Delirium - what it is, its stages, symptoms, examples and treatment. Delirium and delirium

Rave is a thought disorder with inherent this state painful reasoning, ideas, conclusions that do not correspond to reality and are not subject to correction, but in which the patient is unshakably and completely convinced. In 1913, this triad was formulated by K. T. Jaspers; he noted that these signs are superficial and do not reflect the very essence of delusional disorder, but only suggest its presence. This disorder can only appear on a pathological basis. Delirium deeply affects all spheres of the individual’s psyche, especially affecting the affective and emotional-volitional spheres.

The traditional definition of this disorder for the Russian school of psychiatry is as follows. Delirium is a set of ideas, painful reasoning and conclusions that have taken possession of the patient’s consciousness, falsely reflect reality and are not subject to correction from the outside.

Within medicine, delusional disorder is considered in general psychopathology and psychiatry. Delusions, along with hallucinations, are included in the group of psychoproductive symptoms. A delusional state, being a disorder of thinking, affects one of the areas of the psyche, with the affected area being the human brain.

Schizophrenia researcher E. Bleuler noted that the delusional state is characterized by:
- egocentricity, with a bright affective coloring, which is formed on the basis of internal needs, and internal needs can only be affective.

The concept of “delirium” in colloquial language has a different meaning from the psychiatric one, which leads to its incorrect use with scientific point vision.

For example, in everyday life they call delusional behavior unconsciousness a person, accompanied by meaningless, incoherent speech, often occurring in patients with infectious diseases.

WITH clinical point In terms of vision, this phenomenon must be called amentia, since it is a qualitative disorder of consciousness, not thinking. Likewise, others mistakenly call nonsense in everyday life mental disorders, For example, .

IN figurative meaning A delusional state includes any incoherent and meaningless ideas, which is also incorrect, since they may not correspond to the delusional triad and act as delusions of a mentally healthy person.

Examples of nonsense. The delusional state of paralytics is filled with content about bags of gold, untold riches, thousands of wives. The content of delusional ideas is often concrete, figurative and sensual. For example, a patient can recharge from an electrical outlet, imagining himself as an electric locomotive, or can go without drinking fresh water for weeks because he considers it dangerous for himself.
Patients with paraphrenia claim that they live for a million years and are convinced of their immortality or that they were senators of Rome or took part in the life of ancient Egypt; other patients claim that they are aliens from Venus or Mars. At the same time, such people operate with figurative, vivid ideas and are in a state of heightened mood.

Symptoms of delirium

Delirium deeply affects all spheres of the individual’s psyche, especially affecting the affective and emotional-volitional spheres. Thinking changes in complete submission to the delusional plot.

Delusional disorder is characterized by paralogicality (false inference). The symptoms are characterized by redundancy and belief in delusional ideas, and in relation to objective reality there is a discrepancy. At the same time, the person’s consciousness remains clear, slightly weakened.

The delusional state should be distinguished from the delusions of mentally healthy individuals, since it is a manifestation of the disease. When differentiating this disorder, it is important to consider several aspects.

1. For delusions to occur, there must be a pathological basis, just as personality delusions are not caused by a mental disorder.

2. Delusions relate to objective circumstances, and delusional disorder relates to the patient himself.

3. Correction is possible for delusions, but for a delirious patient this is impossible, and his delusional belief contradicts the previous worldview before the onset of this disorder. In real practice, sometimes differentiation can be very difficult.

Acute delirium. If consciousness is completely subordinated to a delusional disorder and this is reflected in behavior, then this is acute delirium. Occasionally, the patient can adequately analyze the surrounding reality and control his behavior, if this does not relate to the topic of delirium. In such cases, delusional disorder is called encapsulated.

Primary delirium. Primary delusional disorder is called primordial, interpretive, or verbal. The primary cause of it is a defeat of thinking. The logical, rational consciousness is affected. In this case, the patient’s perception is not impaired and he is able to long time be efficient.

Secondary (figurative and sensory) delusions occurs due to impaired perception. This condition is characterized by a predominance of hallucinations and illusions. Delusional ideas are inconsistent and fragmentary.

Thinking disturbance appears a second time, a delusional interpretation of hallucinations sets in, and there is a lack of conclusions that occur in the form of insights—emotionally rich and vivid insights.

Elimination of the secondary delusional state is achieved mainly by treating the symptom complex and the underlying disease.

There are figurative and sensory secondary delusional disorder. With figurative thinking, fragmentary, scattered ideas arise, similar to memories and fantasies, that is, delusions of representation.

In sensual delirium, the plot is visual, sudden, rich, concrete, emotionally vivid, and polymorphic. This condition is called delusion of perception.

Delusional imagination differs significantly from sensory and interpretative delusional states. With this variant of delusional disorder, ideas are not based on perceptual disorders or on a logical error, but arise on the basis of intuition and fantasy.

There are also delusions of grandeur, delusions of invention, and delusions of love. These disorders are poorly systematized, polymorphic and very variable.

Delusional syndromes

In Russian psychiatry, it is currently customary to distinguish three main delusional syndromes.

Paranoid syndrome is unsystematic and is often observed in combination with hallucinations and other disorders.

Paranoid syndrome is an interpretative, systematized delusion. Most often monothematic. With this syndrome, there is no intellectual-mnestic weakening.

Paraphrenic syndrome is fantastic, systematized in combination with mental automatisms and hallucinations.

Mental automatism syndrome and hallucinatory syndrome are close to delusional syndromes.

Some researchers identify a delusional “paranoid” syndrome. It is based on an overvalued idea that arises in paranoid psychopaths.

The plot of delirium. The plot of delirium is understood as its content. The plot, as in cases of interpretative delirium, is not a sign of illness and directly depends on the socio-psychological, political and cultural factors within which the patient lives. There can be a lot of such plots. Often ideas arise that are common to the thoughts and interests of all mankind, as well as characteristic of a given time, beliefs, culture, education and other factors.

