mania
Introduction
Introduction to mania Mania is a form of seizure of manic depression. It is a typical symptom of high emotions, thinking and running, and increased speech movements. Emotional hyperactivity or irritability is the main clinical phase, accompanied by vigorous energy, increased speech, increased activity, and severe symptoms accompanied by psychotic symptoms such as hallucinations, delusions, and nervous symptoms. Manic episodes last for more than a week, usually in a paroxysmal course. After each episode, they enter a period of normal remission of mental state. Most patients have a recurrent tendency. In the long-term observation of the course of mood disorders, it is very rare to have only manic or savage madness, and the family history, pre-existing personality, biological characteristics, treatment principles and prognosis of these patients are both bipolar with depressive episodes. The obstacles are similar. Therefore, the International Classification System for Mental Illness (ICD-10) and the American Classification System (DSM-IV) have classified it as a type of bipolar disorder. basic knowledge Sickness ratio: 0.05%-0.08% Susceptible people: no specific population Mode of infection: non-infectious Complications: mental illness
Cause
Mania cause
Genetic and mental factors (15%):
The family survey found that the incidence of bipolar disorder in the first-degree relatives of the proband of the bipolar type I disorder was several times higher than that of the first-degree relatives of the normal person, and the closer the blood relationship, the higher the prevalence. In molecular genetics, many scholars have explored the possible markers associated with bipolar disorder, but there is no definitive and reproducible results. The susceptibility genes for bipolar disorder need further study. At present, the genetic pattern of bipolar disorder tends to be polygenic. The onset of manic depressive psychosis may be related to mental stimuli, but can only be considered as a predisposing factor.
Physical factors (5%):
The main characteristics of the circular personality are good communication, cheerful, wide-ranging interest, active, easy to be optimistic, and more likely to become more worried, mesodermal leaf type bones, muscular, connective tissue enriched patients, than the outer blast People who are slender and delicate are more likely to suffer from illness.
Biological factors (5%):
1 Neurobiochemistry, psychopharmacological studies and neurotransmitter metabolism studies have confirmed that patients have abnormalities in central neurotransmitter metabolism and corresponding receptor function changes. Lack of serotonin (5-HT) functional activity may be the basis of bipolar disorder and a sign of susceptibility to bipolar disorder; a decrease in noradrenaline (NE) functional activity may be associated with depressive episodes, norepinephrine function Increased activity may be associated with manic episodes; dopamine (DA) functional abnormalities; gamma-aminobutyric acid (GABA) is a central nervous system inhibitory neurotransmitter, may have abnormal functional activity due to resistance to this neurotransmitter Epilepsy can be used as a mood stabilizer to effectively treat mania and bipolar disorder.
2 The second messenger balance is imbalanced, and the second messenger is an indispensable intermediary between extracellular information and intracellular effects.
3 neuroendocrine dysfunction, mainly dysfunction of hypothalamic-pituitary-adrenal axis and hypothalamic-pituitary-thyroid axis.
Prevention
Mania prevention
Generally, there is a history of genetic disease, introverted personality, solitude, sensitivity, poor environmental adaptability, and people who have been stimulated by mental stimulation are prone to mania. For these causes, there are some targeted methods to control or prevent mania. The citizens of hereditary history must always have a sense of prevention, be alert to the onset of illness, treat in time, cultivate cheerful, open-minded, and accommodated personality from an early age, absolutely prevent the occurrence of mania, and strive to create a good interpersonal environment for themselves. The problem is dialectical. "Every black cloud is inlaid with Phnom Penh." Things always have a beautiful side.
Complication
Mania complications Complications
If the manic disorder is not treated, it is easy to recurrent, and long-term recurrent attacks lead to chronic disease, personality changes and social function impairment. Due to the pre-existing personality and disease symptoms, the incidence of alcohol dependence, substance abuse, and drug dependence is high.
Symptom
Mania symptoms common symptoms irritating behavior and emotional abnormalities sullen emotions ups and downs
The main clinical symptoms of the manic state are high mood, thinking and emotional excitement.
