What Are the Different Types of Concentration Disorders?

Mental disorder refers to a general term for disturbances in the functional activities of the brain that cause different degrees of mental activity such as cognition, emotion, behavior, and will. Emotional and mental disorders are common. The pathogenic factors have many aspects: congenital heredity, personality characteristics and physical factors, organic factors, social environmental factors, and so on. Many people with mental disorders have delusions, hallucinations, delusions, affective disorders, impatience in crying and laughing, talking to themselves, weird behavior, and reduced will. The vast majority of patients lack self-awareness, do not acknowledge their illness, and do not actively seek help from their doctors. . Common mental illnesses include: schizophrenia, manic-depressive mental disorder, menopausal mental disorder, paranoid mental disorder, and mental disorders associated with various organic diseases.

Mental disorders

Mental disorder refers to a general term for disturbances in the functional activities of the brain that cause different degrees of mental activity such as cognition, emotion, behavior, and will. Emotional and mental disorders are common. The pathogenic factors have many aspects: congenital heredity, personality characteristics and physical factors, organic factors, social environmental factors, and so on. Many people with mental disorders have delusions, hallucinations, delusions, affective disorders, impatience in crying and laughing, talking to themselves, weird behavior, and reduced will. The vast majority of patients lack self-awareness, do not acknowledge their illness, and do not actively seek help from their doctors. . Common mental illnesses include: schizophrenia, manic-depressive mental disorder, menopausal mental disorder, paranoid mental disorder, and mental disorders associated with various organic diseases.

Causes of mental disorders

Biological factors of mental disorders

(Internal cause)

1. Hereditary factors are one of the most important causative factors, but they are not the only factors or positive single-gene inheritance. It is generally believed that multi-gene interactions increase the "risk" or possibility of mental disorders. Taking schizophrenia as an example, even with a single egg twin, the same disease rate is less than 50%. The lifetime prevalence of normal people is about 1%, while the lifetime prevalence of family members of patients with schizophrenia is only about 10%.

2. Central nervous system infection and trauma

Psychological and social factors

(External cause)

1. Personality personality disorder is a mental disorder in itself. People with impaired personality are more likely to develop mental disorders. And some personality disorders are closely linked to specific mental disorders.

2. Stress is generally only a cause of mental disorders. Only in rare cases (such as acute stress disorder) can it be the direct cause.

Psychological perspective:

Consciousness: Psychoanalysis

Cognitive Theory: Cognitive Analysis

Behavior Theory: Behavior Analysis

Common mental disorders in old age: Alzheimer's

Alzheimer's disease, also known as Alzheimer's disease, is a syndrome. Onset after age 65. Although the onset is slow, the lesions are quietly progressing non-stop, manifested as mental retardation, the patient is not as flexible as before, the memory is significantly reduced, and enters the so-called "forgetting period" in medicine (the first stage of senile dementia) I often forget about things, often with the help of notes, I forget everything I just did. Subsequently, there was a lack of concentration, a great loss of orientation, and a very poor vocabulary, which made it difficult to think of proper terms (which was not the case before) and entered the so-called "confusion period" in medicine (the second stage of Alzheimer's disease). She has severe disorientation, can't distinguish between husband and wife, has obvious anxiety, and doesn't know what to do next. Delusions and hallucinations are increasingly apparent. Air-brain angiography shows enlarged ventricles.

At present, it is believed that there are many causes of senile dementia. One of the main reasons is the atrophy of the cerebral cortex due to arteriosclerosis.

Mental disorder causes mental disorder character

Personality refers to an external expression of a person's attitude and behavior towards reality. The formation of personality has a certain relationship with heredity, but it is mainly affected by the surrounding environment. Modern medicine believes that the occurrence and development of certain diseases have a very close relationship with the personality of the person, especially in the early days of mental illness. Symptoms, which are not noticed so much, delay the opportunity for early treatment.

The personality changes of mental patients have a development process. As long as the surrounding people can be identified in detail, the bad personality that easily induces mental illness has these aspects.

1. Outbreak character: also known as "epileptic character defect". This kind of person often explodes strong anger and impulsive behavior for a small mental stimulation. After a short period of time, everything returns to calm. Usually sticky, dignified, inflexible, once the anger is on, he is completely out of control, his emotional behavior becomes abnormally rude, and he is very aggressive, regardless of the consequences, regardless of the impact. Intermittent period is normal, and it is more common in young and middle-aged men. There are often similar patients in the family. Injuries during delivery, asphyxia, head trauma, encephalitis, ADHD, childhood abandonment, lack of normal family warmth, etc. are the causes of the outbreak of personality Important factor.

2. Paranoid character: stubborn, temperamental, sensitive and suspicious, like jealousy or blame others, narrow-minded, overly fussy, irritable, often friction with others, self-centered in work and life, not listening Other people's opinion, this personality is more common in young men, and is prone to paranoid psychosis and schizophrenia.

3. Divided personality: introverted, lonely and out of place, quirky, usually quiet, timid, lonely, not communicative, at work, fancy thinking, like to be horny when talking about things, talking upside down, regardless of the occasion, no proportion. Treating people coldly, this personality may be an important signal of early schizophrenia.

4. Cyclic personality: It is characterized by sometimes very high emotions, especially enthusiasm for people, extra initiative for work, great interest in things around, optimistic and active, good at socializing, and full of fantasy; sometimes emotions plummet, both passion and interest The smoke disappeared, no interest in anything, lack of spirit, lack of physical strength, and pessimism about life's future, only indifference, boredom, and loneliness. The two very different personality traits appear alternately, so they are called "reserve members" of emotional psychosis.

