Kandinsky-Clerambault syndrome.

The Kandinsky-Clerambault syndrome has a hallucinatory-paranoid nature. The syndrome is also known under the names: "Kandinsky-Konovalov syndrome"; "alienation syndrome"; "psychic automatism syndrome". The psychiatrist V. Kandinsky was the first to describe this disease, in particular its symptoms, and M. Clerambault studied it in more detail, summarizing the information on the problem of alienation syndrome, he identified its main types.

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Causes Kandinsky-Clerambeau syndrome

This pathology most often develops in the following conditions: schizophrenia, traumatic and epileptic psychoses.

If Kandinsky-Clerambault syndrome is aggravated by schizoid states, therapy must be carried out in specialized clinics in a hospital.

Risk factors

The following factors can cause Kandinsky-Clerambault syndrome:

• addiction;
• substance abuse;
• hypoxia of the brain of various etiologies;
• stroke;
• TBI;
• alcoholism.

In these situations, delirium may appear as a defensive reaction due to traumatic factors.

Often the syndrome is a companion to Wilson's disease. This disease is associated with the accumulation of large amounts of copper in the human body. With a large amount of this element in the human body, severe irreversible changes in the liver and kidneys develop, the functioning of the nerve cells of the brain is disrupted, and vision pathologies develop.

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Pathogenesis

In the initial stage of the disease, patients report obsessive pain, suffer from hallucinations, complain of a burning sensation and a feeling of fluid flowing in the head, considering this to be the result of exogenous influence. This type of neurosis is characterized by externally imposed gestures (various types of pathological automatisms that a person performs - running, blinking, etc. are a consequence of external factors). Patients may suffer from psychomotor hallucinations, the pronunciation of words and phrases occurs forcibly.

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Symptoms Kandinsky-Clerambeau syndrome

The characteristics of the disease are: a sense of detachment, loss of personal emotional, mental, sensory and motor functions. Patients are aware of influence: their body and thoughts are controlled by someone or something, and they must obey the one who controls them.

• Impaired thinking (thoughts may speed up, slow down, or stop).
• Mentism - thoughts appear without human participation).
• Openness of thought - others know about their thoughts, ideas, feelings.
• Echo thoughts - people nearby pronounce the patient's thoughts out loud.
• Taking away thoughts.
• Non-verbal dialogues with individuals.
• Pseudo-hallucinations - communication with spirits, mental voices.

Painful sensations in the internal organs - feelings of heat and burning, are caused by foreign entities from the outside.

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Stages

Acute and chronic stages of the disease are noted.

The acute stage can last from several days to 3 months. The patient develops delusional fantasies, complaints of a fragmentary nature, paradoxical and changeable. Strong emotions arise, manifested in excessive speech-motor excitability and aggressive behavior. A feeling of panic, fear, alertness, suspicion.

The chronic stage can last for years, the symptoms are erased. The presence of Kandinsky-Clerambault syndrome in combination with schizoid states is an unfavorable sign for the course and prognosis of mental illness. The patient experiences the influence of external forces and makes fantastic complaints.

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Forms

1. Associative - non-verbal communication with non-existent individuals, often with offenders; those around him know and reproduce his thoughts.
2. Sensory - unpleasant sensations on the surface of the body and internal organs.
3. Motor - actions and movements that occur beyond the patient's will, imposed by "violent intervention of external factors". This type corresponds to the conviction that movements and actions are not performed by one's own will.

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Diagnostics Kandinsky-Clerambeau syndrome

The diagnosis of Kandinsky-Clerambault syndrome is established by the corresponding symptoms: with the sudden appearance and development of a mental disorder with a growing feeling of alienation and understanding of its violence.

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Differential diagnosis

In differential diagnostics of a patient with suspected Kandinsky-Clerambault syndrome, it is necessary to conduct a series of tests that recognize psychoses of various etiologies or schizophrenia. When establishing a diagnosis, Kandinsky-Clerambault syndrome should be distinguished from HBS (hallucinatory-delusional state), which have similar symptoms. The only difference is the presence of true hallucinations in HBS and no sense of alienation of the individual.

Treatment Kandinsky-Clerambeau syndrome

Patients with suspected Kandinsky-Clerambault syndrome are hospitalized in a psychoneurological department or a specialized clinic, where doctors will prescribe complex drug therapy. In drug correction, neuroleptic drugs are used that inhibit nervous processes in the central nervous system (triftazin, haloperidol, clozapine).

