Kandinsky-Konovalov syndrome

The disease of mental automatism, Kandinsky-Clerambo syndrome is a serious mental pathology, which has a third common name - Kandinsky-Konovalov syndrome. This disorder is considered one of the types of paranoid-hallucinatory diseases. Its essence consists in the development of a special state, in which some external or otherworldly influence is exerted on the patient. Thus the patient can make unnatural deeds, act as if "separately" from his personality and from his own desires.

Pathology was named after the little-known doctor Kandinsky, who lived during the Russo-Turkish war. He felt the signs of a mental disorder and described them, which subsequently was combined into a syndrome. By the way, the doctor himself still could not suppress this feeling of external influence and after some time committed suicide.

Let's consider this pathology in more detail.

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Epidemiology

The disease can occur in patients of almost any age. In children, signs of the syndrome usually appear in the evening, which can not be overlooked.

Most of the cases of the syndrome are found in adolescence and later.

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Causes of the kandinsky-Konovalov syndrome

The Kandinsky-Konovalov syndrome can not exist independently. Usually it develops against other mental disorders, for example, schizophrenia, manic-depressive psychosis, compulsive asthenia.

The chronic course of the syndrome is found only in patients with schizophrenia, and in cases of a continuous painful process. Very rarely the disease begins its development against the background of epidemic encephalitis, mental epilepsy and progressive paralysis.

The acute course of the Kandinsky-Konovalov syndrome in most cases is also diagnosed in schizophrenia, often with a paroxysmal development of the disease.

Other causes - such as craniocerebral trauma, alcoholic delirium, etc. - cause a generally acute form of the syndrome.

Risk factors

Sometimes there is a certain dependence of the syndrome on external causes. This makes it possible to identify the following risk factors:

• chronic intoxication, long-term exposure to toxic drugs and substances;
• trauma, closed damage to the skull and brain;
• drug addiction, the impact on the brain of psychotropic substances;
• disorders of cerebral circulation, strokes;
• chronic alcoholism.

Pathogenesis

Often the pathogenesis of the syndrome is associated with neuropsychic Wilson's disease, the beginning of which predetermines a failure in the body of copper metabolism. Accumulating in tissues, copper damages the structure of organs and systems, which leads to disruption of the stable function of nerve cells and fibers. But in most cases, the etiology of the disease is identified with schizophrenia and organic psychosis.

Most of the research on this topic was conducted by P. P. Pavlov, who considered hallucinatory and paranoid signs of isolation, violence, influence and external possession as a reflection of the painful process of CNS irritation. As a consequence of such irritation, changes and disturbances occur in mental and speech processes, as well as in self-consciousness, which in turn leads to functional disturbance of the psyche-personal decay.

Symptoms of the kandinsky-Konovalov syndrome

The first signs of the syndrome are, as a rule, the so-called affective disorders:

• emotional exhaustion;
• faked anger;
• artificially upbeat mood with elements of enthusiasm, which soon turns into the extreme opposite - depressing depression.

The emotional background of the patient, as it were, "loosens" from side to side: the patient creates the feeling that he plays the role of a doll that "twists for the strings", forcing one to carry out this or that action, to grieve, or rejoice.

With the progression of the disease a person becomes more withdrawn, often trying to hide his obsession. After a while, this becomes impossible, and the patient loses control over what is happening.

The syndrome of sensory automatism can manifest itself with such symptoms:

• the emergence of painful and uncomfortable sensations within the body, often in specific organs;
• an apparent increase in temperature, burning all over the body;
• increasing sexual arousal;
• difficulties with urination;
• incessant defecation.

The patient himself connects all the listed signs with some orders and external forces.

For the syndrome of associative automatism, the following symptoms are characteristic:

• destabilization of mental functions;
• obsessive memories;
• conversational pseudo-hallucinatory states (dialogues with thoughts, voices, etc.);
• a sign of mental openness, when the patient is sure that any of his thoughts become public;
• a sign of "echo", when the patient "hears" that others are stealing and voicing his thoughts.

Syndrome of motor automatism is characterized by loss of will, absolute indulgence to "violent" external influences, complete loss of control over statements. The patient becomes rude and uncontrollable.