5. Ridiculous character: also known as dramatic character, more common in young and middle-aged women, feelings are easy to fluctuate, emotions are extremely unstable, one day constant changes, speaking depth does not matter, say what you think, act sloppy, pose, and love fantasy , High suggestiveness, strong dependence, like to be self-centered, superficial to others, superficial, dishonest, difficult to maintain normal social connections with the surroundings, and often think of imagination as reality. People with this character are extremely susceptible to rickets once they experience trauma.

6. Depressive character: The emotions of these people are often prone to depression, depression, pessimism and depression, and it is not easy to get rid of unpleasant situations and life conflicts. Their thinking, will and behavior are often suppressed, their energy is low, their physical strength is reduced, and their lives are not fun And dynamism, low self-evaluation, different levels of inferiority, often feeling emptiness and loneliness, uninterested, tedious life, full of grief and sadness towards others, to society, to one's current situation and future. Tend to be negative and pessimistic, this kind of character is a kind of psychological defect, severe can become depression. ^[1]

Common mental disorders

Schizophrenia

Related books

Schizophrenia is a common mental illness with unknown etiology. It has many obstacles such as perception, thinking, emotion, will, and behavior. It is characterized by uncoordinated mental activity or disconnected from reality. Consciousness and intelligence are usually clear, and some cognitive impairment may occur. Basic loss of self-knowledge during illness (self-knowledge refers to the patient's ability to understand and criticize his own mental illness, and is used by the psychiatry department to determine whether the patient has a mental disorder, the severity of the mental disorder, and the effect of treatment One of the important indicators) that is, a schizophrenic patient denies that he has a mental illness and refuses treatment.

[Common clinical types]

1) Simple type: onset in adolescence, slow onset, often not easy to find early, symptoms similar to neurasthenia: fatigue, weakness, insomnia, decline in reading performance, loneliness, lazy life, emotional indifference. Patients are sometimes mistaken for unhappy thoughts or personality problems.

2) Adolescent: Frequently occurs in adolescence, and the onset is more rapid. The main manifestations are bizarre thinking, difficult to understand, emotional moodiness, naive behavior, stupidity, impulsivity, sexual desire, hyper appetite, etc.

3) Paranoid: Frequently occurs in young or middle-aged people, and the onset is relatively slow. At first, it is sensitive and suspicious. If you feel that someone is talking about you and rejecting yourself, you will gradually believe that you will form a delusion, and your behavior and Emotional activity is also dominated by hallucinations and delusions.

4) Tense type: Rarely seen at present, mostly in young adults, onset is faster, more common in the state of stiff, patients with speech movement inhibition, not drinking or eating, muscle tension fixed in a certain posture, no response to the environment You may even get up suddenly, hurt someone or destroy things, and then lie down suddenly.

5) Mixed type (undifferentiated type): other schizophrenia patients who are difficult to be classified as the above type 4, this type is currently the most common, accounting for about 60%.

[clinical diagnosis]

The diagnosis of schizophrenia still mainly depends on the clinic, and there is still no confirmed biological index of diagnosis. Laboratory tests can only exclude other organic causes. The diagnosis of schizophrenia needs to last for more than 3 months, have significant impairment of social function or lack of ability to test reality (loss of self-knowledge-deny that you have a mental illness), and at least the following manifestations of mental symptoms Two must exist:

1) Associative obstacles: obvious slack thinking, logical inversion, or pathological symbolic thinking, such as the lack of central content of speech, inaccurate narration of things, making people's sense difficult to understand, and putting together irrelevant words to give special Meaning, spitting by others refers to their own phlegm.

2) Delusion: Primary delusion or ridiculous content, such as thinking that your brain is controlled by radio waves, a wiretapping device installed in the room, being tracked, and everyone around you looking at yourself with a different eye.

3) Emotional disorders: incoordination, indifference or perversion, such as talking to yourself, ridiculous, moody, etc.

4) Hearing: I hear someone commenting on my own voice or order, controversial hallucination, feeling that my thinking is being spoken out loud.

5) Behavioral disorders: a group of stress symptoms (stiffness), or weird stupid behavior.

6) Loss of will: loneliness, flinching, lazy life, inattention to personal hygiene, no haircut, no bathing for several days, etc.

7) Passive physical examination: feeling of being controlled, thinking being insightful, thinking being inserted, withdrawn or interrupted.

[[Treatment and Prevention]

It is generally advocated that early detection and early treatment of patients with schizophrenia mainly use antipsychotic drugs (such as chlorpromazine, Vestone, haloperidol, sulpiride, etc.). It should be noted that long-term adherence to medication and assistance in certain psychosocial rehabilitation training.

Mental disorder

Delusion : It is a pathological thinking that is divorced from reality. Its characteristics are: first, reasoning on the premise of unfounded assumptions, contrary to the logic of thinking, can not reach a conclusion that meets the reality. Second, we firmly believe in ridiculous conclusions. We cannot correct this ridiculous conclusion by educating ourselves with facts and teaching knowledge and our own experience. In clinical medicine, it is usually classified according to the main content of delusion. The common ones are:

Relationship delusion, the patient considers things that have nothing to do with him as related to him. For example, the patient turned off the television because he thought he and his family were acting on the television. Considering that the content of the newspaper was an insinuation of him and their family, he angrily left the newspaper aside. He thought that the conversation between strangers on the road was talking about him, coughing and spitting was directed at him, and he was scornful, so he refused to leave the house.

The victim's delusion is that the patient firmly believes that someone or some group around him will follow him, frame him, and even think that they will poison his food and drinking water. Patients subject to this delusion will refuse to eat, sue others, avoid or hurt others, and hurt themselves.