Based on this principle, three groups of delusional states are distinguished, united by a common plot. These include:

1. Delusion of persecution or mania of persecution, persecutory delusion, which in turn includes:

• delusion of damage - the belief that the patient’s property is being damaged or stolen by some people;
• delusion of poisoning - the patient is convinced that one of the people wants to poison him;
• delusion of relationship - it seems to a person that the entire environment is directly related to him and the behavior of other individuals (actions, conversations) is determined by them special treatment to him;
• delusion of meaning - a variant of the previous plot of delirium (these two types of delusional state are difficult to differentiate);
• delusion of influence - a person is haunted by the idea of ​​extraneous influence on his feelings, thoughts with an accurate assumption about the nature of this influence (radio, hypnosis, “cosmic radiation”); - erotic delusion - the patient is sure that he is being pursued by his partner;
• delirium of litigiousness - the sick person fights to restore “justice”: courts, complaints, letters to management;
• delusions of jealousy - the patient is convinced that his sexual partner is cheating;
• delusion of staging - the patient’s conviction that everything around is specially arranged and scenes of some kind of performance are being played out, and an experiment is being conducted, and everything is constantly changing its meaning; (for example, this is not a hospital, but a prosecutor’s office; a doctor is an investigator; medical staff and patients are security officers disguised in order to expose the patient);
• delusion of possession - a person’s pathological belief that he has been possessed by an evil spirit or some hostile creature;
• Presenile delirium is the development of a picture of depressive delirium with ideas of condemnation, guilt, and death.

1. Delusions of grandeur (expansive delusions, delusions of grandeur) in all its varieties include the following delusional states:

• delusions of wealth, in which the patient is pathologically convinced that he possesses untold treasures or wealth;
• delirium of invention, when the patient is susceptible to the idea of ​​making a brilliant discovery or invention, as well as unrealistic various projects;
• delirium of reformism - the patient creates social, absurd reforms for the benefit of humanity;
• delusion of origin - the patient believes that his real parents are high-ranking people, or attributes his origin to an ancient noble family, another nation, etc.;
• rave eternal life- the patient is convinced that he will live forever;
• erotic delusion - the patient’s conviction that a certain person is in love with him;
• love delusional conviction, which is noted in female patients by the fact that they are loved famous people, or everyone who meets them at least once falls in love;
• antagonistic delusion - the patient’s pathological belief that he is a passive witness and contemplator of the struggle of opposing world forces;
• religious delusional belief - when a sick person considers himself a prophet, claiming that he can perform miracles.

1. Depressive delusions include:

• delusions of self-abasement, self-blame, sinfulness;
• hypochondriacal delusional disorder - the patient’s belief that he has a serious illness;
• nihilistic delirium - a false feeling that the patient or the surrounding world does not exist, and the end of the world is coming.

Separately, induced (induced) delusions are distinguished - these are delusional experiences that are borrowed from the patient through close contact with him. This looks like being “infected” with delusional disorder. The person to whom the disorder is induced (transmitted) is not necessarily submissive or dependent on the partner. Usually those people from the patient’s environment who communicate very closely with him and are connected by family relationships are infected (induced) with delusional disorder.

Stages of delirium

The stages of delirium include the following stages.

1. Delusional mood - the belief that changes have occurred around and trouble is approaching from somewhere.

2. Delusional perception arises in connection with an increase in anxiety and a delusional explanation of individual phenomena appears.

3. Delusional interpretation - a delusional explanation of all perceived phenomena.

4. Crystallization of delirium - the formation of complete, coherent, delusional ideas.

5. The fading of delirium - the emergence of criticism of delusional ideas.

6. Residual delirium - residual delusional phenomena.

Treatment of delirium

Treatment of delusional disorder is possible with methods that affect the brain, that is, psychopharmacotherapy (antipsychotics), as well as biological methods (atropine, insulin comas, electrical and drug shock).

The main method of treating diseases that are accompanied by delusional disorder is treatment psychotropic drugs. The choice of antipsychotics depends on the structure of the delusional disorder. In case of primary interpretative with pronounced systematization, drugs with a selective nature of action (Haloperidol, Triftazin) will be effective. For affective and sensory delusional states, antipsychotics are effective wide range actions (Frenolone, Aminazine, Melleril).

Treatment of diseases accompanied by delusional disorder, in many cases, occurs in a hospital setting followed by supportive outpatient therapy. Ambulatory treatment is prescribed in cases where the disease is observed without aggressive tendencies and is reduced.

Delirium is a disorder of thinking, which is characterized by the appearance of painful ideas, judgments and conclusions that do not correspond to reality and cannot be corrected, which seem to the patient to be absolutely logical and correct.

This triad was formulated in 1913 by K. T. Jaspers, who noted that the signs he identified are superficial, since they do not reflect the essence of the disorder and do not define, but only assume the presence of the disorder.

According to the definition of G.V. Grule, delusion is a set of ideas, concepts and conclusions that arose without reason and cannot be corrected with the help of incoming information.

Delirium develops only on a pathological basis (accompanies schizophrenia and other psychoses), being a symptom of brain damage.

Along with hallucinations, delusions belong to the group of “psychoproductive symptoms.”

General information

Delirium as a pathology of mental activity was identified with the concept of madness back in antiquity. Pythagoras to denote the correct, logical thinking used the term “dianoia”, which he contrasted with “paranoia” (going crazy). The broad meaning of the term “paranoia” gradually narrowed, but the perception of delusion as a disorder of thinking remained.

German doctors, relying on the opinion of the director of the Winenthal psychiatric hospital, E. A. von Zeller, opened in 1834, believed until 1865 that delirium develops against the background of mania or melancholy and is therefore always secondary pathology.

In 1865, the director of the Hildesheim psychiatric hospital, Ludwig Snell, read a report based on numerous observations at a congress of naturalists in Hanover. In this report, L. Snell noted that there are primary delusional forms independent of melancholy and mania.

The German psychiatrist and neuropathologist Wilhelm Griesinger (1881) also considered delirium to be an independent disease, calling it primary insanity.

The first attempt to classify paranoia and separate it from other forms was the work of V. Zander, published in 1868, “On one special form of primary insanity.” In his work, V. Zander noted that in some cases the disease develops gradually, reminiscent of the developmental process normal character. For such cases, V. Zander proposed using the term “innate paranoia,” linking the formation of a delusional system with the character and personality of the patient.

The gradual development in a number of cases of delusions of persecution, delusions of relation and special significance was also noted by E. Lasegue.

New data made it possible to divide delirium according to the method of occurrence into:

• primary (interpretive or paranoid), which was described in 1909 by P. Sereux, J. Capgras;
• secondary (sensual delirium), which occurs against the background of melancholy or mania (altered affect).

Secondary delusions began to include the delusion of explanation described in 1900 by K. Wernicke, hallucinatory delusion and cathethetic delusion described in 1938 by V. A. Gilyarovsky, which occurs in the presence of painful sensations.

In 1914, the French psychiatrists E. Dupre and V. Logre described delirium of the imagination.

Persecutory delirium (delusion of persecution) was first described by E. Lasegue in 1852. This form of delirium was also described later by J. Falret the Father (1855) and L. Snell (1865).