Triftazin is prescribed intramuscularly - 1-2 ml of 0.2% solution. Side effects associated with the use of the drug are impaired coordination of movements, inflammatory processes in liver tissues and various allergic reactions.

Haloperidol is prescribed in tablet and injection form. When taking the medicine orally, it is taken half an hour before meals (to reduce the negative effect on the stomach, it is recommended to wash it down with milk).

The dosage is strictly prescribed by the doctor individually. Treatment begins with a dose of 0.5-2 mg per day and is divided into 2-3 doses. Gradually increasing the dose, the desired therapeutic effect is achieved (0.5-5 mg). The maximum permissible dose of the drug per day is 100 mg. On average, therapy takes 2-3 months. At the end of the course, the attending physician prescribes a maintenance dose - with a gradual reduction. Negative effects of taking haloperidol: headache, dizziness, anxiety, euphoric or depressive states, epileptic attacks are possible.

Clozapine is used in tablet or injection form. When taken orally, the usual dose is 0.05-0.1 g, divided into 2-3 doses (regardless of diet). After which the daily dose is increased to 0.2-0.4-0.6 g. The duration of the course of treatment is prescribed by the doctor individually. When conducting maintenance therapy, clozapine is prescribed at 0.025-0.2 g or intramuscularly 1-2 ml of a 2.5% solution for evening use. Side effects when using the drug are: drowsiness, muscle weakness, confusion, attacks of tachycardia, fever, collapse.

If psychotropic drugs are effective, the patient is recommended psychotherapy and rehabilitation.

Timely initiation of treatment of the acute stage of Kandinsky-Clerambault syndrome is aimed at eliminating the possibility of dangerous consequences of the patient's behavior.

Cachexic patients are recommended to take brewer's yeast, iron-containing preparations, phytin and other general tonics. Patients especially need vitamins.

Physiotherapy is not very effective in cases of Kandinsky-Clerambault syndrome.

Folk remedies

Traditional healers advise making an amulet for Kandinsky-Clerambault syndrome using a piece of peony root, which has a calming effect on the body and improves well-being during illness.

An ancient Tibetan method. A large portion of olive oil is placed in a clay vessel and buried in the ground to a depth of 1.5 m for at least 12 months. After a year, the clay vessel is removed and the oil is used to rub the patient's body. For 30 minutes, the patient's body is rubbed with smooth massage movements, with special attention to the head and neck. The course of treatment is carried out for two months. At the end of the first course, massage treatment must be repeated after 1 month.

Sachets with thyme, hops, oregano and mint help to quickly calm down and fall asleep. A bath with willow decoction has a relaxing effect.

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Herbal treatment

Pour 100 g of fragrant mignonette flowers with 0.5 l of unrefined vegetable oil and leave for 14 days in a dark place. The mixture should be shaken periodically. Then it should be filtered and rubbed into the temporal region twice a day.

If your hands are shaking, traditional healers recommend: pour 3 tablespoons of oregano into 3 cups of boiling water and leave in a thermos for 8 hours. After straining the infusion, drink it in equal portions throughout the day. The course of phytotherapy lasts 1 month. Repeat again after 1 month.

To strengthen the nervous system, healers recommend: pour boiling water (400 ml) over 2 tbsp. of a mixture of hop cones and dry crushed blackberry leaves in a thermos. Leave overnight. Take equal portions (100 ml) 30-40 minutes before meals 4 times. Brew the seven-strong and comfrey herbs alternately. The duration of treatment with these herbs is from 1.5 to 2 years.

Homeopathy

Henbane, datura, and belladonna affect a person's psycho-emotional state. They are used to prepare homeopathic remedies.

Before taking medications, folk or homeopathic remedies for the treatment of the syndrome, a specialist consultation is necessary.

Prevention

For the purpose of prevention of Kandinsky-Clerambault syndrome, specialists prescribe appropriate therapy for the underlying mental illness. It should be timely and adequate. Correct diagnosis plays a major role.

After inpatient treatment, psychotherapy is recommended. Adaptation sessions are held in groups, families and individually. They affect the restoration of the patient's independent existence in society. According to research, during the sessions, the stress resistance of patients increases and the likelihood of a relapse of the disease decreases. It is necessary to adhere to a diet that excludes foods containing copper (nuts, chocolate, beans). Physical therapy sessions are also recommended.

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Forecast

Treatment of the acute form of the disease with rapid and correct diagnosis usually ends with a favorable outcome.

The chronic stage of Kandinsky-Clerambault syndrome tends to progress over a long period of time, leading to personality degradation.