Exaggerate delusions, patients exaggerate their wealth, status, capabilities, rights, etc. I had received such a patient in person when I was in college. At that time, when I was an assistant in the counseling room of our school's psychological education center, a student came to consult. He said that he was Jiang Zemin's nephew, because he was afraid of being known by others. Come and change your name to come to our school. During the consultation, he said how much wealth he had, and then said that he had a lot of guns and shells, and how much each gun was worth. All these wealth was given to him by Jiang Zemin. He also said that if we can ask him for help in the future, he can certainly help us. Wait for something that is obviously exaggerated.

Suspected delusion. Patients have no basis to believe that they have a serious physical illness or incurable disease, so they seek medical advice everywhere. Even through a series of detailed examinations and repeated medical verifications, they cannot correct the patients' distorted beliefs. Delusion. Severe patients even think that "their internal organs have all rotted", "I no longer have a solution, and the rest is just an empty shell of the body." He figured it out.

Hallucination : Perception without objectivity. In other words, the perceived image is not caused by objective things, but the patient is born out of nothing. In other words, it is something that does not exist, but the patient thinks it exists and affects the patient's life. According to the different receptors, hallucinations can be divided into hallucinations, hallucinations, hallucinations, and so on. Clinically, hallucinations are the most common, followed by hallucinations.

Hearing means that patients can hear sounds that others cannot hear, when in fact those sounds do not exist at all. Auditory auditory hallucinations can be divided into imperative auditory hallucinations, critical auditory hallucinations, and controversial auditory hallucinations. For example, a schizophrenic patient will hear someone give him an order to follow someone or do something. Some patients told the doctor that there were always people discussing many things around him, which made him annoying. But he couldn't get rid of this argument.

Hallucinations refer to hallucinations that lack a specific form and clear structure, that is, what the patient can see are things that do not exist in reality.

In the movie "Beautiful Mind" is about a very outstanding university mathematics professor because of schizophrenia. In the early stage of schizophrenia, he denied that he was mentally ill. He could hear what others couldn't hear, he could See people that others can't see. These are actually his fictional characters, which means that these are the illusions of the professor. He believed that these fictitious people were the highest commanders of the US military and asked him to do intelligence gathering. So the wall of his office was covered with paper-cuts of various newspapers and magazines. When the professor's schizophrenia reached a certain level, he thought that someone was going to kill him and asked his wife to run away with him. In the end, his wife only sent him to a mental hospital for treatment. In the mental hospital, the professor still did not admit that he had a mental illness. It was at the end of the film that the professor realized that he was really suffering from a mental illness, which is schizophrenia. He started taking medicine for schizophrenia at this time, but in the process, these fictional people will still appear in front of him, and he can only try to ignore their existence. At the end of the film, the professor won the Nobel Prize in Economics, but, until the end of the film, the professor did not get rid of the illusion. In other words, during the treatment of patients with schizophrenia, the condition will be repeatedly aggravated or worsened, and only some people can remain cured or reach a basic healing state, but most people still fail to achieve a healing state.

The hero in this story is indeed someone. The talented mathematician John Nash worked at the Massachusetts Institute of Technology and made amazing mathematical discoveries at a very young age. This laid the mathematical foundation of game theory in economics and began to gain an international reputation. But at the age of 30, he was diagnosed with paranoid schizophrenia. His emotional life is also not simple, including once he was arrested because of inappropriate exposure in the men's bathroom, and he had children outside of marriage. He went through pain in his genius and frenzy. His beautiful mind not only has extraordinary intelligence but also courage, so that he will not sink into the abyss. This was a long and painful journey, but the disease gradually recovered. He was awarded the Nobel Prize in Economics for his research results on game theory. But this is not a general biographical movie. "It's not through facts, but through imagination that tries to praise the spirit of a life and reach some truth."

Phobia of mental disorder

Fear is the emotional response and evasion that occurs when facing an adverse or dangerous situation. More common in phobias, anxiety disorders, physical diseases associated with mental disorders and cerebral organic mental disorders.

[Clinical Features]

1) Those who are lightly feared are suspicious, meaning they are often intimidated and always think that they are in a disadvantageous and dangerous situation.

2) Those who are afraid of fear are called horrors, meaning extreme nervousness and fear of behavior disturbances such as running and shouting.

3) In addition to extreme nervousness in fear, there are obvious autonomic nervous system symptoms. Such as palpitations, shortness of breath, frequent urination, tremors in the extremities, and more than sweat.

4) The fear content of some patients is relatively stable, and tension and anxiety only occur in specific environments, such as animal horror, square horror, and social horror.

5) The fear that arises under the control of psychotic symptoms such as hallucinations and delusions can also be called panic, but they are psychotic symptoms. Extreme panic can leave patients as wood chickens, leaving them in a stiff state.

[Clinical significance]

1) Fear of certain things is the main symptom of phobia. Such as square terror, social terror, insect terror and so on. Once a patient enters a specific environment, he will be an enemy, anxiety, tension, and fear will occur one after another, sometimes knowing that he should not be afraid, but he cannot control his emotions.

2) Fear can often be caused by hallucinations, delusions, and delusions. Under the control of hallucinations and illusions, panic attacks often occur. Panic attacks often occur in delirium patients with cerebral organic mental disorders and physical diseases accompanied by mental disorders and conscious disturbances. Patients with brain trauma accompanied by mental disorders also have panic attacks due to optical illusions.

3) In the acute episode of anxiety, there is intense fear and autonomic dysfunction. The complexion is pale and sweaty, and generally there is no corresponding incentive. It lasts about 30 minutes each time.

4) Normal people suffer from physical diseases, such as coronary heart disease, cerebral hemorrhage, cancer or patients before surgery, and they have fears, which can be alleviated by appropriate counseling.

Forced action

Forced action is a repetitive action that indicates that it is unnecessary but difficult to restrain. Common in obsessive-compulsive neurosis, or early in schizophrenia.

[Clinical Features]

1) The patient knows that it is not necessary to do this action, but he has to do it and has to repeat it.

