mental disorder
Introduction
Introduction Mental disorders refer to disorders in which mental functioning of the brain occurs, leading to different levels of mental activity such as cognition, emotion, behavior, and will. Common emotional disorders, brain organic disorders and so on.
Cause
Cause
There are many factors in the pathogenic factors: congenital inheritance, personality characteristics and physical factors, organic factors, and social environmental factors. Many people with mental disorders have delusions, hallucinations, delusions, affective disorders, laughter, self-talk, strange behavior, and decreased will. Most patients lack self-awareness, do not admit that they are sick, and do not actively seek medical help. . Common mental illnesses include schizophrenia, manic depressive disorder, menopausal mental disorder, paranoid mental disorder, and mental disorders associated with various organic lesions.
(1) Biological factors (internal factors)
1. Genetic inheritance factors are one of the most important pathogenic factors, but they are not the only factors, nor are they positive single-gene inheritance. It is generally believed that multi-gene interactions increase the "riskness" or possibility of mental disorders. In the case of schizophrenia, even if it is a single egg, the same rate is less than 50%. The lifetime prevalence of normal people is about 1%, and the lifetime prevalence of schizophrenia patients is only about 10%.
2. Central nervous system infection and trauma
(2) Psychological and social factors (external causes)
1. Personality disorder is itself a mental disorder. People with impaired personality are more likely to suffer from mental disorders. And some personality disorders are closely related to specific mental disorders.
2. Stress stress is generally only a cause of mental disorder, and only in rare cases (such as acute stress disorder) may be the direct cause.
Examine
an examination
1. Clinical diagnostic features
(1) Mania and depression are mainly manifestations of significant and persistent mood rise or fall. In the case of manic episodes, the background of emotional excitement is accompanied by an increase in thinking and willingness activities; in the case of depressive episodes, on the background of low emotions, accompanied by slow thinking and reduced will activities. Most patients' thinking and action abnormalities are coordinated with high or low moods.
(2) may be accompanied by symptoms of physical discomfort. Manic episodes are often accompanied by increased appetite, hypersexuality, and decreased sleep; physical symptoms are more common in depressive episodes, such as early awakening, loss of appetite, weight loss, loss of libido, and depression. The rhythm changes to help diagnose.
2. Most of the course of the disease has a paroxysmal course, and the mental state can recover the pre-disease level during the episode. There have been similar episodes in the past, or alternating episodes of mania and depression in the course of the disease, which are helpful for diagnosis.
3, the family, especially the first-degree relatives have a high positive family history of similar diseases, physical and neurological activity examinations and laboratory tests generally no positive findings, brain imaging and psychochemical examination results for reference.
Diagnosis
Differential diagnosis
1. Secondary affective disorder
Brain organic diseases, physical diseases, certain drugs and psychoactive substances can cause secondary mood disorders, and the identification points of primary mood disorders:
1 The former has a clear organic disease, or has a history of taking certain drugs or using psychoactive substances, physical examination has positive signs, and laboratory and other auxiliary examinations have corresponding indicators;
2 The former may have disturbance of consciousness, amnesia syndrome and mental retardation, the latter in addition to spastic manic episodes, unconscious, memory and intelligent disorders.
3 The symptoms of organic and drug-induced mood disorders fluctuate with the disease of the primary disease, the primary disease improves, or the emotional symptoms are improved or disappeared after the drug is stopped.
4 Some manic episodes caused by manic episodes, the symptoms of high mood are not obvious, but manifested as irritability, anxiety and nervousness, such as hyperthyroidism; or manifested as euphoria, irritability, emotional instability Such as cerebral arteriosclerosis, are different from mania.
5 The former has no history of episodes of mood disorders, while the latter may have a similar history of seizures.
2, schizophrenia
In the early stages of schizophrenia, psychomotor excitement often occurs, or depressive symptoms appear, or depression occurs during the recovery period of schizophrenia, similar to manic or depressive episodes.
