For psychoses are not characterized by gross disorders of the intellect, they increase gradually as the disease progresses.

Treatment

Treatment of senile psychosis combines medical and psychotherapeutic methods. The choice depends on the severity of the condition, the type of disorder, the presence of somatic diseases. Patients are prescribed the following groups of drugs:

The doctor selects a combination of drugs according to the type of psychosis.

Also, in parallel, it is necessary to treat a somatic disease, if it appeared cause of the disorder.

Psychotherapy

Psychotherapeutic classes are an excellent tool for the correction of psychosis in the elderly. In conjunction with drug therapy they give positive results.

Doctors use mainly group classes. Old people, being engaged in groups, acquire a new social circle with common interests. A person can start talking openly about his problems, fears, thereby getting rid of them.

Most effective methods psychotherapy:

Senile psychoses This is a problem not only for the patient himself, but also for his relatives. With timely and correct treatment, the prognosis of senile psychosis is favorable. Even with severe symptoms, it is possible to achieve a stable remission. Worse treatable chronic psychoses especially those associated with depression.

Relatives of the patient need to be patient, show care and attention. A mental disorder is a consequence of the aging of the body, so not a single person is immune from it.

Senile psychosis (or senile psychosis) is a group of mental illnesses of various etiologies that occur after 60 years of age. It manifests itself in a clouding of consciousness and the occurrence of various endoform disorders (reminiscent of schizophrenia and manic-depressive psychosis). In various sources, you can find information that senile psychosis is identical to senile dementia, that it is one and the same. But this is not entirely true. Yes, senile psychosis can be accompanied by dementia, but in this case it is not total. And the key signs of senile psychosis, nevertheless, are in the nature of a psychotic disorder (sometimes the intellect remains intact).

Allocate acute and chronic forms of senile psychosis. Sharp forms are manifested by clouding of consciousness, and chronic - by the occurrence of paranoid, depressive, hallucinatory and paraphrenic states. Regardless of age medical treatment such states are essential.

Acute forms of senile psychosis

Their occurrence is associated with the presence of somatic diseases, therefore they are called somatogenic. The cause may be a lack of vitamins, heart failure, diseases genitourinary system, diseases of the upper respiratory tract, lack of sleep, physical inactivity, decreased hearing and vision.

Such somatic diseases in the elderly are not always diagnosed in a timely manner, and treatment is often overdue. On this basis, and arises, as a consequence, an acute form of senile psychosis. All this emphasizes once again how important role has timely treatment of any somatic diseases in the elderly - their mental health may depend on this.

Usually, the acute form of senile psychosis occurs suddenly. But, in some cases, the occurrence acute psychosis preceded by the so-called prodromal period (1-3 days).

During this period, the patient develops weakness and problems in self-care, spatial orientation becomes difficult, appetite and sleep are disturbed. Then there is, in fact, the attack of acute psychosis itself.

It is expressed in motor restlessness, fussiness, confusion of thinking. Various delusional ideas and thoughts arise (the patient usually believes that they want to harm him, take away his property, etc.). Hallucinations and illusions may appear, but they are few and persistent. As a rule, when acute senile psychosis develops, the symptoms of somatic disorders that led to its development also become aggravated. Psychosis lasts from a few days to 2-3 weeks. The disease itself can proceed continuously, or maybe in the form of periodic exacerbations. In the period between exacerbations, the patient feels weakness, apathy. Treatment of the acute form of senile psychosis is preferably carried out in a hospital.

Chronic forms of senile psychosis

There are several chronic forms, and they are determined by those key signs (symptoms) that accompany the course of the disease.

depressive states

Depressive states (more common in women). In mild cases, there is lethargy, apathy, a sense of the meaninglessness of the present and the futility of the future. At severe course- there is a pronounced anxiety, deep depression, delusions of self-accusation, agitation up to Cotard's syndrome. The duration of the disease is usually 12-17 years, and yet, the patient's memory disorders are usually not deep.

paranoid states

They are characterized by chronic delirium, which is usually directed at the immediate environment (relatives, neighbors). The patient constantly says that he is offended and oppressed in his own house, they want to get rid of him. It seems to him that his personal belongings are stolen from him or spoiled. In severe cases, delusional ideas arise that they are trying to destroy him - to kill, poison, etc. The patient can lock himself in his room, limit access to other people. However, with this form of the disease, a person is able to serve himself, and in general, socialization is maintained. The disease develops and lasts for many years.