2) If deduplication is restricted or prohibited, the patient will develop severe anxiety.

3) Once the patient repeats, he often feels satisfied and has a relaxed feeling of relief, but after a while, the patient will still be troubled by the new repetition.

4) Compulsive actions and behaviors are often caused by compulsive ideas and compulsive ideas.

5) Forced action can be controlled for a certain period of time when there are large crowds in the court or strangers. Once the environment allows it, it will be repeated and intensified to compensate.

[Clinical significance]

1) Common obsessive-compulsive disorder, such as patients washing their hands compulsively for fear of contracting the disease, washing their hands repeatedly, and even washing their hands with whitening and peeling, but he does not care; the patient needs to count the telephone poles while walking. Repeat to count.

2) In the early stage of schizophrenia, patients may have compulsive actions and behaviors, which are mostly caused by weird thinking. Some patients have autopsychosis, but they are not experiencing forced pain, and most patients do not have a strong desire to get rid of these symptoms.

insomnia

Insomnia refers to insufficient sleep time or reduced sleep quality, which is very common in the general population. The most common symptoms are difficulty falling asleep (not falling asleep for at least half an hour after going to bed), waking up early (waking up at 3 to 4 in the morning, and having difficulty falling asleep again), or sleepless dreams.

Generally speaking, with the increase of age, the sleep time of adults gradually decreases. Young people generally spend 7 to 8 hours per day and night, 6 to 7 hours for middle-aged people, and 4 to 6 hours for older people. Regardless of insomnia, of course, there are exceptions, and individuals may need more sleep time. There are two clinical situations that need to be identified: young people "don't sleep at night and can't get up in the morning" and older people "sleep early at night and wake up in the morning". These are not insomnia because the total sleep time is not Decreased, but changes in sleep habits and sleep cycles, that is, the sleep cycle of young people is delayed, and the sleep cycle of older people is advanced. Therefore, do not advocate the use of sleeping pills, but adjust sleep habits and lifestyle.

There are many causes of insomnia, including environmental changes, physical illnesses, emotional changes, and diet and medication. Insomnia can be caused by drinking, coffee, strong tea, smoking, noise, etc. Therefore, the cause of insomnia needs to be clarified before treating insomnia.

Sleep, like eating and drinking, is a person's basic physiological and psychological needs. If there is occasional 1-2 days of insomnia, treatment is generally not needed, because it will automatically compensate for the sleep on the 2nd to 3rd days to make up for past sleep lack of. In fact, it is impossible for a person to stay up all night for 3 consecutive days (72 hours). It is as unrealistic as a person who has not dripped for 3 consecutive days. But why do many patients complain that they have not slept for several months? This is mainly because the subjective sensation of sleep is missing or not sleeping deeply (not entering the deep sleep period), so that the subjective sensation of waking up in the morning is a night without sleep, but the family members may give the patient a good sleep.

Of course, insomnia may also be an early symptom of certain diseases, such as depression, anxiety, and schizophrenia. For these patients, the primary disease and insomnia should be actively treated to prevent the disease from recurring. There are many commonly used drugs for treating insomnia, but they should be taken under the guidance of a doctor, and should not be taken at random, because most sedative sleeping pills will have addiction or dependence after long-term use. Once withdrawal is often withdrawn syndrome, insomnia will instead Heavier.

The clinical significance of insomnia generally includes the following:

1) The main symptoms are sleep disorders, and other symptoms are secondary to insomnia, at least 2 to 3 times per week, manifested as difficulty falling asleep, susceptible to awakening, more dreams, early awakening, and discomfort when waking up. It can be considered as insomnia.

2) Schizophrenia and mania are often accompanied by insomnia due to psychomotor excitement. The former are often caused by hallucinations and delusions. On the other hand, mania reduces the need for sleep, and can stay up all night without losing energy.

3) Most patients with neurosis, such as anxiety, often have insomnia, and most of them have difficulty falling asleep and subjective insomnia. In addition to insomnia, the patient also has emotional instability, difficulty concentrating, and autonomic dysfunction.

4) The pain and discomfort caused by physical diseases, such as pain, can cause insomnia, but it can be relieved by taking pain relief, treating the primary disease, and supplementing with small doses of sleeping pills.

5) Depression patients often have insomnia, but waking up early is the main feature. They often wake up in the middle of the night or early in the morning and never find it difficult to fall asleep. Because the mental symptoms of depression patients have the characteristics of light in the morning and light in the night, the risk of suicide is very high when the patient wakes up in the morning or early morning, so it is necessary to attach great importance to insomnia in depression.

Alzheimer's disease

(Alzheimer's disease)

Alzheimer's disease

Alzheimer's disease usually starts in the elderly or presenile, with dementia as the main manifestation. Memory disorders are the first symptoms of the disease, such as frequent loss of items, forgetting of promises, repetition of words, etc. As the symptoms worsen, the patient's intelligence declines. He can eat without knowing his hunger and fullness, cannot go home after going out, can't name his family, and can't even answer his age, name, etc. In severe cases, he cannot take care of himself. From the onset of death to death in the elderly, the general course of disease is 5 years. Alzheimer's disease may be a hereditary disease of the family. The pathology includes cerebral cortex atrophy, enlarged ventricles, and widened sulci. The commonly used early identification tool in clinical practice is simple dementia screening scale (BSSD). Total score 0-30 points, such as those with a medium or higher education score <22 points, primary school education <19 points, illiteracy <16 points suggest dementia. The BSSD is attached below:

Guidance: Older people often have problems with memory and attention. The following questions check your memory and attention. They are simple. Please answer them carefully.

Rating: Right and wrong

1. what year is it now 1 0

2 months 1 0

3 days 1 0

4. Day of the week 1 0

5. What city (province) is this 1 0

6. What district (county) 1 0

7. What street (township, town) 1 0

8. What way 1 0

(Remove the following items, please say their names one by one)

9.5 cents 1 0

10. Pen case 1 0

11.Key ring 1 0

(Remove items and ask "what did you see?"