The stages of delirium formation were first described in 1855 by J. P. Falre.

The existence of acute forms of delusional disorder was pointed out in 1876 by Karl Westphal - the primary delusion described by Westphal did not differ in anything from chronic paranoia, except for the course of the disease.

As part of the study of schizophrenia, delusions and its characteristics were considered by E. Bleuler and E. Kraepelin.

According to research, the general features of delirium and the mechanism of its development do not have pronounced national and cultural characteristics, but a certain cultural pathomorphosis is observed (changes in the signs of a particular disease) - in the Middle Ages, delusional ideas were mainly associated with magic and obsession, and in our time delirium prevails, associated with “the influence of telepathy, biocurrents or radar.”

In everyday life, delirium refers to the unconscious state that occurs in somatic patients at elevated temperatures, which is accompanied by meaningless and incoherent speech. Since this condition is a qualitative disorder of consciousness, and not a disorder of thinking, it is more correct to use the term “” to denote it.

Forms

Depending on the clinical picture of this thinking disorder are distinguished:

• acute delirium, which completely takes over the patient’s consciousness, as a result of which the patient’s behavior is completely subordinate to the delusional idea;
• encapsulated delusion, in the presence of which the patient adequately analyzes the surrounding reality not related to the topic of delirium and is able to control his behavior.

Depending on the cause of the thinking disorder, delusions are distinguished into primary and secondary.

Primary delusion (interpretative, primordial or verbal) is the direct expression pathological process. This type of delirium occurs on its own (not caused by affects and other mental disorders) and is different primary lesion rational and logical knowledge, therefore, the existing distorted judgment is consistently supported by a number of specifically systematized subjective evidence.

The patient's perception is not impaired, performance is maintained for a long time. Discussion of topics and subjects affecting the delusional plot causes affective tension, which in some cases is accompanied by emotional lability. Primary delirium is characterized by persistence and significant resistance to treatment.

There is also a trend towards:

• progression (more and more parts of the surrounding world are gradually drawn into the delusional system);
• systematization, which looks like a subjectively coherent system of “evidence” of delusional ideas and ignoring facts that do not fit into this system.

This form of delirium includes:

• Paranoid delusion, which is the mildest form of delusional syndrome. Manifests itself in the form of a primary systematized monothematic delusion of persecution, invention or jealousy. May be hypochondriacal (distinguished by sthenic affect and thoroughness of thinking). Devoid of absurdity, develops with unchanged consciousness, there are no perception disorders. Can be formed from an extremely valuable idea.
• Systematized paraphrenic delusion, which is the most severe form of delusional syndrome and is distinguished by a combination of dream-like delusions of grandeur and delusions of influence, the presence of mental automatism and elevated background moods.

According to K. Jaspers, primary delirium is divided into 3 clinical variants:

• delusion of perception, in which what a person perceives at the moment is directly experienced in the context of “another meaning”;
• delusional ideas, in which memories acquire delusional meaning;
• delusional states of consciousness in which real impressions are suddenly invaded by delusional knowledge not associated with sensory impressions.

Secondary delusions can be sensual and figurative. This type of delusion occurs as a result of other mental disorders (senesthopathy, deceptions of perception, etc.), that is, impaired thinking is a secondary pathology. It is characterized by fragmentation and inconsistency, the presence of illusions and hallucinations.

Secondary delusions are characterized by a delusional interpretation of existing hallucinations, bright and emotionally rich insights (insights) instead of conclusions. Treatment of the main symptom complex or disease leads to the elimination of delirium.

Sensual delirium (delusion of perception) is characterized by the appearance of a sudden, visual and concrete, polymorphic and emotionally rich, vivid plot. The plot of delirium is closely related to depressive (manic) affect and imaginative ideas, confusion, anxiety and fear. With manic affect, delusions of grandeur arise, and with depressive affect, delusions of self-abasement arise.

Secondary delusions also include delusions of representation, manifested by the presence of scattered, fragmentary ideas such as fantasies and memories.

Sensory delirium is divided into syndromes including:

• Acute paranoid, which is characterized by ideas of persecution and influence and is accompanied by pronounced affective disorders. Occurs in disorders of organic origin, somatogenic and toxic psychoses, schizophrenia. In schizophrenia, it is usually accompanied by mental automatisms and pseudohallucinosis, forming Kandinsky-Clerambault syndrome.
• Staging syndrome. Patient with this type Brad is convinced that a dramatization is being played out around him, the plot of which is related to the patient. Delirium in in this case can be expansive (delusional increase in self-esteem) or depressive depending on the existing affect. Symptoms are the presence of mental automatism, delusions of special significance and Capgras syndrome (delusions of a negative double that has replaced itself or a person from the patient’s environment). This syndrome also includes the depressive-paranoid variant, characterized by the presence of depression, delusions of persecution and condemnation.
• Antagonistic delirium and acute paraphrenia. In the antagonistic form of delusion, the world and everything that happens around the patient is seen as an expression of the struggle between good and evil (hostile and benevolent forces), in the center of which is the patient’s personality.

Acute paraphrenia, acute antagonistic delusions and delusions of staging can cause intermetamorphosis syndrome, in which events occurring in the patient are perceived at an accelerated pace (the symptom is extremely serious condition patient).

In schizophrenia, sensory delirium syndromes gradually replace each other (from acute paranoid to acute paraphrenia).

Since secondary delirium may differ in its specific pathogenesis, delusions are distinguished:

• holothymic (always sensual, figurative), which occurs when affective disorders(delusions of grandeur in a manic state, etc.);
• catathymic and sensitive (always systematized), which occurs in those suffering from personality disorders or very sensitive people during strong emotional experiences (delusions of relationship, persecution);
• caesthetic (hypochondriacal delirium), which is caused by pathological sensations arising in various organs and parts of the body. It is observed with senestopathies and visceral hallucinations.

Delirium of foreign speakers and those with hearing loss is a type of delusion of relation. The delusion of the hard of hearing is manifested in the belief that people around the patient constantly criticize and condemn the patient. Delusions of foreign speakers are quite rare and are manifested by the confidence of the patient, who is in a foreign language environment, in the negative reviews of others about him.

Induced delusions, in which a person, in close contact with a patient, borrows delusional experiences from him, some authors consider a variant of secondary delusions, but in ICD-10 this form is identified as a separate delusional disorder (F24).

Dupre's delusion of imagination is also considered a separate form, in which delusions are based on fantasies and intuition, and not on perception disorders or logical errors. It is characterized by polymorphism, variability and poor systematization. It can be intellectual (the intellectual component of imagination predominates) and visual-figurative (pathological fantasy and visual-figurative representations predominate). This form includes delusions of grandeur, delusions of invention and delusions of love.

