Mental disorders associated with scleroderma
Introduction
Introduction to mental disorders associated with scleroderma Scleroderma belongs to the category of autoimmune diseases. In a family of a small number of patients, there are related diseases such as lupus erythematosus, dermatomyositis, rheumatoid arthritis, etc. The disease is divided into diffuse and localized types, mainly involving the skin. Subcutaneous tissue, muscle, bone and nervous system, including central and peripheral nerves, and extensive damage to the sympathetic nerves, are more common in women with introverted personality. Mental disorders caused by scleroderma are mental and neurological symptoms caused by lesions of tissues such as skin and subcutaneous tissues, muscles, bones, internal organs and nervous system. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: malnutrition
Cause
Causes of mental disorders associated with scleroderma
Disease factor (54%)
Scleroderma belongs to the category of autoimmune diseases, and its etiology is not clear. Regarding the cause of mental disorders associated with scleroderma, scleroderma is a major factor in the onset of mental disorders, leading to mental disorders of mental disorders. Secondary to scleroderma, but not all patients with scleroderma are accompanied by mental disorders, so scleroderma is not the only cause of mental disorders, there are other factors related to the occurrence of mental disorders.
Other factors (45%)
Such as other biological factors, including the patient's gender, age, genetic factors, personality characteristics, and past neuropsychiatric history; psychological factors include stress, long-term psychological contradiction; environmental factors, such as overcrowded, noisy environment , damp, air pollution, etc., all of the above factors can become a triggering factor for polymyositis associated with mental disorders.
Pathogenesis
The pathogenesis of scleroderma associated with mental disorders is still lacking evidence, because schizophrenia with mental disorders is a physical disorder associated with mental disorders, and the mental symptoms of mental disorders caused by physical diseases do not depend on primary physical diseases. The type is related to the following factors.
1. Physical and mental impairment refers to the psychological reaction to physical illness, such as anxiety, depression, irritability, suspiciousness, loneliness, etc. after suffering from a certain physical illness.
2. Mental disorders are caused directly by biological factors caused by physical diseases, such as insufficient energy supply (insufficient blood supply to the brain, hypoxia, etc.), toxins, water, electrolyte imbalance, stress response, neurotransmitter changes, etc.
3. In most cases, it is often the result of the combination of the two.
Prevention
Prevention of mental disorders associated with scleroderma
Because the pathogenesis of scleroderma is still not very clear, there is no effective preventive measure, good personality, and psychology will help to reduce the occurrence of mental symptoms after illness.
Focus on the patient's physical and mental health:
1. Physical and mental disorders refer to psychological reactions to physical illnesses, such as anxiety, depression, irritability, suspiciousness, and loneliness after suffering from a physical illness.
2. Mental disorders are caused directly by biological factors caused by physical diseases, such as insufficient energy supply (insufficient blood supply to the brain, hypoxia, etc.), toxins, water, electrolyte imbalance, stress response, neurotransmitter changes, etc.
3. In most cases, it is often the result of the combination of the two.
Complication
Complications of mental disorders associated with scleroderma Complications malnutrition
It is prone to the following complications: joint damage; gastrointestinal smooth muscle damage; malnutrition; myocardial formation of fibrous tissue, which may lead to permanent damage and / or functional deterioration; kidney damage and / or renal dysfunction; thyroid formation of fibrous tissue.
Symptom
Symptoms of mental disorders associated with scleroderma Common symptoms Anxiety hallucinations Illusion hallucinations Powerless conscious disorder Medullary palsy Double vision Muscle Depression Muscle atrophy
A mental disorder associated with scleroderma is a physical disorder associated with a physical disorder. Usually, such mental disorders have a common clinical feature: they are derived from physical illness and generally occur in the acute or most severe period of physical illness; The primary somatic diseases are often parallel in degree, and the symptoms are characterized by phlegm and light weight. In the early stage of the disease and during the recovery period, the cerebral weakness syndrome often occurs. In the acute phase, acute encephalopathy syndrome often occurs after severe physical illness. Chronic encephalopathy syndrome may occur when improper treatment affects brain function.