Usually expressed by a combination of hallucinations of various kinds with paranoid ideas and thoughts. This disease manifests itself at the age of about 60 years, and lasts for many years, sometimes up to 10-15 years. The clinical picture quickly becomes similar to the signs of schizophrenia (for example, the patient suspects that they want to kill or rob him, and this is accompanied by various visual hallucinations, the patient "hears voices", etc.). At the same time, memory impairments develop slowly, are not noticeable at the first stages of the disease, and are clearly manifested after many years of the course of the disease.

Senile paraphrenia (confabulosis)

Typical signs of the disease are multiple confabulations related to the past (the patient attributes to himself acquaintances and connections with famous and influential people, there is an overestimation of himself, up to delusions of grandeur). Such confabulations take on the form of a "cliché", that is, they practically do not change either in form or in content. There are such violations at the age of 70 years and more, memory impairment for initial stage are not expressed, and develop gradually.

Of course, the gradual age-related decay of the psyche is partly a natural process. However, the symptoms of such ailments can be painful both for the patient himself and for his loved ones. When extremely severe conditions the patient may cause unintentional harm to himself or others. Therefore, the treatment of such conditions is certainly necessary. While a person is alive, everything possible must be done so that the last years of his life are filled with joy and peace.

Methods of treatment of senile psychosis

The decision on the need for hospitalization is made by the doctor, with the consent of the patient's relatives. Treatment is based on general condition patient: the form and severity of the disease, as well as the presence and severity of somatic diseases are taken into account.

In depressive states, psychotropic drugs such as azafen, pyrazidol, amitriptyline, melipramine are prescribed. Sometimes a combination of two drugs in a certain dosage is used. Other forms of senile psychosis are treated with the help of such drugs: triftazin, propazine, haloperidol, sonapaks. Treatment of any form of senile psychosis also involves the appointment of correctors (for example, cyclodol).

In each individual case, drugs are selected individually, and treatment should also include the correction of concomitant somatic diseases.

Doctors give the most favorable prognosis in the acute form of senile psychosis. For long, chronic forms ah disease, the prognosis is usually unfavorable, most often the drugs only stop the symptoms, but the disease remains and accompanies the person until the end of life. Therefore, the relatives and friends of the patient need to be patient, show calmness and loyalty - after all, the age-related decay of the psyche is an objective phenomenon, it does not depend on the will of the old person.

Senile psychoses

e. acute forms of senile psychoses are symptomatic psychoses.

Causes of senile psychosis:

In some cases, the cause of senile psychosis can be physical inactivity, sleep disturbances, malnutrition, sensory isolation (decreased vision, hearing). Since the detection of a somatic disease in the elderly is often difficult, its treatment in many cases is too late. Therefore, mortality in this group of patients is high and reaches 50%. For the most part, psychosis occurs acutely, in some cases its development is preceded by a prodromal period lasting one or several days, in the form of episodes of fuzzy orientation in the environment, the appearance of helplessness in self-service, increased fatigue, as well as sleep disorders and lack of appetite.

Clearly defined clinical pictures are much less common, more often it is delirium or stunning.

The disease can proceed both continuously and in the form of repeated exacerbations. During the recovery period, patients constantly have adynamic asthenia and passing or persistent manifestations of the psychoorganic syndrome.

Forms and symptoms of senile psychosis:

Chronic forms of senile psychoses occurring in the form of depressive states are more common in women. In the mildest cases, subdepressive states occur, characterized by lethargy, adynamia; patients usually complain of a feeling of emptiness; the present seems insignificant, the future is devoid of any prospects. In some cases, there is a feeling of disgust for life. There are constantly hypochondriacal statements, usually associated with one or another existing somatic diseases. Often these are “silent” depressions with a small number of complaints about their state of mind.