Delusional syndromes

Russian psychiatry identifies 3 main delusional syndromes:

• Paranoid, which is usually monothematic, systematized and interpretative. In this syndrome there is no intellectual-mnestic weakening.
• Paranoid (paranoid), which in many cases is combined with hallucinations and other disorders. Slightly systematized.
• Paraphrenic, characterized by systematization and fantasticness. For of this syndrome hallucinations and mental automatisms are characteristic.

Hallucinatory syndrome and mental automatism syndrome are often part of the delusional syndrome.

Some authors also include paranoid syndrome as a delusional syndrome, in which, as a result, pathological development personality, persistent overvalued formations are formed, which significantly disrupt the patient’s social behavior and his critical assessment of this behavior. Clinical variant syndrome depends on the content of highly valuable ideas.

According to N. E. Bacherikov, paranoid ideas are either the initial stage of the development of paranoid syndrome, or delusional, affectively charged assessments and interpretations of facts affecting the interests of the patient. Such ideas often arise in accentuated individuals. During the transition to the stage of decompensation (during asthenia or a psychotraumatic situation), delirium arises, which can disappear during therapy or on its own. Paranoid ideas differ from overvalued ideas in the falsity of judgments and greater intensity of affect.

The plot of delirium

The plot of delirium (its content) in cases of interpretative delirium does not refer to signs of the disease, since it depends on cultural, socio-psychological and political factors influencing the individual patient. In this case, patients usually develop delusional ideas that are characteristic of all humanity at a given time period and characteristic of a certain culture, level of education, etc.

All types of delirium, based on the general plot, are divided into:

• Delusion of persecution (persecutory delusion), which includes a variety of delusional ideas, the content of which is the actual persecution and intentional infliction of damage.
• Delusion of grandeur (expansive delirium), in which the patient extremely overestimates himself (even to the point of omnipotence).
• Depressive delusion, in which the content of the pathological idea that arose against the background of depression consists of imaginary mistakes, non-existent sins and illnesses, uncommitted crimes, etc.

In addition to the persecution itself, the story of persecution may include:

• Delusion of damage, based on the patient’s belief that his property is being stolen or deliberately damaged by some people (usually neighbors or close people). The patient is convinced that he is being persecuted with the aim of ruining him.
• Delirium of poisoning, in which the patient eats only home-cooked food or canned food in tin can, because he is sure that they want to poison him.
• Delirium of attitude, in which the entire surrounding reality (objects, people, events) acquires a special meaning for the patient - the patient sees in everything a message or hint addressed to him personally.
• Delusion of influence, in which the patient is confident in the existence of physical or mental influence on him (various rays, devices, hypnosis, voices) in order to control emotions, intellect and movements so that the patient performs the “right actions”. Frequent delusions of mental and physical impact is included in the structure of mental automatisms in schizophrenia.
• Delirium of querulantism (litigiousness), in which the patient feels that his rights have been infringed, so he, with the help of complaints, legal proceedings, etc. similar methods actively fights for the restoration of “justice”.
• Delusion of jealousy, which consists of confidence in the betrayal of a sexual partner. The patient sees traces of betrayal in everything and looks for evidence of it “with passion,” misinterpreting the partner’s trivial actions. In most cases, delusions of jealousy are observed in men. Characteristic for chronic alcoholism, alcoholic psychoses and some other mental disorders. Accompanied by a decrease in potency.
• Delirium of staging, in which the patient perceives everything that happens as a performance or an experiment on himself (everything is a set-up, the medical staff are bandits or KGB officers, etc.).
• Delusion of possession, in which the patient believes that another entity has taken possession of him, as a result of which the patient occasionally loses control over his body, but does not lose his “I”. This archaic delusional disorder is often associated with illusions and hallucinations.
• Delirium of metamorphosis, which is accompanied by the “transformation” of the patient into an animated living being and into in rare cases- into the subject. In this case, the patient’s “I” is lost and the patient begins to behave according to this creature or object (growls, etc.).
• Delusion of a double, which can be positive (the patient considers strangers to be friends or relatives) or negative (the patient is sure that friends and relatives are strangers). The external resemblance is explained by successful makeup.
• Delusion of other people's parents, in which the patient is convinced that his biological parents are educators or doubles of his parents.
• Delusion of accusation, in which the patient feels that everyone around him is constantly blaming him for various tragic incidents, crimes and other troubles, so the patient has to constantly prove his innocence.

This group includes presenile dermatozoal delirium, which is observed mainly in psychoses. late age and is expressed in the feeling of “insects crawling” in the skin or under the skin that occurs in patients.

Delusions of grandeur unite:

• Delusions of wealth, which can be believable (the patient is sure that he has a substantial amount in his account) and implausible (the presence of houses made of gold, etc.).
• Delirium of invention, in which the patient creates a variety of unrealistic projects.
• Delirium of reformism, in the presence of which the patient tries to transform existing world(suggests ways to change climate, etc.). May be politically motivated.
• Delusion of origin, accompanied by the belief that the patient is a descendant of a noble family, etc.
• Delirium of eternal life.
• Erotic or love delirium (Clerambault syndrome), which affects mainly women. Patients are convinced that a person who is inaccessible due to a higher social status (other reasons are possible) is not indifferent to them. Erotic delirium without positive emotions is possible - the patient is convinced that he is being pursued by his partner. This type of disorder is rare.
• Antagonistic delusion, in which the patient considers himself the center of the struggle between good and evil.
• Altruistic delusion (delirium of messianism), in which the patient imagines himself to be a prophet and miracle worker.

Delusions of grandeur can be complex.

Depressive delirium is manifested by belittling self-esteem, denial of abilities, opportunities, and confidence in the absence of physical characteristics. With this form of delirium, patients deliberately deprive themselves of all human comforts.

This group includes:

• Delirium of self-accusation, self-abasement and sinfulness, constituting a single delusional conglomerate, observed in depressive, involutionary and senile psychoses. The patient accuses himself of imaginary sins, unforgivable offenses, illness and death of loved ones, evaluates his life as a series of continuous crimes and believes that he deserves the most severe and terrible punishment. Such patients may resort to self-punishment (self-harm or suicide).
• Hypochondriacal delusion, in which the patient is convinced that he has some kind of disease (usually severe).
• Nihilistic delusions (usually observed in manic-depressive psychosis). Accompanied by the belief that the patient himself, other people or the world around him do not exist, or are confident that the end of the world is imminent.
• Cotard's syndrome is a nihilistic-hypochondriacal delusion in which bright, colorful and absurd ideas are accompanied by nihilistic and grotesquely exaggerated statements. In the presence of severe depression and anxiety, ideas of denial of the outside world dominate.