12.5 cents 1 0

13. Pen case 1 0

14.Key ring 1 0

How much is 15.1 yuan for 7 points () 1 0

16. How much is left to use 7 points () 1 0

17. How much is left with 7 points () 1 0

(I want to say a few words, please listen to what I have said, listen clearly and do as I say. Please take the paper with your right hand, then fold the paper in half, and then put the paper on the table)

18. Take 1 0

19.fold 1 0

20. Put 1 0

(Q: Please think again, what have you seen?)

21.5 cents 1 0

22. Pen case 1 0

23.Key ring 1 0

(Take out the picture and ask "please see who this picture is)

24. Sun Yat-sen 1 0

25. Mao Zedong 1 0

(Remove the picture and let the subjects say the subject of the picture)

26. Send umbrella 1 0

27. Buying Oil 1 0

28. Who is the Prime Minister of China 1 0

How many days in 29.1 1 0

30. In what year was New China established 1 0

Mental disorder behavior will disorder

I. Hyperdulia

Increased will activity, different mental disorders manifested differently. When the manic state is high, the patient is tirelessly busy all day long, but it is often a "snake and a tail". Patients who have been victimized by delusions are subject to delusions, constantly investigating and understanding, seeking so-called evidence or deriving complaints.

Lack of will (adulia)

It is manifested that the patient lacks the due initiative and enthusiasm, passive behavior, extremely short and lazy life, and poor personal and room hygiene. In severe cases, the patient even loses self-defense, feeding and sexual instincts.

Lack of will is more common in patients with schizophrenia and mental decline, and can be seen in patients with dementia.

Third, hypovolia

Refers to a reduction in the patient's voluntary activity. Common in two situations:

One is patients with depression. Such patients do not lack certain will requirements, but are affected by their depression, and they always feel that they cannot do anything. Or, because of the lack of happiness, he is simply interested in everything around him and feels that he has no interest in doing anything. As a result, his will is depressed, which significantly affects the patient's academic, work, or household chores. Depression states these things about themselves

Mental disorders

Changes are generally conscious, and self-knowledge may be partially present. Another case is hypovolatility, which can be seen in the lesser degree of willpower mentioned above, namely patients with low will. What this suggests is that although the above two types of patients have significantly lower voluntary activities than they normally do, this is the same point of both. However, these two types of patients have different inner emotional experiences, different disease diagnosis, and different treatment schemes, which should be distinguished.

Fourth, psychomotor excitement (psycomotor excitement)

Often divided into two types of coordinated and uncoordinated psychomotor excitement. When coordinated psychomotor excitement, the patient's movements and behaviors must be increased in harmony with thinking and emotional activity, and in harmony with the environment. Patients' actions and behaviors are purposeful and understandable. More common in manic episodes of emotional psychiatric disorders. Patients with uncoordinated psychomotor excitement have increased movements, behaviors, and inconsistent thinking and emotion. The patient's movements are chaotic, and the movements and purpose are not clear, making it difficult for people to understand. It is more common in adolescent or nervous type of schizophrenia, but also in delirium state of conscious disorder.

V. Psycomotor inhibition

; stupor

Refers to patients who are silent, do not eat, drink, or move, and their speech activities and actions are safely inhibited. Due to the suppression of swallowing reflex, a large amount of saliva accumulates in the mouth, and the lateral head flows out along the corner of the mouth. If the patient's speech activity and motor behavior are significantly reduced, but have not reached the point of complete disappearance, it is called a sublime state. Stupor pairs are found in the nervous type of schizophrenia, called: catatonic stupor . In addition to tension stiffness, depressive stiffness in depression, psychogenic stiffness in psychogenic mental disorders, and organic stiffness in cerebral mental disorders can be seen clinically. Although all of them are stiff, the etiology, treatment and prognosis are different, and they should be identified.

(negativism)

The patient not only does not perform the action that others ask him to do, but makes the action completely contrary to the request, which is called active violation. If the patient does not respond to any other person's request, it is called passive violation. More common in the nervous type of schizophrenia.

Waxy flexibility

Not only does the patient appear stiff, but the patient's limbs are at his disposal, and even if placed in a very uncomfortable position, it can remain immobile for a long time like wax. If the patient's head is raised, and the posture is made like a pillow, the patient can also stay still for a long time, which is called an air pillow. More common in the nervous type of schizophrenia.

Mute

The patient is silent and does not answer questions, but sometimes he can use gestures or nod, shake his head, or communicate with others by writing. More common in patients with schizophrenia nervous type and hysteria.

Passive obedience

The patient passively obeys the orders and demands of the doctor or other people. Even if the patient is unfavorable to him and completes the actions requested by others, it will make him uncomfortable and the patient will absolutely obey. More common in the nervous type of schizophrenia.

Stereotyped act

Refers to a patient repeating a monotonous action mechanically, often simultaneously with stereotyped speech. More common in the nervous type of schizophrenia.

Emoji (echopraxia)

Refers to the patient's purposeless imitation of other people's movements. It often appears at the same time as imitation of speech, which is more common in schizophrenia. The main clinical manifestations are stiff wood. At the same time, there are several symptoms of mental symptoms such as waxy buckling, silence, passive obedience, stereotyped language, stereotyped movements, imitated speech, and mimicked movements, which constitute the nervous stiffness syndrome, which is part of the tension syndrome . Tension stiffness and tension excitement appear alone or alternately, which constitute the entire contents of the tension syndrome. It is more common in the schizophrenic nervous type, but also in other mental disorders such as cerebral organic mental disorders.