Forms

For a more accessible description of the clinical picture, Kandinsky-Konovalov syndrome is divided into several types and forms of the disease.

Thus, the following main types of this state are distinguished:

• a syndrome of motor automatism - is characterized by external, tactile and internal sensations of influence. For example, a patient constantly develops the feeling that he makes any movements other than his own desire. As a result, others note that the patient's behavior becomes chained and unnatural;
• syndrome of associative automatism - for this species is characterized by a pathological sensation that the patient's thoughts become accessible to all. The patient complains that his thoughts and ideas are being stolen, forcing him to express in his own way other people's interpretations that are not his own;
• a syndrome of sensory automatism - is characterized by pseudo-hallucinations that arise in the patient's morbid imagination.
• Separately, it is necessary to distinguish the stages of the syndrome:
• the acute stage is characterized by a rapid course (not longer than 3 months) and frequent changes in the clinical picture, from excessive emotionality to depression depression;
• The chronic stage proceeds slowly, with a sluggish increase in symptoms.

Complications and consequences

The main consequence of the Kandinsky-Konovalov syndrome is a gradual loss of efficiency, loss of control over oneself and communication with the society. At the initial stage of the disease, the processes of thinking, concentration of attention, and memory worsen. Over time, the patient begins to suffer from insomnia, inadequately behaves in society and even avoids it, closing in on himself.

Often the syndrome leads to violations of the function of internal organs, which further affects human adaptation.

Simultaneously with misunderstanding of the public, the patient receives and misunderstanding of family and close people. Often this leads to conflicts and scandals. As a result, the patient closes in himself, becomes angry, resentful, intimidated.

The last stages of the disease are characterized by the most dangerous complication - a total loss of control over their actions and thoughts. Unfortunately, in most cases this condition provokes a patient to commit suicide.

Diagnostics of the kandinsky-Konovalov syndrome

The diagnosis of Kandinsky-Konovalov syndrome is established on the basis of complaints of the patient himself and his surroundings. Also of great importance is the information obtained during examination and examination by a psychiatrist who can additionally prescribe special psychological testing.

Usually doctors are interested in the following anamnestic data:

• when suspicious signs of the disease first appeared;
• whether any of the blood relatives suffered from mental disorders;
• what is the cause of the disease?
• how often the symptoms of pathology occur during the day;
• that can provoke an attack.

It is often possible to observe situations when such patients are treated ineptly by therapists, cardiologists and gastroenterologists, trying to cure an invented somatic pathology. Therefore, the doctor must take into account all the nuances in order to properly diagnose the syndrome.

• In some cases, the doctor prescribes laboratory diagnostics. Most often, analyzes are made to eliminate somatic diseases, to assess the condition of the patient's organs and systems. The patient is biochemical blood test, determine the quality of fat and carbohydrate metabolic processes, examine the hormonal level.
• Instrumental diagnosis can help clarify the diagnosis if there is any doubt. Of no small importance are such studies as ECG, ultrasound of the thyroid gland, abdominal cavity, kidneys. Such a diagnosis is needed because often such mental disorders occur against the background of inflammatory infectious diseases.

In addition, it is possible to use color triplex scanning of the brain. This method allows you to assess the quality of blood supply and blood filling of the arteries and veins of the head.

Differential diagnosis

Differential diagnostics is performed with a syndrome of obsessive states, with schizophrenia, with other anxiety-phobic and obsessive-compulsive disorders. An accurate diagnosis is established only after receiving the results of all the studies listed.

Treatment of the kandinsky-Konovalov syndrome

Kandinsky-Konovalov syndrome is a rather complex mental disorder, so treatment should be qualified and competent. It is impossible to cure the disease completely: it is important to reduce the severity of clinical manifestations in a timely manner and to ensure the patient's control over his condition.

For most patients, treatment consists of the following stages:

• taking appropriate medicines;
• psychotherapist's help;
• rehabilitation period.