Paranoid states (psychosis):

Paranoid states, or psychoses, are manifested by chronic paranoid interpretive delusions that spread to people in the immediate environment (relatives, neighbors) - the so-called delusions of small scope. Patients usually talk about being harassed, wanting to get rid of them, deliberately spoiling their products, personal belongings, or simply robbing them. More often, they believe that by “bullying” others want to hasten their death or “survive” from the apartment. Much less often are statements that they are trying to destroy them, for example, to poison them. At the onset of the disease, delusional behavior is often observed, which is usually expressed in the use of all kinds of devices that prevent entry into the patient's room, less often in complaints sent to various government agencies and in relocation. The illness continues for years with gradual reduction delusional disorders. Social adaptation such patients usually suffer little. Lonely patients fully serve themselves, maintain family and friendly ties with former acquaintances.

hallucinatory states:

Hallucinatory states, or hallucinosis, manifest mainly in old age. Allocate verbal and visual hallucinosis (Bonnet hallucinosis), in which other psychopathological disorders are absent or occur in a rudimentary or transient form. The disease is combined with severe or complete blindness or deafness. With senile psychosis, other hallucinoses are also possible, for example, tactile.

Tactile hallucinosis:

Hallucinatory-paranoid state:

Hallucinatory-paranoid states often appear after the age of 60 in the form of psychopathic disorders lasting for many years, in some cases up to 10-15 years. The complication of the clinical picture occurs due to the paranoid delusions of damage and robbery (delusions of a small scale), which can be joined by unsystematized ideas of poisoning and persecution, which also extend to people in the immediate environment. The clinical picture changes mainly at the age of 70-80 years, as a result of the development of polivocal verbal hallucinosis, similar in manifestations to Bonnet's verbal hallucinosis. Hallucinosis can be combined with individual ideational automatisms - mental voices, a sense of openness, echo thoughts.

Senile paraphrenia (senile confabulosis):

Another type of paraphrenic condition is senile paraphrenia (senile confabulosis). Among these patients, persons aged 70 years and older predominate. The clinical picture is characterized by multiple confabulations, the content of which refers to the past. Patients talk about their participation in unusual or significant events social life, about acquaintances with high-ranking people, and relationships that are usually erotic in nature.

Signs of senile psychosis:

Most chronic senile psychoses are characterized by the following common signs: limitation of clinical manifestations to one range of disorders, preferably one syndrome (for example, depressive or paranoid); the severity of psychopathological disorders, which makes it possible to clearly qualify the psychosis that has arisen; long-term existence of productive disorders (delusions, hallucinations, etc.) and only their gradual reduction; a combination for a long period of productive disorders with sufficient preservation of intelligence, in particular memory; memory disorders are more often limited to dysmnestic disorders (for example, in such patients affective memory is retained for a long time - memories associated with emotional influences).

Diagnosis of senile psychosis:

The diagnosis of senile psychosis is established on the basis of the clinical picture. Depressive states in senile psychoses are differentiated from depressions in manic-depressive psychosis that arose in late age Paranoid psychoses are distinguished from late-onset schizophrenia and paranoid states in the onset of senile dementia. Verbal hallucinosis Bonnet should be differentiated from similar conditions, occasionally occurring in vascular and atrophic diseases of the brain, as well as in schizophrenia; visual hallucinosis Bonnet - with a delirious state, noted in acute forms of senile psychosis. Senile paraphrenia should be distinguished from presbyophrenia, which is characterized by signs of progressive amnesia.

Treatment of senile psychosis:

Treatment is carried out according to physical condition sick. From psychotropic drugs (it must be remembered that aging causes a change in the reaction of patients to their action), in depressive states, amitriptyline, azafen, pyrazidol, melipramine are used. In some cases, two drugs are used simultaneously, for example, melipramine and amitriptyline. For other senile psychoses, propazine, stelazin (triftazin), haloperidol, sonapax, and teralen are indicated. In the treatment of all forms of senile psychosis psychotropic drugs correctors are recommended (cyclodol, etc.). Side effects more often manifested by tremor and oral hyperkinesia, which easily take a chronic course and are difficult to treat. In all cases, strict control over the somatic condition of patients is necessary.

The prognosis for acute forms of senile psychosis is favorable in the case of timely treatment and the short duration of the state of stupefaction. A long-term stupefaction of consciousness entails the development of a persistent and in some cases progressive psycho-organic syndrome. The prognosis of chronic forms of senile psychosis in relation to recovery is usually unfavorable. Therapeutic remission is possible in depressive conditions, Bonnet's visual hallucinosis, and in other forms - a weakening of productive disorders. Patients with a paranoid state usually refuse treatment; the best adaptive capabilities, despite the presence of delirium, are noted in them.