Inversion (parabulia)

It means that the patient's intentional activities are inconsistent with the general situation, resulting in the patient's behavioral activities cannot be understood by others.

More common in schizophrenia

Mannerism

The patient makes childish, stupid, quirky gestures, movements, gaits, and expressions.

More common in schizophrenia

Compulsion

It is a recurring action against my will. The patient clearly knew that it was not necessary to do these movements by himself, and tried to get rid of it, but in vain, the patient felt very painful. More common in obsessive-compulsive disorder, can also be seen in schizophrenia as part of the obsessive-compulsive state.

Postpartum mental disorders

After giving birth, some mothers will develop mental disorders due to excessive stress and other reasons. If you do not pay more attention, it will even threaten the life of your new mother and bring misfortune to your family.

Pregnancy and childbirth are major changes in a woman's life and the foundation of life continuity. At this stage, women are under tremendous physical and psychological stress. After a long pregnancy process in October and the struggling pain and physical exertion in the delivery room In addition, it is followed by the needs of their own physical and mental recovery and the responsibility of bearing role changes, adjustment of life and care for the nurturing of new life.

However, if the physical and mental disorders caused by it are not taken seriously, it will cause great distress to mothers and their families. Postpartum mental disorders are generally roughly classified according to their severity: 1. postpartum psychosis. 2. Postpartum depression. 3. Maternity blues.

Postpartum psychosis usually occurs from the third to the fourteenth day after delivery. At first, there may be symptoms of insomnia, loss of self-consciousness, restlessness, and emotional instability. Later, obvious hallucinations, delusions (including delusions of being victimized or delusions of deformity or death of the baby), and delirium of confusion will soon appear. , Impaired thinking processes, inability to take care of children, or even harm yourself or your newborn. Throughout the course of the disease, the symptoms are very rapid, and will be relieved within a few weeks to two or three months. About 90% of them are manifested as emotional symptoms. After treatment, their prognosis is good, but unfortunately, there are still hundreds of Five percent of patients will commit suicide, and about four percent will kill their babies because of symptoms.

Non-psychotic postpartum depression, characterized by inattention, forgetfulness, and moodiness

Treatment of mental disorders

Calmness, often crying or tearing, dependence, anxiety, tiredness, sadness, irritability, unbearable frustration, negative thinking, etc., generally occurs during the first day to the sixth week postpartum, with the first postpartum period The period from day ten to ten is the crisis period, and its severity is usually moderate to severe, and occasionally the symptoms will last for six to nine months. Postpartum depression is also known as baby blues. Its typical symptoms are sudden crying, agitation, rapid emotional changes, and even euphoria, sleep disturbances, and loss of appetite. It usually starts after the third day after delivery, about a week Disappears automatically. This is minimal and does not cause psychosocial dysfunction, so it is usually not considered a disease.

The factors that cause postpartum mental disorders can be summarized into three major categories-1. Physiological factors: related to the sudden decline of hormones in the body, including estrogen, progesterone, thyroxine, epinephrine, and so on. 2. Psychological factors: Scholars point out that women with postpartum depression usually have anxiety and compulsive traits or have excessive self-control and obedience. They are prone to conflicts and maladaption in the role of mothers, so they cannot overcome the pressure of motherhood. Other scholars believe that emotional stress and high anxiety during pregnancy are prone to postpartum mental disorders. 3. Social factors: including the problems of economic and child care, the lack of support systems or the pressure on children's gender expectations, etc.

According to research and analysis, the results found that the four main factors that cause postpartum women's stressors are: 1. The feeling of stress caused by the role of mother and childbearing: Maternal women will "worry about baby overflowing milk" and "Worry about the baby wearing too much or too much clothing Less "," worrying about babies getting sick "," worrying about baby's instability when bathing, letting baby slide into the water "," worrying about baby getting in while feeding "and other problems related to mothering and responsibility. 2. The pressure caused by the lack of support system: Content items are "Unable to receive sufficient psychological support from family members", "Mr. cannot accept newborns", "In-laws and family members cannot accept newborns", "Mr. Caring for company time Not enough "," family views too much about caring for babies "," baby gender does not meet expectations "and so on. 3. Feeling the pressure caused by the decision: Because there is one new member in the family, life is facing readjustment, so many things need to be decided. The projects include "must give the baby to someone else", "must quit work", " It's not easy to find a babysitter "," The baby's naming is not perfect "," I don't know which milk powder brand to use "," It's difficult to make a decision to feed breast milk or milk "and so on.

4. Feeling of stress caused by changes in the body's mental image: problems caused by changes in the body structure, physical function, physical sensation, and social function caused by pregnancy and childbirth, such as "the weight control cannot achieve the ideal", "the body has not recovered" , "Abdominal muscle relaxation", "excessive dietary intake", "life feels uncomfortable", "worry about getting pregnant again after sex" and so on.

Therefore, for the prevention and treatment of depression, the following suggestions are made: Genders cultivate the characteristics of "equality" and "neutral", respect each other, be considerate, and appreciate their differences. Rebuilding the social values of gender equality. Strengthen communication with each other (including with your husband, family, or other members), and be more caring, frank, listen and praise, and avoid discrimination. 3. Fertility and parenting are the responsibility of family events rather than women. Therefore, each member of the entire family must adjust himself and experience the role change together.

Women must continue to grow and break through in cognition, be an independent woman, realize their own value, and affirm their role importance. 5. The community can be used to arrange various housewife activities and exchange life experiences with each other, so as to avoid falling into emotional depression when busy with their children's housework all day. 6, more exercise on weekdays, maintaining a happy mood can promote the production of endorphine (endorphine) in the body, prevent the occurrence of depression, because "a joyful heart is a good medicine."

Treatment of mental disorders

Basic methods of mental disorders

1

Treatment of mental disorders

Try to get rid of the pathogenic environment, eliminate the factors related to the disease, and strengthen mental treatment.

