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Affective syndromes

Affective syndromes are symptoms of mental disorders, determined by mood disorders.

Affective syndromes are divided into two main groups - with a predominance of high (manic) and low (depressive) moods. Patients with depressive syndromes are found many times more often than with manic ones , and they need special attention, since approximately 50% of those who attempt suicide suffer from depression.

Affective syndromes are noted for all mental illnesses. In some cases, they are the only manifestations of the disease (circular psychosis, schizophrenia ), in others - its initial manifestations ( progressive paralysis , syphilis , brain tumors, vascular psychosis). The last circumstance, as well as a very large suicide rate among patients with depressive syndromes, determines the tactics of the behavior of medical workers. For these patients, round-the-clock strict medical supervision should be established, and they should, if possible, be referred to a psychiatrist as soon as possible. It must be remembered that not only rude, but just careless handling of manic patients always leads to increased arousal in them. On the contrary, attention, sympathy for them allows, albeit for a short time, to achieve their relative comfort, which is very important when transporting these patients.

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Affective syndromes are syndromes, in the clinical picture of which the disturbances of the emotional sphere take the leading place - from mood fluctuations to pronounced disorders (affects). By the nature of the affects are divided into sthenic, occurring with a predominance of excitement (joy, delight), and asthenic - with a predominance of inhibition (fear, sadness, sadness, despair). Affective syndromes include dysphoria, euphoria, depression, mania.

Dysphoria is a mood disorder characterized by intense, viciously melancholy affect with marked irritability, reaching to explosions of anger with aggressiveness. The most common dysphoria is found in epilepsy; in this disease, they begin suddenly, without external reason, last for several days and also end suddenly. Dysphoria is also observed in organic diseases of the central nervous system, in excitable type psychopaths. Sometimes dysphoria is combined with drunken drunkenness.

Euphoria - elevated mood with a hint of contentment, carelessness, serenity, without accelerating the associative processes and increasing productivity. Signs of passivity and inactivity predominate. Euphoria occurs in the clinic of progressive paralysis, atherosclerosis, and brain injury.

Pathological affect is a short-term psychotic condition arising in connection with mental trauma in persons who are not suffering from mental illness, but are characterized by unstable mood and asthenia. The intensity of passion, anger and rage in this state is immeasurably greater than those characteristic of physiological affects.

The dynamics of pathological affect is characterized by three phases: a) asthenic affect of insult, fear, which is accompanied by disturbances in thinking (incompleteness of individual thoughts, their slight incoherence) and autonomic disorders (blanching of the face, hand trembling, dry mouth, reduced muscle tone); b) the affect becomes sthenic, rage, anger prevail; consciousness narrows sharply, mental trauma dominates its content; disorders of consciousness deepen, accompanied by agitation and aggression; the nature of vegetative changes becomes different: the face turns red, the pulse quickens, the muscle tone rises; c) a way out of pathological affect, which is realized by prostration or sleep, followed by complete or partial amnesia.

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Treatment of affective states . The presence of this or that affective syndrome in patients requires emergency measures from the physician: establishing patient supervision, referral to a psychiatrist. Depressed patients who may commit a suicide attempt are hospitalized in the department with enhanced supervision. To transport them to the hospital must be under the constant supervision of medical staff. On an outpatient basis (before hospitalization), patients in a state of agitated depression or depression with persistent suicidal attempts are given an injection of 5 ml of a 2.5% solution of aminazine.

In appointing therapy, the nosological diagnosis and the particular condition of the patient are taken into account. If depression is a phase of circular psychosis, the treatment is carried out by psychotropic drugs - antidepressants. In the presence of agitation in the structure of this depression, anxiety is prescribed a combination therapy with antidepressants (in the first half of the day) and antipsychotics (in the second half of the day) or is carried out, treatment with nosinan, amitriptyline.

In case of psychogenic depressions, if they are shallow, hospitalization is not necessary, since their course is regredient. The treatment is carried out with sedatives and anti-depressants.

Patients in a manic state are usually hospitalized, since they should be protected from those who are wrong and often unethical by others and patients themselves. For the treatment of manic states, antipsychotics are used - aminazine, propazin, etc. Patients with euphoria should be hospitalized, as this condition indicates either intoxication (which requires quick recognition to take emergency measures) or organic brain disease, the essence of which should be clarified . The euphoria of convalescents who have had an infectious or general somatic disease at home or in a somatic (infectious) hospital does not serve as an indication for hospitalization in a psychiatric hospital. Such patients should be under the constant supervision of a doctor and staff. For their treatment, sedatives can be used along with fortifying agents. Patients in a state of epileptic dysphoria are also hospitalized due to the possibility of aggression.