Separately, induced delirium is distinguished, which is often chronic. The recipient, with close contact with the patient and the absence of a critical attitude towards him, borrows delusional experiences and begins to express them in the same form as the inductor (the patient). Typically, recipients are people from the patient’s environment who are related to him through family relationships.

Reasons for development

As in the case of other mental illnesses, the exact causes of the development of delusional disorders have not been established to date.

It is known that delirium can occur as a result of the influence of three characteristic factors:

• Genetic, since delusional disorder is more often observed in those people whose relatives had mental disorders. Since many diseases are hereditary, this factor primarily influences the development of secondary delirium.
• Biological - the formation of delusional symptoms, according to many doctors, is associated with an imbalance of neurotransmitters in the brain.
• Impacts environment– according to available data, trigger mechanism The development of delirium can be due to frequent stress, loneliness, alcohol and drug abuse.

Pathogenesis

Delirium develops in stages. On initial stage the patient develops a delusional mood - the patient is sure that some changes are happening around him, he has a “premonition” of impending disaster.

The delusional mood due to the increase in anxiety is replaced by delusional perception - the patient begins to give a delusional explanation for some perceived phenomena.

At the next stage, a delusional interpretation of all phenomena perceived by the patient is observed.

Further development of the disorder is accompanied by the crystallization of delusions - the patient develops harmonious, complete delusional ideas.

The stage of attenuation of delirium is characterized by the patient’s emergence of criticism towards existing delusional ideas.

The last stage is residual delusion, which is characterized by the presence of residual delusional phenomena. It is detected after delirium, during hallucinatory-paranoid states and upon recovery from an epileptic twilight state.

Symptoms

The main symptom of delusion is the presence in the patient of false, unfounded beliefs that cannot be corrected. It is important that the delusional ideas that appeared before the disorder were not characteristic of the patient.

Signs of acute delusional (hallucinatory-delusional) states are:

• presence of delusional ideas of persecution, attitude and influence;
• the presence of symptoms of mental automatism (feelings of alienation, unnaturalness and artificiality of one’s own actions, movements and thinking);
• rapidly increasing motor excitement;
• affective disorders (fear, anxiety, confusion, etc.);
• auditory hallucinations (optional).

The surroundings acquire a special meaning for the patient, all events are interpreted in the context of delusional ideas.

The plot of acute delirium is changeable and unformed.

Primary paranoid delusions are characterized by preservation of perception, persistence and systematization.

Secondary delusions are characterized by impaired perception (accompanied by hallucinations and illusions).

Diagnostics

Diagnosis of delirium includes:

• studying the patient's medical history;
• comparison of the clinical picture of the disorder with diagnostic criteria.

Currently used criteria for delirium include:

• The occurrence of a disorder on a pathological basis (delirium is a manifestation of the disease).
• Paralogicality. A delusional idea is subject to its own internal logic, which is based on the internal (affective) needs of the patient’s psyche.
• Preservation of consciousness (with the exception of some variants of secondary delirium).
• Inconsistency and redundancy of judgments in relation to objective reality, combined with an unshakable conviction in the reality of delusional ideas.
• The constancy of a delusional idea with any correction, including suggestion.
• Preservation or slight weakening of intelligence (a significant weakening of intelligence leads to the collapse of the delusional system).
• The presence of deep personality disorders caused by centering around a delusional plot.

Delusions differ from delusional fantasies by the presence of a strong conviction in their authenticity and dominant influence on the behavior and life of the subject.

It is important to take into account that misconceptions are also observed in mentally healthy people, but they are not caused by a mental disorder, in most cases they relate to objective circumstances, not the person’s personality, and can also be corrected (correction for persistent misconceptions can be difficult).

Delirium in varying degrees affects all spheres of the psyche, especially noticeably affecting the emotional-volitional and affective sphere. The patient’s thinking and behavior are completely subordinated to the delusional plot, but the effectiveness of professional activity is not reduced, since mnestic functions are preserved.

Treatment

Treatment of delusional disorders is based on complex application medicinal and exposure.

Drug therapy includes the use of:

• Neuroleptics (risperidone, quetiapine, pimozide, etc.), blocking dopamine and serotonin receptors located in the brain and reducing psychotic symptoms, anxiety and restlessness. In case of primary delirium, the drugs of choice are antipsychotics with a selective nature of action (haloperidol, etc.).
• Antidepressants and tranquilizers for depression, depression and anxiety.

To switch the patient's attention from a delusional idea to a more constructive one, individual, family and cognitive behavioral psychotherapy are used.

At severe forms delusional disorders patients are hospitalized in medical institution until the condition normalizes.

Later it was supplemented by the statement that delusions arise only on a pathological basis. Therefore, V.M. Bleicher gives the following definition of what is traditional for the domestic school of psychiatry:

Another definition of delirium is given by G. V. Grule (German) Russian : “establishing a relational connection without a basis,” that is, an uncorrectable establishment of relationships between events without a proper basis.

Current criteria for delirium include:

Within medicine, delirium belongs to the field of psychiatry.

It is fundamentally important that delirium, being a disorder of thinking, that is, the psyche, is also a symptom of a disease of the human brain. Treatment of delirium, according to ideas modern medicine, is possible only by biological methods, that is, mainly drugs (for example, antipsychotics).

According to research conducted by V. Griesinger (English) Russian in the 19th century, in general terms, delirium regarding the mechanism of development does not have pronounced cultural, national and historical characteristics. At the same time, a pathomorphosis of delirium is possible: if in the Middle Ages obsession, magic, love spells prevailed, in our time delusions of influence by telepathy, biocurrents or radar are common.

Often in everyday life, delirium is mistakenly called mental disorders (hallucinations, confusion), sometimes occurring in somatic patients with elevated body temperature (for example, in infectious diseases).

Classification

If delirium completely takes over consciousness, then this state is called acute delirium. Sometimes the patient is able to adequately analyze the surrounding reality, if this does not concern the topic of delirium. Such nonsense is called encapsulated.

As a productive psychotic symptomatology, delusions are a symptom of many brain diseases.

Primary (Interpretive, Primordial, Verbal)

At interpretive delirium The primary defeat of thinking is the defeat of rational, logical cognition, the distorted judgment is consistently supported by a number of subjective evidence that has its own system. In this case, the patient's perception is not impaired. Patients can remain functional for a long time.

