Mentizm

An episodic disorder of the dynamics of thinking, manifested as an uncontrolled influx of a multitude of unrelated thoughts, subjectively felt alien, appeared from outside and against the will of the individual, called mentism, from the Latin mens, mentis - thought, reason. To get rid of them, distract, switch to other thoughts at their discretion, a person is not able to. Under the action of a violent thought stream of any content, he temporarily loses the ability to adequately perceive what is happening and act according to circumstances. In this case, his mind remains clear, and at the end of the attack, the person feels the pain of what was happening. Even short-term episodes of mentism are severely experienced by patients and lead to mental exhaustion.

The process of thinking in moments of attack is not productive. Despite the accelerated flow of ideas or images, they lack concrete content. In fact, there is a delay in the associative thinking process, which impedes logical and purposeful activity.

Epidemiology

Statistics show that most often mentism is included in the symptom complex of mental automatism syndrome (Kandinsky-Klerambo) and is one of the signs of the debut of schizophrenia. It is in its initial stages that patients critically assess the pathological nature of the influx of thoughts. The disease is usually diagnosed for the first time at the age of 20-28 among the male population, 26-32 among the female population.

Causes of the mentizma

The vortex involuntary influx of diverse thoughts, some of which cannot be thought out to the end, can be felt under the influence of stressful circumstances, emotional overload by any person, sometimes long enough for days and weeks, until his situation is disturbed. Nevertheless, the source of thoughts is usually perceived by a healthy person as belonging to his own “I” and the associations between thoughts, although superficial, often confused, are still more or less logical and understandable.

When mentalism doesn’t just flow like a river, they come from the outside, are perceived as alien, imposed, it’s impossible to get rid of them. Images, memories, ideas flash like in a kaleidoscope. Causes of periodic occurrence of their pathological influx usually refer to psychiatric or neurological diseases.

Mentism is often a symptom of the debut of schizophrenia, especially if the breakdown of the thought process lasts a long time or occurs very often and for no apparent reason. It can also be a manifestation of affective disorder, neurosis, and psychopathy. Sometimes observed in epileptics. On this basis, an important factor that increases the likelihood of menthism, is a hereditary predisposition, the significance of which cannot be underestimated in the development of such diseases as schizophrenia and epilepsy. In addition, it causes particular sensitivity to the action of various kinds of stressors, and the development on their background of personality disorders and neuroses.

Mentism can accompany exogenous psychosis and organic brain pathology. In these cases, any risk factors that interfere with blood circulation and metabolism in brain structures that can cause an imbalance in the course of neurobiological processes and trigger the pathogenesis of thinking disorder can act. These include head injuries, tumors, hemorrhages, chronic alcoholism, drug addiction, acute poisoning and cases of hypoxia.

Mentism as a symptom demonstrates the presence of a mismatch in the functioning of the brain systems. What kind of neurobiological processes involved in its development mechanism is not yet entirely clear.

Symptoms of the mentizma

Patients usually complain of the sudden appearance of a multitude of thoughts, memories, images of absurd content, unusual for a given person and current circumstances. Quickly being replaced, they do not give focus on any of them. However, it is impossible to get rid of this stream. Most of these episodes are short-lived, the person does not have time to figure out anything, and the attack has already passed. Nevertheless, a feeling of painfulness of what was happening remains, patients evaluate mentality as the first signs of impending insanity.

Usually, after an attack, people cannot coherently describe what they saw or thought about. All are united in the fact that images, ideas, memories change very quickly, not allowing to concentrate on anything. Drive them away from themselves, switch to something else does not work. At the time of the attack, the person as if leaves the real world, losing the ability to rationally think and act, at the same time remaining in consciousness and aware of what is happening.

In most cases, there are lighter short-term episodes of mentism, lasting a few seconds or minutes. Patients note the sudden appearance of separate ideas that are absolutely not in line with the course of current thinking, sometimes frightening content, wild and not peculiar to a given person. They come unexpectedly, as if from the outside, and almost immediately disappear. Such thoughts violate the harmony of the thinking process, drawing attention to themselves by their absurdity, exhausting the human psyche.

