paranoid state
Introduction
Introduction to paranoid status Paranoid state and paranoidpsychosis are considered synonymous by some scholars, but some scholars believe that paranoid state is characterized by prominent paranoia and no hallucination. Its clinical manifestations are similar to paranoia, but paranoia is not paranoid. Such a system is not fixed, but may be accompanied by hallucinations, but it is different from the paranoia of paranoid schizophrenia and the bizarre, absurd, illusory, and personality decline. It is believed that the paranoid state seems to be a state between paranoia and paranoid schizophrenia. Patients with paranoid status generally had a better prognosis, but during follow-up, some patients eventually turned to mental decline. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: sleep disorders
Cause
Paranoid state
(1) Causes of the disease
There is no accepted argument about the cause of the paranoid state. It may be the result of the interaction between personal qualities and certain predisposing factors, that is, caused by long-lasting mental stress on the basis of certain personality defects. Acute trauma can be As a predisposing factor.
(two) pathogenesis
According to clinical observations, the patient's pre-existing personality characteristics have certain defects, such as subjective, self-centered, inferiority, sensitive and suspicious or stubborn, and some have psychological and social factors as incentives, such as isolation, immigration, exile or being captured.
Hearing impairment may also be one of the triggering factors. Because people with hearing impairment are difficult to understand each other because of interpersonal communication, patients often feel that they are being left out and scorned, especially in crowded situations, they feel that they are excluded and even feel Being laughed at, leading to delusions (Tolle R, 1997).
Prevention
Paranoid state prevention
The prevention of mental illness comes from practice and advances in constant practice. So far, the prevention of mental illness is basically still in the exploratory stage. As for the preventive measures based on modern natural science, it is far from perfect. It is recognized and mastered by people. However, it is worth emphasizing that it is precisely the ultimate goal of scientific prevention work to explore the cause and expose the inherent pathogenesis.
In the working methods of prevention of mental illness, it is generally considered that the actual work of prevention of mental illness is feasible in the following three categories, namely: prevention of the onset of mental illness; early detection, early treatment, seeking complete remission and good prognosis To prevent recurrence; to make rehabilitation arrangements for those who have already suffered from the disease, and to reduce the loss of ability caused by the disease.
It is worth noting that it is necessary to guard against the paranoid state of menopause. The onset of the disease is relatively slow, and the course of disease is relatively long. It often lasts for several years. The symptoms of menopausal syndrome are often accompanied by the onset or course of the disease. The clinical manifestations are paralyzed and murdered. Desperate and suspected diseases are mainly imaginary, often accompanied by corresponding auditory hallucinations. Their delusional content is relatively fixed, or systematic, rarely generalized. Most of the objects of delusion are their relatives or friends, and with reality. The environment is closely related, especially the sexual delusions. I always suspect that my lover is not loyal, dislikes herself, has a new love or an affair, suspects that the lover has an improper relationship with a colleague or neighbor, and even suspects that the lover is plotting to harm himself. At the same time, in the suspicion of conjecture, it often shows a series of vivid emotional reactions such as nervous anxiety and fear, and often has auditory hallucinations consistent with delusions. Under the control of various auditory hallucinations, the patient is very nervous and afraid. Uneasy, the performance is that you can't go home late or don't dare to go home; or you are afraid that food is poisonous and you can't eat or drink; or you often follow your lover; or with doubt Like frequent bickering, such patients may suffer from hunger strikes, self-injury, suicide and wounding due to the suspicion of suspicion and the illusion and influence of illusory delusions. Individually serious cases may occur. There will be a certain degree of recession and dementia, and the prognosis is worse than that of menopausal depression. However, about one-third of patients can self-heal, and early diagnosis and timely treatment are better. Therefore, it is necessary to pay attention to such people, if there are suspicious symptoms, timely Seek medical attention.
Complication
Paranoid state complications Complications, sleep disorders
This disease is generally uncomplicated.
