to be addressed before reading this section. Recommendations on the choice of treatment and daily care of patients are given in the section devoted to the management of patients. Antidepressants having great importance to the Medical Research Council (Clinical Psychiatry Committee 1965) compared the therapeutic effect of imipramine, phenelzine, and placebo ECT 250 patients suffering from moderate to severe depression. By the end of the first four weeks of ECT was the most effective treatment of the four pa

Causes of mood disorders: psychological theories of etiology

These theories consider the psychological mechanisms by which the recent and long-term time-life experiences can lead to depressive disorders. In the literature on the subject, as a rule, is not carried out properly distinguish between individual symptom of depression and depressive syndrome. Starting psychoanalysis psychoanalytic theory of depression was laid article Abraham in 1911, she received further development in the work of Freud's Mourning and Melancholia (Freud 1917). Note the similarity between the symptoms of sadness and depression symptoms, Freud speculated that the pr

The etiology of affective disorders: genetic factors

There are many different approaches to the etiology of affective disorders. This section primarily discusses the role of genetic factors and childhood experiences in shaping the predisposition to the development of affective disorders in adulthood. Then considered stressors that can provoke affective disorders. Following is an overview of the psychological and biochemical factors, through which predisposing factors and stressors may lead to the development of affective disorders. In all these aspects, researchers are studying mainly depressive disorders, much less attention is paid to ma

Classification and description of depressive disorders in daily practice

Although neither the DSM-IIIR, or ICD-10 can not be considered satisfactory, it is unlikely that what whatever further processing of descriptive categories at this stage could lead to more acceptable results. The real way to solve this problem, open only when sufficient progress in understanding the etiology. In the meantime, in the preparation of statistical data should be used either ICD-10 or DSM-IIIR. For research purposes, it is best to classify cases of diseases considered a standardized scheme, for example, using the diagnostic criteria for RDC (Research Diagnostic Criteria) or PSE CATEGO

Classification of depressive disorders on the basis of the disease and the time of occurrence

Monopolar and bipolar disorder When Kraepelin concluded that mania and depression should be treated as a single clinical entity, the reason for this was the course of the disease: to find that it is essentially the same when the manic and depressive disorders, he introduced them to a single category of both manic depressive psychosis. This view was widespread until 1962, when Leonhard et al. suggested to distinguish three groups, including the first of these patients with only depressive disorder (unipolar depression) In vtoruyustradayuschih only mania (unipolar mania), third in those with Ac

Classification of depressive disorders based on etiology

Reactive and endogenous depression According to this classification scheme, which is based on etiology, two groups of depressive disorders: endogenous and reactive (sometimes called exogenous). When endogenous disorders symptoms are caused by internal factors and do not depend on external influences. When reactive dist roystvah symptoms are a reaction to external stressors. Differentiation of endogenous and reactive disorders depending on the nature of the reasons for unsatisfactory as a result of the classification system introduced in categories that are not mutually exclusive but rather overlap: for

Periodic psychosis

Some bipolar disorder regularly renewed, with the intervals between attacks account for only a few weeks or months. In the XIX century French psychiatrist Falret (1854) called these regularly recurring disorder / Yale Circulate (circular psychosis). Nowadays, the term is often used periodic psychosis, but it is not entirely satisfactory. Different authors put it unequal content, including in this concept and other disorders such as schizophrenia, recurrent, rare syndromes type periodic catatonia (see Chap. 9) and recurrent atypical psychosis, which Leonhard (1957) gave the name of the circular n
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