Senile psychosis is a group of diseases mental nature, developing, as a rule, in people aged about 60 years.

These disorders are characterized by a loss to some extent of intellectual abilities, skills acquired throughout life, a decrease in mental activity.

What is characteristic this problem is not fully dementia, as it may be written in some literature, although this phenomenon may be one of the symptoms of the disease, but in any case, it will not be of a total nature.

The symptomatology of this group of diseases is of a psychotic type, which is important, the intellect can be fully preserved in a person. Very often the disease occurs in the form of depression or delusional disorder.

Less commonly, the problem may manifest itself as anxiety, confusion. Thus, there is a partial clouding of consciousness as a result of disorders in the activity of the central nervous system (central nervous system).

AT medical practice There are two types of development of senile psychosis:

• spicy senile syndrome, characterized by clouding of consciousness, disadaptation in society and loss of personality;
• chronic senile psychosis, which manifests itself in the form of depression, hallucinations, the condition can be paraphrenic, hallucinatory-paranoid.

Causes of the disease

The etiology and pathogenesis of senile psychosis are not yet well understood. According to statistics, this problem in more women are more susceptible than men. The risk of the disease increases if the family already had precedents of senile psychosis, that is hereditary factor plays an important role.

The main reasons for the development of the disease are:

• gradual age-related death of cell groups;
• degenerative processes in the brain;
• various infectious diseases can affect the development of the disease;
• somatic pathologies;
• traumatic circumstances.

Also, the pathogenesis can be affected by:

• hypodynamia;
• sleep disorders;
• malnutrition (incorrect diet);
• hearing and vision problems.

Clinical picture

In the event that senile psychosis occurs as depression, delusional ideas are inherent in such a state, increased anxiety, general depression of mood, suicidal tendencies, "self-destruction".

Psychoses are characterized by disorders accompanied by jealousy, persecution, and prejudice. So, the main "victims" of a suffering old man can be relatives and friends, neighbors, others, as they can be accused of theft, damage to their property, etc.

Senile psychosis in its acute form is quite common, its symptoms appear mainly in people undergoing treatment with somatic and mental disorders. It is in the process of complications of these diseases that an impetus to the development of psychoses appears.

Symptoms of acute psychosis are:

• clouding of consciousness;
• motor excitation;
• fussiness;
• lack of coordinated action;
• delusional disorders;
• hallucinations (verbal, visual, tactile);
• unfounded fears;
• anxiety.

This type of course of the disease can be observed for several weeks, and can proceed continuously as recurring relapses.

The development of acute psychosis can be determined by the presence of some symptoms:

• loss of appetite;
• sleep disturbance;
• disorientation in space, which is episodic;
• severe fatigue;
• helplessness;
• self service problems.

Further clouding of consciousness is followed by amnesia. The clinical picture is fragmentary. Patients may experience physical activity, as well as different forms clouding of consciousness (amentia, stunning), which occur both singly and in combination.

Chronic senile psychosis is observed mainly in older women. In mild forms, there may be:

• lethargy;
• feeling of uselessness;
• adynamia;
• negative attitude.

Against the background of the course of the disease, unreasonable feelings of guilt and anxiety may appear. Such a disease occurs with a slight manifestation of a mental disorder, which over time suppresses the functions of the body.

Such sluggish depression in some cases can lead to suicide. Psychosis can develop over 10 years, with only minor memory impairment present.

Diagnostic criteria

In the early stages, it is almost impossible to determine the presence of the disease, since it has a lot of symptoms similar to other pathologies: the cardiovascular system, tumors and other problems.

The reason for the diagnosis is the progressive impoverishment of the psyche, leading in a few years to irreversible dementia.

A trip to the doctor is mandatory if the patient has a number of factors: disorders for more than six months, leading to violations of social, professional, daily activities. At the same time, a person has a completely clear consciousness, there are no mental disorders that could lead to a decrease in intelligence.

Differential diagnosis

Differential diagnosis helps to distinguish senile syndrome from similar diseases, such as schizophrenia.

Dementia is often complemented depressive disorders(pseudo-dementia), so it is quite difficult to differentiate the disease.