Symptom
Paranoid state symptoms Common symptoms Victims delusion Tinnitus Sleep disorder Illusion hallucinations
The onset of depression is mainly due to the development of delusions. Common delusions are forms of murder, jealousy, lawsuits, love, exaggeration, doubts, etc., delusional systems, but the structure is not rigorous, firmness is not as paranoid, and delusions are close to reality, often involving Family members, neighbors and colleagues are generally not generalized. The patients with this disease have no hallucinations and rarely decline. Most of the victimizations are related to litigation delusions. They always think that they are completely correct, and they endlessly report that they will be strong and will not I will never give up.
There are considerable variations in the symptoms of paranoid state, and there is a lack of agreement among scholars. This is mainly due to the lack of definitive clinical studies and long-term follow-up observations of the disease. From the term paranoid, it includes All the delusions, in many delusions, regardless of their content and nature, are a bit of a distorted belief in the patient's life and interpersonal relationships, and it is difficult to be persuaded.
The term paraphrenia is basically not used, but similar patients will be seen in the clinic. This is a part of patients isolated from schizophrenia (Kraepelin, 1920). This disease is more common in middle-aged patients. In addition to the dominant fixed delusions, there are no symptoms of schizophrenia, such as disordered thinking, lack of emotion and lack of intention, and can be accompanied by auditory hallucinations. According to the outstanding clinical manifestations, it can be divided into 4 subtypes:
1 systemic mental paranoia (paraphrenia systematiea), this type is difficult to identify with paranoia;
2 exaggerated sexual paranoia (paraphrenia expansive);
3 fictional paranoia (paraphrenia confabulation);
4 paraphrenia phantastica (paraphrenia phantastica), this type is the rarest, the course of the disease is slow and progressive, as time progresses, the paranoid structure tends to fragment, but the patient's social function remains relatively good, no obvious The manifestation of mental decline is considered by some scholars to be a special type of schizophrenia (Mckenna PJ, 1994).
For patients with suspected delusions as the main symptom, it is difficult to diagnose and treat. In the early stage of the disease, the patient pays too much attention to his or her health and feels certain uncomfortable discomfort such as headache, tinnitus or sleep disorder. If you don't understand it deeply, it will often be misdiagnosed. When the condition develops further and the symptoms can be fixed in an organ or a certain part, it is considered to be a malignant lesion. It has an incurable disease. Although it has been carefully examined, including precision instruments such as magnetic resonance. Prove that everything is normal, the patient is still unable to relieve, firmly believe that it is cancer, even regardless of the doctor's advice, to be surgically explored.
Examine
Paranoid state check
There is no specific laboratory test for this disease. When complications such as infections occur, laboratory tests show positive results of complications.
There is currently no specific laboratory support for this disease.
Diagnosis
Paranoid state diagnosis
diagnosis
The diagnosis of paranoid state should pay attention to the systematic and relative fixation of delusion. The disease is based on personality defects, mental stimulation is the cause, more delusions, more systematic, emotional response, more illusion, and personality remains relatively intact. Good intelligence, no mental decline, no characteristic symptoms of schizophrenia, delusion for at least 3 months.
Differential diagnosis
For the differential diagnosis of paranoid state, it is often necessary to exclude organic mental disorders (such as endocrine diseases, brain degeneration and drug-induced mental symptoms), affective disorders (such as the exaggeration of mania).
1. Distinguish from schizophrenia paranoid type, it is difficult in the early stage of the disease. The paranoia of paranoid schizophrenia is peculiar and fragmentary, and it is accompanied by other schizophrenia symptoms. It is not difficult to identify with paranoid state, and the paranoid state is usually lacking. Schneider primary symptoms and four "A" symptoms of Bleuler.
2. The identification of affective disorders is relatively easy, because the paranoid state is more persistent, the social function remains relatively good, and the affective disorder is mostly a paroxysmal disease course, although the social function is obviously impaired, but the treatment effect is good.
3. Paranoia and paranoia are characterized by systemic paranoia. The paranoia of the paranoid state is not as good as the paranoid system. The fixed and delusional content can be changed due to environmental changes. The prognosis is good, but it is difficult to identify at the beginning of the disease.