1 schizophrenia new mental exercise excitement or depressive symptoms, the emotional symptoms are not the primary symptoms, but the thinking disorder and emotional apathy as the primary symptoms; mood disorders with mood high or low as the primary symptoms.
2 mental activities such as thinking, emotion and will behavior of schizophrenia patients are uncoordinated, often showing disordered speech, incoherent thinking, uncoordinated emotions, and bizarre behavior; acute manic episodes can be characterized as irritability, psychotic symptoms There may also be uncoordinated psychomotor excitement, but the appearance of emotional symptoms appears. If the patient has a similar episode in the past and is relieved well, or is treated with a mood stabilizer, the diagnosis should be considered as a manic episode.
3 Most cases of schizophrenia progress or continue to progress, often have residual mental symptoms or personality defects during the remission period; and mood disorders are intermittent episodes of disease, the interval is basically normal. 4 pre-existing personality, family genetic history, prognosis and drug treatment response can be helpful in identification.
3. Psychogenic mental disorders
Post-traumatic stress disorder in psychogenic disorders is often accompanied by depression, which should be differentiated from depressive symptoms. The main points of identification are:
1 The former often appears in severe, catastrophic, life-threatening traumatic events such as being raped, earthquaked, or abused. It is mainly caused by anxiety, pain, and irritability, and mood swings are large. Light rhythm changes.
2 The former mental function is not obvious, sleep disorders are difficult to fall asleep, there are nightmares and nightmares related to trauma, especially from the dream of screaming; and depression has obvious mental retardation, more sleep disorders Wake up early.
3 The former often re-experiences the traumatic event, and has repeated intrusive memories, which is easy to be shocked.
4, depression and bad emotional disorders
There is no essential difference between the two, the same patient can be a typical depressive episode in the episode of the cloth head, and the other can be a bad mood disorder, but the degree of research of the symptoms is different, or the difference in the disease period. However, some people think that there is still a difference between the two, the main identification points:
1 The former is the main, the family heritage history is more obvious, the latter is due to the heart because of the main, the family's genetic history is not obvious.
2 The former has obvious clinical psychomotor retardation badges, and there are obvious biological characteristic symptoms, such as loss of appetite, weight loss, decreased libido, morning and morning light and night rhythm changes; the latter are not obvious.
3 The former may be accompanied by psychotic symptoms, the latter without.
4 The former is mostly a self-limiting course, and the latter has a long period of time, lasting at least 2 years, and the interval is short.
5 The former can be a cyclical personality or not necessarily, the latter is sentimental, unhappy, and more inner.
5. Mania and depression and circulatory affective disorder
The main difference is that the latter's mood disorder is less severe and does not meet the diagnostic criteria for manic or depressive episodes, and there are no psychiatric symptoms.
1. Clinical diagnostic features
(1) Mania and depression are mainly manifestations of significant and persistent mood rise or fall. In the case of manic episodes, the background of emotional excitement is accompanied by an increase in thinking and willingness activities; in the case of depressive episodes, on the background of low emotions, accompanied by slow thinking and reduced will activities. Most patients' thinking and action abnormalities are coordinated with high or low moods.
(2) may be accompanied by symptoms of physical discomfort. Manic episodes are often accompanied by increased appetite, hypersexuality, and decreased sleep; physical symptoms are more common in depressive episodes, such as early awakening, loss of appetite, weight loss, loss of libido, and depression. The rhythm changes to help diagnose.
2. Most of the course of the disease has a paroxysmal course, and the mental state can recover the pre-disease level during the episode. There have been similar episodes in the past, or alternating episodes of mania and depression in the course of the disease, which are helpful for diagnosis.
3, the family, especially the first-degree relatives have a high positive family history of similar diseases, physical and neurological activity examinations and laboratory tests generally no positive findings, brain imaging and psychochemical examination results for reference.