This type of delirium is persistent and tends to progress and systematization: “evidence” is put together into a subjectively coherent system (at the same time, everything that does not fit into this system is simply ignored), more and more parts of the world are drawn into the delusional system.

This variant of delusion includes paranoid and systematized paraphrenic delusions.

Secondary (sensual and figurative)

Hallucinatory delusion arising from impaired perception. This is delusion with a predominance of illusions and hallucinations. Ideas with it are fragmentary, inconsistent - primarily a violation of perception. Disruption of thinking occurs secondarily, there is a delusional interpretation of hallucinations, a lack of conclusions, which are realized in the form of insights - bright and emotionally rich insights. Elimination of secondary delirium can be achieved mainly by treating the underlying disease or symptom complex.

There are sensual and figurative secondary delusions. With sensory delirium, the plot is sudden, visual, specific, rich, polymorphic and emotionally vivid. This is nonsense of perception. With figurative delirium, scattered, fragmentary ideas arise, similar to fantasies and memories, that is, delusions of representation.

Syndromes of sensory delirium:

Syndromes develop in the following order: acute paranoid → staging syndrome → antagonistic delusion → acute paraphrenia.

Classic variants of unsystematized delusions are paranoid syndrome and acute paraphrenic syndromes.

In acute paraphrenia, acute antagonistic delirium, and especially staging delirium, intermetamorphosis syndrome develops. With it, events for the patient change at an accelerated pace, like a movie shown in fast mode. The syndrome indicates an extremely acute condition of the patient.

Secondary with a special pathogenesis

Delirium of the imagination

Delusional syndromes

Currently, in Russian psychiatry it is customary to distinguish three main delusional syndromes:

• nonsense relationship- it seems to the patient that the entire surrounding reality is directly related to him, that the behavior of other people is determined by their special attitude towards him;
• nonsense meanings- a variant of the previous plot of delirium, everything in the patient’s environment is given special significance;
• delusions of influence- physical (rays, devices), mental (as an option according to V.M. Bekhterev - hypnotic), forced sleep deprivation, often in the structure of the syndrome of mental automatism;
• option erotic delirium without positive emotions and with the conviction that the partner is allegedly pursuing the patient;
• delirium of litigiousness (querulantism)- the patient fights to restore “trampled justice”: complaints, courts, letters to management;
• delirium of jealousy- the belief that a sexual partner is unfaithful;
• delirium of damage- the belief that the patient’s property is being damaged or stolen by some people (usually people with whom the patient communicates in everyday life), a combination of delusions of persecution and impoverishment;
• delirium of poisoning- the belief that someone wants to poison the patient;
• delirium of staging (intermetamorphoses)- the patient’s belief that everything around him is specially arranged, scenes of some kind of play are being played out, or an experiment is being conducted, everything constantly changes its meaning: for example, this is not a hospital, but in fact the prosecutor’s office; the doctor is actually an investigator; patients and medical staff are security officers disguised in order to expose the patient. Close to this type of delusion is the so-called “Truman Show syndrome”;
• delirium of obsession;
• presenile dermatozoal delirium.

Induced (“induced”) delirium

Main article: Induced delusional disorder

In psychiatric practice, induced (from Lat. induce- “induce”) delusion, in which delusional experiences are, as it were, borrowed from the patient in close contact with him and in the absence of a critical attitude towards the disease. A kind of “infection” with delusions occurs: the inductee begins to express the same delusional ideas and in the same form as the mentally ill inductor (dominant person). Usually, delusions are induced by those people from the patient’s environment who communicate especially closely with him and are connected by family relationships.

Psychotic illness in a dominant person is most often schizophrenic, but not always. The initial delusions in the dominant person and the induced delusions are usually chronic in nature and are based on delusions of persecution, grandeur, or religious delusions. Typically, the group involved is closely connected and isolated from others by language, culture, or geography. A person inducing delusions is most often dependent or subordinate to a partner with true psychosis.

The diagnosis of induced delusional disorder can be made if:

1. one or two people share the same delusion or delusional system and support each other in this belief;
2. they have an unusually close relationship;
3. there is evidence that the delusion was induced in the passive member of the couple or group through contact with the active partner.

Induced hallucinations are rare, but do not exclude the diagnosis of induced delusions.

Stages of development

Differential diagnosis

Delusion must be distinguished from the delusion of mentally healthy people. In this case, firstly, there must be a pathological basis for the occurrence of delirium. Secondly, delusions, as a rule, relate to objective circumstances, while delusions always relate to the patient himself. Moreover, the delusion contradicts his previous worldview. Delusional fantasies differ from delusions in the absence of a strong conviction in their authenticity.

see also

Literature

• Delirium // Thinking disorders. - K.: Health, 1983.
• Kerbikov O.V., 1968. - 448 p. - 75,000 copies. ;
• N. E. Bacherikov, K. V. Mikhailova, V. L. Gavenko, S. L. Rak, G. A. Samardakova, P. G. Zgonnikov, A. N. Bacherikov, G. L. Voronkov. Clinical Psychiatry / Ed. N. E. Bacherikova. - Kyiv: Health, . - 512 s. - 40,000 copies. - ISBN 5-311-00334-0;
• Guide to Psychiatry / Ed. A. V. Snezhnevsky. - Moscow: Medicine,. - T. 1. - 480 p. - 25,000 copies.;
• Tiganov A. S. Hallucinatory-paranoid syndromes // General psychopathology: a course of lectures. - Moscow: Medical Information Agency LLC, . - P. 73-101. - 128 s. - 3000 copies. -

In modern psychiatry, delirium (synonyms: thought disorder, delirium) is a complex of ideas or ideas that appeared as a result developing disease brain as a symptom They erroneously reflect reality and are not corrected by new incoming information, regardless of whether the existing conclusion corresponds to reality or not. Most often, delusion is one of the components of the manifestations of schizophrenia or other

In what cases do the words “delirium” have synonyms - “mental disorder” and “insanity”

But in order to talk about the presence of a mental disorder in a patient, one cannot start only from the content of the idea that has overwhelmed him. That is, if for others it looks like complete nonsense, this cannot serve as evidence that a person has

In delirium, what is painful is not the content that falls out of generally accepted ideas, but the disruption of the flow of a person’s life associated with it. A delusional patient is removed from the world, uncommunicative, he is isolated in his belief, which greatly changes his appearance and life values.

Features of delusional ideas

A delusional belief is not amenable to any correction from the outside. Unlike the delusions of a healthy person who firmly defends his point of view, delusion is a kind of unshakable idea that does not require real confirmation, since it exists independently of events occurring in reality. Even the negative experience of following a delusional idea does not force the patient to abandon it, and sometimes even, on the contrary, strengthens faith in its truth.