Long, up to several days, episodes of mentism are even more debilitating. Patients complain that the flow does not stop either day or night. Sometimes they turn into dreams, just as chaotic, frightening and incomprehensible.

Hypnagogic mentism is a kind of influx of images, frames replacing each other, pictures, some fragments that are not related to each other by a common theme. Images can be flat and voluminous, black and white and color. Patients see silhouettes, spots and whirlwinds, circles, fragments of cities and streets, animals, flowers. Images can be clear and consistent, blurred and fragmented. They are united by one thing - they appear unexpectedly, forcibly and the patient cannot stop their flow. The figurative (hypnagogic) mentism often occurs in a patient when he closes his eyes, in most cases this happens when he falls asleep. Patients confidently differentiate mentality before bedtime from the dreams themselves and note that sometimes the influx of images gradually goes into sleep. It is this type of mentality that can be observed in a perfectly healthy person - before going to sleep after a day full of exciting events, a stream of uninvited and incoherent thoughts or images can invade.

The content of thoughts can be different - just strange, alarming, pessimistic, joyful, to have an accusatory character. With long-term attacks of mentism, the person’s mood, his speech and behavior correspond to this content, and the thoughts themselves reflect the background of his mood and correspond to the patient’s psycho-type and diagnosis.

In depressive disorders, obsessive thoughts flow in the nature of negativism, self-accusation, hopelessness. Patients often imagine the misfortunes and diseases (hypochondriacal mentality) that lie in wait for them and their close people. They come to mind scenes of death, disaster, funeral. The patient is afraid of such a development of events in reality, however, these thoughts fascinate his imagination.

During neurosis, mentism often arises in hysterical or asthenic types. Asthenics feel an influx of thoughts, reflecting their lack of self-confidence and their own abilities. The content of ideas and images is often associated with irritants, attacks can be caused by loud sounds, bright light, strong odors.

Accelerated influx of thoughts and mentism belong to the same type of thought disorder. His pace is broken. In the case of mentism - greatly accelerated. However, tachyphenia or the accelerated pace of thinking, even its vortex form is still accompanied by the presence of associative connections between alternating thoughts. Such a state is characterized by increased distractibility of the patient, not too coherent and not always finished choking speech, but still the meaning of the statements can be understood. It is understandable to the patient, who, although confused, can bring it to the listener. A surge of ideas is usually accompanied by a loud, quick speech.

Poor speech or lack thereof is characteristic of mentism. It is also called "dumb leap of ideas." Whirling successive ideas, images, thoughts are so absurd and incomparable that the patient can only watch their flow. Neither can he stop him, nor can he redirect. Thoughts do not have time to acquire speech design, the patient often falls silent and falls into a stupor.

Experts refer mentism and sperrungi to manifestations of small automatism. These opposing symptoms, an influx and blockade of thoughts, are observed mainly in the manifestation of schizophrenia and in schizophrenia-like disorders, when the patient does not yet have a pronounced mental defect, and he is critical of attacks. Many psychiatrists see these symptoms as the forerunners of the coming alienation of thoughts. Later, when delusions of influence take possession of the sick, criticism of the attacks of mentism weakens and disappears altogether.

Mentism in schizophrenia is characterized by prolonged episodes of ideal vortex flows, which leave the patient for increasingly shorter periods of time.

Complications and consequences

The violent influx of uninvited thoughts is not dangerous in itself. Especially with short-term bouts of mentality, the ability to think, speak and act is usually restored fairly quickly.

However, regularly repeated episodes speak, at a minimum, of the presence of neurotic disorder. Especially if such conditions occur periodically on their own, and not provoked by stressful situations. Patients usually suffer from such attacks, they lead to nervous and mental exhaustion.

Prolonged bouts of mentism are also an alarming sign. They may indicate the beginning of schizophrenia, and this disease poses a serious danger. Untreated schizophrenia has a progressive course. Patients lose the ability to adequately assess the situational and reaction to the events, they have violated behavioral control and self-organization of activity in everyday life and at work. They become dependent on outside care, which provokes a depressive mood, contributes to the formation of antisocial behavior, increases the likelihood of suicide.