2. Maintain psychological balance, strengthen confidence and courage to overcome all kinds of difficulties, and help prevent various reactive mental disorders.

Drug treatment for mental disorders

1. Select Shumianjieyu combination step therapy according to clinical symptoms

2. You can also choose drugs to extend physiological sleep 3. Chinese medicine treatment.

Other treatments for mental disorders

1. For those with reactive depression and paranoia, when the above treatments are not effective, electroconvulsions or insulin coma can be considered.

2. Acupuncture treatment.

Common Sense Mental Disorder Nursing

First, the main nursing diagnosis and related factors:

1. Lack of self-care ability: (Causes caused by mental disorders. Shows indulging in drinking cravings all day long, without trimming, undressing, unkempt, and loss of self-care ability.)

2. There is danger of violence: against yourself and others. (Alcohol or drug poisoning; secondary excitement of alcohol or drug poisoning; caused by hallucinations, delusions, or bad emotions, often showing impulsiveness, hurting people, destroying things or anger.

3. Risk of falls: (Related to damage to nervous system function. Instability in walking, limb tremor, fall and fall.)

4. Imbalance of water and electrolyte balance: (with long-term drinking, replacing rice with wine, causing severe nutritional imbalances. Manifested wasting, dehydration, and metabolic acidosis in severe cases.)

5. There is a danger of suicide and self-injury: (It is related to the patient's bad mood, which is manifested as depression and anxiety.)

6. Disorders of sleep pattern: (Related to long-term damage to the central nervous system, manifested insomnia.)

7. Social dysfunction:

8. Nutritional deficiencies: (Below the body's requirements are related to antifeeding and anorexia; replacing food with alcohol or drugs; malabsorption caused by chronic alcohol and drug abuse.)

9. Seeking behavior: (related to adaptive changes in the nervous system).

10. Acute disturbance of consciousness. (Related to alcohol addiction, drug addiction, individual severe poisoning, and extreme excitement.)

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primary prevention The main contents include:

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secondary prevention Its main contents include:

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The main point of tertiary prevention is to do a good job of rehabilitation training for people with mental disabilities, to maximize the recovery of patients' social functions, reduce functional disabilities, delay the process of disease decline, and improve the quality of life of patients. Its main contents include:

1. Actively seek the attention and support of government departments at all levels for mental illness, coordinate the work of relevant departments, form a mental disorder prevention and rehabilitation system, and provide assistance to reduce mental disability and improve the quality of life and life security of patients with mental disorders.

2. For patients who have stabilized after treatment, various forms of psychological therapy and rehabilitation training are conducted. Let patients correctly understand the illness, further correctly understand themselves, overcome personality weaknesses, and correctly deal with various psychological and social problems and contradictions in real life. At the same time, patients are urged to take medicines on time and in order to prevent the disease from worsening and reduce disability, so that patients can recover their psychological and social functions to the maximum.

3. Establish various industrial and recreational treatment stations, operating stations, and entertainment stations to conduct various rehabilitation trainings for patients, and at the same time carry out health education and disease consultation to enable patients to restore family life and social functions as soon as possible.

4. Do regular follow-up of discharged patients so that patients can receive timely and targeted medical guidance and services. Adjust the living environment of discharged patients, mobilize family members to support and participate in patients 'rehabilitation activities, guide family members to formulate life plans for patients, and strive to solve patients' mental health problems and practical difficulties in daily life.

5. Care and meet the reasonable requirements of patients with mental disorders, and pay attention to the impact of psychological and social environment on the prognosis and recurrence of disease. Finding ways to properly solve the problem of returning to work or re-employment for people with mental disorders and people with mental disabilities has a very important role in supporting their mental state and devoting themselves to the social environment to receive exercise.

The relationship between mental disorders and mental illness

Psychosis refers specifically to mental disorders with "psychotic symptoms" such as hallucinations, delusions, or significant psychomotor excitement or inhibition. The most typical are schizophrenia, paranoid psychosis, severe mania, and depression. So mental illness is only a small part of mental disorders.

Mental disorder refers to the dysfunction of the central nervous system under the influence of various biological, psychological and social environmental factors, which leads to the occurrence of various mental activity abnormalities such as cognition, emotion, will and behavior as the main clinical manifestations A general term for a class of diseases. Generally refers to all the psychological and social functions of individuals affected by mental problems, mental disorders is a broader category.

Psychological abnormality This is a common term rather than a professional term, which refers to all abnormal psychological phenomena or external behavior phenomena that are unacceptable to ordinary people.

Mental health refers to the state of being free of physical illness, being happy and full, and being able to adapt to good social functions. It is an ideal state and a state that everyone wants to pursue.

The relationship between mental disorders and depression

I was the first teacher of psychology in our school, so many teachers joked with me when they saw me: Osmanthus, I'm mentally ill, I always feel depressed. How to do? Actually, I understand that what she wants to express is that she has depression. Does she really have depression? How is depression judged? In other words, what are the symptoms of depression?

Depression is a mood disorder, which refers to a group of mental disorders that are dominated by a marked and lasting rise in mood or depression. Accompanied by changes in cognition and behavior, severe patients will develop psychotic symptoms such as hallucinations and delusions. Most tend to have recurrent attacks. After the treatment was relieved or during the episode, the mental state was basically normal, but some patients had residual symptoms or turned to chronic mental illness. Depression is divided into manic episodes, depressive episodes, and bipolar disorder.

Manic episodes are characterized by patients with high mood, thoughtfulness, and psychomotor excitement.

Depression episodes are characterized by a patient's depressed mood, slow thinking, reduced speech movements, and sluggishness.

The onset of bipolar disorder is an alternating episode of high mood and low mood. Most of the general mood disorders are bipolar.