Since a delusional idea is always very closely fused with previously occurring cardinal personal changes, it necessarily causes radical changes in the patient’s attitude towards himself and the outside world, turning him into a “different person”.

Delirium is often accompanied by the so-called mental automatism syndrome or alienation syndrome, in which the patient has the feeling that any of his actions or thoughts do not occur of his own free will, but are invested or inspired by an outside force. In these cases, patients suffer from persecutory delusions.

Paranoid delusions are the result of distrust of the environment

Paranoid delusions are formed from opposition to the environment and distrust of other people, transforming over time into extreme suspicion.

At some point, the patient begins to understand that everyone around him treats him unfairly, infringes on his interests, and humiliates him. Due to the paranoid person's inability to interpret the actions and words of others, this belief develops into paranoid syndrome.

In psychiatry it is divided into three types.

1. Delusion of influence, in which the patient is convinced of an external influence on his behavior and thoughts.
2. Delusion of attitude, when a person assumes that others are talking about him, laughing at him, looking at him.
3. Paranoid delusion. This state is expressed in the patient’s deep conviction that some mysterious forces want his death or harm him in every possible way.

By the way, the latter type of thinking disorder in certain situations can be easily transmitted to the patient’s environment, which leads to an incident that is characterized as induction, that is, the borrowing of the beliefs of a sick person by a healthy one.

What is induced delirium

In psychiatry, this phenomenon is called “induced delirium.” This is an induced, borrowed belief that is adopted from the patient by those around him - those who are in closest contact with him and have not developed a critical attitude towards pathological condition the patient, since he is an authority in this group or enjoys trust.

In such cases, those being induced begin to express the same ideas and present them in the same form as the patient-inductor. The person who induces the delusion is, as a rule, a suggestible person who is subordinate to or dependent on the source of the idea. Most often, but not always, the dominant person (inducer) is diagnosed with schizophrenia.

It should be noted that this disorder , just like the initial delusion of the inductor, this is a chronic condition, which, according to the plot, turns out to be delusions of grandeur, persecution, or religious delirium. Most often, groups that find themselves in cultural, linguistic or territorial isolation fall under this influence.

Under what conditions can a diagnosis be made?

In order to make a correct diagnosis, it should be remembered that induced delirium is:

• a condition in which several people share the same delusional idea or a system built on it;
• support each other in the said belief;
• such people have very close relationships;
• even passive members of this group are induced after contact with active partners.

When contact with the inductor is terminated, the views instilled in this way most often dissipate without a trace.

How does hypochondriacal delirium occur?

In psychiatric practice, another type of thinking disorder is often encountered - hypochondriacal delusion. characterized by the patient's deep conviction that he has a severe incurable disease or shameful, one that does not respond to conventional therapy.

The fact that doctors cannot find it is perceived by a delusional person only as their incompetence or indifference. Data from tests and examinations for such patients are not proof, because they have a deep conviction in their own unique illness. The patient is seeking more and more examinations.

If hypochondriacal delusions begin to grow, then the idea of ​​persecution, which the doctors allegedly organized in relation to the patient, also joins it. These symptoms are often supplemented by the previously mentioned delusion of exposure, which is supported by the belief that the disease is caused by specially organized radiation, which is why they are destroyed. internal organs and even the brain.

How does hypochondriacal delirium change?

Sometimes in patients with hypochondriacal delusions it changes to the idea of ​​the opposite content - that the patient was always absolutely healthy or, most often, that he was suddenly completely healed. As a rule, such delirium is a consequence of a change in mood caused by the disappearance of (usually shallow) depression and the appearance of a hypomanic state.

That is, the patient was and remains fixated on the topic of health, but now his delirium changes vector and, having become a delusion of health, is directed towards healing those around him.

By the way, many so-called traditional healers, who disseminate personally invented methods of curing all ailments, have the described category of thought disorder. IN best case scenario Such methods are simply harmless, but this happens quite rarely!

How delirium becomes systematized

What’s interesting is that delusional constructs in all the above cases are interconnected, consistent and have some logical explanation. Such a thinking disorder indicates that we are faced with systematized delirium.

This disorder is most often observed in people with a good level of intelligence. The structure of systematized nonsense includes the material on the basis of which the idea is built, as well as the plot - the design of this idea. As the disease progresses, it can become colored, become saturated with new details, and even change direction, as shown above.

By the way, the presence of systematized delirium always confirms its long-term existence, since an acutely onset illness, as a rule, does not have a coherent system.

A person often uses the word “nonsense” in his speech. However, he understands this as a meaningless expression of thoughts that are not associated with a thinking disorder. IN clinical manifestations the symptoms of delirium and its stages resemble insanity, when a person really talks about something that is devoid of logic and meaningfulness. Examples of delirium help in establishing the type of disease and its treatment.

You can be delirious even if you are healthy. However, clinical ones are often more serious. Online magazine site considers serious mental disorder under in a simple word rave.

What is delirium?

Delusional disorder and its triad were examined by K. T. Jaspers in 1913. What is delirium? This is a mental disorder of thinking when a person makes unthinkable and unrealistic conclusions, thoughts, ideas that cannot be corrected and in which the person unconditionally believes. It is impossible to convince him or shake him in his faith, since he is completely subject to his own delusions.

Delusion is based on mental pathology and mainly affects such areas of his life as emotional, affective and volitional.

In the traditional sense of the word, delusion is a disorder accompanied by a set of ideas, conclusions and reasoning of a painful nature that has taken possession of the human mind. They do not reflect reality and cannot be corrected from the outside.

Psychotherapists and psychiatrists deal with delusional states. The fact is that delirium can be either an independent disease or a consequence of another disease. main reason appearance – brain damage. Bleuler, studying schizophrenia, singled out delirium main feature– egocentricity based on affective internal needs.

In colloquial speech, the word “nonsense” is used in slightly distorted meanings, which cannot be used in scientific circles. Thus, delirium refers to the unconscious state of a person, which is accompanied by incoherent and meaningless speech. Often this condition is observed during severe intoxication, during an exacerbation of infectious diseases, or after an overdose of alcohol or drugs. In the scientific community, such a condition is called amentia, which is characterized by thinking rather than thinking.

Delusion also means seeing hallucinations. The third everyday meaning of delirium is incoherence of speech, which is devoid of logic and reality. However, this meaning is also not used in psychiatric circles, since it is devoid of the triad of delusion and can only indicate the presence of errors in the reasoning of a mentally healthy person.