Diagnostics of the mentizma

When a patient complains about episodes of mentism, its comprehensive examination is necessary, including a detailed interview of a psychiatrist, testing, consultation of a neurologist, a narcologist, and sometimes a oncologist and a trauma specialist.

Assigned laboratory tests to assess the overall health and instrumental diagnostics, which gives an idea of the functioning of the brain: electroencephalography, ECHO encephalography, magnetic resonance imaging.

Differential diagnosis

Differential diagnosis, first of all, should confirm or exclude the presence of schizophrenia in a patient. This disease is characterized by a wide range of manifestations, and mentality, which violates associative thinking, is considered one of the main precursors to the alienation of thoughts, the appearance of voices and delusions of influence.

Mentism is not an unambiguous symptom, it is present in various pathological processes. In epileptics, violent influx of thoughts can develop in the prodromal period before and between seizures.

Vortex flows of thoughts can be a consequence of traumatic brain injuries and tumors. With the delimitation of organic damage to the structures of the brain based on the results of hardware research.

Affective disorders, neuroses are distinguished from mental illness by the absence of personal changes in a patient.

Differentiating psychopathological states is usually possible while observing clinical symptoms over time, taking into account the patient’s somatic condition.

Treatment of the mentizma

Therapy of mentism is determined by the nature of the underlying disease. In general, drug therapy.

The main drugs for the treatment of schizophrenia are neuroleptics. Their patients are usually taken throughout their lives, which allows them to maintain its quality at a near-normal level.

The antipsychotic effect of this group of drugs is realized through the blockade of central neurotransmitter receptors. Drugs in this group have the ability to influence the frequency and intensity of nucleation of nerve impulses in different parts of the central nervous system and their transfer to the periphery. They are able to influence the metabolic processes in the cerebral cortex and regulate higher nervous activity, which includes associative thinking.

Neuroleptics are used to accelerate the pace of thinking in cases of affective, alcoholic, post-traumatic psychosis, severe neurosis. Preference is given to drugs with a retarding effect. They can be administered in small doses - below the so-called antipsychotic level, that is, used for sedation, as hypnotics or to achieve anxiolytic action.

Depending on the observed symptoms, different generations of drugs are used, they all have a wide range of side effects. Therefore, the drugs are dosed individually; it is not recommended to deviate from the treatment regimen proposed by the doctor. When the course is interrupted, withdrawal occurs, so the drug should be withdrawn gradually and under the supervision of a physician. You can not change the dosage yourself.

The direct effects of neuroleptics are associated with the main neuroplegic side effects caused by them - muscle numbness, persistent muscle spasms, tremors in the limbs and other extrapyramidal reactions. However, when using small doses, side effects are usually not realized.

The absolute contraindications to the use of antipsychotics are severe systemic pathologies of the brain and spinal cord, inflammatory and degenerative diseases of the liver and kidneys, decompensated heart disease, impaired hematopoiesis, myxedema, and thrombosis of blood vessels.

Patients with depressive disorders and negative thought content may be prescribed antidepressants, as well as lighter sedatives of plant origin. For disorders of cerebral blood circulation, hypoxia, the effects of intoxication and injury, nootropic activity preparations are used.

In the presence of comorbidities, appropriate therapy is prescribed, based on known drug interactions.

In conjunction with drug therapy, psychocorrection is used - coursework with a psychologist is conducted in the form of group classes or according to an individual program. They are focused on restoring impaired thinking functions.

Prevention

It is possible to prevent the appearance of mentism within the framework of neuroses and personality disorders in practically healthy people by increasing their resistance to stress, positivism and trying to avoid traumatic situations.

Leading a healthy lifestyle, people are insured against alcohol and drug psychosis. Even the likelihood of injuries, severe infections and tumors, as well as neuroses among fans of proper nutrition and mode, an active lifestyle, abandoning bad habits, is much lower.

For mentally ill people, the main preventive measure is timely diagnosis and conscientious treatment of the underlying disease with the implementation of all medical recommendations.

Forecast

More favorable in terms of prognosis are neurosis and affective disorders. In the presence of mental illness, drug-compensated states of prolonged remission occur in the vast majority of cases.