Below we combine a schematic diagram of the emotional cycle to understand the situation of high mood and low mood. B is the mood fluctuation in mania and depression.

The A line represents the emotional fluctuation cycle of our normal people.

The B line represents the mood swing cycle of a person with a mood disorder.

The upper and lower dashed lines refer to a range of normal mood swings. Those that exceed the dashed line above are high in mood, and those below the dashed line are low in mood.

We can see that the blue A line is within the range of normal emotional fluctuations, while the red B line is beyond the top dotted line and sometimes lower than the bottom dotted line. Beyond the top dotted line is fretful A manifestation of mania, and below the dotted line is the manifestation of depression. Bipolar mood disorder refers to this alternating appearance of mania and depression.

Do you still think you have depression?

Biological factors of mental disorders

The main biological factors that affect mental health or mental illness can be roughly divided into heredity, infection, physical illness, trauma, malnutrition, and poison. These causative factors will be detailed in the following chapters of the disease. Here we only list the relationship between genetics, environment, infection and mental disorders.

Mental Disorders (I) Genetic and Environmental Factors

It has long been recognized that genes are one of the main factors affecting the normal and abnormal behavior of humans and animals. We conducted familial clustering studies on so-called "functional psychiatric disorders" (such as schizophrenia, affective disorders, child autism, anorexia nervosa, ADHD, panic disorder, etc.), including understanding how these disorders are inherited, From heritability to gene scanning, the common conclusion is that these diseases are hereditary, and genes pass the susceptibility of diseases from generation to generation.

We know that, like Huntington's disease, it is a single-gene hereditary disease. Mutated genes make the disease pass on from generation to generation. However, most of the current mental disorders cannot be explained by single-gene inheritance, but the interaction of multiple genes. The increased risk, coupled with the involvement of environmental factors, produces disease. In this sense, the interaction of genes increases the risk of disease, but the role of each individual gene is limited, which makes it very difficult for us to find the exact pathogenic gene. However, it seems easier to find the environmental factors that are most closely related to the occurrence of diseases. Therefore, changing the environmental factors that cause diseases will be the focus of current prevention of mental disorders.

At present, the interaction between genes and the environment to produce diseases or behavioral problems has become a consensus. For example, research has found that individuals with low monoamine oxidase A activity are more likely to develop antisocial behaviors during severe childhood abuse. Individuals with serotonin transporter s / s genotype are more prone to depression after suffering life events.

The Human Genome Project shows us a bright future. Through various high-tech means and years of hard work, we will finally find the disease-causing genes. The significance is that if you find a gene, you may know the crux of the problem. For example, if you find a gene that increases the risk of schizophrenia, we can understand when this gene is activated during brain development and what Problems with cells or pathways in the brain have provided favorable opportunities for our intervention; in addition, genetic research will help us to study the pathogenic effects of environmental factors.

Mental disorders (b) infection

As early as the early 20th century, we have known that infectious factors can affect the central nervous system and cause mental disorders. For example, Treponema pallidum caused by sexual transmission first causes reproductive system symptoms. After many years of incubation, it enters the brain and causes neurosyphilis. Neurosyphilis mainly manifests as degenerative changes in the nervous system, including dementia, psychotic symptoms and paralysis. Human immunodeficiency virus (HIV) can also enter the brain, causing progressive cognitive and behavioral damage. Early manifestations include memory impairment, inattention, and emotional apathy. As time goes on, more extensive damage occurs. Such as mutism, incontinence, paraplegia and so on. About 15% to 44% of people with HIV infection have dementia-like manifestations. HIV does not directly infect neurons, but infects immune cells-macrophages. When macrophages die, they release toxins and damage surrounding neurons.

Severe mental disorder harm

1. Positive symptoms such as obvious hallucinations and delusions: the patient can hear someone order him to commit suicide, or feel that people around him want to frame him without a way out, and can only commit suicide;

2. Simultaneous severe depression;

3. Without proper treatment, mental symptoms cannot be effectively controlled;

4. Lack of care or insufficient care of patients, prone to suicide and other accidents;

5. Accompanied by chronic physical diseases, leading to physical and mental fatigue;

6. People with a good education background and high professional expectations can be aware of their mental illness problems and possible discrimination and fear in the future.

Characteristics of mental disorders during puerperium

Although people now know more about mental disorders than before, in general, they are still scarce. For example, what is the psychiatric disorder during the puerperium? Not many people have any performance characteristics that may be known. Experts say that understanding puerperal psychiatric disorders is good for both mothers and babies.

Features of the symptoms of postpartum mental disorders:

Most of this disease is sudden onset, and may have incipient symptoms such as insomnia, depression, unpleasant mentality, and fatigue easily at the beginning, and then manifests as a disorder of mental activity. Because of its various symptoms, it can be divided into the following types:

Melancholy and indifferent: This type is most common and occurs more than a week after delivery. The main manifestations are low mood, depression, anxiety and nervousness, inferiority, grief and tears for no reason, insomnia, or speech delay, unwillingness to talk, inactivity, drowsiness, etc.

Manic and excited type: This type is relatively rare, mostly manifested as irritability, irritability, high emotions, increased words and deeds, confused thinking, quarreling with others, and even destroying people.

Neurosymptomatic type: mainly manifested as insomnia, or difficulty falling asleep, even a few hours before falling asleep; or it is easy to wake up after sleep, and it is difficult to fall asleep after waking up. As a result, symptoms such as fatigue and weakness, headaches such as wrapping, dizziness, loss of appetite, and diarrhea appear.

Hallucinations and delusions: manifestation of thought disorder, violation of logic, often hallucinations (mainly auditory hallucinations), delusions (mostly paranoid delusions or exaggerated delusions), lonely behavior, severe suicidal ideation and behavior.