Package of measures

After clinical picture was studied and an accurate diagnosis was made, you can begin to treat the patient. With the permission of the relatives of the patient, he is placed in a medical facility.

The main goal of treatment is to stop the development of the disease, symptomatic treatment and alleviation of these characteristic symptoms.

In the case of depression, a specialist may prescribe psychotropic drugs such as Melipramine, Pyrazidol, Azafen. In some cases, drugs can be combined at a certain dose. For all other types of senile psychosis, Propazine, Haloperidol is prescribed.

In each case, the patient is prescribed an individually selected drug and additionally medicines that correct associated symptoms.

Tellingly, the acute form of senile psychosis is more successfully treated. A protracted disease can only be muffled medicines, but it is impossible to get rid of it completely.

What should relatives and friends do?

For supporting mental state a patient who has been diagnosed with senile psychosis, his relatives and friends around him should treat the current situation with understanding and understand that this process is inevitable and incurable. This disease is objective and does not depend on the patient at all.

In severe cases of senile psychosis, patients need special care, which is best organized in medical institution. If the patient is inactive, bedsores may appear, which will significantly worsen the state of health.

Patients who are characterized by untidiness require special care. Yes, relatives or medical staff(depending on the location of the patient) are required to wipe it with camphor alcohol, wash it regularly, change bed linen and prevent sleeping on a wet bed. Cleansing enemas should also be regular.

What to expect?

The most favorable prognosis is given to patients with an acute form of the disease, especially if medical care turned in time, and the consciousness was not in a state of stupefaction for long.

The chronic form does not entail anything good and the prognosis in this case is not comforting: the disease develops from one to ten years and the later this process begins, the better, since in the end the disease ends with cachexia, problems with making movements and even building phrases and pronunciation of words.

Experts believe that if prevention of senile psychosis is started at the age of 35, then in the future, a person will be able to avoid such a disease:

• the person must be physically active;
• an important factor is the development of mental abilities;
• attention to body weight;
• blood pressure control;
• control of cholesterol levels;
• proper nutrition.

Description:

Unfortunately, there is no cure for dementia. Psychology, as a science, is still studying senial. In the treatment of senile psychosis, symptomatic therapy. In a state of confusion with anxiety, antipsychotics with a sedative effect (tizercin, sonapax) are prescribed in small dosages. If the patient has Then small doses of antidepressants are prescribed along with sedatives (pyrazidol, amitriptyline). With anxiety and loss of sleep, tranquilizers and neuroleptics with hypnotic properties (phenazepam, chlorprothixene, radedorm) are prescribed. Patient care is also essential.

Symptoms:

The initial symptoms of the manifestation of senile psychosis are an increasing change in personality. This is stinginess, and egocentrism, and coarsening. The individuality of the patient's character is lost. At the same time, the level of judgment decreases in the patient, he is not able to acquire new knowledge and skills, memory gradually fades away (first recently acquired, and then experience acquired throughout life), false memories arise, speech becomes laconic. Only basic physical needs remain. Against the background of dementia, psychotic states alternate - anxious or angry depression, material damage, jealousy. In patients, consciousness is confused when combined with a somatic disease.
Occur in patients with depression. They are not severe, but last a long time and are characterized by discontent, sullenness and hypochondriacal diseases.
Somatic diseases aggravate the course of psychosis. Women are most affected by this disease. The risk of the disease increases if someone in your family has been sick or is sick with this type of disease. Average age the patient at the onset of the disease is from seventy to seventy-eight years.

Causes of occurrence:

The etiology, pathogenesis of senile dementia is unknown. Women get sick more often than men. The risk of disease in families of patients with senile dementia is higher than among the rest of the population. Concomitant somatic diseases modify and aggravate the picture of psychosis.

Treatment:

For treatment appoint:

Unfortunately, there is no cure for dementia. Psychology, as a science, is still studying senile psychosis. In the treatment of senile psychosis, symptomatic therapy is carried out. In a state of confusion with anxiety, antipsychotics with a sedative effect (tizercin, sonapax) are prescribed in small dosages. If the patient is depressed. Then small doses of antidepressants are prescribed along with sedatives (pyrazidol, amitriptyline). With anxiety and loss of sleep, tranquilizers and antipsychotics with a hypnotic property (phenazepam, chlorprothixene, radedorm) are prescribed. Patient care is also essential.