1. High mood:
The patient's performance is relaxed, happy, cheerful, and self-satisfied. It seems that the human body is free from troubles. The mood is often vivid and vivid. It is in harmony with the inner experience and the surrounding environment. It is contagious. Patients often claim to be "optimists." "Happy", "Life is full of sunshine, beautiful and colorful", emotional reactions may be unstable, irritating, can be refuted due to small trivial matters or opinions, demanding unsatisfied and violent, can cause damage or aggression, some The patient may also experience a short-term mood during the manic phase.
2. Thinking and running:
The association process has obviously accelerated, the concept has followed, and there have been a lot of speeches, and there are many voices. Because of the distraction of attention, the topic often shifts with the situation, and there may be floating concepts, the phenomenon of the sound union, and the patients often have "the brain has opened up." , "get smart", "the tongue and the thought race" experience.
3. Self-evaluation is too high:
On the background of high mood, I feel good about myself, I feel that my body has never been so healthy, my energy has never been so abundant, I am quick and quick, I am always looking at my talents, my status, my pretentiousness, and I can exaggerate my ideas.
4. Psychomotor excitement:
Manic patients have a wide range of interests, likes to be lively, have more contacts, and take the initiative to be close to others. People who dont know each other are also seeing each other. They are amused, nosy, and unfair. Everything is lacking in deliberation. The salary was swept away in a few days. Although the patient said more and more, he was so motivated and exhausted that he was exhausted and his energy was extremely strong.
5. Appetite, libido is generally enhanced, and sleep needs are reduced.
Examine
Mania check
1 Meet the symptom criteria and severity criteria for at least one week.
2 There may be some schizophrenic symptoms, but it does not meet the diagnostic criteria for schizophrenia. If the symptoms of schizophrenia are met at the same time, the standard of mania episodes is met for at least one week after the symptoms of splitting are relieved.
Diagnosis
Mania diagnosis
diagnosis
First, the symptom standard: the main characteristics of high mood or irritability, and the symptoms last for at least one week, in the state of high mood, at least three of the following symptoms:
1. Speech is significantly more than usual.
2. Lenovo speeds up, or the concept is erratic, or self-sense can't keep up with the speed of thinking activities.
3. Attention is not concentrated, or transfer with the environment.
4. The self-evaluation is too high and can reach the level of delusion.
5. Self-feeling, such as a particularly flexible mind, or a particularly healthy body, or a particularly energetic.
6. The need for sleep is reduced and not tired.
7. Increased activity, or emotional excitement.
8. Behave rashly or pursue pleasure, regardless of consequences, or be adventurous.
9. Sexual desire is clearly advanced.
Second, the severity criteria, at least one of the following:
1. Work, study and housework are impaired.
2. Social ability is impaired.
3. Cause danger or adverse consequences to others.
Third, the exclusion criteria:
1. Does not meet brain-induced mental disorders, physical illnesses and psychoactive substances and non-dependent substances caused by mental disorders.
2. There may be some schizophrenic symptoms, but it does not meet the diagnostic criteria for schizophrenia. If it meets the diagnostic criteria for schizophrenia, the differential diagnosis can refer to the diagnostic criteria for schizoaffective psychosis.
Differential diagnosis
Schizophrenia
It is common in clinical practice that adolescent schizophrenia is misdiagnosed as mania. The opposite situation also occurs. This is because schizophrenia can also have a cyclical course, and clinical manifestations can also have motoric excitement, but schizophrenia. After several episodes, the course of circulation is gradually less obvious, but it is a chronic progressive disease. Although the clinical phase is excited and agitated, the emotion is not easy, happy, but moody, and the behavior is also impulsive. There are some clinical problems. Patients with depression have psychiatric characteristics that are incompatible with their mood, but they are short-lived and long with the course of the disease.
2. Toxic psychosis
Certain drugs such as corticosteroids, isoniazid, and A. can cause a manic state. According to the history of medication, the time of administration, the relationship between dose and disease, it can be identified after drug withdrawal or drug reduction. Toxic psychosis often With varying degrees of disturbance of consciousness.
3. Brain organic psychosis
For paralytic dementia, senile psychosis can be manic, but there are often mental disorders, emotions are not high, but euphoria-based, detailed medical history, physical and neurological examinations help identify.
4. Mental disorders caused by physical illness
Hyperthyroidism can be mildly manic, but the emotions are not really high, but mainly anxiety, emotional instability, accompanied by primary physical symptoms and signs.