As a first stage of treatment, medicines can be prescribed:

Psychotropic drugs
	Haloperidol	Triftazine
Dosing and Administration	The dose is set individually and can be about 2-10 mg in the form of intramuscular injections, which are carried out every 4-8 hours.	Assign intramuscularly, 1-2 mg every 4-6 hours. The course of treatment - no more than 3 months.
Contraindications	Pregnancy, children's age, breast-feeding, severe depression of the central nervous system, coma.	Children's age, pregnancy, breast feeding, a tendency to allergies, severe liver damage.
Side effects	Extrapyramidal disorders, dyspepsia, hyperprolactinemia, lowering blood pressure, tachycardia.	Headache, sleep disturbances, clouding of the lens, appetite disorders, liver dysfunction.
Special instructions	The maximum daily dose is 18 mg.	The daily dosage should not exceed 6 mg, since there may be signs of cumulation of the drug.

Neuroleptics
	Aminazine	Tizercin
Dosing and Administration	The drug can be administered orally, in the form of intramuscular or intravenous injections. Dosage is selected by the doctor individually.	Assign in the form of tablets of 25-50 mg per day, gradually increasing the dosage to persistent improvement in the condition. The usual daily amount of the drug is 250 mg.
Contraindications	Cirrhosis, hematopoiesis, cardiac decompensation, coma.	Glaucoma, problems with urination, Parkinson's disease, childhood, decompensation of cardiac activity, a tendency to allergies.
Side effects	Allergic reactions, dyspepsia, skin pigmentation, depressive conditions, retardation.	Lowering blood pressure, drowsiness, orientation disorder, weight loss, indigestion.
Special instructions	The drug enhances the effect of sleeping pills and painkillers.	Use with caution in the elderly.

Antidepressants
	Pirazidol	Amitriptyline
Dosing and Administration	Assign 50-75 mg per day, gradually increasing the amount of the drug to 200-300 mg per day. Treatment scheme is individual.	Take inside at 50-75 mg per day, gradually increasing the dosage to achieve a persistent improvement in the condition. After 14-28 days the amount of the drug is gradually reduced.
Contraindications	Acute liver damage, hematopoiesis, simultaneous treatment with MAO inhibitors.	Severe heart disease, arrhythmia, hypertension, stomach ulcer and duodenal ulcer, difficulty with urination, child age, pregnancy.
Side effects	Dyspepsia, trembling of limbs, dizziness, increased sweating, allergies.	Visual impairment, headache, fatigue, arrhythmia, dyspepsia, breast enlargement, changes in sexual desire, allergic manifestations.
Special instructions	Do not administer with MAO inhibitors.	It is not allowed to drink alcohol at the same time.

The second stage is the counseling sessions of the psychotherapist. To such treatment they start only when the doctor will observe a clear positive dynamics from drug therapy. This approach is necessary because only in this case it is possible to obtain from the patient a full awareness of his illness.

The rehabilitation period includes the holding of psychotherapeutic sessions in groups with other patients, correction of nutrition and lifestyle, massage and exercise therapy.

Prevention

Mental health of a person is closely connected with his way of life, features of intellectual activity, adaptation in society, and the state of health in general. Therefore, for the prevention of Kandinsky-Konovalov syndrome or other similar disorders, the following recommendations can be made:

• avoid stressful situations, do not get nervous and do not worry (especially without reason);
• to struggle with own fears, to learn to abstract;
• to lead a healthy and mobile way of life, engage in feasible social activities, be socially active;
• do not take alcohol and drugs;
• provide a full rest, a long sleep;
• do your favorite thing: it can be fishing, reading books, caring for pets, sewing, etc .;
• periodically provide yourself with an emotional discharge in the form of laughter or other positive emotions. Also for this purpose, sex with a loved one is well suited.

Any of us should understand that frequent or prolonged psychoemotional stresses and stresses can sooner or later lead to mental problems. The same applies to alcohol abuse or drug use. Therefore, it is worthwhile to prevent the disorder without waiting for the development of psychopathology.

Forecast

Acute syndrome usually ends favorably. What can not be said about the chronic form of the disease, which will require patience and prolonged treatment. The Kandinsky-Konovalov syndrome requires mandatory hospitalization of the patient in the psychoneurological clinic, where the doctors will conduct the necessary complex therapy.