Syndromes in Psychiatry

The general picture of mental illness consists of individual symptoms (symptoms), which are considered together with each other. Such combinations of symptoms are called syndromes. Syndromes in psychiatry - this is an important component for setting the right diagnosis. For the convenience of classification and recognition of mental disorders, specialists identified a number of the most common symptom complexes, which we briefly consider.

General characteristics

To make the correct diagnosis, the characterization of the syndrome plays a very important role. Despite the fact that in other diseases it is most important to determine the cause of the pathology, in psychiatry it is not so relevant. In most cases, it is not possible to determine the cause of a mental disorder. Proceeding from this, the emphasis is placed on the definition of leading signs, which then combine into a typical syndrome for the disease.

For example, for deep depression, the emergence of thoughts of suicide. In this case, the tactics of the doctor should be directed to an attentive attitude and, literally, supervision of the patient.

In patients with schizophrenia, the main syndrome is a contradiction, or schism. This means that the person's external emotional state does not coincide with his inner mood. For example, when a patient is happy, he cries bitterly, and when he is hurt, he smiles.

In patients with epilepsy, the main syndrome is paroxysmal - this is the sudden appearance and the same dramatic fading of the symptoms of the disease (attack).

Even the international classification of diseases - ICD-10 - is based not so much on psychiatric diseases as on syndromes.

List of the main syndromes in psychiatry

Syndromes associated with hallucinations and delirium.

• Hallucinosis - the presence of a variety of hallucinations, related to either hearing, or to vision, or to tactile sensations. Hallucinosis can occur in acute or chronic form. Accordingly, with auditory hallucinosis, the patient hears non-existent sounds, voices addressed to him and forcing him to do something. With tactile hallucinosis, the sick feel some non-existent touch to themselves. In a visual hallucinosis, a patient can "see" what is really not - it can be non-living objects, or people or animals. Often this phenomenon can be observed in blind patients.
• Paranoid syndrome is a primary delusional state that reflects the surrounding reality. It can be an initial sign of schizophrenia, or develop as an independent disease.
• The hallucinatory-paranoid syndrome is a multifaceted combination and the presence of hallucinations and delusions, which have a common pathogenesis of development. A kind of such syndrome is the mental automatism of Kandinsky-Clerambo. The patient insists that his thinking or the ability to move does not belong to him, that someone from the outside automatically controls him. Another type of hallucinatory-paranoid syndrome is Chikatilo syndrome, which is a development in man of a mechanism that begins to guide his behavior. The increase in the syndrome occurs for a long time. The discomfort that has arisen in the patient gives impetus to committing sadistic crimes on the basis of sexual weakness or dissatisfaction.
• The syndrome of pathological jealousy is one of the forms of obsessive and delusional ideas. This condition is further subdivided into several syndromes: the syndrome of the "existing third" (with really inherent jealousy and passion passing into reactive depression), the "probable third" syndrome (with obsessive states associated with jealousy), as well as the "imaginary third" syndrome with delirious zealous fantasies and signs of paranoia).

Syndromes associated with impaired intellectual development.

• Syndrome of dementia, or dementia - a stable, hard-to-compensate loss of mental ability, the so-called intellectual degradation. The patient not only refuses and can not cognize the new, but also loses the previously acquired level of intelligence. Dementia may be associated with certain diseases, such as cerebral atherosclerosis, progressive paralysis, syphilitic brain damage, epilepsy, schizophrenia, etc.

Syndrome associated with a state of affect.

• Manic syndrome - characterized by such a triad of signs, as a sharp increase in mood, accelerated flow of ideas, motor-speech excitement. As a consequence, there is a reassessment of oneself as a person, there is a megalomania, emotional instability.
• Depressive state - on the contrary, is characterized by a decreased mood, slowed-down presentation and motor-speech retardation. There are such effects as self-abasement, loss of aspirations and desires, "dark" thoughts and oppressed state.
• An anxious depressive syndrome is a combination of a depressive and a manic state that alternate with each other. There may be motor stupor against a background of increased mood, or motor activity simultaneously with mental retardation.
• Depressive paranoid syndrome can manifest itself as a combination of signs of schizophrenia and other psychotic conditions.
• Asthenic syndrome is characterized by increased fatigue, excitability and mood instability, which is especially noticeable against the background of autonomic disorders and sleep disorders. Usually signs of asthenic syndrome subsided in the morning, manifesting with new strength in the second half of the day. Often, asthenia is difficult to distinguish from a depressed state, so specialists distinguish the syndrome, calling it asthenic-depressive.
• An organic syndrome is a combination of three symptoms, such as a worsening of the memorization process, a decrease in intelligence and the impossibility of containing affect. This syndrome has another name - the Walter-Buel triad. At the first stage, the condition reveals itself as a general weakness and asthenia, instability in behavior and decreased efficiency. The patient's intellect suddenly begins to drop, the circle of interests narrows, the speech becomes poor. Such a patient loses the ability to remember new information, and also forgets what was written in memory earlier. Often the organic syndrome passes into a depressive or hallucinatory state, sometimes accompanied by epileptic attacks or psychoses.

Syndrome associated with impaired motor and volitional functions.

• Catatonic syndrome has such typical symptoms as catatonic stupor and catatonic arousal. Such states are manifested in stages, one after another. This psychiatric syndrome is caused by the pathological weakness of neurons, when quite harmless stimuli cause an excessive reaction in the body. During the stupor, the patient is sluggish, does not show interest in the world around him or herself. Most of the patients simply lie in the wall for many days and even years. Characterized by the sign of the "air cushion" the patient lies, and at the same time his head is raised over the pillow. The sucking and grasping reflexes that are inherent only in infants are resumed. Often at night, the manifestations of catatonic syndrome are weakened.
• Catatonic excitation manifests itself as an impellent, and emotional excited state. The patient becomes aggressive, negatively tuned. Facial expressions on the face are often two-sided: for example, the eyes express joy, and the lips are squeezed in a fit of anger. The patient can either persistently remain silent, or it is irrepressible and meaningless to talk.
• Lucic catatonic state occurs in full consciousness.
• One-ore catatonic state is manifested with depression of consciousness.

Neurotic syndrome

• Neurasthenic syndrome (the same asthenic syndrome) is expressed in weakness, impatience, exhausted attention and sleep disorders. The condition can be accompanied by pain in the head, problems with the autonomic nervous system.
• The hypochondriacal syndrome is manifested by excessive attention to one's body, health and comfort. The patient constantly listens to his body, visits doctors without any reason and gives away a lot of unnecessary analyzes and research.
• Hysterical syndrome is characterized by excessive self-suggestion, selfishness, imagination and emotional instability. Such a syndrome is typical for hysterical neuroses and psychopathies.
• The psychopathic syndrome is a disharmony of the emotional and volitional state. It can proceed according to two scenarios: excitability and increased inhibition. The first option implies excessive irritability, negative mood, striving for conflicts, impatience, predisposition to alcoholism and drug addiction. For the second option is characterized by weakness, lethargic response, inactivity, decreased self-esteem, skepticism.

When assessing the mental state of the patient, it is important to determine the depth and scale of the detected symptoms. On the basis of this syndromes in psychiatry can be divided into neurotic and psychotic.