The clinical features of schizophrenia associated with mental disorders are: early neurological manifestations, insomnia, snoring-like episodes, and depression are the most common, often accompanied by anxiety. In severe cases, depressive stupor state can occur, and excitement can also be seen. And the disturbance of consciousness is mostly in a state of disorder. When it is serious, it enters a coma. In the chronic phase, there may be hallucinations or delusions. In order to be victimized, the relationship is more common, and those who are chronically delayed have mental retardation.
Mental symptoms
(1) Depressive state: the most common, and often appear at the beginning of the disease, often anxious depression.
(2) Illusion delusion state: often occurs in the chronic phase, mostly for the victim, tracking and relationship delusion, can be accompanied by auditory hallucinations.
(3) Stiff state: less common.
(4) Excited state.
(5) Disorder of consciousness: mostly in a state of confusion, and finally into a coma.
2. Neurological symptoms Neuromuscular symptoms, lesions from the skin along the muscles, often caused by multiple muscles, muscle hardening, atrophy, weakness, palpitations and contractures, can affect the facial muscles, eye muscles, ball, facial paralysis, Double vision, nystagmus, bulbar palsy, and acral arterial spasm.
Examine
Examination of mental disorders associated with scleroderma
Conforms to a positive test for scleroderma.
Conforms to the results of scleroderma examination.
Scleroderma can be manifested as poor, hematuria, proteinuria, tubular urine, increased erythrocyte sedimentation rate, decreased serum albumin, and increased globulin.
Immunological examination: ANA positive rate >90%, mainly spot type and nucleolar type, about 20% anti-RNP antibody positive, about 50%-90% CREST patients anti-centromere antibody (ACA) positive, (labeled antibody) 20%-40% of patients with systemic sclerosis are positive for serum SCL-70 antibody (labeled antibody), 30% of cases have RF, the total number of peripheral blood T cells is normal or slightly lower, and T helper cells increase, T suppresses cells decrease .
Diagnosis
Diagnosis and diagnosis of mental disorders associated with scleroderma
The diagnosis of physical illness with mental disorders must first determine that mental symptoms are caused by physical illness, so a comprehensive understanding of the medical history includes a complete history of physical and mental disorders, detailed physical examinations and laboratory tests, and some necessary psychological tests. And the identification of the nature, characteristics and symptom of the psychiatric symptoms is the premise of making a correct diagnosis. On the basis of comprehensive evaluation and comprehensive analysis of the results of the above-mentioned aspects, the diagnosis of mental disorders caused by physical diseases can be made or excluded. It is divided into 3 steps.
1. Determine the presence and diagnosis of scleroderma, ie evidence of scleroderma.
2. Determine the nature, characteristics, and diagnosis of psychiatric symptoms, and carefully identify the following mental symptoms and the presence of symptom groups and their relationship to scleroderma:
1 intelligent damage syndrome;
2 amnesia syndrome;
3 personality changes;
4 disturbance of consciousness;
5 psychotic symptoms (such as hallucinations, delusions, nervous syndrome, etc.);
6 affective disorder syndrome (such as mania syndrome, depression syndrome, etc.);
7 dissociation (conversion) syndrome;
8 neurosis-like syndrome (such as anxiety syndrome, emotional vulnerability syndrome, etc.), mental symptoms can not be attributed to other mental illness.
3. Determine the relationship between scleroderma and psychiatric symptoms. If scleroderma is present first, psychiatric symptoms occur, psychiatric symptoms improve with the relief of scleroderma, or worsen due to its aggravation, then mental symptoms can be determined. Related to scleroderma.
It should be differentiated from other mental disorders caused by connective tissue diseases and other functional psychosis such as schizophrenia, snoring and depression.