Any situation can be an example of delusion. Delusions are often associated with sensory perception and visual hallucinations. For example, a person may think that he can recharge himself from electricity. Some may claim that he lives for a thousand years and has participated in all significant historical events. Some delusional ideas are associated with alien life, when a person claims to communicate with aliens or is himself an alien from another planet.

Delirium is accompanied bright images and elevated mood, which further reinforces the delusional state.

Symptoms of delirium

Delirium can be identified by characteristic symptoms, which correspond to it:

• Influence on affective behavior and emotional-volitional mood.
• Conviction and redundancy of a delusional idea.
• Paralogicality is a false conclusion that manifests itself in a discrepancy with reality.
• Weakness.
• Maintaining clarity of consciousness.
• Changes in personality that occur under the influence of immersion in delirium.

It is necessary to clearly distinguish delusions from simple delusions that can arise in a mentally healthy person. This can be determined by the following signs:

1. Delusion is based on a certain pathology, delusion does not have mental disorders.
2. Delusion cannot be corrected, since the person does not even notice the objective evidence that refutes it. Misconceptions can be corrected and changed.
3. Delusion arises based on the internal needs of the person himself. Misconceptions are based on real facts that are simply misunderstood or not fully understood.

There are various types of delusions, which are based on certain reasons and have their own manifestations:

• Acute delusion is when an idea completely subjugates a person’s behavior.
• Encapsulated delusion is when a person can adequately assess the surrounding reality and controls his behavior, but this does not relate to the topic of delusion.
• Primary delusion is an illogical, irrational cognition, a distorted judgment, supported by subjective evidence that has its own system. Perception is not impaired, but is noted emotional stress when discussing the topic of nonsense. It has its own system, progression and resistance to treatment.
• Hallucinatory (secondary) delusion is a violation of the perception of the environment, which is why illusions arise. Delusions are fragmentary and inconsistent. Impaired thinking is a consequence of hallucinations. Conclusions take the form of insights - bright and emotionally charged insights. The following types of secondary delirium are distinguished:

1. Figurative - nonsense of representation. Characterized by fragmentary and scattered ideas in the form of fantasies or memories.
2. Sensual - paranoia that what is happening around is a performance organized by some director who controls the actions of both those around him and the person himself.
3. Delusions of imagination - based on fantasy and intuition, and not on distorted perception or erroneous judgment.

• Holothymic delirium is a disorder in affective disorders. During a manic state, delusions of grandeur occur, and during depression, delusions of self-abasement occur.
• Induced (infection with an idea) delusion is the joining of a healthy person to the delusions of a sick individual with whom he is constantly in contact.
• Cathethetic delirium occurs against the background of hallucinations and senesthopathy.
• Sensitive and catathymic delusions occur during severe emotional disorders in sensitive people or those suffering from personality disorders.

Delusional states are accompanied by three delusional syndromes:

1. Paranoid syndrome – lack of systematization and the presence of hallucinations and other disorders.
2. Paraphrenic syndrome is systematized, fantastic, accompanied by hallucinations and mental automatisms.
3. Paranoid syndrome is a monothematic, systematized and interpretive delusion. There is no intellectual-mnestic weakening.

Paranoid syndrome, which is characterized by an overvalued idea, is considered separately.

Depending on the plot (the main idea of ​​delusion), there are 3 main groups of delusional states:

1. Delusion (mania) of persecution:

• Delusion of harm is the idea that someone is harming or stealing from someone.
• Delusion of influence is the idea that a person is influenced by some external force, which subordinates his thoughts and behavior.
• Delusion of poisoning is the belief that someone wants to poison a person.
• Delusion of jealousy is the belief that a partner is unfaithful.
• Relational delusion is the idea that all people have some kind of relationship to a person and it is conditioned.
• Erotic delusion is the belief that a person is being pursued by a certain partner.
• Delusion of litigiousness is a person’s tendency to constantly fight for justice through the courts, letters to management, and complaints.
• Delusion of possession - the idea that a person has been possessed by some living force, an evil creature.
• The delusion of staging is the belief that everything around is being played out as a performance.
• Presenile delusions – ideas of condemnation, death, guilt under the influence of a depressive state.

1. Delusions of grandeur:

• The delirium of reformism is the creation of new ideas and reforms for the benefit of humanity.
• Delusion of wealth is the belief that one has countless treasures and riches.
• The delusion of eternal life is the belief that a person will never die.
• Delirium of invention - the desire to make new discoveries and create inventions, carrying out various unrealistic projects.
• Erotic delusion is a person’s conviction that someone is in love with him.
• Delusion of descent - the belief that parents or ancestors are noble or great people.
• Delusion of love - the belief that you are in love with a person famous person or everyone with whom he has ever communicated or met.
• Antagonistic delusion is a person’s conviction that he is an observer of a war between two opposing forces.
• Religious delusion - a person's idea that he is a prophet can work miracles.

1. Depressive delirium:

• Nihilistic delirium - the end of the world has come, man or the surrounding world does not exist.
• Hypochondriacal delusion is a belief in the presence of a serious illness.
• Delirium of sinfulness, self-accusation, self-abasement.

Stages of delirium

Delirium is divided into the following stages of its course:

1. A delusional mood is a premonition of trouble or a conviction that the world around us will change.
2. An increase in anxiety due to delusional perception, as a result of which delusional explanations for various phenomena begin to arise.
3. Delusional interpretation is an explanation of phenomena using delusional thinking.
4. Crystallization of delirium is a complete, harmonious formation of a delusional conclusion.
5. Attenuation of delirium - criticism of the delusional idea.
6. Residual delirium – residual effects after delirium.

This is how delirium is formed. At any stage a person can get stuck or go through all stages.

Treatment of delirium

Treatment of delirium involves a special effect on the brain. This can be done with antipsychotics and biological methods: electric shock, drug shock, atropine or insulin coma.

Psychotropic drugs are selected by the doctor depending on the content of delirium. For primary delirium, selective medications are used: Triftazin, Haloperidol. For secondary delirium, a wide range of antipsychotics are used: Aminazine, Frenolone, Melleril.

Treatment of delirium is carried out inpatiently followed by outpatient therapy. Outpatient treatment is prescribed in the absence of aggressive tendencies towards reduction.

Forecast

Is it possible to save a person from delirium? If we are talking about mental illness, then you can only stop the symptoms, briefly allowing the person to experience the reality of life. Clinical delirium gives an unfavorable prognosis, since patients left unattended can cause harm to themselves or others. Only an everyday understanding of delirium can be treated, allowing a person to get rid of delusions that are natural to the psyche.